Spontaneous Healing Research Articles

Management of Traumatic Perforation of Tympanic Membrane Through Ayurveda

Traumatic tympanic perforations can occur due to various reasons, such as concussion, insertion of objects, temporal bone fractures, barotrauma, etc. Slap injuries are a common cause. Symptoms include sudden conductive deafness, pain and/or blood-stained discharge. Tinnitus and vertigo may complicate the condition. Appropriate and timely management is crucial to reduce the risk of permanent impairment, as studies indicate that spontaneous healing occurs within 1.5 to 3 months. While Ayurvedic texts don’t directly mention traumatic tympanic perforations, they can be categorized as ‘Agantuja Vrana’ (wounds caused by external factors). Ayurvedic treatment includes both local and systemic approaches. In this case study, medicines were used internally for 2 months: Sarivadi Vati, Lakshadi Guggul, Mahayograj Guggul, Gandha Taila capsules and a combination of Vatashamaka Churnas. This combination led to significant improvement; the perforation completely healed in 2 months. Thus, internal use of these drugs helped in the healing of traumatic perforations.

Healing of Extraction Sites after Alveolar Ridge Preservation Using Advanced Platelet-Rich Fibrin: A Retrospective Study.

Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing. A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction. CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant (p ˂ 0.0005). The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.

Changes of the Alveolar Bone Ridge Using Bone Mineral Grafts and Collagen Membranes after Tooth Extraction: A Systematic Review and Meta-Analysis.

Alveolar preservation techniques for esthetic or functional purposes, or both, are a frequently used alternative for the treatment of post-extraction sockets, the aim of which is the regeneration of the lesion and the preservation of the alveolar bone crest. Studies published in PubMed (Medline), Web of Science, Embase, and Cochrane Library databases up to January 2024 were consulted. Inclusion criteria were established as intervention studies, according to the PICOs strategy: adult subjects undergoing dental extractions (participants), with alveoli treated with bone mineral grafts and collagen membranes (intervention), compared to spontaneous healing (comparison), and observing the response to treatment in clinical and radiological measures of the alveolar bone crest (outcomes). We obtained 561 results and selected 12 studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool, and methodological quality was assessed using the Joanna Briggs Institute. Due to the high heterogeneity of the studies (I2 > 75%), a random-effects meta-analysis was used. Despite the trend, no statistical significance (p > 0.05) was found in the experimental groups. The use of bone mineral grafts in combination with resorbable collagen barriers provides greater preservation of the alveolar ridge, although more clinical studies are needed.

Tissue changes around dental implants installed in alveolar ridge preservation sites: A 1-year follow-up randomized controlled clinical trial.

This study aimed to assess radiographic marginal bone changes 22 months post extraction, which is 1 year after implant loading in alveolar ridge preservation (ARP) sites grafted with a combination of collagen-embedded xenogenic bone substitute (DBBM-C) and collagen matrix (CMX), comparing them with implants placed in naturally healed sites. This randomized controlled clinical trial was conducted over 22 months. Patients who needed a single tooth extraction and subsequent implant placement in nonmolar areas were enrolled. The test group received deproteinized bovine bone mineral with 10% collagen covered by a procaine collagen membrane, while the control group allowed spontaneous healing. Radiographic bone level changes were documented using periapical radiographs at implant placement and follow-up visits (6, 10, and 22 months postextraction). Early implant soft tissue exposure, clinical parameters, and patient-reported outcomes were recorded. Twenty-two out of 28 participants completed a 22-month follow-up, 9 in the test group and 13 in the control group. At 10-month postextraction follow-up, the mean MBL was 1.01 ± 1.04 mm in the treatment group and 0.81 ± 0.93 mm in the control group (p = 0.804). At 22 months, the mean MBL was 2.09 ± 1.03 mm in the treatment group and 1.58 ± 0.73 mm in the control group (p = 0.339). No statistically significant differences in probing depth (PD) and bleeding on probing (BOP) were found at the 22 -month follow-up as well. Soft tissue mean recession was observed in the control group (0.36 ± 0.84 mm), while no recession was found in the test group (p = 0.2). Early implant soft tissue exposure occurred in 33% of test group participants, while none was observed in the control group (p = 0.047). One year after implant loading, no significant differences in marginal bone resorption were found between implants placed in ARP-treated and naturally healed sites. However, ARP-treated sites exhibited early implant soft-tissue exposure, suggesting a possible impairment in soft tissue healing.

Comprehensive approach and real-life patient registry: exploring management and patient outcomes in dealing with septal complications during left bundle branch area pacing

Abstract Background Left bundle branch area pacing (LBBAP) aims to capture the left bundle branch (LBB) through a transventricular septal approach. Pacing this left-sided conduction system requires deep septal lead positioning due to the subendocardial course of the LBB at the left-sided septum. Such deep septal lead deployment might cause iatrogenic septal complications and collateral damage to septal vasculature. Purpose This study aims to explore both the immediate and medium-term clinical results of septal complications during LBBAP in a large single-center patient cohort, while also entailing the management strategies employed to address these issues. Methods The LBBAP implant procedure was conducted using a lumen-less (LLL) or a stylet-driven pacing lead (SDL) and a dedicated delivery sheath. Septal complications encompassed septal perforations into the left ventricular cavity, septal coronary artery or venous fistulas (SCAF/SCVF) and septal hematomas, which were identified using fluoroscopy, echocardiography and electrocardiographic criteria. Enrollment included adult patients who required permanent pacing for bradycardia or heart failure indications in whom LBBAP was attempted between November 2019 and October 2023. Results The study enrolled 508 patients, with a mean age of 71±16 years and 60% male. Successful LBBAP was achieved in 471 (93%) patients. Septal complications during implant occurred in 24/508 patients (5%), including 19 cases of septal perforation (4%), 4 cases of SCAF (0.8%) and 1 case of SCVF (0.2%). All cases of septal perforation were identified during the implantation procedure and were effectively managed by lead retraction and septal repositioning, eventually resulting in successful LBBAP. With regard to SCAF and SCVF, all but one were detected via septography during implantation and were addressed by lead repositioning. One case of SCAF was detected the day after implant on post-procedural echocardiography and was conservatively managed without lead repositioning. No ventricular septal defects were observed on echocardiography, either immediately or during follow-up (mean follow-up period of 25±12 months). Septal kinetics remained unaffected on follow-up echocardiography (mean follow-up 23±9 months), and all SCAF cases healed spontaneously. Additionally, no septal hematomas were observed. Importantly, no late septal perforations occurred during the follow-up period. Furthermore, no cardiac ischemia or thoracic discomfort were reported among any of these patients. Conclusions The findings of this study underscore the safety of deep septal lead deployment in LBBAP, and highlight that LBBAP provides near physiologic pacing with a high success rate and a low incidence of septal complications. The majority of these complications are promptly detected during the implant procedure and often remain asymptomatic. Furthermore, they exhibit spontaneous healing without enduring persistent septal harm throughout the follow-up period.

An Optical Tomography-Based Score to Assess Pediatric Hand Burns

To define the morphologic pattern of pediatric hand burns as visualized via optical coherence tomography (OCT) and dynamic OCT (D-OCT). We designed a scoring system to assess the depths of burn wounds on pediatric hands and tested this score in our cohort of children with burn injuries to the hand. Overall, 67 hand burns in 48 children (0–15 years) were prospectively examined. Scans were interpreted by two independent observers. Relevant OCT findings were surface irregularity, loss of epidermis, loss of dermal pattern (skin lines or papillary spots, loss of surface regularity and irregular vascular pattern of the plexus papillaris. Score values were calculated retrospectively. A score of 4 was associated with spontaneous healing without the need for skin grafting, with a positive predictive value of 97%. Deeper wounds with delayed healing and/or the need of skin grafting received a score of 5 or above, with an agreement of medical healing in 80% and a positive predictive value of 56%. OCT and D-OCT provide clinically useful additional information in cases of pediatric hand burns. The OCT burn score has the potential to support clinical decision making and, subsequently, improve clinical outcomes and shorten hospital stays.

Socket Preservation Following Tooth Extraction Using Polylactide-Polyglycolide Acid Scaffold: Radiologic and Histologic Evaluation.

To assess the healing process of the extraction socket and the dimensional changes that occur after alveolar ridge preservation utilizing a polylactide-co-glycolide scaffold (PLGA). The present study involved the extraction of 28 teeth from 14 patients. The total number of sockets was 28, which were divided into two groups consisting of 14 test sockets and 14 control sockets. The study group (SG) was subjected to socket preservation with a PLGA scaffold while the control group (CG) was left for spontaneous healing. The dimensions were measured before and after operation at 1, 3, and 5 mm below the alveolar crest horizontally and the height of buccolingual bone vertically. According to the histologic analyses, the PLGA scaffold was resorbed within 4 months. CBCT imaging revealed a decrease in the horizontal crest dimension at three distinct coronoapical levels in SG, measuring 2.05 ± 1.05 mm at -1 mm, 1.51 ± 0.89 mm at -3mm, and 0.92 ± 0.7 mm at-5mm.CG showed readings of 1.22 ± 1 at-1mm, 0.92 ± 0.67at-3mm, and 0.73 ± 0.69 at -5 mm. In comparison to CG, SG showed a significant reduction in horizontal losses at -1 mm. Vertical crest dimensions decreased by 1.64 ± 1.11 mm for the buccal bone height and by 1.56 ± 1.08 mm for lingual bone height in SG; in CG, the buccal and lingual bone height had mean values of 2.08 ± 1.44 mm and 1.73 ± 1.27 mm, respectively. There was no statistically significant difference observed in the vertical losses between the groups. Following a period of 4 months, the PLGA scaffold was completely resorbed. Based on CBCT measurements, horizontal resorption was lower than CG at -1 mm coronally.

Global tele-music therapy program reduces pain, discomfort and stress with enduring effects during COVID – 19: A pilot study

Abstract: Of particular need was access to easily applied modalities to improve recovery during the COVID-19 pandemic. The current state of knowledge regarding music therapy has allowed improvements among victims of stroke, dementia, spinal cord injuries, and so forth. The goal of this pilot study was to provide individuals with symptom reduction such as perceived pain, discomfort and anxiety, improved emotional processing, improved relaxation and well-being for participants with current, recent case or long haul COVID-19; those who had lost a loved one to COVID; those experiencing workplace burnt out, or symptoms related to getting the vaccine. Sixty-one individuals participated in a follow-up survey out of one hundred seventy one participants from twelve countries who were treated using one to one zoom sessions following a 30 minute protocol of live music using instruments chosen for soothing or activating energy. Recipients responded to assessment questions showing decrease in pain, anxiety and stress, sustained effect, most effective instruments, spontaneous imagery and open-ended narrative responses. The totality of all instruments were considered most helpful with the drum and Native American style flute considered the most beneficial. Many participants reported spontaneous healing imagery without any guidance demonstrating the power of sound and music to evoke individualized visualization.

A facile and smart strategy to enhance bone regeneration with efficient vitamin D3 delivery through sterosome technology

The spontaneous healing of critical-sized bone defects is often limited, posing an increased risk of complications and suboptimal outcomes. Osteogenesis, a complex process central to bone formation, relies significantly on the pivotal role of osteoblasts. Despite the well-established osteogenic properties of vitamin D3 (VD3), its lipophilic nature confines administration to oral or muscle injection routes. Therefore, a strategic therapeutic approach involves designing a multifunctional carrier to enhance efficacy, potentially incorporating it into the delivery system. Here, we introduce an innovative sterosome-based delivery system, utilizing palmitic acid (PA) and VD3, aimed at promoting osteogenic differentiation and facilitating post-defect bone regeneration. The delivery system exhibited robust physical characteristics, including excellent stability, loading efficiency, sustained drug release and high cellular uptake efficiency. Furthermore, comprehensive investigations demonstrated outstanding biocompatibility and osteogenic potential in both 2D and 3D in vitro settings. A critical-sized calvarial defect model in mice recapitulated the notable osteogenic effects of the sterosomes in vivo. Collectively, our research proposes a clinically applicable strategy for bone healing, leveraging PA/VD3 sterosomes as an efficient carrier to deliver VD3 and enhance bone regenerative effects.

Comparative Study on the Effectiveness of Three Inoculation Methods for Valsa sordida in Populus alba var. pyramidalis.

A key step in the study of tree pathology is the identification of an appropriate method for inoculating pathogens of diseases in branches and trunks. Pathogens of diseases in branches and trunks are commonly inoculated through punching, burning, and toothpick inoculation. However, there is a lack of comparative analyses of the inoculation outcomes of these three methods. In this work, six-year-old P. alba var. pyramidalis were inoculated with V. sordida using punching, burning, and toothpick techniques to investigate the differences in the effectiveness of these inoculation methods. Results reveal that the incidence rate was 93.55% in the toothpick inoculation group, significantly higher than the 80.65% in the burning inoculation group (chi-square, n = 90, p = 0.007), while punching inoculation exhibited significant pathological responses in the early stages, with spontaneous healing in the later stage. Additionally, toothpick inoculation was more efficient in inducing Valsa canker when inoculating the pathogen at the bottom of the tree, with lower intra- and inter-row spacing (stand density) providing better outcomes than higher intra- and inter-row spacing. The results of this study demonstrate that toothpick inoculation is an optimal option for studying the artificial inoculation of V. sordida in six-year-old P. alba var. pyramidalis, providing technical support for research on poplar diseases and offering a theoretical basis for the inoculation of other diseases in the branch and trunk.

Artificial periosteum promotes bone regeneration through synergistic immune regulation of aligned fibers and BMSC-recruiting phages

Given the crucial role of periosteum in bone repair, the use of artificial periosteum to induce spontaneous bone healing instead of using bone substitutes has become a potential strategy. Also, the proper transition from pro-inflammatory signals to anti-inflammatory signals is pivotal for achieving optimal repair outcomes. Hence, we designed an artificial periosteum loaded with a filamentous bacteriophage clone named P11, featuring an aligned fiber morphology. P11 endowed the artificial periosteum with the capacity to recruit bone marrow mesenchymal stem cells (BMSCs). The artificial periosteum also regulated the immune microenvironment at the bone injury site through the synergistic effects of biochemical factors and topography. Specifically, the inclusion of P11 preserved inflammatory signaling in macrophages and additionally facilitated the migration of BMSCs. Subsequently, aligned fibers stimulated macrophages, inducing alterations in cytoskeletal and metabolic activities, resulting in the polarization into the M2 phenotype. This progression encouraged the osteogenic differentiation of BMSCs and promoted vascularization. In vivo experiments showed that the new bone generated in the AP group exhibited the most efficient healing pattern. Overall, the integration of biochemical factors with topographical considerations for sequential immunomodulation during bone repair indicates a promising approach for artificial periosteum development. Statement of significanceThe appropriate transition of macrophages from a pro-inflammatory to an anti-inflammatory phenotype is pivotal for achieving optimal bone repair outcomes. Hence, we designed an artificial periosteum featuring an aligned fiber morphology and loaded with specific phage clones. The artificial periosteum not only fostered the recruitment of BMSCs but also achieved sequential regulation of the immune microenvironment through the synergistic effects of biochemical factors and topography, and improved the effect of bone repair. This study indicates that the integration of biochemical factors with topographical considerations for sequential immunomodulation during bone repair is a promising approach for artificial periosteum development.

A dual dynamically cross-linked hydrogel promotes rheumatoid arthritis repair through ROS initiative regulation and microenvironment modulation-independent triptolide release

High oxidative stress and inflammatory cell infiltration are major causes of the persistent bone erosion and difficult tissue regeneration in rheumatoid arthritis (RA). Triptolide (TPL) has become a highly anticipated anti-rheumatic drug due to its excellent immunomodulatory and anti-inflammatory effects. However, the sudden drug accumulation caused by the binding of “stimulus-response” and “drug release” in a general smart delivery system is difficult to meet the shortcoming of extreme toxicity and the demand for long-term administration of TPL. Herein, we developed a dual dynamically cross-linked hydrogel (SPT@TPL), which demonstrated sensitive RA microenvironment regulation and microenvironment modulation-independent TPL release for 30 days. The abundant borate ester/tea polyphenol units in SPT@TPL possessed the capability to respond and regulate high reactive oxygen species (ROS) levels on-demand. Meanwhile, based on its dense dual crosslinked structure as well as the spontaneous healing behavior of numerous intermolecular hydrogen bonds formed after the breakage of borate ester, TPL could remain stable and slowly release under high ROS environments of RA, which dramatically reduced the risk of TPL exerting toxicity while maximized its long-term efficacy. Through the dual effects of ROS regulation and TPL sustained-release, SPT@TPL alleviated oxidative stress and reprogrammed macrophages into M2 phenotype, showing marked inhibition of inflammation and optimal regeneration of articular cartilage in RA rat model. In conclusion, this hydrogel platform with both microenvironment initiative regulation and TPL long-term sustained release provides a potential scheme for rheumatoid arthritis.

Silk fibroin-gelatin films crosslinked by genipin for regenerating tympanic membrane perforations

The tympanic membrane (TM) integrity is necessary for our normal hearing function. TM perforations pose significant morbidities such as middle ear infection, recurrent otorrhea, hearing loss, and acquired cholesteatoma. Myringoplasty is commonly performed to repair chronic perforations; although various grafts and materials have been utilized to promote TM regeneration, all have associated restrictions. This study aimed to prepare and evaluate the efficacy and feasibility of a tissue-engineered patch based on silk fibroin and gelatin (SF-GT) to improve regeneration. A casting technique was used to make the SF-GT films, using 0–30 v/v% GT, as it is shown that films are remarkably efficient for TM regeneration, easy to mass produce and cheap to make. The surface morphology (SEM), chemical structure (FTIR), crystallinity (XRD), mechanical strength (tensile test), water uptake and in vitro degradation, and cellular biocompatibility (MTT and scratch) were investigated for SF-GT films, and the optimal patch was chosen based on the results (SF-30GT). SF-30GT was used for in vivo studies in a rat model with TM perforations to induce TM regeneration. The morphology of the TM was assessed at days 0, 3, 5, 7, 9 and 11 post-implantation using otoscopy and functional outcomes by auditory brainstem responses (ABRs). This study indicates that compared with the control group (spontaneous healing), the SF-30GT scaffold was more effective in promoting early TM regeneration (complete healing at day 7) and normal hearing (back to 20 dB after healing), suggesting that this scaffold can be a potential substitute for clinical use.

Major clinical outcomes of the alveolar ridge preservation post-extraction sockets: a systematic review

Introduction: After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes can be difficult or even impede the placement of dental implants and prosthetic rehabilitation. Minimizing bone remodeling means optimizing the esthetics and functional aspects, and mainly, the success of implant treatment. To avoid residual ridge resorption different techniques and bone graft materials have been proposed. Objective: It was to evaluate the efficiency of the many techniques of extraction socket treatment in the alveolar ridge dimension preservation. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 158 articles were found, 62 articles were evaluated in full and 34 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=63.6%>50%. It was concluded that the application of autologous growth factor concentrate after surgical extraction offers an easy, low-cost, and efficient option for preserving the alveolar ridge. Therefore, the use of autologous growth factor concentrate by dentists during tooth extractions can be encouraged, especially when preservation of the alveolar ridge is necessary. The present study suggests that the alveolar graft technique may increase the risk of disease transmission, cost, and time of treatment. Several studies have stated that the graft material is not fully incorporated into the newly formed bone, indicating less vital bone tissue. Spontaneous scarring is still the most used feature since, in intact alveoli and small defects, it is a procedure that does not present significant losses that justify the use of edge preservation techniques. In larger defects, techniques after spontaneous healing, such as a block graft, can be used without the drawbacks of alveolar grafting, such as delayed healing and poor bone qualit.

Assessment of bone regeneration after maxillary radicular cyst enucleation with or without bone grafting materials: a retrospective cohort study

ObjectiveThe limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT).Materials and methodsSeventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing.ResultsBoth groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05).ConclusionBio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions.Clinical relevanceClinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases.

Alveolar Bone Loss in a Ligature-Induced Periodontitis Model in Rat Using Different Ligature Sizes.

Ligature-induced periodontitis model has been widely used as a preclinical stage for investigating new treatment modalities. However, the effect of different ligature sizes on alveolar bone loss has never been studied. Therefore, we examined alveolar bone loss in this rat model using different sizes of silk ligatures, as well as healing after ligature removal. Left maxillary second molars of Sprague-Dawley rats were ligated with 3-0, 4-0, or 5-0 silk ligatures (n = 4-5/group) for 14 days before harvested maxillae and gingival tissues. For subsequent experiment, animals were ligated for 14 days using the ligature size that induced the most alveolar bone loss before ligature removal and sacrificed at 0, 7 and 14 days (n = 5-6/group). All maxillae and gingival tissues were harvested to evaluate alveolar bone level, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) levels. Data was analyzed using SPSS Statistics 23.0 software (SPSS Inc., Chicago, Illinois, United States). Data from all experiments were tested for normality using Shapiro-Wilk test. Data between ligatured and nonligatured teeth were compared using Student's t-test or Wilcoxon signed-rank test. Differences among different ligature sizes were analyzed by analysis of variance followed by multiple comparisons with post-hoc test. A p-value less than 0.05 was considered statistically significant. The alveolar bone loss of ligated teeth was substantially higher than that of control after 14 days of ligation. While 3-0 and 4-0 resulted in significantly greater bone loss than 5-0 silk, the 3-0 group had the lowest rate of ligature loss. Therefore, alveolar bone healing postligature removal was investigated further using 3-0 silk. The results showed no significant bone level change at 2 weeks after ligature removal. In term of IL-1β and TNF-α levels, there was no statistically significant difference in IL-1β level between groups at any time point, while TNF-α was undetectable. These data showed that 3-0 silk was the most effective ligature size in promoting alveolar bone loss comparing with 4-0 and 5-0 silk. During the 2-week period following ligature removal, spontaneous bone healing was not observed.

Computer-Assisted Evaluation Confirms Spontaneous Healing of Donor Site One Year following Bone Block Harvesting from Mandibular Retromolar Region-A Cohort Study.

The study was conducted on patients who underwent an alveolar ridge augmentation using an intraoral retromolar bone graft. Three CBCT scans were performed-intraoperative, and at six months and one year after the surgical procedure. By using the Materialise Mimics Innovation Suite software 26.0 features segmentation by thresholding, Hounsfield unit averaging, and superimposition of the tomographies, we could precisely quantify the healing process utilizing spatial and characteristic measures. In all cases, the computer-aided quantification showed that six months following surgery, the donor site had recovered up to 64.5% ± 4.24 of its initial volume, and this recovery increased to 89.2% ± 2.6 after one year. Moreover, the Hounsfield unit averaging confirmed dynamic bone quality healing, starting at 690.3 ± 81 HU for the bone block, decreasing to 102 ± 27.8 HU at six months postoperatively, and improving to 453.9 ± 91.4 HU at the donor site after a year. This study demonstrates that there is no need for additional replanting at the donor site following retromolar bone block harvesting, whether autogenous or allograft, since spontaneous healing occurs 12 months following the surgery.

Mesenchymal Stem Cell-derived Exosomes Improved Healing of Cutaneous Wound in a Rat Model

Abstract Introduction: Wounds of skin are common injuries causing familial burdens. Exosomes received attention as a cell-free therapy. Aim: Studying the role of exosomes (derived from mesenchymal stromal cells [MSCs]) on healing of cutaneous wound in adult male Wistar rats. Materials and Methods: Five weaned rats were used for exosome isolation. Exosomes were isolated (from bone marrow-MSCs) through ultracentrifugation. They were then characterized using a transmission electron microscope. The study was conducted on 42 adult male rats. They were divided into Group I (control group); Group II (spontaneous wound healing) and Group III (exosomes treated group): 24 h after generation of skin wound rats received a single intravenous injection of 1 mL phosphate buffer saline containing purified exosomes. Skin specimens were collected after 14 days and 21 days. Skin specimens were subjected to proper histological techniques. Results: Administration of exosomes decreased pain experienced by rats, improved wound healing, enhanced epidermal reepithelization and the regeneration of skin appendages, significantly increased epidermal cell proliferation and lead to better organization of newly formed collagen. Conclusions: Intravenous injection of exosomes was effective in accelerating cutaneous wound healing in adult rats.

Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis.

To investigate the efficacy of alveolar ridge preservation (ARP) in periodontally compromised molar extraction sites. An electronic search was performed on 10th November 2023 across five databases, seeking randomised/non-randomised controlled trials (RCTs/NCTs) that included a minimum follow-up duration of four months. The RoB2 and Robins-I tools assessed the risk of bias for the included studies. Data on alveolar ridge dimensional and volumetric changes, keratinized mucosal width, and need for additional bone augmentation for implant placement were collected. Subsequently, a meta-analysis was carried out to derive the pooled estimates. Six studies were incorporated in the present review, and a total of 135 molar extraction sockets in 130 subjects were included in the meta-analysis. ARP was undertaken in 68 sites, and 67 sites healed spontaneously. The follow-up time ranged from 4 to 6 months. The meta-analysis of both RCTs and NCTs showed significant differences in mid-buccal ridge width changes at 1 mm level below ridge crest with a mean difference (MD) of 3.80 (95% CI: 1.67-5.94), mid-buccal ridge height changes (MD: 2.18; 95% CI: 1.25-3.12) and volumetric changes (MD: 263.59; 95% CI: 138.44-388.74) in favour of ARP, while the certainty of evidence is graded low to very low. Moreover, ARP appeared to reduce the need for additional sinus and bone augmentation procedures at implant placement with low certainty of evidence. Within the limitations of this study, alveolar ridge preservation in periodontally compromised extraction sites may, to some extent, preserve the ridge vertically and horizontally with reference to spontaneous healing. However, it could not eliminate the need for additional augmentation for implant placement. Further, longitudinal studies with large sample sizes and refined protocols are needed.

Effect of root immaturity and depth of intrusion on spontaneous re-eruption and healing complications: Aretrospective analysis.

Dental trauma resulting in tooth intrusion is a severe injury of permanent dentition, with a prevalence of 0.5%-1.9% among traumatic dental injuries. Currently, treatment guidelines for intruded permanent teeth depend on root development and the degree of intrusion. However, the categorization of tooth maturity as mature or immature simplifies a complex continuum of root development stages. This study aims to investigate the impact of various stages of root development on the success of spontaneous re-eruption (SRE) of intruded teeth. This retrospective study analysed data from 80 children (125 teeth) aged 6-12 years who experienced dental intrusion between 2018 and 2022. Root maturation was classified based on Cvek's classification, eight were categorized as stage 1, 29 as stage 2, 44 as stage 3, 25 as stage 4, and 19 as stage 5. Intruded teeth with immature roots (Cvek's class 1-4) underwent SRE, while mature teeth (Cvek's class 5) were treated with SRE, orthodontic repositioning, or surgical repositioning based on the degree of intrusion. Primary outcome measures were successful re-eruption and secondary outcomes included observed complications during follow-up. Regression analysis revealed that the patient's age, degree of root maturation, and degree of intrusion significantly affected spontaneous re-eruption (p < .05). SRE was more successful in teeth with Cvek's stages 1 and 2 compared to stages 3 and 4. Complications were associated with the treatment method, degree of root immaturity, and degree of intrusion. The study demonstrates that as root maturation progresses, the likelihood of re-eruption decreases, and the risk of pulp necrosis and infection increases. Therefore, teeth in later stages of immaturity (Cvek stage 4) should be repositioned orthodontically or surgically without waiting for spontaneous re-eruption.