Long-lasting Results Research Articles

Facilitating Posttraumatic Growth Among U.S. Military Veterans: Evaluating an Innovative Training Program

Studies indicate that 87% of U.S. veterans experience at least one potentially traumatic event in their lifetime, with approximately 34% of these being combat-related. There is a need for targeted interventions that engage veteran clients effectively, deliver prompt and long-lasting results, and acknowledge the existential challenges associated with military-related traumatic exposures. Posttraumatic growth (PTG) theory offers a fresh perspective on the aftermath of trauma, emphasizing the potential for psychological growth following such experiences. Boulder Crest Foundation’s Warrior PATHH (Progressive and Alternative Training for Helping Heroes) program, based on key tenets of PTG theory, has demonstrated promise in promoting PTG and reducing symptomology (i.e., PTSD symptoms, depression, anxiety, stress, and insomnia) in veteran populations. The current study evaluates the outcomes of a further development (labeled 5.0) of the Warrior PATHH program on 343 U.S. veteran participants and quantifies the observed effects this training had on PTG-related outcomes and symptomology across four time points through determination of omnibus significance via ANOVA and evaluation of pre-post effect size and significance via paired samples t-tests. Results of analyses indicated significant medium-to-large effects across all outcomes at time 3 (d=.515-1.722) and maintenance at time 4 with minimal alteration to effect sizes (d=.554-–1.57). These findings indicate that the Warrior PATHH 5.0 program is effective in promoting PTG and reducing PTSD and other symptoms over at least a 3-month period. Further research into interventions based on PTG may enhance the understanding of how to enhance outcomes beyond standard trauma therapies for trauma-exposed veterans.

MANAGEMENT OF EKAKUSTA THROUGH SHODHANA - A SINGLE CASE STUDY

Twacha represents the health of an individual. A good complexion of skin makes a person feel happy and confident. Nowadays, skin disorders are increasing due to various aetiological factors. In Ayurveda, skin diseases are explained as Kushtha Vyadhi. Ekakushtha- a type of Kshudra Kushtha that appears similar to psoriasis in terms of symptoms, remission, and seasonal variation. Shodhana Purvaka Shamana (Purificatory and Palliative) treatment modalities of Ayurveda provide safe, effective treatment with long-lasting results and a better life for the patient. In the present case, a 28-year-old female patient diagnosed with Psoriasis is treated with Virechanaa, followed by Shamana Chikitsa.

Liquid Polycaprolactone (PCL) for Reversing PXE's Skin Laxity of Inner Thighs and Knees: A Case Report.

Pseudoxanthoma elasticum (PXE) is a genetic connective tissue disorder that affects the skin with limited treatment options. A recent technology employing particle-free polycaprolactone (PCL) has shown promising results in treating inner thighs and kness of a 27-year-old female patient. This article provides a case report along with our detailed treatment protocol based on the efficacy of PCL in reversing skin laxity that can be easily incorporated into the therapeutic approaches for patients with PXE. The pinch test for clinical assessment, photographic documentation as well as satisfaction questionnaire were used in order to evaluate the improvement observed in skin laxity. After the finish of the protocol, the Pinch test score was diminished from 4 to 2, and the depth of the wrinkles was obviously improved in the photos. All the above, together with the high score of the patient satisfaction questionnaire, verified the efficacy of this novel PCL protocol in reversing PXE's skin laxity. Fully liquid PCL appears to outperform other bio-stimulators in improving skin quality in PXE, offering longer-lasting results and a high safety profile. However, further clinical trials with long-term follow-up are required to confirm its efficacy in PXE's skin laxity.

Commentary on: The Gargano Yin Yang Breast Reduction Technique: How to Obtain Better Breast Shape, Volume Distribution, and Size With Long-Lasting Results.

Commentary on: The Gargano Yin Yang Breast Reduction Technique: How to Obtain Better Breast Shape, Volume Distribution, and Size With Long-Lasting Results.

Treatment of the Temples: Brazilian Consensus.

The temporal region is emblematic and challenging due to its structural and volumetric changes during aging, which significantly affect facial aesthetics. Despite the importance of addressing temporal aging, many injectors hesitate due to the region's anatomical complexity and risk of complications. This consensus aimed to provide expert guidance on the safest and most effective treatment strategies for the temple. Twelve Brazilian dermatologists and plastic surgeons with expertise in cosmiatry participated in a survey of 54 objective and one open-ended question to identify best practices. The results were analyzed for consensus, with agreement categorized as a simple majority (50-75%), consensus (> 75%), or strong consensus (> 95%). Participants agreed that volumization (100%), lifting (90%), and restructuring (82%) are essential for temporal rejuvenation. Hyaluronic acid (HA) was the preferred product for volumization and structuring, with the subcutaneous plane identified as the best option for both. There was no consensus on the product for lifting, though 45.5% favored poly-L-lactic acid (PLLA). Biostimulants such as PLLA and calcium hydroxyapatite were commonly used, with specific dilution strategies. Complications reported included hematomas and nodules, particularly with HA and PLLA. The consensus emphasized the importance of anatomical knowledge and product selection in achieving safe and long-lasting results in temporal rejuvenation. It provided clear recommendations for injection techniques and product choices, advocating for subcutaneous plane treatments for beginners. The findings highlight the need for expert-driven approaches to reduce the risk of complications and optimize patient outcomes in this sensitive region. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Combined supraperiosteal microfat grafting and intradermal nanofat for the treatment of periorbital melanosis (dark circles)

Objectives: Dark circles are one of the most common aesthetic concerns in India. While several treatment options exist, none address both volume deficiency and skin quality simultaneously. We felt that fat grafting and nanofat provided a novel treatment option to address both aspects of dark circles in one treatment. Material and Methods: Patient records were examined from 2017 to 2021. A total of 28 patients were identified as having undergone fat grafting and nanofat for dark circles specifically. The patients were analyzed for age, gender, volumes injected, and outcomes based on patient self-assessment. Results: A total of 36 patients underwent fat grafting ranging from the age of 20 to 40 (average 31). All procedures were done under local anesthesia as day care procedures. The volumes injected range from 2 cc/side to 8 cc/side, with an average of 4.36 cc. Using the Likert scale, 28 (77%) rated their results as very satisfied. Six (17%) rated it as satisfied. One rated it as neutral and two rated it as average, and underwent a second session of fat grafting where another 2 cc was injected per side. Conclusion: Fat grafting and nanofat are an exciting treatment option for the treatment of dark circles, which is usually regarded as a recalcitrant problem. It has the advantages of addressing both volume and skin quality, being a single-stage procedure, and producing comparatively long-lasting results.

Surgical and Non-Surgical Approach for Tear Trough Correction: Fat Repositioning Versus Hyaluronic Acid Fillers.

Objective: This paper compares two popular techniques for tear trough correction-fat repositioning and hyaluronic acid (HA) fillers-highlighting their efficacy, safety profiles, patient satisfaction, and associated complications. Methods: A narrative review of 20 studies comparing fat repositioning and HA fillers was conducted, focusing on parameters such as duration of results, volume restoration, complication rates, and patient satisfaction. Results: Fat repositioning provides long-lasting results but carries higher surgical risks compared with HA fillers. The transconjunctival approach is suitable for patients with minimal skin excess. The supraperiosteal plane allows for a quicker procedure and, despite postoperative edema and temporary irregular contouring, shows no difference in final cosmetic outcomes compared with other planes. Internal fixation reduces the risk of fat relapse and skin scarring but carries the risk of suboptimal positioning. HA fillers offer immediate, minimally invasive results but require periodic maintenance. The use of a cannula reduces the risk of vascular occlusion. Combining a high G' filler for the midface with a low G' with low hydrophilicity for the tear trough reduces the amount of filler needed and prolongs the results. Both surgical and non-surgical methods are effective, depending on patient needs and anatomical considerations. Conclusions: Fat repositioning is ideal for patients seeking long-term correction and are willing to undergo surgery, while HA fillers suit those preferring non-invasive treatments with customizable, short-term effects. Both techniques have pros and cons that must be matched to patient goals and conditions.

Optimized Calcium Hydroxylapatite Formulation and Its Injection Technique for Hand Rejuvenation: A Retrospective Study.

Hand rejuvenation treatment is in high demand in cosmetic medicine. Radiesse®, a commercially available formulation of calcium hydroxylapatite (CaHA), is safe, biocompatible, and provides long-lasting results. The study aimed to retrospectively evaluate the efficacy and safety of the presented formulation of Radiesse® and its injection procedure. The hands of 58 women were treated employing Radiesse® diluted with lidocaine. The treatment was performed using a blunt cannula following the proximal-to-distal fanning technique at two entry points on the dorsum of the hands. The patients received 1-4 treatments over a follow-up period of up to five years. The hands of 58 females were evaluated using the Merz Hand Grading Scale (MHGS) and treated with the presented CaHA formulation. After the first treatment, 55 patients (94.8%) achieved a 1-point improvement, and 19 patients (32.8%) did not receive further treatment, being satisfied with the results. The remaining 39 women (67.2%) received 2-4 follow-up treatments. At the end of the treatment(s), 46 women (79%) achieved a final improvement of one point, and 12 women (21%) a final improvement of two points. Three minor adverse events were registered. Radiesse® diluted with lidocaine is an excellent choice for hand rejuvenation. The formulation and technique proved to be safe and efficient. In our experience, a blunt cannula should be employed for optimal vein correction. The treatment was highly satisfying, although planning a second treatment during the 1-month follow-up visit is recommended to best achieve long-lasting results.

Simple Epithelial Transplantation for Ocular Surface Reconstruction After Severe Ocular Burn Injury.

To manage ocular surface complications and recover conjunctival and corneal epithelia after unilateral severe chemical burn. We performed simple conjunctival epithelial transplantation (SCET) to obtain renewal of fornix and bulbar-tarsal conjunctiva epithelium, followed by simple limbal epithelial transplantation (SLET) to recover limbal function and epithelial corneal surface. Slit-lamp examination, fluorescein staining, in vivo confocal microscopy, Kheirkhah grading system for symblepharon severity, Wong-Baker FACES Pain Rating Scale, and best-corrected visual acuity were assessed before surgery, at 1 to 3 months after SCET and SLET, and thereafter at 6 to 12 to 36 months. Two patients with unilateral burn injuries underwent surgery. Eye mobility and fornix reconstruction were promptly achieved, and conjunctival epithelium with goblet cells was observed on the bulbar and tarsal conjunctiva 3 months after SCET. After SLET, corneal epithelium and cornea-conjunctiva transition zone were observed at 3 and 6 months, respectively. From before surgery to 6 months after SLET, symblepharon improved from grade IVa2 and IIIb2 to Ic0 and Ib0, the Wong-Baker FACES Pain Rating Scale changed from grade 6 and 4 to 0, and best-corrected visual acuity upgraded from 1.40 and 1.10 logarithm of the minimum angle of resolution to 0.5 logarithm of the minimum angle of resolution, in patient 1 and 2, respectively. After 3 years, results remained stable. SCET effectively healed the bare conjunctival area relieving subjective symptoms and discomfort. Sequential SCET and SLET showed to be feasible in restoring a normal ocular surface with long-lasting results suggesting the aim in patients with severe ocular burn is not merely corneal epithelium renewal but also the regeneration of ocular surface homeostasis.

Multilevel analysis of the central-peripheral-target organ pathway: contributing to recovery after peripheral nerve injury.

Peripheral nerve injury is a common neurological condition that often leads to severe functional limitations and disabilities. Research on the pathogenesis of peripheral nerve injury has focused on pathological changes at individual injury sites, neglecting multilevel pathological analysis of the overall nervous system and target organs. This has led to restrictions on current therapeutic approaches. In this paper, we first summarize the potential mechanisms of peripheral nerve injury from a holistic perspective, covering the central nervous system, peripheral nervous system, and target organs. After peripheral nerve injury, the cortical plasticity of the brain is altered due to damage to and regeneration of peripheral nerves; changes such as neuronal apoptosis and axonal demyelination occur in the spinal cord. The nerve will undergo axonal regeneration, activation of Schwann cells, inflammatory response, and vascular system regeneration at the injury site. Corresponding damage to target organs can occur, including skeletal muscle atrophy and sensory receptor disruption. We then provide a brief review of the research advances in therapeutic approaches to peripheral nerve injury. The main current treatments are conducted passively and include physical factor rehabilitation, pharmacological treatments, cell-based therapies, and physical exercise. However, most treatments only partially address the problem and cannot complete the systematic recovery of the entire central nervous system-peripheral nervous system-target organ pathway. Therefore, we should further explore multilevel treatment options that produce effective, long-lasting results, perhaps requiring a combination of passive (traditional) and active (novel) treatment methods to stimulate rehabilitation at the central-peripheral-target organ levels to achieve better functional recovery.

Acne vulgaris in adolescents – the review

Acne vulgaris is one of the most common chronic inflammatory skin disorders that affects almost 90% of the adolescents worldwide. Due to its effect on one’s appearance, it causes not only physical but also psychological consequences. The cause of acne involves increased sebum production, hyperkeratinisation of the follicle, bacterial colonization and inflammation, which result in formation of comedones, papules, pustules and nodules. Diet, Body Mass Index, hyperhidrosis and stress can be triggering factors. The pharmacological treatment of acne involves substances administered topically as well as orally. First line of treatment of mild-to-moderate acne involves topical benzoyl peroxide, retinoids, chemical peels, antibiotics and combinations of those agents. The treatment of moderate-to-severe or inflammatory acne consists of oral antibiotics, isotretinoin, oral contraceptives and spironolactone. New therapies are being investigated and show a great potential, however further research should be pursued in order to achieve long-lasting results of the treatment.

Structural Mastopexy: Volume Displacement in Breast Reshaping.

Although in breast reshaping, the restoration of a suitable mammary cone is the main goal of the procedure, long-lasting upper pole fullness preservation is the most common weak point of all mastopexy. Mastopexy is a challenging procedure, and a surgical procedure to create desirable long-lasting results has not been well standardized. In this paper, the authors report their experiences in structural mastopexy procedures, describing three different adipo-glandular flaps, each repositioned as auto-prosthesis to reshape upper pole contour in patients affected by a severe degree of breast ptosis. A 6-year retrospective iconographic-chart and review was performed on 89 patients undergoing mastopexy between January 2016 and December 2021. Surgical candidates reported grades 2 and 3 of ptosis following Regnault classification. Minimum follow-up was 24 months. Pre- and postoperative data for all patients were collected in the same standard conditions. 89 patients affected with bilateral breast ptosis were included in the study, for a total of 178 breasts. Patients' mean age at the time of surgery was 40.45 years, ranging between 28 and 59 years. Follow-up ranged between 2 and 6 years with an average of 47.13 months. Out of 89 patients, 50 underwent general anesthesia, and the remaining 39 underwent local anesthesia. Among the 178 treated breasts, 10 (17.8%) experienced minor complications: No major complications were reported. Autologous tissue displacement, collecting parenchyma wherever surplus can be recruited, permits the transfer of extra tissue to the lack of volume, recontouring satisfactory breast shape and ensuring long-lasting results. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Information Technology Investment Assessment Using Val IT Framework

Organizations must evaluate information technology (IT) expenditures to ensure that IT resources' use contributes value and is in line with their strategic goals. This paper investigates how the Val IT Framework can be used as an efficient tool for managing and evaluating IT investments. Val IT offers a thorough framework for assessing IT initiatives' advantages, disadvantages, and risks and their influence on accomplishing company objectives. We examine how the Val IT Framework may enhance accountability, facilitate IT performance monitoring, and increase transparency in investment decision-making through case studies of multiple businesses. The findings demonstrate that the application of Val IT fosters the advancement of improved IT management techniques and raises knowledge of the worth of IT investments. To attain optimal and sustainable outcomes, IT managers and stakeholders are advised by these findings to utilize a framework-based approach when evaluating investments. However, several challenges remain before the framework can be implemented, including a lack of funding, knowledge about it, and opposition to change. Organizations must, therefore, develop a comprehensive plan. To facilitate change adaptation, this plan should offer incremental implementation, adequate training to enable all stakeholders to better understand Val IT and enough resources to support adoption. These steps can assist businesses in more successfully overcoming their existing challenges. By adopting the right approach, businesses may maximize their IT investments and ensure that every dollar invested contributes significantly to achieving their strategic goals. The Val IT Framework serves as both an assessment tool and a roadmap for better, long-lasting results in IT management when used appropriately. This illustrates how crucial it is to make the investment necessary to implement this framework if the business is to be successful and viable in the long run.

Microwave ablation: a technical and clinical comparison to other thermal ablation modalities to treat benign and malignant thyroid nodules.

Microwave ablation (MWA) is a novel modality for thermal ablation (TA) to treat benign and malignant thyroid nodules, mostly papillary thyroid cancer (PTC). Compared to surgery, TA is less invasive and less painful, has faster recovery, better cosmetic outcomes, and fewer complications. TA techniques have been evolving over the past decade to be more energy efficient, precise, and produce long-lasting results. The general approach is similar between various TA techniques. However, each technique has uniqueness in its energy delivery and, thus, risk profile and outcomes. MWA has a few critical technical differences that make it safer for patients with surgical implants and cardiac comorbidities. It has proven effective in treating benign thyroid nodules (BTNs) in adults and pediatric populations with benign and malignant lesions. The clinical and theoretical outcomes of MWA compared to other thermal ablative techniques, such as radiofrequency ablation (RFA) and laser ablation (LA), have been investigated in some studies and meta-analyses. Minimally invasive procedures such as MWA are an important tool for the management of thyroid lesions. Thus, it is crucial for clinicians to be equipped with the knowledge to use these tools. In this review, we provide a clinical review detailing the technical differences and clinical outcomes for the three major TA techniques-MWA, RFA, and LA.

Abdominal Etching-A Novel Classification Method for Surgical Approach.

The abdomen is the aesthetic and physical center of the body. Abdominal etching is used to enhance the appearance of the abdominal musculature. Body contouring and abdominal etching are popular among both men and women, and these procedures have been shown to result in high patient satisfaction and are considered safe. The aim of this study was to describe a novel classification for abdominal etching based on the senior author's technique and experience. This single surgeon, nonrandomized, retrospective study was conducted from December 2016 to September 2022. Patients were classified into 4 groups based on their body habitus, abdominal skin pinch test and skin quality, and the surgical plan was tailored accordingly. Sixty-two patients (42 male) with an average age of 36years underwent abdominal etching during the study period. Subgrouping included 4 (6.45%) in Class 1, 22 (35.5%) in Class 2, 32 (51.6%) in Class 3 and 4 (6.45%) in Class 4. The most common complication was seroma. Concomitant procedures included silicone implants to the pectoral region (male), fat injection to the buttocks, breast reduction and mastopexy and treatment of post-liposuction irregularities. The abdominal etching technique is safe and reproducible. It has demonstrated long-lasting results and high patient satisfaction. Our classification of patients will enable surgeons to better understand the problem presented and provide aesthetic and efficient results. Use of these guidelines and tailoring treatment options will further improve patient and physician satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

"The Jigsaw Puzzle Locking Technique" to Augment the Stabilization between the Septal Cartilage and Extension Graft in End-to-End Suture Fixation.

Nasal tip stability is crucial for long-lasting results. Usage of the extension graft is one of the most reliable stabilization techniques. With a septum in the midline, the extension graft is fixed end to end. The "jig-saw puzzle technique" reinforces this end-to-end fixation. The specific protrusion on one piece of the puzzle is inserted in a groove on adjacent piece. This settlement provides stabilization between the pieces. Application of this philosophy between the nasal septum and extension graft may provide a long-term fixation. Between April 2022 and March 2024, the "jig-saw puzzle technique" was applied in 26 female patients. Trapezoid-shaped protrusion was created at the septum. Similar indentation was created at the extension grafts. The protrusion is then settled in the indentation. The preop, immediate postoperative and one-year postoperative pictures are compared to assess the rotations and projections with Adobe Photoshop Program. All 26 patients were females with mean age 27.5 years (20-32). Satisfactory graft stabilization was obtained without loss of projection and rotation in all patients. Statistically significant difference was found between the preoperative, immediate postoperative and postoperative 1-year projection and rotation assessments of the patients (p=0.001; p<0.01). The results were evaluated at a 95% confidence interval and significance was evaluated at p<0.05 level. These statistical analyses verify that both projection and rotation were preserved with jig-saw puzzle technique. The jigsaw puzzle technique may provide suture-independent, long-term end-to-end fixation opportunity of the septal cartilage and the extension graft. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Outcomes of Watch-and-Wait Versus Abdominoperineal Resection in Lower Rectal Adenocarcinoma Post Neoadjuvant Therapy: An Iraqi Cohort Study.

Rectal malignancy ranks among the most prevalent malignancies in humans. Neoadjuvant chemoradiotherapy (nCRT) is advocated as the standard treatment for locally advanced rectal cancer. In patients who achieve complete clinical response (cCR), successive surgical intervention may result in favorable immediate and long-lasting results; however, itmay be associated with decreased quality of life. This study aims to evaluate the incidence of local recurrence in rectal adenocarcinoma between patients who underwent a watch-and-wait approach and those who underwent abdominoperineal resection following the achievement of a cCRafter nCRT. This is ananalytic cohort study that included 68 patients and was conducted in Baghdad Teaching Hospital/Medical City, Baghdad. The data were collected from the 1st of April 2021 to the 1st of October 2023. All patients with stage II and III rectal adenocarcinoma who achieved cCR after receiving nCRTwere included in the study. There was no statistically significant difference between the two study groups regarding non-regrowth disease-free survival (p-value = 0.708). Cox-regression multivariate analysis revealed that baseline T stage and serum carcinoembryonic antigen (CEA) were significantly associated with locoregional failure. The present study reveals that implementing the watch-and-wait strategy had the benefit of avoiding major surgery, stoma, and their complications without coming at the cost of reduced locoregional recurrence.

Full SMAS: Endoscopy-Assisted Full Facial Rejuvenation.

Every region of the face may bear the signs of aging. Treating isolated areas without adequate anatomical knowledge can lead to incomplete or artificial-looking results and decrease patient satisfaction. The authors' "Full SMAS" technique for complete rejuvenation addresses the anatomical continuity of the superficial musculoaponeurotic system (SMAS)-platysma to the deep-plane suspension of the face. The aim of this study was to evaluate the contribution of endoscopic techniques to traditional facelift and neck lift procedures. Procedures treating from the frontal and temporal regions of the superior part of the face to its mid and lower parts, including the cervical region, were evaluated. Treatment of the 3 sub-SMAS layers of the face was performed using endoscopy for repositioning the frontal region and midface. This procedure involved frontal and zygomatic-masseter ligament release, open treatment of the lower subplatysmal section, and the complete release of the retaining ligaments of the face and approach to the jowl. One hundred sixty-one patients underwent the Full SMAS technique, leading to long-lasting results, low complication rates, and high patient satisfaction. The Full SMAS is a systematic technique that provides complete facial rejuvenation by combining an endoscopic approach for the temporal and midface regions with traditional open approaches for the lower face and neck. Treating the temporal and midface regions by minimally invasive techniques (endoscopy) reduces the possibility of permanent nerve injuries, provides smaller scars, and creates natural, long-lasting results.

The evolution of adhesive dentistry: a review of materials and techniques

Adhesive dentistry has undergone remarkable advancements since its inception, fundamentally transforming restorative dental care. Initially marked by the development of early resins and etching techniques, adhesive dentistry has evolved to incorporate sophisticated materials and innovative techniques that significantly enhance clinical outcomes. The introduction of Bis-GMA resins in the 1960s improved mechanical properties and reduced polymerization shrinkage, paving the way for modern composite resins. These composites, enhanced by nanotechnology and advanced filler technology, provide superior strength, wear resistance, and esthetic qualities. Techniques such as selective enamel etching and multi-layering of adhesive systems have further improved bond strength and reduced technique sensitivity. The clinical applications of adhesive dentistry are extensive, ranging from direct and indirect restorations to cosmetic procedures and preventive measures. Direct composite restorations offer minimally invasive solutions with excellent esthetics, while indirect restorations such as inlays, onlays, and veneers benefit from strong, reliable bonds and improved durability. Cosmetic procedures, including veneers, achieve dramatic esthetic improvements with long-lasting results. Preventive applications, such as sealants, effectively protect against caries, especially in pediatric and high-caries-risk patients. The continuous refinement of materials and techniques has led to better clinical outcomes, increased patient satisfaction, and reduced need for invasive procedures. Advances in adhesive materials and methods have ensured that restorations not only mimic natural tooth structures but also maintain their integrity under functional forces. As research and development in adhesive dentistry continue to progress, the field is poised to offer even more innovative and effective solutions, further enhancing the quality of dental care. Overall, the evolution of adhesive dentistry underscores its pivotal role in modern dental practice, providing durable, esthetic, and reliable restorative options that meet the diverse needs of patients.

Comparing Complication Rates, Costs, and Length of Stay between Unicompartmental and Total Knee Arthroplasty: Insights from a Big Data Analysis Using the National Inpatient Sample Dataset.

Background: Unicompartmental knee arthroplasty (UKA) is increasingly used for knee osteoarthritis due to faster recovery, better range of motion, and lower costs compared to total knee arthroplasty (TKA). While TKA may offer longer-lasting results with lower revision rates, this study compares the relative benefits and limitations of UKA and TKA using the National Inpatient Sample (NIS) database. Methods: This retrospective analysis examined outcomes of elective UKA and TKA procedures from 2016 to 2019, identifying 2,606,925 patients via ICD-10 codes. Propensity score matching based on demographics, hospital characteristics, and comorbidities resulted in a balanced cohort of 136,890 patients. The present study compared in-hospital mortality, length of stay, postoperative complications, and hospitalization costs. Results: The results showed that UKA procedures increased significantly over the study period. Patients undergoing UKA were generally younger with fewer comorbidities. After matching, both groups had low in-hospital mortality (0.015%). UKA patients had shorter hospital stays (1.53 vs. 2.47 days) and lower costs (USD 55,976 vs. USD 61,513) compared to TKA patients. UKA patients had slightly higher rates of intraoperative fracture and pulmonary edema, while TKA patients had higher risks of blood transfusion, anemia, coronary artery disease, pulmonary embolism, pneumonia, and acute kidney injury. Conclusions: UKA appears to be a less-invasive, cost-effective option for younger patients with localized knee osteoarthritis.