scholarly journals Epi-Mucosa Fixation and Autologous Platelet-Rich Fibrin Treatment in Medication-Related Osteonecrosis of the Jaw

2021 ◽  
Vol 9 (5) ◽  
pp. 50
Author(s):  
Antonio Cortese ◽  
Antonio Casarella ◽  
Candace M. Howard ◽  
Pier Paolo Claudio
Keyword(s):  
Osteonecrosis Of The Jaw ◽  
Mandibular Fracture ◽  
Surgical Removal ◽  
Necrotic Bone ◽  
Platelet Rich Fibrin ◽  
Surgical Field ◽  
High Doses ◽  
New Treatment ◽  
Fracture Risks

Medication-related osteonecrosis of the jaw (MRONJ) frequently affects patients after treatments with bisphosphonates or denosumab, especially with high doses in patients with bone osteoporosis, neoplastic metastases, or possibly anti-angiogenic treatment for cancer. The aim of this article was to show a new treatment planning for stage 2 and stage 3 MRONJ using platelet-rich fibrin (PRF) at the surgical field to enhance healing in association with a new epi-mucosal fixation technique to prevent or treat mandibular fracture. Two cases were treated by epi-mucosa fixation and autologous PRF use for prevention of mandibular fracture risks related to necrotic bone resection or a narrow fracture reduction. Both cases were successfully treated by this new technique of epi-mucosa fixation combined with autologous PRF and achieved good results and good quality of life. Ability to wear prosthesis with good mastication in the absence of side effect such as infection, plate and screw mobilization, pain, and other disabilities or extension of necrosis was reported. After surgical removal of necrotic bone, no infection was detected without any extension of the necrosis.

scholarly journals A Systematic Review of Oxygen Therapy for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ)

2019 ◽  
Vol 9 (5) ◽  
pp. 1026 ◽  
Author(s):  
Roberto Sacco ◽  
Racheal Leeson ◽  
Joseph Nissan ◽  
Sergio Olate ◽  
Carlos Bettoni Cruz de Castro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Osteonecrosis Of The Jaw ◽  
Level Of Evidence ◽  
Nonsurgical Management ◽  
Published Evidence ◽  
Antiangiogenic Drugs ◽  
Skeletal Related Events ◽  
High Doses ◽  
Antiangiogenic Drug

Background: Medication-related osteonecrosis of the jaw (MRONJ) can be a life changing iatrogenic complication of antiresorptive and antiangiogenic drug therapy. It is most often associated with high doses of these medications that are used to prevent skeletal-related events in patients with cancer and bone pathologies. Unfortunately, managing MRONJ lesions has proven difficult and remains a major challenge for clinicians. Due to the lack of efficacy in treating MRONJ by surgical modalities (local debridement and free flap reconstruction), the nonsurgical management of MRONJ is still advocated to aid healing or avoid disease progression. The aim of this systematic review is to identify, analyse and understand the published evidence related to the success of oxygen therapies such as ozone (OT) and hyperbaric oxygen (HBO) in treating MRONJ. Material and methods: A multi-database (PubMed, MEDLINE, EMBASE, CINAHL and Cochrane CENTRAL) systematic search was performed by three authors. The identified articles were independently assessed for their risk of bias. Any type of study evaluating humans treated with antiresorptive and antiangiogenic drugs were considered. The aim is primarily to evaluate the success of OT and HBO in resolving MRONJ and secondarily to identify any improvements in quality of life (QoL), rate of complications, time-to-event and severity of side effects related to these treatments. Results: In total, just 13 studies were eligible for analysis. A pooled total of 313 patients (HBO group n = 82; OT group n = 231) described in these studies have shown good tolerance for oxygen therapies. Complete resolution of MRONJ was reported in 44.58% of OT patients but only 5.17% of the HBO group. Progression of MRONJ was reported only in the HBO studies in 10.34% of cases (6 patients). The quality of evidence was low or very low in all studies. This was due to limitations in how the studies were designed, run and reported. Conclusions: Based on the limited data available, it is difficult to suggest OT is better or worse than HBO or whether it is better than a placebo. As the level of evidence available is low, this necessitates larger well-designed trials to justify these interventions for patients affected by MRONJ.

Systematic literature review of clinical outcomes in adults with metastatic or advanced synovial sarcoma

2020 ◽  
Vol 16 (35) ◽  
pp. 2997-3013
Author(s):  
Kentaro Kogushi ◽  
Michael LoPresti ◽  
Shunya Ikeda
Keyword(s):  
Synovial Sarcoma ◽  
High Frequency ◽  
Clinical Evidence ◽  
Systemic Treatment ◽  
Progression Free Survival ◽  
Treatment Modalities ◽  
Free Survival ◽  
New Treatment ◽  
Poor Outcomes

Background: Synovial sarcoma (SS) is a rare, aggressive soft tissue sarcoma with a poor prognosis after metastasis. The objective of this study was to conduct a systematic review of the clinical evidence for therapeutic options for adults with metastatic or advanced SS. Materials & methods: Relevant databases were searched with predefined keywords. Results: Thirty-nine publications reported clinical data for systemic treatment and other interventions. Data on survival outcomes varied but were generally poor (progression-free survival: 1.0–7.7 months; overall survival: 6.7–29.2 months) for adults with metastatic and advanced SS. A high frequency of neutropenia with systemic treatment and low quality of life post-progression were reported. Conclusion: Reported evidence suggests poor outcomes in adults with metastatic and advanced SS and the need for the development of new treatment modalities.

Comparison of two high doses of subcutaneous buprenorphine in cats undergoing ovariohysterectomy

2019 ◽  
Vol 24 (10) ◽  
pp. 504-514
Author(s):  
Rosa Leedham ◽  
Kate L White ◽  
David Yates ◽  
Lauren Brown
Keyword(s):  
Clinical Study ◽  
Acute Pain ◽  
Pain Scale ◽  
Rescue Analgesia ◽  
Physiological Variables ◽  
Blinded Observer ◽  
High Doses ◽  
Induction Of Anaesthesia ◽  
To Receive

Objectives: The aim of the study was to evaluate the analgesia and recovery effects of two doses (0.12 mg/kg and 0.24 mg/kg) of subcutaneous buprenorphine in cats undergoing ovariohysterectomy. Methods: This was an assessor-blinded, randomised, clinical study. A total of 83 cats were recruited and randomly allocated to receive 0.12 mg/kg buprenorphine or 0.24 mg/kg buprenorphine subcutaneously, followed 30 minutes later by 40 μg/kg medetomidine intramuscularly. Anaesthesia was induced with intravenous alfaxalone to effect and maintained with isoflurane in oxygen. All cats received meloxicam before surgery. Temperament score, quality of sedation, induction of anaesthesia, dose of alfaxalone and recovery were scored using simple descriptive scales. Atipamazole was administered following surgery. Physiological variables during anaesthesia were recorded. Cats were assessed postoperatively by the same blinded observer at 2, 4 and 24 hours using a modified Colorado Feline Acute Pain scale. The presence or absence of mydriasis was noted. Results: No significant differences were identified between groups. Three cats in the 0.12 mg/kg group and four in the 0.24 mg/kg group required rescue analgesia. Mydriasis persisting for at least 24 hours was evident in 75 cats. Conclusions and relevance: No differences in analgesia were detected between groups with these protocols; mydriasis was common in both groups.

scholarly journals Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars

2021 ◽  
Vol 18 (16) ◽  
pp. 8249
Author(s):  
Grzegorz Trybek ◽  
Justyna Rydlińska ◽  
Magda Aniko-Włodarczyk ◽  
Aleksandra Jaroń
Keyword(s):  
Treatment Process ◽  
Infectious Complications ◽  
Control Group ◽  
Surgical Removal ◽  
Study Group ◽  
Impacted Tooth ◽  
Platelet Rich Fibrin ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.

scholarly journals A guide to do randomized controlled trials in the field of otolaryngology

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Sameh M. Zamzam ◽  
Mosaad Abdel-Aziz ◽  
Ahmed Atef ◽  
Usama Abdel-Naseer ◽  
Mostafa Hamoda ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Study Groups ◽  
Controlled Trials ◽  
Main Body ◽  
Main Research ◽  
Randomized Controlled ◽  
New Treatment ◽  
Meta Analyses ◽  
Based Medicine

Abstract Background Randomized controlled trials (RCTs) are prospective comparative studies in which study groups are allocated randomly to intervention or serve as controls. RCT is the mainstay to achieve evidence in the literature in clinical research. A RCT is the main research design to study the effect of an intervention and the only way to confirm the value of a new treatment. Main body RCT also gives the way to generate meta-analyses and systematic reviews giving a stronger evidence for clinical practice. Evidence-based medicine (EBM) is crucial for safe, effective, and standardized patient care. Although there is an agreement on the importance of performing RCT, it can be challenging to do it efficiently including different aspects like study design, funding, randomization, blinding, follow-up, data analysis, statistics, generalization of results, and reporting of quality of the studies. Conclusion In this article, we gave a comprehensive review for RCT in otolaryngology discussing their importance, advantages, and drawbacks, types, steps, challenges, reporting their quality and their prevalence in the literature.

Climate impact of an optimised gas treatment on old landfills

2022 ◽  
pp. 0734242X2110701
Author(s):  
Roland Berger ◽  
Joachim Lehner
Keyword(s):  
New Technology ◽  
Landfill Gas ◽  
Calorific Value ◽  
Climate Impact ◽  
Treatment Technology ◽  
Gas Treatment ◽  
Treatment Measures ◽  
Established Fact ◽  
New Treatment

It is a well-established fact that the quality and quantity of landfill gas (LFG) start declining after a landfill is closed to further waste intake. Conventional gas treatment and utilisation systems such as flares and gas-driven engines require a certain quality of LFG: specifically, a sufficient methane concentration. Various measures are utilised to maintain the necessary quality of LFG, including a turn-down of gas extraction rates and a shutdown of low-quality gas wells, resulting in a decline of LFG production. This, however, does not have to be the case. The low calorific value (LCV) LFG capture and treatment technology developed by e-flox and referred to in this article as ‘LCV LFG System’ can significantly increase the collection rate and the amount of treated methane in an old landfill. This article introduces such new treatment measures, describes gas capture calculation methodologies and presents actual results based on a medium-sized landfill in Germany. The study demonstrates, among other things, that the LCV LFG system can reduce the CO2 avoidance costs to roughly 10 €/tCO2eq. We present this new technology as a quick and straightforward measure of dealing with the climate issues related to methane emissions of old landfills.

scholarly journals Platelet rich fibrin in dentistry: A review of literature

2015 ◽  
Vol 3 (2) ◽  
pp. 72 ◽  
Author(s):  
Vishnu Ravi Kumar ◽  
Gayathri Gangadharan
Keyword(s):  
First Generation ◽  
Platelet Rich Plasma ◽  
Invasive Procedure ◽  
Great Promise ◽  
Review Of Literature ◽  
Platelet Concentrates ◽  
Platelet Rich Fibrin ◽  
Patient Morbidity ◽  
Affected Tissue ◽  
High Doses

<p>The aim of any invasive procedure is the complete eradication and elimination of the infection and associated necrotic tissue followed by repair and regeneration of the affected tissue. In order to achieve this goal various biological products have been introduced, among which are present the platelet concentrates. Platelet concentrates with their higher concentration of platelets has been used in the field of medicine since the 1990s in the form of the first-generation concentrates-Platelet Rich Plasma, and the second generation concentrated -Platelet Rich Fibrin. Choukroun’s Platelet Rich Fibrin is one such material, which is used by itself and also as an adjunct with grafts. It has been successful as it delivers high doses of growth factors and has anti-inflammatory properties. They have been shown to be of great promise in the field of dentistry, ranging from implantology; Sinuses lift procedures, treating of endodontic and periodontal lesions to regeneration of necrotic pulp. This novel technique has the potential to revolutionize the treatment mode in dentistry and help with reducing patient morbidity. We will be further looking into the specification and implications of this material in this review.</p>

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