Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis.

BACKGROUND: Pterygium is a common ocular surface disorder that requires surgical intervention for treatment. Conjunctival autografts are preferred over simple excision due to lower recurrence rates. This systematic review and meta-analysis compared the modified sutureless glue-free (MSGF) method with conventional sutures (CS) for conjunctival autograft fixation in primary pterygium surgery. METHODS: A comprehensive search was conducted in MEDLINE, Embase, CENTRAL, Google Scholar and ClinicalTrials.gov for randomised controlled trials (RCTs) comparing MSGF and CS conjunctival autografts. Outcome measures included operation time, recurrence and postoperative complications. Standardised mean difference (SMD) and risk ratio (RR) were used for continuous and dichotomous outcomes, respectively. RESULTS: 11 RCTs involving 833 participants were included. The analysis revealed that MSGF had a significantly shorter operation time compared with CS (SMD -3.704, 95% CI -5.122 to -2.287, p<0.001). CS was associated with a higher risk of foreign body sensation (RR 0.22, 95% CI 0.06 to 0.74, p=0.01). MSGF was associated with a higher risk of graft dehiscence (RR 9.01, 95% CI 2.74 to 29.68, p=0.000) and graft retraction (RR 2.37, 95% CI 1.17 to 4.77, p=0.02). No significant differences were found in recurrence, graft haemorrhage, granuloma, Dellen and conjunctival oedema. CONCLUSION: Using the MSGF technique in conjunctival autograft fixation for pterygium surgery reduces operation time by relying solely on the patient's blood for fixation. However, it increases the risk of graft dehiscence and retraction. However, CS is linked to a higher likelihood of experiencing foreign body sensations. Understanding the learning curve and surgeon familiarity with novel techniques is crucial for optimising patient care and surgical outcomes, while individualised decision-making is necessary considering the advantages and disadvantages of each approach. Further research is warranted to minimise complications and optimise surgical outcomes.

Influence of irrigating agents on fiber postpush-out bond strength to radicular dentin sections with the different adhesive system.

OBJECTIVE: The objective of this study is to evaluate the effect of irrigating agents on push-out bond strength of resin postcemented with various adhesive systems at different radicular dentin sections. MATERIALS AND METHODS: Sixty single-rooted premolar teeth were root canal treated, subsequently decorated at cementoenamel junction. The endodontic postspace was irrigated with 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) for Group A (n = 30) and Group B (n = 30), respectively. The sample from each group was subdivided into three groups (10) according to luting protocol of etch-wash, self-etch, and self-adhesive. Individual teeth with cemented resin postsamples were sectioned into coronal, middle, and apical segments. Subsequently, subjected for pushout bond strength test by applying a load at 0.5 mm/min speed. The data were analyzed by three-way analysis of variance and Tukey comparison test at a significant difference level of 0.05. RESULTS: The coronal section with 5.25% NaOCl irrigation and self-etch luting protocol provided the highest push out strength at 16.282 Mpa. The etch-wash luting protocol in both irrigations showed the lesser bond strength at 8.273 and 8.493 MPa, respectively, in coronal section. CONCLUSIONS: The self-etch adhesive system showed better push out bond strength and 17% EDTA had a negative influence on self-etch bond strength. The coronal sections had highest bond strength in comparison with apical radicular dentin sections.