Removal Procedure Research Articles

Hypoxaemia risk in pediatric flexible bronchoscopy for foreign body removal: a retrospective study

BackgroundHypoxemia represents the most prevalent adverse event during flexible bronchoscopy procedures aimed at foreign body retrieval in pediatric patients; if not expeditiously managed, it carries the potential for cardiac or respiratory arrest. The specific risk factors contributing to the occurrence of hypoxemia during foreign body FB removal via bronchoscopy have yet to be definitively established.MethodsThis retrospective study included a cohort of 266 pediatric subjects from January 1, 2015, to December 31, 2022, who underwent flexible bronchoscopy for the purpose of FB extraction. In this cohort, the supraglottic airway was used to connect the anesthesia apparatus during the removal procedure.ResultsIn total, 45 of the pediatric patients (16.9%) experienced episodes of hypoxemia during the FB removal procedure. Multivariate analysis revealed that the following factors were significantly associated with the occurrence of hypoxemia: an operation time exceeding 60 min (odds ratio [OR] 8.55; 95% confidence interval [CI] 3.82–19.13), a maximum diameter exceeding 7 mm (OR 5.03; 95% CI, 2.24–11.29), and the presence of radiological evidence indicating pneumonia (OR 2.69; 95% CI, 1.27–5.69).ConclusionDuring flexible bronchoscopy procedures aimed at FB removal in pediatric patients, there is an increased susceptibility to hypoxemia. Factors including extended operation duration, larger FB dimensions, and radiographic evidence suggestive of pneumonia significantly contribute to a heightened risk of hypoxemia.

Advancing Robotic Single-Site Cholecystectomy: Innovations, Challenges, and Future Directions.

The crystalization of the components of bile within the gallbladder can lead to the formation of gallstones (cholelithiasis), which may often require surgical removal of the gallbladder, a procedure known as cholecystectomy, in symptomatic cases.Robotic single-site cholecystectomy (RSSC) is a recently introduced groundbreaking minimally invasive procedure for gallbladder removal. RSSC utilizes robotic technology, offering enhanced dexterity through a single-incision approach, promising improved outcomes such as reduced postoperative pain and superior cosmesis. However, certain limitations, such as restricted instrument movement and heightened hernia risk, necessitate a critical evaluation of this modality. Furthermore, as the widespread adoption of RSSC remains undecided due to concerns over its costs, efficiency, and overall superiority over prior models, this paper assesses future possibilities forRSSC's evolution. In vivo robotics, improved digital imaging, and re-engineering of the surgical instruments themselves are all potential avenues to augment the current RSSC design, although it is currently unclear as to what extent they could impact the procedure's viability. This review critically examines the available literature on the effectiveness and potency of RSSC compared to its predecessors in the modern healthcare setting and proposes future directions through which innovation could more firmly establish the procedure as the standard of care for cholecystectomy.

Ultrasensitive and Highly Selective o-Phenylenediamine Molecularly Imprinted Polymer for the Detection of 2,4-Dichlorophenoxyacetic Acid

Herein, we report an ultrasensitive and highly selective analytical methods to detect 2,4-dichlorophenoxyacetic acid (2,4-D) using an o-phenylenediamine based molecularly imprinted polymer (o-PD-MIP) sensor. Electrochemical Quartz Crystal Microbalance (EQCM) is used to investigate both the kinetics and the mass of the electropolymerized o-phenylenediamine. Additionally, successful removal of the template from the imprinted cavities is confirmed by comparing the XP spectra of imprinted and o-PD-MIPs after various template removal procedures. The most effective method involves a 70:30 mixture of MeOH:H2O for 15 min under stirring. The o-PD-MIP sensor exhibits high sensitivity with a LoD of (3 ± 1) × 10−12 M, which is below the EU regulation limits for drinking water by six orders of magnitude, a linear range between 10 and 100pM, and an excellent selectivity. These results proved the effectiveness of template removal procedure by using a 70:30 MeOH:H2O mixture and are a proof-of-concept for ultrasensitive and selective 2,4-D detection in real samples.

A comparative and experimental study to evaluate the use of nanocontainer solutions for removing polymeric coatingsfrom glass artifacts

Purpose The purpose of this study is to evaluate the effectiveness of nanocontainer solutions in removing deteriorated and aged polymers commonly used in coating and consolidating archaeological glass. Design/methodology/approach This study focused on characterizing glass surfaces coated with two commonly used polymeric materials in archaeological glass preservation. Furthermore, the study evaluates the elimination of these coatings from the surfaces by using innovative aqueous systems composed of micellar solutions (MS) and oil-in-water (O/W) Texapon-P microemulsions (TEX). Glass samples coated with selected polymers were subjected to thermal and photochemical aging to simulate natural degradation conditions. This study aimed to evaluate the effectiveness of nanocontainer aqueous systems compared to acetone (Ac), a conventional solvent commonly used for removal procedures. The characterization procedures involved transmission electron microscopy, USB digital microscopy, scanning electron microscopy, color alteration and gravimetric measurement. Findings The findings indicate that the effectiveness of novel techniques using aqueous nanocontainer systems is quite promising when considering a “green approach” to preserving cultural heritage. Microscopic examination demonstrated the efficacy of MS in effectively removing acrylic and vinyl polymers from the glass surface. Furthermore, TEX proved effective in removing polyvinyl acetate (PVA) over Paraloid B72 (B-72). In addition, the measurement of color alteration values revealed a decrease after using MS compared to the standard sample before applying the polymers, with values of ΔE = 1.48 and 1.82 for B-72 polymer and PVA, respectively. Originality/value This research provides nanocontainer solutions for removing aged polymers from the glass surface. This makes the current study a promising step for treating archaeological glass.

Organo acid-activated clays for water treatment as removal agent of Eosin-Y: Properties, regeneration, and single batch design absorber

Organoclays have been proposed as efficient removal agents for colored wastewater treatment. In this study, organo-acid-activated clays were investigated for their ability to remove eosin Y dye molecules. Firstly, the clay was acid activated using sulfuric solution at 90 °C for overnight. Secondly, the resulting materials were treated by hexadecyltetramethylammonium bromide solutions to obtain organo-acid-activated clays. Several techniques were used, such as X-ray diffraction, carbon hydrogen nitrogen analysis, silicon-29 and carbon-13 solid-state nuclear magnetic resonance, and nitrogen adsorption isotherms. The cation exchange capacity values were reduced and the specific surface area values increased from 80.1 m2/g to 183.2 m2/g during the acid activation process. The resulting organo-acid-activated clays had a similar expansion of interlayer spacing of 3.90 nm with less intercalated hexadecyltetramethylammonium surfactants, ranging from 0.80 mmol/g to 1.22 mmol/g; 13C solid NMR indicated that the intercalated surfactants exhibited different degree of conformation. Many factors, including the solid dose, solution pH, amount of intercalated surfactants, and starting eosin-Y concentrations, were studied in relation to the removal capabilities of organo acid-activated clays. Based on the Langmuir model, the removal capacity of the organo acid-activated clays ranged from a minimum of 43.5 mg/g to a maximum of 79.3 mg/g, dependent on the surfactant quantities and acid activation degree. , and the pH. The removal percentage of eosin-Y was increased from 50.5 % to 80.8 % by treating the organo acid-activated clay with HCl solution before the removal procedure. Regeneration and reuse of two selected organo acid-activated clays were carried out for seven successive cycles, and a reduction in the initial efficiency was in the range of 26.4 %–30.1 %. However, for organoclay (without acid activation), approximately 52.1 % efficiency was maintained. Using the Langmuir model and mass balance equations, a single-stage adsorber design was suggested for different dye volumes at a constant starting concentration.

14 Yıllık Bir Port Kateterin Sık Karşılaşılmayan Komplikasyonu

Percutaneous subclavian catheters or port-catheters are commonly used for oncology patients who require long-term or continuous intravenous therapy. There are several reported complications related to port-catheters like arterial puncture, pneumothorax and hematoma. We aimed to report an unusual port-catheter case. Our patient was a 45-year-old male who had a port-catheter inserted after the diagnosis of rectum cancer in 2009 and has never showed up for a catheter removal after his chemotheraphy regimen had been completed. The silicone port of the catheter was found to be disintegrated during the catheter removal procedure. Removal was performed but distal 5 cm of the catheter was missing. At the end of the procedure, control X-ray was obtained , but the last part of the catheter could not be visualized. There are reported cases of pinch-off syndrome in the literature however we couldn’t find any such case as we report. Following port-catheter implantation and throughout the course of treatment, patients should be consistently monitored, and an appropriate time should be scheduled for removal. Physicians should be aware of complications and multidisciplinary approaches should be made to avoid serious events and further harm. Keywords: Port-catheter complication, port-catheter removal, port-catheter detachment, pinch-off syndrome

The midterm psychological effect of cast removal procedures in children.

This study aimed to compare the course of anxiety change in children who used headphones during cast removal with controls in midterm follow-up. Sixty-six patients who underwent forearm fracture treatment with closed reduction and long arm casting between June 2021 and March 2023 were retrospectively reviewed. Patients were divided into two groups based on the use of headphones (n=27; 21 males, 6 females; mean age: 8.0±1.8 years; range, 6 to 12 years) or not (n=39; 27 males, 12 females; mean age: 8.9±1.8 years; range, 6 to 12 years) during cast removal with an oscillating saw. Primary outcome measures included preprocedure, postprocedure, and six-month anxiety assessments with the State-Trait Anxiety Inventory. There was an acute increase in the mean state anxiety scores after the procedure, which returned to below baseline at the six-month follow-up in the headphone (31.4±8.3, 33.3±8.7, and 25.1±4.1, respectively) and control groups (34.9±11.1, 37.4±9.5, and 27.3±5.3, respectively). The mean trait anxiety scores before the procedure, after the procedure, and at six months remained similar in the headphone (33.6±3.0, 34.6±3.2, and 32.4±2.8; p>0.05) and control groups (34.1±2.7, 33.7±3.0, and 33.7±3.0, p>0.05). This study suggests that the acute anxiety during cast removal did not create anxiety sequelae in the sixth month regardless of headphone use.

Mussel-inspired interface deposition strategy for mesoporous metal-phenolic nanospheres with superior antioxidative, photothermal and antibacterial performance

Metal-phenolic networks (MPNs) have emerged as a versatile and multifunctional platform applied in bioimaging, disease treatment, electrocatalysis, and water purification. The synthesis of MPNs with mesoporous frameworks and ultra-small diameters (<200 nm), crucial for post-modification, cargo loading, and mass transport, remains a formidable challenge. Inspired by mussel chemistry, mesoporous metal-phenolic nanospheres (MMPNs) are facilely prepared by direct deposition of the metal-polyphenol complex on the interface of oil nano-droplets composed of block copolymers/1,3,5-trimethylbenzene followed by a spontaneous template-removal process. Due to the penetrable and stable networks, the oil nano-droplets gradually leak from the networks driven by shear stress during the stirring process. As a result, MMPNs are obtained without additional template removal procedures such as solvent extraction or high-temperature calcination. The materials have a large pore size (∼12.1 nm), uniform spherical morphology with a small particle size (∼99 nm), and a large specific surface area (49.8 m2 g−1). Due to the abundant phenolic hydroxyl groups, the MMPNs show excellent antioxidative property. The MMPNs also have excellent photothermal property, whose photothermal conversion efficiency was 40.9 %. Moreover, the phenolic hydroxyl groups can reduce Ag+ in situ to prepare Ag nanoparticles loaded MMPNs composites, which have excellent inhibition performance of drug-resistant bacteria biofilm.

Correction to: Effect of root pass removal procedures on mechanical and microstructural properties of shielded metal arc welded joints

Correction to: Effect of root pass removal procedures on mechanical and microstructural properties of shielded metal arc welded joints

The Insertion and Management of Gastrostomies in Children in the United Kingdom – A Survey of Practice

BackgroundGastrostomy insertion is one of the most frequently performed procedures by specialist paediatric surgeons. We aimed to determine practice across the United Kingdom (UK) and in particular to identify areas where there was consistency or variation in practice between practitioners and centres. MethodsA structured survey was distributed to all consultant practitioners who insert gastrostomies in the UK. Practice surrounding a range of aspects of gastrostomy care including insertion technique, device use, post-operative management and subsequent care were determined. ResultsOf total 135 practitioners who insert gastrostomies, responses were received from 103 (76%) with responses received from all UK centres. There was variation between centres in the provision of pre-operative information, and between practitioners in preferred device, insertion techniques, post-operative feeding practice and change/removal procedures. The most frequently preferred device for primary gastrostomy insertion was a Freka® PEG (36%) button device (30%), CorFlo™ PEG (21%), or G-tube (10%). Laparoscopy was always used when inserting either PEG or button device by over 50% of respondents and selectively used by the majority of the remainder. Feeds were started between 1 and 24 h post-insertion, most practitioners (64%) plan a minimum one night hospital stay but a third plan for more than one night. ConclusionThere is considerable variation in practice for most stages of the pathway for children having a gastrostomy. Further work is warranted to understand the relationship between different practices and patient outcomes, resource use and cost and subsequently to develop best practice guidelines. Level of Evidence3.

VOx Matrix Confinement Approach to Generate Sub-3nm L10-Pt-Based Intermetallic Catalysts for Fuel Cell Cathode.

Pt-based intermetallic compounds (IMCs) are considered as a class of promising fuel cell electrocatalysts, owing to their outstanding intrinsic activity and durability. However, the synthesis of uniformly dispersed IMCs with small sizes presents a formidable challenge during the essential high-temperature annealing process. Herein, a facile and generally applicable VOx matrix confinement strategy is demonstrated for the controllable synthesis of ordered L10-PtM (M = Fe, Co, and Mn) nanoparticles, which not only enhances the dispersion of intermetallic nanocrystals, even at high loading (40 wt%), but also simplifies the oxide removal and acid-washing procedures. Taking intermetallic PtCo as an example, the as-prepared catalyst displays a high-performance oxygen reduction activity (mass activity of 1.52 A mgPt -1) and excellent stability in the membrane electrode assemblies (MEAs) (the ECSA has just 7% decay after durability test). This strategy provides an economical and scalable route for the controlled synthesis of Pt-based intermetallic catalysts, which can pave a way for the commercialization of fuel cell technologies.

Detection of residual stones by peroral direct cholangioscopy in patients with intrahepatic stones after hepaticojejunostomy: a prospective study (with video)

Background and AimsThe difficulty of radiographic confirmation of the presence of stones remains a challenge in the treatment of intrahepatic bile duct (IHBD) stones in patients after hepaticojejunostomy (HJ). Peroral direct cholangioscopy (PDCS) enables direct observation of the bile duct and is useful for detecting and removing residual stones; however, its effectiveness is not clearly established in this clinical context. MethodsThis single-center, single-arm, prospective study included 44 patients with IHBD who underwent bowel reconstruction with HJ during the study period. Stone removal was performed by short-type double-balloon enteroscopy (DBE). Following balloon-occluded cholangiography, the DBE was exchanged for an ultraslim endoscope through the balloon overtube for PDCS. The primary endpoint was the rate of residual stones detected by PDCS. Secondary endpoints were success rate of PDCS, residual stone removal with PDCS, procedure time for PDCS, procedure-related adverse events, and stone recurrence rate. ResultsPDCS was successful in 39/44 patients (89%), among whom residual stones were detected in 16 (41%) (95% CI: 28%–54%). Twelve patients (75%) had residual stones <5 mm. Stone removal was successful in 15 (94%) patients and median procedure time for PDCS was 16 (IQR: 10–26) min. The rate of procedure-related adverse events was 7% (3/44), all of which improved with conservative treatment. During median follow-up of 2.1 years (IQR: 1.4–3.3), the overall probability of recurrence-free status at 1, 2, and 3 years was 100%, 92%, and 86%, respectively. ConclusionsPDCS is a safe and effective procedure for complete stone removal in patients with IHBD stones after HJ.

Effect of root pass removal procedures on mechanical and microstructural properties of shielded metal arc welded joints

Effect of root pass removal procedures on mechanical and microstructural properties of shielded metal arc welded joints

Complete versus incomplete caries removal procedures and their effects on dental pulp in primary teeth - An in vivo study.

Dental caries results from an ecologic shift within the dental biofilm from a balanced population of microorganisms to an acidogenic, aciduric, and cariogenic microbiological population developed and maintained by frequent consumption of fermentable dietary carbohydrates. Total caries removal (TCR) of deep lesion may result in pulpal exposure requiring more invasive treatment. Hence, current pediatric dentistry has shifted to minimally invasive treatment that avoids more complex, time-consuming procedure, and the child's discomfort. The aim of this study is to evaluate and compare clinical performance and radiographic changes after complete and incomplete caries removal procedures. The study was conducted on 60 primary molars in children aged 6-9 years. Selected 60 primary molars were randomly divided into two groups. Group 1 (PCR): infected dentin was removed, while the affected dentin was maintained on the pulpal wall. Group 2 (TCR): both infected and affected dentin were removed through low-speed carbide bur and hand excavator. Teeth were evaluated at 4 and 6 months clinically and radiographically. The proportion was compared using Fisher's exact test. The Statistical Package for the Social Sciences version 21 was used for analysis. The level of significance was kept at 5%. The clinical and radiographic success rates of ICR and CCR in primary teeth with deep carious lesions were high and did not differ significantly, indicating that the retention of carious dentin does not interfere with pulp vitality. Thus, ICR is a reliable minimally invasive approach that might replace the CCR in primary teeth when correctly indicated.

Ensuring radiation safety during dismantling, transportation and long-term storage of the SM-3 research reactor core

Described shortly here is a procedure of demounting, removal, transport and long-term storage of the SM-3 core, based on the previous experience of reactor refurbishment undertaken in 1991. Prior to performing refurbishment, computations and calculated data analysis were performed to prove radiation safety of this work, which included estimation of the activity level for activation products in the structural materials of the nuclear research reactor core and the radiation conditions at different stages of its handling. As evidenced by the calculated data, the activity of the main dose-forming radionuclide 60Co attains equilibrium in about 12 years of radiation exposure. Taking into account the fact that the time period between two refurbishments was longer than 12 years, the calculated values of the equivalent dose rate were normalized to the radiation monitoring data obtained during the previous refurbishment, taking into account the calculated activity of 60Co radionuclide. The normalization made it possible to confirm reliability of estimates. The obtained activity data of activation products and taking into account the time spent during the SM-3 refurbishment in 1991, the radiation impact on personnel was estimated. Calculated values of the anticipated effective radiation exposure doses to the personnel engaged in the refurbishment revealed that the main limits of the personnel radiation exposure established in accordance with NRB-99/2009 were not exceeded. Comparison of the results of calculating the equivalent dose rate with the results of radiation monitoring at various points allowed us to establish that during the calculation and analytical justification of the radiation safety of work, the assessment of reflected radiation was significantly underestimated. But the radiation monitoring data, personal radiation monitoring, as well as recorded data of automatic radiation monitoring system show that all work was performed in compliance with the requirements of regulatory documents in the field of radiation safety.

Removal of the central venous port system in children. Is this an appropriate training procedure for resident physicians? A single-center retrospective study.

&lt;b&gt;Introduction:&lt;/b&gt; A venous port system consists of a port chamber attached to a central catheter, which is implanted into the central venous system. The removal of the vascular port includes all items of this system. This procedure is usually simple and quick. Complications with port removal are rare but possible.&lt;b&gt;Aim:&lt;/b&gt; The study aimed to summarize venous port removal procedures performed by pediatric surgeons.&lt;b&gt;Material and methods:&lt;/b&gt; The single-center, retrospective study was conducted on 360 pediatric patients treated during the years 2010-2022 in the Department of Pediatric Surgery, Traumatology, and Urology in Poznan.&lt;b&gt;Results:&lt;/b&gt; The port usage time before the removal ranged from 3 days to 8 years and 3 months, with an average of 22 months. The leading cause of vascular port removal was the end of treatment (78.06%). Other less frequent reasons were the infection (13.89%) and mechanical damage of the port (3.33%). There were almost no complications connected with the procedure of vascular port removal (92.2%). If the complications occurred, they included bleeding during surgery (3%), covering the vascular catheter with bone tissue of the clavicle, causing difficulties with the catheter removal from the vein (1.4%), and connected with the previous complications-prolonged clavicle pain after surgery (1.4%) and hematoma after surgery (2%).&lt;b&gt;Conclusions:&lt;/b&gt; Removing the venous port is a safe procedure with a low risk of complications. This procedure can be considered as an appropriate training procedure for young trainees. A more extended period of use of the vascular port before its removal may be associated with more difficulties during surgery.

Design and analysis of shadow detection and removal scheme in real-time still images

This research’s main objective is to study and evaluate the detection and removal of undesired shadows from still images since these shadows might mask important information caused by light sources and other obstructions. A variety of methods for detecting and eliminating shadows as well as object tracking approaches based on movement estimation and identification are investigated. This includes shadow removal methods like background subtraction, which are intended to improve obstacle recognition of the source item and increase the accuracy of shadow removal from objects. When new items enter the frame, they are first distinguished from the background using a reference frame. The tracking procedure is made more difficult by the merging of the shadow with the foreground object. The approach highlights the difficulties in object detection owing to frequent occurrences of obstacles by using morphological procedures for shadow identification and removal. The proposed approach uses feature extraction is also discussed, highlighting its importance in image processing research and the use of suggested methods to get over obstacles in image sequences. The proposed method for shadow identification and removal offers a novel approach to improve image processing when dealing with still images. The purpose of this technique is to better detect and remove shadows from images, which will increase the precision of object tracking and detection. Depending on the type of images being processed, the process begins with initializing a background model, which is based on a static image background.

Bioelectrical Impedance Analysis Detects Body Fat Changes After Surgical Subcutaneous Fat Removal.

Background: The risk and metabolic effects of obesity are determined by the distribution of fat throughout the body. It has been proposed that the distribution of abdominal fat is more closely related to the metabolic risks of obesity. High prevalence of overweight and obesity has thereby contributed to an increased uptake of surgical subcutaneous fat removal (SSFR) procedures. The goal of this study was to determine whether bioelectrical impedance analysis (Tanita system) can be used to detect the removal of excess abdominal subcutaneous fat tissue during SSFR when studying the metabolic effects of such procedures. Methods: Study population comprised patients who received body contouring procedures at the Hamad General Hospital's plastic surgery department between November 2020 and December 2022. To evaluate the factors of interest, subjects were prospectively followed up at two time points: within 1 week before the surgery and within 1-2 weeks thereafter. The following factors were measured: body weight, body fat percentage, body fat mass, body mass index (BMI), fat-free mass, estimated muscle mass, total body water, visceral fat score, and basal metabolic rate. Results: In total, 22 patients were included in the study. The two visits' medians for height, weight, BMI, fat percent (fat%), fat mass, visceral fat rating, and Doi's weighted average glucose (dwAG) were compared. Only in the case of Tanita fat% and fat mass, were the preoperative and postoperative medians significantly different. Furthermore, there was no association between these Tanita measures and dwAG or homeostatic model assessment (HOMA; insulin resistance [IR]) changes (before and after surgery). Tanita measures overestimated fat loss, as seen by the mountain plot and Bland-Altman plot agreement methods. Conclusions: Our findings indicated that the only two Tanita measures exhibited meaningful early associations with the amount of tissue excised which were fat mass and fat% differences. Although dwAG and HOMA-IR are not impacted immediately postsurgery, a trend was seen that suggested improvements in those parameters, even though the changes are not clinically significant.

Single versus double retrograde intramedullary nail technique for treatment of displaced proximal humeral fractures in children: A retrospective cohort study.

Highly displaced proximal humeral fractures in children with low remodeling potential need to be reduced and fixed. The use of two flexible retrograde nails became the most popular fixation technique due to the excellent functional outcome, the low complication rates, and the possibility of early mobilization. A modified single retrograde technique has been suggested by the authors to address the main disadvantage of this technique, the long operative duration. The aim of this study was to compare these techniques in terms of efficacy, and clinical and radiological outcomes. We performed a retrospective, monocentric study. Two groups of patients were defined: One was treated with the standard flexible retrograde double nail technique and the other with the modified single nail technique. The demographic and fracture characteristics were similar in both groups and the postoperative immobilization with a simple sling for 2 weeks. We compared the surgical duration for the initial fixation and hardware removal procedures. The Quick Disabilities of the Arm, Shoulder, and Hand score, the secondary displacement at 1-week follow-up, the radiological union at 6-week follow-up, and the perioperative and short-term complications were also assessed for both groups. The surgical duration of the initial fixation procedure was significantly shorter in single nail technique group (p = 0.005). The percentage of excellent Quick Disabilities of the Arm, Shoulder, and Hand score (0) was similar in the two groups (p = 0.98). No secondary displacement was reported for the double nail technique group. In only one patient from the single nail technique group, we detected a secondary displacement at the first week control which did not need reoperation. In both groups, fractures were healed on the 6-week radiologic control. No cases of infection, superficial skin irritation, neurological damage, or complications related to implant removal were reported in both groups. The single nail technique of fixation proximal humeral fractures in children addresses the disadvantage of long surgical times, described until today, with the double nail technique without compromising the excellent functional and radiological short-term outcomes. level III.

Fluorescence intensity of composite resin for direct veneer removal using a fluorescence-aided identification technique.

This laboratory study evaluated the influence of the fluorescence intensity of composite resins on additional tooth wear and the presence of restorative material in different dental thirds during the retreatment of direct veneers. The crown dimensions of 60 bovine incisors were reduced to 10 × 8 mm. The teeth were classified according to the fluorescence intensity of the composites: low (LOW) (TPH Spectra), medium (MED) (Opallis), and high (HIGH) (Essentia) groups. The teeth were divided according to the removal methods: conventional (CON) and fluorescence-aided identification technique (FIT). The specimens were scanned (T0), received veneer preparation, and scanned again (T1). After restorations, the composites were removed and the teeth were scanned (T2). Measurement assessments between T1 and T2 were performed to determine additional wear, presence of residual areas, and the average between additional wear and the presence of residual areas. Kruskal Wallis, Mann-Whitney, Friedman, 2-way ANOVA, and post-Tukey tests were performed (α < 0.05). The comparison of composite resins indicated a smaller area of additional wear and greater residue presence in the HIGH group than the LOW group for both techniques in the cervical third. Regarding removal methods, the FIT produced greater additional wear than the CON method for the LOW and MED groups in the middle and cervical thirds. The incisal third exhibited greater additional wear than the other thirds. Composite resins with high fluorescence intensity removed using FIT had less tooth wear. The incisal third was the most affected area for direct veneer removal procedures. A FIT has been proposed for composite resin removal; however, the different fluorescence intensities of composite resins can influence tooth wear caused during this procedure.