Soft Tissues In Patients Research Articles

Masticatory function and three-dimensional facial morphology of soft tissues: One year after orthognathic surgery

ObjectiveDentofacial deformities (DFD) require orthodontic treatment, orthognathic surgery, and speech therapy for aesthetic and functional problems. This longitudinal study analyzed changes in masticatory function and three-dimensional (3D) facial soft tissue in patients with Class II and Class III DFD after orthognathic surgery. In addition, the study investigated the relationship between facial measurements, maximum bite force (MBF), and orofacial myofunctional status (OMS). DesignThe sample consisted of 46 participants, including 10 patients with Class II DFD, and 11 patients with Class III DFD. These groups were assessed before (T0) and 6 months (T1) after surgery. Twelve patients who completed the treatment protocol were evaluated 12 months post-surgery (T2). The patient groups were compared with each other and with a control group (CG) of 25 healthy subjects. The participants underwent MBF and clinical evaluation of OMS, including masticatory behavior, using a validated protocol. The 3D facial soft tissue was assessed using laser scanning. ResultsCompared to the CG, DFD patients showed reduced MBF, masticatory behavior, and OMS scores at T0. At T2, there was an improvement in MBF, masticatory, and OMS scores, but differences were observed compared to the CG. Changes in facial soft tissue followed the underlying hard tissue movement resulting from surgery, and reduction of vertical measurements contributed to improvements in masticatory function. ConclusionThese findings indicated that combined surgery, orthodontic treatment, and speech therapy can lead to a significant improvement in masticatory function and facial soft tissue in DFD patients, although not completely 12 months post-surgery.

Comparative analysis of 3D tomography based soft tissue rendering and Proface facial scanning systems in orthognathic surgery

PurposeThis study aimed to investigate the linear and angular differences in the nasolabial soft tissue in patients who underwent bimaxillary orthognathic surgery using two different three-dimensional imaging methods. Furthermore, the advantages, disadvantages, and limitations of these methods were determined after comparing the data obtained from the imaging methods used in the study. Materials and MethodsPreoperative (T0) and 6-months postoperative (T1) cone-beam computed tomography (CBCT) and three-dimensional facial scanning (3DFS) data from 22 patients who underwent maxillary advancement surgery were examined. The DICOM (Digital Imaging and Communications in Medicine) data (CBCT group) and “.obj” format images (3DFS group) of the patients were analyzed using Dolphin software (Dolphin Imaging®, Version 12, Chatsworth, CA, USA). The linear and angular soft tissue measurements were calculated after determining the reference anatomical landmarks for both groups. ResultsMeasurements with CBCT and 3DFS imaging methods were compared at T0, T1, and all measurements (T0+T1). No statistically significant difference was observed between the CBCT and 3DFS groups for five measurements performed at T0 and T0+T1, but statistically significant differences were observed between the groups for the other seven measurements. There was no statistically significant difference between the CBCT and 3DFS groups for six measurements at T1, but there were statistically significant differences between the groups for the other six measurements. After reviewing the postoperative differences in the nasolabial soft tissue, a statistically significant increase in four linear and one angular measurement in the 3DFS group was observed, and there was a statistically significant increase in two linear and two angular measurements in the CBCT group. Upon comparison of postoperative differences in soft tissue alterations, no statistically significant difference between the 3DFS group and the CBCT group were observed in any of the soft tissue measurements. ConclusionOrthognathic surgery has significant effects on nose width and upper lip morphology. Although both 3DFS and CBCT methods can be used to evaluate such effects, the results of the present study revealed differences in sensitivity and limitations between the two methods. Thus, surgical outcomes should be evaluated in consideration of the abovementioned parameters.

Exploring Progression and Differences in Facial Asymmetry for Hemifacial Microsomia and Isolated Microtia: Insights from Extensive 3D Analysis.

Aiming to measure and compare asymmetry of facial hard and soft tissues in patients with HFM and isolated microtia, examining how it evolves. This cross-sectional study assessed facial asymmetry in male East Asian patients aged 5-12 diagnosed with unilateral hemifacial microsomia (Pruzansky-Kaban types I and IIA) or isolated microtia. Using 3D imaging of computed tomography scans, it measured root-mean-square (RMS) values for surface deviations across facial regions. Statistical analyses explored differences between conditions and the relationship of age with facial asymmetry. A total of 120 patients were categorized into four groups by condition (HFM or isolated microtia) and age (5-7 and 8-12 years). Patients with HFM exhibited the greatest asymmetry in the lower cheek, while those with isolated microtia showed primarily upper face asymmetry. Significant differences, except in the forehead and nasal soft tissue, were noted between the groups across age categories. Notable distinctions in hard tissue were found between age groups in the nasal and mid-cheek areas for patients with HFM (median RMS (mm) 0.9 vs. 1.1, P = 0.02; 1.5 vs. 1.7, P = 0.03) and in the nasal and upper lip areas for patients with isolated microtia (median RMS (mm) 0.8 vs. 0.9, P =0.002; 0.8 vs. 1.0, P = 0.002). Besides these areas for HFM, no significant age-asymmetry correlation was detected. Significant differences in facial asymmetry were observed between HFM and isolated microtia, with the asymmetry in specific area evolving over time. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants.

Superficial infection is a common minor complication of transcutaneous implants that can be challenging to predict or diagnose. Although it remains unclear whether superficial infections progress to deep infections (which may require implant removal), predicting and treating any infection in these patients is important. Given that flap thinning during stage II surgery requires compromising vascularity for stability of the skin penetration aperture, we hypothesized that early skin temperature changes predict long-term superficial infection risk. We obtained standardized thermal imaging and recorded surface temperatures of the aperture and overlying flaps 2 weeks postoperatively for the first 34 patients (46 limbs) treated with the Osseointegrated Prosthesis for the Rehabilitation of Amputees transfemoral implant system. We used two-sided t tests to compare temperatures surrounding the aperture and adjacent soft tissues in patients with and without subsequent infection. During median follow-up of 3 years, 14 limbs (30.4%) developed 23 superficial infections. At patients' initial 2-week visit, mean skin temperature surrounding the aperture was 36.3ºC in limbs that later developed superficial infections and 36.7ºC in uninfected limbs (P = 0.35). In four patients with bilateral implants who later developed superficial infection in one limb, average temperature was 1.5ºC colder in the infected limb (P = 0.12). Superficial infections remain a frequent complication of transfemoral osseointegration surgery. We did not find differences in early heat signatures between limbs subsequently complicated and those not complicated by superficial infection. Further research should explore more objective measures to predict, diagnose, and prevent infections after osseointegration surgery.

A narrative review of the measurement methods for biomechanical properties of plantar soft tissue in patients with diabetic foot.

This article provides an overview of the development history and advantages and disadvantages of measurement methods for soft tissue properties of the plantar foot. The measurement of soft tissue properties is essential for understanding the biomechanical characteristics and function of the foot, as well as for designing and evaluating orthotic devices and footwear. Various methods have been developed to measure the properties of plantar soft tissues, including ultrasound imaging, indentation testing, magnetic resonance elastography, and shear wave elastography. Each method has its own strengths and limitations, and choosing the most appropriate method depends on the specific research or clinical objectives. This review aims to assist researchers and clinicians in selecting the most suitable measurement method for their specific needs.

Effect of proximal fibula osteotomy on tension of lateral knee soft tissue in patients with knee osteoarthritis

To evaluate the short-term efficacy of proximal fibula osteotomy in the treatment of knee osteoarthritis, and to analyze the effect of osteotomy on the tension of the lateral knee soft tissue of patients and verify the reliability of the Arch string theory. A total of 71 patients with varus knee osteoarthritis from December 2019 to March 2022 were included, 3 patients dropped out, and 68 patients completed all trials, collected 27 males and 41 females, aged from 51 to 79 years old, with an average of (68.0±7.0 ) years old. The follow-up time ranged from 4 to 12 weeks, with an average of (3.76±1.94) weeks. After admission, the patient underwent Proximal fibula osteotomy, and the tension of lateral knee soft tissue, visual analogue scale (VAS) of pain, the western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and other indicators were recorded before surgery and 1 month after surgery in the weight-bearing state. According to the VAS, the curative effect of a single index was evaluated by referring to the score before and after treatment by Bao Zongzhao. Thirty seven cases were markedly effective, 27 cases were effective, and 4 cases were ineffective. After surgery, 3 patients presented with weakness of dorsalis pedis extension and 1 presented with paresthesia of dorsalis pedis, which disappeared after symptomatic treatment . The VAS and WOMAC score at 1 month after operation were lower than those before operation, and the differences were statistically significant(P<0.001). The tension of lateral knee soft tissue 1 month after operation was lower than that before operation, and the difference had statistical significance(P<0.001). Proximal fibula osteotomy is safe and effective in the treatment of varus knee osteoarthritis in the short term. One month after osteotomy, the tension of lateral knee soft tissue increases under weight-bearing state, but the long-term changes still need further observation and follow-up.

Effect of body mass index on soft tissues in adolescents with skeletal class I and normal facial height.

The evaluation of soft tissues in patients undergoing orthodontic treatment plays a critical role in diagnosis and treatment planning. This study aims to evaluate the effect of body mass index (BMI) on facial soft tissues in skeletal Class I patients with normal vertical growth. The study included 72 patients with a normal vertical growth pattern (SN-GoGn 26-38°) and skeletal Class I (ANB 2‒4°) malocclusion. According to their BMI (kg/m2) values, the patients were divided into three groups of 24 individuals each: underweight (>5th percentile) (13 females, 11 males; mean age, 11.58 ± 1.95 years), normal weight (5‒85th percentile) (12 females, 12 males; mean age, 11.54 ± 1.95 years), overweight (85‒95th percentile) (12 females, 12 males; mean age, 11.62 ± 2.01 years). Soft tissue thickness and height measurements were made on lateral cephalometric radiographs. In all soft tissue thickness measurements, except for the nasion, the overweight weight group had higher values. In comparing the underweight and normal weight groups, statistically significant differences were found in the thickness measurements at the nasion and gnathion (p < 0.05). The differences in thickness measurements at the glabella, labiale superius, stomion, labiale inferius, pogonion, gnathion, and menton are statistically significant between the underweight and overweight groups (p < 0.005). Comparing the normal and overweight groups revealed statistically significant differences the thickness measurements at the glabella, labiale superius, stomion, pogonion and menton (p < 0.05).

Clinical Application of Ultrasound Elastic Imaging in Assessing Poststroke Complex Regional Pain Syndrome (CRPS).

This study aimed to explore the characteristics and clinical application of ultrasonic elastography in peripheral soft tissue in patients with poststroke complex regional pain syndrome (CRPS). Complex regional pain syndrome (CRPS) type I is also known as shoulder hand syndrome (SHS). Its main symptoms include shoulder pain, limited activity, upper arm, wrist, and knuckle joint pain. Ultrasonic elastic imaging technology is gradually being applied to musculoskeletal system evaluation, primarily for the elastic examination of superficial tissue, as a result of the continual advancements in ultrasound technology. To make up for the absence of conventional imaging, functional state evaluation of the motor system can offer conventional ultrasonic tissue elasticity and hardness data. The purpose of this study was to objectively quantify the soft tissue surrounding the shoulder joint of stroke patients with CRPS using ultrasonic elastic imaging and to determine the diagnostic usefulness of ultrasonic elastic imaging for CRPS in stroke in order to promote its usage in clinical practice. Patients diagnosed with CRPS following a stroke and admitted to the rehabilitation unit at Shanxi Bethune Hospital between January, 2021 to June, 2021 were included in the analysis. The control group consisted of people without pain in their shoulder joints. Each group consisted of 30 patients. A high-frequency wire array probe (frequency = 8-16 Hz) was employed in conjunction with an ultrasonic diagnostic apparatus. A quantitative analytic system determined Young's modulus of the tissue, while the tracking of the shear wave provided an elastin map in real-time. An excitation pulse of acoustic radiation force was used to cause shear waves in the tissue. The Young's modulus of supraspinatus muscle in the study and control groups was 289.16±22.07 Kpa and 231.99±23.61 Kpa, respectively (P <0.01). Young's modulus values of the study group's subscapular biceps were compared to those of the control group (P > 0.05). The supraspinatus shear wave elastographic (SWE) imaging value was 10.01±0.49 m/s in the study group and 7.92±0.50 in the control group (P <0.05). The study and control groups had subscapular muscle SWE values of 15.99±1.95 and 8.64±0.56 m/s, respectively (P <0.05). The average biceps tendon SWE value in the study and control groups was 6.39±0.42 and 4.69±0.36 m/s, respectively (P <0.05). In conclusion, the SWE assessed by ultrasound elastography is useful for early diagnosis and evaluation of the superior shoulder tendon, subscapular tendon, and biceps tendon of CRPS following stroke.

Radiographic evidence of neo-vascularization of the lower abdominal soft tissues in patients after abdominoplasty and previous abdominal free flap breast reconstruction

Radiographic evidence of neo-vascularization of the lower abdominal soft tissues in patients after abdominoplasty and previous abdominal free flap breast reconstruction

Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization.

Spontaneous bleeding into the soft tissues of the abdominal and thoracic wall is described as complication of anticoagulant therapy. Computed tomography (CT) allows to detect the presence of extravasation of the contrast agent into a hematoma, which is indicated as a sign of ongoing bleeding. Other specific CT signs of such coagulopathic bleeding have been described earlier. To evaluate the significance of specific coagulopathic CT signs for predicting the dynamics of spontaneous bleeding into soft tissues in patients with COVID-19. A retrospective study included 60 patients with COVID-19 with spontaneous bleeding into soft tissues and extravasation of a contrast agent on CT. In addition to extravasation, a "hematocrit effect" was detected in 43 patients on CT. Of these, 39 had extravasation in the form of a "signal flare." All patients underwent transarterial catheter angiography (TCA). To assess the prognostic value of CT signs, the results of CT and TCA compared. The absence of extravasation on the TCA more often corresponded to stopped bleeding. Extravasation on TCA found in 27 (45%) patients. The presence of the "hematocrit effect" or the combination of this sign with the phenomenon of a "signal flare" on CT (n = 43) led to more frequent confirmation of extravasation on TCA than in their absence (n = 17): 23.5% vs. 53.4% (p = 0.028). The presence of a fluid level and the phenomenon of a "signal flare" on CT in the structure of spontaneous hematomas of the soft tissues of the abdominal and thoracic wall in COVID-19 patients more often corresponded to ongoing bleeding on the TCA. The absence of coagulopathic CT signs more often corresponded to stopped bleeding.

Reliability of 3D Stereophotogrammetry for Measuring Postoperative Facial Swelling.

This study aimed to determine the reliability of three-dimensional (3D) stereophotogrammetry as a measurement instrument for evaluating soft tissue changes in the head and neck area. Twelve patients received a bilateral sagittal split osteotomy (BSSO). Test and retest 3D photographs were captured within the first three postoperative weeks, and a reference 3D photograph was capture at three months postoperatively. Distance measurements, mean and root mean square of the distance map, and volume differences were obtained. Reliability of these parameters was assessed by intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and smallest detectable change (SDC). All distance measurements had an ICC > 0.91, and the distance map parameters and volume differences showed ICCs > 0.89. The neck region presented the largest SEMs (5.09 mL) and SDC (14.1 mL) for the volume difference. In conclusion, 3D stereophotogrammetry is reliable for distance and volume measurements of soft tissues in patients after a BSSO advancement.

Clinical efficacy of the new dental gel based on dihydroquercetin in the treatment of patients with inflammatory periodontal diseases

On the basis of periodontal indices, the anti-plaque and anti-inflammatory effect of the gel composition of the new domestic drug, the main active ingredient of which is dihydroquercetin contained in the bark of Siberian larch, which has an antioxidant and antihypoxant effect, was studied. From practically healthy patients aged 18 to 40 years with inflammatory changes in the marginal periodontium (with chronic catarrhal gingivitis and mild periodontitis) without serious concomitant diseases, 2 groups were formed — control (group "A") and experience (group "B"), 30 people in each group. Patients were not separated by gender. At the first stage, patients were taught the rules of brushing their teeth and hygienic care of the oral cavity using demonstration phantoms. Then, after antiseptic treatment of the marginal periodontium and application anesthesia, dental deposits were removed for patients of both groups. At this point, treatment intervention for patients in the control group (Group B) was limited. Patients of group A were additionally prescribed applications of a therapeutic gel. Patients applied the drug to the gums previously dried with a cotton swab from the outer and inner surfaces on their own with a frequency of 3 times a day after demonstrating the rules for the procedure and monitoring by the specialist the correctness of its implementation by the patients themselves.&#x0D; The clinical condition of the soft tissues in patients of both groups was monitored before the start of treatment, after 3, 7 and 14 days based on a number of indices: Silness-Loe, PMA and Mulleman).&#x0D; The Muhleman Index values in patients before treatment in both groups were 2.4±0.5 and 2.3±0.5 c.u. (conventional unit)., respectively. In subsequent terms, after 3, 7 and 14 days, the index values progressively decreased. 3 days after the removal of dental deposits, the index values significantly decreased: to 1.7±0.5 c.u. in the first and up to 1.9±0.6 c.u. in the second (p&lt;0.05) group of patients. After 7 days, the bleeding index progressively decreased also in both groups, but less intensively. Moreover, the index in patients in group A was 1.1±0.4 and in patients in group B 1.5±0.5 and 0.5±0.1 c.u. Most clearly, the difference in the effect manifested itself on the 14-th day: 0.5±0.3 units. in patients of group A and 1±0.5 c.u. in patients in group B (in all cases p&lt;0,05). The dynamics of the RMA inflammation index turned out to be very comparable with the dynamics of the Muhleman index in patients of both groups.&#x0D; The initial training in the rules of brushing the teeth made it possible to achieve an ideal cleansing of the oral cavity in both groups of patients, and the achieved effect was maintained throughout the study period. This confirmed the decrease in the Silness-Loe plaque index to almost zero, despite the fact that before the start of the study its values were the same and reached almost the maximum value: 2,4 c.u. in patients. of both groups. Characteristically, after 3 days, the index value in patients in both groups decreased almost identically to a value of 0.8 c.u., and after 7 and 14 days — almost to zero.&#x0D; This fact allowed us to attribute the achieved anti-inflammatory effect not due to more thorough brushing of teeth during the experiment, but precisely due to the therapeutic effect of the applied gel.&#x0D; The presented numerical data of clinical indicators were confirmed by the results of statistical processing using the Student's method with the determination of the reliability criterion.&#x0D; Examination and questioning of patients made it possible to establish the absence of negative clinical and organoleptic sensations from the use of the gel in patients of both groups.&#x0D; The data obtained made it possible to establish a pronounced anti-inflammatory effect of the therapeutic gel "Flamena stom." and to recommend the gel for use in wide clinical practice as part of the complex treatment of patients with inflammatory periodontal diseases.

Clinical efficacy of the new dental gel based on dihydroquercetin in the treatment of patients with inflammatory periodontal diseases

On the basis of periodontal indices, the anti-plaque and anti-inflammatory effect of the gel composition of the new domestic drug, the main active ingredient of which is dihydroquercetin contained in the bark of Siberian larch, which has an antioxidant and antihypoxant effect, was studied. From practically healthy patients aged 18 to 40 years with inflammatory changes in the marginal periodontium (with chronic catarrhal gingivitis and mild periodontitis) without serious concomitant diseases, 2 groups were formed — control (group "A") and experience (group "B"), 30 people in each group. Patients were not separated by gender. At the first stage, patients were taught the rules of brushing their teeth and hygienic care of the oral cavity using demonstration phantoms. Then, after antiseptic treatment of the marginal periodontium and application anesthesia, dental deposits were removed for patients of both groups. At this point, treatment intervention for patients in the control group (Group B) was limited. Patients of group A were additionally prescribed applications of a therapeutic gel. Patients applied the drug to the gums previously dried with a cotton swab from the outer and inner surfaces on their own with a frequency of 3 times a day after demonstrating the rules for the procedure and monitoring by the specialist the correctness of its implementation by the patients themselves.&#x0D; The clinical condition of the soft tissues in patients of both groups was monitored before the start of treatment, after 3, 7 and 14 days based on a number of indices: Silness-Loe, PMA and Mulleman).&#x0D; The Muhleman Index values in patients before treatment in both groups were 2.4±0.5 and 2.3±0.5 c.u. (conventional unit)., respectively. In subsequent terms, after 3, 7 and 14 days, the index values progressively decreased. 3 days after the removal of dental deposits, the index values significantly decreased: to 1.7±0.5 c.u. in the first and up to 1.9±0.6 c.u. in the second (p&lt;0.05) group of patients. After 7 days, the bleeding index progressively decreased also in both groups, but less intensively. Moreover, the index in patients in group A was 1.1±0.4 and in patients in group B 1.5±0.5 and 0.5±0.1 c.u. Most clearly, the difference in the effect manifested itself on the 14-th day: 0.5±0.3 units. in patients of group A and 1±0.5 c.u. in patients in group B (in all cases p&lt;0,05). The dynamics of the RMA inflammation index turned out to be very comparable with the dynamics of the Muhleman index in patients of both groups.&#x0D; The initial training in the rules of brushing the teeth made it possible to achieve an ideal cleansing of the oral cavity in both groups of patients, and the achieved effect was maintained throughout the study period. This confirmed the decrease in the Silness-Loe plaque index to almost zero, despite the fact that before the start of the study its values were the same and reached almost the maximum value: 2,4 c.u. in patients. of both groups. Characteristically, after 3 days, the index value in patients in both groups decreased almost identically to a value of 0.8 c.u., and after 7 and 14 days — almost to zero.&#x0D; This fact allowed us to attribute the achieved anti-inflammatory effect not due to more thorough brushing of teeth during the experiment, but precisely due to the therapeutic effect of the applied gel.&#x0D; The presented numerical data of clinical indicators were confirmed by the results of statistical processing using the Student's method with the determination of the reliability criterion.&#x0D; Examination and questioning of patients made it possible to establish the absence of negative clinical and organoleptic sensations from the use of the gel in patients of both groups.&#x0D; The data obtained made it possible to establish a pronounced anti-inflammatory effect of the therapeutic gel "Flamena stom." and to recommend the gel for use in wide clinical practice as part of the complex treatment of patients with inflammatory periodontal diseases.

811 Dermal Fillers and Delayed Hypersensitivity Following Influenza Vaccine: A Case Report

BackgroundDermal fillers can be used to improve cosmetic appearance of facial soft tissue in patients with Human Immunodeficiency Virus (HIV) associated lipodystrophy. There are documented cases of delayed hypersensitivity reaction to dermal fillers following influenza-like illness, and similarly following coronavirus vaccination, however none following the influenza vaccine.CaseA 52-year-old female was treated with dermal filler injections to her zygomatic and buccal regions for lipoatrophy secondary to HIV treatment. Her HIV was well controlled with a low viral load. Six months following dermal filler treatment she presented with periorbital and zygomatic arch swellings one week after vaccination for influenza. The swelling was initially treated as periorbital cellulitis with antibiotics; however, it did not resolve. The swelling was in the same distribution as her filler and as it did not appear to be an infection but rather a delayed hypersensitivity reaction, it was treated with prednisolone for one week. There was further reduction in nodules following intralesional triamcinolone injections and following weaning of prednisolone there was no recurrence of swelling.DiscussionTo our knowledge this is the first case of its type to be described; literature searching does not retrieve any reports to date of adverse events related to the influenza vaccine following the use of dermal fillers. This is an important consideration in terms of the risks posed by this treatment in immunocompromised patients, and detailed informed consent is an important component of treatment.

Expression of selected inflammatory proteins and metalloproteinases in periodontitis.

Periodontitis is a chronic inflammatory disease caused by microbial dental plaque which leads to the destruction and loss of supporting tissues of the tooth. Microbial plaque alone, however, is not enough to cause the disease. The body's response plays an important role, in which an imbalance between the pro-inflammatory and anti-inflammatory effects of cytokines leads to an inflammatory reaction. We detected changes in mRNA expression and protein levels of MIP-1α, and metalloproteinases (MMP-2, MMP-9) contributing to cascades in the initiation and progression of inflammatory bone resorption and destruction of periodontal soft tissues in patients with aggressive (AP) or chronic (CP) forms of periodontitis in comparison with healthy individuals (control). MIP-1α mRNA levels were highest in AP (280 ± 23% higher than the control) also in comparison with CP. The difference in protein level was less pronounced. MMP-2 mRNA expression values were similar (300 ± 12% higher in comparison with control), but protein levels were lower, also when compared to CP. Only in CP MMP-9 mRNA levels were significantly higher than the control (30 ± 8%), while protein levels were again higher in AP. Both AP and CP showed a positive correlation between the level of MIP-1a and MMP-2 (0.879, and 0.954 respectively). However, a strong positive correlation was only found between the levels of MMP-2 and MMP-9 in CP (0.812). MIP-1α, MMP-2 and MMP-9 mRNA expression, along with the concentration of proteins in saliva in patients with periodontal disease, is higher than in healthy individuals and correlates with the severity of the disease.

Reliability of cone beam CT for morphometry of nasolabial soft tissue in patients with skeletal class III malocclusion: A qualitative and quantitative analysis.

To assess reliability of cone-beam CT (CBCT) for nasolabial soft tissue measurements in patients with skeletal class III malocclusion based on 3-dimensional (3D) facial scanner results. CBCT and 3D facial scan images of 20 orthognathic patients are used in this study. Eleven soft tissue landmarks and 15 linear and angular measurements are identified and performed. For qualitative evaluation, Shapiro-Wilk test and Bland-Altman plots are applied to analyze the equivalence of the measurements derived from these two kinds of images. To quantify specific deviation of CBCT measurements from facial scanner, the latter is set as a benchmark, and mean absolute difference (MAD) and relative error magnitude (REM) for each variable are also calculated. Statistically significant differences are observed in regions of nasal base and lower lip vermilion between two methods. MAD value for all length measurements are less than 2 mm and for angular variables < 8°. The average MAD and REM for length measurements are 0.94 mm and 5.64%, and for angular measurements are 2.27° and 3.78%, respectively. The soft tissue results measured by CBCT show relatively good reliability and can be used for 3D measurement of soft tissue in the nasolabial region clinically.

Ultrasound picture in soft tissues in patients after surgical operations

Ultrasound picture in soft tissues in patients after surgical operations

MORPHOLOGICAL FEATURES OF WOUND PROCESS IN PATIENTS WITH INFLAMMATORY AND DESTRUCTIVE PERIODONTAL DISEASES IN CASE OF DIABETES MELLITUS

The aim of this study implied comparing the morphology of periodontal tissues in patients with diabetes mellitus following the results of surgical intervention due to inflammatory and destructive periodontal diseases. We used an erbium laser and a standard surgical method. For this, histological samples obtained from 34 patients were examined. The biopsy samples in Group 1 were studied prior to the surgical treatment of inflammatory and destructive periodontal diseases. Group 2 included histological samples of patients following surgeries employing conventional surgical techniques. Group 3 included gum biopsies obtained after surgical interventions performed with the erbium laser. The research outcomes revealed that when performed in patients with diabetes mellitus complicated with diabetic microangiopathy of the gingival mucosa, surgical curettage or a standard surgical operation with a scalpel did not lead to any significant decrease in the chronic inflammatory process. The morphological picture of the gum soft tissues in patients with Type I and II diabetes mellitus, 3 months after the treatment with the erbium laser as a cutting tool, matched the usual structure of the mucous membrane with no obvious signs of inflammation.

Occipital condyle screw fixation after posterior decompression for Chiari malformation: Technical report and application.

Background: Surgical techniques for stabilization of the occipital cervical junction have traditionally consisted of screw-based techniques applied in conjunction with occipital plating and rods connected to subaxial instrumentation in the form of pars, pedicle, or lateral mass screws. In patients with type 1 Chiari malformation (CM-1) and evidence of occipital cervical junction instability who have undergone posterior decompression, the occipital condyle (OC) represents a potential alternative cranial fixation point. To date, this technique has only been described in pediatric case reports and morphometric cadaver studies.Methods: Patients underwent posterior fossa decompression for treatment of CM. Subsequently, patients received occipital cervical stabilization using OC screws.Results: Patients were successfully treated with no post-operative morbidity. Patient 2 was found to have pseudoarthrosis and underwent revision. Both patients continue to do well at 1-year follow-up.Conclusion: Placement of the OC screw offers advantages over traditional plate-based occipital fixation in that bone removal for suboccipital decompression is not compromised by the need for hardware placement, screws are hidden underneath ample soft tissue in patients with thin skin which prevents erosion, and the OC consists of primarily cortical bone which provides for robust tricortical fixation. These cases demonstrate the novel application of the OC screw fixation technique to the treatment of occipital cervical junction instability in adult patients undergoing simultaneous posterior fossa decompression.

Вакуум-терапія діабетичних ран м’яких тканин: вплив на активність матриксних металопротеїназ

Метою роботи було вивчити вплив вакуум-терапії на основні стадії загоєння гнійних ран м’яких тканин у пацієнтів із цукровим діабетом, ступінь мікробної контамінації ран та активність матричних металопротеїназ (ММП) тканин ранової поверхні. Проаналізовано результати лікування та обстеження 48 пацієнтів із хронічними діабетичними ранами м’яких тканин. У 26 хворих (основна група) у лікувальному комплексі застосовували вакуум-терапію ран. Під час лікувального періоду проводили визначення мікробіологічних та цитологічних показників. Активність ММП у тканинах ранової поверхні пацієнтів контрольної та основної груп визначали методом желатинової зимографії на різних етапах загоєння. Установлено, що в пацієнтів основної групи очищення ран від гнійного субстрату та мікроорганізмів відбувалося на 5,2 ± 1,5 доби раніше порівняно з пацієнтами контрольної групи. Разом із тим у тканинах ранової поверхні пацієнтів основної групи відбувається статистично вірогідне (р &lt; 0,05) зниження активності ММП, величина якої на 5-ту та 10-ту добу лікування становила відповідно 68 і 45 % від початкового рівня. У ранах пацієнтів із діабетом, які проходили курс традиційного медикаментозного лікування, колагеназна активність залишалася стабільно високою протягом усього періоду спостереження. Отже, разом з антимікробними та протизапальними ефектами нормалізація протеолітичних процесів у рановому ложі може бути одним із ключових механізмів високої лікувальної ефективності VAC-терапії.