Effect of Thermo-Mechanical Aging and Repressing on Fracture Resistance of Lithium Disilicate Crowns

Objective: The recycling of heat pressed lithium disilicate glass-ceramic leftover material has been reported to be done by dental laboratories. The effect of this procedure on the fracture resistance of single crowns is unknown, especially when it is functioning inside the oral cavity with subsequent exposure to temperature changes and cycles of mastication. Material and Methods: A total of 28 lithium disilicate glass-ceramic crowns (IPS emax Press) were constructed and randomly assigned into two groups (n = 14); Group (P): Included crowns fabricated from new e.max ingots. Group (R): Included crowns fabricated from repressed e.max buttons. Specimens of each group were divided into two equal subgroups (n = 7) according to whether the aging of specimens will be performed or not before fracture resistance testing. Subgroup (N), samples were subjected to fracture resistance without thermo-mechanical aging, while subgroup (A), samples were subjected to thermo-cycling and cyclic loading before being subjected to fracture strength testing. Different methods; SEM, XRD, EDAX were used to characterize the properties of lithium disilicate glass-ceramics before and after repressing. Results: The highest statistically significant fracture resistance value was recorded for the subgroup (RN) repressed/non-aged, followed by the subgroup repressed/aged (RA), while the lowest statistically significant mean value was recorded for the subgroup pressed/aged (PA). There was no significant difference between pressed/non-aged (PN) and repressed/aged (RA) subgroups. Conclusion: Repressing of leftover buttons may increase the fracture resistance of IPS emax Press crowns. Thermo-mechanical aging may negatively affect the fracture resistance of IPS emax Press crowns, yet Repressing may decrease this effect. Clinical implications: This is a novel approach that targets a point of research that has not been investigated before. It elaborates how repressing may decrease the effect of aging and increase the fracture resistance of lithium disilicate crowns. Thus, recycling of lithium disilicate glass ceramics might decrease its failure and prolong their serviceability. Keywords Fracture resistance; Heat pressed; Lithium disilicate; Recycling; Repressing; Thermo-mechanical aging.

Outcome of Extra-Articular Fractures of Distal Femur: Less Invasive Stabilization on System (LISS) Plating versus Closed Retrograde Intramedullary Interlocking Nail

Objective: To evaluate the functional outcome of extra-articular fracture of distal femur, LISS plating versus retrograde intramedullary interlocking nailing. Study Design: Prospective/Randomized control trial Place and Duration of Study: Department of Orthopaedic Surgery, Ghulam Muhammad Mahar Medical College Sukkur from 1st July 2019 to 31st December 2020. Methodology: One hundred patients of both genders with ages 20 to 60 years presented with fractures of distal femur were included in this study. Patients were equally divided into two groups I and II. Group I contained 50 patients and received LISS plating and Group II contained 50 patients and received closed retrograde intramedullary interlocking nail, Pre and post-operative assessment was done. Post-operative complications were noted at 12th day. Functional outcomes were examined after 6 months by the NEERs criteria. Results: Sixty five (65%) patients were males (35 in group I and 30 in group II) and 35 (35%) patients were females (15 in group I and 20 in group II). Road traffic accident was the most common mode of injury in 62 (62%) patients. Most of the fractures were on right side 66 (66%). According to the NEER criteria, 80% patients shows excellent, 20% patients shows satisfactory with no poor results in Group I and in Group II 30% patients shows excellent, 66% patients shows satisfactory results and 4% shows unsatisfactory results. Conclusion: The LISS plating and closed retrograde intramedullary interlocking nail was safe and effective methods for extra-articular fractures of distal femur but there were less complications found in LISS plating. Keywords: Fracture of distal femur, LISS plating, Interlocking nail

An injectable glass polyalkenoate cement engineered for fracture fixation and stabilization

Glass polyalkenoate cements (GPCs) have potential as bio-adhesives due to their ease of application, appropriate mechanical properties, radiopacity and chemical adhesion to bone. Aluminium (Al)-free GPCs have been discussed in the literature, but have proven difficult to balance injectability with mechanical integrity. For example, zinc-based, Al-free GPCs reported compressive strengths of 63 MPa, but set in under 2 min. Here, the authors design injectable GPCs (IGPCs) based on zinc-containing, Al-free silicate compositions containing GeO2, substituted for ZnO at 3% increments through the series. The setting reactions, injectability and mechanical properties of these GPCs were evaluated using both a hand-mix (h) technique, using a spatula for sample preparation and application and an injection (i) technique, using a 16-gauge needle, post mixing, for application. GPCs ability to act as a carrier for bovine serum albumin (BSA) was also evaluated. Germanium (Ge) and BSA containing IGPCs were produced and reported to have working times between 26 and 44 min and setting times between 37 and 55 min; the extended handling properties being as a result of less Ge. The incorporation of BSA into the cement had no effect on the handling and mechanical properties, but the latter were found to have increased compression strength with the addition of Ge from between 27 and 37 MPa after 30 days maturation. Keywords: fracture fixation; distal radius fracture; germanium oxide; polyacrylic acid; injectable glass polyalkenoate cements; bovine serum albumin

An injectable glass polyalkenoate cement engineered for fracture fixation and stabilization

Glass polyalkenoate cements (GPCs) have potential as bio-adhesives due to their ease of application, appropriate mechanical properties, radiopacity and chemical adhesion to bone. Aluminium (Al)-free GPCs have been discussed in the literature, but have proven difficult to balance injectability with mechanical integrity. For example, zinc-based, Al-free GPCs reported compressive strengths of 63 MPa, but set in under 2 min. Here, the authors design injectable GPCs (IGPCs) based on zinc-containing, Al-free silicate compositions containing GeO2, substituted for ZnO at 3% increments through the series. The setting reactions, injectability and mechanical properties of these GPCs were evaluated using both a hand-mix (h) technique, using a spatula for sample preparation and application and an injection (i) technique, using a 16-gauge needle, post mixing, for application. GPCs ability to act as a carrier for bovine serum albumin (BSA) was also evaluated. Germanium (Ge) and BSA containing IGPCs were produced and reported to have working times between 26 and 44 min and setting times between 37 and 55 min; the extended handling properties being as a result of less Ge. The incorporation of BSA into the cement had no effect on the handling and mechanical properties, but the latter were found to have increased compression strength with the addition of Ge from between 27 and 37 MPa after 30 days maturation. Keywords: fracture fixation; distal radius fracture; germanium oxide; polyacrylic acid; injectable glass polyalkenoate cements; bovine serum albumin

Gambaran Penyembuhan Tulang Sekunder pada Fraktur dengan Anatomical Reduction Fixation Tipe Plate and Screw di RSUP Prof. Dr. R. D. Kandou Periode 2019 – 2020

Theoretically, fractures fixed by anatomical reduction fixation will undergo direct bone healing without any callus formation. However, in some cases with anatomical reduction fixation show sceondary bone healing in radiographic examination. This study was aimed to obtain the profile of patients who had secondary bone healing in fractures fixed with anatomical reduction fixation at Prof. Dr. RD Kandou Central General Hospital Manado from 2019 to 2020, distribution of patients based on age, sex, and fracture location, as well as the patient's callus indexes. This was a retrospective and descriptive study using data at the Surgery Section, Radiology Section and the Medical Record Section of Prof. Dr. R. D. Kandou General Hospital Manado. The results showed that the incidence of secondary bone healing in fractures with anatomical reduction fixation was the highest in the 21 - 35 years age group (50%). The number of male patients was greater than of female patients. The location of most fractures was the lower limb. The most frequent callus index was 0.51-0.75, the highest was 0.8, and the lowest was 0.25. In conclusion, secondary bone healing in fractures with anatomical reduction fixation was more common in age group 21-35 years, males, and had callus index of 0.51-0.75.Keywords: fracture, secondary bone healing, callus Abstrak: Secara teori fraktur yang difiksasi secara anatomical reduction fixation akan mengalami penyembuhan tulang secara langsung tanpa pembentukan kalus. Dalam praktik klinis pada beberapa kasus terlihat adanya gambaran kalus pada pemeriskaan radiografi yang menggambarkan adanya penyembuhan tulang sekunder pada fraktur dengan anatomical reduction fixation. Penelitian ini bertujuan untuk mendapatkan profil pasien yang mengalami penyembuhan tulang sekunder pada fraktur dengan anatomical reduction fixation di RSUP Prof. Dr. R. D. Kandou periode 2019 sampai dengan 2020, distribusi pasien berdasarkan usia, jenis kelamin dan lokasi fraktur, serta indeks kalus pasien. Jenis penelitian ialah deskriptif retrospektif menggunakan data di Bagian Bedah, Bagian Radiologi, dan Bagian Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan bahwa angka kejadian penyembuhan tulang sekunder pada fraktur dengan anatomical reduction fixation tertinggi pada kelompok usia 21-35 tahun (50%). Jumlah pasien laki-laki lebih banyak daripada perempuan dan lokasi fraktur tersering ialah ekstremitas bawah. Indeks kalus tertinggi (0,8) dan indeks kalus terendah (0,25), dan yang terbanyak ialah 0,51-0,75. Simpulan penelitian ini ialah penyembuhan tulang sekunder pada fraktur dengan anatomical reduction fixation tertinggi pada kelompok usia 21-35 tahun, jenis kelamin laki-laki, dengan indeks kalus 0,51-075Kata kunci: fraktur, penyembuhan tulang sekunder, kalus

Penile Fracture - Our Initial Experience and Outcome

BACKGROUND Penile fractures occur when the engorged penile corpora are forced to buckle and “pop” under the pressure of a blunt sexual trauma, due to slippage of the penis out of the vagina during intercourse. Patients typically describe that a “plop” sound was followed by immediate de-tumescence, severe pain, and swelling, called as “egg-plant” deformity, as a result of the injury. The immediate surgical exploration with evacuation of the haematoma and repair of tunica albuginea defect is the ideal treatment. METHODS Over a period of more than 3 years between May 2015 and January 2019 we have treated 26 patients with penile fractures. All of them presented within 24 hours after sustaining the injury. None had associated urethral injury. Apart from clinical examination and history the investigation most commonly used by us to aid diagnosis was Ultrasound (USG) and colour doppler which helped in identifying the site and size of the defect as well as the blood collections. All were treated by surgical exploration. RESULTS Patients were discharged either on 2nd or 3rd post-operative day. None of our patients developed any postoperative wound infection. Post-operative hematoma developed in 01 patient. 01 patient had complaints of slight bend of the penis to the affected side but with no sexual problem. There was no history of erectile dysfunction in any of these patients. CONCLUSIONS To diagnose penile fracture, our study relied on history and physical examination mainly and did not recommend imaging, except for, in patients with possible urethral injuries. Immediate surgical intervention can make good functional results and surgical exploration can be considered in all cases of penile fractures. The procedure is simple with minimal morbidity, low morbidity and short hospital stay. KEYWORDS Fracture, Corpora, Tear

Hubungan antara Nyeri Fraktur dengan Kualitas Tidur Pasien yang di Rawat Inap

This study aims to determine the relationship between fracture pain and sleep quality. This research was conducted in the Seruni room of Dr. M. Yunus Bengkulu and in the Seruni room at Bhayangkara Hospital TK III Bengkulu. The research design used was correlational using a cross sectional approach. The results of the univariate analysis showed that (73.3%) respondents had poor sleep quality and (60%) had severe fracture pain intensity. The results of bivariate analysis with correlation test obtained p-value = 0.002 (p <0.05). In conclusion, there is a relationship between fracture pain and the sleep quality of patients hospitalized at the hospital in Bengkulu Province. Keywords: Fracture Pain, Sleep Quality

FRAKTUR AKIBAT OSTEOPOROSIS

This thesis to find out thypes of fractures due to osteoporosis, complementary examination to diagnose osteoporosis, and treatment of osteoporosis general. The contents of thus thesis aimed to reduce the occurrence of fracture due to osteoporosis. Metods used in this thesis is the collection of reference materials and data on fracture due to osteoporosis from text book journals, magazines, and the internet. The result obtained it is influenced by the hormone estrogen. The number of women threatened Indonesia’s increasing osteoporosis caused by such as smoking, alcohol consumption, anda long term use of steroid. Thus knowledge and information about age prematurely. Avidly consume foods high in calcium such as milk and processed milk products, expand activity, often basking in the morning, avoid smoking, as well as avoid consumption of alcoholic beverages Keywords: fracture, osteoporosis, women, calsium, life style. Abstrak: Skripsi ini bertujuan untuk mengetahui jenis-jenis fraktur akibat osteoporosis, pemeriksaan penunjang untuk mendiagnosis osteoporosis, dan penanganan osteoporosis secara umum. Isi dari skripsi ini ditujukan untuk mengurangi terjadinya fraktur akibat osteoporosis. Metode yang digunakaan dalam skripsi ini yaitu pengumpulan bahan-bahan acuan dan data tentang fraktur akibat osteoporosis yang berasal dari buku teks, jurnal, internet, maupun majalah. Hasil yang didapatkan menunjukkan bahwa osteoporosis merupakan penyakit wanita dibanding pria karena dipengaruhi oleh hormon estrogen. Jumlah wanita yang terancam osteoporosis di Indonesia semakin meningkat yang disebabkan karena kurangnya asupan kalsium dan perubahan gaya hidup seperti merokok, konsumsi alkohol, dan penggunaan steroid jangka panjang. Dengan demikian, pengetahuan dan informasi tentang osteoporosis sangat penting sebagai upaya pencegahan bagi wanita usia dini. Rajin mengkonsumsi makanan berkalsium tinggi seperti susu dan produk olahan susu lainnya, perbanyak aktivitas, sering berjemur di pagi hari, hindari rokok, serta hindari konsumsi minuman beralkohol. Kata kunci: fraktur, osteoporosis, wanita, kalsium, gaya hidup

Management of ankle injuries in the prehospital environment: A review of the literature

IntroductionAnkle fractures have traditionally been seen as low priority cases as they do not pose an immediate life threat. Ankle fractures have the potential to create long-term mobility consequences for a person if managed inappropriately. The objective of this study was to determine the most effective way to manage ankle injuries in the prehospital environment.MethodsA literature search was conducted of the medical related electronic databases, Ovid preMedline, Medline, Cinahl, Cochrane CENTRAL, and EMBASE from 1980 to the end of May 2013. A previously published prehospital search filter was used in each of the databases including additional keywords “fracture”, “ankle”, “ankle injuries”, “bone fractures”, and “sprains and strains”. Articles were included if their primary aim was to examine the appropriate management of ankle fractures in the prehospital environment. The references of retrieved articles were also reviewed. Articles were excluded if they were not written in English.ResultsThere were 531 articles located in the search. After reviewing the articles three were determined to meet the inclusion criteria. One article was set primarily in the emergency department but also included prehospital management. The remaining two articles were set in the prehospital setting. The findings suggest there is a defined set of questions to ask and specific assessment criteria for a patient with an ankle injury to determine its potential severity. Where there is neurovascular compromise anatomical realignment should be attempted.ConclusionA thorough initial assessment and good basic management by prehospital care providers is essential to assist in decreasing delays to definitive treatment for patients with suspected ankle fractures, dislocations or fracture/dislocations. Further research is needed to determine to most effective management strategies in order to achieve optimal outcomes for patients with ankle injuries.

Acoustic characterization of fracture permeability at Chalk River, Ontario

This study was undertaken to test recently formulated acoustic-analysis methods for fracture interpretation. The study area was selected because surface outcrops of igneous and metamorphic rocks have numerous, interconnected fractures and major lithology changes. In-situ acoustic-refraction data were obtained by digitally recording the entire pressure signal received by a conventional acoustic borehole logging system. The acoustic energy source had a centerband frequency of 34 kHz, and data were obtained at 60 and 90 cm source/receiver spacing. Borehole geometry produces waveforms with strong shear arrivals and high amplitudes associated with the fundamental guided fluid mode known as the tube wave. Waveforms refracted across fractures that are open on the borehole have shear mode excitation and tube-wave attenuation effects similar to previously described effects for isolated fractures in very uniform lithologies. Independent permeability data for the Chalk River boreholes are available in the form of effective-fracture apertures determined by straddle packer isolation and injection tests. The best correlation between the permeabilities measured by packer tests and acoustic data is obtained by integrating the difference between local tube-wave amplitude and an average amplitude from many adjacent stations. This synthetic amplitude-deficit log shows close correlation with zones of large measured permeabilities; however, there are some quantitative differences. These are attributed to: (1) differing radii of investigation, (2) effects of fracture interconnectivity, and (3) drilling damage in highly weathered and fractured zones. The tube-wave-amplitude method also does not seem applicable to depths less than about 50 m where the tube-wave mode is relatively unexcited. Keywords: fracture permeability, borehole acoustics, fracture hydrology.