Radiographic Evaluation Research Articles

Mid-term radiographic evaluation of a monoblock trabecular metal tibia following total knee arthroplasty in obese and morbidly obese patients.

Indications for primary total knee arthroplasty (TKA) have become more inclusive of morbidly obese patients, however, higher rates of complications and lower implant survival have also been reported in this population. The purpose of this study was to investigate the mid-term survival, clinical, and radiographic outcomes of a cementless trabecular metal monoblock tibial component in severely obese patients. This was a retrospective study of class II and III obese (BMI > 35) patients who received a cementless primary TKA. Standing radiographs were assessed for the presence of progressive tibial radiolucent lines (RLL), and clinical measures were assessed at least 2 years post-operative via the Oxford Knee Score (OKS), UCLA Activity and Satisfaction Score, and the Euro-QoL 5-dimension (EQ-5D-5L) index and visual analogue scale (EQ-VAS) health status. Patients (n = 176) were 61.2 ± 8.3 years of age, BMI 44.9 ± 6.5 kg/m2, and were predominantly female (n = 118, 66.7%). Mean follow-up was 59.2 ± 17.1 months. There were two total revisions at 6- and 57-months post-operative, respectively, and the 5-year survival estimate was 98.3% (95% confidence interval: 93.0%, 99.6%). Patient satisfaction was 93.9% and the post-operative OKS, EQ-5D-5L index, and EQ-VAS were 40.2 ± 7.9, 0.856 ± 0.205, and 73.6 ± 14.7, respectively. No cases of radiolucent lines were detected. At 6years this cementless monoblock tibial component demonstrated excellent survival without radiographic indications of aseptic loosening in a population of severely obese patients.

Precooling storage of bone cement in percutaneous vertebroplasty for osteoporotic vertebral compression fracture

PurposeThis study aimed to investigate the effect of precooling storage of bone cement in percutaneous vertebroplasty(PVP) for the patients with osteoporotic vertebral compression fracture (OVCF).MethodsA total of 207 OVCF patients who underwent PVP were included in this study. Two different storage methods for the bone cement were randomly utilized: an operating room (NT group, 23 °C) and a refrigerator (PC group, 4 °C). Clinical outcomes were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. In addition, radiographic evaluations were performed using anterior vertebral height and Cobb angle.ResultsThe time of cement infusion was 10.8 ± 2.1 min in the PC group, which was significantly longer compared to the NT group (6.9 ± 1.8 min)(P < 0.0001). However, the postoperative VAS score was lower in the PC group than the NT group (P < 0.0001). Moreover, compared to the NT group, the cement distribution score and rate of cement touching both upper and lower vertebral endplates were higher in the PC group (P < 0.0001 and = 0.037, respectively). Additionally, the anterior vertebral height was higher in the PC group compared to the NT group at both the 2-day postoperative assessment and the final follow-up (P = 0.046 and 0.026, respectively). Lastly, the rates of cement leakage and re-compression were lower in the PC group (P = 0.016 and 0.034, respectively) compared with the NT group.ConclusionPrecooling storage of bone cement may prolong manipulation time in percutaneous vertebroplasty, optimize pain relief for patients, and mitigate the risk of bone cement leakage and re-compression.Trial registrationTrial registration number: ChiCTR2400092330. Retrospective registration date: 14/11/2024 (www.chictr.org.cn).

The Radiologic Evaluation and Clinical Significance of Glenohumeral Bone Loss in Anterior Shoulder Instability

Glenoid and humeral bone loss is associated with a high incidence of recurrent shoulder instability and failure of arthroscopic stabilization procedures. However, the radiographic evaluation of bony Bankart and Hill–Sachs injuries continues to pose a diagnostic challenge, and a universally accepted optimal method of measurement is lacking. The purpose of this review is to summarize the advantages and disadvantages of various techniques and imaging modalities available for measuring glenoid bone loss in shoulder instability, including conventional roentgenography, 2-dimensional and 3-dimensional computed tomography (CT), and magnetic resonance imaging (MRI). We also review the concepts of engaging “on-track” and “off-track” Hill–Sachs lesions. Finally, we highlight the clinical importance of obtaining accurate determinations of bone loss by the various methods available, as it can affect surgical decision making and the appropriate procedure required to ensure shoulder stability is adequately restored.

FOOT RADIOGRAPHY IN EUROPEAN BISON (BISON BONASUS).

Bone lengths of paired digits of front and hind limbs from 12 captive European bison (Bison bonasus) of different ages (from nine to 175 months) and sexes were measured on digital radiographs in palmarodorsal (PaD) and dorsoplantar (DPl) projections of each limb. All bone lengths were measured, and lateral/medial ratios calculated. The bone measurements included length of the canon bone condyle (LCBC), length of the first, second, and third phalanges (LP1, LP2, LP3), and overall digit length (OL). Furthermore, radiographic abnormalities such as new bone formation (NBF), soft tissue mineralization (SFT), osteolysis (OS), widened vascular channels (WVC), and soft tissue swelling (STS) were recorded using PaD, DPl, and oblique projections. NBF and SFT received a single combined grade as without radiographic changes (0), mild (one to 10 changes = 1), moderate (11 to 20 changes = 2), and severe (>20 changes = 3). OS, WVC, and STS were graded as 0 = absent and 1 = present. There were no significant differences (P > 0.1) of lateral to medial ratios for LCBC, LP1, LP2, and OL in front limbs as compared with hind limbs. Only LP3 was significantly longer (P = 0.004) in the lateral digit of the hind limbs as compared with the front limbs. For both the front and the hind limbs, the lateral LCBC, LP1, LP2, LP3 and OL were significantly longer than the respective measurements of the medial bones (P < 0.05), except for LP2 and LP3 of the hind limbs. Length measurement ratios did not vary significantly with age (P > 0.1). The most common radiographic changes were both NBF and SFT, observed in all animals from 39 months of age and older. This study provides baseline data on in vivo radiographic anatomy and evaluation of feet of European bison under field conditions.

Dental Dam Isolation for Crown Removal, Atraumatic Tooth Extraction, Immediate Implant Placement, and Restoration Cementation: A Case Study.

This case report describes the clinical protocols for the removal of crowns, tooth extraction, immediate implant placement, and cementation of new crowns, all performed under total or partial isolation with a dental dam. The patient's chief complaint was dissatisfaction with her smile. Radiographic and clinical evaluations led to the recommendation to replace the porcelain-fused-to-metal crowns on the maxillary central and lateral incisors with all-ceramic crowns. Considering the patient's wide smile, ceramic veneer restorations were also recommended for the maxillary canines and first premolars. An immediate implant placement was advised to replace the fractured maxillary right central incisor. Well-planned dental care including crown removal, tooth extraction, immediate implant placement, and cementation of new restorations can be successfully executed under isolation using a dental dam. The isolation improves access, visibility, and hygiene by preventing cross-contamination during the cementation procedure. The final outcome fulfilled the patient's esthetic demands.

Mixing Metals During Operative Fixation and Reconstruction in the Appendicular Skeleton: Does Theoretical In Vivo Galvanization Cause Clinically Detrimental Outcomes?

Traditional training and teaching have advised against mixing varying metal types to avoid the potential for in vivo galvanization and corrosion. The objective of this study was to retrospectively analyze patients who have undergone operative reconstruction with mixed metal (MM) constructs to report any related complications. Design: Retrospective case series. Single Level II Trauma Center. Patients that underwent trauma and/or arthroplasty surgery at a single level II trauma center between 2017-2022 with 'mixed' fixation defined as contact and proximity within the bone (≤10mm) with complete radiographs and medical records and minimum 1 year follow-up was eligible for study inclusion. The primary outcome measure were incidence of corrosion directly related to hardware related complications causing unplanned reoperation. The final analysis included 56 patients (67.9% female), with a mean age of 62.0±16.6 years, mean BMI of 28.9±8.4 kg/m2, and mean Charlson Comorbidity Index (CCI) of 2.5±1.8. Seventy-three percent of the MM implants had direct metal on metal contact, and the average distance between non contacting metals was 0.32±0.28cm. The most common combination of metals was titanium+stainless steel (69.6%). At an average postoperative follow-up of 25.9±19.6 months, hardware-related complications were observed in 15 (26.8%) of patients, with reoperation due to hardware-complications in 12 (21.4%) within 18.5±15.8 months. No evidence of metal-on metal galvanic corrosion was observed on radiographic evaluation at an average of 25.9±19.6 months. Patients who received mixed metal implants showed no radiographic or clinical signs of corrosion. While theoretical concerns exist regarding use of mixed metal implants, these findings suggest that the consequence of such combinations in clinical practice may not be as significant. IV, Retrospective case series.

A Prospective Randomised Clinical Trial Evaluating Pulpotomy in Primary Molars With Three Bioceramic Calcium Silicate Cements: 24 Month Follow-Up.

In recent times, bioceramic calcium silicates have gained attention due to high success rates with pulpotomy in primary teeth. To evaluate and compare the clinical and radiographic outcomes of three different bioceramic calcium silicate cements in vital deciduous teeth treated with pulpotomies over a period of 24 months. Children aged 4-9 years, with deep dentinal caries (ICDAS 4-6) in primary molars, having no history of spontaneous pain or signs of non-vitality were included in the study. Following clinical and radiographic evaluation 117 primary molars diagnosed as having reversible pulpitis received pulpotomy treatment, after randomly being assigned into three groups based on the bioceramic calcium silicate medicament used: a pre-mixed syringe-loaded MTA putty (NeoPUTTY); a traditional powder-liquid hand mix MTA material (NeoMTA Plus), and a precapsulated, trituration mixed material (Biodentine). Clinical and radiographic evaluation was done at 6, 12, 18 and 24 months. The cumulative clinical and radiographic success for NeoPUTTY was 92%, NeoMTA Plus 97% and for Biodentine 95% and 89%, respectively, after 24 months follow-up. The clinical and radiographic success rates of all three bioceramic calcium silicate cements were found to be high, with no significant differences over a period of 24 months. Clinical trial registration number: CTRI/2021/03/031655.

Efficacy of adipose tissue-derived stromal fraction in the treatment of osteochondral defects in rabbits

This study aimed to evaluate the efficiency of stromal derived from adipose tissue in the treatment of osteochondral defects in rabbits. A total of 36 white New Zealand rabbits were used: 24 to perform an osteochondral defect in the trochlear groove of the joints and 12 to collect adipose tissue in the region of the adipose panicle, divided in three digestion times (30, 45 and 50 min). The groups were divided into negative control (C−), stromal fraction of adipose tissue (SFAT) and positive control (C +) with autogenous osteochondral graft. Clinical, radiographic, macroscopic and histopathological evaluations showed that the therapeutic effects of the stromal fraction of adipose tissue minimized the degenerative signs of articular cartilage in the treatment of osteochondral defects in rabbits. The digestion time of 30 min was the best option for obtaining the stromal fraction from adipose tissue of rabbits and its use at the lesion site was satisfactory, without any immunological complications, indicating potential as an alternative for the treatment of osteochondral defects.

Cut-off value for the posterior tibial slope indicating the risk for retear of the anterior cruciate ligament.

The significance of the posterior tibial slope (PTS) has increasingly come into focus in anterior cruciate ligament (ACL) reconstruction being a risk factor for ACL graft failure. Nevertheless, inconsistent data on the critical value of the PTS exist. The purpose of this study was to define a cut-off value for the PTS in ACL surgery. In a retrospective cohort study, 350 revision ACL reconstructions (ACL-RR) with a failed ACL hamstring graft and 350 primary ACL reconstructions (ACL-R) were matched according to age, gender, concomitant injuries and graft characteristics and compared to a healthy control group. Using the proximal anatomic axis, lateral knee radiographs were evaluated for the PTS, interrater reliability was defined, ROC curves, Fischer's exact test and Baptista-Pike method were applied to define specificity and the odds ratio for a critical PTS value. Radiographic evaluation proved excellent interrater reliability (intraclass correlation coefficient 0.969). Evaluation of the PTS revealed 10.0 ± 2.2 (5-15) degrees in the ACL-RR group, 7.8 ± 1.8 (4.2-13) degrees in the ACL-R group and 6.6 ± 1.9 (3.6-12) degrees in the control group with significant differences between the groups (p < 0.001). A PTS value of 10.1 degrees proved a specificity of 98% for the prediction of an ACL graft failure and indicated an 11-fold risk for a retear of the ACL. A PTS exceeding 10.1 degrees carries an 11-fold risk for ACL graft failure and, therefore, should be considered in ACL reconstruction. These findings might serve as a cut-off value for the indication of a slope-reducing high tibial osteotomy in ACL surgery. Level III.

Comparison of Femoral and Tibial Tunnel Widening after Anterior Cruciate Ligament Reconstruction with Biostable and Bioabsorbable Interference Screws: A Radiographic Evaluation

Comparison of Femoral and Tibial Tunnel Widening after Anterior Cruciate Ligament Reconstruction with Biostable and Bioabsorbable Interference Screws: A Radiographic Evaluation

A Study on Position and Lumen Geometry at the Origin of External Carotid Artery in Human Adult Cadavers

Background: External carotid artery is the predominant source of blood supply to the structures in the head and neck region. Morphological anomalies in the external and internal carotid arteries may lead to severe complications, when radiographic evaluations and surgical proceedings are done in the neck without any prior knowledge. Normal arterial diameters of external carotid arteries were important in-patient selection, preoperative planning, and design of new endovascular devices for arterial reconstruction. Material and Methods: A descriptive study was performed on 60 formalin fixed male and female Human adult cadavers, aged between 45 to 75 yrs in the department of Anatomy, Dr.Pinnamaneni Siddhartha Institute of Medical Sciences and Research foundation, chinoutapalli and Mamatha academy of medical sciences, Hyderabad , during the academic years, 2018- 2023 during the academic years . Observations from both right and left external carotid arteries (total- 120 sides) were noted. Results: In the present study, positions of external carotid artery observed were, antero-medial in 90%, anterolateral in 6.66% and lateral position in 3.33% of cases. The mean ± standard deviation calculated for the diameter of lumen at the origin of external carotid artery on the right side was 0.623±0.048 cm and on the left side was 0.608±0.050cm. For both right and left sides was 0.616±0.049cm. Conclusion: Positional variations of external carotid artery observed in the present study were anterolateral and lateral positions. In such cases Carotid endarterectomy can be safely done, after transposing the internal carotid artery to normal location. Data on normal arterial diameters were helpful during reconstructive surgeries and manufacture of endovascular devices, respective to different ethnic groups. KEYWORDS: Common Carotid Artery, Carotid Artery External, Positional Variations, Lumen Geometry, Carotid Endarterectomy.

Clinical case report of non-surgical and surgical endodontic treatment (apicoectomy)

Endodontic treatment, both non-surgical and surgical, aims to eliminate the neurovascular bundle and the microbiota present within the root canal system and the extraradicular region. This study reports the clinical management of a 31-year-old female patient with odontalgia in tooth #46. Following clinical and radiographic evaluation, a periapical radiolucent lesion approximately 5 mm in diameter was identified. Initially, conventional endodontic treatment was performed using the Reciproc Blue mechanized system, followed by an apicoectomy due to persistent symptoms associated with a high bacterial load. The therapeutic approach was based on the review of 12 scientific articles to establish an accurate pulp and periapical diagnosis and to select appropriate techniques and materials. Treatment outcomes demonstrated adequate healing and periapical repair, with resolution of clinical symptoms and functional improvement of the treated tooth. It is concluded that the integration of non-surgical and surgical treatments is essential in cases of pulp necrosis and chronic periapical abscess with high bacterial load. This complementary approach optimizes therapeutic outcomes, preserves the tooth, and improves the patient’s quality of life

Impact of postoperative cauda equina clumping on recovery after biportal endoscopic decompression for severe lumbar stenosis.

This study determined the prevalence of cauda equina clumping among patients with Schizas grade C or higher central stenosis after decompression and compared the radiographic and clinical outcomes between patients with and without clumping. We conducted a single-center retrospective cohort study involving 98 patients who underwent biportal endoscopic spine surgery between January 2019 and June 2022. Based on postoperative magnetic resonance imaging findings, the patients were divided into the clumping (n = 40) and non-clumping (n = 58) groups. Clinical outcomes were assessed using the visual analog scale for back and leg pain, Oswestry Disability Index (ODI), and EuroQol 5-Dimension (EQ-5D-5L) questionnaire at 1, 3, 6, and 12 months postoperatively. Radiographic evaluations included measuring the cross-sectional area of the dural sac preoperatively and 1 month postoperatively using the PACS software. Postoperative cauda equina clumping was observed in 40.8% of the patients. Despite an average dural sac expansion of approximately 270%, the clumping group exhibited significantly higher radiating pain at 3 and 6 months (p < 0.05) than the non-clumping group. The ODI and EQ-5D scores were worse in the clumping group at 3 months (p < 0.05). At 12 months postoperatively, differences in clinical outcomes between the two groups were not significant. Patients in the clumping group required longer duration of postoperative medication than those in the non-clumping group (p = 0.024). Post-decompression cauda equina clumping is commonly observed in patients with severe lumbar stenosis and impacts intermediate-term clinical recovery. Although long-term outcomes at 1 year are similar, tailored postoperative care is essential for patients exhibiting clumping to effectively manage prolonged symptoms.

Efficacy of chemo-mechanical caries removal: a 24-month randomized trial.

Chemo-mechanical caries removal (CMCR) offers an alternative to conventional drilling for carious dentin removal, but limited evidence exists on its long-term effects on treating caries in primary teeth. The primary aims of this study were to compare CMCR to drilling in terms of restoration status and the presence of secondary caries after 24 months. A randomized, parallel-group, single-blinded, controlled trial was conducted in Thailand. Participants were children aged 7-8 years with occlusal caries in second primary molars, randomly assigned to CMCR with Papacarie® (n = 242) or drilling (n = 246). All cavities were restored using glass ionomer cement. Completeness of caries removal was evaluated clinically by two blinded dentists, and patients' discomfort was measured using a facial visual analogue scale. Restoration status and development of secondary caries were assessed every six months clinically and every 12 months radiographically over a 2-year period. Both groups achieved complete caries removal, but the CMCR took significantly longer than the drilling method (9 vs. 2.3 min, p < 0.001). Children in the CMCR group reported significantly lower discomfort during treatment (p < 0.001). At 24 months, ten (4.6%) restorations in the CMCR group failed, compared to three (1.2%) in the drilling group. Clinically, four restorations (CMCR = 2, control = 2) exhibited secondary caries at the margin, while nine restorations (CMCR = 8, control = 1) showed radiographic evidence of secondary caries beneath the restoration. However, neither clinical nor radiographic evaluations revealed statistically significant differences in treatment outcomes at the two-year mark. CMCR demonstrated comparable efficacy to conventional drilling for complete caries removal and restoration success at 24 months in primary teeth. Despite a longer chair time, it resulted in less discomfort during treatment. https://clinicaltrials.gov/study/NCT01641861, identifier: NCT01641861.

Diagnostic ecologies: Medical standards, tinkering, and worker health in Turkey

AbstractIn Turkey's occupational health system, doctors must use the International Labor Organization's (ILO) standards to classify the chest radiographs of workers at risk of lung diseases caused by dust exposure. Yet these standards do not provide a uniformity of care within the tripartite structure of the occupational health system, which divides disease surveillance, disease diagnosis, and worker compensation into distinct silos. This division often produces ambiguity and unpredictable outcomes for occupational disease claims. The traffic of diagnostic decisions among workplaces and medico‐legal institutions—what I refer to as diagnostic ecologies—shapes medical knowledge. The tripartite organization of the occupational health system in Turkey makes the evaluation of chest radiographs a space where professional expertise and professional ethics are constantly negotiated. A focus on diagnostic ecologies illustrates how disease ontology is distributed across the occupational health system's components.

Treatment of external root resorption with Biodentine in a tooth with a periodontal pocket: a case report with 2-year follow-up

External root resorption is characterized by the loss of mineral tissues in the dental root. This condition is difficult to diagnose, and if not identified early, it can lead to tooth extraction. The treatment consists of surgical access, removal of granulation tissues, and sealing the area with a biological material. Objective: This article reports on the treatment of ERR in the middle third of the root, associated with an 8 mm periodontal pocket using Biodentine, with a two-year follow-up. Case report: A 57-year-old woman attended complaining of discomfort in the palate. After a thorough medical history, clinical, radiographic, and tomographic evaluation, the final diagnosis was External Root Resorption. Concerned about preserving the tooth, it was suggested to fill the resorption with Biodentine and regular follow-ups. The patient agreed, and a tissue flap was raised in the palatal region, followed by sealing of the perforation with Biodentine and suturing. After 7 days, the sutures were removed, and during the six-month and two-year follow-ups, the tooth exhibited no mobility, good periodontal health, and maintained its function. Conclusion: The case demonstrated a reduction in the periodontal pocket (from 8 mm to 4 mm), maintenance of the tooth, and the effectiveness of Biodentine in treating ERR, even when exposed to the oral cavity.

The rate of ileostomy site incisional hernias: more common than we think?

Incisional hernias (IH) rates after diverting loop ileostomy reversal (DLI-R) have been reported up to 24%. We aimed to characterize the incidence rate and risk factors associated with DLI-R site IH formation within 1-year in a large patient cohort. A retrospective review at a single quaternary referral center hospital of adult patients who underwent DLI-R over a 5-year period and abdominal computerized tomography (CT) imaging performed within 1-year for any indication postoperatively was conducted. All CTs scans were independently reviewed by staff surgeons to determine the presence of a fascial defect at the DLI-R site. 2,196 patients underwent DLI-R; of these, 569 (25.9%) underwent CT imaging for any indication. Mean patient age, 54.8 (± 14.9), BMI 27.6kg/m2. 87 (15%) patients had a parastomal hernia at time of DLI-R. After median follow-up of 10 months, 203 patients (35.7%) had IH at the DLI-R site. Age (p = 0.14), sex (p = 0.39), race (p = 0.75), and smoking status (p = 0.82) weren't associated with IH after DLI-R. Comorbidities weren't significantly associated with IH following DLI-R. In univariate analysis, increased BMI (p < 0.001), presence of a parastomal hernia (p = 0.008), and suture type (p = 0.01) were associated with IH development. On multivariate analysis, BMI remained significant, and polyglyconate compared to polydioxanone suture were associated with higher rates of IH (p < 0.001). We observed that the rate of incisional hernias within 1-year of diverting ileostomy reversal was indeed common at 36%. Granted, a high percentage of the population was excluded due to heterogeneity in radiographic evaluation that could be mitigated in future prospective studies. Our study suggests that IH preventative strategies include weight loss for overweight and obese patients prior to DLI-R and that the optimal suture for DLI-R is polydioxanone.

Closed Reduction Followed by Percutaneous Fixation of Acute Femoral Neck Fractures in Young Adults: A Retrospective Cohort Study

OBJECTIVES: To evaluate the surgical outcomes of femoral neck fractures (FNF) in young adults treated with a closed reduction technique because it pertains to reduction quality, rates of union, and risk factors for complication. METHODS: Design: Retrospective cohort study with radiograph and electronic medical record review. Setting: Level 1 Swiss Trauma Center. Patient Selection Criteria: Between 2012 and 2021, young adults with isolated FNF (AO/OTA 31-B1) treated with percutaneous internal fixation were selected. Exclusion criteria were open reduction technique, age older than 65 years or younger than 16 years, pathologic fractures, and associated femoral head or shaft fractures. Outcome Measures and Comparisons: Primary outcome was quality of reduction, as assessed by 3 experienced trauma surgeons' evaluation of intraoperative and/or first postoperative radiographs using the overall impression, the Garden alignment index, and Lowell criteria. In addition, clinical outcomes, conversion to arthroplasty, and complications after closed reduction and fixation of femoral neck fractures were reviewed. RESULTS: A total of 54 patients with a median interquartile range age of 57.5 (48–60) years were included. Among them, 22 (41%) were women and 32 (59%) were men. The closed reduction technique demonstrated satisfactory reduction results in up to 87% of cases. Major complications occurred in 19%, with 17% requiring conversion to total hip arthroplasty. Unacceptable or borderline acceptable reduction quality correlated significantly with the need for later conversion (P = 0.03). CONCLUSIONS: The study supported the use of the closed reduction technique for acute FNF in patients younger than 65 years, achieving satisfactory reduction results in up to 87% of cases with comparable complication rates to treatment of young femoral neck fractures with open reduction. Furthermore, it underscored the significance of the surgeon's overall impression of reduction quality, alongside the established reduction criteria, the Garden alignment index, and Lowell criteria, in evaluating the quality of the reduction. In addition, risk of conversion to total hip arthroplasty was associated with worse closed reduction quality. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Thermosensitive Hydrogels for Periodontal Regeneration: A Systematic Review of the Evidence.

Thermosensitive hydrogels are now among the most commonly used biomaterials in tissue engineering. Due to their unique characteristics, this review aimed to evaluate the suitability of thermosensitive hydrogels in periodontal regeneration. PubMed, Scopus, and Web of Science databases were searched until March 25, 2024, to retrieve relevant articles. The eligibility criteria for the included studies were determined by the designed PICO elements. Results from each included study were extracted, focusing on the three main areas: thermosensitivity, cellular characteristics, and in vivo characteristics. Nineteen studies were included in our study. The thermosensitivity assessment of the hydrogels indicated a range of sol-gel transition times from 40 s to 20 min based on the type of polymers and the fabrication process. The cellular characterization was assessed based on three main cellular behaviors: cellular viability/proliferation, differentiation, and migration. The in vivo characterization was performed based on two main approaches: radiographic and histologic evaluation. The results indicated that the addition of bioactive agents could enhance the in vivo efficacy of thermosensitive hydrogels in periodontal regeneration through three main areas: antimicrobial, anti-inflammatory, and regenerative effects.

Radiographic Evaluation of Trapeziometacarpal Total Joint Arthroplasty: Why and How?

Radiographic Evaluation of Trapeziometacarpal Total Joint Arthroplasty: Why and How?