Lesion Depth Research Articles

Impact of contact force on the lesion characteristics of very high-power short-duration ablation using a QDOT-MICRO catheter.

Lesion size is reported to become larger as contact force (CF) increases. However, this has not been systematically evaluated in temperature-guided very high-power short-duration (vHPSD) ablation, which was therefore the purpose of this study. Radiofrequency applications (90 W/4 s, temperature-control mode) were performed in excised porcine myocardium with four different CFs of 5, 15, 25, and 35 g using QDOT-MICRO™ catheter. Ten lesions for each combination of settings were created, and lesion metrics and steam-pops were compared. A total of 320 lesions were analyzed. Lesion depth, surface area, and volume were smallest for CF of 5 g than for 15, 25, and 35 g (depth: 2.7 mm vs. 2.9 mm, 3.0 mm, 3.15 mm, p < .01; surface area: 38.4 mm2 vs. 41.8 mm2, 43.3 mm2, 41.5 mm2, p < .05; volume: 98.2 mm3 vs. 133.3 mm3, 129.4 mm3, 126.8 mm3, p < .01 for all pairs of groups compared to CF = 5 g). However, no significant differences were observed between CFs of 15-35 g. Average power was highest for CF of 5 g, followed by 15, 25, and 35 g (83.2 W vs. 82.1 W vs. 77.1 W vs. 66.1 W, p < .01 for all pairs), reflecting the higher incidence of temperature-guided power titration with greater CFs (5 g:8.8% vs. 15 g:52.5% vs. 25 g:77.5% vs. 35 g:91.2%, p < .01 for all pairs except for 25 g vs. 35 g). The incidence of steam-pops did not significantly differ between four groups (5 g:3.8% vs. 15 g:10% vs. 25 g:6.2% vs. 35 g:2.5%, not significant for all pairs). For vHPSD ablation, lesion size does not become large once the CF reaches 15 g, and the risk of steam-pops may be mitigated through power titration even in high CFs.

Techno-functional properties of active film based on guar gum-propolis and its application for “Nanguo” pears preservation

Guar gum (GG) composite films, incorporating the ethanolic extract of propolis (EEP), were prepared and subjected to a comprehensive investigation of their functional characteristics. The addition of EEP resulted in a discernible enhancement in the opacity, moisture barrier capacity, and elongation at break. Incorporating EEP led to a noteworthy increase in the total phenolic and total flavonoid content of the films, resulting in superior antioxidant capacity upon GG-EEP films. Remarkably, the addition of 5 % EEP yielded noteworthy outcomes, manifesting in a DPPH radical scavenging rate of 47.60 % and the ABTS radical scavenging rate of 94.87 %, as well as FRAP and cupric reducing power of 331.98 mmol FeSO4-7H2O kg−1 and 56.95 μg TE mg−1, respectively. In addition, GG-EEP films demonstrated antifungal effect against Penicillium expansum and Aspergillus niger, along with a sustained antibacterial effect against Escherichia coli and Staphylococcus aureus. GG-EEP films had superior inhibitory ability against Gram-positive bacteria than Gram-negative bacteria. Crucially, GG-EEP composite films played a pivotal role in reducing both lesion diameter and depth, concurrently mitigating weight loss and firmness decline during the storage period of “Nanguo” pears. Therefore, GG-EEP composite films have the considerable potential to serve as advanced and effective active packaging materials for food preservation.

ACCURACY OF A FRAMELESS OPTICAL STEREOTACTIC NEURONAVIGATION SYSTEM FOR BRAIN BIOPSY IN CATS: A CADAVERIC STUDY

Image-guided stereotactic techniques can display the locations of surgical instruments and biopsy targets in real time, allowing minimally invasive brain biopsies with reduced risk. This study aimed to assess the accuracy of an optical frameless neuronavigation system in feline cadavers and describe potential influencing factors. Phantom lesions were created in different brain regions and depths in 15 feline cadavers. After installing eight fiducial markers in the frontal bone and zygomatic arches, magnetic resonance imaging (MRI) was performed, and the images were imported into the neuronavigation system. Following patient and instrument registration, diluted gadolinium was injected into the phantom lesion (target), guided by the neuronavigation system. The coordinates of the target and contrast points were determined on repeated MRI scans and the distance between them was defined as the targeting error. The time from target selection to the completion of gadolinium injection was recorded as the required time. The targeting error and required time were compared between the initial 30% and final 30% of the collected data to assess the influence of operator experience. Among 76 lesions, the mean targeting error was [Formula: see text][Formula: see text]mm (95% confidence interval 2.76–3.15[Formula: see text]mm). Lesion location, lesion depth, and operator experience did not affect the accuracy; however, operator experience reduced the required time. This frameless optical neuronavigation system is potentially feasible for feline brain biopsy. The demonstrated accuracy substantiates its clinical utility for feline brain lesions [Formula: see text][Formula: see text]mm, and is comparable to that of other neuronavigation systems described in dogs.

Мануальная диагностика термических ожогов кожи. Сообщение первое

The aim of the study is to assess the possibility of studying the depth and area of high-temperature skin lesions in burns by manual methods. Materials and methods: 99 patients with II-III degree thermal skin burns with a lesion area of up to 10% of the body surface were examined at admission to hospital as well as in dynamics. Clinical (palpation diagnostics), instrumental (laser Doppler fluorometry), analytical, and statistical methods of research were used. The study result is the substantiation of the manual (palpation) diagnosis method for determining the true depth and area of the burn wound, the condition of the underlying tissues, the involvement of which in the burn process in the projection of the burn wound affects the course and prognosis of II-III degree thermal burns in patients and their quality of life in the future. The novelty, informativeness, and efficiency of the manual method of diagnosis are shown.

Мануальная диагностика термических ожогов кожи. Сообщение второе

The novelty of this study lies in the application of manual (osteopathic) approach to the diagnosis of thermal skin burns in patients in the acute period (1-3 days) of burn injury in order to study the depth and area of high-temperature skin lesions in burns. Materials and methods: 24 patients with II-III degree thermal burns with a lesion area up to 10% were examined by clinical, osteopathic, and instrumental methods. Clinical (palpation diagnostics), instrumental (laser Doppler fluorometry), analytical, and statistical methods of research were used. The study result is the substantiation of the palpation diagnostics method for determining the true depth and area of the burn wound, the condition of the underlying tissues, the involvement of which in the burn process in the projection of the burn wound affects the course and prognosis of II-III degree thermal burns in patients and their quality of life in the future. The novelty, informativeness, and efficiency of the manual method of diagnosis are shown (Russian Patent for the invention No. 2339300 “A method for diagnosing the depth of a burn wound”)

Remineralization potential of apacider gel on enamel and cementum surrounding margin of ceramic restoration.

Modern management of carious lesions has been targeted upon using remineralizing agents. This study investigated the remineralization potential of apacider gel (AG) and casein phosphopeptide-amorphous calcium fluoride phosphate (CA) on enamel and cementum around the cavosurface area of the ceramic margin. Seventy-five extracted human mandibular molars were sectioned at 0.8 mm above and below the cemento-enamel junction (CEJ) to remove the CEJ portions and replaced them with glass ceramic disks by bonding them to the crown and root portions with resin cement. The enamel and cementum area of 4x4 mm2 surrounding ceramic was demineralized with Carbopol-907. The demineralized surfaces were treated with either AG or CA, while one group was left with no treatment (NT) and served as control. Vickers microhardness was determined before-, after demineralization, and after remineralization. The percentage of hardness recovery (%HR), and remineralization potential (%RP) were analyzed with ANOVA and Bonferroni's test (α=0.05). Polarized light microscopy (PLM) was assessed for lesion depth. Scanning electron microscopy (SEM) was investigated for surface alterations. Significant differences in remineralization were found upon various remineralizing agents compared to NT for both enamel and cementum (p<0.05). No significant difference in %HR and %RP was observed between AG and CA (p>0.05). However, AG signified greater decrease in lesion depth and better improvement in surface characteristics for both enamel and cementum than CA. AG possesses comparable remineralization ability to CA. However, decreasing in carious lesion depth was evinced with using AG more than CA. AG was recommended as a potential remineralization material for handling initial caries for both enamel and cementum. Key words:Apacider, artificial carious lesion, CCP-ACFP, remineralizationCare Team.

Re-Establishing the Esthetics of Incisors in Patients with Molar Incisor Hypomineralisation.

The awareness of molar incisor hypomineralisation (MIH) has led to its increased clinical detection, consequently drawing more attention to its associated complications. This text offers an overview of the esthetic management of anterior teeth affected by MIH, a condition characterized by enamel defects that present significant cosmetic challenges. The focus is on the clinical presentation of MIH characteristics, considering the depth of lesions and the clinical aspects, and the treatment protocols available, despite a lack of extensive scientific evidence. To the best of the current scientific knowledge, the text evaluates the potential of minimally invasive procedures, as well as the use of traditional composite resin techniques and their possible combinations, highlighting the critical role of esthetic considerations for the impacted anterior teeth. The chapter is augmented with five illustrative clinical cases that display the practical application of these treatment approaches. These examples articulate the clinical decision-making process and personalized restorative strategies, aiming to balance function with enhanced esthetic results. The described cases act as a roadmap for clinicians tackling the complexities of MIH treatment in the context of limited empirical evidence, providing insights into achieving both satisfactory and esthetically pleasing outcomes for patients suffering from this condition.

A taxonomy for superficial cerebral cavernous malformations: subtypes of cortical and subcortical lesions.

A taxonomy for superficial cerebral cavernous malformations (CMs), those based cortically in gyral gray matter or subcortically in underlying white matter, is proposed to build on the comprehensive, systematic characterization of CMs in the entire brain. Patients with superficial cerebral CMs were retrospectively analyzed from a consecutive surgical series between November 2008 and June 2021 at the authors' center. Superficial cerebral CMs were categorized into 4 subtypes based on their cortical location or, if subcortical, proximity to the nearest cerebral surface: convexity, medial, basal, and sylvian. Lobar location was also included for subtyping: frontal, temporal, parietal, and occipital. A total of 362 CMs were resected in 346 patients. CM subtypes were as follows: 132 (36.5%) convexity, 78 (21.5%) medial, 72 (19.9%) basal, and 80 (22.1%) sylvian. Frontal CMs were most common (155 [42.8%]), followed by parietal (89 [24.6%]), temporal (87 [24.0%]), and occipital (31 [8.6%]). Of all CMs, 302 (83.4%) were cortical and 60 (16.6%) were subcortical. The mean subcortical depth of deep lesions was 2.97 cm, and the mean lesion volume was 4.68 cm3. Overall, 228 lesions (63.0%) were resected through a transgyral approach, and 134 (37.0%) were resected through a transsulcal approach. Good outcomes (modified Rankin Scale [mRS] score ≤ 2) were observed in 314 patients (86.7%) and poor outcomes (mRS score > 2) in 25 patients (6.9%), and 23 patients (6.4%) were lost to late follow-up (mean follow-up duration 11.5 months). Relative outcomes were good (unchanged or improved mRS score) in 327 patients (90.3%) and poor (worse or died) in 35 patients (9.7%). Superficial cerebral CMs were resected through a gyrus or sulcus to open the subarachnoid dissection corridors, traversing the full extent of sulci to deepen the approach and minimize tissue transgression. Transgyral dissection avoids associated arteries but is inherently transgressive, whereas transsulcal dissection preserves cortical tissue and may reduce morbidity. Superficial cerebral CMs occupy the largest territory of the 7 types, and the size and surface complexity of the cerebrum make taxonomic subtyping valuable for clear anatomical description.

Implementation of fluorescent imaging technology in endovideosurgical treatment of colorectal endometriosis

The article includes a clinical case of a patient with deep infiltrating endometriosis with rectum involving and using intraoperative controlled fluorescence in order to increase the radicality of surgery and improve the prognosis of the disease. Surgical excision of the endometrioitic nodules is the only effective way of treating patients with colorectal endometriosis in terms of relieving pain, improving quality of life and restoring reproductive function. The possible types of surgical interventions can be performed: endometrioid lesion shaving, discoid or circular intestinal resection with anastomosis. The extent of the operation is determined by the following morphological parameters: the number of endometrioid infiltrates of the intestinal wall, the size of each of them, the degree of involvement of the intestine circumference, the depth of the intestinal wall lesion, the distance from the level of anus to the endometriotic nodule and lymphatic dissemination.

Effect of treatment with phosphate, casein phosphopeptide and fluoride on the remineralization: in vitro study.

This study aimed to evaluate in vitro the effect protocols and anticaries agents containing casein amorphous calcium fluoride phosphopeptide-phosphate (CPP-ACPF, MI Paste Plus), sodium trimetaphosphate (TMP) and fluoride (F), in remineralization of caries lesions. Bovine enamel blocks with initial caries lesions were divided into groups (n = 12): 1) Toothpaste without F-TMP-MI Plus (Placebo); 2) Toothpaste 1100 ppm F (1100F), 3) 1100F + MI Paste Plus (1100F-MI Paste Plus), 4) Toothpaste with 1100F + Neutral gel with 4,500 ppm F + 5%TMP (1100F + Gel TMP) and 5) Toothpaste with 1100F + Neutral gel with 9,000 ppm F (1100F + Gel F). For the 4 and 5 groups the gel was applied only once for 1 minute, initially to the study. For the 3 group, after treatment with 1100F, MI Paste Plus was applied 2x/day for 3 minute. After pH cycling, the percentage of surface hardness recovery (%SHR); integrated loss of subsurface hardness (ΔKHN); profile and depth of the subsuperficial lesion (PLM); concentrations of F, calcium (Ca) and phosphorus (P) in enamel was determined. The data were analyzed by ANOVA (1-criterion) and Student-Newman-Keuls test (p < 0.001). Treatment with 1100F alone led to ~ 28% higher remineralization when compared to treatment with 1100F associated with MI Paste Plus (p < 0.001). The 1100F and 1100F + Gel F groups showed similar values for %SHR (p = 0.150). 1100F + Gel TMP treatment also remineralized the enamel surface by ~ 30% and 20% when compared to the 1100F + Gel F and 1100F groups (p < 0.001). The lower lesion depth (ΔKHN) was observed for the 1100F + Gel TMP group (p < 0.001), where it was 54% and 44% lower in comparison to the 1100F and 1100F + Gel F groups (p < 0.001). Polarized light microscopy photomicrographs showed subsurface lesions in all groups, but these lesions were present to a lower extent in the 1100F + Gel TMP group (p < 0.001). Treatment with 1100F + Gel TMP promoted an increase in the concentration of Ca in the enamel by ~ 57% and ~ 26% when compared to the 1100F and 1100F + MI Paste Plus groups (p < 0.001), respectively. There were no significant differences between the 1100F, 1100F + MI Paste Plus and 1100F + Gel F groups (p > 0.001). Similar values of P in the enamel were observed in the 1100F, 1100F + MI Paste Plus and 1100F + Gel F groups (p > 0.001), except for the 1100F + Gel TMP group, which presented a high concentration (p < 0.001). We conclude that the 1100F+TMP gel treatment/protocol led to a significant increased remineralization when compared to the other treatments/protocols and may be a promising strategy for patients with early caries lesions.

Visualization of etching cycles efficacy at the resin infiltration into artificial enamel caries: in-vitro study on bovine teeth.

This study evaluated the effect of repeated etching cycles on resin infiltrant penetration. Enamel samples measuring 4 × 4 × 3 mm3 were obtained from the facial aspect of 50 extracted bovine teeth. Samples were immersed in a demineralization solution for 21 days to create artificial lesions and divided into five equal groups (n = 10). A 15% hydrochloric acid gel was administered to each group. The acid etching application time differed between groups: Group 1; 2 min, Group 2; 2 × 2 min, Group 3; 3 × 2 min, Group 4; 4 × 2 min, and Group 5; 5 × 2 min. Resin infiltration was visualized using a confocal laser scanning microscopy. The lesion, penetration and erosion depth (µm) were calculated, and data were statistically analyzed. The highest penetration depth (75.59 ± 9.42 µm) was seen in Group 5, followed by Groups 4, 3, 2 and 1. However, there were no statistically significant differences in the penetration depths between Groups 4 and 5 and between Groups 2, 3 and 4 (p > 0.05). In conclusion, a repeated etching cycle enhanced resin infiltrant penetration.

Comparison of biofilm models for producing artificial active white spot lesions.

This study compared three protocols for developing artificial white spot lesions (WSL) using biofilm models. In total, 45 human enamel specimens were sterilized and allocated into three groups based on the biofilm model: Streptococcus sobrinus and Lactobacillus casei (Ss+Lc), Streptococcus sobrinus (Ss), or Streptococcus mutans (Sm). Specimens were incubated in filter-sterilized human saliva to form the acquired pellicle and then subjected to the biofilm challenge consisting of three days of incubation with bacteria (for demineralization) and one day of remineralization, which was performed once for Ss+Lc (four days total), four times for Ss (16 days total), and three times for Sm (12 days total). After WSL creation, the lesion fluorescence, depth, and chemical composition were assessed using Quantitative Light-induced Fluorescence (QLF), Polarized Light Microscopy (PLM), and Raman Spectroscopy, respectively. Statistical analysis consisted of two-way ANOVA followed by Tukey's post hoc test (α=0.05). WSL created using the Ss+Lc protocol presented statistically significant higher fluorescence loss (ΔF) and integrated fluorescence (ΔQ) in comparison to the other two protocols (p<0.001). In addition, Ss+Lc resulted in significantly deeper WSL (137.5 µm), followed by Ss (84.1 µm) and Sm (54.9 µm) (p<0.001). While high mineral content was observed in sound enamel surrounding the WSL, lesions created with the Ss+Lc protocol showed the highest demineralization level and changes in the mineral content among the three protocols. The biofilm model using S. sobrinus and L. casei for four days was the most appropriate and simplified protocol for developing artificial active WSL with lower fluorescence, higher demineralization, and greater depth.

Outcomes of Osteochondral Autologous Transplantation with Ipsilateral Lateral Talar Autograft for Medial Osteochondral Lesions of the Talus.

Osteochondral autologous transplantation (OAT) has been widely used in the treatment of osteochondral lesion of the talus (OLT). Previous studies have reported successful outcomes following the use of osteochondral autogenous grafts from the intercondylar notch of the knee or a non-weight-bearing region of the femoral condyle. However, donor-site morbidity of the knee joint has been observed in several cases. This study aimed to investigate the outcomes and safety of OAT with autografts from the ipsilateral lateral talar articular facet as an alternative donor site for medial OLT. Among 40 patients who underwent OAT, 29 patients were excluded. Eleven patients who underwent OAT with an osteochondral graft harvested from the ipsilateral lateral talar articular facet from 2011 to 2022 were retrospectively analyzed. The size of OLT was measured on ankle magnetic resonance imaging, including coronal length, sagittal length, depth, and area. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and a visual analog scale (VAS). Weight-bearing ankle radiographs were obtained postoperatively and at 1 year after surgery. The average follow-up time after surgery was 64.7 months (range, 14-137 months). The average diameter of lesions was 8.8 mm (range, 8-9.9 mm). The average size of lesions was 51.2 mm2 (range, 33.6-71.3 mm2) , and all lesions included subchondral cysts. The average depth of lesions was 7.3 mm (range, 6.2-9.1 mm). Graft sizes ranged from 8 to 10 mm in diameter (8 mm, n = 1; 10 mm, n = 10) All measured clinical outcomes improved postoperatively, including the AOFAS scores (preoperative, 55.4 ± 9.0; 1-year follow-up, 92.1 ± 7.6; p = 0.001) and VAS scores (preoperative, 5.5 ± 0.7; 1-year follow-up, 1.9 ± 0.8; p = 0.001). All weight-bearing ankle radiographs of the graft and donor sites did not reveal arthritic change in the ankle joint, lateral talar dome collapse, and graft-site delayed union or nonunion at 1 year after surgery. For a single medial OLT, harvesting autografts from the ipsilateral lateral talar articular facet without knee donor-site morbidities can be a good alternative in OAT for OLT.

Effect of CO2 Laser-Assisted Titanium Tetra-fluoride on Demineralization of Enamel Around Orthodontic Brackets.

Introduction: One of the clinical problems following orthodontic treatment is white spot lesions around orthodontic brackets due to enamel demineralization. Confronting enamel demineralization during fixed treatments has long been a challenge for orthodontists. The aim of this in vitro study was to evaluate the effect of CO2 laser and Titanium Tetra-fluoride (TiF4) application on the prevention of enamel demineralization around orthodontic brackets. Methods: Eighty permanent premolars were selected and bonded with brackets. They were randomly divided into four groups (n=20): topical titanium tetra-fluoride gel 4% (TiF4), CO2 laser (10.6 μm wavelength for 10 seconds, peak power=291 W), fluoride+laser (F+L) and control (C). All specimens were demineralized for 10 days in a 0.2 M acetate buffer solution. The mean lesion depths were determined by using polarized light microscopy. Results: The mean depth of lesion was the highest in the C group and then decreased in the TiF4, CO2 laser, and F+L groups, respectively. The difference between all groups was significant (P<0.05), except for the CO2 laser and F+L groups. Conclusion: The lowest amount of demineralization around the orthodontic brackets was observed in the L+F group, followed by the CO2 laser, TiF4, and control groups, respectively.

Effect of nanometric β-calcium glycerophosphate supplementation in conventional toothpaste on enamel demineralization: An in vitro study

The aim of this study was to evaluate the effects of supplementing toothpastes containing 1100 ppm F with micrometric or nanometric [beta]-calcium glycerophosphate (β-CaGPm/β-CaGPn) on artificial enamel demineralization, using a pH cycling model. Bovine enamel blocks (4 mm × 4 mm, n = 120) selected using initial surface hardness were randomly allocated to ten toothpaste groups (n = 12): without fluoride or β-CaGPm or β-CaGPn (Negative control), 1100 ppm F (1100 F), and 1100 ppm F plus 0.125%, 0.25%, 0.5%, and 1.0% of β-CaGPm or β-CaGPn. Blocks were treated two times per day with toothpaste slurry and subjected to five pH cycles (demineralizing and remineralizing solutions) at 37 °C. The final surface hardness, percentage of surface hardness loss (%SH), cross-sectional hardness (ΔKHN), and profile analysis and lesion depth subsurface were analysed using polarized light microscopy (PLM). Fluoride (F), calcium (Ca), and phosphorus (P) concentrations were also measured. Data were analysed using ANOVA and Student-Newman-Keuls tests ([alpha] = 0.001). Blocks treated with 1100 F toothpaste containing 0.5%β-CaGPm or 0.25%β-CaGPn showed with reduced %SH values when compared with those treated with 1100 F alone (p < 0.001). Reduced lesion depths (ΔKHN and PLM) were observed for the slurry made up of 1100 F and 0.25%β-CaGPn (p < 0.001). The addition of β-CaGPm and β-CaGPn did not influence the enamel F concentration, with the 1100 F/0.25%β-CaGPn group exhibiting the highest Ca and P enamel concentrations (p < 0.001). Based on the findings of this in vitro study, we can conclude that the fluoride toothpaste produced a superior effect when combined at an appropriate β-CaGP molar ratio. This effect was achieved with a lower proportion of β-CaGP in the form of nanometric particles.

Effects of Contact Force on Lesion Size During Pulsed Field Catheter Ablation: Histochemical Characterization of Ventricular Lesion Boundaries.

Effects of contact force (CF) on lesion formation during pulsed field ablation (PFA) have not been well validated. The purpose of this study was to determine the relationship between average CF and lesion size during PFA using a swine-beating heart model. A 7F catheter with a 3.5-mm ablation electrode and CF sensor (TactiCath SE, Abbott) was connected to a PFA system (CENTAURI, Galvanize Therapeutics). In 5 closed-chest swine, biphasic PFA current was delivered between the ablation electrode and a skin patch at 40 separate sites in right ventricle (28 Amp) and 55 separate sites in left ventricle (35 Amp) with 4 different levels of CF: (1) low (CF range of 4-13 g; median, 9.5 g); (2) moderate (15-30 g; median, 21.5 g); (3) high (34-55 g; median, 40 g); and (4) no electrode contact, 2 mm away from the endocardium. Swine were sacrificed at 2 hours after ablation, and lesion size was measured using triphenyl tetrazolium chloride staining. In 1 additional swine, COX (cytochrome c oxidase) staining was performed to examine mitochondrial activity to delineate reversible and irreversible lesion boundaries. Histological examination was performed with hematoxylin and eosin and Masson trichrome staining. Ablation lesions were well demarcated with triphenyl tetrazolium chloride staining, showing (1) a dark central zone (contraction band necrosis and hemorrhage); (2) a pale zone (no mitochondrial activity and nuclear pyknosis, indicating apoptosis zone); and a hyperstained zone by triphenyl tetrazolium chloride and COX staining (unaffected normal myocardium with preserved mitochondrial activity, consistent with reversible zone). At constant PFA current intensity, lesion depth increased significantly with increasing CF. There were no detectable lesions resulting from ablation without electrode contact. Acute PFA ventricular lesions show irreversible and reversible lesion boundaries by triphenyl tetrazolium chloride staining. Electrode-tissue contact is required for effective lesion formation during PFA. At the same PFA dose, lesion depth increases significantly with increasing CF.

Encapsulation of a novel peptide derived from histatin-1 in liposomes against initial enamel caries in vitro and in vivo.

Biomimetic mineralization mediated by proteins and peptides is a promising strategy for enamel repair, and its specific application model needs more research. In this work, we exploited a liposomal delivery system for a novel peptide (DK5) derived from histatin-1 (DK5-Lips) as a new biomimetic mineralization strategy against initial enamel caries. The DK5-Lips was prepared using calcium acetate gradient method and then the in vitro release, salivary stability, and cytotoxicity were studied. Initial enamel caries was created in bovine enamel blocks and subjected to pH-cycling model treated with DK5-Lips. Surface microhardness testing, polarized light microscopy (PLM), and transverse microradiography (TMR) were analyzed. Then the biocompatibility of DK5-Lips was evaluated in the caries model of Sprague-Dawley rats, and the anti-caries effect was assessed using Micro-CT analysis, Keyes scores, and PLM in vivo. DK5-Lips provided a mean particle size of (97.63 ± 4.94)nm and encapsulation efficiency of (61.46 ± 1.44)%, exhibiting a sustained release profile, excellent stability in saliva, and no significant toxicity on human gingival fibroblasts (HGFs). The DK5-Lips group had higher surface microhardness recovery, shallower caries depth, and less mineral loss in bovine enamel. Animal experiments showed higher volume and density values of residual molar enamel, lower Keyes score, and shallower lesion depth of the DK5-Lips group with good biocompatibility. As a safe and effective application model, DK5-Lips could significantly promote the remineralization of initial enamel caries both in vitro and in vivo. The potential of liposome utilization as vehicle for oral delivery of functional peptides may provide a new way for enamel restoration.

Xylitol associated or not with fluoride: Is the action the same on de- and remineralization?

ObjectivesThis study evaluated the effect of xylitol combined or not with fluoride (F) on reduction of demineralization and increase of remineralization of shallow and deep artificial enamel lesions. MethodsBovine enamel samples were allocated to the following solutions groups: no xylitol (negative control), 5% xylitol, 10% xylitol, 20% xylitol, 500 ppm F (as NaF), 5% xylitol+F, 10% xylitol+F or 20% xylitol+F (n = 12–15). For the demin study, a pH-cycling model (demineralization-6 h, pH 4.7/remineralization 18 h, pH 7.0) was employed for 7 days. Treatments were applied 2 × 1 min. In the remin study, specimens were pre-demineralized for 2, 5 or 10 days. Afterwards, a pH-cycling protocol was conducted (2 h demineralizing and 22 h remineralizing solution/day for 8 days) and the same treatments were done. The response variables were percentage surface hardness loss (%SHL) and transverse microradiography. Data were analyzed by RM ANOVA/Tukey or Kruskal-Wallis/Dunn (p < 0.05) ResultsF and Xylitol combined with F reduced the %SHL (23–30%) compared to the negative control (61.5%). The integrated mineral loss and the lesion depth were not reduced by any treatment. Surface hardness recovery was seen only for shallow lesions in case of 20% xylitol+F compared to negative control. No lesion depth recovery, but significant mineral recovery was seen for F (2-days and 10-days lesion). ConclusionsAll concentrations of xylitol+F reduced enamel surface demineralization, while only 20% xylitol+F improved surface remineralization of shallow lesions in vitro. Clinical significanceOur results suggest that while F or any concentration of xylitol + F reduces surface demineralization, only 20% xylitol+F improves surface remineralization of shallow lesions in vitro. Therefore, xylitol may be added into oral products, combined to F, to control dental caries.

Risk Factors for Caries in Elementary School Children Based on Caries Management by Risk Assessment (CAMBRA)

Background: the prevalence of dental caries in children aged 10 to 14 years is almost 41.4%. The CAMBRA method helps doctors identify the cause of dental caries by identifying risk factors in each patient. Based on research, the etiology of dental caries was found by identifying risk factors in each participant. This study aims to describe what factors influence dental caries in children based on CAMBRA. Method: This research uses observational analysis with. The respondents were students at SDN Kadipiro I, Bantul, Special Region of Yogyakarta, Indonesia. Purposive sampling was used to create the sample, which included 82 children between the ages of 10 and 12 years. The research was carried out by finding dental caries risk factors using the CAMBRA method: 1. cavity or new dentin lesion, 2. white spot, 3. restoration in the last three years, 4. saliva volume, 5. plaque index/PHPM, 6. water pH saliva, and 7. Frequency of consumption of sweet foods. Data were analyzed using the SPSS version 25.0 program which included frequency analysis. Results: The results of the analysis showed five risk factors for caries, namely the condition of the teeth, cavities or new dentin lesions were found in 58 respondents (70.7%), predisposing factors, the number of plaque was obtained in 44 respondents (53.7%), the frequency of protective factors was obtained and the frequency of caries was obtained. 63 respondents experienced dental caries. Conclusion: The risk factors for dental caries based on CAMBRA that influence children's dental caries are the criteria for lesion depth of dentin, saliva pH, and amount of plaque. Keywords: CAMBRA, risk actors, caries, children

Computed Tomography Guided Transthoracic Lung Biopsy: Evaluating Risk Factors of Post-Procedure Pneumothorax- A Multivariate Analysis

Background: CT Guided lung biopsy is a common procedure in our department and pneumothorax is one of its commonest complications. To study the incidence of pneumothorax after CT guided lung biopsy and the various factors associated with the risk of developing pneumothorax after biopsy.&#x0D; Materials and Methods: Our study was a retrospective observational study. We analyzed 360 cases of lung biopsy performed using 18G Coaxial needle for assessing the incidence of post- procedure pneumothorax. The risk factors for pneumothorax were evaluated by univariate analysis, followed by multivariate logistic regression analysis to know the independent risk factors of pneumothorax.&#x0D; Results: The incidence of pneumothorax in our study was 41.9% (151/360 cases). On univariate analysis, we identified the following as risk factors of post-procedure pneumothorax: the presence of emphysema, smaller lesion size, Greater lesion depth, Lateral position, multiple passes and acute angulation of needle trajectory. On multivariate logistic regression analysis these were also revealed to be independent risk factors of post-procedure pneumothorax.&#x0D; Conclusion: Independent risk factors of post procedure pneumothorax are the presence of emphysema, smaller lesion size, greater lesion depth, Lateral position, multiple passes and acute angulation of needle trajectory. Of these lateral position is a novel predictor of pneumothorax that has been scarcely mentioned in literature. As such the radiologist should be prepared for managing pneumothorax in cases with one or more of these risk factors