Soft Tissue Pain Research Articles

Invasive group A streptococcus infections in the intensive care unit: an unsupervised cluster analysis of a multicentric retrospective cohort

BackgroundInvasive group A streptococcus (iGAS) infection incidence is rising. These infections have been studied as a whole but can be associated with critical illness in a population with a wide array of underlying conditions, sites of infection and clinical presentations. Using an unsupervised clustering approach, we aimed to identify specific clinical phenotypes regarding presentation, management and outcome.MethodsThis was a retrospective multicentric study including all patients admitted to one of 9 ICUs of Paris University Hospitals for an iGAS infection between 01/03/2018 and 01/08/2023. iGAS infection was defined as GAS growth in any microbiological sample from a sterile site. Patients were grouped according to a clustering algorithm (k-prototypes) using a comprehensive set of clinical and biological variables available upon ICU admission. Clusters were described and clinical presentation, management and outcome were compared.Results148 patients were included. According to the Silhouette criterion, patients were grouped in 3 clusters, and 7 patients remained unclassified. Cluster 1 (n = 73) comprised a greater proportion of less severely-ill female patients with painful skin and soft tissue infections, a quarter of whom had taken non-steroidal anti-inflammatory drugs. Cluster 2 (n = 42) was characterized by a high rate of respiratory infections with frequent viral co-infections. Cluster 3 (n = 26) included mostly socially deprived patients with high rates of chronic alcohol consumption and psychiatric illness, with severe organ dysfunction related to otherwise pauci-symptomatic skin and soft tissue infections. There was no significant difference in time to source control across clusters (0 [0–0] vs 0 [0–0] vs 0 [0–1] days, p = 0.12). Patients included in cluster 2 less frequently received antitoxin antibiotics than patients from clusters 1 and 3 (79% vs 45% vs 69%, p < 0.001) and tended to more frequently require ECMO support (3% vs 12% vs 0%, p = 0.07), while those from cluster 1 were less likely to receive invasive mechanical ventilation (48% vs 74% vs 77%, p = 0.005). There was no difference in ICU-mortality between clusters (19% vs 29% vs 31%, p = 0.32).ConclusionsBased on simple and readily available clinical admission characteristics of critically ill patients with iGAS, unsupervised clustering analysis identified three specific patient populations that differed regarding ICU management. Whether tailoring management would affect outcome warrants further research.

Advising patients with dental and oral soft tissue pain Free CPD for dentists and other dental health professionals.

Advising patients with dental and oral soft tissue pain Free CPD for dentists and other dental health professionals.

Chikungunya and other viral arthritis.

Chikungunya and other viral arthritis.

Postoperative course assessment after displaced third molar extraction

Background: According to published data, the incidence of mandibular third molar retention is 55%. Surgical intervention in this condition is one of the most challenging inpatient surgical procedures, with the highest number of complications. Aim: To assess the postoperative course after third molar extraction using various postoperative management approaches. Methods: The study included 57 patients aged 20 to 35 years with confirmed third molar retention and displacement who were examined and received surgical treatment at the surgery unit of the General Dentistry Clinic of the Kirov Military Medical Academy. The patient were divided into four groups based on the postoperative management approach. In Group 1 (n=14), blood clots formed in extraction sockets, with complete closure of the postoperative wound; in Group 2 (n=15), blood clots formed in extraction sockets, the sockets were sutured, and a glove drain was used; in Group 3 (n=15), extraction sockets were filled with «Alvanes» material, the sockets were sutured, and a glove drain was used; and in Group 4 (n=13), extraction sockets were filled with «Alvanes» material, with complete closure of the postoperative wound. Results: Groups 1 and 4 had the most severe soft tissue edema, fever response, and pain, whereas Group 2 had the least. Group 3 had mild pain and soft tissue edema; no fever response was reported. Conclusion: Filling extraction sockets with «Alvanes» material after mandibular third molar extraction improves the postoperative course and reduces the incidence of complications. Postoperative wound drainage reduces edema and facilitates recovery in complicated cases of third molar extraction.

Low intensity pulsed ultrasound versus low-level laser therapy on peri-implant marginal bone preservation and soft tissue healing following dental implant surgery: a randomized controlled trial

BackgroundLow-intensity pulsed ultrasound (LIPUS) and low-level laser therapy (LLLT) are proposed adjunctive therapies to enhance healing after dental implant surgery. However, direct comparisons of their effects on peri-implant marginal bone preservation and soft tissue healing remain limited. This randomized controlled trial aimed to compare the effectiveness of LIPUS and LLLT on peri-implant marginal bone preservation, soft tissue healing, pain levels, and oral health-related quality of life following dental implant placement.MethodsThis single-blind, randomized controlled trial included 63 patients undergoing maxillary or mandibular implant placement, randomly allocated to LIPUS (n = 21), LLLT (n = 21), or control (n = 21) groups. LIPUS was applied twice weekly for 4 weeks, while LLLT was administered in 4 sessions over 2 weeks post-implant. Marginal bone loss (MBL) and OHRQoL (OHIP-14) were assessed at baseline, 6, and 12 weeks. Soft tissue healing (Landry Healing Index) and pain (VAS) were evaluated at baseline, 7-, 14-, 21-, and 30-days post-implant.ResultsLIPUS significantly reduced marginal bone loss at 6 weeks and 3 months post-implant compared to LLLT and control groups (p < 0.05). LLLT demonstrated superior soft tissue healing at 7-, 14-, 21-, and 30-days post-implant (p < 0.05). Both interventions significantly decreased pain intensity and improved OHRQoL at various time points compared to the control group (p < 0.05).ConclusionsLIPUS and LLLT significantly enhance peri-implant marginal bone preservation, soft tissue healing, pain management, and OHRQoL in dental implant patients compared to standard care. LIPUS was more effective for peri-implant marginal bone preservation, while LLLT excelled in soft tissue healing.Trial registrationThis study was registered at ClinicalTrials.gov (NCT05938868) on July 11, 2023.

Burden of Musculoskeletal (MSK) Pain and Arthritis in India: A Community Oriented Program for Control of Rheumatic Diseases (COPCORD-Bone and Joint Decade (BJD)) India Project.

Several countries have participated in WHO COPCORD. The Global Disease Burden program (GBD) reports selected MSK disorders. We used a COPCORD India protocol to estimate the national burden of MSK disorders. Trained paramedics used standard questionnaires to screen the population and identify respondents with current and/or past MSK pain (non-traumatic) in 12 survey sites (8 rural); cross-sectional design and prospective data. Several standard measures were recorded; MSK pain was self-reported (on human manikin). The site rheumatologist examined each respondent and provided a clinical diagnosis. Pooled data (anonymized) from all sites was analyzed using standard statistical software. Standardized point prevalence rates (adjusted to Indian Census) and odds ratios (risk factors) were calculated: 95% confidence intervals in parentheses. 56 548 population (60% rural, response rate > 70%) was screened; 10 273 respondents (18%, 65% women). The prevalence of MSK pain was 16.14 (14.2, 18.3) and higher in the rural population (20% vs. 10.3%); rheumatoid arthritis 0.34%, undifferentiated inflammatory arthritis 0.22%, spondyloarthritis 0.23%, osteoarthritis 4.39%, Gout 0.05%, chikungunya arthritis 1.2%. Non-specific arthralgias, soft tissue pains, and degenerative arthritis were dominant disorders; 12% of respondents reported inflammatory arthritis. Significant risk factors associated with MSK pain included female gender, poor literacy, non-vegetarian diet, chronic non-MSK illness, past trauma, and tobacco use. Limitations included non-random selection, clinical diagnosis, and limited investigations. However, in comparison to GBD, the COPCORD outcome seemed all-inclusive and clinically meaningful. The high prevalence of MSK pain and arthritis indicates a huge disease burden in India and prioritizes the need for a national control program.

Pain in Soft Tissue Tumors: A Comprehensive Retrospective Study.

In the field of orthopedics, few studies have examined pain associated with soft tissue tumors. To accurately and promptly diagnose soft tissue tumors and provide appropriate treatment, it is necessary to have a comprehensive understanding of the relationship between soft tissue tumors and pain. We analyzed data from patients with mass lesions in the extremities or trunk diagnosed by biopsy or surgery in our department and patients with ganglion cysts diagnosed by puncture between October 1, 2005, and September 30, 2011. Using medical records, we retrospectively investigated the clinical data. Data from 473 patients with 482 lesions were analyzed. Pain was observed in 204 of the 482 lesions (42.3%). So-called painful tumors accounted for approximately half of the painful lesions (45.0%). Logistic regression indicated that pain was significantly associated with so-called painful tumors (odds ratio [OR]: 5.64; P < 0.001), inflammatory nodules (OR: 3.42; P = 0.007), and sites with strong physical stimulation (OR: 2.45; 95% confidence interval [CI]: 1.58-3.81; P < 0.001) but not with long diameter (OR: 0.90; P = 0.001) or malignancy (OR: 1.78; P = 0.144). Our findings suggest that so-called painful tumors account for approximately half of soft tissue mass lesions requiring surgery, biopsy, or puncture in orthopedics. It is thus important to have a clear understanding of such tumors. Inflammatory nodules are also important in the differential diagnosis of painful soft tissue lesions. Lesions at sites exposed to strong physical stimulation can cause pain.

Evaluating Noninvasive Pulsed Electromagnetic Field Therapy for Joint and Soft Tissue Pain Management: A Prospective, Multi-center, Randomized Clinical Trial

IntroductionStrategies to reduce pharmacologic use for pain are needed. Pulsed electromagnetic field (PEMF) therapy is a noninvasive, nonpharmacologic treatment for pain that modifies nitric oxide signaling to improve healing. This study examined whether PEMF decreased pain and pharmacologic use vs. standard-of-care (SOC) treatment for joint and soft tissue pain.MethodsThis prospective, randomized controlled trial enrolled 120 patients presenting with joint or soft tissue pain at five orthopedic clinic sites. The PEMF group self-administered daily therapy from a commercially available device and the SOC group received standard treatment daily as prescribed by the clinician. Patients recorded their pain level, pharmacologic usage, and adverse events daily for 14 days. After 14 days, patients in the SOC group were given the option to crossover to PEMF therapy and continue for 16 days. The study was overseen by an independent clinical research organization. It was hypothesized that PEMF would be superior to SOC for pain management.ResultsPEMF treatment provided significant analgesic benefits compared to SOC. Complete data was collected for 91 patients, 48 from the PEMF group and 43 from the SOC group. The least squares mean pain score change from baseline was − 1.8 (a 36% reduction) for the PEMF group, significantly surpassing − 0.46 (a 10% reduction) for the SOC group (p < 0.0001). Pharmacologic usage decreased from 40 to 18% for the PEMF group (a 55% reduction), while the SOC group decreased from 40 to 35% (a 12% reduction). In the crossover subgroup, patients experienced an additional 18% decrease in pain score and 63% decrease in pharmacologic use after switching from SOC to PEMF treatment.ConclusionsPEMF was significantly more effective than SOC at managing pain and reducing pharmacologic use. PEMF therapy should be considered for noninvasive, nonpharmacologic management of joint and soft tissue pain.Trial RegistrationClinicalTrials.gov ID NCT05244187.

Percutaneous Ablation versus Radiotherapy for Pain Related to Bone and Soft Tissue Malignancies: AMultipayor Database Analysis of Outcomes.

Percutaneous Ablation versus Radiotherapy for Pain Related to Bone and Soft Tissue Malignancies: AMultipayor Database Analysis of Outcomes.

Bunionectomy as an Acute Postoperative Pain Model: Overview of Common Experimental Methods, and Insights from Past Clinical Trials.

To obtain broad regulatory approval for a new analgesic agent in acute postoperative pain, US and European regulatory authorities require pivotal studies in both hard (bony) tissue pain and soft tissue pain. Bunionectomy is by far the most common hard tissue pivotal trial model, in spite of the fact that the model has limited relevance to clinicians prescribing pain drugs (pain from bunionectomy is not extreme or long-lasting, and is adequately treated by existing drugs). The authors outline the experimental characteristics that make bunionectomy an appealing study model for researchers despite its lack of clinical relevance compared to larger surgeries. These include bunionectomy's high signal-to-noise ratio (secondary to the ability to standardize surgical procedures, anesthesia and perioperative care) and relative operational simplicity (including relatively easy subject enrollment). They present an overview of the surgical and anesthetic protocols typical to modern bunionectomy studies, as well as common design paradigms, common endpoints, and other key design features of bunionectomy trials. They also provide an informal qualitative review of bunionectomy acute pain studies performed in the past 15 years, and a master table of acute pain bunionectomy trials performed from 2006-2023. Drawing from their informal review of past studies, the authors discuss trends in rescue medication, study enrollment rates, subject demographics, and the advantages and disadvantages of bunionectomy compared with another common acute pain model, dental impaction pain (third molar extraction).

Improvement in Health-Related Quality of Life and Symptoms Following Lipedema Liposuction: A Longitudinal Study.

Lipedema is a chronic fat disorder characterized by disproportionate fat deposition in the lower limbs, leading to pain, mobility issues and reduced health related quality of life (HRQoL).There is growing evidence that liposuction of the excess fat not only reduces soft tissue pain but also improves HRQoL. The published data, however, remain limited, and there are no studies of liposuction in the UK lipedema population. This study aimed to evaluate the effectiveness of liposuction on HRQoL and symptoms in UK lipedema patients using 2 HRQoL instruments and a Lipedema Symptom Scale. Lipedema patients undergoing liposuction between January 2016 and December 2021 completed Short-Form Health Survey (SF-36), World Health Organization Quality-of-Life Assessment (WHOQOL-BREF), and 17-question Lipedema Symptom Scale preoperatively and postoperatively. Paired t test was used to compare the preoperative and postoperative mean scores of the different domains of the SF-36 and WHOQOL-BREF and preoperative and postoperative mean scores for the lipedema symptom scale. Paired t test was also used to compare preoperative and postoperative SF-36 scores to age-matched normative data for the English population to assess the extent of HRQoL improvement relative to the general population. Seventy-six women were included in the study with a mean age of 46.4 ± 12 years. Mean follow-up (interval between first liposuction surgery and postoperative completion of the instruments) was 25.3 ± 23.2 months. There was significant improvement in all SF-36 and WHOQOL-BREF domains postoperatively ( P < 0.001). Compared with age-matched normative data, postoperative SF-36 scores remained lower in physical functioning, social functioning, and general health. Postoperative results also showed a highly significant improvement ( P < 0.001) across all 17 items of the Lipedema Symptom Scale. This longitudinal study indicates liposuction is an effective treatment for improving HRQoL and symptoms in lipedema patients, although it may not completely restore HRQoL to normative levels. Limitations include potential selection bias, sampling bias, and the need for longer follow-up. The findings support liposuction as a first-line treatment for lipedema and could inform decision-making for both patients and policymakers.

Successful remission of a recurrent metacarpal osteosarcoma of a Warmblood gelding after radiation therapy

SummaryA 15‐year‐old Warmblood gelding was presented with recurrence of a histologically confirmed osteosarcoma of the left second and third metacarpal bones 3 years after initial diagnosis and treatment. Initially, surgical excision was performed, followed by local injection of carboplatin 11 weeks later. The horse was sound after surgery and was used for low‐level dressage and jumping. Three years later, the horse developed an acute onset of lameness in the left forelimb and a painful soft tissue swelling at the proximomedial metacarpal region. Radiographs showed a spiculated periosteal reaction on the medial aspect of the third metacarpal bone, indicating re‐activation of the lesion. Stereotactic radiation therapy was performed with a protocol consisting of three fractions under general anaesthesia (Mo‐We‐Fr schedule), and a total dose of 30 Gy. The technique used was volumetric‐modulated arc therapy guided by cone beam computed tomography for daily positioning. Following the radiation therapy, the horse became sound at walk, and 1 month later, it became sound at trot. Follow‐up by veterinary examination 18 months after final treatment revealed no lameness at walk and trot, and a stable radiographic appearance.

Evaluation of Clinical Performance of Ponto Implantation Using a Minimally Invasive Surgical Technique-A Prospective Multicenter Study.

To investigate the clinical outcomes of bone-anchored hearing implant surgery using the MONO procedure. Multicenter, multinational, single-arm, prospective trial with a 12-month follow-up. Seven European university hospitals from the United Kingdom, Sweden, Denmark, and The Netherlands. Fifty-one adult patients requiring surgical intervention for bone conduction hearing. Bone-anchored hearing implant surgery using the MONO procedure. The primary endpoint assessed implant usability 3 months after surgery. Implant status, soft tissue reactions, pain and numbness, postoperative events, and sound processor usage were assessed at all follow-up visits. Hearing-related quality of life was evaluated using the Glasgow Benefit Inventory (GBI). At 3 months, 94.2% of the implant/abutment complexes provided reliable anchorage for sound processor usage. No severe intraoperative complications occurred. Sixty-nine percent of surgeries were performed under local anesthesia, with surgery lasting 10 minutes on average. Four implants were lost due to trauma (n = 2), spontaneous loss of osseointegration (n = 1), or incomplete insertion (n = 1). Adverse soft tissue reactions occurred in 2.6% of visits, with a maximum Holgers grade of 3 (n = 1) and grade 2 (n = 5) across patients. Hearing-related quality of life at 3 months improved in 96% of patients. The MONO procedure provides a safe and efficient surgical technique for inserting bone-anchored hearing implants with few and minor intra- and postoperative complications.

Effect of collaborative nursing method based on RAM model on postoperative functional reconstruction, soft tissue pain and living quality in patients with femoral trochanter fracture

ObjectiveTo explore the effect of collaborative nursing based on Roy Adaptive Mode (RAM) on postoperative functional reconstruction, soft tissue pain and quality of life in patients with femoral intertrochanteric fracture.MethodsA retrospective matched control method was used in this study. A total of 96 patients with femoral intertrochanteric fracture admitted to our hospital from July 2018 to September 2021 were selected. According to different nursing methods, the patients were divided into a collaborative group and a routine group, with 48 cases in each group. Patients in both groups were treated with intramedullary nail surgery. The routine group was given routine perioperative nursing intervention, and the collaborative group was given collaborative nursing intervention on this basis. The hip function recovery and quality of life before and after the intervention were compared between the two groups. The preoperative and postoperative pain degree, and the perioperative complications of the two groups were recorded. Logistic multivariate regression analysis was used to analyze the risk factors affecting the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation, thereby constructing a risk prediction model. ROC curve was used to analyze the clinical value of influencing factors in predicting postoperative hip function recovery in patients with femoral intertrochanteric fracture.ResultsHarris score each dimension after intervention in the collaborative group was obviously higher than that of before intervention and the conventional group (P < 0.05). After intervention, the excellent and good rate of hip joint function the collaborative group was 83.33%, which was significantly higher than 60.42% in the routine group (P < 0.05). Postoperative VAS scores each time point in the collaborative group was obviously lower than that in the routine group (P < 0.05). After intervention, the scores of physiological function, physiological role, body pain and general health in the collaborative group were significantly higher than those in the routine group (P < 0.05). The incidence of complications in the collaborative group was 6.25%, which was significantly lower than 22.92% in the routine group (P < 0.05). There were statistically significant differences in age, preoperative ASA grade, internal fixation method, osteoporosis grade and perioperative nursing methods between the excellent hip recovery group and the poor hip recovery group (P < 0.05). Logistic multivariate regression analysis showed that age, preoperative ASA grade, internal fixation method and osteoporosis grade were the risk factors affecting the recovery of hip joint function after operation, and perioperative nursing method was the protective factor (P < 0.05). Among the influencing factors, the internal fixation method and the grade of osteoporosis had certain clinical value in predicting the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation.ConclusionThe RAM model-based collaborative nursing method may effectively restore the hip joint function of patients with femoral intertrochanteric fracture after operation, and may reduce the perioperative pain degree of patients, improve the quality of life of patients and reduce the incidence of complications, which can be popularized and applied in clinical practice. In addition, there are many factors influencing the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation, and targeted measures should be taken according to the influencing factors to improve the effect of intramedullary nail treatment.

Randomized placebo controlled trial of phytoterpenes in DMSO for the treatment of plantar fasciitis

Plantar fasciitis is the most common cause of heel pain in adults with an overall prevalence of 0.85% in the adult population of the US, affecting over 2 million adults annually. Most current treatment modalities are not supported by sufficient evidence to recommend one particular strategy over another. Topical application of analgesics for soft tissue pain is well established, however the plantar fascia presents challenges in this regard due to thick skin, fibrotic tissue, and an often thickened fat pad. Sixty-two patients with plantar fasciitis were randomized to a placebo controlled trial testing the efficacy of a topical solution of plant terpenes containing camphor, menthol, eugenol, eucalyptol, and vanillin. Skin permeation of the mixture was enhanced with 15% dimethylsulfoxide (DMSO), 1% limonene, and rosemary oil. One ml of solution was applied topically twice daily, and pain scores evaluated on Day 0, Day 1, Day 3, and Day 10. Using the validated foot function index 78.1% of patients reported an 85% or greater decrease in their total pain score by day 10 while placebo treatment was without effect (One Way ANOVA, P < 0.01). This study adapts the treatment modality of topical analgesia for soft tissue pain to a problematic area of the body and shows therapeutic promise.ClinicalTrials.gov Identifier: NCT05467631

Comparative effects of myofascial release with and without eccentric resistance on pain, range of motion, and functional disability in patients with Achilles tendinopathy

Comparative effects of myofascial release with and without eccentric resistance on pain, range of motion, and functional disability in patients with Achilles tendinopathy

Fracturas por avulsión de la tuberosidad posterior del calcáneo “en pico de pato”. Evaluación funcional y radiográfica

Objetivos: Comunicar los resultados funcionales y radiográficos en seis pacientes con fractura “en pico de pato” (beak fracture) y realizar una revisión de la bibliografía. Materiales y Métodos: Se evaluaron los resultados funcionales (escala de la AOFAS) y radiológicos en seis pacientes (3 hombres y 3 mujeres; edad promedio 35.6 años). El tiempo promedio transcurrido entre la lesión y el ingreso en el quirófano fue de 2.83 h. Se realizó la rama vertical del abordaje lateral extendido. Se fijó con tornillos canulados y macizos de 3,5; 4,0 o 4,5 mm solos o combinados con placas de 3,5 y 2,7 mm bloqueadas. Resultados: Después de un seguimiento de entre 8 y 24 meses, todos los pacientes tenían signos francos de consolidación. Al ingresar, todos presentaban signos de sufrimiento de partes blandas sin signos de necrosis. El puntaje de la escala de la AOFAS fue de 82,4 (5, buenos y 1, regular). Las complicaciones fueron: una infección profunda y pérdida de la reducción en el mismo paciente. Conclusiones: Las fracturas “en pico de pato” pueden generar complicaciones de partes blandas si no son tratadas de manera urgente, debido al compromiso inicial de partes blandas. La reducción abierta y la fijación con tornillos y placas es el sistema de fijación más estable.

Do Platelet-Rich Concentrates Improve the Adverse Sequelae of Impacted Mandibular Third Molar Removal?

Do Platelet-Rich Concentrates Improve the Adverse Sequelae of Impacted Mandibular Third Molar Removal?

Effects of Myofascial Release and Neuromuscular Taping (NMT) on Decreasing Pain in The Condition Myofascial Pain Syndrome Upper Trapezius Muscle

Myofascial pain syndrome (MPS) refers to soft tissue pain resulting from irritation of local points within the skeletal muscle and myotendinous junctions. MTP produces pain with any activating stimulus (direct or indirect trauma), causing local and referred pain, tenderness, motor dysfunction, autonomic phenomena, and hyperexcitability of the central nervous system. This study aimed to determine the effectiveness of Neuromuscular Taping (NMT) and Myofascial Release (MR) intervention in reducing pain in patients with Myofascial Pain Syndrome of the Upper Trapezius Muscle. Methods: Case study with pre and post-test research design that compares the pain values before and after being measured with a measuring instrument Visual Analog Scale (VAS) to determine the effect of Myofascial Release (MR) and Neuromuscular Taping (NMT) on the condition of Myofascial Pain Syndrome in the Upper Trapezius Muscle for 4 weeks Result: the results of the Wilcoxon test analysis indicated that P&lt;0.05, with a P value of 0.000. Therefore, it was determined that in patients with Upper Trapezius Muscle Myofascial Pain Syndrome, there was a difference in pain levels before and after receiving physiotherapy techniques such as Neuromuscular Taping (NMT) and Myofascial Release (MR).

Eggshell membrane as a regenerative material in alveolar bone grafting in combination with advanced platelet rich fibrin.

The eggshell and the eggshell membrane (ESM) are significant by-products of the poultry industry and are being utilized for various valuable purposes in health care, like soft tissue healing and pain alleviation. The aim and objective of our study are to assess the effect of the eggshell membrane on alveolar bone regeneration after tooth extraction. A total of 40 extraction sockets (bilateral) among 20 patients were assessed clinically for healing, and radiographic parameters of bone density and socket volume were assessed on CBCT at baseline, 3 months, and 6 months. Advanced platelet-rich fibrin was created from 5 ml of autologous blood from the patient and centrifuged for 15 minutes at 1500 RPM/168 RCF. The commercially available powdered form of egg shell membrane was used in the study. Based on the randomized allotment (coin-flip), A-PRF alone or A-PRF mixed with eggshell membrane was placed inside the extraction socket and was stabilized using 3-0 silk sutures. It was ob-served that wound healing was uneventful in all 20 patients. No evidence of dry sockets or allergic reactions was noted in any patient. Statistical analysis was done using the un-paired t-test and Mann-Whitney U test with SPSS version 20.0. P<0.05 was considered significant. On comparison of the mean bone density at baseline, 3 months, and 6 months, the socket density in the eggshell with the PRF group was higher compared to the control group. To conclude, eggshell membrane has good regenerative properties and excellent osteogenic capacity; therefore, it could be a useful graft due to its low cost, abundant availability, and simple application.