Soft Tissue Inflammation Research Articles

Comparative Clinical Study of the Effect of Nigella Sativa Oil on Soft Tissue Healing and Inflammation Reduction Compared to Eugenol in the Context of Dry Socket.

Research background Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but despiteits high incidence, there is noestablished treatment for this condition. Nigella sativa oil has anti-inflammatory propertiesand enhances woundhealing. Thus, we have decided to conduct a study to evaluate the efficacy of Nigella sativa oil in the context of dry sockets. Aim of the study This study aims to evaluate the effect of a Nigella Sativa oil dressing compared with an Eugenol dressing for the treatment of dry sockets in terms of accelerating soft tissuehealing and reducing the intensity of inflammation. Materials and methods A total of 36 patients (19 males, 17 females), ranging between 20 and 50 years, 40 sockets with Alveolar osteitis randomized into 20 sockets for each group. In the first group, Eugenol with a Gelfoam carrier was used, in the second group, Nigella Sativa oil with a Gelfoam carrier was usedand after copious irrigation with normal saline in both groups. Soft tissue healing and the degree of inflammation were monitored on the third (T1) and seventh (T2) days. Results The results of our study showed clinicaland statisticalsuperiority in favor of the Nigella Sativa oil group compared to the Eugenol group at time T2, where the P-value was less than 0.05. Conclusions Within the limits of our study, we found that Nigella Sativa oil led to better healing of soft tissues and reduced the intensity of inflammation in the context of dry socket, and was superior in effectiveness to Eugenol, and we recommend its use for the treatment of dry socket.

Changes in Tophus Composition During Urate-Lowering Therapy: A Dual-Energy Computed Tomography Study.

The gouty tophus is an organized structure composed of monosodium urate (MSU) crystals and chronic inflammatory soft tissue. This dual-energy computed tomography (DECT) study aimed to determine whether the composition of the tophus changes during urate-lowering therapy. Serial DECT scans from 32 people with gout were obtained over 2 years of allopurinol therapy, dose-escalated to serum urate of <0.36 mmoles/liter. Up to 5 index tophi were selected for each patient, with 103 separate tophi included in the analysis. Using manual outlining methods of conventional CT and DECT scans, the same index tophi were serially measured for total tophus volume and urate volume. For each tophus, the soft tissue volume was then calculated by subtracting the urate volume from the total tophus volume. The mean ± SD serum urate reduced from 0.43 ± 0.03 mmoles/liter at baseline to 0.31 ± 0.02 mmoles/liter at year 2. The mean ± SD total tophus volume reduced over the 2-year period from 5.17 ± 5.55 cm3 to 2.61 ± 2.73 cm3 (P < 0.0001). Greater reductions in tophus urate volumes than tophus soft tissue volumes were observed; the tophus urate volume decreased by 70.6%, and tophus soft tissue volume decreased by 37.8% (P < 0.0001). The mean tophus urate:soft tissue ratio reduced from 0.15 at baseline to 0.05 at year 2 (P < 0.001). The composition of the tophus is dynamic and changes during urate-lowering therapy for gout management. The soft tissue component of the tophus is slower to respond and may persist without measurable MSU crystal deposition.

Multiprotocol treatment modality in chronic peri-implantitis utilizing decontaminating, single phase bio-ceramic and autologous fibrin matrix

Introduction: Peri-implant diseases are defined as pathological inflammatory reactions in the tissue surrounding osseointegrated implants. They are classified into two categories: mucositis—defined as peri-implant soft tissue inflammation and peri-implantitis—bone loss in the peri-implant region. Case Report: A clinical case of a 61-year-old woman with an implant in the 46 anatomical position presented with peri-implantitis after a 5-year follow-up. A probe depth of 5 mm and a bone defect length of 35% was observed. The Implacure Protocol was applied, with the main objective of eliminating the biofilm present on the exposed implant surface. There are multiple approaches to treat peri-implant diseases. While non-surgical treatment is essentially sufficient for mucositis control, the treatment in most cases of peri-implantitis should be surgery. Regenerative bone reconstruction promotes bone repair in the defect area and reduces bleeding during probing. To achieve that, autologous fibrin combined with Cerasorb M was used. Conclusion: The proposed approach in the presented clinical case involves the application of Implacure Protocol, whose combination of the physical decontamination technique, together with the use of chlorhexidine and orthophosphoric acid, added with the combination Piperacillin + Tazobactam together with hyaluronic acid, provided a base that allows to regenerate bone using platelet-rich fibrin with Cerasorb M and increase the implant survival time.

Early laser treatment of local complications after surgical blepharoplasty

Purpose of the study: to evaluate the effectiveness of early laser treatment of various types of local complications after surgical blepharoplasty based on the dynamics of the clinical picture and outcome, as well as patient satisfaction indicators according to FACE-Q.Material and methods. The study involved 24 patients with various types of local postoperative complications: scars with a tendency to hypertrophic growth (5 cases), inversion of the lower eyelid (4), seroma with undetected ligature fragments (2), aseptic inflammation of soft tissues of unknown genesis (2), neoangiogenesis in the eyelid area (3), extensive hemorrhages in the surgical intervention area (8 cases). Treatment was started on the day of the patient's treatment when the fact of the complication was established. The treatment was performed using the MultilineTM laser multiplatform using the Nd:YAP/KTP vascular laser with a combination of two wavelengths of 540 and 1079 nm and/or the Er:YAG, 2940 nm laser with SMA technology. The choice of the type of laser radiation and the interval between sessions were determined by the nature of the complication. Patients' satisfaction with the results of treatment was determined by the FACE-Q questionnaire.Results. The results of treatment by evaluators were determined as excellent in 19 patients (79.2%) and good in 5 patients (20.8%). The outcome of the resolution of complications in all patients was a thin, flat, inconspicuous scar, persistent defects requiring additional correction were not observed. During 6 months of follow-up, the dynamics of FACE-Q indicators after laser treatment of complications showed a statistically significant improvement on all assessed scales: the general appearance of the eye, the outcome of the operation performed, the severity of side effects, psychological stress, social adaptation.Conclusion. Laser treatment of postoperative complications of blepharoplasty allows improving the aesthetic result of the operation and restoring the psychoemotional state of the patient.

Short-term influence of antimicrobial photodynamic therapy as an adjuvant to mechanical debridement in reducing soft-tissue inflammation and subgingival yeasts colonization in patients with peri-implant mucositis

ObjectiveThe objective of this short-term follow-up study was to evaluate the influence of antimicrobial photodynamic therapy (aPDT) as an adjuvant to mechanical debridement (MD) in reducing soft-tissue inflammation and subgingival yeasts colonization (SYC) in patients with peri‑implant mucositis (PiM). MethodsIndividuals diagnosed with PiM were included. Demographic data was collected using a questionnaire. Peri-implant plaque index (PI), bleeding index (BI), probing depth (PD), crestal bone levels and SYC were measured at baseline. Therapeutically, these individuals were divided into test and control groups. In the control-group patients underwent MD and in the test-group patients underwent MD with adjunct single session of aPDT. Clinical peri‑implant parameters and SYC were reassessed after 12-weeks. Correlation between age, gender and duration of implants with SYC and clinical peri‑implant status was assessed using logistic regression models. P < 0.05 was selected as an indicator of statistical significance. ResultsThe test and control-groups comprised of 24 and 23 individuals, respectively. In the test and control groups, toothbrushing twice daily was reported by 7 (29.2%) and 5 (21.7%) individuals, respectively. None of the individuals had ever used a dental floss. At baseline, there was no difference in peri‑implant PI, BI, PD and CBL in the test and control groups. At follow-up, peri‑implant PI (P < 0.01), BI (P < 0.01) and PD (P < 0.01) were significantly higher in the control compared with the test-group. At baseline, SYC in the test and control groups were 1865.3 ± 403.4 CFU/ml and 1963.7 ± 512.4 CFU/ml, respectively. At 90 days’ follow-up, SYC in the test and control groups were 1472 ± 202.7 and 1538.4 ± 331.7 CFU/ml, respectively. There was no significant difference in SYC in both groups when baseline values were compared with 90 days’ follow-up. ConclusionOne session of aPDT after MC with adjunct aPDT is effective in reducing soft tissue inflammation but not SYC in patients with PiM.

Low-level laser therapy prevents medication-related osteonecrosis of the jaw-like lesions via IL-1RA-mediated primary gingival wound healing

BackgroundMedication-related osteonecrosis of the jaw (MRONJ) is a serious debilitating disease caused by anti-resorption and anti-angiogenesis drugs, significantly affecting patients' quality of life. Recent studies suggested that primary gingival wound healing may effectively prevent the development of MRONJ. This study aimed to evaluate the effects of low-level light therapy (LLLT) on promoting gingival wound healing in extraction sockets of MRONJ-like mice and preventing the occurrence of MRONJ. Furthermore, we explored underlying mechanisms.MethodsMice were randomly divided into the Ctrl, Zol, and Zol + LLLT groups. Administration of zoledronate and tooth extraction of bilateral maxillary second molars were used to build the MRONJ model, and LLLT was locally administered into the tooth sockets to examine the effect of LLLT. Next, to explore the function of IL-1RA, we performed LLLT with interleukin-1 receptor antagonist (IL-1RA) neutralizing antibody (named Zol + LLLT + IL-1RA NAb group) or negative control antibodies for tooth extraction in subsequent rescue animal experiments. Stereoscope observations, micro-computed tomography, and histological examination were conducted to evaluate gingival wound healing and bone regeneration in tooth sockets. The effects of LLLT on the migration capacities of zoledronate-treated epithelial cells were assessed in vitro.ResultsLLLT promoted primary gingival wound healing without exposed necrotic bone. Micro-computed tomography results showed higher bone volume and mineral density of the tooth sockets after LLLT. Histology analysis showed complete gingival coverage, obvious bone regeneration, and reduced soft tissue inflammation, with down-regulated pro-inflammation cytokines, like interleukin-1 beta (IL-1β) and tumor necrosis factor-α (TNF-α), and up-regulated IL-1RA expression in the gingival tissue in the LLLT group. The rescue assay further showed that the effects of LLLT promoting gingival wound healing and preventing MRONJ might be partially abolished by IL-1RA neutralizing antibodies. In vitro studies demonstrated that LLLT accelerated zoledronate-treated epithelial cell migration.ConclusionsLLLT might promote primary gingival wound healing and contribute to subsequent bone regeneration of the tooth extractions in MRONJ-like lesions via IL-1RA-mediated pro-inflammation signaling suppression.

Anti-Inflammatory Potency of Mangosteen (Garcinia mangostana L.): A Systematic Review

BACKGROUND: Mangosteen (Garcinia mangostana L.) is a tropical fruit, widely used in Southeast Asia as a health food and supplement, because of its beneficial effects on the body. In many studies, mangosteen is described to have many health effects such as antimicrobial, antioxidant, anti-proliferative, anti-carcinogenic, and antiinflammatory. The anti-inflammatory effect is important because many diseases have pathophysiology associated with the inflammatory process. AIM: This study aimed to assess and conclude the scientific database systematically to investigate the anti-inflammatory potency of mangosteen (Garcinia mangostana L.). METHODS: Cochrane handbook for systematic reviews and the guideline of preferred reporting items for systematic review and meta-analysis (PRISMA) were used as guidelines in this review. RESULTS: The authors searched the study in electronic databases which met inclusion and exclusion criteria. The authors independently evaluated 412 studies in database finding, 24 studies fulfilled the criteria for this review. CONCLUSION: Mangosteen (Garcinia mangostana L.) has anti-inflammatory potency (especially the component of xanthone and flavonoid) in various inflammatory conditions and diseases; such as obesity, skin disease, psychiatric disease, tooth disease, asthma, atherosclerosis, acetaminophen-induced hepatotoxicity, peritonitis, colitis, prostatic hyperplastic, arthritis, and soft-tissue inflammation.

Surgical Excision of Hypertrophic Tissue and Retrieval of Orthodontic Mini-implant using Diode Laser- A Rare Case Report

Orthodontic mini-implants or transient anchorage devices can be used to shift difficult teeth. There is substantial evidence showing the effectiveness of Temporary Anchorage Devices (TAD) and their anchorage requirements. However, there are also reports of failures and complications like soft tissue inflammation, tissue overgrowth, peri-implantitis and mini-implant fracture. The present case report of 22 years old female patient, discusses a rare occurrence of tissue overgrowth over the mini-implant on right buccal mucosa in relation to 45, 46 regions. A 1.3×9 mm stainless steel mini-implant was used as an interim anchorage device. The tissue overgrowth was attributed to soft tissue inflammation around the mini-implant. Under adequate anaesthesia, the tissue was removed using a laser, and the mini-implant was retrieved using tissue forceps. After achieving hemostasis, simple interrupted sutures were placed. It is recommended to administer antibiotics, analgesics, and along with postoperative instructions. When used correctly, mini-screws are valuable tools that enhance the effectiveness of orthodontic treatment. However, there is a scarcity of case studies discussing the complications and side-effects of mini-implants. Clinicians should carefully evaluate both general and unique side-effects and complications at the insertion site. This case report demonstrates the successful removal of an orthodontic mini-implant following diode laser ablation of hyperplastic tissue.

Surgical Success in Peri-implantitis Management using Guided Bone Regeneration: A Case Report with 2-Year Follow-up

Dental implant-supported restorations have become a potential treatment option for edentulous patients. However, complications may arise due to an inappropriate selection of patients and/or inadequate treatment planning, along with irregular maintenance. In such scenarios, peri-mucositis and Peri-Implantitis (PI) may occur as sequelae to dental implants. The prevalence rates of these complications are reported to be high. Inflammation of peri-implant soft tissue and resorption of supporting bone are significant features of PI. Routine evaluation should include Probing Pocket Depth (PPD) measurement and radiographic assessments to determine pathological changes in the peri-implant tissue. Treatment modalities for PI include non-surgical therapy, local drug delivery, anti-infective therapy, and surgical management focused on regenerating the lost peri-implant tissue. This case report demonstrates successful surgical management of PI in a 22-year-old male patient who presented with exudate in relation to an endosseous implant in the 12 region, with a PPD of 7 mm and peri-implant bone loss. Meticulous planning and comprehensive management led to the implant finally being restored to a healthy and fully functional status.

Nekrotizirajući fascitis - prikaz slučaja

Background. Necrotizing soft tissue infections are actually the diseases with a severe outcome characterized by the progression of soft tissue inflammation with a catastrophic prognosis and the risk of major functional consequences. Only prompt diagnosis and prompt care, including prompt administration of appropriate antibiotic therapy and surgical treatment, can improve the outcome. Case report. A female patient, aged 66 years, came due to swelling and pain in the perineum. Before admission, the pains were of low intensity, and immediately before admission, their intensity increased. An incision was made in the perineal region and the abdominal region on the left. During the preparation, we came across a necrotic tissue from which a dark-gray liquid flew that had a strong smell. From the tenth postoperative day, secondary sutures were partly placed. Conclusion. Mortality and morbidity in this disease are high. A potential new treatment for this disease may be an antigen-inhibiting vaccine.

The efficacy of hydrogel containing zinc oxide-loaded and minocycline serum albumin nanopartical in the treatment of peri-implantitis.

We conducted this animal study to assess the efficacy of the novel hydrogel containing zinc oxide-loaded and minocycline serum albumin nanoparticals (Mino-ZnO@Alb NPs) on peri-implantitis in an experimental mouse model. Mino-ZnO@Alb NPs was prepared as previously reported. The peri-implantitis model was successfully established in rats, and the rats were divided into three groups randomly: Mino-ZnO@Alb NPs (Mino-ZnO) group, minocycline group, and untreated group. Four weeks later, clinical and radiographic assessments were performed to evaluate soft tissue inflammation and bone resorption level. Histologic analysis was performed to estimate the amount of remaining supporting bone tissue (SBT) around implants. ELISA tests were used to determine the concentration of inflammation factor interleukin-1-beta (IL-1β) and anti-inflammation factor tumor necrosis factor-alpha (TNF-α) around implants. After one month, the Mino-ZnO group showed better results than the other two groups in regards to the results of bleeding on probing, probing pocket depth, bleeding index and gingival index. X-ray showed that SBT at mesial and distal sites around implants in the other two groups was significantly lower compared with that of Mino-ZnO group. The quantity of osteoclasts in peri-implant tissues of the Mino-ZnO group was less than that in the minocycline and untreated groups. IL-1β in the Mino-ZnO group was lower than that in the other two groups. TNF-α level was the opposite. Mino-ZnO@Alb NPs can effectively treat peri-implantitis and promote soft tissue healing, and may act as a promising product.

Indication and Success Rates of Skeletal Anchorage System in Orthodontics

Skeletal anchorage systems, a pivotal innovation in orthodontics, involve the use of Temporary Anchorage Devices (TADs) or mini-implants, providing stable anchor points in the bone to facilitate precise tooth movements. This comprehensive review article aims to investigate the indications and success rates of skeletal anchorage systems in orthodontics. The research, initiated on November 2nd, 2023, involved an extensive examination of existing literature, utilizing databases like PubMed, Web of Science, and Cochrane. Various components, including mini-screws, mini plates, palatal, buccal shelf implants, and infrazygomatic implants, have enriched orthodontic diversity. Mini screws have displayed remarkable success rates, with most complications related to manageable soft tissue inflammation. Gingival health and smoking habits have been identified as influential factors in mini screw implant success. Mini plates offer sturdy anchorage with resistance to root damage and fracture, surpassing mini screws in overall success rate. Age, implantation site viability, and soft tissue characteristics influence their success. Palatal and buccal shelf implants provide exceptional stability, enhancing the results of fixed bracket appliances. The anterior palatal region is a preferred site for implantation. Infrazygomatic implants, while offering commendable stability, display failure rates within the range of 21-28%, with compromised oral hygiene, immediate loading, inflammation, tooth mobility, and a high mandibular plane angle as potential failure factor. These anchorage methods have expanded treatment possibilities, offering effective solutions for challenging orthodontic cases and ultimately improving patient outcomes.

Histopathological evaluation of benign soft tissue lesions at Nnamdi Azikiwe University teaching hospital, Nnewi, south-east Nigeria: A 9-year review

Background: Soft tissue lesions are remarkably diverse and range from inflammatory, self-limited lesions to neoplasm. The diversity of these lesions frequently poses a diagnostic challenge to pathologists and remains a subject of interests. Lack of research on soft tissues in our setting has prompted the need to study them. Objectives: The aim of this study was to determine the benign lesions of soft tissues with respect to age, sex, anatomic site, and histologic types. It also aimed to determine the baseline data of benign soft tissue lesions in Nnewi, Nigeria. Materials and Methods: This study reviewed all histologically diagnosed benign soft tissue lesions at the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria from 2011 to 2019 and classified the tumors using the 2020 WHO Classification of Soft Tissue Tumours. Results: A total of 351 cases of soft tissue lesions were diagnosed during the study period, out of which 251 were benign lesions and accounted for 71.5% (251/351) of all soft tissue lesions, whereas 28.5% (100/351) of the cases were malignant. The benign lesions included inflammatory and benign neoplasm, of which neoplasm accounted for the majority of the cases with a frequency of 94.0% (236/251), whereas inflammatory lesions accounted for 5.9% (15/251). The 236 benign soft tissue tumors diagnosed had a male-to-female ratio of 1: 1.4 with a mean age (SD) of 37.5 (19.5) years. The most frequent occurrence of benign tumors was seen in the fourth decade with 52 cases (21.0%), followed by fifth decade with 42 cases (16.7%). Adipocytic tumors were the commonest with a frequency of 54.0% (135/251), followed by peripheral nerve sheath tumors (PNSTs) with 12.4% (31/251) and then vascular and fibroblastic/myofibroblastic tumors with 10.8% (27/251) and 5.6% (14/251), respectively. Lipoma is the most common histologic type of benign soft tissue tumor and the only benign adipocytic tumor. This is followed by hemangioma 9.6% (24/251) and then neurofibroma 7.6% (19/251). Lipoma accounted for 37.09% (135/351) of all soft tissue lesions and the majority of them were seen in the fourth decade, whereas hemagioma and neurofibroma occurred more at the first decade. The most common anatomic distributions of these benign tumors were lower extremities with 23.5% (n = 59/251), followed by trunk 21.1% (n = 53). The major inflammatory lesions were tuberculoid granulomatous inflammation and panniculitis with 2.3% (6/251) of cases each. Others were necrotizing fasciitis (n = 2) and eosinophilic myositis (n = 1). Conclusion: Benign soft tissue tumors had a slight female preponderance. Lipoma is the single most common benign soft tissue neoplasm, whereas tuberculosis and panniculitis were the two most common inflammatory soft tissue lesions. Histopathological evaluation of these lesions still stands as a gold standard in their diagnosis.

A study of the diagnostic efficacy of diffusion-weighted magnetic resonance imaging in the diagnosis of perianal fistula and its complications.

To determine the diagnostic efficacy of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis of perianal fistula and its complications. This is a retrospective study based on the data of 47 patients with a clinical diagnosis of perianal fistula, who had an MRI study performed on a 1.5-T GE Signa MR scanner. DWI sequences were done using 3 different b-values. Other routine MR sequences were included. The MR images were studied to compare the diagnostic efficacy of the DW MRI sequence and other sequences in diagnosing perianal fistula and its complications. Apparent diffusion coefficient (ADC) values of abscesses and inflammatory soft tissue lesions were measured using ADC maps. The standard reference to obtain diagnostic efficacy was post-surgical data. Seventy-nine perianal fistulas were diagnosed in 47 patients who had undergone an MRI study. The sensitivity and specificity of different MR sequences in diagnosing perianal fistulas are T2 FSFSE: 92% sensitivity; DWI: 96% sensitivity; combined T2+DWI: 100% sensitivity; and post-gadolinium T1 FS has 100% sensitivity in diagnosing perianal fistulas. The mean apparent diffusion coefficient for the abscess in our study was 0.990 ± 0.05 × 10-3, and the mean apparent diffusion coefficient for an inflammatory soft tissue lesion was 1.440 ± 0.05 × 10-3. The optimal ADC cut-off for the abscess was 1.098 × 10-3 mm2/s showing 100% sensitivity and 93.8% specificity. DW imaging is a reliable sequence to diagnose perianal fistula and its complications. Measurement of ADC values is reliable in diagnosing perianal abscess collection. DWI sequence helps patients with renal impairment in whom IV gadolinium is contraindicated.

ORAL HEALTH RELATED QUALITY OF LIFE BY USING ORAL HEALTH IMPACT PROFILE (OHIP) SCORES IN PARTIALLY DENTATE PATIENTS WITH PROVISION OF TOOTH- SUPPORTED FIXED PARTIAL DENTURES

Globally, dentistry and healthcare policies now follow a different paradigm. These days, the focus is more on theindividuals’ improved quality of life than on the marginal treatment of physical and psychological illnesses. Thisstudy assessed the quality of life associated with oral health in patients who were partly dentate and receiving fixedpartial dentures supported by teeth by utilizing the Oral Health Impact Profile (OHIP) scores. From October 2015to April 2016, 209 participants in this quasi-experimental research were seen in the prosthodontics departmentin the prosthodontics department at Bacha Khan Medical College, Mardan. Patients with one or two missing teeththat will be replaced by a fixed partial denture, excellent general health, the ability to comprehend and react to thequestionnaire, and no soft or hard tissue inflammation in the oral cavity were included. Patients ranged in age from18 to 60. Excluded from the study were those with severe congenital or surgical deformities of the jaws, drug addiction, psychological instability, acute pain associated with TMJ disorders, life-threatening illnesses, disability, lack ofcooperation, and active periodontal disease or caries. The cumulative score for each of the 14 questions in the OHIPquestionnaire was recorded as the patient’s OHIP score. With SPSS version 17, statistical analysis was carried out.For every variable, descriptive statistics were calculated. Age and gender-based stratification of the OHIP Score wasdone to look for impact modifiers. The Paired T-test compared the Oral Health Impact Profile scores before and after.A significant threshold of P≤0.05 was used.The OHIP score changed on average by 20.84±3.25, a statistically significant change (P&lt;0.0001). Thirty patients(14.35%) had two missing teeth, compared to n=179 (85.64%) who had one missing tooth overall. In terms ofmastication and aesthetics, fixed partial dentures may statistically considerably enhance a partly dentate patient’squality of life.Study design: A quasi-experimental studyDuration and place of study : From October 2015 to April 2016, 209 participants in this quasi-experimentalresearch were seen in the prosthodontics department at the Bacha Khan Medical College, MardanKeywords: OHRQoL, fixed partial denture, partial edentulism, and Oral Health Impact Profile scores

Venous thrombosis: a mimic of musculoskeletal injury on MR imaging.

Clinical signs and symptoms of venous thrombosis and musculoskeletal pathologies frequently overlap. Sometimes, patients with venous thrombosis undergo MR examinations under an equivocal suspicion of muscle, tendon or articular injury. A low pretest clinical suspicion and lack of familiarity with the conventional MR imaging signs of venous thrombosis may result in failure to diagnose venous thrombosis, delaying treatment and raising morbimortality. In MR imaging, thrombosis presents as venous ectasia with intraluminal heterogeneous content. Small vein thrombosis is often identified as having a branching aspect. Perivenous edema and inflammatory soft tissue changes may be the most prominent findings. The purpose of this paper is to illustrate MR findings of venous thrombosis in patients who underwent MR examinations due to suspected musculoskeletal pathologies. Cases of venous thrombosis in different sites of the body diagnosed through MR are presented.

Physiopathology of peri-implant diseases.

Peri-implant health is characterized by the absence of clinical signs of soft tissue inflammation. Peri-implant diseases are initiated by the presence of bacterial biofilms and share a similar etiology as that involved in the onset of periodontal diseases. To summarize available evidence on the physiopathology of peri-implant diseases with emphasis on similarities and differences with periodontal diseases. Evidence on the biologic mechanisms involved in the pathogenesis of peri-implant mucositis and peri-implantitis were explored in the recent scientific literature. Findings of studies in animals and in humans indicate that experimental peri-implant mucositis leads to a larger inflammatory connective tissue infiltrate and to a higher frequency of bleeding sites around implants compared with teeth. Tissue destruction at experimental peri-implantitis sites is more pronounced compared with that at experimental periodontitis sites. Although human periodontitis and peri-implantitis lesions share similarities with respect to etiology and clinical features, they represent distinct entities from a physiopathologic point of view. Diagnosis of peri-implant health requires a clinical examination to confirm absence of peri-implant soft tissue inflammation. In order to make a correct diagnosis and select the appropriate therapeutic steps to manage peri-implant diseases, knowledge of their pathogenetic mechanisms is required.

Do silver/hydroxyapatite and zinc oxide nano-coatings improve inflammation around titanium orthodontic mini-screws? In vitro study

Overcoming the failure percentage of orthodontic mini-screws (OMSs), which is about 30% of overall orthodontic cases, especially in malocclusion treatment that requires orthopaedic heavy forces, is a great challenge. Bacterial infections, soft tissue and bone inflammation, and weak connections between bones and the OMS surface are among the main causalities of this failure. The aim of the study is to evaluate in vitro the microbiological activities of the deposited nanomaterials (Silver/hydroxyapatite nanoparticles (Ag/HA NPs) and zinc oxide nanoparticles (ZnO NPs)) in terms of microbial inhibition. In addition, the in-vitro cytotoxicity and cytocompatibility of the synthesized nano-coatings prior to their in-vivo application in animal models were tested on four types of cells, namely, fibroblasts, osteocytes, osteoblasts, and oral epithelial cells. Ag/HA NPs and ZnO NPs were built up onto the surface of titanium OMSs by electrochemical deposition. This electrochemical deposition was performed on 50 orthodontic mini screws and the deposited materials were characterized with the aid of scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX) analysis, X-ray Diffraction (XRD) and nano-scratch test. In addition, the microbiological activities of the deposited nanomaterials were explored in vitro in terms of microbial inhibition. Furthermore, the cytotoxicity and cytocompatibility were tested on four types of cells, namely, fibroblasts, osteocytes, osteoblasts and oral epithelial cells. SEM images revealed spherical Ag NPs in the range of 40-70nm in diameter, rod-shaped HA NPs and porous scaly ZnO NPs on the surface of the OMSs. XRD analysis confirmed the crystal structures of AgNPs, HA NPs, and ZnO NPs. ZnO NPs coated OMS had the highest antimicrobial activity than Ag/HA coated OMS against Gram-positive, Gram-negative and fungal strains. Moreover, after incubation, the decrease in the number of bacterial colonies was significant with ZnO and Ag/HA nanoparticles (with the greatest decrease for the former), due to the potent antibacterial effect of nanoparticles against Escherichia coli and Enterococcus faecalis. Moreover, ZnO NPs-coated OMSs showed a better cytocompatibility with oral epithelium, bone cells, and fibroblasts compared to Ag/HA NPs. The suggested nanocoating is a promising strategy to overcome the development of an inflammatory zone around the fixed OMSs.

Radioiodine Ablation of Thyroid Remnants in Patients with Graves' Orbitopathy.

Our purpose was to assess response after ablation of thyroid remnants (ATR) with radioactive iodine therapy in patients with unstable Graves' orbitopathy (GO) after subtotal thyroidectomy. Methods: Thirty patients with mild (n = 4, 13%), moderate-to-severe (n = 25, 83%), or very severe GO (n = 1, 3%) were analyzed in this retrospective study. The primary endpoint was the improvement of GO-related symptoms as assessed by clinical activity scores, NOSPECS, and soft-tissue inflammation scores at 3 and 12 mo after ATR. Ablation success was defined by a decrease in 99mTc uptake on thyroid scintigraphy, remnant volume, and thyrotropin receptor antibody levels at 3 mo after ATR. Results: Twelve months after ATR, clinical activity scores, NOSPECS, and soft-tissue inflammation scores showed a significant decrease from 3.4 to 1.3 (P < 0.0001), 5.9 to 4.9 (P = 0.007), and 4.7 to 2.1 (P = 0.0001), respectively. The GO was inactive in 27 of the 30 (90%) patients after 3 mo and in 29 (97%) after 12 mo. No new activation of GO occurred. Remnant volume (1.4 vs. 0.4 cm3, P = <0.0001), mean thyrotropin receptor antibody level titer (19.02 vs. 13.37 IU/L, P < 0.0001), and 99mTc uptake (0.5% vs. 0.1%; n = 12; P = 0.04) decreased significantly until 3 mo after ATR. Discussion: Radioactive iodine therapy after thyroidectomy can successfully ablate residual thyroid remnants, leading to an improvement in GO, a reduction in inflammatory activity, and stabilization of thyroid function. Thus, scintigraphy should be considered for patients with unstable GO after thyroidectomy to rule out thyroid remnants.

Mycetoma caused by Madurella mycetomatis in immunocompromised patients - a case report and systematic literature review.

The aim of this study was to review the available literature concerning Madura foot ("mycetoma") caused by Madurella mycetomatis in immunocompromised patients. With a systematic literature search, we identified only three papers, describing a total of three immunocompromised patients. Hence, the clinical presentation and prognosis of the disease in this patient population have not yet been well described. In addition, we present a case from our institution, illustrating the complexity of the treatment of this rare disease. Although very rare in non-endemic countries, we emphasize that mycetoma should be included in the differential diagnoses of (immunocompromised) patients who have been residing in a geographical area where the disease is endemic and presenting with soft tissue inflammation of one of the extremities.