Evaluation of the efficacy of salmon calcitonin nasal spray on bone healing following open reduction and internal fixation of mandibular fractures — A randomized controlled trial

The objective of this study was to assess the efficacy of calcitonin spray on bone healing following open reduction internal fixation (ORIF) of mandibular fractures. Fourteen patients were subdivided into a study group and a control group. A standardized surgical protocol for ORIF was followed. Postoperatively, salmon calcitonin nasal spray was administered to only the study group. The outcome parameters assessed were serum osteocalcin, pain, and radiographic bone healing. Serum osteocalcin was assessed pre- and postoperatively. Postoperative pain was documented using a visual analogue scale (VAS) on the 7th, 14th, 23rd, and 30th days. An orthopantomogram was used to score fracture healing at four time intervals, as follows: 1 — absence of callus; 2 — presence of minimal callus; 3 — considerable callus; and 4 — complete fusion of fracture. Pain scores were lower for the study group, with no pain from the fifth day, while the control group produced a mean score for day 5 of 2.43 ± 0.98 (p = 0.001). Mean postoperative serum osteocalcin levels were higher for the study group (67.82 ± 8.89) compared with the control group (57.69 ± 6.22; p = 0.029). Bone healing at 12 weeks postoperatively was level 4 for 28.6% of patients in the study group and level 3 for 71.4%. In comparison, 85.7% in the control group demonstrated level 3 healing, while 14.3% remained at level 2 (p = 0.462). Within the limitations of the study, it can be concluded that intranasal salmon calcitonin spray reduces postoperative pain and facilitates fracture healing, although its economic efficiency is still to be proven.     

Biomechanical evaluation of caudally and buccally screwed customised reconstruction plates for lateral segmental defects of mandible

The aim of this study was to compare locking reconstruction plates with caudobuccally screwed custom mandibular reconstruction plates in bridging lateral mandibular segmental defects. The in vitro study was conducted on 13 polyurethane mandibles. A total of 7 mandibles with lateral segmental defects were bridged with locking reconstruction plates in group I, 6 mandibles with the same standard defect were bridged with caudobuccally screwed customised reconstruction plates in group II. Mean yield displacement, yield load, and displacement at 80 N (Newtons), 100 N, 200 N, 300 N loading were compared among the 2 groups. The mean (SD) displacement for Group I was 11.27 (3.6) mm, Group II was 21.08 (2.5) mm. Group II had significantly greater (p=0.0001) displacement when compared with Group I. The mean (SD) force before failure for Group I was 638.4 N (127.2), Group II was 1398. 3 N (162.7). Group II withstood significantly greater force than Group I (p=0.0001). The study reveals that the caudobuccally screwed custom reconstruction plates can significantly enhance yield load as preserving the preoperative shape of the face and mandible.     

Finite element contact analysis as a critical technique in dental biomechanics: A review

PurposeNonlinear finite element contact analysis is used to mathematically estimate stress and strain in a time- and status-dependent mechanical model. However, the benefits and limitations of this method have not been thoroughly examined.Study selectionThe current review summarizes the utility of contact analysis in characterizing individual stressors: (1) tooth-to-tooth contact, (2) restorative interface, and (3) bone–implant integration.ResultsOpposing tooth contact, friction, and sliding phenomena were simulated to estimate stress distribution and assess the failure risk for tooth enamel, composite, and ceramic restorations. Mechanical tests such as the flexural tests were simulated with the contact analysis to determine the rationale underlying experimental findings. The tooth–restoration complex was modeled with interface contact elements that simulate imperfect bonding, and the normal and tangential stresses were calculated to predict failure progression. Previous studies have used a friction coefficient to represent osseointegration adjacent to dental implants, but the relationship between interface friction and the bone quality is unknown. An understanding of the local stress and strain may better predict loss of osseointegration, however, the effective stress as a critical contributor to bone degradation and formation has not been established.ConclusionsContact analysis provides numerous benefits for dental and oral health sciences, however, a fundamental understanding and improved methodology are necessary.     

Fetuin-A to adiponectin ratio is an independent indicator of subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes mellitus

AimsThe purpose of this research was to explore the associations of fetuin-A, adiponectin, and fetuin-A/adiponectin ratio (F/A ratio) with subclinical atherosclerosis as evaluated by carotid intima-media thickness (CIMT) in cases with newly diagnosed type 2 diabetes mellitus (T2DM).MethodsA total of 283 newly diagnosed T2DM patients were enrolled in this study. Serum fetuin-A and adiponectin levels were determined with an ELISA method. Other clinical and biochemical parameters were also collected.ResultsSignificant linear increases in waist-to-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure, homoeostasis model assessment of insulin resistance, C-reactive protein (CRP) and F/A ratio, and a significant linear decrease in adiponectin with increasing tertiles of CIMT were observed (P for trends <0.05). However, no significant correlation between fetuin-A and CIMT was detected (P > 0.05). In multivariate logistic regression models, WHR, SBP and F/A ratio were independently correlated with higher CIMT. Receiver operating characteristic curve analysis indicated that F/A ratio had a better predictive power for higher CIMT than adiponectin and fetuin-A, with an area under the curve of 0.802, 0.713 and 0.646, respectively.ConclusionF/A ratio is an independent indicator of subclinical atherosclerosis in patients with newly diagnosed T2DM.     

Clinical,volumetric and densitometric evaluation of tissue engineered constructs for secondary alveolar cleft reconstruction: A randomized clinical trial

The objective of this study was to assess the efficacy of tissue engineered (TE) constructs compared to the standard autogenous anterior iliac crest (AIC) bone graft in secondary maxillary alveolar cleft reconstruction.This clinical trial was registered on (clinical trials.gov); the trial registry number is: NCT03563495. Patients with unilateral alveolar clefts were allocated on the basis of simple randomization. Selected patients were randomly divided into two equal groups: the AIC group (control) received autogenous particulate bone graft from anterior iliac crest, whereas the TE group received tissue engineered construct. Assessment included the newly formed bone volume and density at the grafted cleft sites, which were measured immediately, 6 and 12 months postoperatively on axial computed tomograms.The study population included 10 patients; each group comprised 5 patients. There was no statistically significant difference between the 2 groups regarding the mean volume of the newly formed bone (p = 0.91 at 6 months, p = 0.994 at 1 year) and the mean density of the newly formed bone (p = 0.364 at 6 months, p = 0.073 at 1 year). However, there was a significant increase of TE graft density from 6 months to 1 year (p = 0.048).Within the limitations of the study it seems that the tissue engineered construct (collagen/osteogenically differentiated bone marrow−derived mesenchymal stem cells) might be an alternative to autogenous bone for unilateral secondary alveolar cleftgrafting.     

Protection of an intraoral surgical wound with a new dressing: a randomised controlled clinical trial

Operations that involve the maxillofacial region often require intraoral incisions, and contamination of these wounds is common as a result of the presence of saliva, plaque, and food debris. Postoperative infection is therefore common. The aim of the study was to evaluate the clinical efficacy of an intraoral dressing material, Reso-Pac®, in improving postoperative comfort for patients and its effect on wound healing. One hundred patients who required removal of impacted mandibular third molars were recruited, and were randomised into two groups (50 in each). A standardised surgical technique was used for removal of the impacted teeth, and wounds were closed with sutures. Postoperatively, the study group was given Reso-Pac® dressing while the control group was not. Postoperative pain was measured using a visual analogue scale (VAS). Wound healing was assessed with the help of Landry’s scale, and we also measured thermal sensitivity. Data were analysed using the paired t test. The results in the study group were significantly better than those in the control group (p < 0.001). Reso-Pac® promoted wound healing and improved patients’ comfort during the postoperative phase.