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Dificuldades na higienização de próteses fixas implanto-suportadas é uma queixa frequente dos pacientes. Embora a higiene bucal seja primordial para a manutenção em longo prazo, não há consenso na literatura com relação à eficácia de protocolos de higienização em implantes dentários e as melhores abordagens ainda estão por ser estabelecidas. Assim, o objetivo do presente estudo foi avaliar e comparar a eficácia de 2 protocolos de higienização, irrigador bucal e escova interproximal, como adjuvantes à escovação convencional na limpeza peri-implantar entre indivíduos reabilitados com prótese total implanto-suportadas. Para tal, um ensaio clínico randomizado controlado cruzado foi realizado com 21 indivíduos. No momento da seleção, cada participante foi aleatoriamente designado para um dos grupos do estudo: 1) grupo IB = escova interproximal + escova convencional ou 2) grupo IO = irrigador oral + escova convencional. Após 60 dias sob o protocolo de tratamento inicial, e transcorridos um período de washout de 30 dias, todos os participantes mudaram seus respectivos protocolos de higiene bucal. Os desfechos presença de placa bacteriana peri-implantar (PPi) e sangramento à sondagem (SSi) foram coletados no baseline, 7, 14, 30 e 60 dias após o início de cada tratamento. A análise estatística incluiu comparações intra e intergrupos através do teste de Friedman. Além disso, uma regressão logística de efeitos mistos foi usada para determinar as variáveis preditoras associadas aos desfechos do estudo. Ambos os grupos apresentaram melhorias no controle de PPi e SSi, embora as reduções tenham sido maiores no grupo IO, em todos os tempos de avaliação. As melhorias no controle de PPi e SSi após o período de monitoramento de 60 dias foram, respectivamente, cerca de 36% e 33% maiores no grupo IO. Escovação interproximal e sítios linguais foram associados com a ocorrência de PPi e SSi nos modelos logísticos finais de efeitos mistos. Os achados do presente estudo suportam a recomendação do irrigador bucal como adjuvante a escovação convencional na higiene peri-implantar em indivíduos reabilitados com prótese total inferior implanto-suportada (ensaiosclinicos.gov.br #RBR-62hsp9).
Comparison of oral irrigator and interproximal brush in peri-implant oral hygiene in implant-fixed full-arch mandibular prosthesis: randomized controlled crossover clinical trial. Great difficulties in oral hygiene of implant-fixed prostheses are a common complaint of patients. Although oral hygiene is paramount for long-lasting healthy and functional prosthetic rehabilitations, there is no literature consensus with respect to the efficacy of self-performed oral hygiene protocols around dental implants and the best approaches are yet to be established. Therefore, the aim of the present study was to evaluate and compare the efficacy of oral irrigator and interproximal brush as adjuvant to conventional brushing in peri-implant oral hygiene among individuals rehabilitated with implant-fixed full-arch mandibular prosthesis. A randomized controlled crossover clinical trial was conducted with 21 individuals. At the enrollment, each participant was randomly assigned to one of the study groups: 1) IB group = interproximal brush + conventional brush ou 2) OI group = oral irrigator + conventional brush. After 60 days under the initially treatment and a 30-day washout period, all participants changed their respective oral hygiene protocol. Peri- implant dental plaque (PiDP) and bleeding on probing (BOPi) were collected at baseline, 7, 14, 30 and 60 days after the beginning of each treatment. Statistical analysis included intra-and intergroup comparisons through the Friedman test. Mixed-effects logistic regression was used to determine the effects of predictors associated to study outcomes. Both groups presented improvements in PiDP and BOPi control, although reductions were greater in the OI group, at all examination times. Improvements in PiDP and BOPi after the 60-day monitoring period were, respectively, around 36% and 33% greater in the OI group. Interproximal brushing and lingual sites were associated with PiDP and BOPi in the mixed effects final models. Findings support the recommendation of oral irrigator as adjuvant to conventional brushing in the peri-implant oral hygiene in implant-fixed full-arch rehabilitated individuals (ensaiosclinicos.gov.br #RBR-62hsp9).
Subject(s)
Oral Hygiene , Toothbrushing , Dental Implants , Clinical Trial , Dental Plaque , Denture, Complete , HemorrhageABSTRACT
Objective To observe the effect of varying intensities of water-jet force on autologous fat graft viability.Methods Lipoaspirate was taken from 12 female patients undergoing waterjet assisted abdominal liposuction at our department.According to the intensity of water-jet force,the experimental group was divided into four subgroups:R1 (pressure,30 bar),R2 (pressure,50 bar),R3 (pressure,70 bar) and R4 (pressure,90 bar).Hand-held suction was taken as the control group C.Adipose tissue was filtered with cotton cushion and centrifuged at low speed,and the composition ratio of water and fat tissue from each group was observed.Calcein-AM/Hoechst 33342 staining was used to detect the viability of adipocytes.Results Fat aspirates was divided into four layers:oil layer,pure fat tissue,liquid and bottom sediment.Oil ratios of R1,R2,R3,R4 and C were (8.9 ± 2.3) ％,(9.6±2.1)％,(10.3±1.3)％,(14.2±1.6)％ and (9.5±1.8)％,respectively.There was no statistically significant difference between R1,R2,R3 and C (P＞0.05).Statistically significant difference was found between R4 and other groups (P＜0.001).Viability of adipocytes from R1,R2,R3,R4 and C groups were (88.1±2.8)％,(89.9±1.9)％,(84.8±2.3)％,(78.0±1.7)％ and (91.1±2.9)％ respectively.There was no statistically significant difference between R1,R2 and C (P＞ 0.05).Statistically significant difference was found between R3,R4 and C (P ＜ 0.05).Conclusions Viability of fat graft harvested under lower intensity of water-jet force (R1,R2) is higher than that harvested under higher intensity of water-jet force (R3,R4).
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Objective To explore the effect of different harvest methods of liposuction on the autologous fat grafting.Methods The clinical data of 60 patients with fat grafting for breast augmentation from January 2014 to January 2017 were analyzed retrospectively.According to the method of liposuction,60 patients were divided into the water-jet assisted liposuction group (30 cases) and negative-pressure machine liposuction group (30 cases).The surgical time of different liposuctions and the fat survival were compared after breast augmentation.The clinical effect of different liposuction methods was analyzed by follow-up one year after operation.Results Sixty patients completed the surgery.The fat survival rate of water-jet assisted liposuction was (66.71±2.68) ％,and the fat survival rate of the negative-pressure machine liposuction was (51.44 ± 1.16) ％.There were statistically significant difference between the two groups (P＜0.05).As for the operation time of liposuction,the water-jet assisted liposuction group was (33.28 ± 2.96) min,the negative-pressure machine liposuction group was (52.91± 5.03) min;there were statistically significant difference between the two groups (P ＜ 0.05).There was no statistically significant difference in satisfactory rate (P＞0.05).Conclusions Compared with negative pressure liposuction,water-jet assisted liposuction using autologous fat grafting in breast augmentation can improve the survival rate of fat transplantation.This technique has good clinical application value.
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Objective To evaluate the efficacy and safety of submucosal injection using endoscopic water-jet in peroral endoscopic myotomy (POEM) for treatment of patients with achalasia of cardia (AC). Methods A retrospective analysis was performed on the data of 126 AC patients undergoing POEM in PLA General Hospital from March 2013 to February 2016. All the 126 patients were divided into two groups, 73 in the water-jet group and 53 in the needle injection group. The time to creating a submucosal tunnel, entire operation time, and incidence of complications were compared between the two groups. Results The time to creating a submucosal tunnel and the entire operation time of the water-jet group were both significantly less than those of the needle injection group (6. 38±0. 94 min VS 13. 81±1. 13 min, P<0. 05;27. 81±5. 76 min VS 70. 25±22. 67 min, P<0. 05). The hospital stay of patients after operation was less in the water-jet group than that in the needle injection group (4. 38±1. 87 days VS 5. 64±1. 83 days, P<0. 05). The incidence of bleeding [5. 5％ (4/73) VS 17. 0％ (9/53), P<0. 05] and fever [12. 3％ (9/73) VS 26. 4％ (14/53), P<0. 05] were lower in the water-jet group than those in the needle injection group. The incidences of perforation and pectoralgia were not significantly different between the two groups ( both P>0. 05 ) . Conclusion Endoscopic water-jet injection is safe and effective in POEM, which effectively shortens the time to creat a submucosal tunnel and the operation time, and reduces the incidences of complications including bleeding and fever.
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Objective To observe the effect of a novel pressure controlled water jet used in transurethral resection of bladder tumor. Methods Clinical data of 12 patients who underwent a transurethral resection of bladder tumor by using a novel water jet was retrospectively analyzed. Results All 12 cases were successfully operated. Estimated blood loss during operation was less than 5 ml. Operation time was 20-45 minutes (median was 28 min), time of water injection was 8-15 minutes (median was 12 min). There were no significant complications. All patients were followed up for 4-10 months, and tumor recurrence or progression was not found by cystoscopic examination. Conclusion Transurethral resection of bladder tumor by using a novel pressure controlled water jet is advantageous with favorable safety and feasibility.
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Objective To evaluate the effectiveness of water jet debridement combined with negative pressure wound therapy (NPWT) for the treatment of early infection after fracture internal fixation.Methods The study cohort included 6 men and one woman with an average age of 43.6 years (range,from 36 to 58 years) who had presented with early infection after fracture internal fixation from October 2013 to March 2015.All the patients sustained closed fractures initially.The wound debridement was done within 3 to 5 days after the infection was confirmed.The length and depth of an incision was determined by the methylene staining range.Water jet was used to eliminate the dying tissues thoroughly from a shallower layer to a deeper layer while the internal fixator was retained.The wound was closed by full thickness sutures in a sparse fashion for drainage.Sensitive antibiotics were systematically administered for all the patients.The NPWT device was kept for 5 days.Results All the wounds healed uneventfully after an average of 18 days (range,from 10 to 25 days).The mean follow-up time was 12 months (range,from 8 to 24 months).No antibiotics were used during follow-up.There were no local or systematical symptoms like new sinus,broken wound or fever.Bony callus formed at the fracture sites after an average of 4.3 months (range,from 2.5 to 8.0 months) and no fracture nonunion happened.All the fractures healed after an average of 10.1 months (range,from 5.5 to 16.0 months).All the patients were satisfied with their treatment outcomes.Conclusion Since water jet provides simple,rapid and radical debridement while NPWT simplifies operative procedures and promotes wound healing,combination of the two can be an effective treatment for early infection after fracture internal fixation.
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Colorectal endoscopic submucosal dissection (ESD) is now a well-established endoscopic treatment for early-stage colorectal neoplasms, especially in Asian countries, including Japan. Despite the spread of colorectal ESD, there are still situations in which achieving successful submucosal dissection is difficult. Various novel techniques and devices have been developed to overcome these difficulties, and past reports have shown that some of these strategies can be applied to colorectal ESD. We review several recent developments in the field. The techniques reviewed include the pocket creation method and traction methods and the devices reviewed include the overtube with balloon and electrosurgical knives with water-jet function. These improved techniques and devices can facilitate safer, more reliable ESDs and expand its applicability and acceptability all over the world.
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Humans , Asian People , Colorectal Neoplasms , Japan , Methods , TractionABSTRACT
Objective To study mechanical properties of the medical water-jet scalpel when cutting parenchyma such as liver and verify its tissue-selective cutting characteristic. Methods The tension mechanical properties of porcine liver parenchyma and its vessels with different sizes were determined. Porcine and Wistar rat liver tissues were cut with arteriovenous vessels well reserved, and pathological section of the rats were analyzed by HE staining to explain the experimental phenomena. Results When the working pressure was set at 3 MPa, the incising and separating on the right lobe of porcine liver by medical water-jet scalpel in this experiment were done with minimal vessels of 0.8 mm in diameter left. Pathological sections from ordinary scalpel and medical water-jet scalpel showed that the medical water-jet scalpel caused smaller tissue damage. Conclusions The medical water-jet scalpel could cut heterogeneity soft tissue with highly-selective characteristics, which may effectively avoid the existing “one size fits all” phenomenon caused by ordinary scalpel.
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Although bidets are widely used in Korea, its effects on anorectal pressures have not been studied in detail in terms of the water settings used. Twenty healthy volunteers were placed on a toilet equipped with a bidet, and anorectal pressures were measured with a manometry catheter inserted into the rectum and anal canal before and after using the bidet at different water forces (40, 80, 160, 200 mN), temperatures (24degrees C vs 38degrees C), and water jet widths (narrow vs wide). The pressure at anal high pressure zone decreased from 96.1 +/- 22.5 to 81.9 +/- 23.3 mmHg at water jet pressure of 40 mN and 38degrees C wide water jet (P < 0.001), from 94.3 +/- 22.4 to 80.0 +/- 24.1 mmHg at water jet pressure of 80 mN and 38degrees C narrow water jet (P < 0.001), and from 92.3 +/- 22.4 to 79.6 +/- 24.7 mmHg at a water jet pressure of 80 mN and 38degrees C wide water jet (P < 0.001). At other settings, no significant changes were observed. Our results indicate that, in addition to cleansing effect, bidet could be used to reduce anal resting pressure in the same manner as the traditional warm sitz bath under the conditions of low or medium water jet pressure, a warm water temperature, and a wide type water jet.
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Adult , Female , Humans , Male , Anal Canal/physiology , Manometry , Pressure , Rectum/physiology , Temperature , Toilet Facilities , WaterABSTRACT
Although bidets are widely used in Korea, its effects on anorectal pressures have not been studied in detail in terms of the water settings used. Twenty healthy volunteers were placed on a toilet equipped with a bidet, and anorectal pressures were measured with a manometry catheter inserted into the rectum and anal canal before and after using the bidet at different water forces (40, 80, 160, 200 mN), temperatures (24degrees C vs 38degrees C), and water jet widths (narrow vs wide). The pressure at anal high pressure zone decreased from 96.1 +/- 22.5 to 81.9 +/- 23.3 mmHg at water jet pressure of 40 mN and 38degrees C wide water jet (P < 0.001), from 94.3 +/- 22.4 to 80.0 +/- 24.1 mmHg at water jet pressure of 80 mN and 38degrees C narrow water jet (P < 0.001), and from 92.3 +/- 22.4 to 79.6 +/- 24.7 mmHg at a water jet pressure of 80 mN and 38degrees C wide water jet (P < 0.001). At other settings, no significant changes were observed. Our results indicate that, in addition to cleansing effect, bidet could be used to reduce anal resting pressure in the same manner as the traditional warm sitz bath under the conditions of low or medium water jet pressure, a warm water temperature, and a wide type water jet.
Subject(s)
Adult , Female , Humans , Male , Anal Canal/physiology , Manometry , Pressure , Rectum/physiology , Temperature , Toilet Facilities , WaterABSTRACT
Objective To evaluate the effect of dental water jet on oral hygiene maintenance in orthodontic patients with fixed appliances. Methods One hundred and twenty orthodontic patients with fixed appliances were randomly assigned into the manual toothbrush group and the dental water jet group. Dental plaque was evaluated and compared before the bonding of orthodontic appliances, three months and six months after the treatment. Results There was no significant difference between two groups before treatment. But the dental water jet group was superior than the manual toothbrush group in dental plaque index 3 and 6 months after treatment. Conclusions Dental water jet can reduce dental plaque and im -prove the oral hygiene of patients with fixed appliances.
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Objective To evaluate the clinical application of Helix water-jet dissector in complex hepatectomy. Methods Clinical data were retrospectively analyzed in 47 patients who received complex hepatectomy using Helix water-jet dissector for the parenchymal division. It was evaluated for the intraoperative blood loss, operation time, postoperative hepatic function and complications in these patients.Results Forty seven patients including 10 cases of hepatic giant cavernous hemangioma, 34 cases of hepatocellular carcinoma, and 3 cases of miscellaneous liver tumors. Among these patients, caudate lobe resection was performed in 6 cases, hepatic segment Ⅵ + Ⅷ resection in 19 cases, segment Ⅳ + Ⅴ + Ⅷresection in 9 cases, segment Ⅷ resection in 5 cases and right hepatic trisegmentectomy in 8 cases. The operation time was (240 ±85) min, intraoperative blood loss was (950 +650) ml, 13 out of 47patients (27.7%) received heterologous packed red blood cell (PRBC) transfusion for more than 2 units per case.Length of stay in hospital was ( 12. 5 ±4. 7) days. Post-operative complications included ascites in 6 cases,hydrothorax in 4 cases, atelectasis in 2 cases and pulmonary infection in 4 cases. No severe complications and death occurred in this group. Conclusion Water-jet dissector may increase operation accuracy,decrease massive blood loss and postoperative complications, therefore, it should be widely used in complex hepatectomy.
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The technology of water-jet is an advanced technology of cold cutting which is widely used in industry, espe-cially in the cutting of metal, glass, ceramics and paper. Its character and classification are introduced, especially basic prineiple, development and application. The technology of water-jet will paly an important role in medicine.
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Various surgical technologies have been developed to minimize the risk of the operation. With continuous water flow being the dissector, a relatively bloodless operation and a clear view for the operator can be obtained. When applied to the adventitia and the soft tissue adjacent to the vascular structure, it is satisfying and the vessel and ureter can be protected perfectly if ligated selectively. The operation time is also shorter than the routine one. So, further studies of this technology are necessary.
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Water Jet flow was projected at normal human aortic walls and human chronic obstructive iliac arteries in the air or in the ordinary saline solution. Ordinary saline solution was used for the jet, which was projected at a pressure of 10kg·f/cm<sup>2</sup> through a nozzle 0.10mm in diameter. When the Water Jet was projected at the normal aortic intima, damage to the wall was more severe with duration of fluid projection, and projection for ten sec ruprured the elastic fiber of the media. But when the fluid jet projected ordinary saline, damage to the aortic wall was slight and projection for 30sec only dissected the surface of the intima. Water Jet projection in air showed slight effect on thrombi of the chronic obstructive iliac arteries, and projection for 60sec only made small irregular holes in the thrombi. When the Water Jet was projected in ordinary saline solution, however, destructive effects on thrombi were stronger and the projection for 40sec could remove almost all the thrombi for a distance of 2cm, while damage to the initima was very slight. This study demonstrated that fluid jet projection using ordinary saline solution could remove thrombi in chronically obstructive artery safely and effectively and suggested the possibility of the Water Jet angioplasty.