Exposure Technique Research Articles

Conceptualization of Stress-Related Disorders and PTSD by Cognitive Behavior Therapists

Background: Many people experience stressful life events like social conflicts, accidents, or physical violence. Some develop post-traumatic stress disorders (PTSD) thereafter. A diagnostic problem is the differentiation between causal stressful events, occasional causes, pseudo-causes or retrospective reinterpretations. This study investigates how often the diagnosis PTSD is mentioned in outpatient behavioral therapy patients, and which causes, findings, and therapeutic measures are reported. Patients and Method: In 1,480 behavioral therapy case reports the assignment of the diagnosis PTSD was explored. Cases with PTSD (N = 106) were compared with other cases without PTSD (N = 95). Results: In 7.16% the diagnosis PTSD was given. In both groups 90% reported earlier stressful experiences. In only 17% of the PTSD cases an “extraordinary threat of catastrophic proportions” was reported. In a quarter, the trauma assumption was based only on therapist or patient suggestions. Dissociative symptoms or intrusion were described only in the PTSD cases. Discussion: The data suggest that (a) almost all patients report stressful experiences, (b) the diagnosis of PTSD is given only in a limited number of patients, (c) in PTSD cases, intrusion and dissociation are reported only in a minority of cases, and (d) in PTSD cases, the full spectrum of exposure techniques is mentioned. Conclusion: Stress-associated disorders need precise description and differentiation.

Lumbar discectomy and fusion: Organs’ dose and effective dose estimation using Monte Carlo simulation

In this study, the effect of patient- and procedure-related parameters on organs' dose (OD), peak skin dose (PSD) and effective dose (ED) during lumbar discectomy and fusion (LDF) was assessed. Intra-operative parameters obtained from 102 LDFs were inserted into VirtualDose-IR software implementing sex-specific and BMI-adjustable anthropomorphic phantoms for dosimetric calculations. Fluoroscopy time (FT), kerma-area product (KAP), cumulative and incident air-kerma (Kair) were also recorded from the dosimetric report of the mobile C-arm. An increase in KAP, Kair, PSD and ED was found for male or higher BMI patients, multi-level or fusion or L5/S1 procedures. However, a significant difference was found only for PSD and incident Kair between normal and obese patients and for FT between discectomy and discectomy and fusion procedures. The spleen, kidneys and colon received the highest doses. The BMI have a significant impact only for kidneys, pancreas, and spleen doses when comparing obese to overweight and for urinary bladder when comparing overweight to normal patients. Multi-level and fusion procedures resulted in significantly higher doses for lungs, heart, stomach, adrenals, gallbladder and kidneys, while pancreas and spleen doses significantly increased only for multi-level procedures. Additionally, a significant increase was found only for urinary bladder, adrenals, kidneys, and spleen ODs when comparing L5/S1 and L3/L4 levels. The mean ODs were lower compared to the literature. These data may aid neurosurgeons in optimising exposure techniques during LDF to keep patients’ dose as low as is practicably possible.

Use of the right retroperitoneum as an alternative approach to the abdominal aorta

ObjectiveThe left retroperitoneal approach to the aorta is a well-established technique for aortic exposure. The right retroperitoneal approach to the aorta is performed less commonly, and the outcomes remain unknown. This study aimed to evaluate the outcomes of right retroperitoneal aortic-based procedures and to determine its utility in aortic reconstruction when faced with hostile anatomy or infection in the abdomen or left flank. MethodsA retrospective query of a vascular surgery database from a tertiary referral center was performed for all retroperitoneal aortic procedures. Individual patient charts were reviewed, and data were collected. Demographics, indications, intraoperative details, and outcomes were tabulated. ResultsFrom 1984 through 2020, there have been 7454 open aortic procedures; 6076 were retroperitoneal-based, and 219 of which were performed from the right retroperitoneal approach (Rrp). Aneurysmal disease was the most common indication (48.9%), and graft occlusion was the most common postoperative complication (11.4%). The average aneurysm size was 5.5 cm, and the most common reconstruction was with a bifurcated graft (77.6%). Average intraoperative blood loss was 923.8 mL (range, 50-6800 mL; median, 600 mL). Perioperative complications occurred in 56 patients (25.6%) for a total of 70 complications. Perioperative mortality occurred in two patients (0.91%). The 219 patients treated with Rrp required 66 subsequent procedures in 31 patients. These included 29 extra-anatomic bypasses, 19 thrombectomies/embolectomies, 10 bypass revisions, 5 infected graft excisions, and 3 aneurysm revisions. Eight Rrp eventually underwent a left retroperitoneal approach for aortic reconstruction. Fourteen patients with a left-sided aortic procedure required a Rrp. ConclusionsThe right retroperitoneal approach to the aorta is a useful technique in the setting of prior surgery, anatomic abnormality, or infection that complicates the use of other more frequently employed approaches. This review demonstrates comparable outcomes and the technical feasibility of this approach. The right retroperitoneal approach to aortic surgery should be considered a viable alternative to left retroperitoneal and transperitoneal access in patients with complex anatomy or prohibitive pathology for more traditional exposure.

Obsessive-compulsive disorder: conceptual and clinical aspects

Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and disabling psychiatric disorder that affects people of all ages and may have been worsened by the COVID-19 pandemic. This study aims to review conceptual and clinical aspects of OCD, including its history, diagnosis, symptom dimensions, etiology, assessment, prevention, and treatment. The history of OCD shows the transition from religious to medical conceptions. The main symptoms of OCD involve the presence of obsessive thoughts and compulsive acts, which can manifest themselves in four dimensions: ‘contamination and cleanliness’, ‘order and symmetry’, ‘doubt and verification’, and ‘disgusting thoughts and mental rituals’. This heterogeneity in the manifestation of OCD can make it difficult to understand its causes and to compare treatment responses. OCD management involves symptom assessment; prevention through psychoeducation and reducing family accommodation; pharmacological and psychotherapeutic treatment. First-line treatments involves the administration of serotonin reuptake inhibitor drugs and/or cognitive-behavioral therapy, with exposure and ritual avoidance techniques, and cognitive reappraisal.

Virtual reality exposure therapy for panic disorder

IntroductionVirtual reality exposure therapy (VRET) is a treatment in a virtual environment based on the representation of a patient’s disease in virtual reality. VRET means getting used to a specific situation by intentionally facing the patient’s fearful situation based on the ‘exposure technique.’ By repeatedly exposing the patient to a fearful situation, in the end, inducing the intensity of fear to decrease without avoiding the situation. Virtual reality exposure therapy (VRET) was initially used to treat phobias, anxiety disorders, and stress. It has been proven to be an effective psychotherapy method mainly focusing on acrophobia, flight phobia, arachnophobia, social phobia, and post-traumatic stress disorder (PTSD).ObjectivesVirtual reality exposure therapy (VRET) is used to treat phobias, anxiety disorders, and stress. The virtual reality treatment system can reproduce virtual scenes with the environment modified or removed, and can familiarize patients with such environments. This study aims to verify the degree of improvement of the symptoms of panic disorder by conducting VRET that we have made considering the degree of gradual exposure to the panic disorder group and the control group.MethodsA total of 60 subjects were included in this study, including 43 patients with panic disorder and 17 control group. Subjects were systematically exposed to specific situations over five steps. We checked the heart rate, body temperature, EEG and symptoms before and after exposure using the following assessment instruments; Subjective Units of Discomfort (SUD), Anxiety Sensitivity Index (ASI), Panic Disorder Severity Scale. Repeated measures ANOVA was performed separately for presence, SUDS (distress) scores, and PDSS across time points.ResultsIn the patient group, the program proved to be effective as the sensitivity to anxiety decreased significantly after the VR program (F=3.570, p<0.05). Among the subcategories of ASI, the fear of anxiety symptoms showed statistical significance between sessions (F=3.883, p<0.05) and in the interaction between group and time (F=4.585, p<0.01). The study confirmed the effectiveness of the VR program in situations that mainly induce panic attacks in patients diagnosed with panic disorder (elevator riding, driving a car, driving a car in a tunnel, driving a car in rain). The program effect was significant through repeated measurement ANOVA for each variable of EEG (Alpha, Beta, Delta, Gamma, Theta) (F=3.249, p<0.01).ConclusionsVRET is the process of gradually being exposed to fear stimuli, deliberately confronting and experiencing a fear situation, and learning that nothing dangerous will happen. Even if the patient experiences bodily sensations that are the subject of fear, they can reduce their fear of bodily sensations by repeatedly confirming that they are safe and getting used to them.Disclosure of InterestNone Declared

How Is the Spectrum of Sarcoma Surgery Assessed?

To meet the challenges of the precision medicine era, quality assessment of shared sarcoma care becomes pivotal. The MDT approach is the most important parameter for a successful outcome. Of all MDT disciplines, surgery is the key step to rendering sarcoma patients disease free; therefore, defining its spectrum is critical. To the best of the authors' knowledge, a comprehensive interoperable digital platform to assess the scope of sarcoma surgery in its full complexity is lacking. An interoperable digital platform on sarcoma surgery has been created to assess the clinical exposure, tumor characteristics, and surgical settings and techniques applied for both resections and reconstructions of sarcomas. The surgical exposure of an individual surgeon over time served as a pilot. Over the study period of 10 years, there were 723 sarcoma board/MDT meetings discussing 3130 patients. A total of 1094 patients underwent 1250 surgical interventions on mesenchymal tumors by one single sarcoma surgeon. These included 615 deep soft tissue tumors (197 benign, 102 intermediate, 281 malignant, 27 simulator, 7 metastasis, 1 blood); 116 superficial soft tissue tumors (45 benign, 12 intermediate, 40 malignant, 18 simulator, 1 blood); and 519 bone tumors (129 benign, 112 intermediate, 182 malignant, 18 simulator, 46 metastasis, 14 blood, and 18 sequelae of first treatment). Detailed types of resections and reconstructions were analyzed. An interoperable digital data platform on sarcoma surgery with transparent real-time descriptive analytics is feasible and enables large-scale definition of the spectrum of sarcoma surgery to meet the challenges of sarcoma precision care in the future.

Fractures of the Capitellum and Trochlea

Capitellar and trochlear fractures are articular injuries of the distal humerus without involvement of the humeral columns. These fractures occur in a bimodal distribution, most commonly after high-energy trauma in young males or ground level falls in elderly females. Open reduction and internal fixation (ORIF) with a variety of implants and exposure techniques is a mainstay of treatment for displaced fractures, while non- or minimally- displaced fractures may be treated non-operatively. Operative management has expanded to include novel arthroscopic and open approaches, such as surgical dislocation of the elbow. Rarely, in elderly patients with severe comminution, total elbow arthroplasty may be the best option. In general, if the capitellar and trochlear injury is appropriately classified, the articular fragments are adequately secured, associated soft tissue injuries are identified and repaired, and a quality therapy program is instituted, patients who sustain these injuries are likely to have a good result with a well-functioning elbow, although complications will occur than 30% of the time.

What Works in Preventing Emerging Social Anxiety: Exposure, Cognitive Restructuring, or a Combination?

Programs that aim to reduce symptoms of social anxiety in children generally include multiple components, such as exposure and cognitive restructuring. It is unknown if separate components yield positive intervention effects in children or whether a combination of components is required. We investigated the effectiveness of exposure, cognitive restructuring, and a combination of both components in reducing social anxiety symptoms and anxiety-related social-emotional outcomes in an indicated-prevention setting. To this end, we conducted a cluster-randomized microtrial using a sample of 191 children aged 8 to 13 years (M = 10.48, SD = 1.10). Children with elevated social anxiety symptoms participated in one of three group interventions, each lasting four weeks, and completed a questionnaire on four measurement occasions. Latent change models demonstrated that the intervention with either exposure or cognitive restructuring reduced social anxiety symptoms and anxiety-related outcomes. The analyses showed that both of these intervention components were effective, with more favorable effects for exposure. Combining exposure and cognitive restructuring techniques did not yield greater benefit than either component alone. Future research should investigate whether specific components may be more effective for particular subgroups (e.g., based on sex or level of behavioral inhibition) in more detail.

Doctoral clinical psychology student commentary on common myths about CBT: lessons learned for competency-based training

Abstract Effective methods for training and education in the dissemination of evidence-based treatments is a priority. This commentary provides doctoral clinical psychology graduate student authors perspectives on common myths about cognitive behavioural therapy (CBT). Three myths were identified and considered: (1) CBT does not value the therapeutic relationship; (2) CBT is overly rigid; and (3) exposure techniques are cruel. Graduate students were engaged in a competency-based course in Cognitive Behavioural Approaches to Psychotherapy at an American Psychological Association (APA)-accredited doctoral clinical psychology program. The origins of common myths identified by graduate students included a lack of in-depth coverage of CBT and brief video segments provided during introductory courses, lived experience with CBT, and pre-determined views of manualized treatment and exposure techniques. Myth-addressing factors discussed by graduate students included holding space at the start of training for a discussion of attitudes about CBT, specific learning activities, and course content described in this commentary. Finally, self-reported changes in graduate students’ attitudes and behaviour following the course included a more favourable view of CBT as valuing the therapeutic relationship, as well as implementation of resources provided, and techniques learned and practised at practicum settings. Limitations and lessons learned are discussed through the lens of a model of adult learning that may be applied to future graduate training in evidence-based therapies like CBT. Key learning aims (1) To understand common myths about cognitive behavioural therapy (CBT) that doctoral students in clinical psychology hold prior to entering a course in CBT. (2) To understand the possible origins of these myths, factors that may address their impacts, and changes in attitudes and behaviour among graduate students as a result. (3) To examine the lessons learned that can be applied to future training in evidence-based therapies like CBT.

Outcome of Anterior Wall Acetabulum and Pelvis Fracture through a Modified Stoppa Approach: A Prospective Cohort Study

Introduction: Acetabular fractures are becoming more common these days. The treatment of complicated acetabular fractures is challenging due to their location and associated injuries. Since the development of the Stoppa approach, it has been used as an alternative to the conventional ilioinguinal strategy. Aim: To assess the postoperative outcomes based on clinical and radiographic results in patients with fractures of the pelvis and acetabulum treated using the Modified Stoppa method. Materials and Methods: This prospective cohort study was conducted at Shri BM Patil Medical College, Hospital and Research Centre in Vijayapura, Karnataka, India, from January 2021 to May 2022. The study included 30 patients with acetabular fractures. Fracture reduction was achieved using a modified Stoppa technique. The patients were followed up for six months, and postoperative function was assessed using the Merle D’Aubigne Score and postoperative X-rays. Frequency distribution was used to analyse the frequency and percentage of study variables. The Chi-square test was used to determine the association between outcomes and radiographic results. Pearson’s correlation coefficient test was used to compare the follow-up time of the patients and the Merle D score. Results: Out of the 30 cases operated on using the modified Stoppa approach, 86.67% achieved anatomical reduction, with 53.33% showing a good outcome and 33.33% achieving an excellent outcome post-surgery. The results were subjected to statistical analysis. Frequency distribution was used to analyse the frequency and percentage of study variables. The Chi-square test was used to determine the association between outcomes and radiographic results. Pearson’s correlation coefficient test was used to compare the follow-up time of the patients and the Merle D score. There was a statistically significant correlation (r-value of 0.007) between the patient’s outcome and the radiographic results post-surgery. Conclusion: The use of less invasive techniques has simplified surgery and reduced complications in the treatment of difficult acetabular fractures. With improved surgical skills and early intervention, this innovative technique for anterior exposure of the acetabulum can be used effectively.

Development of low-loss minimal exposure technique for thallium foil fabrication

Despite its availability as a solid bead or ingot, non-isotopic thallium metal is no longer commercially produced as a foil because of its high toxicity. To conduct fundamental studies on the material, the Stable Isotope Materials and Chemistry Group (SIMC) at Oak Ridge National Laboratory (ORNL) was approached to develop a safe method to process thallium and produce 40 non-isotopic thallium foils. The commercially sourced metal was consolidated into an ingot by melting the material in a special tube furnace under a reducing atmosphere. The resulting ingot was cold rolled using a work-hardened, stainless-steel pack and oil lubricant before cutting the final foils to 2.5 × 2.5 cm2 area and thickness of 50–75 mg/cm2. The appropriate safeguards used at each step are outlined to ensure the safe and consistent production of high-quality foils. The low-loss process enables future requests for isotopic thallium and other hazardous and rare materials.

The first application of the luminescence surface exposure dating method on active fault scarps in the Western Anatolia extensional province: the Manisa Fault as an example

While there has been significant research on the dating of paleoearthquakes using methods such as surface cosmogenic dating, and trench-based luminescence or radiocarbon dating, this paper focuses on implementing an alternative surface dating method using a fault scarp-based optically stimulated luminescence (OSL) dating approach. Hence for the first time, we investigated the Pleistocene to Holocene earthquake cycle of the Manisa Fault, one of the dip-slip active faults of the Western Anatolia extensional province, utilizing novel OSL surface exposure techniques. In this technique, OSL bleaching profiles on the fault surface are directly related to the exposure of the fresh fault scarps that are produced by earthquakes. The results indicate that the Manisa Fault is responsible for at least six surface rupturing earthquakes since the Holocene, occurring at 154 ± 22 year (E6: LSD3), 416 ± 48 year (E5: LSD4), 1103 ± 82 year (E4: LSD5), 2067 ± 138 year (E3: LSD6), 5376 ± 48 year (E2: LSD7), and 6432 ± 218 year (E1: LSD8). Our results of the first use of this novel method on the Manisa Fault are in agreement with prior cosmogenic dating of fault scarps and trench-based paleoseismological chronological data, and we conclude that the OSL surface chronology is a promising alternative for fault scarp dating of paleoearthquakes.

Experience of laser myringoplasty in children with juvenile ideopathic arthritis

Surgeons' dissatisfaction with the surgical treatment for tympanic membrane perforations results leads to the constant improvement of the surgical technique and the emergence of new techniques. Difficulties arise in the surgical treatment of rheumatological patients treated with immunosuppressive drugs due to the high potential risk of postoperative complications. The most promising direction in this cohort of patients can be considered the use of laser exposure techniques under endoscopic control. The experience of performing endoscopic laser myringoplasty in 9 children aged from 6 to 16 years (mean age 10±3 years) with tympanic membrane perforation up to 6 mm in diameter and juvenile idiopathic arthritis treated with methotrexate and tocilizumab is presented. The effectiveness of the studied technique in relation to the closure of perforation of the tympanic membrane was 66.7%. Considering that in children, reconstructive ear surgery is considered less effective than in adults, and the presence of chronic systemic rheumatoid disease and immunosuppressive therapy are risk factors for recurrence of perforation after tympanoplasty, these results can be considered successful. The presented method is promising in this cohort of patients for the restoration of small tympanic membrane defects. However, further research is needed.

Minimally Invasive Carpal Tunnel Release Using a Hook Knife through a Small Transverse Carpal Incision: Technique and Outcome.

Compared to the classic open technique, limited exposure techniques have the advantages of less scar pain, more grip and pinch strength, and earlier return to daily life. We evaluated the effectiveness and safety of our novel method of minimally invasive carpal tunnel release using a hook knife through a small transverse carpal incision. This study included 111 carpal tunnel decompressions in 78 patients who underwent carpal tunnel release from January 2017 to December 2018. We performed carpal tunnel release using a hook knife through a small transverse incision just proximal to the wrist crease under local infiltration of lidocaine with tourniquet inflation in the upper arm. All patients were tolerable during the procedure and discharged following the procedure on the same day. At an average of 29.4 months of follow-up (range, 12-51 months), all but one patient (99%) revealed complete or near complete symptomatic recovery. The average of the symptom severity score on the Boston questionnaire was 1.31 ± 0.30 and the average of the functional status score was 1.19 ± 0.26. The final mean Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) score was 8.66 (range, 2-39). There was no superficial palmar arch injury or nerve injury of the palmar cutaneous branch, recurrent motor branch, or median nerve itself as a complication of the procedure. No patient showed any wound infection or wound dehiscence. Our carpal tunnel release using a hook knife through a small transverse carpal incision performed by an experienced surgeon is a safe and reliable method that is expected to have the benefits of simplicity and minimal invasiveness.

Travma Sonrası Stres Bozukluğu ve Tedavisinde Kullanılan Davranışçı Terapi Müdahale Teknikleri

Post-traumatic stress disorder (PTSD) is a disorder that significantly reduces the functionality of people with symptoms of this disorder and negatively affects their psychological health. Behavioral therapy is an empirically based therapy approach used in the treatment of this psychological disorder and many other psychological disorders. In this study, the articles on behavioral therapy intervention techniques used in the treatment of PTSD and the empirical basis of these techniques were compiled. The literature review in Turkish and English revealed that psychoeducation, real-life exposure, imaginary exposure, prolonged exposure, breathing exercises, relaxation training and systematic desensitization behavioral therapy intervention techniques are commonly used in the treatment of PTSD and that these techniques are effective in the treatment of the disorder.

How I do it:- Endoscopic Reverse Denker's Approach.

Introduction: Endoscopic Denker's approach involves complete exposure of the anterior, inferior and lateral walls of the maxillary sinus providing access to both infratemporal and pterygopalatine fossa. Open approaches to maxillary sinus may lead to a high chance of cranial nerve dysfunction, trismus and wound healing issues. Surgical methods differ based on pathology, exposure, visualization and extent of clearance of the pathology. Method: The technique and surgical steps of Endoscopic Reverse Denker's approach are presented. Results: Critical steps include inferior turbinectomy, uncinectomy, followed by mega middle meatal antrostomy. For exposure drilling is started from the anterior margin of middle meatal antrostomy up to the pyriform aperture anteriorly till the anterior wall of the maxilla is visualized and the nasolacrimal duct can be visualized and transected. This method preserves the pyriform aperture and anterior wall similar to inside-out mastoidectomy tracing the pathology with less bone removal, faster and less morbidity. Conclusion: Endoscopic Reverse Denker's is a 2-handed or 4-handed endoscopic technique for proper exposure, visualization and clearance of the maxillary pathology of the anterolateral and anterior wall. Olfaction is preserved and crusting is less as there is less bone removal with no atrophic nasal changes. It preserves the pyriform aperture thereby preventing alar collapse.

The Strategy of Islamic Religious Education Teacher in Istilling Character Values in Al-Azhar Mandiri Palu Junior High School

This study discusses the strategy of Islamic religious education teachers and manners in instilling character values at Al-Azhar MandiriPalu Junior High School. The formulation of the problem in this study is 1) what are the strategy of Islamic religious education and morals teachers in instilling character values at Al-Azhar MandiriPalu Junior High School? 2) what are the obstacles and solutions provided in instilling character values in Al-Azhar MandiriPalu Junior High School? The objectives of this study are 1) to find out the strategies used by Islamic religious education and morals teachers in instilling character values at Al-Azhar MandiriPalu Junior High School. 2) to explain the constraints and solutions provided in instilling character values in Al-Azhar MandiriPalu Junior High School. This study used a qualitative approach with descriptive informant exposure techniques, and this study used data collection techniques through observation, in-depth interviews and analysis of documentation. Then the data obtained were analyzed using data reduction techniques, data presentation, data verification, and draw conclusions. The results of this study indicate that 1) the strategy used by Islamic religious and moral education teachers in instilling character values ​​both inside and outside the classroom is a) habituation, so that students get used to carrying out the characters being taught, such as discipline, arriving on time at school and others, b) giving advice so that students are motivated and encouraged to do things that the teacher advises during learning, c) set a good example for students with regard to educational values character, d) emphasis strategy, emphasizing doing or applying the material that has been taught in everyday life such as justice and honesty material, e) role-playing, so that students can emulate the role-playing 2) the obstacles faced namely a) some students are spoiled, b) have not been able to understand all students, c) students are less focused on following the lesson learning, d) the network is difficult and long. 3) solutions to overcoming these obstacles include a) taking a personal approach, b) giving a warning to students who make mistakes such as dressing untidy and others, and c) coordinating with class teachers and guidance counsellors in overcoming problems faced by students.

A review on the pesticides in coffee: Usage, health effects, detection, and mitigation.

Coffee is considered among the most popular beverages and is classified as the second most exported item worldwide. The presence of pesticides in this staple commodity is a challenge to import and export activities, in addition to the fact that pesticides are toxins of public health concern. Even if pesticides are applied properly and their residues are within the acceptable range, it is important to know the fate of these pesticides prior to their ingestion. A plethora of research has been done to optimize methods and thus to have valid procedures to test for the presence of pesticides in coffee. In this review, the analytical methods used in these articles to detect and quantify the pesticides in coffee beans, roasted coffee, and coffee infusion were identified. This review highlights as well the main factors that play a key role in having good separation, identification, and recovery of pesticide residues in the aforementioned items. In addition, the review explains the effect of pesticides on human health and the mitigation techniques for pesticide exposure.

The usage of Nd:YAG laser in SMAS lifting of the middle and lower third of the face

The purpose of the work is to improve the quality of vertical face lifting by introducing into surgical practice a laser system of the Fotona SP Spectro model with a Nd:YAG laser source. The technique of intraoperative exposure of the Fotona SP Spectro laser system with an Nd:YAG laser source to the superficial muscular-aponeurotic system (SMAS) of the middle and lower third of the face is proposed. The authors conclude that the use of Nd:YAG laser in a single procedure shortens the rehabilitation period and significantly increases the rejuvenation effect in cases with hypermobile and thinned SMAS.

Management of the palatally displaced maxillary canine. Part 2: exposure and orthodontic alignment

In Part 2 of this article, we highlight the differences between the open and closed exposure techniques in the management of palatally displaced canines (PDCs), the mechanical principles of alignment and the management of ankylosis. CPD/Clinical Relevance: The wide positional variation in the presentation of PDCs requires a degree of clinical flexibility with different exposure techniques and treatment mechanics.