Minimizing the risk of fracture of definitive casts for removable partial dentures: A dental technique

A technique is described to facilitate impression making and safely obtain the definitive cast for removable partial dentures with long, retentive, or lone-standing abutment teeth. Firstly, the individualized stock tray receives a coating of melted wax. Next, the prepared teeth are impressed with irreversible hydrocolloid, and the set impression is removed from mouth. The mold is then poured conventionally and, after the gypsum has set, is immersed in hot water to soften the wax and allow removal of the tray. The impression material is carefully cut away with a scalpel blade to expose the cast. With these straightforward and easily made changes compared with the conventional technique, the risk of fracturing the definitive cast is minimized, especially when reproducing long retentive teeth. A dental technique is presented that uses wax to coat the impression tray to facilitate the passive displacement of the cast. This results in a straightforward and precise definitive cast for removable partial dentures.

Technique description: Incisionless ultrasound-assisted biceps tenotomy in dogs

Background: Bicipital tendinitis and/or tendinopathy is a common cause of forelimb lameness in dogs, particularly in larger and more active patients. Although conservative treatment aimed at resolving discomfort and preserving the tendon remains the primary therapeutic goal, in certain cases it is necessary to surgically transect the tendon to eliminate pain and lameness. Transection of the tendon can be performed by open arthrotomy, arthroscopically, or percutaneously using a scalpel blade. This paper examines the utility of a modified percutaneous approach using ahypodermic needle in place of a scalpel blade, under ultrasound-guided assistance.Aim: To develop and describe a surgical technique for performing a percutaneous biceps tenotomy using a hypodermic needle under ultrasound guidance Method: The technique was piloted using the shoulders of 12 cadaver dogs initially and once developed, then applied to another 12 cadavers. The final procedure was performed on a total of 22 shoulders. Assessments were recorded on time to complete the procedure, completeness of bicipital tendon transection, and presence of any iatrogenic damage to associated joint structures. Results: Procedure time averaged fewer than 2 minutes. Complete transection was achieved in 20 out of 22 of the shoulders, with evidence of incomplete transection discernable by ultrasound imaging in the remaining two shoulders. One cadaver shoulder experienced iatrogenic damage secondary to incorrect hypodermic needle angulation. Conclusion: Percutaneous biceps tenotomy using a hypodermic needle is an efficient and straightforward procedure. The lack of a surgical incision makes it the least invasive technique devised so far. Ultrasound imaging allows thepractitioner to assess the completeness of the transection increasing precision.

Broken surgical blade retrieval following lumbar discectomy through paravertebral/lateral transpsoas approach: A case report

Background: There are rare reports of broken surgical blades occurring during lumbar discectomy, and even fewer that discuss their retrieval. Case Description: While a 54-year-old male was undergoing a lumbar discectomy, the knife blade was broken. As it was difficult to retrieve the fragment through the original incision, the patient was closed, and a postoperative angio-computerized tomography (CT) was obtained. When the CT angiogram (CTA) documented the retained fragment had become lodged near the iliac vein within the psoas muscle, a second operation for blade retrieval, consisting of a paravertebral, lateral transpsoas approach, was successfully performed. Conclusion: In some cases, it is difficult to retrieve a broken scalpel blade during the index surgery. When this occurs, we would recommend closing the patient, and obtaining a CTA to better document the location of the retained foreign body. Based upon these findings, a safer second stage procedure may be performed (e.g., as in this case using a paravertebral lateral transpsoas approach) to avoid undue sequelae/morbidity.

The retrieval of a surgical blade broken within the alveolar bone during minimally traumatic tooth extraction

Minimally traumatic tooth removal is the norm for removing teeth when a dental implant is planned at that site. The quantity of available bone is the primary requisite to place an implant. The initial use of a scalpel blade to widen the periodontal space followed by the use of luxators is one of the techniques that is being followed for atraumatic extraction. A case of accidental breakage of a number 11 scalpel blade while attempting tooth removal and the method adopted in removing this portion of the blade without further bone destruction is reported here. The authors have not found any previously published cases, reporting the breakage of a scalpel blade during the bone expansion procedure and its management.

Excellent Response of Dermatophytoma and Nail Splitting to Nail Plate Debridement Plus Topical Ciclopirox Olamine 1% Solution

Onychomycosis often presents as thickened, discolored nails. Usually, one or both great toenails are affected. Eventually, the nail plate becomes friable and may split and break up, often due to trauma or invasion of the plate by dermatophytes that have keratolytic properties. Dermatophytoma is a unique feature of onychomycosis that occurred by abundant fungal filaments and spores forming a fungal ball under the nail plate. It is often refractory to traditional therapy. Based on the clinical and mycological examination, a case of onychomycosis in a 45-year-old woman presented as dermatophytoma with longitudinal nail splitting caused by <i>Trichophyton rubrum</i> is presented. The case was successfully treated with nail plate debridement plus topical ciclopirox olamine 1% solution. Nail debridement was performed using a 15-scalpel blade to remove the affected nail portion with the underlying subungual debris to enhance the effect of topical ciclopirox 1% solution which was then applied 3 times daily to the debrided area. Follow-up visits with nail photography were planned every 2 weeks after the procedure to check treatment progress. A complete clinical resolution was achieved after 5 months. This treatment option can be advocated for similar nail conditions avoiding unnecessary and expensive lines of treatment.

Minimal Access Tendon Harvesting without a Harvester: A Cheap and Effective Alternative Technique Using a Plastic Yankauer Suction Tip

Tendon grafting is a key component of hand reconstructive procedures. Commercially produced tendon harvesters facilitate this grafting process but are not always available. We present an innovative technique that allows tendon harvest to be undertaken using equipment readily available in all hospitals. Only a scalpel blade and a plastic Yankauer suction tip are required. Two simple and rapid modifications are made to the suction tip using the blade prior to its use. The described tool has been conceived, refined and used successfully by the authors, without complications, and allows tendon harvest via the standard minimally invasive approach associated with a conventional harvester. Creating this improvised harvester is neither challenging nor time-consuming, and this cheap and effective substitute allows tendon grafts to be harvested using a minimal access approach in environments where a traditional harvester is not available, or not sterile.

A comparison of behavioural methodologies utilised to quantify deviations in piglet behaviour associated with castration

Surgical castration is a painful procedure that is routinely performed without pain relief on commercial pig (Sus scrofa domesticus) farms. Previous research has focused on quantifying piglet pain response through behaviours. However, to date, behavioural sampling methodologies used to quantify pain associated with castration have not been validated. Therefore, the objective of this study was to validate scan sampling methodologies (2-min, 3-min, 5-min, 10-min and 15-min intervals) to quantify piglet pain responses expressed by castrated piglets behaviour. A total of 39 Yorkshire-Landrace × Duroc male piglets (five days of age) were surgically castrated using a scalpel blade. Behaviour frequency and duration (scratching, spasms, stiffness, tail wagging and trembling) of each piglet were continuously collected for the first 15 min of the following hours relative to castration (–24, 1–8 and 24). To determine if the sampling interval accurately reflected true duration and frequency for each behaviour, as determined by continuous observation, criteria previously utilised from other behavioural validation studies were used: coefficient of determination above 0.9, slope not statistically different from one and intercept not statistically different from zero. No scan sampling interval provided accurate estimates for any behavioural indicators of pain. The results of this study suggest that continuous sampling is the most appropriate methodology to fully capture behaviour specific to pain associated with castration. Using validated behavioural methodologies in future research can assist in the development of objective, science-based protocols for managing pig pain.