Biomechanical Evaluation of Zygomatic Implant Versus Pterygoid Implant in Atrophic Maxilla: An In vitro Finite Element Study.

Background and Purpose: Dental implants are considered to be one of several treatment options that can be used to replace missing teeth. The objective of the study is to examine and compare the biomechanics of zygomatic and pterygoid implants planned on the atrophic maxilla with three different bone types. Materials and Methods: An in vitro finite element study was conducted on a three-dimensional model of zygomatic and pterygoid implants. In a total of 24 implants, two bilateral zygomatic and pterygoid implants with two anterior dental implants were inserted in models. 150 N vertical occlusal and 300 N load on masseter and medial pterygoid were simulated on the modeled prosthesis. The data were processed with ANSYS software. The stress on and deformations of the bones and implants were observed and compared. Results: When comparing the D4, D3, and D2 bones in subgroup I with zygomatic implants, the D2 bone was subjected to less stress compared to D3 and D4. The smallest displacement (0.125784 mm) was seen in D4 followed by the largest displacement (0.74073 mm) in D2. Similarly, when comparing the D2, D3, and D4 bone in subgroup II with pterygoid implants, the D2 bone in the atrophic maxilla received the least amount of stress from the pterygoid implants compared to D3 and D4. Furthermore, the smallest displacement (0.030934 mm) was seen in D2, and the largest (0.046319 mm) in D4. Conclusion: Results suggest firstly, that the overall stress was better distributed in D2 bone and secondly, the pterygoid implant showed higher stress concentration than the zygomatic implant.

Outpatient Pediatric Cardiology Follow-Up of Patients with Multisystem Inflammatory Syndrome in Children (MIS-C): A Single-Institution, Medium-Term Follow-Up Study.

We are continuing to learn about the multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection. There are many published studies regarding the acute management of MIS-C; however, there is still much to learn regarding the long-term outcomes of patients with MIS-C. In this study, we report the outcomes of patients admitted at our institution with MIS-C and the follow-up practices in Pediatric Cardiology over the last three years. We included patients who were admitted at Lucile Packard Children's Hospital between January 1, 2020 and October 31, 2022, who met the CDC criteria for MIS-C, and were followed in the Pediatric Cardiology Outpatient Clinic at our institution. There were 25 patients who met our inclusion criteria. Eighteen patients (72%) had their initial follow-up visit within 1-2 weeks of discharge and seven patients (28%) had their initial follow-up visit within 4-6 weeks of discharge. Six patients out of the 25 (24%) had decreased left ventricular ejection fraction (LVEF < 50%) during their hospitalization. No patients had left main coronary artery aneurysm (z-score > 2.5), two patients (8%) had proximal right coronary artery aneurysm (z-score > 2.5), and one patient (4%) had left anterior descending coronary artery aneurysm (z-score > 2.5) during hospitalization. Patients who were admitted with the diagnosis of MIS-C showed normalization of left ventricular dysfunction at their initial follow-up visit as early as 2-4 weeks after discharge. In this cohort of MIS-C patients, a 4-6-week window for the first follow-up visit after discharge seems reasonable.

COVID-19 Positive Versus Negative Complete Kawasaki Disease: A Study from the International Kawasaki Disease Registry.

To determine clinical differences for children with complete Kawasaki disease (KD) with and without evidence of preceding SARS-CoV-2 infection. From January 2020, contemporaneous patients with complete KD criteria were classified as either SARS-CoV-2 positive (KDCOVID+; confirmed household exposure, positive PCR and/or serology) or SARS-CoV-2 negative (KDCOVID-; negative testing and no exposure) and compared. Of 744 patients in the International Kawasaki Disease Registry, 52 were KDCOVID- and 61 were KDCOVID+. KDCOVID+ patients were older (median 5.5 vs. 3.7 years; p < 0.001), and all additionally met diagnostic criteria for multisystem inflammatory syndrome in children (MIS-C). They were more likely to have abdominal pain (60% vs. 35%; p = 0.008) and headache (38% vs. 10%; p < 0.001) and had significantly higher CRP, troponin, and BUN/creatinine, and lower hemoglobin, platelets, and lymphocytes. KDCOVID+ patients were more likely to have shock (41% vs. 6%; p < 0.001), ICU admission (62% vs. 10%; p < 0.001), lower left ventricular ejection fraction (mean lowest LVEF 53% vs. 60%; p < 0.001), and to have received inotropic support (60% vs. 10%; p < 0.001). Both groups received IVIG (2 doses in 22% vs. 18%; p = 0.63), but KDCOVID+ were more likely to have received steroids (85% vs. 35%; p < 0.001) and anakinra (60% vs. 10%; p = 0.002). KDCOVID- patients were more likely to have medium/large coronary artery aneurysms (CAA, 12% vs. 0%; p = 0.01). KDCOVID+ patients differ from KDCOVID-, have more severe disease, and greater evidence of myocardial involvement and cardiovascular dysfunction rather than CAA. These patients may be a distinct KD phenotype in the presence of a prevalent specific trigger.

Outpatient monitoring of patients with multisystem inflammatory syndrome (MIS-C): A mini review.

Introduction: As we learn more about the novel multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection, the protocols for long-term follow-up have evolved and only some of these protocols have been published. Here, we review the current literature on follow-up guidelines in MIS-C patients. Methods: We conducted a PUBMED search of all articles published on "MIS-C" and the term "follow-up" between 2020 and 2022. Inclusion criteria were that (1) the study was an observational study or case series, and (2) the study population included pediatric population who met the diagnostic criteria for MIS-C. Results: There were 206 publications on MIS-C and follow-up in the last 2 years with 11 studies that fit the inclusion criteria. These papers were representing 11 different centers and encompassed a total of 343 participants. Seven of the 11 studies had participants follow-up with their cardiologist within 1 month of discharge. Between 12% and 62% of patients within each study had depressed left ventricular ejection fraction (LVEF) at admission. At the initial follow-up visit, five studies showed a normal LVEF in all patients while the other seven studies showed 2%-13% patients continuing to have depressed LVEF. In eight of the 11 studies, 9%-52% of patients had coronary artery dilation at admission. At their initial follow-up visit, 3%-28% of patients continued to have coronary artery dilation. Conclusion: There is some institutional variation in the outpatient follow-up protocols in patients diagnosed with MIS-C. A standardized follow-up guidelines might be helpful to monitor long-term prognosis of these patients.

Is Salivary Sialic Acid a Reliable Biomarker in the Detection of Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma.

PURPOSE: Glycoprotein is an important constituent of saliva, and the observed increase in salivary glycoproteins such as sialic acid in oral potentially malignant disorder (OPMDs) and OSCC has stimulated the interest of researchers to explore it as a possible biomarker. METHODS: The study used 60 subjects, who were divided into three groups: Group I-20 subjects who were clinically and histopathologically diagnosed with OSCC; Group II-20 subjects who were clinically and histopathologically diagnosed with OPMDs; and Group III-20 healthy subjects with good oral hygiene and with no systemic disorders detected. Two millilitres of unstimulated salivary samples was collected in a pre-sterilized container to analyse total salivary sialic acid (TSA) levels using a sialic acid kit and UV spectrophotometer. RESULTS: The TSA levels in OSCC (545.45 ± 100.04) were much higher when compared to the level in OPMDs (169.80 ± 66.43) and in healthy subjects (25.45 ± 16.07). Statically significant correlation was observed between different grades of OSCC. Moreover, sialic acid showed 100% sensitivity and specificity between all the three groups. Statistical analysis was done with Kruskal-Wallis, followed by Mann-Whitney post hoc test at P < 0.05. The results suggested the utility of sialic acid as an efficient biomarker.

Continuous flow pulsed power plasma reactor for the treatment of aqueous solution containing volatile organic compounds and real pharmaceutical wastewater.

The degradation of four recalcitrant and toxic VOCs (volatile organic compounds) present in pharmaceutical wastewater was studied using a continuous flow plasma reactor, along with evaluating its potential for real effluent treatment. The wastewater was sprayed into the plasma zone of the reactor, and it was re-circulated for better performance. The effect of different HRTs (hydraulic retention time) and initial concentrations of VOCs on the degradation efficiency were evaluated. In continuous reactor, complete removal of 200 mg/L of chloroform, chlorobenzene, and toluene was achieved at a HRT of 33.3 min, with an energy consumption of 22.4 kWh/m3. The study on the effect of different inlet loading rates of VOCs on elimination capacity showed that, the removal was limited initially by diffusion of reactive species and at higher loads, it was limited by insufficient amount of reactive species produced. During degradation of VOC mixture, more than 90% removal of chloroform, chlorobenzene and toluene was achieved at HRT of 33.3 min, and the TOC removal was 78.3%. The degradation efficiency of VOC mixture reduced slightly compared to that of individual compounds, due to insufficient amount of reactive species produced. The COD and BOD removal achieved after 140 min of direct plasma treatment of real pharmaceutical wastewater in batch reactor was 92.7% and 95.2%, respectively. Coagulation pre-treatment did not have a significant effect on the plasma treatment of real wastewater. When pharmaceutical effluent treatment was carried out in continuous flow reactor, 91.8% COD removal, 90.9% BOD removal and more than 90% degradation of all VOCs were achieved at a HRT of 150 min. Plasma treatment alone was capable of effectively treating the real pharmaceutical wastewater without any pre-treatment.

Comparative study of degradation of toluene and methyl isobutyl ketone (MIBK) in aqueous solution by pulsed corona discharge plasma.

Effectiveness of pulsed power plasma for the degradation of two toxic volatile organic compounds (VOCs), toluene and methyl isobutyl ketone (MIBK), in aqueous solution was evaluated. The plasma degradation of MIBK has been studied for the first time. The influence of initial concentration of target compound, solution pH and scavengers on percentage degradation was evaluated. 100% removal of 200 mg/L of toluene and MIBK was achieved both in liquid and gaseous phases after 12 and 16 min of plasma treatment, respectively. The first order rate constant of toluene and MIBK degradation (for 200 mg/L each) was 0.421 and 0.319 min-1 respectively when they were treated individually, and these values decreased slightly during degradation of their mixture. MIBK degradation was slower than toluene and it might be due to semi volatile and hydrophilic nature of MIBK. The effect of initial concentration of toluene and MIBK showed different degradation patterns. Highest degradation of both the compounds was obtained in neutral pH and in absence of scavengers. •OH radical was the major reactive species involved in their degradation. Their degradation in real environmental matrices showed that removal reduced significantly in secondary effluent due to scavenging of reactive species by various ions and organic matter. The total number of degradation intermediates identified in case of toluene and MIBK was 11 and 14 respectively and formate was the one recalcitrant byproduct generated. The degradation pathway of toluene and MIBK involving reactions of reactive oxygen and nitrogen species and reductive species is proposed.

Comparative Evaluation of Antimicrobial Activity of QMiX, 2.5% Sodium Hypochlorite, 2% Chlorhexidine, Guava Leaf Extract and Aloevera Extract Against Enterococcus faecalis and Candida albicans - An in-vitro Study.

INTRODUCTION: Debridement and disinfection of the root canal system is a critical step in endodontic treatment. Most of the irrigants presently used in the endodontic treatment can have an impact on the microbes surviving in the biofilm but none of them are able to do all of the required tasks. Researches are going on its full swing in order to produce an endodontic irrigant having ideal properties. AIM: To compare the antimicrobial efficacy of different irrigants like QMiX, guava leaf extract, aloevera extract, 2.5% sodium hypochlorite and 2% chlorhexidine gluconate against Enterococcus faecalis and Candida albicans. MATERIALS AND METHODS: The antimicrobial activity was determined using agar diffusion test. The solutions were divided into five groups: Group I- QMiX, Group II- Guava leaf extract and Group III-Aloevera extract, Group IV-2.5% Sodium hypochlorite and Group V-2% Chlorhexidine. The zones of inhibition of growth were recorded. RESULTS: Statistical analysis was performed using one way ANOVA with post-hoc Tukey's HSD. Values obtained were statistically analyzed (p<0.05). QMiX showed maximum inhibitory effect against Enterococcus faecalis and Candida albicans followed by, 2% chlorhexidine, 2.5% sodium hypochlorite, guava leaf extract and aloevera extract. Results obtained were statistically significant. CONCLUSION: Guava leaf extract showed significant inhibitory effects against Enterococcus faecalis and Candida albicans. QMiX demonstrated the best results among the tested solutions and can be considered as a potential alternative to existing root canal irrigants.