RESUMO
Severe edentulous posterior mandible atrophy with inadequate bone height superior to the inferior alveolar canal may increase the risk of neurosensory impairment and other complications during inferior alveolar nerve (IAN) transposition (IANT) prior to dental implant insertion. The current report describes the tubing technique as a practical and feasible procedure that ensures IAN preservation during IANT. The technique involves wrapping a standard suction catheter around the exposed nerve to facilitate full coverage. This work presents a retrospective review of 31 patients undergoing IANT procedures followed by immediate placement of dental implants between January 2015 and January 2020. IANT was performed either unilaterally or bilaterally on all patients, followed by IAN tubing before implant placement. A total of 46 IANT procedures involving the tubing technique were performed. Overall, 149 dental implants were inserted during IANT surgeries, with a success rate of 98.6%. Sensory disturbance was documented in 47.8% of the treated sites (left/right mandible) at 1 month (22/46 sites), 21.7% at 3 months (10/46 sites), 6.5% at 6 months (3/46 sites), and 2.2% at 12 months (1/46 sites) postimplantation. In total, except for 1 case, sensory disturbance was fully resolved by the end of the 12-month follow-up period. Taken together, the tubing technique described herein is a practical and reproducible method for protecting the IAN during transposition.
Assuntos
Implantes Dentários , Cirurgiões , Humanos , Implantação Dentária Endóssea/métodos , Mandíbula/cirurgia , Nervo Mandibular/cirurgiaRESUMO
Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. Coincident with the rapid developments of COVID-19 vaccines globally, concerns about the safety of such a vaccine could contribute to vaccine hesitancy. We analyzed 1941 anonymous questionnaires completed by healthcare workers and members of the general Israeli population, regarding acceptance of a potential COVID-19 vaccine. Our results indicate that healthcare staff involved in the care of COVID-19 positive patients, and individuals considering themselves at risk of disease, were more likely to self-report acquiescence to COVID-19 vaccination if and when available. In contrast, parents, nurses, and medical workers not caring for SARS-CoV-2 positive patients expressed higher levels of vaccine hesitancy. Interventional educational campaigns targeted towards populations at risk of vaccine hesitancy are therefore urgently needed to combat misinformation and avoid low inoculation rates.
Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinação/psicologia , Betacoronavirus , COVID-19 , Vacinas contra COVID-19 , Comunicação , Infecções por Coronavirus/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Israel/epidemiologia , Masculino , Pais , SARS-CoV-2 , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Vacinas , Vacinas Virais/administração & dosagem , Vacinas Virais/efeitos adversosRESUMO
AIM: To explore the role of keratinocyte myeloid differentiation primary response 88 (MyD88) expression in the adhesion of Porphyromonas gingivalis to the cells and its subsequent invasion and intracellular survival. MATERIALS AND METHODS: Primary mouse keratinocytes from wild-type (WT) or Myd88-/- mice were infected with P gingivalis alone or co-infected with Fusobacterium nucleatum. Bacterial adhesion and invasion were measured using fluorescent microscopy and flow cytometry, and intracellular survival in keratinocytes was quantified by an antibiotic protection assay. Keratinocyte expression of antimicrobial peptides was measured by real-time PCR. RESULTS: In the absence of MyD88, P gingivalis adherence, invasion, and intracellular survival were enhanced compared with WT keratinocytes. The presence of F nucleatum during infection increased the adhesion of P gingivalis to WT keratinocytes but reduced the adhesion to Myd88-/- keratinocytes. Fusobacterium nucleatum improved mildly the invasion and survival of P gingivalis in both cell types. Baseline expression of beta-defensin 2, 3, 4 and RegIII-γ was elevated in Myd88-/- keratinocytes compared to WT cells; however, following infection beta-defensin expression was strongly induced in WT cells but decreased dramatically in the MyD88 deficient cells. CONCLUSION: In the absence of MyD88 expression, P gingivalis adhesion to keratinocytes is improved, and invasion and intracellular survival are increased. Furthermore, keratinocyte infection by P gingivalis induces antimicrobial peptide expression in a MyD88-dependent manner. Thus, MyD88 plays a key role in the interaction between P gingivalis and keratinocytes.
Assuntos
Infecções por Bacteroidaceae/imunologia , Queratinócitos/microbiologia , Fator 88 de Diferenciação Mieloide/imunologia , Porphyromonas gingivalis , Animais , Peptídeos Catiônicos Antimicrobianos/imunologia , Aderência Bacteriana , Fusobacterium nucleatum , Queratinócitos/imunologia , Camundongos , Camundongos KnockoutRESUMO
The aim of this study is to compare the effectiveness of intra-articular and three-point sub-synovial steroid injections. In this retrospective Cohort study an OSCA lysis and lavage, intra-articular and threepoint sub-synovial steroid injections were performed and the maximal interincisinal opening (MIO), pain using 10- point visual analog scale (VAS) and quality of life (QOL) were measured one week before the procedure and 1, 3, 6, 12 months, and 2 and 3years after surgery. Sixty-five patients suffering from internal derangement refractory to conservative treatment charts were reviewed. successfully lowered pain (p value = 0.0012), and improved mouth opening (p value = 0.023), and quality of life (QoL) (p value = 0.003) for up to 6 months after surgery. OSCA with intra-articular CS injections effectively lowered pain (p value = 0.0025), and improved mouth opening (p value = 0.03) and QoL (p value = 0.004) for 12 months. In comparison, OSCA with sub-synovial steroid injections was significantly effective in lowering pain (p value = 0.000002), improving mouth opening (p value = 0.000004), and QoL (p value p = 0.000006) for the duration of the 36-month follow-up period within the limitations of the study it seems that the OSCA technique with site-specific, sub-synovial CS injections should be the preferred treatment approach when the priority is long-term success concerning pain relief, increased mouth opening and improved quality of life in Wilkes II-IV patients.
Assuntos
Artroscopia , Transtornos da Articulação Temporomandibular , Artroscopia/métodos , Cânula , Humanos , Injeções Intra-Articulares , Dor , Qualidade de Vida , Estudos Retrospectivos , Esteroides , Transtornos da Articulação Temporomandibular/cirurgia , Irrigação Terapêutica , Resultado do TratamentoRESUMO
Compared to traditional manufacturing methods, additive manufacturing and 3D printing stand out in their ability to rapidly fabricate complex structures and precise geometries. The growing need for products with different designs, purposes and materials led to the development of 3D printing, serving as a driving force for the 4th industrial revolution and digitization of manufacturing. 3D printing has had a global impact on healthcare, with patient-customized implants now replacing generic implantable medical devices. This revolution has had a particularly significant impact on oral and maxillofacial surgery, where surgeons rely on precision medicine in everyday practice. Trauma, orthognathic surgery and total joint replacement therapy represent several examples of treatments improved by 3D technologies. The widespread and rapid implementation of 3D technologies in clinical settings has led to the development of point-of-care treatment facilities with in-house infrastructure, enabling surgical teams to participate in the 3D design and manufacturing of devices. 3D technologies have had a tremendous impact on clinical outcomes and on the way clinicians approach treatment planning. The current review offers our perspective on the implementation of 3D-based technologies in the field of oral and maxillofacial surgery, while indicating major clinical applications. Moreover, the current report outlines the 3D printing point-of-care concept in the field of oral and maxillofacial surgery.
RESUMO
Endometrial polyps (EPs) are benign overgrowths of the endometrium, with the potential to cause severe complications, ranging from discomfort to inflammation and infertility. Dysfunction of endometrial fibroblasts may be a critical component leading to the development of polyps. Although surgical intervention is the common remedy for severe cases, it comes with drawbacks, including infection, bleeding, and risk of damage to the cervix and adjacent tissues. Adipose-derived mesenchymal stromal cells (ASCs) are at the focus of modern medicine, as key modulators of tissue homeostasis, inflammation, and tissue repair, rendering them prime candidate agents for tissue regeneration and cell-based therapies. In this study, EPs were isolated from patients admitted to the OB/GYN department at the Galilee Medical Center and extracted fibroblasts (endometrial polyp fibroblasts, EPFs) were isolated and characterized. ASCs were isolated from healthy patients. The effect of EPF- and ASC-conditioned media (CM) on polyp-derived fibroblasts was evaluated, in both 2D and 3D assays, as well as on the expression of matrix-related gene expression. Herein, EPFs exposed to ASC-CM exhibited reduced migration, invasion, contraction of hydrogels, and extracellular matrix deposition, compared with those exposed to EPF-CM. Altogether, this study suggests that ASCs may have a modulating effect on fibroblasts involved in forming EPs and may serve as the basis for conservative treatment strategies aimed at treating severe cases of EPs.
Assuntos
Adipócitos , Tecido Adiposo , Tecido Adiposo/metabolismo , Meios de Cultivo Condicionados/metabolismo , Meios de Cultivo Condicionados/farmacologia , Feminino , Fibroblastos/metabolismo , Humanos , Inflamação/metabolismo , Células-Tronco/metabolismoRESUMO
The COVID-19 pandemic spread rapidly across the globe, leading governments to impose prolonged lockdowns on both movement and commerce. Although lockdowns decrease the rates of novel infections, they can have devastating consequences on the economy and employment levels. One of the most severely affected sectors during this crisis has been dental medicine. Dental professionals are uniquely exposed to environments with high levels of occupational hazards, conferring additional risks of viral exposure and transmission. We analyzed 506 anonymous questionnaires completed by dentists and residents regarding acceptance of a future potential SARS-CoV-2 vaccine. Our results demonstrate a statistically significant correlation between the individual's unemployment rate and their willingness to inoculate with a SARS-CoV-2 vaccine when it becomes available. This information can be used to predict trends of vaccine acceptance or rejection based on economic burden during the COVID-19 pandemic by different sectors as part of the preparedness toward global vaccination programs.
RESUMO
The COVID-19 pandemic raises the need for diverse diagnostic approaches to rapidly detect different stages of viral infection. The flexible and quantitative nature of single-molecule imaging technology renders it optimal for development of new diagnostic tools. Here we present a proof-of-concept for a single-molecule based, enzyme-free assay for detection of SARS-CoV-2. The unified platform we developed allows direct detection of the viral genetic material from patients' samples, as well as their immune response consisting of IgG and IgM antibodies. Thus, it establishes a platform for diagnostics of COVID-19, which could also be adjusted to diagnose additional pathogens.
Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , Teste Sorológico para COVID-19/métodos , COVID-19/diagnóstico , SARS-CoV-2/imunologia , Imagem Individual de Molécula/métodos , Proteínas Virais/genética , Anticorpos Antivirais/sangue , Sequência de Bases , COVID-19/sangue , COVID-19/imunologia , COVID-19/virologia , Teste de Ácido Nucleico para COVID-19/normas , Teste Sorológico para COVID-19/normas , Ensaio de Imunoadsorção Enzimática , Humanos , Soros Imunes/química , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Nasofaringe/virologia , Poliproteínas/sangue , Poliproteínas/genética , RNA Viral/sangue , RNA Viral/genética , SARS-CoV-2/genética , Sensibilidade e Especificidade , Imagem Individual de Molécula/instrumentação , Proteínas Virais/sangueRESUMO
The COVID-19 pandemic raises the need for diverse diagnostic approaches to rapidly detect different stages of viral infection. The flexible and quantitative nature of single-molecule imaging technology renders it optimal for development of new diagnostic tools. Here we present a proof-of-concept for a single-molecule based, enzyme-free assay for detection of SARS-CoV-2. The unified platform we developed allows direct detection of the viral genetic material from patients' samples, as well as their immune response consisting of IgG and IgM antibodies. Thus, it establishes a platform for diagnostics of COVID-19, which could also be adjusted to diagnose additional pathogens.