The Application of Beta-Tricalcium Phosphate in Implant Dentistry: A Systematic Evaluation of Clinical Studies

The demand for synthetic graft materials in implant dentistry is rising. This systematic review aims to evaluate the survival rate of dental implants placed simultaneously with bone regeneration procedures using the material β-tricalcium phosphate, one of the most promising synthetic graft materials. The electronic search was conducted in PubMed, Scielo, and the Cochrane Central Register of Controlled Trials. There were five randomized clinical trials, one of which was a non-randomized controlled clinical trial and four of which were observational studies without a control group included. Implant survival rate and other clinical, radiographic, and histological parameters did not differ from those of implants placed simultaneously with another type of graft material, or placed in blood clots or natural alveolar ridges. Based on the available literature, β-tricalcium phosphate seems to be a promising graft material in implant dentistry. Nevertheless, more randomized clinical trials, with long follow-up periods, preoperative and postoperative CBCT, and histological analysis, are necessary to assess its long-term behavior.

Fixation Rotator cuff repair of shoulder by Patch augmentation technique. A Case Report

Rotator cuff repair has excellent outcomes for many patients but continues to be suboptimal for large, retracted tears, and revision procedures. In certain circumstances, augmentation may be explored to aid healing. This is a case study. A 61-yearold man with a 3-month history of left shoulder arthroscopic subacromal decompression with bursectomy, acromioplasty, rotator cuff repair with patch augmentation, strengthening with bio synthetic graft fleece, and ACJ excision. After a physical examination, the left shoulder was found to have active forward elevation of 130 degrees and passive forward elevation of 150 degrees, pain in the periscapular region, rotator cuff strength of 4/5, and distal neurovascular integrity. Finally, the patient is pleased with the results of the operation, and he now has a decent functional range of motion, although he still has weak muscles and severe scapular discomfort

Off-Pump Aortic Bypass for Hypoplastic Arch and Aortic Coarctation Via Anterolateral Thoracotomy

We report the case of a 21-year-old woman who was referred with uncontrolled hypertension. Computed tomography angiography revealed aortic arch hypoplasia and severe aortic coarctation. An off-pump ascending-to-descending aortic bypass surgery using synthetic graft was performed via left anterolateral thoracotomy. The patient recovered well and was discharged home uneventfully after five days. This procedure was performed without touching the head vessels or any collateral vessels. We consider this a safe and less invasive alternative technique for adult coarctation patients who have aortic hypoplasia or interrupted aorta.

External Stenting (Exostenting) to Correct Vascular Torsion and Angulation

Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the organ and/or body parts. On many occasions, mild angulations and torsions can be successfully addressed by repositioning the organ. In cases where the abnormal findings persist, maneuvers such as placing a fat pad to create a smoother curve, or even opening the peritoneum (in the case of kidney transplants) to allow for a better positioning of the organ, are associated with successful outcomes. When such torsions/angulations persist despite these approaches, further innovative tactics are required. In the current report, we propose a technique that involves longitudinally opening of a synthetic graft that is rigid enough to maintain its shape, such as a ringed polytetrafluoroethylene graft, and placing it as an external stent around the angulated/torsioned vessel. This maneuver will correct the underlying vascular compromise without having to perform any further invasive interventions, such as reimplanting the organ or resecting part of the involved vessel. Although primarily illustrated for application by describing an instance in which exostenting was applied during kidney transplantation, our approach could be applied to any vessel under many circumstances where angulations/twists are encountered. In this report, we describe the use of an external stent, also called exostenting, to correct a severe torsion/angulation of the external iliac artery in a kidney transplant recipient where all other measures were unsuccessful.

Linear plication and external wrapping in ascending aortic aneurysm in well-selected patients: Surgical technique

An aortic aneurysm is known as a bulging or dilatation of the aorta for more than one and half of its normal diameter result in making the wall of the aorta thinner and at the risk of dissection or rupture. For a long time ago surgeons have worked hard to find the best surgical technique to treat this pathology. Open surgery with the replacement of the aneurysmatic segment by a synthetic graft is still the standard surgical treatment method. In the past, some surgeons tried patching the aneurysmatic segment with synthetic patches. This technique was not accepted by many surgeons. In our cardiovascular surgical center, we perform linear plication and external wrapping (LPEW) surgical technique for more than ten years in well-selected patients whose aortic aneurysm diameter is less than 6 cm with normal aortic root and who has not any connective tissue disease, dissection, or rupture. Our results are satisfying with low morbidity and mortality.