Semi-occlusive dressing for the treatment of fingertip amputations with exposed bone: quantity and quality of soft-tissue regeneration

2013 ◽  
Vol 39 (5) ◽  
pp. 505-509 ◽  
Author(s):  
D. Hoigné ◽  
U. Hug ◽  
M. Schürch ◽  
M. Meoli ◽  
U. von Wartburg
Keyword(s):  
Soft Tissue ◽  
Tissue Thickness ◽  
Occlusive Dressing ◽  
Soft Tissue Regeneration ◽  
Soft Tissue Thickness ◽  
Exposed Bone ◽  
Bone Quantity ◽  
Palmar Aspect

Nineteen fingertip amputations with exposed bone were treated with a semi-occlusive dressing. The quantity and quality of the regenerated soft tissue was examined. In all 19 fingers there was sufficient uncomplicated healing such that secondary surgical procedures were not needed. At follow-up 6–18 months after the injury, soft tissue thickness around the bone of the distal phalanx measured 6.0 mm (SD 1.6) on the palmar aspect (opposite side 7.0 mm (SD 0.8)) and 4.2 mm (SD 1.7) distally (opposite side 4.5 mm (SD 0.8)). The two-point discrimination was 4 mm (SD 2) (opposite side 3 mm (SD 1)). The skin healed almost without scarring and the dermal ridges reformed. The regeneration of the soft tissue thickness to almost 90% of its former extent is higher than we expected.

Gingival Thickness and Outcome of Periodontal Plastic Surgery Procedures: A Meta-regression Analysis

2020 ◽  
pp. 238008442094217
Author(s):  
L. Paternò Holtzman ◽  
G. Blasi ◽  
E. Rivera ◽  
F. Herrero ◽  
K. Downton ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Secondary Outcome ◽  
Root Coverage ◽  
Tissue Thickness ◽  
Gingival Thickness ◽  
Soft Tissue Thickness ◽  
Periodontal Plastic Surgery ◽  
The Impact

Objective: To evaluate the impact of soft tissue thickness (STT) on root coverage achieved with different periodontal plastic surgery procedures. Background: Gingival recession has been managed successfully through various surgical approaches, with great variability in outcomes. Anatomic characteristics of the recipient site and selected technique account in part for this variability. Gingival flap thickness is one of the most critical site-related characteristics. Methods: An electronic search was conducted on the major databases (PubMed, Embase, Web of Science). Human prospective studies with at least 6 mo of follow-up and with a numeric baseline measurement for gingival thickness were eligible. Only studies including nonsmoking patients were considered. Variables included surgical approach, participant characteristics, local anatomic factors, and follow-up time. Primary outcome was mean percentage root coverage (%RC) achieved, and complete root coverage was a secondary outcome. Results: A total of 42 studies were included (35 randomized controlled trials, 5 case series, 1 prospective cohort study, and 1 controlled clinical trial). Across studies, the pooled %RC was 81.9% (95% CI, 79.1% to 84.7%). The %RC was not significantly associated ( P = 0.267) with baseline soft tissue thickness; however there was a significant ( P = 0.031) inverse relationship between STT and %RC after 12-mo follow-up. Subgroup analysis showed that for no graft, there was a significant ( P = 0.025) positive relationship between STT and %RC with the exclusion of the single outlier study based on STT. Conclusions: STT plays a limited role in predicting root coverage across all approaches; when flaps are performed with no graft, the effect of STT is most critical. The length of time following surgery appears to influence outcomes, with 12-mo follow-up offering greater insight. Knowledge Transfer Statement: The results of this study can suggest to clinicians which periodontal plastic surgery technique to employ when treating challenging cases. In particular, it can be helpful when selecting the treatment approach to treat thin phenotype sites. This study could help clinicians provide a more appropriate treatment decision in such cases.

Anterior cervical discectomy and fusion with a zero-profile integrated plate and spacer device: a clinical and radiological study

2014 ◽  
Vol 21 (4) ◽  
pp. 529-537 ◽  
Author(s):  
Innocent Njoku ◽  
Marjan Alimi ◽  
Lewis Z. Leng ◽  
Benjamin J. Shin ◽  
Andrew R. James ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Anterior Cervical Discectomy ◽  
Tissue Thickness ◽  
Postoperative Dysphagia ◽  
Cervical Discectomy ◽  
Vas Score ◽  
Soft Tissue Thickness ◽  
Prevertebral Soft Tissue ◽  
Vas Scores

Object Anterior cervical plating decreases the risk of pseudarthrosis following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-profile, stand-alone polyetheretherketone (PEEK) interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited. The object of the present study was to determine the clinical and radiological outcomes for patients who underwent ACDF using a zero-profile integrated plate and spacer device, with a focus on the course of postoperative prevertebral soft-tissue thickness and the incidence of dysphagia. Methods Using a surgical database, the authors conducted a retrospective analysis of all patients who had undergone ACDF between August 2008 and October 2011. All patients received a Zero-P implant (DePuy Synthes Spine). The Neck Disability Index (NDI) and visual analog scale (VAS) scores for arm and neck pain were documented. Dysphagia was determined using the Bazaz criteria. Prevertebral soft-tissue thickness, spinal alignment, and subsidence were assessed as well. Results Twenty-two male and 19 female consecutive patients, with a mean age of 58.4 ± 14.68, underwent ACDF (66 total operated levels) in the defined study period. The mean clinical follow-up in 36 patients was 18.6 ± 9.93 months. Radiological outcome in 37 patients was assessed at a mean follow-up of 9.76 months (range 7.2–19.7 months). There were significant improvements in neck and arm VAS scores and the NDI following surgery. The neck VAS score improved from a median of 6 (range 0–10) to 0 (range 0–8; p < 0.001). The arm VAS score improved from a median of 2 (range 0–10) to 0 (range 0–7; p = 0.006). Immediate postoperative dysphagia was experienced by 58.4% of all patients. Complete resolution was demonstrated in 87.8% of affected patients at the latest follow-up. The overall median Bazaz score decreased from 1 (range 0–3) immediately postoperatively to 0 (range 0–2; p < 0.001) at the latest follow-up. Prevertebral soft-tissue thickness significantly decreased across all levels from a mean of 15.8 ± 4.38 mm to 10.1 ± 2.93 mm. Postoperative lordosis was maintained at the latest follow-up. Mean subsidence from the immediate postoperative to the latest follow-up was 4.1 ± 4.7 mm (p < 0.001). Radiographic fusion was achieved in 92.6% of implants. No correlation was found between prevertebral soft-tissue thickness and Bazaz dysphagia score. Conclusions A zero-profile integrated plate and spacer device for ACDF surgery produces clinical and radiological outcomes that are comparable to those for nonintegrated plate and spacer constructs. Chronic dysphagia rates are comparable to or better than those for previously published case series.

scholarly journals Improvement of Quality of Life with Implant-Supported Mandibular Overdentures and the Effect of Implant Type and Surgical Procedure on Bone and Soft Tissue Stability: A Three-Year Prospective Split-Mouth Trial

2019 ◽  
Vol 8 (6) ◽  
pp. 773 ◽  
Author(s):  
Ron Doornewaard ◽  
Maarten Glibert ◽  
Carine Matthys ◽  
Stijn Vervaeke ◽  
Ewald Bronkhorst ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Soft Tissue ◽  
High Survival ◽  
Success Rates ◽  
Tissue Thickness ◽  
Implant Surface ◽  
Soft Tissue Thickness ◽  
Chewing Ability ◽  
Mandibular Overdenture

In fully edentulous patients, the support of a lower dental prosthesis by two implants could improve the chewing ability, retention, and stability of the prosthesis. Despite high success rates of dental implants, complications, such as peri-implantitis, do occur. The latter is a consequence of crestal bone loss and might be related to the implant surface and peri-implant soft tissue thickness. The aim of this paper is to describe the effect of implant surface roughness and soft tissue thickness on crestal bone remodeling, peri-implant health, and patient-centered outcomes. The mandibular overdenture supported by two implants is used as a split-mouth model to scrutinize these aims. The first study compared implants placed equicrestal to implants placed biologically (i.e., dependent on site-specific soft tissue thickness). The second clinical trial compared implants with a minimally to a moderately rough implant neck. Both studies reported an improvement in oral health-related quality of life and a stable peri-implant health after three years follow-up. Only equicrestal implant placement yielded significantly higher implant surface exposure, due to the establishment of the biologic width. Within the limitations of this study, it can be concluded that an implant supported mandibular overdenture significantly improves the quality of life, with limited biologic complications and high survival rates of the implants.

Comparison of Peri-implant Soft Tissue Color with the Use of Pink-Neck vs Gray Implants and Abutments Based on Soft Tissue Thickness: A 6-Month Follow-up Study

2020 ◽  
Vol 33 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Nurit Bittner ◽  
Ulrike Schulze-Späte ◽  
Silva Cleber ◽  
John Da Silva ◽  
David Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Thickness ◽  
Follow Up Study ◽  
Soft Tissue Thickness

ZERO-PROFILE ANCHORED SPACER SYSTEM IN THE TREATMENT OF CERVICAL DEGENERATIVE DISEASE WITH A FOLLOW-UP OF 1 YEAROUR EXPERIENCE .

2021 ◽  
pp. 64-67
Author(s):  
Harish chandra Gupta ◽  
Alok Nath ◽  
Subhasis Ghosh ◽  
Sudipto Chatterjee ◽  
Shubhamitra Chaudhuri
Keyword(s):  
Soft Tissue ◽  
Intervertebral Disc ◽  
Degenerative Diseases ◽  
Tissue Thickness ◽  
Postoperative Dysphagia ◽  
Soft Tissue Thickness ◽  
Intervertebral Disc Height ◽  
Prevertebral Soft Tissue ◽  
Vas Scores

Objects: Anterior cervical plating decreases the risk of pseudarthrosis, increases rate of fusion following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-prole, stand-alone interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited. We are reporting our ndings in term of clinico-radiological outcomes following the use of such devices in the treatment of cervical spine degenerative diseases with a focus on the course of postoperative prevertebral soft-tissue thickness and the incidence of dysphagia. The authors conducted a prospective analysis of all Methods: patients who had undergone ACDF between December 2018 and December 2019. All patients received a Zero-P implant (DePuy Synthes Spine).The Neck Disability Index (NDI),Modied Japanese Orthopaedic Association Score(mJOA) and visual analog scale (VAS) scores for arm and neck pain were documented. Dysphagia was determined using the Bazaz criteria. Prevertebral soft-tissue thickness, spinal alignment, intervertebral disc height were assessed as well. The nal outcome was assessed with Odom's criteria. Total 30 patients Results: were studied prospectively, and data were collected and analyzed. 17 male and 13 female consecutive patients, with a mean age of 48.28 ± 8.17 years, underwent ACDF with Zero-Prole spacer (42 total operated levels) in the dened study period. There were signicant improvements in neck and arm VAS scores, the NDI and mJOA scores following surgery at last follow up. The neck VAS score improved from a mean 7.34 ±1.87 to 1.04 ± 0.09 (p<0.01) . The arm VAS score improved from 7.22±2.03 to1.03±0.10 at latest follow up. NDI score improved signicantly from preoperative 31.94±6.73 to 12.87±5.24 and mJOAscore improved from preoperative 9.53±1.98 to 15.6±1.26 at last follow up. Immediate postoperative dysphagia was experienced by 36.67% of all patients. Complete resolution of dysphagia was demonstrated at the latest follow-up. Prevertebral soft-tissue thickness at postoperative 48 hrs decreased across all levels from a mean of 15.87 ±0.69 to 11.81 ± 0.53 mm at last follow up. Cervical alignment and intervertebral disc height were also improved signicantly after surgery. Radiographic fusion was achieved in 100% of implants. No correlation was found between prevertebral soft-tissue thickness and Bazaz dysphagia score. Majority of the patients had excellent outcomes in odom's criteria. Conclusions: Zero-Prole device is a safe and effective alternative for the treatment of cervical degenerative diseases. Chronic dysphagia rates are comparable to or better than those for previously published case series.

Accuracy of robot-assisted versus optical frameless navigated stereoelectroencephalography electrode placement in children

2019 ◽  
Vol 23 (3) ◽  
pp. 297-302 ◽  
Author(s):  
Julia D. Sharma ◽  
Kiran K. Seunarine ◽  
Muhammad Zubair Tahir ◽  
Martin M. Tisdall
Keyword(s):  
Soft Tissue ◽  
Entry Point ◽  
Electrode Placement ◽  
Target Point ◽  
Localization Error ◽  
Bone Thickness ◽  
Tissue Thickness ◽  
Robot Assisted ◽  
Soft Tissue Thickness ◽  
Safety Margins

OBJECTIVEThe aim of this study was to compare the accuracy of optical frameless neuronavigation (ON) and robot-assisted (RA) stereoelectroencephalography (SEEG) electrode placement in children, and to identify factors that might increase the risk of misplacement.METHODSThe authors undertook a retrospective review of all children who underwent SEEG at their institution. Twenty children were identified who underwent stereotactic placement of a total of 218 electrodes. Six procedures were performed using ON and 14 were placed using a robotic assistant. Placement error was calculated at cortical entry and at the target by calculating the Euclidean distance between the electrode and the planned cortical entry and target points. The Mann-Whitney U-test was used to compare the results for ON and RA placement accuracy. For each electrode placed using robotic assistance, extracranial soft-tissue thickness, bone thickness, and intracranial length were measured. Entry angle of electrode to bone was calculated using stereotactic coordinates. A stepwise linear regression model was used to test for variables that significantly influenced placement error.RESULTSBetween 8 and 17 electrodes (median 10 electrodes) were placed per patient. Median target point localization error was 4.5 mm (interquartile range [IQR] 2.8–6.1 mm) for ON and 1.07 mm (IQR 0.71–1.59) for RA placement. Median entry point localization error was 5.5 mm (IQR 4.0–6.4) for ON and 0.71 mm (IQR 0.47–1.03) for RA placement. The difference in accuracy between Stealth-guided (ON) and RA placement was highly significant for both cortical entry point and target (p < 0.0001 for both). Increased soft-tissue thickness and intracranial length reduced accuracy at the target. Increased soft-tissue thickness, bone thickness, and younger age reduced accuracy at entry. There were no complications.CONCLUSIONSRA stereotactic electrode placement is highly accurate and is significantly more accurate than ON. Larger safety margins away from vascular structures should be used when placing deep electrodes in young children and for trajectories that pass through thicker soft tissues such as the temporal region.

A dense approach for computation of facial soft tissue thickness data

2021 ◽  
pp. 200460
Author(s):  
Diana Toneva ◽  
Silviya Nikolova ◽  
Stanislav Harizanov ◽  
Dora Zlatareva ◽  
Vassil Hadjidekov
Keyword(s):  
Soft Tissue ◽  
Tissue Thickness ◽  
Facial Soft Tissue ◽  
Soft Tissue Thickness
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