scholarly journals Comparison of outcome of two plate fixation with one plate fixation along with arch bar in management of parasymphysis; A Randomized Control Trial.

2020 ◽  
Vol 27 (09) ◽  
pp. 2007-2013
Author(s):  
Mohammad Umar ◽  
Jawad Ahmad Kundi ◽  
Muhammad Sulaiman ◽  
Muhammad Zaib Khan ◽  
Ali Altaf
Keyword(s):  
Plate Fixation ◽  
Maxillofacial Surgery ◽  
Treatment Protocol ◽  
Advantages And Disadvantages ◽  
Arch Bar ◽  
Group A ◽  
Group B ◽  
Inferior Border ◽  
Two Miniplates

Objectives: The aim of this study is to compare two plate fixation and one plate along with arch bar in the treatment of parasymphsis, and to analyze the advantages and disadvantages over one another. Study Design: Randomized Clinical Trial. Setting: Department of Oral and Maxillofacial Surgery Sardar Begam Dental College and Northwest General Hospital Peshawar. Period: Over a period of one year from June 2017 to August 2018. Material & Methods: 60 patients with parasymphysis fracture after diagnosis established on clinical and radiological examination were equally divided into two groups, 30 patients in each. Group (A) were treated with two miniplates, while Group (B) one miniplate along with arch  bar under general anesthesia with proper antibiotics coverage in the pre- and post-operative period. Results: The infection rate 4 (13.3%) patients in Group B while 0 in Group A. No Loosening /fracture of screw or plate occur in any subject in group A at any follow up visit, while it occurred in 4 subjects in group B at 15 days follow up period. 9 patients in Group A and 6 in Group B presented with immediate post of paresthesia, which was reduced to 7 patients in group A and 6 in group B at 15 days follow up, and to 4 patients in Group A and 5 in Group B at 1 month follow up. Similarly, no subject had inferior border misalignment in group A at any follow up period while 3 subjects have immediate post -op inferior border discrepancy in group B and 6 subjects in the same group shows inferior border discrepancy at 15 days , but the overall result of this variable was also statistically non-significant. Conclusion: Isolated mandibular parasymphysis fracture can be treated with either two miniplates or one miniplate along with arch bar for 6 weeks. Both treatment protocol shows advantages and disadvantages with the aim of achieving the best treatment outcome for the patients.

scholarly journals Caries Inhibition of Pit and Fissure Non Cavitated Lesions in Children by Low Level Lasers – A Clinical Study

2020 ◽  
pp. 13-21
Author(s):  
Lt Col Sonali Sharma ◽  
Lt Gen SM Londhe SM ◽  
Dr. Mithra N Hegde ◽  
Dr. Vandana Sadananda
Keyword(s):  
Treatment Protocol ◽  
Laser Fluorescence ◽  
Low Level ◽  
Level Laser ◽  
Mandibular Molar ◽  
Group A ◽  
Tooth Type ◽  
Group B ◽  
Serial Scanning

Background: The incipient non-cavitated carious lesion are characterized by subsurface dissolution which have potential to remineralize. Traditional remineralization protocols have varying results. An effective remineralizing protocol thus would be one which brings about a change in enamel crystal and makes it more resistant to acidic challenges of oral cavity. Material & Methods: 102 patients of either sex, between age of 6 - 18 years having incipient pit and fissure caries on first or second mandibular molar were selected and its respective contralateral tooth type served as control. Occlusal scanning for both groups was done by LASER fluorescence method (DIAGNOdent) and this was baseline value. Group B (Test) was irradiated with 810 nm AlGaAs low level LASER for 30 seconds followed by application of CPP-ACP F remineralizing paste. In Group a (Control) only remineralization paste was applied. The LASER fluorescence values were recorded after 7 days and the treatment protocol repeated. 18 months follow up at 6 monthly intervals included LASER fluorescence serial scanning. Fall in values from baseline indicates remineralization. Statistical analysis was done.

scholarly journals Arch Bar versus Titanium Mini-Plate Fixation in Anterior Segmental Osteotomy / Orthognathic Surgery (Cohort Clinical Study)

2021 ◽  
pp. 1-8
Author(s):  
Rawaa Y Al-Rawee ◽  
Bashar Abdul-Ghani Tawfeeq
Keyword(s):  
Wound Healing ◽  
Plate Fixation ◽  
Teaching Hospitals ◽  
P Value ◽  
Arch Bar ◽  
Gingival Health ◽  
Group A ◽  
Group B ◽  
Operation Results ◽  
Duration Of Operation

Aims and objectives: To compare the efficacy and outcome of arch bar versus plating fixation on the integrity of the osteomised segment. Materials And Methods: The study involved a total of 43 patients (86 jaws) undergoing upper (Wassmund) and lower (Kole) anterior segmental osteotomy from (2006-2013) in the Maxillofacial Department in Al-Salam Teaching Hospital/Mosul. The sample was divided into two groups, group A (43 jaws), the osteotomized segments fixed with the arch bar, while group B (43 jaws) fixed with mini-plates. The clinical evaluation includes the following criteria: pain, swelling, bleeding, wound healing, oral hygiene ,integrity of stabilization, relapse rate and duration of operation. Results: Clinical parameters as pain, swelling, and wound healing show no significant differences between groups; on the contrary, the bleeding scale and gingival health scale show very high significant differences in p-value. The integrity of stabilization immediately in operation reveals stable surgical correction in both groups. Still, one jaw from each group develops significant mobility (grade II) that necessitate the use of additional local types of fixation. Duration of operation: this manure could be operator skill dependent, in that most cases managed clinically in teaching hospitals necessitating some delayed time in operative work, but as a mean time overall patients in group A was 90 minutes, while in group B was 77 minutes. Conclusions: According to this study, we prefer to use an arch bar rather than manipulates for fixation of anterior segmental osteotomies. Key words: Arch Bar, Complication, Fixation, Miniplate, Osteotomy.

scholarly journals Autogenous Platelet Rich Plasma in Healing of Bone Defects

JMS SKIMS ◽  
2013 ◽  
Vol 16 (2) ◽  
pp. 90-94 ◽  
Author(s):  
Altaf H Malik ◽  
Ajaz A Shah ◽  
Rubeena Tabasum ◽  
Irshad Ahmad ◽  
Manzoor Ahmad
Keyword(s):  
Bone Growth ◽  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Maxillofacial Region ◽  
Group A ◽  
Oral And Maxillofacial Region ◽  
Group B ◽  
Regeneration Of Bone

Purpose: To evaluate the efficacy of PRP in regeneration of bone in defects of the oral and maxillofacial region. Methods: A comparative nonrandomized study including 40 patients with bony defects of cystic origin   in the maxillofacial region was carried out in the Department of Oral and Maxillofacial Surgery. Patients were divided into two groups: group A received PRP and in group B PRP was not used. Postoperatively, the patients were monitored regularly by radiographs to evaluate new bone growth at 1st  ,3rd and 6th month clinically and radiographically. Results: Faster bone healing in was observed in the patients in whom PRP was used at every follow up. Conclusion: Defects filled with PRP showed comparatively earlier and faster bone regeneration. JMS 2013;16(2):90-94

scholarly journals Comparison of Short Term Results of Type IIB2 Middle Third Clavicular Fractures Treated with Figure of Eight Bandage and Locked Plate Fixation

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0026
Author(s):  
Melih Malkoc ◽  
Ozgur Korkmaz ◽  
Erhan Bayram ◽  
Ali Seker ◽  
Murat Yılmaz ◽  
...  
Keyword(s):  
Constant Score ◽  
Plate Fixation ◽  
Locked Plate ◽  
Significant Difference ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Group A ◽  
Student’S T ◽  
Group B

Objectives: Most acute displaced midshaft clavicular fractures conventionally have been treated nonoperatively with the expectation of a high probability of fracture union, good functional outcomes, and a high level of patient satisfaction . However, the outcome of nonoperative treatment is not as favorable as once thought and there has been a growing trend to treat these fractures surgically We aimed to evaluate and compare the short term results of conservative treatment and locked plate fixation in the treatment of type IIB2 clavicula fractures according to Robinson classification in this study. Methods: Thirty eight patients with type IIB2 clavicula fractures according to Robinson classification were retrospectively reviewed. 20 patients who were treated conservatively were enrolled as group A and 18 patients who were operated with locked plate and screws were enrolled as group B. All patients were evaluated with Constant and Oxford scores in their last follow up control. For the patients that were treated conservatively (Group A) figure of eight bandage were applied for six week. Patients (Group B) were operated under general anesthesia in the beach chair position. A straight incision was made over the fracture line. Butterfly or free fragments in comminuted fractures were fixed to the main fragment with a lag screw in 3 patients before fracture reduction and plate fixation. Fracture reduction was performed with taking care of minimal periosteal stripping. After reduction of the main fragments, titanium alloy, locked anatomic compression plate were applied on the superior surface of the clavicle. A minimum of six cortexes were fixed with 3.5 mm locked cortical screws on the medial and lateral sides of the fracture. We did not need any Auto- or allografts during the surgery. Statistical analysis was performed between the scores of two groups. Conservative and surgical treated groups Oxford scores and Constant scores had normal distribution. For this reason Student's t test, and Non-parametric version of Student’s t test Mann Whitney U test were performed. 95% confidence interval and p <0.05 was considered significant as statistically. Results: Mean follow up period is 18 months (12-24 months). At the last follow-up, mean Constant score is 79.5 (98-43) and mean Oxford score was 46.35(49-44) for group A. In group B mean Constant score is 89.3(100-77) and mean Oxford score is 46,6(48-44) at the last follow-up. There were no patients who require any revision surgery in group B. Bone healing was detected in all fractures radiologically in both groups. There was no statistically significant difference between Oxford scores of the two groups (p=0,570). There was statistically significant difference between Constant scores of the two groups whereas results of Group B were better than group A (p=0,013) Surgical treatment with locked plate fixation in type IIB2 clavicle fractures according to Robinson Classification, can be the first treatment choice with better cosmetics, lower complication rate, and better outcomes. Conclusion: Surgical treatment with locked plate fixation in type IIB2 clavicle fractures according to Robinson Classification, can be the first treatment choice with better cosmetics, lower complication rate, and better outcomes.

scholarly journals Mandibular fractures in different pediatric age groups and their current management modalities

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Muhammad Usman Akhtar ◽  
Rafique Chatha ◽  
Adnan Ali Shah ◽  
Muhammad Anwaarul Haq
Keyword(s):  
Age Groups ◽  
Deciduous Teeth ◽  
Mandibular Fractures ◽  
Rigid Fixation ◽  
Arch Bar ◽  
Group A ◽  
Group B ◽  
Condylar Fractures ◽  
Group D

Background: A number of cases of growing age trauma within oro-facial region have been observed in Pakistan, unlike developed countries of world. Mandibular fractures occur in greater frequency than those of the middle third of the face in children, later being very small and plastic comparative to mandible. These fractures of mandible do not demonstrate different clinical features as compared to adults but there is relative difference in treatment management due to, different patterns and plasticity of the facial bones in children, developing tooth buds at different levels in the jaws, mixed dentition, shedding deciduous teeth and incomplete roots of anterior teeth. The causes and patterns of fracture in children older than 12 years resemble to those found in adults. Mandibular fractures are common in Pakistan and commonly related etiology is accidental fall. Method: 57 patients presented with mandibular fractures at Oral and Maxillofacial Surgery department of Punjab Dental Hospital and Children Complex Hospital, Lahore from September 2003 to September 2005. The age of the patients ranged from infancy to early teenage (6 month to 15 years). After confirming diagnosis, the children were divided into following four groups; Group "A" (Infants), Group "B" (Pre-school), Group "C" (School) and Group "D" (Teenage). All patients were treated with one of the following treatment modalities, depending upon the site of fracture and age group of the patients; Micro and miniplates, Eric arch bar splints, Acrylic splints, Ivy eyelet wires, Trans-osseous wiring and Conservative treatment. Results: Group "A" of only 3 patients was managed with open reduction and microplate rigid fixation. Six months follow up showed healing without any complications. Group `B` with 60% males, had mostly body fractures, was treated with acrylic splints and circummandibular wires. Two bilateral body fractures, with avulsed few teeth, were fixed with rigid fixation. Five patients of about age 3 with minimally displaced body fractures were man aged with Eric arch bar fixation alone. Two bilateral condylar bowing fractures were treated conservatively (no active treatment) with no TMJ complications during follow up. The mandibular trauma was noticed exceedingly high in group `C` with overall 50.87% and exclusively in males (90%). Acrylic splints were utilized to treat either condyle with body fractures or condyles alone. Two children had postoperative ipsilateral jaw deviation on opening, which was improved with reverse elastic exercises during follow up. Five patients of high condylar fractures with either no or minimum occlusal disturbance, were conservatively managed. Early mobilization was the prime concern in them to avoid late complications. 17.54 % patients were of group `D` with again high male (90%) ratio. Two horizontally unfavorable angle fractures were managed by trans-osseous wires. Five with minimum displacement were managed with miniplates rigid fixation. All others` with associated condylar fractures were treated with Eric arch bar splint with one plate at body and intermaxillary fixation for two weeks. Conclusion: The patterns and management modalities of pediatric mandibular fractures vary in different age groups. The pediatric fractures should be managed as early as possible to avoid complications. Majority of trauma results in school going and teenage groups with definite high male proportion. High condylar fractures should be treated with extra care, keeping in mind of post traumatic TMJ ankylosis. Acrylic splints showed ideal results in body and condylar fractures, whereas, microplates may be the treatment of choice in infants with no or few deciduous teeth. No serious complications were observed during 6 months follow up.

scholarly journals THE EFFECT OF THERAPUETIC ULTRASOUND AND PHONOPHORESIS ON TMJ PAIN

2020 ◽  
pp. 35-37
Author(s):  
Joyce Sequeira ◽  
Thejas Girishan
Keyword(s):  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Oral And Maxillofacial Surgery ◽  
Pain Status ◽  
Group A ◽  
Tmj Pain ◽  
Group B ◽  
Larger Sample

Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual's life with phases of symptoms affecting the quality of life. Taking into consideration the application of different physical therapies for the reduction of this pain, this study is to compare the effect of ultrasonic therapy and phonophoresis on TMJ pain. Material and methods: The study Sample consist of twenty clinically confirmed cases of TMJ pain, visiting the dental clinic of the Department of oral and maxillofacial surgery, Yenepoya Dental College, Mangalore. They were divided into two groups- Group A patients (n=10) received Hydrocortisone Phonophoresis therapy and Group B patients (n=10) received only Ultrasound, daily for a period of 7 days. The outcome were measured by Pain Status & mouth opening, measured using VAS and vernier calliper. Results: After the treatment period score of the Group-A who received Hydrocortisone Phonophoresis is significantly higher than Group-B on the Pain Intensity and Improvement in mouth opening when analysed using independent ‘t’ test at p<0.05 Conclusion: The data suggest that phonophoresis therapy can be used as an treatment modality in controlling pain associated with TMDs. However, further studies on larger sample size with longer follow up periods are required.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

COMPARATIVE ANALYSIS OF CLOSED REDUCTION AND EXPERT TIBIA NAILING WITH OPEN REDUCTION AND PLATE & SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES

2018 ◽  
Author(s):  
Anil Pandey ◽  
Setul Shah ◽  
Deepak S Maravi ◽  
S Uikey
Keyword(s):  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Proximal Tibia ◽  
Plate Fixation ◽  
Surgical Site Infections ◽  
Delayed Union ◽  
Large Sample Size ◽  
Multicentric Study ◽  
Group A ◽  
Group B

Introduction:- Extra-articular proximal tibial fractures account for 5–10 % of all tibial shaft fractures and it result from high-velocity trauma. Closed reduction with minimally invasive plating and locked intramedullary  nailing have been widely used for treatment of proximal tibia extraarticular fractures. Our pupose is to compare the pros and cons of these two methods. Materials and methods:- 22 patients were included in this study for a period of 2 years. Patients treated with IMN were kept in group A patients treated with percutaneus plating were kept in group B. Standard approach of nailing and plating were used and proper follow up were taken for next upcoming 1 year. Results:- Combined average age was 38years. Male were more commonly affected than female (13:8). Majority of fracture were of type A33. Operative time was < 2 hours in both groups. Less blood loss occurred during intramedullary nailing as compared to locking plate fixation. Surgical site infections (SSIs) were seen in two patients in the PTP group. Delayed union occurred in two patients in the IMN group. The average range of motion was 119.7(range 90-150, SD= 19.18) in group A and 115.2(range 80-150, SD = 17.28) in group B. Conclusion:- in treatment of proximal tibia extra articular fracture use of IMN and PTLCP gives comparable results. To validate this issue further a large sample size multicentric study is recommended   Key words: intramedullary nailing (IMN), Extraarticular tibialn fracture, Surgical site infection.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

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