Postextraction Alveolar Preservation and Use of the Crown of the Extracted Tooth as a Temporary Restoration

Ranging from the extraction of teeth from anterior sector commitment to the loss of bone and soft tissues, alveolar preservation is a regenerative technique that employs biomaterials that induce the preservation of bone tissue and minimize resorption. Placement of provisional restorations at the defect site maintains the stability of the soft tissues and aesthetics at which the definitive restoration is found. The objective of this clinical case was alveolar preservation postextraction of the anterior tooth that presented a coronal fracture, placing the clinical crown of the extracted tooth as the provisional restoration to maintain stability and to avoid soft tissue collapse and compromise to an aesthetic area.

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A CLINICAL CASE OF REMOVING A RESIDUAL FOREIGN BODY FROM THE LEFT SUPRACLAVICULAR REGION

Inter Collegas ◽

10.35339/ic.4.3.120-122 ◽

2017 ◽

Vol 4 (3) ◽

pp. 120-122

Author(s):

V.V. Boyko ◽

V.V. Makarov ◽

A.L. Sochnieva ◽

V.V. Kritsak

Keyword(s):

Surgical Treatment ◽

Foreign Body ◽

Soft Tissue ◽

Clinical Case ◽

Foreign Bodies ◽

Soft Tissues ◽

Life Quality ◽

The Other ◽

Practical Case ◽

The One

Boyko V.V., Makarov V.V., Sochnieva A.L., Kritsak V.V.Residual foreign bodies in soft tissues are one of the main causes of chronical infection lesions and decrease in life quality. Surgical treatment is the most common way to relieve the patient from a foreign body. Often there is a question whether to remove a foreign body? On the one hand, all foreign bodies that are in the human body must be removed. On the other hand, in the absence of symptoms, the risk of surgery performed for the purpose of removal exceeds the risk associated with finding the foreign body. We would like to describe a practical case of removing a foreign body (Kirschner`s wires) from the left supraclavicular region. The young patient lived with a fragment of Kirschner's wire left after the osteosynthesis of the fractured clavicle for 5 years. Surgery to remove the residual foreign body was successful. On the 7th postoperative day the patient was discharged from the hospital under the supervision of surgeons at the place of residence.Key words: foreign body in soft tissue, Kirschner`s wire, surgical treatment. КЛІНІЧНИЙ ВИПАДОК ВИДАЛЕННЯ ЗАЛИШКОВ СТОРОННЬОГО ТІЛА З ЛІВОЇ НАДКЛЮЧИЧНОЇ ОБЛАСТІБойко В.В., Макаров В.В., Сочнева А.Л., Крицак В.В.Залишкові чужорідні тіла м'яких тканин залишаються однією з основних причин виникнення вогнища хронічної інфекції та зниження рівня якості життя. Хірургічне лікування основний спосіб позбавити хворого від наявності чужорідного агента. Часто виникає питання чи видаляти чужорідне тіло. З одного боку, усі сторонні тіла, що знаходяться в тілі людини, підлягають видаленню, з іншого боку при відсутності симптомів ризик операції, проводимої з метою видалення, перевищує ризик, пов'язаний з перебуванням чужорідного тіла. Ми хотіли б поділитися випадком видалення залишкового стороннього тіла (спиці Кіршнера) лівої надключичної ділянки із власної практики. Молода пацієнтка прожила з уламком спиці Кіршнера, залишеної після металлоостеосинтезу поламаної ключиці протягом 5 років. Операція з видалення залишкового стороннього тіла пройшла успішно. На 7 післяопераційну добу пацієнтка була виписана зі стаціонару під спостереження хірурги за місцем проживання.Ключові слова: чужорідне тіло м'яких тканин, спиця Кіршнера, хірургічне лікування. кЛИНИЧЕСКИЙ СЛУЧАЙ УДАЛЕНИЯ ОСТАТКОВ ИНОРОДНОГО ТЕЛА ИЗ ЛЕВОЙ ПОДКЛЮЧИЧНОЙ ОБЛАСТИ Бойко В.В., Макаров В.В., Сочнева А.Л., Крицак В.В.Остаточные инородные тела мягких тканей остаются одной из основных причин возникновения очага хронической инфекции и снижения уровня качества жизни. Хирургическое лечение основной способ избавить больного от наличия чужеродного агента. Часто возникает вопрос удалять ли инородное тело? С одной стороны, все инородные тела, находящиеся в теле человека, подлежат удалению, с другой стороны при отсутствии симптомов риск операции, производимой с целью удаления, превышает риск, связанный с нахождением инородного тела. Мы хотели бы поделится случаем удаления остаточного инородного тела (спицы Киршнера) левой надключичной области из собственной практики. Молодая пациентка прожила с обломком спицы Киршнера, оставленной после металлоостеосинтеза поломанной ключицы в течении 5 лет. Операция по удалению остаточного инородного тела прошла успешно. На 7 послеоперационные сутки пациентка была выписана из стационара под наблюдение хирурги по месту жительства.Ключевые слова: инородное тело мягких тканей, спица Киршнера, оперативное лечение.

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Total Hip Arthroplasty in Patient with Melorheostosis (Case Report)

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2019-25-3-135-142 ◽

2019 ◽

Vol 25 (3) ◽

pp. 135-142

Author(s):

V. V. Kuzin ◽

K. A. Egiazaryan ◽

A. P. Raksha ◽

A. P. Ratyev ◽

A. V. Kuzin ◽

...

Keyword(s):

Soft Tissue ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Clinical Case ◽

Soft Tissues ◽

Proximal Part ◽

Early Postoperative Period ◽

X Rays ◽

Total Hip ◽

Lower Back

Melorheostosis is a rare mesenchymal dysplasia of bone manifesting as regions of sclerosing and thickening of bone tissue. This disease may involve the adjacent soft tissues and lead to joint pain, limitation of joint motion, stiffness resulting from abnormal ossification and soft-tissue contractures due to periarticular fibrosis. The paper describes a clinical case of a patient who presented with pain and stiffness in the proximal part of the left hip which patient suffered for the last 10 years. At first the patient had intermittent pain in the lower back and left hip during and after walking. Radiographs revealed dense sclerotic and wavy cortex and hyperostosis involving the left iliac crest, the acetabulum, and the femur. CT angiography with contrast was performed for preoperative planning. During the procedure the authors performed total hip arthroplasty of the left hip with excision of fibro-ossifications in the left ilioinguinal area. Severe periarticular fibrosis of the soft tissue was observed intraoperatively and cartilage-like formation was visible around the joint. A sample of the ossification bone was resected for histologic confirmation of the diagnosis; extensive cortical sclerosis with varying thickness typical of melorheostosis was found. Early postoperative period went without complications following routine post-THR protocol. Postoperative X-rays at 6, 12, 24 months did not reveal any complications or new ossifications. Full ROM and pain-free function were achieved in the left hip and lower back of the patient. The present clinical case of total hip arthroplasty with excision of fibroossifications provided good clinical outcome for melorheostosis of the left hip.

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MULTIMODAL APPROACH IN THE RECONSTRUCTION OF FIRING DEFECTS OF THE LOWER LIMBS (CLINICAL CASE)

Science Review ◽

10.31435/rsglobal_sr/31102020/7220 ◽

2020 ◽

Author(s):

І. П. Хоменко ◽

К. В. Гуменюк ◽

С. О. Король ◽

Є. В. Цема ◽

Р. М. Михайлусов ◽

...

Keyword(s):

Soft Tissue ◽

Thermal Imaging ◽

Clinical Case ◽

Soft Tissues ◽

Gunshot Wounds ◽

Left Thigh ◽

Lower Limbs ◽

Wound Area ◽

Superficial Femoral Vein ◽

Second Stage

According connection with the global trends, manifested by an increase in the number of illegal firearms, an increase in social, political, ethnic, racial and religious conflicts, accompanied by the use of firearms, the problem of treating gunshot wounds is becoming increasingly important. It is especially acute during local and widespread hostilities, during peacekeeping missions, anti-terrorist operations, in cases of massive gunshot wounds. The aim of the work is to improve the surgical tactics in the reconstruction of severe wounded with soft tissue gunshot defects due to the multimodal scheme. Improvement of dynamic audio and thermal imaging diagnostics of the damaged anatomical area, analysis and modeling of the shape and direction of movement of the donor flap. A clinical case of closure of a bullet-through bullet wound of the left thigh (03.25.19 year) with a gunshot multi-fragment fracture of the left femoral pigtail in the middle third, damage to the superficial femoral vein and marginal damage to the superficial femoral artery was demonstrated.In the preoperative period, the first stage was dynamic digital thermography of the surface of wounds and surrounding soft tissues, which allowed thermal imaging to assess the state of damaged structures, to identify areas of preservation of blood supply. The second stage was the audio control of the identified areas of the "supply" - perforating vessels with a comparison of the blood flow velocity. The results obtained formed the basis for modeling the donor zone and monitoring its movement. The described clinical case of soft tissue defect closure consisted of three stages: The first stage - preparatory (diagnostics and cleaning) - (9 days of inpatient treatment) - repeated surgical treatment of wounds using low-frequency ultrasound (cavitation of the wound surface), controlled negative pressure (in a pulsed mode - 125 mm Hg), the imposition of secondary early sutures, due to which the wound area decreased by 35% compared to the wound area at the time of admission to the VICC of the Southern region. The second stage - the final (reconstructive) - (12 days after the injury) - plastic reconstruction of the defect of the posterior surface of the middle third of the left thigh by moving a ball-and-socket flap from the outer surface of the thigh using the Keystone technique. Conclusions: A multimodal algorithm with dynamic control of changes in the perfusion of the defect zone and surrounding structures is at the heart of the successful reconstruction of a gunshot defect in the soft tissues of the lower extremities, which reduces the treatment time by 1.5 times.

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Endocrown: a conservative approach

Brazilian Dental Science ◽

10.14295/bds.2016.v19i2.1156 ◽

2016 ◽

Vol 19 (2) ◽

pp. 121 ◽

Cited By ~ 3

Author(s):

Rafael Menezes-Silva ◽

Carlos Andres Villavicencio Espinoza ◽

Maria Tereza Atta ◽

Maria Fidela de Lima Navarro ◽

Sergio Kiyoshi Ishikiriama ◽

...

Keyword(s):

Clinical Case ◽

Treatment Time ◽

Therapeutic Option ◽

Acrylic Resin ◽

Case Description ◽

Tooth Structure ◽

Mandibular Molar ◽

And Performance ◽

The Stability ◽

Provisional Restoration

ABSTRACT The purpose of this clinical case description article was to present the planning sequence, indication, treatment and performance to obtain a crown of the Endocrown type. This clinical case description article illustrates a therapeutic option for functional and esthetic rehabilitation of a devitalized mandibular molar, presenting a small amount of remaining coronal tooth structure, by means of cementing a pure porcelain crown of the Endocrown type (Adhesive Endodontic Crown). A 39-year-old woman presented to the Graduate clinic of the Bauru Dental School (FOB), University of São Paulo (USP), with the complaint that tooth #36 had an extensive and unsatisfactory composite resin restoration. The lithium disilicate-based system of monolithic porcelain was used with the lost wax technique. This therapy promoted the stability and retention of the indirect restoration, without the need for performing reconstruction of the above mentioned tooth, either by means of a cast metal core or reconstruction with intracanal post, thereby reducing the treatment time. After the tooth preparation, the provisional restoration was done with acrylic resin to determine if the retention and stability of the remaining tooth was adequate to receive the indirect Endocrown restoration. The characteristics of the internal and external walls of the dental remnants, cervical termination, impression-taking, laboratory stages and adhesive cementation will be discussed. The major advantage of indicating an endocrown is the use of the dental remnants itself, particularly the pulp chamber, to promote retention and stability in cases without adequate height for performing complete dental and crown reconstruction.KeywordsAdhesive endodontic crown; Devitalized tooth; Lithium dissilicate.

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Imaging Features of Primary Tumors of the Hand

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200817173154 ◽

2020 ◽

Vol 16 ◽

Author(s):

Filippo Boriani ◽

Edoardo Raposio ◽

Costantino Errani

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Epithelioid Sarcoma ◽

Case Series ◽

Malignant Neoplasm ◽

Benign Tumors ◽

Imaging Features ◽

Primary Tumors ◽

Therapeutic Decisions ◽

Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

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Developing a Quantifying Device for Soft Tissue Material Prop-Erties around Lumbar Spines

Biosensors ◽

10.3390/bios11030067 ◽

2021 ◽

Vol 11 (3) ◽

pp. 67

Author(s):

Song Joo Lee ◽

Yong-Eun Cho ◽

Kyung-Hyun Kim ◽

Deukhee Lee

Keyword(s):

Lumbar Spine ◽

Soft Tissue ◽

Young’S Modulus ◽

Viscoelastic Properties ◽

Soft Tissues ◽

Young's Modulus ◽

Strain Curve ◽

Stress And Strain ◽

Commercial Device ◽

Tissue Material

Knowing the material properties of the musculoskeletal soft tissue could be important to develop rehabilitation therapy and surgical procedures. However, there is a lack of devices and information on the viscoelastic properties of soft tissues around the lumbar spine. The goal of this study was to develop a portable quantifying device for providing strain and stress curves of muscles and ligaments around the lumbar spine at various stretching speeds. Each sample was conditioned and applied for 20 repeatable cyclic 5 mm stretch-and-relax trials in the direction and perpendicular direction of the fiber at 2, 3 and 5 mm/s. Our device successfully provided the stress and strain curve of the samples and our results showed that there were significant effects of speed on the young’s modulus of the samples (p < 0.05). Compared to the expensive commercial device, our lower-cost device provided comparable stress and strain curves of the sample. Based on our device and findings, various sizes of samples can be measured and viscoelastic properties of the soft tissues can be obtained. Our portable device and approach can help to investigate young’s modulus of musculoskeletal soft tissues conveniently, and can be a basis for developing a material testing device in a surgical room or various lab environments.

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Quantification of assembly forces during creation of head-neck taper junction considering soft tissue bearing: a biomechanical study

Arthroplasty ◽

10.1186/s42836-021-00075-7 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Toni Wendler ◽

Torsten Prietzel ◽

Robert Möbius ◽

Jean-Pierre Fischer ◽

Andreas Roth ◽

...

Keyword(s):

Soft Tissue ◽

Work Experience ◽

Soft Tissues ◽

Force Sensor ◽

Biomechanical Study ◽

Measuring System ◽

Wide Range ◽

Head Neck

Abstract Background All current total hip arthroplasty (THA) systems are modular in design. Only during the operation femoral head and stem get connected by a Morse taper junction. The junction is realized by hammer blows from the surgeon. Decisive for the junction strength is the maximum force acting once in the direction of the neck axis, which is mainly influenced by the applied impulse and surrounding soft tissues. This leads to large differences in assembly forces between the surgeries. This study aimed to quantify the assembly forces of different surgeons under influence of surrounding soft tissue. Methods First, a measuring system, consisting of a prosthesis and a hammer, was developed. Both components are equipped with a piezoelectric force sensor. Initially, in situ experiments on human cadavers were carried out using this system in order to determine the actual assembly forces and to characterize the influence of human soft tissues. Afterwards, an in vitro model in the form of an artificial femur (Sawbones Europe AB, Malmo, Sweden) with implanted measuring stem embedded in gelatine was developed. The gelatine mixture was chosen in such a way that assembly forces applied to the model corresponded to those in situ. A study involving 31 surgeons was carried out on the aforementioned in vitro model, in which the assembly forces were determined. Results A model was developed, with the influence of human soft tissues being taken into account. The assembly forces measured on the in vitro model were, on average, 2037.2 N ± 724.9 N, ranging from 822.5 N to 3835.2 N. The comparison among the surgeons showed no significant differences in sex (P = 0.09), work experience (P = 0.71) and number of THAs performed per year (P = 0.69). Conclusions All measured assembly forces were below 4 kN, which is recommended in the literature. This could lead to increased corrosion following fretting in the head-neck interface. In addition, there was a very wide range of assembly forces among the surgeons, although other influencing factors such as different implant sizes or materials were not taken into account. To ensure optimal assembly force, the impaction should be standardized, e.g., by using an appropriate surgical instrument.

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Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus

Current Rheumatology Reports ◽

10.1007/s11926-021-01040-8 ◽

2021 ◽

Vol 23 (9) ◽

Author(s):

Andrea Di Matteo ◽

Gianluca Smerilli ◽

Edoardo Cipolletta ◽

Fausto Salaffi ◽

Rossella De Angelis ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Soft Tissue ◽

Lupus Erythematosus ◽

Structural Damage ◽

Structural Changes ◽

Soft Tissues ◽

Imaging Techniques ◽

Joint Involvement ◽

Systemic Lupus ◽

Muscle Involvement

Abstract Purpose of Review To highlight the potential uses and applications of imaging in the assessment of the most common and relevant musculoskeletal (MSK) manifestations in systemic lupus erythematosus (SLE). Recent Findings Ultrasound (US) and magnetic resonance imaging (MRI) are accurate and sensitive in the assessment of inflammation and structural damage at the joint and soft tissue structures in patients with SLE. The US is particularly helpful for the detection of joint and/or tendon inflammation in patients with arthralgia but without clinical synovitis, and for the early identification of bone erosions. MRI plays a key role in the early diagnosis of osteonecrosis and in the assessment of muscle involvement (i.e., myositis and myopathy). Conventional radiography (CR) remains the traditional gold standard for the evaluation of structural damage in patients with joint involvement, and for the study of bone pathology. The diagnostic value of CR is affected by the poor sensitivity in demonstrating early structural changes at joint and soft tissue level. Computed tomography allows a detailed evaluation of bone damage. However, the inability to distinguish different soft tissues and the need for ionizing radiation limit its use to selected clinical circumstances. Nuclear imaging techniques are valuable resources in patients with suspected bone infection (i.e., osteomyelitis), especially when MRI is contraindicated. Finally, dual energy X-ray absorptiometry represents the imaging mainstay for the assessment and monitoring of bone status in patients with or at-risk of osteoporosis. Summary Imaging provides relevant and valuable information in the assessment of MSK involvement in SLE.

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Micro-CT imaging of Thiel-embalmed and iodine-stained human temporal bone for 3D modeling

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-021-00522-0 ◽

2021 ◽

Vol 50 (1) ◽

Author(s):

Sebastian Halm ◽

David Haberthür ◽

Elisabeth Eppler ◽

Valentin Djonov ◽

Andreas Arnold

Keyword(s):

Soft Tissue ◽

Temporal Bone ◽

Middle Ear ◽

3D Modeling ◽

Soft Tissues ◽

Ct Imaging ◽

Micro Ct ◽

Data Set ◽

Iodine Staining ◽

Tissue Structures

Abstract Introduction This pilot study explores whether a human Thiel-embalmed temporal bone is suitable for generating an accurate and complete data set with micro-computed tomography (micro-CT) and whether solid iodine-staining improves visualization and facilitates segmentation of middle ear structures. Methods A temporal bone was used to verify the accuracy of the imaging by first digitally measuring the stapes on the tomography images and then physically under the microscope after removal from the temporal bone. All measurements were compared with literature values. The contralateral temporal bone was used to evaluate segmentation and three-dimensional (3D) modeling after iodine staining and micro-CT scanning. Results The digital and physical stapes measurements differed by 0.01–0.17 mm or 1–19%, respectively, but correlated well with the literature values. Soft tissue structures were visible in the unstained scan. However, iodine staining increased the contrast-to-noise ratio by a factor of 3.7 on average. The 3D model depicts all ossicles and soft tissue structures in detail, including the chorda tympani, which was not visible in the unstained scan. Conclusions Micro-CT imaging of a Thiel-embalmed temporal bone accurately represented the entire anatomy. Iodine staining considerably increased the contrast of soft tissues, simplified segmentation and enabled detailed 3D modeling of the middle ear.

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Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211007697 ◽

2021 ◽

pp. 105566562110076

Author(s):

Maria Costanza Meazzini ◽

Noah Cohen ◽

Valeria Marinella Augusta Battista ◽

Cristina Incorvati ◽

Federico Biglioli ◽

...

Keyword(s):

Soft Tissue ◽

Surgical Procedures ◽

Efficient Method ◽

Bone Grafting ◽

Cleft Lip ◽

Soft Tissues ◽

Cleft Lip And Palate ◽

Face Mask ◽

Younger Patients ◽

Good Healing

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

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