Inlay Group Research Articles

Inlay triple-"C" tympanoplasty: a comparative study for its use in large, marginal perforations.

To compare the efficacy of the inlay, composite chondroperichondrial clip (triple-C) tympanoplasty with conventional underlay cartilage island tympanoplasty, and to evaluate its efficacy in treating large, marginal perforations. The study involved 183 patients that were selected from a retrospective chart review of tympanoplasties performed at our center from March 2016 to June 2018. A tertiary referral center hospital. 65 patients underwent inlay, triple-C cartilage tympanoplasty (inlay group) and 118 underwent underlay cartilage island tympanoplasty (underlay group). Postoperative anatomical success rate, surgical time, hearing outcomes, and complications were analyzed. Focused analysis was performed on large or marginal perforations. Both groups exhibited similar characteristics in demographic distribution, general health status, preoperative anatomical and hearing disabilities. Excellent results were achieved in both groups. Re-perforation occurred for 9.2% of the inlay group and 7.6% of the underlay group (p = 0.71). Hearing improvement was significant in both groups. Within the separate groups, 36% of underlay patients and 60% of inlay patients improved to achieve closure of the air-bone gap (ABG) to less than 10dB (p = 0.1). In large or marginal perforations, both groups performed similarly. No significant complications were seen in this cohort. Nevertheless, a significant reduction in surgical time was observed in the inlay group (38min. vs 58min.; p = 0.0004). Inlay triple-C tympanoplasty is comparable to conventional underlay cartilage island tympanoplasty in both anatomical and audiological success rates, even for large, marginal perforations. Due to its shorter operation time, inlay triple-C tympanoplasty should be considered a good surgical option for all tympanic membrane perforations.

Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

Background: Arthroscopic biceps tenodesis (ABT) high in the groove can be achieved using an inlay or an onlay technique. However, there is little information comparing outcomes between the 2. Purpose: To compare postoperative healing and functional outcomes of ABT high in the groove performed using either an onlay or an inlay technique. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective study was performed on patients undergoing ABT at the articular margin (high in the groove) at a single center over a 2-year period. An inlay technique using an interference screw was performed during the first year, followed by an onlay technique using a knotless suture anchor during the second. Tendon healing, elbow flexion strength, functional outcome, and complications were evaluated at a postoperative minimum of 1 year. Results: A total of 37 patients with inlay and 53 with onlay ABTs were available for follow-up. There was no difference in range of motion, functional outcome scores, or elbow flexion strength between the groups. A postoperative popeye deformity was noted in 27% of patients in the inlay group as compared with 9.4% of the onlay group (P = .028). Four patients (10.8%) in the inlay group required revision surgery (2 of which were biceps tenodesis related) as compared with 0% in the onlay group (P = .015). Conclusion: An onlay technique using a knotless suture anchor for ABT at the top of the articular margin is an acceptable alternative to an inlay technique using an interference screw. The onlay technique was associated with lower rates of postoperative popeye deformity and revision surgery as compared with the inlay technique.

The risk of postoperative scapular spine fracture following reverse shoulder arthroplasty is increased with an onlay humeral stem

The purpose of this study was to assess the effects of lateralization and distalization on scapular spine fracture (SSF) after reverse shoulder arthroplasty (RSA). The hypothesis was that postoperative distalization would increase the risk of SSF, whereas lateralization would not. A multicenter retrospective review was performed at a minimum of 1 year postoperatively on primary RSAs with 3 different implants, 2 with an inlay design (n = 342) and 1 with an onlay design (n = 84). Functional outcome, range of motion, stem design, and radiographic measurements, including acromiohumeral distanceand lateralization, were compared between groups with and without fracture. The incidence of SSF in the onlay group (11.9%) was significantly higher compared with the inlay group (4.7%; P = .043). Postoperative acromiohumeral distance was approximately 4 mm higher in the SSF group (37.5 mm) compared with the control group (33.7 mm; P= .042), whereas lateralization was similar between the 2 groups (52.8 mm vs. 53.9 mm; P= .362). Higher return to activity (92.1% vs. 71.4%; P< .001)as well as postoperative forward flexion was observed in the group without fracture (135° vs. 120°; P= .009). Increased postoperative distalization is associated with an increased risk of SSF after RSA. An onlay stem resulted in a 10 mm increase in distalization compared with an inlay stem, and a 2.5 times increased risk of SSF. Lateralization, however, does not appear to increase the risk of SSF.

Ten-Year Experience of Dural Reconstruction Using a Collagen Matrix Inlay Graft in Posterior Fossa Surgery: A Propensity Score–Matched Study

Considering that primary watertight dural closure is not always possible following posterior fossa surgery, several methods of dural reconstruction were proposed to reduce the risk of cerebrospinal fluid (CSF) leakage. This study aimed to evaluate the efficacy of collagen matrix inlay graft compared with other techniques in a propensity score-matched cohort. Between 2000 and 2019, 176 consecutive patients who underwent posterior fossa surgery were enrolled. Of these, 103 patients underwent dural reconstruction with collagen matrix inlay graft (inlay group). After propensity score matching, 67 pairs were derived. The primary outcome was the development of CSF leakage. Pseudomeningocele and surgical site infection were also investigated. Median follow-up period was 53.9 months. None of the patients in the inlay group had CSF leakage; however, leakage was evident in 5 patients (6.8%) who underwent dural reconstruction without a collagen matrix inlay graft (no-inlay group; P= 0.011). Pseudomeningocele was noted in 1 (1.4%) patient in the no-inlay group, while surgical site infection was noted in 3 (3.0%) patients in the inlay group and 4 (5.5%) patients in the no-inlay group. None of the surgical site infections were related to the use of the inlay graft. After propensity score matching, CSF leakage was still prevalent in the no-inlay group (P= 0.042). Dural reconstruction using a collagen matrix inlay graft efficiently reduces CSF leakage after posterior fossa surgery and does not increase the risk of postoperative infection and inflammation. It seems to be a feasible option for dural reconstruction.

Confocal and Histological Features After Poly(Ethylene Glycol) Diacrylate Corneal Inlay Implantation.

PurposeTo evaluate the in vivo biocompatibility of photopolymerized poly(ethylene glycol) diacrylate (PEGDA) intrastromal inlays in rabbit corneas.MethodsSixty-three eyes of 42 New Zealand rabbits were included. Manual intrastromal pockets were dissected in 42 eyes. PEGDA inlays were obtained using a specifically designed photomask and were inserted in the intrastromal pocket of 21 eyes (inlay group); the remaining 21 right eyes did not receive any implant (pocket-only group). Twenty-one eyes with no intervention were used as controls. In vivo confocal microscopy (IVCM) was performed at every visit. After 2 months, rabbits were sacrificed and corneas removed for histological analysis.ResultsCorneas remained clear in all but two animals, and five cases of corneal neovascularization were seen (P = 0.2). Inlays remained stable without evidence of lateral or anterior migration, and no other complications were observed. No changes in anterior and posterior keratocyte density (P = 0.3 and P = 0.1, respectively) or endothelial cell density (P = 0.23) were observed between groups during the study time by IVCM. On pathology samples, thinning of the epithelium over the inlay area and epithelial hyperplasia over the edges were observed. A polygonal empty space with no evidence of PEGDA hydrogel within the midstroma was seen in the inlay group. Keratocytes were normal in shape and number in the vicinity of the PEGDA implant area.ConclusionsPhotopolymerized PEGDA intrastromal inlays have shown relatively good safety and stability in rabbit corneas. Inlays were biostable in the corneal environment and remained transparent during follow up.Translational RelevanceThe investigated PEGDA is promising for the development of biocompatible intrastromal implants.

Two-year performance of CAD/CAM fabricated resin composite inlay restorations: A randomized controlled clinical trial.

The aim of this study was to evaluate the 2-year clinical performance of computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite inlay restorations in comparison with direct resin composite restorations. In 44 patients, 120 class II (mesio-occlusal/disto-occlusal) cavities were randomly assigned into two groups; CAD/CAM resin composite inlay group (Lava Ultimate), direct resin composite group (Clearfil Majesty Posterior). Clinical evaluations were performed after 1 week, 6 months, 1 year, and 2 years according to the FDI criteria. The data were analyzed using Friedman's ANOVA and Mann-Whitney U tests (α = .05). In 41 patients, 114 restorations were evaluated at the second year (recall rate 93.2%). All restorations were ideal or clinically acceptable. At the first year, considering all criteria, there were no statistically significant differences between the groups. However, there was a significant difference in terms of surface luster at second year, in favor of inlay restorations (P = .015). The marginal staining of resin composites increased after 2 years (P = .046), but there was no significant difference between the groups. Except the surface luster, 2-year clinical performance of CAD/CAM resin composite inlay restorations was found similar to direct resin composite restorations according to FDI criteria CLINICAL SIGNIFICANCE: The clinical performance of CAD/CAM resin composite inlays was acceptable in class II cavities subsequent to 2-year evaluation.

Comparison of clinical outcomes between butterfly inlay cartilage tympanoplasty and conventional underlay cartilage tympanoplasty

ObjectiveTo assess the efficacy of butterfly inlay cartilage tympanoplasty and compare it with conventional underlay cartilage tympanoplasty in terms of success rate and hearing outcomes. Materials and methodsThe study included 35 patients (36 ears) who underwent butterfly inlay cartilage tympanoplasty (inlay group, 23 ears of 22 patients) or conventional underlay cartilage tympanoplasty (underlay group, 13 ears). The anatomical success rate and hearing outcomes were analysed. ResultsRe-perforation occurred in 2 cases (8.7%) in the inlay group and 3 (23.1%) in the underlay group. One patient in the inlay group developed a serious infection, and one in the underlay group developed massive granulation of the tympanic membrane. In the inlay group, the air-bone gap (ABG) decreased from 19.9 (±12.6) dB HL preoperatively to 13.8 (±11.3) dB HL postoperatively (p=0.047), in the underlay group, it decreased from 23.5 (±15.8) dB HL to 18.3 (±20.6) dB HL. Regarding improvement in ABG, the difference between the group was not statistically significant (p=0.968). ConclusionButterfly inlay cartilage tympanoplasty is comparable with conventional underlay cartilage tympanoplasty in both anatomic and audiological success rates. Owing to its simplicity, shorter operation time, and rapid patient recovery, butterfly inlay cartilage tympanoplasty could be considered a favourable surgical option.

Impact of the site of mesh implantation on postoperative seroma formation in tension free hernioplasty of ventral hernia repair

Objective. The purpose of this study was to assess and analyze the difference between Onlay, Inlay and Sublay mesh implantation techniques in terms of Postoperative cornma formation. Methods. The prospective study was carried out in y consecutive patients of ventral abdominal hernia. Admitted as elective cases in our department from 1st January 2010 to 31st December 2014. Patients information that was recorded from history as gender, age, chronic cough, constipation, prostatism, Diabetes Mellitus steroid therapy smoking status, and any previous abdominal Surgery. And from the clinical examination as the body mass index and size of the defect. A postoperative observation was made in regards to seroma formation, which forms a rimaryendovoint of the study while the secondary endpoint 1s a complete one-year postoperative follow up. Results. During the study period, 54 (59%) were females and 37 (41%) were males. The mean age was 43.35 years. 37 patients had an incisional, 37 had a paraumbilical and 17 had an epigastric hernia. In the first group were 53 patients (58%) operated by onlay mesh repair method. In the second group were 21 patients (23%) operated by inlay. And in the third group were 17 patients (19%) operated by sublay method. Postoperative sero ma formation occurred in 17 patients (32%) were in the onlay group, 11 patients (52%) were in the inlay group. And 2 patients (12%) in the sublay group. Conclusion. In our study, we have concluded evidence show that the Sublay mesh repair hernio plasty is superior to onlay and inlay mesh repair in terms of seroma formation.

Comparative study between tubularized incised plate urethroplasty with and without dorsal inlay graft

Objectives The aim of this study was to compare the results of two single-stage hypospadias repairs, namely, tubularized incised plate (TIP) repair with and without dorsal inlay preputial skin graft urethroplasty as regards meatal stenosis, urethral stricture, and cosmetic outcome. Background The most commonly performed operation to repair distal hypospadias is the TIP repair. The key step is midline incision of the urethral plate, which widens a narrow plate and converts a flat groove into a deep plate groove, ensuring a vertical, slit neomeatus and a normal-caliber neourethra. At times in cases of distal hypospadias, the urethral plate is very narrow and needs to be augmented or substituted for further tubularization. We report our experience with primary single-stage dorsal inlay urethroplasty using inner preputial skin grafts. Patients and methods This study included 30 patients less than 10 years old who presented with primary distal types of hypospadias with narrow urethral plate at the Department of Plastic Surgery, Menoufia University Hospital and were divided into two groups: group A included 14 patients operated by TIP without dorsal inlay graft and group B included 16 patients operated by TIP with dorsal inlay graft. Patients who had undergone circumcision, previous hypospadias repair, or who had a deeply grooved urethral plate were excluded. Results A total of 16 children underwent primary dorsal inlay preputial graft urethroplasty, of whom one (6.2%) child had partial wound dehiscence, two (12.5%) of the children had meatal stenosis, and one (6.2%) of these children developed urethral stricture; 14 children underwent TIP urethroplasty, of whom two (14.3%) children had wound dehiscence, four (28.6%) of the children had meatal stenosis, and four (28.6%) of these children developed urethral stricture. Conclusion Primary dorsal inlay inner preputial graft urethroplasty successfully fulfills all traditional hypospadias repair criteria. It offers a viable, safe, rapid, and easy option in the management of proximal hypospadias with a narrow urethral plate.

Stress distribution in premolars restored with inlays or onlays: 3D finite element analysis.

PURPOSETo analyze stress distribution in premolars restored with inlays or onlays using various materials.MATERIALS AND METHODSThree-dimensional maxillary premolar models of abutments were designed to include the following: 1) inlay with O cavity (O group), 2) inlay with MO cavity (MO group), 3) inlay with MOD cavity (MOD group), and 4) onlay (ONLAY group). A restoration of each inlay or onlay cavity was simulated using gold alloy, e.max ceramic, or composite resin for restoration. To simulate masticatory forces, a total of 140 N static axial force was applied onto the tooth at the occlusal contact areas. A finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading.RESULTSMaximum von Mises stress values generated in the abutment teeth of the ONLAY group were ranged from 26.1 to 26.8 MPa, which were significantly lower than those of inlay groups (O group: 260.3–260.7 MPa; MO group: 252.1–262.4 MPa; MOD group: 281.4–298.8 MPa). Maximum von Mises stresses generated with ceramic, gold, and composite restorations were 280.1, 269.9, and 286.6 MPa, respectively, in the MOD group. They were 252.2, 248.0, 255.1 MPa, respectively, in the ONLAY group.CONCLUSIONThe onlay design (ONLAY group) protected tooth structures more effectively than inlay designs (O, MO, and MOD groups). However, stress magnitudes in restorations with various dental materials exhibited no significant difference among groups (O, MO, MOD, ONLAY).

Comparison of a hydrogel corneal inlay and monovision laser in situ keratomileusis in presbyopic patients: focus on visual performance and optical quality.

PurposeTo compare the visual performance and optical quality after Raindrop Near Vision Inlay implantation or monovision LASIK for the correction of presbyopia.Materials and methodsIn this retrospective case-series study, patients previously treated in the nondominant eye with monovision LASIK were compared with patients previously implanted with Raindrop Near Vision Inlay. The study enrolled 16 inlay and 15 monovision LASIK patients. Uncorrected near visual acuity, uncorrected distance visual acuity, binocular stereopsis, patient satisfaction, and patient task performance were assessed.ResultsPostoperatively, the mean spherical equivalent was −0.66 D (0.78 SD) for the inlay group and −1.03 D (0.56 SD) for the monovision LASIK group. Monocularly, at uncorrected near distances, 60% of inlay patients and 47% of monovision LASIK patients achieved ≥20/20. Monocularly, at uncorrected far distances, 75% of inlay patients and 40% of monovision LASIK patients achieved ≥20/32 vision. Binocularly, at near distances, 79% of inlay patients and 53% of monovision LASIK patients obtained ≥20/20 vision. All patients achieved ≥20/20 binocularly for distance. On average, inlay patients obtained 98 seconds of arc and monovision LASIK patients obtained 286 seconds of arc for stereopsis. Most (79%) of the inlay patients and 66% of monovision LASIK patients were satisfied with their near vision, while 86% of inlay patients and 67% of monovision LASIK patients were satisfied with their distance vision.ConclusionPatients receiving corneal inlays demonstrated better near and distance visual acuities, binocular stereopsis, task performance, and satisfaction, when compared to patients treated with monovision LASIK.

FRACTURE RESISTANCE AND FAILURE MODE OF TWO RESTORATION DESIGNS MADE OF MONOLITHIC HYBRID AND GLASS MACHINABLE CERAMICS ; IN VITRO STUDY

Statement of the problem: Monolithic hybrid and glass ceramics are indicated for intracoronal and extracoronal ceramic restorations. Available data regarding selection of the appropriate ceramic type for each preparation design and its influence on fracture resistance of tooth restoration complex is still scarce.Purpose: The purpose of this study was to evaluate in vitro the fracture resistance and investigate failure mode of two restoration designs (crowns and inlays) made from lithium disilicate glass ceramic and hybrid ceramic constructed by the CAD /CAM technique.Materials and Methods: A total of twenty ceramic restorations restoring lower molars were designed and fabricated in this study. The restorations were divided into two groups; Group 1: Ten full coverage crowns and Group 2: Ten inlays. Each of the previous groups was further subdivided into two equal subgroups; Subgroup 1: Five restorations constructed from lithium disilicate glass ceramics (e.max CAD) and Subgroup 2: Five restorations constructed from hybrid ceramic (VITA ENAMIC) by the CAD/CAM technology. Two ivorine teeth were prepared following the guidelines for full coverage and inlay ceramic restorations, they were duplicated into stone dies followed by scanning, designing and milling of restorations. The stone dies were duplicated into epoxy dies where the restorations were adhesively cemented on them. All cemented samples were exposed to 2000 thermal cycles (5°C and 55°C in water) with a dwell time of 25 seconds in a computer controlled thermocycler. All specimens were loaded in a universal testing machine where fracture test was done by compressive mode of load applied occlusally using a metallic rod with round tip at cross-head speed of 1mm/min until fracture occurred. Fracture resistance values were recorded in Newtons then they were statistically evaluated and failure modes were analyzed. Results: For group 1 representing crown restorations, a statistically significant difference was found between (e.max CAD) and (VITA ENAMIC) subgroups at (p=0.05) where the highest mean value of maximum load was found in (VITA ENAMIC) (951.77 N ± 81.05) and the lowest mean value of maximum load was found in (e.max CAD) (709.35 N± 49.51). While for the second group representing inlay restorations, no statistically significant difference was found between (e.max CAD) and (VITA ENAMIC) subgroups at (p=0.307) where the highest mean value of maximum load was found in (e.max CAD) (627.71 N ± 80.01) and the lowest mean value of maximum load was found in (VITA ENAMIC) (581.26 N± 51.74). For the e.max CAD subgroup, a statistically significant difference was found between (Crown) and (Inlay) groups at (p=0.005) where the highest mean value of maximum load was found in the crown group (790.35 N± 49.51) and the lowest mean value of maximum load was found in the inlay group (627.71N ± 80.01).Regarding the VITA ENAMIC subgroup, a statistically significant difference was found between (Crown) and (Inlay) groups at (p<0.001) where the highest mean value of maximum load was found in the crown group (951.77 N ± 81.05) and the lowest mean value of maximum load was found in the inlay group (581.26N±51.74).Conclusions: 1. All inlays and crowns constructed from hybrid and glass ceramics in this study revealed fracture load values falling in the range of physiologic masticatory forces 2. When considering restoration of molars with full coverage crowns, VITA ENAMIC is more preferred than e.max CAD ceramic in terms of fracture resistance as it showed a higher statistical significant mean values.3. When planning to restore molars with minimally invasive intracoronal restorations, both ceramics can be used as there was insignificant statistical difference between them , however e.max CAD can be recommended due to its more favorable mode of fracture compared to VITA ENAMIC.4. Irrespective of preparation designs, both ceramics showed insignificant difference regarding fracture resistance mean values.

Early volumetric changes after vertical augmentation of the atrophic posterior mandible with interpositional block graft versus onlay bone graft: A retrospective radiological study

PurposeThe aim of this study was to evaluate volumetric and clinical outcomes of atrophic posterior mandibles treated with inlay or onlay bone grafting techniques. Materials and methodsIn posterior mandibles, alveolar ridges were treated either with interpositional equine cancellous bone block (inlay group) or with onlay autogenous bone block (onlay group). Bone volumes at baseline and at 4 months after surgery were measured by computed tomography. ResultsA total of 20 subjects were enrolled in the present study: 10 in the inlay group and 10 in the onlay group. After surgery, atrophic posterior mandibles showed a mean vertical augmentation height of 6.0 mm in the inlay group and 7.4 mm in the onlay group. No significant differences were recorded between the two groups regarding volume loss of the grafted bone or decrease in vertical bone height of the augmented site (29% and 1.9 mm for the onlay group, and 35% and 1.7 mm for the inlay group) during healing. Two complications (1 wound dehiscence and 1 mandibular fracture) occurred postoperatively in the inlay group; on the other hand, the onlay group had three complications (wound dehiscence). A total of 80 dental implants were placed in augmented areas: 46 in the inlay group with a peri-implant marginal bone loss of 0.8 mm, and 34 in the onlay group with a peri-implant marginal bone loss of 1.3 mm (p = 0.0006). ConclusionsInlay xenogeneic grafts showed volumetric bone remodeling similar to that recorded for onlay autogenous bone. The success of the autogenous onlay blocks (82.4%) appeared to be lower than that registered for the inlay group (93.8%), but the difference was not significant.

Fracture resistance of endodontically treated molars restored with horizontal fiberglass posts or indirect techniques

BackgroundBecause of the many possibilities for endodontically restoring the posterior teeth and the high prevalence of restoration failures, this topic continues to be of major concern. A composite resin (CR) restoration reinforced by a horizontal fiberglass post may improve the fracture resistance of endodontically treated teeth. The authors investigated this possibility by comparing the fracture resistance of molars restored with direct techniques with that of molars restored with indirect techniques. MethodsThe authors divided 50 extracted sound third molars into 5 groups: sound teeth, onlay (ON), inlay (IN), direct CR, and transfixed fiberglass post (TFP) plus direct CR. The authors performed standardized mesio-occlusodistal cavity preparations and endodontic treatments. The authors cemented indirect restorations of Lava Ultimate (3M ESPE) adhesively in the ON and IN groups. The authors restored CR group teeth directly with Filtek Z230 XT (3M ESPE). In the TFP group, the authors transfixed 2 fiberglass posts horizontally and restored the teeth directly with CR. Thereafter, the authors submitted the teeth to cyclic fatigue loading with 500,000 cycles at 200 newtons. The authors tested fracture resistance in newtons in a universal testing machine. The authors analyzed data with 1-way analysis of variance and a Tukey test (P < .05). ResultsSound teeth had the highest fracture resistance. ON had the highest recovery of resistance, followed by TFP. CR had the lowest recovery, which was similar to that of IN. ConclusionsEndodontically treated molars restored with TFP plus CR had fracture resistance similar to those restored with ON, which was higher than that for IN or CR only. Practical ImplicationsHorizontal TFPs placed inside a composite restoration had the same performance as did ON restorations.

Utilization of Ceramic Inlays for Sealing Implant Prostheses Screw Access Holes: A Case-Control Study.

The aim of this study was to evaluate, in a case control study, the esthetic and functional clinical performance of ceramic inlays used for covering the screw access hole in single monolithic lithium disilicate full-contour crowns bonded on computer-aided design/computer-aided manufacturing (CAD/CAM) prefabricated titanium abutments in order to eliminate the drawbacks of alternative restorative methods. Twenty-eight patients with missing teeth in the lateral areas (premolars and molars) received screw-retained implant restorations. In half of the restorations (n = 14), composite fillings were used to seal the access hole (control group), while the other half was sealed with ceramic inlays (test group). To determine the restoration occlusal wear, impressions were obtained after the restorations were finalized, at 1 year, and at 2 years follow-up. The casts were scanned with a 3D Scanner Design System recording the anatomical surfaces of the white model replicates. Wear amounts (μm) were calculated as the maximum loss in height of the occlusal surface. The clinical evaluation was carried out using a kit specifically designed for assessing the FDI criteria. Statistics were performed using analysis of variance (ANOVA). A total of 58 restorations were delivered, and after 2 years of follow-up, the wear values were 228.20 ± 54.68 μm for the control group and 65.20 ± 7.24 μm for the ceramic inlay group. One-way ANOVA showed significant differences among the vertical loss between these two groups (P < .001). Clinical outcomes according to the FDI score for assessing dental restorations revealed substantial deterioration within 2 years of follow-up. The use of ceramic inlays appears to be a predictable, esthetic, and successful method of sealing the screw holes of the screw-retained implant restorations.

Comparison of Intracorneal Inlay for Presbyopia Correction: Hydrogel and Small-Aperture Inlays with a Six- Months Follow-Up

Purpose: To study the safety and efficacy of corneal reshaping and small-aperture inlays and compare the clinical results. Methods: From February 2014 to November 2014, 22 corneal reshaping inlays were inserted at Asan Medical Center and from October 2012 to March 2013, 26 small-aperture inlay surgeries were performed: 6 eyes at Asan Medical Center and 20 eyes at Samsung Medical Center. The preoperative and postoperative parameters were reviewed retrospectively and included monocular uncorrected distance visual acuity (UDVA; log MAR), uncorrected near visual acuity (UNVA; log MAR), refraction and corneal curvature based on automated refractor keratometry, reading distance and patient satisfaction. Results: In the hydrogel inlay group, preoperative mean monocular UNVA was 0.83 ± 0.05 and monocular UDVA 0.07 ± 0.03. At 6 months, mean monocular UNVA was 0.23 ± 0.05 and UDVA 0.05 ± 0.02. The most preferred mean reading distance in the hydrogel inlay group was 39.38 ± 3.18 cm. In the small-aperture inlay group, preoperative mean monocular UNVA was 0.4 ± 0.06 and monocular uncorrected visual acuity 0.27 ± 0.04. At 6 months, mean monocular UNVA was 0.11 ± 0.02 and UDVA 0.09 ± 0.05 and the most preferred mean reading distance was 44.23 ± 5.17 cm. Although 85% of patients in the corneal reshaping inlay group were satisfied or very satisfied, only 20% of patients in the small-aperture inlay group were satisfied. Conclusions: Both inlays are considered good options for correcting presbyopia. However, postoperative satisfaction score was higher and less glare symptoms were reported in the hydrogel inlay group. J Korean Ophthalmol Soc 2015;56(12):1840-1847

Histological and confocal changes in rabbit cornea produced by an intrastromal inlay made of hexafocon A.

The aim of this study was to evaluate biocompatibility of a newly proposed intrastromal inlay in rabbit corneas. Eighteen eyes of 9 New Zealand rabbits were included in this prospective study. An intrastromal pocket was created in both eyes using Melles instruments. Annular intracorneal inlays made of hexafocon A were implanted randomly into the stromal pocket of one eye of each rabbit. Confocal microscopy was performed at each visit during 6-month follow-up. After 6 months, the rabbits were killed and corneal tissues of both eyes were sent for light microscopic studies. Mild stromal edema was present during the first few days and disappeared afterward with mild haze around the tunnel site in all cases. Deposits around the lamellar channel developed in 3 implanted eyes and in none of the pocket-only eyes. No neovascularization or epithelial downgrowth was present at the incision site in any case. All inlays remained centered and optically clear. In confocal imaging, we observed no significant difference in keratocyte cell density and inflammatory cells between the control pocket-only group and inlay group. In pathological evaluation, there was no difference in the average epithelial thickness between both groups. Descemet membrane and endothelium appeared normal in both groups. This study revealed safety and biocompatibility of hexafocon A as an intracorneal inlay in rabbits.

Transtibial Versus Tibial Inlay Techniques for Posterior Cruciate Ligament Reconstruction

Background: The most common technique for posterior cruciate ligament (PCL) reconstruction is transtibial or tibial inlay. However, few studies have reported long-term outcome comparisons between the 2 techniques. Hypothesis: Tibial inlay PCL reconstruction with patellar tendon autograft will exhibit better clinical and radiographic outcomes than transtibial PCL reconstruction with hamstring autograft. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 66 patients (66 knees) treated with PCL reconstruction for chronic injuries constituted the study cohort. Patients were divided into 2 groups: transtibial with hamstring (36 patients) and tibial inlay with patellar tendon (30 patients). The mean time from injury to reconstruction was 12.2 months (range, 2-60 months), and the mean follow-up was 148 months (range, 98-196 months). Outcomes were measured by use of Lysholm knee scores, Tegner activity scores, return to preinjury sports activity, posterior drawer test, laxity test with a Telos device, and development of osteoarthritis. Results: The preoperative mean Lysholm knee score was 59.9 (range, 37-70) in the transtibial group and 54.5 (range, 22-76) in the tibial inlay group, improving postoperatively to 89.9 (range, 74-100) and 92.1 (range, 80-100), respectively. The mean Tegner activity scores increased from 2.5 (range, 2-5) to 5.9 (range, 4-7) in the transtibial group and 2.3 (range, 2-4) to 6.0 (range, 3-8) in the tibial inlay group. Twenty-one patients (58.3%) in the transtibial group and 19 patients (63.3%) in the tibial inlay group were able to return to preinjury sports activity. In the posterior drawer test, 6 patients in the transtibial group and 4 patients in the tibial inlay group showed grade II laxity. The mean side-to-side difference was 10.1 mm (range, 7-12 mm) in the transtibial group and 10.4 mm (range, 9-13 mm) in the tibial inlay group, improving postoperatively to 4.1 mm (range, 0-8 mm) and 4.2 mm (range, 1-8 mm), respectively. There was significant improvement between preoperative and final follow-up values. However, there were no significant differences between the 2 groups in final follow-up outcomes. Final follow-up radiographs showed that 6 patients (16.7%) in the transtibial group and 3 patients (10.0%) in the tibial inlay group were rated grade C according to International Knee Documentation Committee guidelines. Conclusion: Clinical and radiographic outcomes between the 2 PCL reconstruction techniques were comparable. Osteoarthritis was observed in patients, with a significant proportion presenting loss of joint space. Examined factors, excluding meniscectomy, were not correlated with the development of osteoarthritis.

Comparison of Transtibial and Tibial Inlay Techniques for Posterior Cruciate Ligament Reconstruction with an Average of 10 Year- Follow-up

Objectives:We performd this study to determine the long-term results based on clinical and radiographic outcome comparison following either transtibial or tibial inlay technique, and to find out factors related to osteoarthritis after PCL reconstruction.Methods:Seventy-seven patients (77 knees) treated with the PCL reconstruction for chronic injuries constituted the study cohort. The 77 patients were divided into 2 groups, namely, transtibial (44 patients) and tibial inlay (33 patients). The mean time from injury to reconstruction was 12.2 months (range, 2 to 60 months), and their average follow-up was 142 months (range, 97 to 192 months). Outcomes were measured using Lysholm knee scores, Tegner activity scores, laxity test using Telos device, and development of osteoarthritis.Results:There was significant improvement of Lysholm knee scores, Tegner activity scores, and laxity test using Telos device between the preoperative values and final follow-up values (P < .05). However, there was no significant difference in the final follow-up outcomes (P > .05). The final follow-up radiographs according to International Knee Documentation Committee guidelines showed that 7 patients (22.7%) in transtibial group and 4 patients (18.2%) in tibial inlay group were rated as Grade C. We found correlation between meniscectomy and osteoarthritis, but other factors including reconstruction technique, sex, age, and posterior instability did not influence the arthritic changes in both groups (Fig 1).Conclusion:The clinical and radiographic outcomes between the two surgical techniques of PCL reconstruction were comparable. Osteoarthritis was observed in some patients with a significant proportion showing some loss of joint space, and factors except meniscectomy did not show correlation with development of osteoarthritis.

Dorsal onlay (Barbagli technique) versus dorsal inlay (Asopa technique) buccal mucosal graft urethroplasty for anterior urethral stricture: A prospective randomized study

To compare both the dorsal onlay technique of Barbagli and the dorsal inlay technique of Asopa for the management of long anterior urethral stricture. From January 2010 to May 2012, a total of 47 patients with long anterior urethral strictures were randomized into two groups. The first group included 25 patients who were managed by dorsal onlay buccal mucosal graft urethroplasty. The second group included 22 patients who were managed by dorsal inlay buccal mucosal graft urethroplasty. Different clinical parameters, postoperative complications and success rates were compared between both groups. The overall success rate in the dorsal onlay group was 88%, whereas in the dorsal inlay group the success rate was 86.4% during the follow-up period. The mean operative time was significantly longer in the dorsal onlay urethroplasty group (205 ± 19.63 min) than in the dorsal inlay urethroplasty group (128 ± 4.9 min, P-value <0.0001). The average blood loss was significantly higher in the dorsal onlay urethroplasty group (228 ± 5.32 mL) than in the dorsal inlay urethroplasty group (105 ± 12.05 mL, P-value <0.0001). The dorsal onlay technique of Barbagli and the dorsal inlay technique of Asopa buccal mucosal graft urethroplasty provide similar success rates. The Asopa technique is easy to carry out, provides shorter operative time and less blood loss, and it is associated with fewer complications for anterior urethral stricture repair.