ABSTRACT
Background: A systematic review was carried out to compare the disinfectant capacity of hydroxyl radicals (OH-) versus other products commonly used for disinfecting the air and surfaces. Material and Methods: A literature search was made of the Cochrane Library, PubMed (MEDLINE) and Scopus databases. "In vitro" studies evaluating disinfection methods applicable to several surfaces and room air were included in the search. The search was carried out in April 2022, with no restrictions in terms of language or publication date. Results: Of the 308 articles identified from the initial search, 8 were included for the quantitative analysis. All publications corresponded to experimental "in vitro" studies. Seven of them evaluated biocidal action against bacteria, and only two assessed activity against viral loads. The generation of contaminants secondary to application of the disinfectants was only analyzed in one of the studies, with the conclusion that the production of peroxyl radicals (RO2) derived from the oxidation of volatile organic compounds (VOCs) is greater when chemical surface disinfectants are used versus air disinfection systems. Conclusions: The disinfection capacities of the currently available methods are similar, and none of them are able to replace the use of additional physical protection measures. Key words:Disinfection methods, hydroxyl radical, environment, surfaces, dentistry.
ABSTRACT
Background: One of the most frequent complications in guided bone regeneration (GBR) is wound dehiscence, which compromises treatment outcomes. Thus, primary tension-free suture is essential to avoid wound dehiscence. The purpose of this study was to compare the extension of 2 different mandibular flaps in human cadaveric specimens, and to measure the size of the supraperiosteal blood vessels. Material and methods: Five freshly unfrozen human cadaveric specimens were used. Arteries and veins were marked and bilateral classical lingual flaps (extending from the second premolar to the retromolar area) were prepared. In one side, the mylohyoid muscle was detached to increase the coronal extension of the flap. An implant drill was used to measure the extension of the flap after exerting 30 g of traction, before and after detaching the mylohyoid muscle. The size of the largest vascular structures of the flap was measured using a periodontal probe. Results: The classical flap extension was 5.99 mm (95% confidence interval (CI): 5.08 to 6.90), while the coronally advanced flap extension with mylohyoid muscle detachment was 14.96 mm (95%CI: 10.81 - 19.11). A statistically significant difference was found between the 2 groups (p= 0.0002), with a mean extension difference was 8.97 mm (95%CI: 5.02 to 12.91). The mean largest artery had 0.20 mm of diameter (95%CI: 0.15 - 0.26). Conclusions: The detachment of the mylohyoid muscle from the lingual flap allows to significantly increase its extension by 2.5 times. The superficial arteries found in the lingual flap have a small diameter (around 0.2mm). (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Mandible/surgery , Surgical Flaps/surgery , Cadaver , Bone RegenerationABSTRACT
OBJECTIVE: To determine the usefulness of Serum C-terminal telopeptide cross-link of type 1 collagen (sCTX) as a preoperative marker for predicting the risk of developing medication-related osteonecrosis of the jaws (MRONJ) after invasive oral surgery in patients on antiresorptive medication. MATERIALS AND METHODS: Two authors independently searched four electronic databases up to March 25, 2021, for case-control studies and prospective and retrospective cohort studies that assessed preoperative sCTX levels in patients taking antiresorptive medication who underwent oral surgery procedures. The main outcome was the number of MRONJ cases in patients with an sCTX value lower and higher than 150 pg/mL. Qualitative and quantitative data was extracted in tables and the risk of bias was assessed using the QUADAS-2 tool. Estimates of diagnostic accuracy were expressed as sensitivity, specificity, negative and positive likelihood ratio (LR - and LR +), and diagnostic odds ratio (DOR), with a 95% confidence interval (95%CI). The data were combined using random-effects models based on the inverse variance method. RESULTS: Seven studies were included in the meta-analysis. The results were as follows: sensitivity 57% (95%CI: 41-71%), specificity 72% (95%CI: 64-79%), LR + 2 (95%CI: 1.3-3.1), LR - 0.6 (95%CI: 0.4-0.9), and DOR 3.4 (95%CI: 1.5-7.7). CONCLUSIONS: The low overall performance of sCTX indicates that this parameter is not suitable for predicting MRONJ risk in patients on antiresorptive medication who need an oral surgery procedure. CLINICAL RELEVANCE: sCTX should not be considered a reliable preoperative marker to predict MRONJ development.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Bisphosphonate-Associated Osteonecrosis of the Jaw/diagnosis , Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy , Bone Density Conservation Agents/adverse effects , Collagen Type I , Diagnostic Tests, Routine , Diphosphonates/adverse effects , Humans , Jaw , Prospective Studies , Retrospective Studies , Risk FactorsABSTRACT
Background: Buccal Fat Pad (BFP) excision has become an aesthetic surgical procedure. Although this procedureis quite common, it is important to bear in mind that the scientific evidence supporting the efficacy of this treat-ment is scarce and of low quality. The purpose of this systematic review was to analyse all relevant data to assessthe efficacy and safety of BFP excision for improving midface aesthetics.Material and Methods: A thorough search of MEDLINE (PubMed), Scopus and Cochrane Library databases wasconducted. The PICO approach was used where healthy patients seeking cheek slimming and facial silhouetterefining undergo BFP excision and were compared before and after surgery in terms of BFP volume reduction,adverse effects and patient satisfaction.Results: Of the 1,413 references identified, 4 were included in the qualitative synthesis. Only one study reportedBFP volume reduction, which was 3.10 mL (95%CI: 2.38 to 3.80; P < 0.001), and the mean volume of the excisedtissue was 2.74 ± 0.69 mL (range, 1.8-4.9 mL). 84.6% of the patients stated that their facial contour was much bet-ter and the remaining 15.4% noticed that the appearance of their cheeks following BFP excision was better. Sevencomplications were reported in the 134 cheek refinement procedures. Conclusions: BFP removal has an initially favorable outcome for facial aesthetics and a low postoperative complica-tion rate, however, there are many procedures being performed with poor quality methodology and there is also alack of published data on its long-term follow-up results.(AU)
Subject(s)
Humans , Male , Female , Adipose Tissue , Esthetics, Dental , Cheek/surgery , Mouth , Surgery, PlasticABSTRACT
It is well known that wound dehiscence is one of the most frequent complications in guided bone regeneration. The main cause of this complication may be a lack of tension-free and primary wound closure. The aim of this study was to evaluate and compare the effect of periosteal releasing incisions (PRI) on the extension of 3 different flap designs: envelope, triangular, and trapezoidal. Twelve pig mandibles were used to quantify extension of the flap designs. The mandibles were equally and randomly distributed into the 3 flap groups. Each mandible was divided into 2 sides: 1 was subjected to a PRI and the other not. The flap was pulled with a force of 1.08 N, and the extension was recorded. The subgroups without PRI showed an average extension of 5.14 mm with no statistically significant differences among them (P = .165). The PRI provided an average extension of 7.37 mm with statistically significant differences among the subgroups (P < .001). The releasing incisions significantly increased flap extension in each flap design. The increase in extension of the trapezoidal flap with PRI was significantly greater than in the other subgroups. In cases where primary closure is required, surgeons should consider performing trapezoidal flaps with PRI in order to reduce tension.
