APCs in sinus floor augmentation.

After tooth loss in the posterior area of the maxilla, sinus floor elevation is often required to compensate the vertical bone loss due to sinus pneumatization. This narrative review reports on the potential benefits of autologous platelet concentrates (APCs) during this procedure. As for transcrestal approach, APCs have been used as "sole" substitute/graft. However, because of the low number of clinical trials available with PRGF, and even none for PRP, no definitive conclusions can be made regarding their efficacy. The number of studies on the use of L-PRF were outnumbered indicating good feasibility for vertical bone gain, with a high implant survival rate and a low degree of complications. PRP and PRGF have not been studied as a "single/sole" substitute for a one-stage lateral window approach, probably because of the weak physical characteristics of the membranes. L-PRF alone appears to be a predictable grafting material for lateral maxillary sinus grafting and a reduced RBH should not be considered as a risk factor. Compared to a "standard" bone substitute L-PRF shows slightly less vertical bone gain (consider enough membrane application and use of bony window as new sinus floor roof over the implant apices), enhanced early resorption (first 6 months after application), but a similar stable bone gain afterward. For a two-stage lateral window approach, APCs "alone" cannot be recommended, due to their weak withstand to the sinus pneumatization forces. APCs combined with bone substitutes seem to accelerate bone formation, without any additional benefits on the long-term new bone gain. The use of L-PRF membranes for the treatment of perforations appears to be an effective treatment option, but further clinical studies are needed to confirm this. Even though the abovementioned statements are based on large numbers of studies, additional RCTs comparing APCs with different types of grafting procedures for sinus elevation are needed.

Instructions for the use of L-PRF in different clinical indications.

Autologous platelet concentrates (APCs) have demonstrated clear benefits across various clinical applications, including alveolar ridge preservation, guided tissue regeneration, guided bone regeneration, sinus floor elevation (both lateral window approach and transcrestal technique), endodontic surgery, the treatment of medication-related osteonecrosis of the jaw bones, and periodontal plastic surgery. To ensure an optimal clinical outcome, clinicians must adhere strictly to the protocol to prepare the APCs and, especially follow evidence-based surgical guidelines, often simple but crucial, to minimize the likelihood of errors. The majority of clinical trials reported on second-generation APCs [the leukocyte- and platelet-rich fibrin (L-PRF) family, including its modifications (A-PRF, A-PRF+, CGF, T-PRF, H-PRF, etc.)]. These second-generation APCs offer additional benefits compared to the first-generation APCs, making them the preferred choice for the development of clinical recommendations. These recommendations have been formulated through a meticulous examination of the available clinical data and the clinical experience of the authors of this paper.

Introduction and overview on autogenous Platelet concentrates.

This special issue on autologous platelet concentrates (APCs) provides clinicians with an overview on the current understanding of the use of these biomaterials for soft and hard-tissue regeneration. The included papers summarize scientific evidence and the clinical findings, presented in simple tables that outline potential benefits including Patient Reported Outcome Measures (PROMs). This approach enables clinicians to assess clinical relevance and researchers to identify significant gaps in the literature. The first part provides a comprehensive summary of the basic science surrounding APC, with particular focus on their preparation methods. Clear recommendations are outlined, which are crucial for obtaining high-quality APCs, alongside an exploration of how APCs may influence both soft and hard tissue healing processes. Part 2 delves into the clinical evidence for the potential benefits of APCs across a range of applications: alveolar ridge preservation, sinus floor elevation, periodontal plastic surgery, guided tissue regeneration, guided bone regeneration, the healing of Medication-Related Osteonecrosis of the Jaw (MRONJ), and endodontic surgery. In the part 3, the discussion turns to the effects of APCs on the healing of extra-oral wounds, including diabetic foot ulcers, venous leg ulcers, pressure injuries, burns, and more. For those clinicians persuaded by the evidence, the fourth section offers a detailed, step-by-step flowchart for each treatment modality, providing a clear guide for clinical application.

Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process.

In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation (bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.

Comparison of the intraarticular osteotomy and the "window" osteotomy in the treatment of tibial plateau fracture involving depressed posterolateral fragments.

OBJECTIVES: The methods of reduction of depressed posterolateral fragments in tibial plateau fracture through anterolateral approaches remain controversial. This paper aimed to compare the intraarticular osteotomy technique and the "window" osteotomy technique for the reduction of depressed posterolateral fragments through anterolateral approach. METHOD: From January 2015 to January 2022, we retrospectively reviewed the data on patients with tibial plateau fracture involving depressed posterolateral fragments treated with the intraarticular osteotomy or the "window" osteotomy. 40 patients underwent the intraarticular osteotomy were divided into group A, while 36 patients underwent the "window" osteotomy were divided into group B. The operative time, bone grafting volume, fracture healing time, complication, reduction quality and postoperative functional results were compared between the two groups. RESULTS: The average follow-up duration was 16.6 ± 3.7 months. The average bone grafting volume for all patients in group B was essential larger than group A (p = 0.001). Compared to group B, patients in groups A had significantly shorter fracture healing time (p = 0.011). The depth of depressed articular surface, PSA and the radiographic evaluation at 2 days and 6 months after surgery in group A were significantly lower than group B (p<0.05). Based on the HSS knee-rating score, no significant difference in function results was found between the two groups (p>0.05). No significant difference was found in operation time and blood loss between the two groups (p>0.05). CONCLUSION: The intraarticular osteotomy could obtain satisfactory clinical results in tibial plateau fracture involving posterolateral fragments.

Zenker diverticulum treatment: retrospective comparison of flexible endoscopic window technique and surgical approaches.

INTRODUCTION: Different treatments exist for Zenker diverticulum. We compared flexible endoscopic myotomy of the cricopharyngeal muscle, using a technique called the "window technique" in order to improve the field of view, to surgical approaches. MATERIALS AND METHODS: Patients were retrospectively included and divided into a gastrointestinal group, with flexible endoscopic myotomy, and an ear-nose-throat treatments group with either rigid endoscopic treatment, either cervicotomy. We evaluated effectiveness in terms of quality of life (on a scale on 0 to 10) safety and technical aspects of each procedure. RESULTS: A total 106 patients who underwent 128 interventions were included. Rigid endoscopic procedures were the shortest (p < 0.001), with no difference for adverse event. Endoscopic approaches, flexible and rigid ones, were associated with shorter time to intake resumption (1 and 3 days, respectively, vs 6 after cervicotomy) and shorter length of hospital stay (3 and 4 days, respectively, vs 7 after cervicotomy) (p = 0.001). Post-operative QoL was better after flexible endoscopy (9/10) and open cervicotomy (9/10) than after rigid endoscopy (7/10) (p = 0.004). Patients declared fewer residual symptoms after open cervicotomy (77% of low symptomatic patients) and flexible endoscopy (80%) than after rigid endoscopy (43%) (p = 0.003). Conversion to open surgery was more frequent during rigid than flexible endoscopies (18% vs 0%, p = 0.0008). CONCLUSION: Flexible endoscopic approach of Zenker diverticulum treatment seems to be safe and effective and may be an alternative to surgical approaches. Myotomy can be eventually helped by the window technique.

Modified shave surgery combined with nail window technique for the treatment of longitudinal melanonychia: Evaluation of the method on a series of 67 cases.

BACKGROUND: Nail matrix histopathologic examination is still the criterion standard to diagnose longitudinal melanonychia (LM). OBJECTIVE: To introduce modified shave surgery combined with the nail window technique for managing LM and evaluate the postoperative outcome of the procedure. METHODS: We retrospectively reviewed the medical records of 67 patients with LM who underwent shave surgery combined with the longitudinal-strip nail window technique at our institution from March 2015 to June 2018. RESULTS: Pathologic diagnosis was accessible in all cases, and 60 cases were assessable for the postoperative outcomes. A total of 45 cases (75.0%) had no postoperative nail dystrophy, and recurrence of nail pigmentation was found in only 8 cases (13.3%). LIMITATIONS: This was a retrospective study. CONCLUSION: Modified shave surgery combined with the nail window technique is the preferable management for LM cases, with limited postoperative nail dystrophy and recurrence of pigmentation.

Clinical efficacy of the graft free slit-window sinus floor elevation procedure: A 2-year randomized controlled clinical trial.

OBJECTIVE: Slit-window technique is a lateral approach sinus floor elevation (SFE) procedure that utilizes a rigid resorbable membrane in conjunction with stabilizing bony slits to tent the Schneiderian membrane without addition of grafting materials. The aim of this randomized clinical trial was to compare clinical and radiographic outcomes of the Slit-window SFE with those of SFE with bone grafting. MATERIAL AND METHODS: Thirty-three patients with 38 edentulous sites were included. Edentulous sites were randomly allocated to the Slit-window SFE or SFE with bone grafting. Simultaneous with SFE, each site received two dental implants. Implant stability quotient (ISQ) values were recorded at baseline and monthly visits for 8 months. The bone coverage and bone height gain at implant sites were recorded on cone beam computed tomography (CBCT) scans 6 and 24 months postoperatively. RESULTS: There were no significant differences in the mean ISQ values between the groups at any time point (p > 0.05). All implants in both groups were found to have complete bone coverage. Significant increases in the bone height were found 6 and 24 months postoperatively in both groups (p < 0.001). CONCLUSIONS: Within limitations of the present study, it can be concluded that the Slit-window SFE technique without the need for bone grafting resulted in sufficient bone height gain around implants placed simultaneous with the SFE procedures. The bone height around these implants was stable during the 2-year follow-up period. The treatment outcomes for these implants were comparable to those placed simultaneous with lateral approach SFE in conjunction with bone grafting.

[Measurement and analysis of tracheal inner diameter in Chinese adults using multi-slice spiral CT, multi-planar reconstruction and special window technique].

Objective: To measure the inner diameter of tracheal(TD) in Chinese adults by multi-slice spiral CT(MSCT), multi-planar reconstruction(MPR) with special window technique and analyze its influencing factors. Methods: A total of 824 normal adults(male 435, female 389) and 16 patients with small peripheral pulmonary nodules(SPN) receiving chest multi-slice spiral CT (MSCT) in the physical examination at the First Affiliated Hospital of Guangzhou Medical University between January, 2014 and December, 2015 were included and their records were retrospectively analyzed. The 16 patients with SPN received bronchoscopy and the images were recorded followed by measurement of tracheal diameter using software. MSCT and MPR images were obtained by the 3Dview software, and the inner diameter of the trachea at 4 horizontal positions were measured by special window technique (window width 500 Hu, window level 100 Hu): thoracic entrance (TD(1)), aortic arch (TD(2)), 2 cm higher than the carina of trachea (TD(3)) and the narrowest trachea (TD(4)). Results: The results of bronchoscopy and software measurement in 16 patients were consistent with those of MSCT and MPR combined with special window technique (P>0.05). The TD at 4 positions in adult males were larger than those of adult females (P<0.01). The TD values at each position for males and females were as follows: (18.9±1.7) and (15.6±1.3) mm (t=30.9, P<0.01) for TD(1), (18.8±1.6) and (16.1±1.2) mm (t=28.0, P<0.01) for TD(2), (19.0±1.6) and (16.3±1.3) mm (t=26.5, P<0.01) for TD(3), (18.4±1.5) and (15.5±1.1) mm (t=31.3, P<0.01) for TD(4), respectively. The age, weight and BMI were not significantly correlated with the tracheal diameter (P>0.05). The height was linearly correlated with the tracheal diameter: for males, TD(1)=0.071× height (cm) + 6.964 (r=0.249, P<0.05), TD(2)=0.064 × height (cm) + 7.898 (r=0.246, P<0.05), TD(3)=0.074 × height (cm) + 6.533 (r=0.279, P<0.05), TD(4)=0.056 × height(cm) + 8.811(r=0.226, P<0.05); while for females, TD(1)= 0.046× height (cm) + 8.331 (r=0.183, P<0.05), TD(2) = 0.058 × height (cm)+ 6.950(r=0.248, P<0.05), TD(3)=0.059 × height (cm)+ 7.052 (r=0.235, P<0.05), TD(4) =0.044× height (cm) + 8.520 (r=0.208, P<0.05). Conclusion: MSCT and MPR combined with special window technique are accurate and feasible for the measurement of adult tracheal diameter. The diameter of the trachea in males is larger than that in females, and it is positively correlated with height, but not with age, body weight and BMI. The tracheal diameter can be evaluated by linear regression equation.

Orthodontic traction of a deeply impacted mandibular first molar via a ramus miniscrew through lateral-window technique: A case report.

BACKGROUND: The incidence of mandibular first molar impaction is less than 0.01%, and there are no standard treatment guidelines. Orthodontic traction can be chosen as a treatment plan in some circumstances. One miniscrew in the mandibular ramus can offer sufficient anchorage for the traction of impacted mandibular molars. CASE DESCRIPTION: A 10-year-old boy had a completely labially positioned maxillary left canine and a deeply impacted mandibular left first molar associated with a dentigerous cyst. Using 2 palatal miniscrews for distalization, space was created to align the maxillary left canine. In addition, a miniscrew in the mandibular ramus facilitated the traction of the mandibular left first molar. After 3 years and 6 months of orthodontic treatment, the integrity of the dental arch was restored, and occlusal function was reestablished. PRACTICAL IMPLICATIONS: A ramus miniscrew is an effective and viable treatment option for the orthodontic traction of deeply impacted mandibular molars.

Visual Field Restriction in the Recognition of Basic Facial Expressions: A Combined Eye Tracking and Gaze Contingency Study.

Uncertainties and discrepant results in identifying crucial areas for emotional facial expression recognition may stem from the eye tracking data analysis methods used. Many studies employ parameters of analysis that predominantly prioritize the examination of the foveal vision angle, ignoring the potential influences of simultaneous parafoveal and peripheral information. To explore the possible underlying causes of these discrepancies, we investigated the role of the visual field aperture in emotional facial expression recognition with 163 volunteers randomly assigned to three groups: no visual restriction (NVR), parafoveal and foveal vision (PFFV), and foveal vision (FV). Employing eye tracking and gaze contingency, we collected visual inspection and judgment data over 30 frontal face images, equally distributed among five emotions. Raw eye tracking data underwent Eye Movements Metrics and Visualizations (EyeMMV) processing. Accordingly, the visual inspection time, number of fixations, and fixation duration increased with the visual field restriction. Nevertheless, the accuracy showed significant differences among the NVR/FV and PFFV/FV groups, despite there being no difference in NVR/PFFV. The findings underscore the impact of specific visual field areas on facial expression recognition, highlighting the importance of parafoveal vision. The results suggest that eye tracking data analysis methods should incorporate projection angles extending to at least the parafoveal level.

Indications for implant-supported rehabilitation of the posterior atrophic maxilla: A multidisciplinary consensus among experts in the field utilising the modified Delphi method.

PURPOSE: To establish consensus-driven guidelines that could support the clinical decision-making process for implant-supported rehabilitation of the posterior atrophic maxilla and ultimately improve long-term treatment outcomes and patient satisfaction. MATERIALS AND METHODS: A total of 33 participants were enrolled (18 active members of the Italian Academy of Osseointegration and 15 international experts). Based on the available evidence, the development group discussed and proposed an initial list of 20 statements, which were later evalu-ated by all participants. After the forms were completed, the responses were sent for blinded ana-lysis. In most cases, when a consensus was not reached, the statements were rephrased and sent to the participants for another round of evaluation. Three rounds were planned. RESULTS: After the first round of voting, participants came close to reaching a consensus on six statements, but no consensus was achieved for the other fourteen. Following this, nineteen statements were rephrased and sent to participants again for the second round of voting, after which a consensus was reached for six statements and almost reached for three statements, but no consensus was achieved for the other ten. All 13 statements upon which no consensus was reached were rephrased and included in the third round. After this round, a consensus was achieved for an additional nine statements and almost achieved for three statements, but no consensus was reached for the remaining statement. CONCLUSION: This Delphi consensus highlights the importance of accurate preoperative planning, taking into consideration the maxillomandibular relationship to meet the functional and aesthetic requirements of the final restoration. Emphasis is placed on the role played by the sinus bony walls and floor in providing essential elements for bone formation, and on evaluation of bucco-palatal sinus width for choosing between lateral and transcrestal sinus floor elevation. Tilted and trans-sinus implants are considered viable options, whereas caution is advised when placing pterygoid implants. Zygomatic implants are seen as a potential option in specific cases, such as for completely edentulous elderly or oncological patients, for whom conventional alternatives are unsuitable.

Evaluation of alveolar antral anastomosis in south Indian population using cone beam computed tomography: a prospective study.

OBJECTIVES: The posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA), both of which are ultimate branches of the maxillary artery, are connected by a horizontal anastomosis. PSAA anastomoses intraosseously and extraosseously with IOA. Profuse bleeding from the lateral wall while performing the direct sinus augmentation is a significant intraoperative complication.Thus the present study focused to assess the location of an alveolar antral anastomosis (AAA) in relation to the crest of the alveolar bone using cone beam computed tomography (CBCT). METHODS: A total of 200 CBCT scans of patients who were indicated for implant surgery were chosen and assessed. Group 1 includes 100 dentate patients and Group 2 includes 100 partially edentulous patients. The location of anastomosis along the lateral wall of the maxillary sinus was evaluated in association with alveolar bone height with respect to three posterior maxillary teeth: first premolar, second premolar, and first molar. RESULTS: The mean distance for P1, P2, and M1 was 21.94 ± 1.02 mm, 19.41 ± 0.40 mm, and 17.36 ± 0.51 mm, respectively, in the dentate group, whereas in the edentulous group, it was 20.07 ± 0.46 mm, 18.95 ± 0.32 mm, and 16.08 ± 0.16 mm. In 80% of participants, the distance of an AAA from the alveolar crest was between 16 and 23 mm, whereas in 12% of the participants the distance of an AAA from the alveolar crest was less than 16 mm. CONCLUSION: The present study concludes that the first premolar region is safe for preparing the lateral window but for the second premolar and first molar additional care should be taken prior to surgery.

Identifying and quantifying PM2.5 pollution episodes with a fusion method of moving window technique and constrained Positive Matrix Factorization.

PM2.5 pollution episodes rapidly and significantly deteriorate the air quality and are a critical concern worldwide. This study developed a fusion method based on the moving window dataset technique and constrained Positive Matrix Factorization (PMF) to differentiate and characterize potential factors in a PM2.5 episode case assuming having one new contributor. The hourly PM2.5 compositions of elements, ions and carbonaceous components, were collected from September to December 2020 in Taipei, Taiwan. Constraint targets based on the bootstrap analysis result of a PMF model using a long-term input dataset were imposed on the modeling of each moving window to ensure similar features of the retrieved factors. The constituents of an additionally differentiated factor to the episode, which was identified as regional transport, were stable among each moving window that covered the occurrence of the episode as revealed by the profile matching index. The results showed that the largest contributor to the PM2.5 mass during the episode period of 12/12/2020 was regional transport (61%), whereas that of 12/13 was the regular pollution of industry/ammonium sulfate related (43%). According to our review of the literature, this study is the first to apply both the moving window technique and constrained PMF to characterize the episode. The findings provide valuable information that can be used to explore the causes of PM2.5 episodes and implement air pollution control strategies.

Custom double tray for a special impression technique for flabby maxillary residual ridge: Case report.

The construction of a removable dental prosthesis for patients with compromised residual alveolar ridges is a challenge for prosthodontists. Flabby anterior ridges and hypermobile tissues in completely edentulous arches require special considerations during prosthetic management, especially when natural dentations remain on the opposite side. Previous studies have revealed that the displacement of flabby tissue can be reduced during impressions by controlling the applied forces via changes in factors such as the tray design, scraping of impression trays, impression material, window technique, and seating velocity of the impressions. However, there may still be some forces applied during impression or there is no even space because there are no trays supporting the vinyl polysiloxane (VPS) impression material in the open window area. Using a custom double tray with even gap between these trays and injecting light body impression material may eliminate these forces and provide accuracy due to even space for the impression material. This article is a clinical report of a patient who presented with an anterior flabby maxillary edentulous ridge opposing the remaining anterior natural teeth. A custom double tray was fabricated using the principle of the window technique. The gap between the double trays allows mucostatic impressions of flabby ridge tissue to be made with accuracy. The maxillary single denture, which was made with a custom double tray, satisfied the patient.

Effects of diagnostic regions on facial emotion recognition: The moving window technique.

With regard to facial emotion recognition, previous studies found that specific facial regions were attended more in order to identify certain emotions. We investigated whether a preferential search for emotion-specific diagnostic regions could contribute toward the accurate recognition of facial emotions. Twenty-three neurotypical adults performed an emotion recognition task using six basic emotions: anger, disgust, fear, happiness, sadness, and surprise. The participants' exploration patterns for the faces were measured using the Moving Window Technique (MWT). This technique presented a small window on a blurred face, and the participants explored the face stimuli through a mouse-controlled window in order to recognize the emotions on the face. Our results revealed that when the participants explored the diagnostic regions for each emotion more frequently, the correct recognition of the emotions occurred at a faster rate. To the best of our knowledge, this current study is the first to present evidence that an exploration of emotion-specific diagnostic regions can predict the reaction time of accurate emotion recognition among neurotypical adults. Such findings can be further applied in the evaluation and/or training (regarding emotion recognition functions) of both typically and atypically developing children with emotion recognition difficulties.

Predictability of COVID-19 worldwide lethality using permutation-information theory quantifiers.

This paper examines the predictability of COVID-19 worldwide lethality considering 43 countries. Based on the values inherent to Permutation entropy ( H s ) and Fisher information measure ( F s ), we apply the Shannon-Fisher causality plane (SFCP), which allows us to quantify the disorder an evaluate randomness present in the time series of daily death cases related to COVID-19 in each country. We also use Hs and Fs to rank the COVID-19 lethality in these countries based on the complexity hierarchy. Our results suggest that the most proactive countries implemented measures such as facemasks, social distancing, quarantine, massive population testing, and hygienic (sanitary) orientations to limit the impacts of COVID-19, which implied lower entropy (higher predictability) to the COVID-19 lethality. In contrast, the most reactive countries implementing these measures depicted higher entropy (lower predictability) to the COVID-19 lethality. Given this, our findings shed light that these preventive measures are efficient to combat the COVID-19 lethality.

Application of a thyroid cartilage window technique for transoral resection of early glottic cancer involving the anterior commissure.

BACKGROUND: Management of early stage glottic carcinoma involving the anterior commissure is challenging. AIMS/OBJECTIVES: This study aimed to evaluate the efficacy of a thyroid cartilage window (TCW) technique for transoral laser resection of early glottic cancer with involvement of the anterior commissure. MATERIAL AND METHODS: Twenty-one patient who underwent a TCW technique for transoral resection early glottic carcinoma involving the anterior commissure, were retrospectively analyzed. The technical nuances, organ preservation rate and voice outcomes, local and regional recurrence, and perioperative comorbidities, were assessed. RESULTS: All 21 patients underwent a TCW technique for resection, both the organ preservation rate and negative margin achieved 100%. The local control rate achieved 100%, and the 5 years recurrence free survival was 90.5%. For two patients with subglottic involvement (9.5%), regional recurrence with confirmation of a positive pre-laryngeal lymph node was observed. Postoperative granuloma was detected in all 21 patients, 13 of whom spontaneously disappeared (61.9%); whereas the remaining 8 patients (38.1%) demonstrated a consistent presence of granuloma more than 12 weeks, and they accepted surgical extirpation of granuloma under surface anesthesia. The laryngeal web developed in all 21 patients, while no dyspnea and local recurrence were present. By comparison with preoperative baseline, postoperative self-assessment voice demonstrated a significant improvement (p = .01), while objective voice indices were not significantly altered (p > .05). CONCLUSIONS AND SIGNIFICANCE: TCW technique is a valuable means for transoral resection of early glottic laryngeal cancer involving the anterior commissure, with acceptable voice quality and seemingly low comorbidities.

A Simple and Safe Approach for Maxillary Sinus Augmentation with the Advanced Surgical Guide.

OBJECTIVE: The development of digital dentistry has contributed to the astonishing advancement of implant dentistry. Furthermore, digital technology is expected to be applied extensively to sinus augmentation, which is an advanced technique for implant surgery. This study introduces a simple method for a safer and more precise lateral window opening for sinus augmentation using a navigation program. METHODS: Five eligible patients with residual alveolar bone of 4 mm or less are presented, requiring lateral approach for sinus augmentation. Navigation system was opted for the sinus lift with simultaneous implant placement. Virtual planning started with establishing the adequate position of the lateral window based on the radiographic images and the scanned file of the dentition. The position of the window was indicated on the guide within the program. Afterwards, the virtually designed surgical guide was fabricated either with 3D printer or milling machine for the actual surgery. RESULTS: All the patients who underwent surgery with the surgical guide showed no sign of clinical complications including pain, swelling, nausea, epistaxis, or early loss of the implants. Results of radiographic evaluation also showed adequate placement of the implants in a pre-planned position, and the sinus window was also formed in the desired location. CONCLUSION: Lateral window opening combined with digital navigation system is believed to be a promising technique for a more precise as well as safer sinus augmentation.

Anterior knee pain in ACL reconstruction with BPTB graft - Is it a myth? Comparative outcome analysis with hamstring graft in 1,250 patients.

Anterior Knee Pain(AKP) has been quoted as the main disadvantage of Bone Patellar Tendon Bone (BPTB)graft in Anterior Cruciate Ligament Reconstruction (ACLR). We overcome the problem by harvesting BPTB graft by mini-open mobile window technique. OBJECTIVES: To investigate postoperative incidence of AKP with BPTB graft in comparison with hamstring graft during primary ACLR. METHODS: Total of 1737 patients underwent ACLR in the study period of which 1250 met eligibility criteria (622-BPTB graft, , 628-Hamstring graft). RESULTS: Incidence of AKP, Lysholm score and IKDC score were analysed and found no statistically significant difference at 18-month followup. CONCLUSION: BPTB graft harvested by mini-open mobile window technique has a low incidence of AKP as of hamstring graft.