Clinical investigation of botulinum toxin (prabotulinumtoxin A) for bruxism related to masseter muscle hypertrophy: A prospective study.

This study aims to confirm the effectiveness and safety of a prabotulinumtoxin type A (praBTX-A) injection in patients with bruxism and masseter hypertrophy. The study included patients who ground or clenched their teeth while sleeping and had computed tomography (CT) scans that showed a maximum thickness of the masseter muscle of 15 mm or more. The praBTX-A was administered bilaterally into the masseter muscles; 15 U/side for group 1, 25 U/side for group 2, and 35 U/side for group 3. CT scans and bruxism questionnaires were conducted before and eight weeks after the injection. Thirty-seven patients were enrolled, but three dropped out due to loss of follow-up. After injection, masseter thickness decreased to 15.1 ± 2.0 mm for group 1, 14.3 ± 2.9 mm for group 2, and 13.4 ± 1.8 mm for group 3 (p = 0.043). Group 3 showed a statistically significant lower masseter thickness compared to group 1 (p = 0.039). Both subjective and objective frequencies of bruxism decreased for all groups, but there were no significant differences in either subjective (p = 0.396) or objective frequencies (p = 0.87) between the groups after the injection. The results of this study suggest that praBTX-A injection is a safe and effective treatment for bruxism and masseter hypertrophy. A dosage of 35 IU/side can effectively decrease masseter thickness and relieve bruxism symptoms. Even the minimum dosage of 15 IU/side can contribute to improvements in bruxism symptoms. This investigation provides valuable information for managing bruxism that is associated with hypertrophic masseter muscles.

Bioinspired On-Demand Directional Droplet Manipulation Surfaces.

In this study, we exploited the properties of nature-inspired hierarchical structures to propose surfaces capable of on-demand directional droplet manipulation. A microline polydimethylsiloxane structure that simulated a bamboo leaf was fabricated, and silica particles were embedded onto its surface to create hierarchical structures. The as-fabricated multiscale line structures exhibited anisotropic wetting properties along the advancing direction. As the embedded particle size increased, the perpendicular roll-off angle (ROA) decreased and the anisotropic roll-off characteristic disappeared, adopting lotus-leaf characteristics. Consequently, the fabricated surface exhibited characteristics of both bamboo and lotus leaves. The roll off could be controlled through different ROAs by changing the particles size of silica on the same surface.

The distribution of the perforators in the anterolateral thigh and the utility of multidetector row computed tomography angiography in preoperative planning.

This prospective study searches for the clinical relevance of preoperative multidetector row computed tomography (MDCT) angiography (CTA) for anterolateral thigh (ALT) free flap.Preoperative CTA data were collected in 100 patients between November 2004 and April 2008, and data from 139 limbs were evaluated for the number, type, and location of the ALT perforators. This information was used as operative roadmap and correlated with intraoperative findings in 58 patients.The MDCT revealed an average number of perforators of 2.28 per unilateral ALT (range, 0-4) and projected that 23% of the limb have at least 1 septocutaneous perforator. When the reference line connecting the anterior superior iliac spine ASIS and patella was divided into 10 equal parts, most of the perforators were concentrated in 4/10 to 7/10 and the most common was on the proximal 5/10. Two-thirds of septocutaneous perforators were present in the proximal half. Fifty-two of 58 patients had operative findings consistent with CTA, but 4 perforators failed to appear in preoperative CTA and 3 musculocutanenous perforators were initially identified as septocutaneous type but actually had a short intramuscular course.Preoperative mapping using MDCT angiography is fast, simple, and provides fairly accurate information about the location, type, and the course of the perforators. It allows appropriate selection of the sizable perforator with the shortest intramuscular course preoperatively leading to safer and easier operation with optimal outcome.