Nonsurgical Management Techniques Research Articles

Subtle Syndesmotic Instability.

Latent or subtle syndesmotic instability is defined as an injury to the syndesmosis which is not apparent on static radiographs of the ankle. Syndesmotic injuries have also been referred to as high ankle sprains. Injury to the syndesmosis typically occurs with collision sports and often involves an external rotation force to the ankle. Diagnosis can be delayed because of negative initial imaging studies. Physical examination tests including the external rotation test, proximal squeeze test, and fibular shuck test can assist in the diagnosis. Advanced imaging modalities such as MRI and weight-bearing CT have been studied and can provide prognostic indications for management, although arthroscopic stress evaluation remains the benchmark for diagnosis. Both surgical and nonsurgical management techniques have been described, which can assist patients in returning to their preinjury level of function.

Oral Mucocele- A Literature Review of Management Alternatives

Oral Mucocele is a common lesion seen in oral cavity which is a benign disease of minor salivary glands. It clinically presents as single, painless, soft, smooth, spherical, translucent and fluctuant nodule with pink to transclucent blue observed in reflected light.The lesion may resolve spontaneously or traumatically with the rupture of the lining, with the release of a characteristic viscous, mucoid fluid. There has been continuous research with an aim to find ways for management having least recurrence rates in various types of oral mucocele. Multiple treatment options have been trialled for eradication of the lesion, including surgical and non-surgical management techniques. The non-invasive methods also comprised of different intra-lesional injections. Many other invasive procedures with added advantages and few shortcomings have also been researched by the Clinicians.

Non-surgical Management of Large Periapical Lesions with the Agreement Evaluation of the Methods

Aim: The aim of this study is to evaluate the agreement between three routinely used non-surgical management techniques for large periapical lesions namely the treatments with Calcium hydroxide, Mineralo-Trioxide Aggregate and Bio-dentine.
 Methods: Data was collected from 60 patients at the Department of Restorative Dentistry, Faculty of Dental Sciences, University of Peradeniya. The variables age, gender and area of the infected region before and after the treatment and the treatment type were considered. Two homoscedastic and heteroscedastic Mixed-effects models were fitted and the agreement between three treatments were assessed using Concordance Correlation Coefficient (CCC) and Total Deviation Index (TDI).
 Results: CCC value calculated for treatment types 1 & 2, 1 & 3 and 2 & 3 are (0.905, 0.909, 0.874) for homoscedastic model and (0.989, 0.990, 0.975) for heteroscedastic model. Further, corresponding TDI values for homoscedastic and heteroscedastic models are (3.148, 4.390, 1.647) and (2.963, 4.388, 1.457) respectively.
 Conclusions: Since all the CCC values are close to 1 and TDI values are low, there is a strong agreement between all three treatments and hence they be used interchangeably. Moreover, the agreement between Treatments with Calcium hydroxide and Bio-dentine is higher compared to the agreements between the other treatments. (i.e., Calcium hydroxide with Mineralo-Trioxide Aggregate and Biodentine with Mineralo-Trioxide Aggregate).

Conservative management of periapical lesions of endodontic origin - a review of the different techniques

Introduction : Periapical lesions of endodontic origin are common pathological conditions affecting the periradicular tissues. Mainly responsible for the initiation and progression of apical periodontitis is the microbial infection of pulpal tissues. There are different conservative techniques that can be applied in order to establish a healing process of periapical lesions of endodontic origin. Materials and Methods : We have conducted a research that covers related articles and publications, in order to review the different conservative management treatment techniques for lesions affecting the periradicular tissues. Results: Different non-surgical management techniques have been described, namely: conservative root canal therapy, decompression technique, a method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and repair therapy, active non-surgical decompression technique, and the apexum procedure. Conclusion: All of the described management techniques present with advantages, disadvantages and specific indications that should be taken into consideration when managing the treatment plan of every specific clinical case.

Management of metastatic cervical spine tumors.

The skeletal system is the third most common site of metastases after the lung and liver. Within the skeletal system, the vertebral column is the most common site of metastases, and 8% to 15% of vertebral metastases are in the cervical spine, consisting, anatomically and biomechanically, of the occipitocervical junction, subaxial spine, and cervicothoracic junction. The vertebral body is more commonly affected than the posterior elements. Nonsurgical management techniques include radiation therapy (stereotactic and conventional), bracing, and chemotherapy. Surgical techniques include percutaneous methods, such as vertebroplasty, and palliative methods, such as decompression and stabilization. Surgical approach depends on the location of the tumor and the goals of the surgery. Appropriate patient selection can lead to successful surgical outcomes by restoring spinal stability and improving quality of life.

Advances in congenital craniofacial surgery.

Surgery for the correction of craniofacial anomalies has come a long way since its beginnings more than three decades ago. Throughout this period numerous developments have occurred in diagnosis and management, as well as a better understanding of the etiology of craniofacial anomalies. Significant technological advancements in imaging have allowed for more precise diagnosis and surgical planning. Quantitative analysis techniques have been developed allowing for more precise results analysis. Nonsurgical management techniques have improved, as has the understanding of the proper utilization of nonsurgical treatment. Most nonsynostotic cases of head shape abnormality can be successfully managed nonsurgically. Improvements in surgical management include ways of diminishing the need for transfusions. Operative technical refinements also allow for improved results. The discovery of intracranial migration of rigid fixation hardware has led to decreased utilization of the metallic implants. Bone cements and absorbable plating systems promise further enhancements. Distraction osseogenesis allows skeletal changes to be made gradually reducing risks. Finally, the etiologies of craniosynostosis are being elucidated and promise to lead to more elegant management, reducing or alleviating the need for surgery. Genetic manipulation may eliminate many of these problems.

Workup of the patient with an abnormal Papanicolaou smear

There is a premium placed upon the detection of cervical squamous cell cancer precursors in their earliest stages as they are most amenable to nonsurgical management techniques in the early stages and the risk of missing an invasive cancer is substantially reduced. For the patient with an abnormal Papanicolaou smear, examination by a skilled colposcopist followed by multiple punch biopsies of the colposcopically abnormal areas and a thorough endocervical curettage is the diagnostic method of choice unless the patient is pregnant or there are other contravening clinical factors. The patient with a lesion with a size and distribution which makes it amenable to outpatient therapy and in whom invasive cancer has been excluded may be treated by a variety of outpatient modalities, including hot cautery, cryotherapy, or carbon dioxide laser. These techniques appear to be equally effective, and the patient appears to have a relatively low risk of developing a new lesion once the original disease has been eradicated and she has had three negative Papanicolaou smears.