Tissue Repair Techniques Research Articles

Experimental Research on the Process and Performance of Composite Dressing-Assisted Laser Joining of Ruptured Tendons.

Tendon tissue plays an important role in transmitting the force, increasing the incidence of serious tendon injuries. The clinical method of tendon tissue repair is contact surgical suture, which has the problem of high requirements for surgery. Laser has a noncontact feature that can reduce postoperative complications. However, the tissue has low tensile strength due to the weak ability to absorb the energy. Dressing-assisted laser joining of ruptured tendons can improve the tensile strength of ruptured tendon tissue. The enhancement effect of the dressing was tested, and the mechanical properties and thermal damage of the tendon tissue were analyzed. The results show that with 0.005% SWCNTS +0.3% ICG, the tensile strength can be achieved at 1.30 MPa, the collagen content can be achieved at 27.68% and the degree of thermal denaturation is only 0.31. The results have important value for further research on tendon tissue repair techniques.

A transcriptomic analysis of dental pulp stem cell senescence in vitro

Background/purposeThe use of human dental pulp stem cells (hDPSCs) as autologous stem cells for tissue repair and regenerative techniques is a significant area of global research. The objective of this study was to investigate the effects of long-term in vitro culture on the multidifferentiation potential of hDPSCs and the potential molecular mechanisms involved.Materials and methodsThe tissue block method was used to extract hDPSCs from orthodontic-minus-extraction patients, which were then expanded and cultured in vitro for 12 generations. Stem cells from passages three, six, nine, and twelve were selected. Flow cytometry was used to detect the expression of stem cell surface markers, and CCK-8 was used to assess cell proliferation. β-Galactosidase staining was employed to detect cellular senescence, Alizarin Red S staining to assess osteogenic potential, and Oil Red O staining to evaluate lipogenic capacity. RNA sequencing (RNA-seq) was conducted to identify differentially expressed genes in DPSCs and investigate their potential mechanisms.ResultsWith increasing passage numbers, pulp stem cells showed an increase in senescence and a decrease in proliferative capacity and osteogenic–lipogenic multidifferentiation potential. The expression of stem cell surface markers CD34 and CD45 was stable, whereas the expression of CD73, CD90, and CD105 decreased with increasing passages. According to the RNA-seq analysis, the differentially expressed genes CFH, WNT16, HSD17B2, IDI1, and COL5A3 may be associated with stem cell senescence.ConclusionIncreased in vitro expansion induced cellular senescence in pulp stem cells, which resulted in a reduction in their proliferative capacity and osteogenic–lipogenic differentiation potential. The differential expression of genes such as CFH, WNT16, HSD17B2, IDI1, and COL5A3 may represent a potential mechanism for the induction of cellular senescence in pulp stem cells.

Alternative soft tissue repair techniques for glenohumeral instability

Alternative soft tissue repair techniques for glenohumeral instability

Efficacy of different endodontic irrigants in the lesion sterilization and tissue repair technique in primary molars: A randomized controlled clinical trial.

This study aims to evaluate the efficacy of different endodontic irrigants employed in the lesion sterilization and tissue repair (LSTR) technique. Forty children aged 4-8 years having at least one primary molar with irreversible pulpitis/pulpal necrosis indicated for pulpectomy were included. Participants were randomly divided into three test groups (Group A, B, and C) and one control group (Group D). After caries excavation using a spoon excavator, superficial pulp was removed under topical anesthesia in all groups. Following this, pulpal floor was irrigated using different endodontic irrigants in each group: Group A - 20% propolis, Group B - 2% sodium hypochlorite, Group C - 2% chlorhexidine gluconate, and Group D (control) - saline. Alternate 3-Mix (triple antibiotic paste containing metronidazole, ciprofloxacin, and amoxicillin) was then placed over the pulpal floor and the teeth were restored with glass ionomer cement followed by stainless steel crown. Patients were recalled at follow-up periods up to 18 months for clinical and radiographic evaluation. Repeated-measures ANOVA test, Chi-square test, and independent t-test were used for statistical analysis. Clinical success was achieved in all treated teeth, with the results showing statistical significance (P < 0.05). In addition, Group C showed best clinical results. Statistically significant results (P < 0.05) were obtained in reduction in size of furcation radiolucency, with Group B showing the best results compared to other groups. Statistically significant results (P < 0.05) were obtained in terms of rate of root resorption in all teeth, with Group C showing least resorption compared to other groups. The use of endodontic irrigant before the placement of alternate 3-Mix is an effective step for the improved success of LSTR technique in primary teeth, with chlorhexidine showing the best success rate.

Killing Two Birds with One Stone: Shape-Memory Cryogels for Hemostasis and Wound Repair.

The development of shape-memory hemostatic agents is crucial for the treatment of deep incompressible bleeding tissue. However, there are few reports on biomaterials that can monitor bacterial infection at the wound site in real time following hemostasis and effectively promote repair. In this study, we propose a multifunctional QCSG/FLZ cryogel composed of glycidyl methacrylate-functionalized quaternary chitosan (QCSG), fluorescein isothiocyanate (FITC), and a lysozyme (LYZ)-modified zeolitic imidazolate framework (ZIF-8) for incompressible bleeding tissue hemostasis and wound repair. QCSG/FLZ cryogels possess interconnected microporous structure and enhanced mechanical properties, allowing them to be molded into different shapes for effective hemostasis in deep incompressible wounds. Furthermore, the fluorescence quench signal of QCSG/FLZ cryogels enables timely monitoring of bacterial infection when wound triggers infection. Meanwhile, the acidic microenvironment of bacterial infection induces structural lysis of ZIF-8, releasing LYZ and Zn2+, which effectively kill bacteria and accelerate wound repair. In conclusion, our study not only provides potential application of QCSG/FLZ cryogels for hemostasis in deep incompressible wounds but promisingly promotes the development of a tissue repair technique.

Effect of anterior repair on sexual function in heterosexual couples.

Little is known about the impact of native tissue repair techniques on heterosexual intercourse. This study was aimed at investigating the effect of anterior colporrhaphy on women's and their partners' sexual function. Sexually active women with a male partner who were diagnosed with anterior wall prolapse without any incontinence were prospectively recruited from a single academic center. Demographic data were collected and a Pelvic Organ Prolapse Quantification examination was performed. Before and 3 months post-operatively, women completed two validated questionnaires to assess sexual function, the International Consultation on Incontinence Questionnaire Vaginal Symptoms short form (ICIQ-VS SF) 55, and the Female Sexual Function Index (FSFI), and their male partners completed the International Index of Erectile function-5. Pre- and post-operative results were compared using a paired t test. This study was conducted in the gynecology department of a university hospital between May 2022 and June 2023, where 50 heterosexual couples were enrolled and underwent isolated anterior repair. The mean age of women and their partners were 44.3 ± 5.12 and 48.1 ± 5.81 respectively. Overall, female sexual function improved significantly from pre- to 3 months postoperatively with a decrease in ICIQ-VS SF scores from 13.3 ± 3.27 to 1.7 ± 1.1 (p < 0.05) and an increase in FSFI scores from 21.74 ± 9.37 to 29.28 ± 9.97 (p < 0.05). The only domain that did not improve was sexual pain. For their male partners, there was a similar significant improvement in sexual function with an increase in scores from 48.71 ± 8.71 to 60.68 ± 8.63 (p < 0.05). Isolated anterior repair was associated with improved short-term sexual function amongst heterosexual couples.

An Alternative Approach in Primary Teeth Endodontic Treatment: Lesion Sterilization and Tissue Repair Technique

Süt dişleri çiğneme, konuşma, estetik ve daimi dişlerin yerinin korunması için gereklidir. Süt dişlerinde endodontik tedavinin başarısı etkin irrigasyon ve obturasyon ile kök kanal sistemindeki mikroorganizmaların elimine edilmesine bağlıdır. Çocuk hastada her zaman ideal endodontik tedavi yapmak mümkün değildir; bu durumda lezyon sterilizasyonu ve doku tamiri yaklaşımı alternatif bir teknik olarak düşünülebilir. Bu teknik süt dişlerinde apse, mobilite, fistül ve furkasyon bölgesinde radyolüsensi varlığında uygulanabilir. Teknik, kök kanal sistemini dezenfekte etmek için üçlü antibiyotik patın (metronidazol, minosiklin, siprofoksasin) kullanılmasına dayanmaktadır. &#x0D; Bu çalışmanın amacı süt dişlerine uygulanan lezyon sterilizasyonu ve doku tamiri tekniğinin endikasyonlarını, kontrendikasyonlarını, tedavide kullanılan materyalleri ve tedavi protokolünü gözden geçirmektir.

Standardised Competency-Based Training of Medical Doctors and Associate Clinicians in Inguinal Repair with Mesh in Sierra Leone

IntroductionIn low-income settings, there is a high unmet need for hernia surgery, and most procedures are performed with tissue repair techniques. In preparation for a randomized clinical trial, medical doctors and associate clinicians received a short-course competency-based training on inguinal hernia repair with mesh under local anaesthesia. The aim of this study was to evaluate feasibility, safety and effectiveness of the training.MethodsAll trainees received a one-day theoretical module on mesh hernia repair under local anaesthesia followed by hands-on training. Performance was assessed using the American College of Surgeon’s Groin Hernia Operative Performance Rating System. Patients were followed up two weeks and one year after surgery. Outcomes of the patients operated on during the training trial were compared to the 229 trial patients operated on after the training.ResultsDuring three surgical camps, seven medical doctors and six associate clinicians were trained. In total, 129 patients were operated on as part of the training. Of the 13 trainees, 11 reached proficiency. Patients in the training group had more wound infections after two weeks (8.5% versus 3.1%; p = 0.041). There was no difference in recurrence and mortality after one year, and none of the deaths were attributed to the surgery.Discussion and conclusionMesh repair is the international standard for inguinal hernia repair worldwide. Nevertheless, this is not widely accessible in low-income settings. This study has demonstrated that short-course intensive hands-on training of MDs and ACs in mesh hernia repair is effective and safe.Trial Registration: International Clinical Trial Registry ISRCTN63478884.

Need for innovation: laser sutures

In this modern era there is dire need of awareness regarding sutureless surgical procedures. Globally 310 million surgeries are performed each year1. Using thread and needle for suturing is still as common as using legs to walk. This method is not near to ideal because of risk of contamination, infections, scar marks, needle trauma, and reopening of tissues if the stitches are not held tight2. The prevention of wound infections after surgical procedures is of great interest for every surgical discipline, in order to improve the quality of patient care. And the best way to prevent suture-related complications is to have sutureless procedures. A number of sutureless methods have developed over the time which includes fibrin glue, cyanoacrylates, scaffolds and bio-inspired adhesives3. The sutureless technique which is receiving increasing attention is Photochemical Tissue Bonding (PTB), which can also be called laser sutures. PTB is a novel tissue repair technique that causes the proteins on tissue surfaces to crosslink by using visible light and a photosensitizing dye. This technique has been successfully demonstrated in a number of tissue repair models4. This suture-replacement technique is able to close incisions nearly instantaneously without damaging tissue. It gives minimum scar, is time saving, has more accuracy, causes less infections and is less user dependent as compared with typical sutures. This technique does not provide promising results on the skin but also has been tested for vascular and nervous repairs5. Therefore I think it’s high time that surgeons should consider using this in their practice. Ethical approval None. Sources of funding None. Author contribution Misbah Kaleem: Conception of work along with final draft. Musaddiq Kaleem: Editing draft and reviewed article. Conflict of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) None. Guarantor None.

Nonadjacent Wireless Electrotherapy for Tissue Repair by a 3D-Printed Bioresorbable Fully Soft Triboelectric Nanogenerator.

Electrotherapy is a promising tissue repair technique. However, electrotherapy devices are frequently complex and must be placed adjacent to injured tissue, thereby limiting their clinical application. Here, we propose a general strategy to facilitate tissue repair by modulating endogenous electric fields with nonadjacent (approximately 44 mm) wireless electrotherapy through a 3D-printed entirely soft and bioresorbable triboelectric nanogenerator based stimulator, without any electrical accessories, which has biomimetic mechanical properties similar to those of soft tissue. In addition, the feasibility of using the stimulator to construct an electrical double layer with tissue for nonadjacent wireless electrotherapy was demonstrated by skin and muscle injury models. The treated groups showed significantly improved tissue repair compared with the control group. In conclusion, we developed a promising electrotherapy strategy and may inspire next-generation electrotherapy for tissue repair.

COMPARATIVE STUDY OF OPEN DESARDA'S NO-MESH REPAIR AND OPEN MESH REPAIR FOR INGUINAL HERNIA

Inguinal hernia is the most common among the hernias. The best treatment modality of it is primarily surgical. Improvements in surgical techniques of inguinal hernia repair have signicantly improved the outcomes for patients. The success rate of hernia surgeries is mostly noted by its permanence, amount of complications, cost effectiveness, and duration to return to normal activity. Though mesh repair has gained popularity among the surgical repair of hernias, it has certain limitations like availability of mesh, cost, learning curve and complications associated with it. Hence this study is being carried out to compare the effectiveness of Desarda's no mesh repair, a newer cost effective method, with the existing Lichtenstein's tension free repair, and to decide on a better treatment for inguinal hernia repair based on the results of this study. A total of one hundred and twenty patients were included in the study. These patients were grouped into group A (Desarda's repair group) and group B (Lichtenstein repair group) and randomization was done. Results of these two techniques were compared with respect to groin pain, surgical site infections,duration of hospital stay,duration to return to normal activity. There was no signicant differences regarding age, sex, type of hernia, duration of hernia in both the groups. The operation time was 49 minutes in Desarda's group and 54 minutes in the Lichtenstein group which was considered highly signicant. Over a period of two year follow-up there were no recurrences in both the groups. There were no surgical site infections in the Desarda's group when compared to Lichtenstein's repair. The occurrences of other complications like Loss of sensation over the groin, Scrotal edema, abdominal wall stiffness were not seen in Desarda's group, whereas its occurrence was highly signicant in Lichtenstein's group. The mean hospital stay was 4days in Desarda's group while it was 6days in the Lichtenstein group in those patients who were hospitalized. The current study showed that Desarda's technique is easy to learn and simple method when compared to other tissue repair techniques and requires no mesh. It can be performed under local anesthesia when patient is unt for Regional /General anesthesia and is associated with a less duration of surgery and less mesh associated postoperative complications, with a rapid recovery time.

Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh.

The aim of this study was to evaluate the anatomical results after an anterior sacrospinous ligament fixation (ASSLF) with native tissue repair (anterior colporraphy and apical suspension with prolene) compared to mesh repair for the correction of anterior prolapse at 12 months after surgery. A monocentric prospective study comparing two similar cohorts who underwent ASSLF was conducted. The primary endpoint was the gain in the position of the Ba point relative to its position before surgery and twelve months after surgery. The secondary endpoints consisted of objective results, which were assessed using validated questionnaires. Fifty-three women were included in the native tissue repair group between June 2019 and March 2020. They were compared to 53 women operated on with anterior and apical mesh. There was no difference with respect to the Ba point after 1 year between the two groups (-2 [-3; 1.5]; -2 [-3; 1], p = 0.9789). The apex was significantly better corrected in the native tissue repair group (-7 vs. -6, p = 0.0007). There was also a better correction on the rectocele in the native tissue repair group (-3 vs. -2, p = 0.0178). The rate of Stage 2 anterior vaginal prolapse at one year was approximately 30% in both groups (no statistical difference). ASSFL without mesh does not increase the risk of cystocele recurrence at 1 year after surgery. A future prospective comparison of this native tissue repair technique with mesh suspension is necessary to explore these preliminary findings.

A COMPARATIVE STUDY OF LICHTENSTEIN MESH REPAIR VS NON MESH TISSUE REPAIR DESARDAS TECHNIQUE FOR INGUINAL HERNIA REPAIR

Introduction: Inguinal hernia is one of the most common problems encountered in surgery OPD with the necessity of surgicaloperationinutmost cases[1], multitudinous procedures have been proposed for inguinal hernia surgery like Bassinis, Shouldice and other tissue repair techniques. Now generally used procedure is Lichtenstein tension-free mesh technique[2]. Desardasmethod is tissue-related procedure of herniasurgery using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinalcanal. This study deals with the comparison ofthe Lichtenstein technique and Desardas technique for uncomplicated inguinal hernia[9,10,11]. Aim: To find the Effectiveness of Non-Mesh tissue technique(Desarda) in comparison with mesh technique(Lichtenstein) Settings and Design: Prospective study. Materials and methods: All cases with age ranging from 21 years to 60 years with uncomplicated inguinal hernia admitted to the Department of General Surgery of our institute, between August- 2021 and July- 2022 were included. Results: It was observed that there was no significant difference in the rate of recurrence, inguinodynia between Lichtensteins technique and Desardas technique of inguinal hernia surgery. The mean duration of stay in hospital and mean duration return to normal activities was more in cases who underwent surgery by Lichtensteins technique. Complications like surgical site infection, seroma, haematomaandpost-operative pain on 1st, 3rd and 5th day were more in cases who underwent surgery by Lichtenstein technique than compared to Desardas technique. Conclusion:Desardas no mesh technique was observed with similar results to Lichtensteins mesh technique in terms of recurrence of hernia and post-operative morbidity. Desardas group showed improved results when compared to Lichtenstein group in terms of immediate postoperative pain, inguinodynia, surgical site infections, hospital stay duration and the time taken to return to normal life activities. Desardas no mesh procedure may be considered as a substitute to Lichtensteinsmesh repair to avoid long-term meshrelated morbidity for uncomplicated inguinal hernias.

The incidence of hip dislocation after posterior approach primary total hip arthroplasty: comparison of two different posterior repair techniques.

Total hip arthroplasty (THA) remains one of the most successful orthopedic surgical procedures. The posterior approach is associated with a higher incidence of post-operative dislocations than others. Adequate posterior soft tissue repair techniques, including capsulorrhaphy and transosseous bone sutures in the greater trochanter effectively reduce the dislocation rate. Post-operative "posterior hip precautions" were historically believed to reduce dislocation risks, although not clearly proven. The first protocol consists of capsulorrhaphy with the prescription of post-operative posterior hip precautions (TT) and the second, transosseous bone sutures without precautions (TB). This study aims to determine the optimal protocol to decrease the dislocation rate following posterior approach primary THA. A 10-year retrospective case-control chart review analyzed demographic, pre-, intra-, and post-surgical parameters. Primary outcomes were the difference in dislocation and revision surgery rates between protocols. Secondary outcomes included the incidence of recurrent dislocations and the identification of predictors of dislocation. 2,242 THAs were reviewed and 26 (1.2%) resulted in dislocation. Increased age (p = 0.04) ASA score (p = 0.03) and larger acetabular cup size (p < 0.001) were associated with heightened risk. Tendon to tendon (TT) repair saw a 1.62% dislocation rate versus 0.98% for tendon-to-bone (TB) repair, although statistically insignificant (p = 0.2). Transosseous repair resulted in recurrent dislocations for 8/16 (50%) patients compared to 6/10 (60%) in the suture group (p ≤ 0.001). No significance was found for prescription of posterior hip precautions. To our knowledge, this is the first study to perform a direct comparison of TT repair with posterior precautions to TB repair without posterior precautions. Similarity in dislocation rate, decreased recurrent events and the alleviated patient burden from precautions leads the authors to recommend the TB repair without precautions for a successful THA.

Progress on Biomimetic Mineralization and Materials for Hard Tissue Regeneration.

Biomineralization is a process in which natural organisms regulate the crystal growth of inorganic minerals, resulting in hierarchical structured biominerals with excellent properties. Typical biominerals in the human body are the bones and teeth, and damage to these hard tissues directly affect our daily lives. The repair of bones and teeth in a biomimetic way, either by using a biomimetic mineralization strategy or biomimetic materials, is the key for hard tissue regeneration. In this review, we briefly introduce the structure of bone and tooth, and highlight the fundamental role of collagen mineralization in tissue repair. The recent progress on intra-/extrafibrillar collagen mineralization by a biomimetic strategy or materials is presented, and their potential for tissue regeneration is discussed. Then, recent achievements on bone and tooth repair are summarized, and these works are discussed in the view of materials science and biological science, providing a broader vision for the future research of hard tissue repair techniques. Lastly, recent progress on hard tissue regeneration is concluded, and existing problems and future directions are prospected.

The application of local rotating flap and latissimus dorsi flap in thoracic deformity correction.

Wound healing problem is one of the main complications after correction of chest wall deformity. Orthopedic flap tissue repair technique has a clear significance in non-healing wound and defect wound and provides a new choice for poor wound healing after orthopedic surgery of chest wall deformity. To investigate, the application value of modified local rotary flap and latissimus dorsi myocutcutaneous flap in the treatment of poor wound healing after orthodontic treatment of chest wall deformity. A retrospective analysis was performed on patients who admitted to our department from August 2012 to November 2019 due to non-healing incision after surgery for thoracic deformity. Skin flap was selected according to the size of the wound surface, and the effect of skin flap repair was observed. The clinical data of the included patients were recorded, and the preoperative and postoperative wound conditions were evaluated. This study included 13 patients with chest wall deformity who received plastic surgery tissue using flap technique for wound repair, 11 cases used modified local rotation skin flap, and 2 cases used modified latissimus dorsi myocutaneous flap. The mean age of the 13 patients was 18.54±4.14years old, the mean body mass index (BMI) was 17.02±2.16kg/m2 , and the mean preoperative nonunion time of the incision was 64.77±93.01days. Five patients had positive bacteria culture on the wound surface, including 3 cases of Staphylococcus aureus, 1 case of Pseudomonas aeruginosa, and 1 case of Staphylococcus epidermidis. All the 13 patients achieved primary grade A healing. The modified local rotary flap and latissimus dorsi musculocutaneous flap have a significant effect on the postoperative correction of chest wall deformity, which can ensure wound healing while retaining the orthopedic plate to the maximum extent to ensure the effect of the correction.

Reengineering Broken Books (RBB): A Minimally-Interventive Tissue Repair Technique for Hollowback Books

ABSTRACT The reengineering broken book (RBB) technique allows for repair of hollowback structures, both natural and made, while preserving the original function and materials of the artifact. The repair utilizes a continuous sheet of thin tissue Kashiki Tengu-jo to line the contours of the internal surfaces exposed by broken shoulders, joints, and hinges. Subsequent layers of thin tissue introduce support only where needed. RBB requires no specialized tools or equipment and few supplies. Tracking the repair on 58 books in the Massachusetts Institute of Technology's Libraries published over a 200-year span has shown that this layering procedure results in a thin, flexible, and robust repair that is gentle enough for rare books and durable enough for circulating collections. Described here in its most straightforward application with suggested adaptations, RBB is an economical and minimally-interventive treatment.

Current Concepts on Tissue Adhesive Use for Meniscal Repair—We Are Not There Yet: A Systematic Review of the Literature

Background: Tissue adhesives (TAs) represent a promising alternative or augmentation method to conventional tissue repair techniques. In sports medicine, TA use has been suggested and implemented in the treatment of meniscal tears. The aim of this review was to present and discuss the current evidence and base of knowledge regarding the clinical usage of TAs for meniscal repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature search was performed using the PubMed, Embase, and Cochrane Library databases for studies reporting on clinical outcomes of TA usage for meniscal repair in humans in the English language published before January 2020. Results: Ten studies were eligible for review and included 352 meniscal repairs: 94 (27%) were TA-based repairs and 258 (73%) were combined suture and TA repairs. Concomitant anterior cruciate ligament reconstruction was performed in 224 repairs (64%). All included studies utilized fibrin-based TA. Of the 10 studies, 9 were evidence level 4 (case series), and 8 reported on a cohort of ≤40 meniscal repairs. Rates of meniscal healing were evaluated in 9 of 10 studies, with repair failure seen in 39 repairs (11%). Conclusion: The use of TAs, specifically fibrin-based TAs, for meniscal repair shows good results as either an augmentation or primary repair of various configurations of meniscal tears. However, this review reveals an absence of comparative high-quality evidence supporting the routine use of TAs for meniscal repair and emphasizes the lack of an ideal TA designed for that purpose. Further high-quality research, basic science and clinical, will facilitate the development of new materials and enable testing their suitability for use in meniscal repair.

A randomized control trial comparing the efficacy of 3Mixtatin and Modified 3Mix-MP paste using lesion sterilization and tissue repair technique to conventional root canal treatment in primary molars of children aged 4-8 years: An in vivo study.

Background:The aim of this study was to evaluate clinical and radiographic success rates of 3Mixtatin and Modified 3Mix-MP paste and compare it with conventional root canal treatment procedure in primary molars requiring pulpectomy.Materials and Methods:In this in vivo study, 66 primary molars in 52 children aged between 4 and 8 years with primary molars having chronic periapical abscess were treated randomly with 3Mixtatin, Modified 3Mix-MP paste, and Metapex. The subjects were reviewed at 6 and 12 months both clinically and radiographically after pulpal therapy to evaluate and compare the healing process. The data obtained were subjected to statistical analysis at a significance level of 0.05.Results:By the end of 12-month follow-up among the three groups, Group I seemed to be performing consistently better as compared to the other two groups when evaluated clinically and radiographically. However, Group III resulted in the greatest number of failures, with success rate being mere 42.9% at the end of follow-up period.Conclusion:Radiographic and clinical healing occurred in all the three groups; however, based on our results, Group I seemed to be performing consistently better among the three groups at 12-month follow-up. Hence, it can be inferred that 3Mixtatin used as a localized agent is effective and comparable to both Modified 3Mix-MP paste and conventional pulpectomy procedure involving calcium hydroxide and iodoform paste in primary teeth.

Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses.

To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy in primary teeth. Randomized clinical trials comparing LSTR with pulpectomy by means of clinical and radiographic parameters were included. Risk of bias was assessed using Cochrane methodology and the certainty of evidence was determined by GRADE. Six articles were included. Conventional pulpectomy was favored with respect to radiographic success frequency in the systematic review. Four studies were included in meta-analyses. Based on the clinical results at 6months (RR = 0.99, 95% CI, 0.94-1.04, p= 0.67; I2= 0%), 12months (RR = 0.97, 95% CI, 0.90-1.04, p= 0.34; I2= 0%), and 18months (RR = 0.89, 95% CI, 0.77-1.04, p= 0.14; I2= 0%) and radiographic findings at 6months (RR = 0.91, 95% CI, 0.78-1.06, p= 0.23; I2= 9%), 12months (RR = 0.87, 95% CI, 0.65-1.18, p= 0.38; I2= 64%), and 18months (RR = 0.84, 95% CI, 0.69-1.02, p= 0.08; I2= 0%), there was no difference observed regarding success between the two treatments. The quality of evidence ranged from moderate to very low. No difference between the LSTR and pulpectomy approaches could be confirmed by meta-analyses. The quality of evidence according to the GRADE scheme ranged from moderate to very low. The present meta-analyses could not demonstrate the superiority of one treatment over the other.