Characteristics of Suture Materials Used in Oral Surgery: Systematic Review

BackgroundThe aim of this review was to evaluate the most used suture materials with regards to their inflammatory response, their bacterial adhesion, and their physical properties when used to close oral wounds.MethodsFour databases (PubMed, Scopus, Dentistry & Oral Sciences, and OVID) were searched to retrieve relevant studies from January 1, 2000, to January 31, 2020.ResultsOut of the 269 articles, only 13 studies were selected as they were relevant and met the systematic review's protocol. These studies showed that almost all suture materials studies (catgut, polyglycolic acid [PGA] sutures, nylon, expanded polytetrafluoroethylene, and silk sutures) caused bacterial adherence and tissue reaction. In nylon and chromic catgut, the number of bacteria accumulated was lowest. Silk and nylon were found to be more impacted than catgut and PGA in terms of physical characteristics such as tensile strength. PGA, on the other hand, was said to be the most susceptible to knot unwinding.ConclusionsFollowing an oral surgical operation, all sutures revealed varied degrees of irritation and microbial accumulation. Nonresorbable monofilament synthetic sutures, however, exhibited less tissue response and less microbial accumulation.     

Squamous cell carcinoma of the oral cavity: a case series analysis of clinical presentation and histological grading of 1,425 cases from Iraq

Peoples in Iraq face a mixture of health hazards associated with poverty. Oral cancer is a major public health issue worldwide; it remains a highly lethal and disfiguring disease. It is primarily a disease of epithelial origin. A total of 1,425 cases of histologically diagnosed squamous cell carcinoma collected from the main centers of pathology in Iraq were analyzed according to age, sex, site, patient complaints at the time of presentation, and histological grading. Patients at their fifth decade of life were the most commonly affected with a male-to-female ratio of 2:1. The lower lip was the most commonly affected site followed by the tongue. The most common clinical complain was ulceration and swelling. More than 70% of the cases were well-differentiated squamous cell carcinoma. Oral cancer is increasingly seen as a major health problem—In line with general trend in the region, the need for interprofessional health care delivery approaches for reducing oral cancer mortality and improving patient’s quality of life.     

Prevalence of Anosmia or Ageusia in Patients With COVID-19 Among United Arab Emirates Population

ObjectiveThe aim of this research was to determine the relationship and prevalence of taste and smell dysfunction in patients with COVID-19 in the United Arab Emirates (UAE) population.MethodsEnrolled participants were interviewed online via a phone call after obtaining their informed consent. Quantification of smell, taste, and other sensations before, during, and after COVID-19 infection was correlated with the severity of COVID-19 symptoms.ResultsA total of 500 patients with (mild–severe) COVID-19 completed the survey. A total of 26.4% were asymptomatic, and 21.4% were classified as paucisymptomatic with less severe symptoms. Almost equal proportions of the studied population experienced extreme taste sensation reductions (43%) and loss of smell sensation (44%). Statistically significant drastic decreases in smell and taste senses were seen among younger individuals. The magnitude of reduction in both sense changes increased steeply from the asymptomatic group to the paucisymptomatic group to the symptomatic group.ConclusionsSudden anosmia or ageusia need to be recognised for early detection of COVID-19 infection to identify otherwise hidden carriers, thus favoring an early isolation strategy that will restrict the spread of the disease.     

Characterisation of a Bioactive SiO2-CaO-CaF2-Na2O Glass Used in Composites

ObjectivesTo characterise the ion release, pH changes and apatite formation of a phosphate free bioactive glass.MethodsA SiO₂-CaO-CaF₂-Na₂O glass was synthesized by a melt route with a composition close to the reactive glass in the commercial Cention N® composite. The glass was characterized after immersion in three media: Artificial Saliva pH4 (AS4) Artificial Saliva pH7 (AS7) and in a high phosphate artificial saliva at pH6.5 (AS6.5). The pH and fluoride release were measured using a pH meter and an ion selective electrode. The concentration of Ca, P, Na and Si were measured by ICP-OES. The glass powders after immersion were characterized by FTIR, X-ray powder diffraction and ¹⁹F MAS-NMR.ResultsThe glass increased the pH in all three media. Fluoride was detected in all three media but was much higher in AS 6.5. Calcium fluoride formed in AS4 with a small amount of fluorapatite at long immersion times. Fluorapatite and calcium fluoride formed in AS7, whilst in AS6.5 fluorapatite formed.The ion concentrations in solution after immersion reflected the glass composition and the immersion media with fluorapatite being favoured by higher pHs and phosphate contents in the media.SignificanceThe results demonstrated the ability of the glass to increase the pH and to form fluorapatite in phosphate containing media. This may explain the low incidence of secondary caries found in the commercial composite. Unlike the commercial composite evidence was found for the precipitation of fluorite, which will act to reduce the release of fluoride for preventing secondary caries.     

In vivo structural and cellular remodeling of engineered bone–ligament–bone constructs used for anterior cruciate ligament reconstruction in sheep

ABSTRACT

Anterior cruciate ligament (ACL) ruptures rank among the most prevalent and costly sports-related injuries. Current tendon grafts used for ACL reconstruction are limited by suboptimal biomechanical properties. We have addressed these issues by engineering multiphasic bone–ligament–bone (BLB) constructs that develop structural and mechanical properties similar to native ACL. The purpose of this study was to examine the acute remodeling process that occurs as the BLB grafts advance toward the adult ligament phenotype in vivo. Thus, we implanted BLB constructs fabricated from male cells into female host sheep and allowed 3, 7, 14, or 28 days (n = 4 at each time point) for recovery. To address whether or not graft-derived cells were even necessary, a subset of BLB constructs (n = 3) were acellularized, implanted, and allowed 28 days for recovery. At each recovery time point, the following histological analyses were performed: picrosirius red staining to assess collagen alignment and immunohistochemistry to assess both graft development and host immune response. Polymerase chain reaction (PCR) analysis, performed on every explanted BLB, was used to detect the presence of graft-derived male cells remaining in the constructs and/or migration into surrounding host tissue. The analysis of the PCR and histology samples revealed a rapid migration of host-derived macrophages and neutrophils into the graft at 3 days, followed by increased collagen density and alignment, vascularization, innervation, and near complete repopulation of the graft with host cells within 28 days. This study provides a greater understanding of the processes of ligament regeneration in our BLB constructs as they remodel toward the adult ligament phenotype.     

Molecular events on tooth socket healing in diabetic rabbits

Healing of extraction sockets involves complex cellular events such as repair and regeneration of tissue. These events are precisely controlled and regulated by specific signalling molecules such as transforming growth factor beta (TGF-β), vascular endothelial growth factor (VEGF), bone morphogenetic protein (BMP), and insulin-like growth factor (IGF), which are well-conserved proteins involved in the initial response to injury and repair in soft and hard tissues. We studied 48 rabbits, which were divided into 3 groups of 16 each: the control group, the untreated diabetic group, and the insulin-treated diabetic group. The lower incisor of each rabbit was extracted and, after 2, 10, 20, and 30 days of healing, the expression of TGFβ-3, VEGF, IGF-1R, and BMP-4 in the sockets was measured immunohistochemically. Rabbits with untreated diabetes expressed less TGFβ-3 than the other groups throughout the healing periods, whereas IGF-1R expression was higher than that in the other groups. This increase in IGF-1R expression was responsible for increasing the healing time in rabbits in the untreated group. The healing of bone in diabetic rabbits that were not treated with insulin was prolonged because of a delay in the onset of cell proliferation and osteoblast differentiation, and the insulin treatment had a direct effect on the expression of TGFβ-3 and IGF-1R, which accelerated healing of the socket.     

An Australian comparison of specialist care of acute myocardial infarction.

OBJECTIVE: To determine whether patients hospitalized with acute myocardial infarction (AMI) in an Australian setting receive better pharmacological care if managed by cardiologists than by non-cardiologists. DESIGN: Retrospective chart review of patients hospitalized between 1 January 1997 and 30 June 1998, undertaken by abstractors blind to study objectives. SETTING: One tertiary and two community hospitals in south-east Queensland, Australia, in which all patients admitted with AMI were cared for by cardiologists and general physicians, respectively. STUDY PARTICIPANTS: Two cohorts of consecutive patients satisfying diagnostic criteria for AMI: 184 in the tertiary hospital and 207 in the community hospitals. MAIN OUTCOME MEASURES: Frequency of use, in highly eligible patients, of thrombolysis, beta-blockers, aspirin, angiotensin-converting enzyme (ACE) inhibitors, lipid-lowering agents, nitrates, and calcium antagonists. Cohorts were compared for differences in prognostic factors or illness severity. RESULTS: In community hospital patients, there was greater use of thrombolysis [100% versus 83% in the tertiary hospital; difference 17%, 95% confidence interval (CI) 11-26%; P < 0.001] and of ACE inhibitors (84% versus 66%; difference 18%, 95% CI 3-34%; P = 0.02), and lower median length of stay (6.0 days versus 7.0 days; P = 0.001) compared with tertiary hospital patients. Frequency of use of other drugs, and adjusted rates of death and re-infarction were the same for both cohorts. CONCLUSIONS: With respect to pharmacological management of patients hospitalized with AMI, cardiologists and general physicians appear to provide care of similar quality and achieve equivalent outcomes. Further studies are required to confirm the generalizability of these results to Australian practice as a whole.