Tag: pubmed

Pain Physician. 2023 Oct;26(6):E671-E677.

ABSTRACT

BACKGROUND: The mechanism of pain control with pulsed radiofrequency (PRF) is unclear.

OBJECTIVES: We aimed to compare the efficacy of combined PRF on dorsal root ganglion (DRG) with transforaminal epidural steroid injection (TFESI) vs TFESI-alone on pain improvement and serum tumor necrosis factor-alpha (TNF-a) level in lumbar disc-related radicular pain.

STUDY DESIGN: Prospective, randomized, controlled trial.

SETTING: Neurology and Pain Management clinics.

METHODS: A total of 80 patients with lumbar disc prolapse were divided into 2 groups: combined PRF on DRG with TFESI group and TFESI-alone group. The Numeric Rating Scale (NRS-11), Oswestry Disability Index (ODI), and Functional Rating Index (FRI) before intervention and at 2 weeks, 1 month, and 3 months after the intervention were observed. Serum TNF-a level was assessed pre- and post-intervention at 3 months.

RESULTS: The scores of NRS-11, ODI, and FRI showed a significant improvement at 2 weeks, 1 month, and 3 months following intervention in both combined PRF & TFESI group and TFESI-alone group (P < 0.001 in all comparisons), with no significant difference between the 2 groups. Serum TNF-a levels showed a statistically significant reduction, 3 months following intervention in the combined PRF & TFESI group (P < 0.001), but not in the TFESI-alone group (P = 0.297) (P between groups < 0.001).

LIMITATIONS: The main limitation of this study is that TNF-a level was not assessed earlier to see how long the steroids might reduce TNF-a. On the other hand, further study with extended follow-up periods is needed to confirm the long-term lowering effect of TNF-a provided by PRF.

CONCLUSIONS: Combined PRF on DRG with TFESI showed similar outcomes to TFESI-alone in relieving pain in patients with lumbar disc prolapse. However, PRF on DRG caused a significant decrease in TNF-a serum levels at 3 months.

PMID:37847920

Pain Physician. 2023 Oct;26(6):E651-E660.

ABSTRACT

BACKGROUND: Regional anesthesia for an upper limb provides many advantages over general anesthesia, especially in orthopedic surgery.

OBJECTIVES: This trial aimed to compare a retroclavicular approach to the infraclavicular brachial plexus with a costoclavicular approach in term of needle time, image time, and procedure time, and comparing both with the classic technique for upper limb surgeries guided by ultrasound.

STUDY DESIGN: Prospective, randomized, single-blinded controlled trial.

SETTING: Minia University, Faculty of Medicine, Anesthesia and Intensive Care Department.

METHODS: Sixty patients of both sees with an American Society of Anesthesiologists Classification of I and II, a BMI (kg/m2) of 20-35, aged from 18-60 years who were scheduled for a forearm or hand surgery under infraclavicular brachial plexus block were divided into 3 parallel equal groups. Group I (RC) received a retroclavicular approach. Group II (CC)received a costoclavicular approach. Group III (CT) received the classic technique. Procedure time, the sum of the imaging and needling times, was our primary outcome. Secondary outcomes were the motor and sensory block success rate 30 minutes postinjection of local anesthesia, duration of motor and sensory block, Visual Analog Score, first analgesic need, total analgesia requirements during the first postoperative 24 hours, and any complications.

RESULTS: The procedure and needle times were significantly decreased in the retroclavicular group due to better needle visibility. There was no significant difference regarding sensory and motor block data. The VAS score in the first postoperative 24 hours showed no statistical significance. Regarding analgesic data and patient satisfaction, there was no statistical significance among the 3 studied groups. There were no complications in any of the used approaches.

LIMITATION: Our trial did not include patients with a BMI > 35.

CONCLUSIONS: The retroclavicular approach is superior because of its decreased procedure time and needle time than both the costoclavicular approach and classic approach.

PMID:37847918

Pain Physician. 2023 Oct;26(6):E627-E633.

ABSTRACT

BACKGROUND: Percutaneous radiofrequency thermocoagulation (RFT) through the foramen rotundum (FR) is a new approach for the treatment of V2 trigeminal neuralgia (TN). Some studies have shown the novel method seems to have advantages over traditional RFT through the foramen ovale (FO). The optimal interventional surgical strategy for isolated V2 TN remains controversial.

OBJECTIVES: The purpose of our study was to perform a systematic review and meta-analysis to evaluate the clinical results of RFT through the FR and the traditional FO puncture approach.

STUDY DESIGN: A systematic review of randomized controlled trials for thermocoagulation through the foramen rotundum versus the foramen ovale for V2 primary trigeminal neuralgia.

METHODS: Randomized controlled trials or nonrandomized controlled trials published from January 2000 through October 2022 that compared RFT through the FR and the FO for V2 primary TN were found through a comprehensive search in 3 electronic databases (PubMed, EMBASE, Cochrane library). A total of 3 studies (105 patients) were included in this systematic review and meta-analysis.

RESULTS: The results indicate that there are no statistically significant differences between the FR group and the FO group in terms of postoperative immediate effect rate (postoperative one week) (P > 0.1; standardized mean difference [SMD] = 0.67 [0.26- 1.71]) and recurrence rate (P > 0.1; SMD = 0.67 [0.26 – 1.71]). The long-term effect rate (postoperative one year) was significantly higher in the FR group (P < 0.05; SMD = 0.12 [0.01 – 0.22]). The FO group had a significantly higher total complication rate compared with the FR group (P < 0.01; SMD = 0.12 [0.03 – 0.53]).

LIMITATIONS: The limitations of this systematic review and meta-analysis include the small range of study populations. Heterogeneity caused by inconsistent follow-up time, outcome measurements, and RF parameters are other limitations.

CONCLUSION: In conclusion, RFT of the maxillary nerve through the FR for the treatment of primary V2 TN had a better long-term effect rate and fewer complications in comparison with thermocoagulation of the Gasserian ganglion through the FO. No differences were found between both interventions in terms of immediate effect rate and recurrence rate.

PMID:37847916

Pain Physician. 2023 Oct;26(6):E617-E626.

ABSTRACT

BACKGROUND: There have been no recent meta-analysis studies on specific psychological symptoms (depression and anxiety) according to the type of primary headache disorder in children and adolescents.

OBJECTIVES: We performed a meta-analysis of various psychodiagnostic scales. Psychological symptoms of primary headache disorders have been reported in previous studies.

STUDY DESIGN: A systematic review and meta-analysis.

METHODS: We conducted systematic reviews using the PubMed, Embase, Cochrane Library, and Scopus databases up to October 19, 2022. Ten studies were selected by applying the inclusion criteria. The psychological symptoms (depression and anxiety) of children and adolescents with migraine and tension-type headache (TTH) were compared with those of healthy controls using scale scores. All statistical analyses of the pooled data were performed using RevMan 5.3 software.

RESULTS: Psychodiagnostic tools to assess depression scored higher in patients with migraine than in healthy controls; however, most anxiety-related scores were not significantly different between the migraine and control groups. In contrast, anxiety-related scores were higher in patients with TTH than in healthy controls, but the score to measure the degree of depressive symptoms was not significantly different from the control group in patients with TTH.

LIMITATIONS: A limited number of studies for each scale were included. In addition, each scale has different sensitivities and specificities, which may have affected the results. In addition, we did not evaluate the differences in psychological symptoms according to the frequency and severity of headaches.

CONCLUSIONS: Depression is more associated with migraine; whereas, anxiety is more associated with TTH than healthy controls. Therefore, the screening and assessment of psychological symptoms should be performed in children and adolescents with primary headache disorders.

PMID:37847915

J Basic Microbiol. 2023 Oct 17. doi: 10.1002/jobm.202300330. Online ahead of print.

ABSTRACT

Microorganisms that can survive in saline environments, known as halotolerant or halophilic organisms, have a wide range of current and potential uses in biotechnology. In this study, it was aimed to determine the carotenoids of halophilic archaea strains isolated from the brine samples taken from different points of Salt Lake (Turkey) and determine the antioxidant activities of their carotenoids. To identify the halophilic archaea strains, they were cultivated in MAM JCM 168 medium and subjected to antibiotic susceptibility, fatty acid, two-dimensional and three-dimensional imaging by scanning electron microscopy and atomic force microscopy, biochemical and phylogenetic assays. The findings show that five different halophilic archaea strains have been identified as Halorubrum lipolyticum, Halorubrum sodomense, Haloarcula salaria, Halorubrum chaoviator, and Haloarcula japonica with 98% and above similarity ratio. The main fatty acids of all haloarchaeal strains were octadecanoic acid (C18:0) and palmitic acid (C16:0). The major carotenoid of the species was determined as all-trans bacterioruberin, and different carotenoid types such as lycopene, β-carotene, and 2-isopentenyl-3,4-dehydrorodopin were found as well as bacterioruberin isomers. The antioxidant activities of carotenoids extracted from the species were analyzed by the 2,2-diphenyl-1-picrylhydrazyl radical scavenging method and the extracts showed antioxidant activity statistically significantly higher than ascorbic acid and butylated hydroxytoluene as reference products (p < 0.05).

PMID:37847881 | DOI:10.1002/jobm.202300330

Int J Oral Maxillofac Implants. 2023 Oct 17;38(5):1014-1024. doi: 10.11607/jomi.10225.

ABSTRACT

PURPOSE: To compare the fit of 3D-printed titanium (Ti) and cobalt-chromium (Co-Cr) abutments with implants to computer numerical control (CNC)-milled, ready-made abutment-implant assemblies. Their clinical applicability was also evaluated by measuring removal torque values (RTVs) and percentage torque loss of abutment screws.

MATERIALS AND METHODS: A total of 138 abutments were included in the study: 92 abutments were fabricated with Ti and Co-Cr alloys using computer-assisted design (CAD) through selective laser melting, and 46 ready-made abutments were prepared. The fit of interfaces between 90 abutments from the three groups (30 ready-made, 30 3D-printed Ti, and 30 3D-printed Co-Cr abutments) and implant assemblies was demonstrated by scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). After 30-Ncm torque tightening of Ti abutment screws twice within 10 minutes, the RTVs and percentage torque loss of screws of 48 abutments (16 ready-made, 16 3D-printed Ti, and 16 3D-printed Co-Cr) were evaluated after 10 minutes of thermocycling and cyclic loading.

RESULTS: The fits of 3D-printed Co-Cr abutments were not statistically different from those of ready-made abutments (P = .383), while the fit of 3D-printed Ti abutments was inadequate (P < .001). The RTVs of 3D-printed abutments after cyclic loading were significantly decreased compared with those of CNC-milled abutments (P < .001).

CONCLUSION: The fit of interfaces between 3D-printed Co-Cr abutments and implants was adequate. The RTVs of 3D-printed Co-Cr abutments were not significantly different from those of CNC-milled abutments after 10 minutes of 30-Ncm torque tightening and thermocycling.

PMID:37847843 | DOI:10.11607/jomi.10225

Int J Oral Maxillofac Implants. 2023 Oct 17;38(5):985-995. doi: 10.11607/jomi.10311.

ABSTRACT

PURPOSE: To evaluate the peri-implant outcomes of customized healing abutments (CstHA) placed on dental implants inserted in fresh tooth extraction sockets.

MATERIALS AND METHODS: The study was registered on PROSPERO: CRD42022304320. A systematic search in PubMed, Scopus, and Web of Science was conducted between April 2022 and October 2022 to identify clinical studies involving immediate implant surgery associated with CstHA placement. The Joanna Briggs Institute Critical Appraisal and RoB2 tool were performed for the risk of bias analysis.

RESULTS: A total of 12 studies were included, most of them with low risk of bias. Four studies compared CstHA vs conventional healing abutments (CnvtHA), two compared CstHA vs cover screw and collagen matrix (CMa), and six were clinical case series. For the CstHA vs CnvtHA comparison, favorable results were observed for CstHA considering papilla maintenance and probing depth, yet the mean marginal bone level was statistically similar between CstHA and CnvtHA. CstHA showed advantages when compared to CMa for total bone volume, papilla height, and midfacial mucosa maintenance. Significantly less horizonal bone loss was reported when using CstHA compared with CMa. Horizontal and vertical bone loss was observed in a few (or no) sites in the case series using CstHA.

CONCLUSIONS: CstHA provides favorable peri-implant response because in general it does not result in a significant loss of soft and hard tissues.

PMID:37847840 | DOI:10.11607/jomi.10311

Int J Oral Maxillofac Implants. 2023 Oct 17;38(5):963-975. doi: 10.11607/jomi.10258.

ABSTRACT

PURPOSE: To evaluate the survival rate (primary outcome) and the marginal bone loss (secondary outcome) of the OsseoSpeed EV Implants (Astra Tech Implant System, Dentsply Sirona Implants; hereinafter EV implants) used in a wide range of clinical scenarios and followed up to 8 years in a nonuniversity setting.

MATERIALS AND METHODS: All EV implants consecutively placed from 2013 to 2021 in a private dental clinic were included, and medical and radiologic records were retrospectively investigated. Independent reviewers collected 11 data types as potential influencing variables and measured the mesial and distal marginal bone levels to the nearest 0.5 mm on available radiographs, either panoramic or periapical. Tables of descriptive statistics were made at implant and patient levels. Univariate and multiple Cox regression models were adjusted for clustering effects and determined the hazard ratio (HR) and odds ratio (OR) for each independent variable collected.

RESULTS: The study sample consisted of 597 EV implants and 235 patients. During a mean follow-up of 42.1 ± 23 months (range: 10 to 94 months), 44 implants were lost (7.4%)-34 early (5.7%) and 10 late (1.7%)-in 38 patients (16.1%). The overall survival rate (SR) was 92.6% (CI: 90.5% to 94.7%), and the proportion of patients with all their implants surviving was 83.8% (CI: 79.1% to 88.5%). At the end of the study, the probability of survival of an implant that did not fail early was 98.2% (CI: 97.1% to 99.3%). Implant-level analysis identified two significant variables: implant diameter (HR 0.37, P = .009**) and immediate postextraction placement (HR 2.35, P = .025*). At the patient level, bruxism (OR = 3.29; P = .009**), history of periodontitis (OR = 2.18, P = .030*), and the number of implants placed (OR = 1.43; P = .001**) were found to be statistically significant. After removing dropouts and early failures from a sample of 528 implants, 412 (78%) had a marginal bone loss (MBL) ≤ 0 mm at the end of the observation time, and 106 surviving implants (22%) showed a mean MBL of 1.42 ± 1.08 mm (range: 0.25 to 6.75 mm).

CONCLUSIONS: An overall medium-term SR of the EV implants was 92.6%. Four of five EV implants showed a mid-term MBL ≤ 0 mm, and 91.86% of implants completed the observation period with an MBL < 2 mm. Thus, the EV implant system was shown to be a valid alternative for routine use in a nonuniversity setting. Clinicians should remember that there is no 100% implant survival in everyday practice and that bruxism, periodontitis, narrow-diameter implants, and immediate placement are risk factors for a higher failure rate.

PMID:37847838 | DOI:10.11607/jomi.10258

Int J Oral Maxillofac Implants. 2023 Oct 17;38(5):943-953. doi: 10.11607/jomi.10276.

ABSTRACT

PURPOSE: To evaluate the bone level changes in a new implant design (fully tapered with platform switching) with the one-abutment one-time protocol after 1 year of loading.

MATERIALS AND METHODS: Thirty patients received 1 or 2 implants (6-, 8-, or 10-mm length and 3.5-, 3.75-, or 4.5-mm diameter, bone-level design) to replace one or multiple edentulous sites. Only the mesial implant was assessed. Radiographic, clinical, and esthetic results and the survival and success rates were evaluated 1 year after final loading.

RESULTS: At 1 year, no peri-implant bone loss was seen in any of the cases. Mean marginal crestal bone loss between surgery and crown placement was 0.19 ± 0.17 mm (P < .0001). Between surgery and the 1-year follow-up, the mean marginal crestal bone loss was 0.25 ± 0.24 mm (P < .0001). The difference in the modified Plaque Index between 1 year of follow-up and crown placement was significant for in the mesial (0.33 ± 0.54 mm; P = .003) and distal surfaces (0.5 ± 0.73 mm; P = .001). The probing pocket depth was statistically significantly deeper at 1 year than at crown placement at the mesial and distal aspects (average depth = 0.75 mm; P < .0005). No statistically significant differences were found for any other clinical or esthetic parameters. The overall survival and success rates after 1 year were 100%.

CONCLUSIONS: The fully tapered, deep-thread, platform-switched implant design placed with the one-abutment one-time protocol demonstrated minimal marginal crestal bone loss and crestal bone stability at 1 year of follow-up.

PMID:37847836 | DOI:10.11607/jomi.10276

Int J Oral Maxillofac Implants. 2023 Oct 17;38(5):923-932. doi: 10.11607/jomi.9822.

ABSTRACT

PURPOSE: To compare bone substitutes composed of glycated collagen with synthetic micro-sized (1 to 10 μm) hydroxyapatite (OB) vs non-cross-linked collagen matrix with large-particle (250 to 1,000 μm) bovine-derived hydroxyapatite (BOC).

MATERIALS AND METHODS: The P1 to P4 premolars were bilaterally extracted from the mandibles of 19 Beagle dogs. After 21 days, osteotomies were created in each dog that received OB or BOC and were covered with a collagen membrane or were left untreated. The animals were randomly divided into three groups based on sacrifice time (4, 12, or 24 weeks). The right and left hemimandibles were trimmed to facilitate imaging and histology, and all tissues were placed in 10% neutral-buffered formalin. Microcomputed tomography (MicroCT 40 Scanner, Scanco) was used to analyze bone sections. Bone volume, residual material volume, and bone mineral density were determined for each treatment site (OB and BOC) based on a volume of interest that encompassed the original defect. Additionally, blinded histopathologic assessment (based on the ISO 10993-6 scoring system) and histomorphometry were performed on sections ground to < 100 μm thick and stained with Stevenel’s blue.

RESULTS: No clinical side effects were noted. No statistical differences were observed for OB vs BOC regarding the mineral volume percentage. Compared to OB, BOC had significantly higher mean mineralization densities at 12 weeks (P < .01), but this difference did not extend to 24 weeks. For residual grafting material, bone maturation, alveolar ridge restoration, and inflammatory response, OB showed a residual amount of bone graft and no statistical differences compared to BOC.

CONCLUSION: Both OB and BOC represent valid treatment options for critically sized bone defects. Both bone fillers outperformed the sham-operated, ungrafted (empty) control, demonstrating statistically improved bone growth and ridge restoration.

PMID:37847834 | DOI:10.11607/jomi.9822