Horizontal Defects Research Articles (Page 1)

If a prosthetically guided implant rehabilitation is to be carried out, the patient must have adequate bone volume, which is not always present due to bone resorption in the alveolar process. An ef-fective technique in regenerative surgery involves the use of titanium mesh to recreate the missing bone volume. A new generation of meshes have been created, presenting a new texture with mi-croholes and possessing space-making and barrier effects. The primary objective of this study was to measure the height and width of the regenerated bone following the use of a new-generation customized titanium mesh. This retrospective case series involved 18 patients (23 bone atrophies) who underwent bone-regeneration surgery with a titanium mesh and received subsequent implant placement. An average vertical bone gain of 5.2 ± 2.9 mm and an average horizontal bone gain of 12.3 ± 2.6 mm were achieved, as well as an average regenerated bone volume of 3.2 ± 1.3 cm3. One failure occurred (4.3%), and in three cases (13%) it was necessary to perform a minor second surgery. The average follow-up time for implants after loading was 22.3 ± 15.6 months. This study shows the innovation of new-generation titanium mesh and its microperforated texture that offers both a space-making effect and a partial barrier effect. This has led to excellent regeneration results, with a significant improvement in treated vertical and horizontal defects and reduced operating times. Future studies with longer follow-ups are necessary to confirm these findings.

Background The utilization of the robotic platform for ventral hernia repair is increasing, however is facing criticism for perceived high costs. This study aimed to compare the procedure-specific costs of robot-assisted ventral or incisional hernia repair with laparoscopic repair. Methods This propensity score-matched nationwide database study included patients undergoing primary ventral and incisional hernia repair from 2017 to 2022. A total of 554 patients undergoing robot-assisted repair were matched 1:1 with patients undergoing laparoscopic repair by the confounding variables of age, type of hernia (primary ventral/incisional), and horizontal defect size. The primary outcome was the total cost per procedure in Euros including robotic/laparoscopic approach, mesh, tackers, length of stay, readmission, and operative reintervention. The price of obtaining laparoscopic and robotic systems was not included. Results The length of stay was significantly shorter, and readmission rate was significantly lower for robot-assisted repairs (0.5 days and 7.0%) than for laparoscopic repairs (1.2 days and 12.5%), P < 0.001 and P = 0.003, respectively. The mean procedural cost of an incisional hernia repair was significantly reduced with the robot-assisted approach (1,533 Euros (sd: 1,584)) compared to the laparoscopic approach (2,077 Euros (sd: 1,840), P = 0.002). Multivariable linear regression analysis confirmed that robotic ventral hernia repair was independently associated with decreased overall costs (coeff −682.1, CI −1,331.5 - −32.6, P = 0.040). Conclusion For primary ventral hernias, the mean procedural costs of a robot-assisted and a laparoscopic repair are comparable, but for incisional hernia repairs the mean procedural cost is decreased with a robot-assisted approach.

In precast concrete shear wall structures, the joints formed during the vertical connection of precast units are referred to as the “horizontal joint”. Serving as vertical connection nodes in this structure system, the construction quality of theses horizontal joints significantly influences the structural integrity. To investigate the influence of horizontal joint quality defects on the mechanical behaviour of precast concrete shear walls, three precast concrete shear wall specimens with quality defects in different regions and three control specimens were designed. Quasi-static tests under a constant axial load were conducted to investigate the effects of defect area, location and other factors on the mechanical behaviour of the walls. Results demonstrate that the quality defects in horizontal joints significantly affect the mechanical behaviour of precast concrete shear walls. When the ratio of the quality defect area to the cross-sectional area of the boundary member reaches 100%, the yield load and peak load of the precast concrete shear wall decrease by 13% and 20%, respectively. Additionally, the structural stiffness exhibited a 13% degradation at a drift angle of 1/1000. Although the failure mode remains largely unchanged, yielding of longitudinal reinforcement in the boundary members is observed. Moreover, as the proportion of the quality defect area to the cross-sectional area decreases, its adverse effects on the mechanical behaviour of the precast concrete shear wall gradually diminish. The established numerical analysis model is shown to be reasonable and reliable. When the defective area of the horizontal joints is less than 25% of the total cross-sectional area, the quality defects essentially have no influence on the mechanical behaviour of the precast concrete shear walls.

This study aimed to assess the clinical effectiveness of the sausage technique with simultaneous implant placement in the aesthetic zone. A total of 28 patients with horizontal bone defects and consecutive loss of multiple teeth in the maxillary anterior region were included in this retrospective study. Bone augmentation was performed using the sausage technique, and the conventional guided bone regeneration (GBR) technique served as the control. Cone-beam computed tomography (CBCT) was performed preoperatively, postoperatively, and after 6 months of bone healing. The horizontal bone width and bone volume were measured from CBCT images. The changes in horizontal width and bone volume, along with the corresponding resorption rates, were calculated. After 6 months of bone healing, the average bone width increased from 3.18mm to 7.82mm, with an increase of 4.64mm in the sausage technique group. Meanwhile, the horizontal bone width, horizontal bone gain, and bone augmentation volume were significantly higher in the sausage technique group than in the conventional GBR group (P<0.05). The sausage technique resulted in more horizontal bone gain compared with the conventional technique in the cases with horizontal bone defects and consecutive loss of multiple teeth in the anterior maxillary region. When combined with simultaneous implant placement for horizontal bone augmentation, the sausage technique achieves favorable clinical outcomes in the aesthetic zone.

Background and Objectives: Adequate buccal bone thickness is critical for long-term peri-implant health and stability. When residual alveolar bone volume is insufficient, guided bone regeneration (GBR) is a widely adopted technique. While non-resorbable membranes provide structural support, they carry a higher risk of complications and require secondary surgery. Resorbable collagen membranes, offer promising biological properties and easier clinical handling, yet clinical data remain limited. This prospective cohort study aimed to evaluate the clinical and radiographic outcomes of horizontal GBR using a native, non–cross-linked resorbable porcine pericardium membrane fixed with titanium pins, in conjunction with simultaneous implant placement. Materials and Methods: Eighteen patients (26 implants) with horizontal alveolar defects (<6 mm) underwent implant placement and GBR with deproteinized bovine bone mineral and a porcine pericardium collagen membrane. Horizontal bone gain and buccal bone thickness were measured at baseline and 6 months post-operatively. Post-operative complications, patient-reported outcomes (PROMs), and peri-implant tissue health were assessed up to 1 year post-loading. Results: Mean bone gain was 2.95 ± 0.95 mm, and all sites achieved a buccal bone thickness ≥ 1.5 mm. No membrane-related complications occurred. PROMs revealed low morbidity. At 1-year follow-up, marginal bone loss averaged 0.54 ± 0.7 mm, mean probing depth was 2.79 ± 0.78 mm, 92% of sites exhibited keratinized mucosa ≥ 2 mm. Conclusions: Native resorbable porcine pericardium membranes, when combined with DBBM and mechanical stabilization, seem to be effective for horizontal bone regeneration.

Introduction: This study aims to perform a systematic review and meta-analysis to compare the laparoscopic intraperitoneal onlay mesh (IPOM) versus the robotic retromuscular (RM) techniques and their respective outcomes for small and medium-sized ventral hernia repair. Methods: A comprehensive online search was conducted using PubMed, Cochrane, and Embase. Studies comparing laparoscopic IPOM to robotic RM techniques were included. The results analyzed were the length of stay (LOS), surgical site infection (SSI), surgical site occurrence (SSO), readmission, and reoperation. Statistical analysis was performed with R Studio version 4.4.1 using a random-effects model. Results: From 956 records, three retrospective observational studies were included, encompassing 1351 patients (laparoscopic IPOM n = 882; robotic RM n = 469). Primary hernias represented 63%, and 88% had horizontal defects between 3.1 and 3.4 cm. Overall analysis showed comparable results between groups regarding LOS (mean difference: 0.58; 95% confidence interval [CI]: -0.07 to 1.24; P = .08), SSI (risk ratio (RR): 0.90; 95% CI: 0.28-2.85; P = .85), and SSO rates (RR: 1.07; 95% CI: 0.17-6.55; P = .94). In addition, no statistically significant results were seen for readmission (RR: 1.50; 95% CI: 0.79-2.85; P = .21) and reoperation rates (RR: 1.16; 95% CI: 0.47 to 2.86; P = .74). Conclusion: This meta-analysis found similar postoperative outcomes for both laparoscopic IPOM and robotic RM techniques. Future studies are still required to evaluate the role of these operative methods following small- and medium-sized VHR.

Mechanical properties of grouted sleeve splice with horizontal grouting defect after exposure to high temperature

SummaryA 4‐year‐old Thoroughbred gelding was presented with a history of severe colic signs that were non‐responsive to non‐steroidal anti‐inflammatory drugs. During initial evaluation, distended small intestine was observed, together with continued colic signs and a serosanguinous abdominocentesis sample. It was therefore elected to perform an exploratory laparotomy to ascertain and resolve the source of colic. Intraoperatively, a 2 cm horizontal defect was located at the junction between the diaphragm and the left 12th rib, midway between the dorsal and ventral body walls. One metre of small intestine was entrapped within the thoracic cavity. The diaphragmatic defect was digitally extended to 6 cm to allow safe exteriorisation of the intestine. The resulting defect extended from just left of midline to the body wall; the defect was sutured closed using 4 M polyglactin 910 in a simple continuous pattern, utilising forwarder and Aberdeen self‐locking knots. Subsequently, the horse also underwent a jejunoileostomy. The horse progressed well post‐operatively, with the exception of an incisional infection. Repeat thoracic evaluation 2 weeks post‐operatively and again 6 months post‐operatively revealed no evidence of reoccurrence.

Recurrence after open incisional hernia repair remains an issue. Where the mesh preferably is placed in a retrorectus position, it is undetermined what the optimal mesh overlap is. This study aimed to assess the effect of mesh width on long-term recurrence after open incisional hernia repair. The Danish Ventral Hernia Database was merged with The Danish National Patients Registry allowing a 100% follow-up. From 2011 to 2023 we included patients who underwent elective incisional hernia repair with vertical incision, retromuscular mesh placement, and linea alba reconstruction. Mesh and hernia size and repair type were registered. Kaplan-Meier plots showed cumulative incidences of operation for hernia recurrence over a 5-year period. Possible confounders were included in Cox proportional hazard and logistic regression analyses. We included 1,539 patients. Mean (sd) age was 61.2 (12.4) years, 46.2% were females. Mean horizontal defect size was 8.4 (4.2) cm. Seventy-two (4.7%) patients underwent reoperation within 90 days and 112 (7.3%) developed recurrence (median follow-up 3.8 (IQR 1.8-6.1) years). Mesh width of 10-15cm was associated with significantly decreased risk of operation for recurrence compared to both smaller and larger sizes (HR 0.38, CI 0.16-0.90, P = 0.029). Interestingly, fascial defect width was not associated with recurrence risk when adjusting for mesh width. A 10-15cm mesh width is associated with lower risk of recurrence for patients undergoing elective open midline retromuscular incisional hernia repair: this "golden mean" should be of aim rather than "too little" or "as much as possible".

ABSTRACTObjectiveTo evaluate, in a simulation of surgical peri‐implantitis treatment, the impact of type of handpiece, device settings, and instrumentation time on the efficacy of airflowing in cleaning the implant surface, depending on the type of bone defect and implant surface.MethodsTurned and modified surface implants (54 each) were coated with biofilm imitation and mounted on resin models replicating purely horizontal or circumferential intraosseous peri‐implant defects (both 5 mm deep). Implants were instrumented with an airflowing device using a supra‐ or submucosal handpiece, with three settings: (a) power 5, 5 s (b) power 10, 5 s, and (c) power 5, 15 s per implant/defect sextant.ResultsThe amount of residual biofilm imitation was associated with defect configuration, type of handpiece, and device settings (p < 0.15); implant surface did not have an effect. In horizontal defects, with the supramucosal handpiece, only 3 of 54 implants showed > 5% residual biofilm imitation and 23 of 54 implants were completely clean; with the submucosal handpiece, 12 of 18 implants showed ≤ 5% residual biofilm imitation when used for 15 s/sextant, yet none were completely clean. In intraosseous defects, all implants presented ≤ 5% residual biofilm imitation and 10 of 18 implants were completely clean with the submucosal handpiece used for 15 s/sextant; the supramucosal handpiece was largely inefficacious.ConclusionWithin the limitations of this laboratory study, peri‐implant bone defect configuration should dictate the choice of airflowing handpiece (i.e., for horizontal defects, the supramucosal handpiece; for intraosseous defects, the submucosal handpiece) and intrasurgical airflowing requires a prolonged instrumentation time, but not increased power.

BackgroundOne of the notable challenges in implant dentistry is the inadequacy of bone dimensions. While guided bone regeneration remains the standard approach for horizontal bone reconstruction, emerging new approaches such as the shell technique offer the potential for significant bone gain through effective space creation. This article presents a modified shell technique as a promising and practitioner-friendly solution for managing horizontal bone deficiencies before and during implant placement. This article aims to introduce a simplified and minimally invasive approach that enhances space maintenance and surgical management and allows for extraoral screw fixation to the disc with just a single screw.MethodologyThis study included six patients with horizontal bone defects that made them candidates for bone augmentation procedures. We employed a newly modified shell technique utilizing a single-screw cortical disc. The cortical discs were fabricated from cortical plates using a trephine drill and Cortico-Cage device. A titanium screw was secured extraorally to the cortical disc. The assembly of the screw and disc was anchored bi-cortically in the appropriate position, and the gap between the cortical disc and the underlying bone bed was filled with a combination of autogenous chips and allograft material. This simplified shell technique is designed to facilitate bone augmentation in areas with horizontal bone deficiencies.ResultsCone-beam computed tomography assessments performed five months postoperatively in five cases demonstrated that the increase in bone width at the crestal area, specifically at the site of cortical discs, ranged from a minimum of 2.03 mm to a maximum of 5.76 mm. Moreover, the initial bone width before reconstruction in the evaluated cases ranged from a minimum of 1.74 mm to a maximum of 4.40 mm. Radiographs before and after the procedure indicated a noteworthy bone formation.ConclusionsThe findings suggest that employing a single screw to secure the cortical disc while connecting it to the disc outside of the patient’s oral cavity can facilitate the surgical process and enhance patient comfort.

Horizontal lines were discovered during the reliability test of micro‐LED display. The basic reason is the short of metal lines with different voltages owing to edge design and film structure. By optimizing process flow and backplane design, the defect is significantly improved. Furthermore, several suggestions of design have been proposed.

Background/Objectives: Guided bone regeneration (GBR) is a regenerative technique used to treat maxillary osseous defects to enable implant placement for prosthetic rehabilitation. It is generally performed with the use of barrier membranes and bone substitute materials of human or animal origin. Here, we report the clinical and histological outcomes of a horizontal GBR, treated using only synthetic biomaterials. Methods: A graft of nanocrystalline hydroxyapatite (NH) embedded in a silica gel matrix was used to fill a horizontal bone defect. The graft was covered with a titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membrane, and primary closure was completed and maintained for 10 months. Then, the site was re-opened for membrane removal and implant insertion. During implant bed preparation, a bone biopsy was obtained for histological evaluation. A metal–ceramic crown was fitted, and the 5-year follow-up after prosthetic loading showed clinical and radiographically healthy tissues. Results: Histological examination revealed good integration of the biomaterial into the surrounding tissues, which were composed of lamellar bone trabeculae and connective tissue. New bone formation occurred not only around the NH granules but even inside the porous amorphous particles. Conclusions: The combination of NH and the TR-dPTFE membrane produced good clinical and histological results, which remained stable for 5 years.

Background: The autogenous bone core block (BCB) is a viable, biologically advantageous, and minimally invasive alternative to other augmentation procedures for small bone defects around dental implants. This study focused specifically on horizontal vestibular defects in the mandible, a frequently encountered yet underrepresented clinical situation, to evaluate the effectiveness and predictability of bone core grafting. Methods: Cylindrical autogenous bone cores, harvested from the implant-site osteotomy using trephine drills with a 2.5 internal diameter, were stabilized with osteosynthesis screws, and implants were placed simultaneously. Initial preoperative measurements of the edentulous ridge width were performed based on cone beam computer tomography (CBCT). At 4 months postoperatively, a subsequent CBCT measurement was performed for each implant site. Results: A total of 38 augmentation procedures were analyzed with a mean horizontal bone gain of 1.8 mm (p = 0.000). Improved outcomes were observed in V-shaped defects with remaining vertical bony walls, which contributed to better graft stability and volume preservation. While Khoury et al. previously validated the general applicability of this technique across various defect types, our study refines its indication by offering a clear protocol tailored to a common clinical niche. Conclusions: The proposed BCB method proved to be a safe, efficient, and with reduced morbidity procedure, providing clinicians with a practical and evidence-based tool for predictable horizontal bone augmentation.

Both cosmetic and functional aspects are important in reconstructing the lower eyelid tissue defects. In this case report, we describe a two-stage reconstruction of a skin defect, including the orbicularis oculi muscle, after resection of a basal cell carcinoma using a paramedian forehead flap combined with the frontalis muscle and periosteum. In the first stage, the paramedian forehead flap, including the frontalis muscle and periosteum, was elevated, the periosteal flap was fixed to the outer orbital periosteum to lift the lower eyelid, and the skin flap, including the frontalis muscle, was sutured to the defect. In the second stage, the flap was divided and the frontalis muscle flap was sutured to the medial palpebral ligament. Electromyography at 1 year postoperatively confirmed neurotization of the transferred muscle, and at 6 months, voluntary contraction of the transferred muscle was observed during eyelid closure. These results suggest that a paramedian flap combined with the frontalis muscle and periosteum is a useful option for reconstructing horizontal skin defects involving the orbicularis oculi muscle.

Introduction: In the context of tooth extraction, this clinical practice is common for dentists, with the main causes of caries, periodontal disease, and coronal-radicular fractures. The choice for rehabilitation with implants has been growing, and to be carried out, it needs alveolar bone preservation at the implant site and adequate gingival contour, especially in aesthetic regions. However, the new techniques and instruments for minimally traumatic extraction still need to be analyzed, as little research has evaluated the success rate and limitations of these devices. Objective: It was developed a systematic review to highlight the importance of minimally traumatic tooth extraction for dental implants and aesthetics. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 130 articles were found, 32 articles were evaluated in full and 25 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 32 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=81.6%&gt;50%. It was concluded that the use of precise and minimally traumatic techniques enabled satisfactory and functional aesthetic results, as well as improving the patient's aesthetics and self-esteem. The immediate implant placement procedure after tooth extraction preserves bone height and thickness, reduces treatment time and cost, in addition to maintaining the gingival architecture, being important for the aesthetic success of future prosthetic rehabilitation. Also, it presents success rates comparable to implants in fully healed edges, the extraction must be done in a minimally traumatic way, to preserve the maximum bone tissue. The horizontal defects present after the installation of the immediate implant, if they are less than or equal to 3mm, will heal with complete bone filling. However, if they are larger than 3mm, bone graft material and/or membrane should be used so that there is bone healing.

In rock blasting, the stress wave energy attenuation, projection reflection, and stress concentration at the crack tips—caused by variations in the filling medium, crack size, and other factors—lead to the initiation and deflection of crack propagation paths. To investigate the underlying mechanisms, organic glass, which can effectively simulate rock materials, was used in model experiments. These experiments utilized the dynamic caustic line method to analyze the influence of filling medium and material thickness on the rock blasting process. The results indicated that different filling media affect crack development in the borehole. However, when the filling medium closely matches the defect matrix, stress concentration at the left end of both vertical and horizontal defects becomes more pronounced. The crack propagation speed and stress intensity factor (K_I)—which measures the intensity of stress near the crack tip—were found to be significantly higher when the filling medium is air, with values of 350 m/s and 1.781 MN/m3/2, respectively, far exceeding those observed with the other two media. At t = 175 μs, the stress intensity factor for epoxy resin was 1 MN/m3/2, which is greater than the value of 0.5 MN/m3/2 for air, indicating that a favorable free surface and higher diffraction effects provide some compensation for crack propagation. The defect thickness also influences the direction and length of crack propagation. However, when the thickness reaches a certain level, delamination occurs in the triangular area between the vertical and horizontal defects, causing the crack propagation speed at the ends of the horizontal defects to initially decrease and then increase. As the defect thickness increases, the time required for crack initiation at both ends of the vertical and horizontal defects increases. The stress intensity variation curves at the ends of the horizontal defects show that, regardless of thickness, the left end of the horizontal defect is more prone to crack initiation than the right end.

Vertical bone augmentation (VBA) in the anterior maxilla is a technically and biologically challenging technique with high complication rates and unpredictable outcomes. Selecting appropriate soft tissue management strategies is crucial to avoid short-term and long-term complications. This article aims to assist clinicians in making treatment decisions based on different soft tissue conditions during VBA. It is divided into two parts. Incision and flap design based on the quality and quantity of different soft tissues during VBA. For mucosa of good quality and quantity, a trapezoidal flap incision design is adopted, and the periosteum extension technique is applied for tension reduction. For a shallow vestibular sulcus, a larger trapezoidal flap is used, and the tension reduction method of mucosa-oralis muscle separation is applied, along with papilla transposition suture to ensure primary wound closure. For thin mucosa or with perforating defects, a pedicled periosteal flap is used for repair. Selection of appropriate soft tissue augmentation techniques during the second-stage surgery based on the soft tissue status to improve esthetic outcomes. For horizontal soft tissue defects, free connective tissue graft (CTG) or palatal pedicled flap can be used for treatment; for vertical soft tissue defects, techniques such as the iceberg technique or customized CTG with bowtie-like shape can be used for vertical augmentation; for combined horizontal and vertical defects, the connective tissue platform technique can be used for three-dimensional soft tissue reconstruction.

The textile sector is crucial to India's economy, and one of its most significant facets is the management of fabric quality. In computer vision, texture analysis is used for the purposes of defect detection, classification, and segmentation. In order to save manufacturing time and costs, this paper explains a fundamental method for identifying various fabric flaws in the textile industry. An essential part of quality control, automated fabric inspection systems help find textile flaws quickly and accurately while also cutting down on human labor. In this work, we assess two classifiers—the NN classifier and the SVM classifier—on a 5000 fabric image samples, TILDA dataset for the purpose of recognizing six distinct defects: holes, horizontal defects, reed markings, burls, slubs, stains, and double end marks. One of the most fundamental and significant components of modern fashion is textile. We can't fathom a world devoid of textiles. Another essential problem in the textile production sector is fabric quality monitoring. When it comes to finding various types of fabric defects, such as holes, slubs, oil stains, etc., automatic defect detection is seen to be quite interesting. Using the provided fabric samples, this study introduces a novel method for fault and defect identification. The five-step process for textile defect detection begins with collecting picture samples from the industry-standard TILDA dataset. Grayscale transformation is a preprocessing technique that is used to enhance the picture quality and eliminate undesired noise. As a last step in feature extraction, SVM takes the gray-level co-occurrence matrix (GLCM) into account. The testing phase, however, involves validating these two classifiers using the test data and calculating their sensitivity, specificity, and accuracy.

Evaluation of Injectable Platelet-rich Fibrin with Xenograft (Sticky Bone) for the Treatment of Horizontal Bone Defect in Periodontitis by Assessing Bone Fill: A Randomized Controlled Clinical Trial