Intraoperative three-dimensional navigation for surgical treatment of osteoid osteoma in the foot and ankle – A series of 14 cases

BackgroundThe surgical treatment for osteoid osteoma (OO) in the foot and ankle is challenging. It is difficult to locate the lesion and the anatomy is crowded by sensitive structures. The purpose of this study was to describe the outcomes of navigated mini open-intralesional curettage (NMIC) or navigated minimally invasive radiofrequency ablation (NMRFA) in treating these lesions.MethodsAll patients who underwent surgery for OO in the foot and ankle between 2015 and 2020 were included. O-arm navigation was used in All procedures. The choice of NMIC versus NMRFA was made by the surgeon according to the location of the lesion and its proximity to sensitive anatomic structures.ResultsFourteen patients were included. Ten were operated by NMRFA and 4 by NMIC. All patients’ symptoms related to OO resolved following a single procedure. Average AOFAS score increased by 18.7 (P < .001). Three patients had the following complications: pathologic fracture, superficial infection and transient deep peroneal nerve sensory loss.ConclusionNavigated surgical treatment of OO in the foot and ankle is accurate, efficient and safe.     

腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效分析

目的 探讨腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效及对内分泌的影响.方法 选择2011年1月至2015年12月剖宫产瘢痕妊娠患者57例,其中A组32例患者给予超声引导下清宫术治疗,B组25例患者给予腹腔镜下子宫双侧动脉阻断术联合清宫术治疗,比较两组患者出血量、住院时间、月经复潮时间、术后人绒毛膜促性腺激素(hCG)降至正常时间,并发症情况及术前(T0)、术后第1d(T1)、第3d(T2)神经内分泌激素水平.结果 ①B组患者出血量低于A组,住院时间、月经复潮时间短于A组,比较差异有统计学意义(t出血量=31.85,k院时间=9.36,t月经复t潮时间=16.37,均P＜0.05);②B组患者并发症发生率为8.00％,低于A组的15.63％,比较差异有统计学意义(x2=9.35,P＜0.05);③B组T1、T2血清COR、β-EP、GLU水平低于A组(CORF交互=17.67,β-EPF交互=132.36,6LUF交互=155.38,均P＜0.05).结论 腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠微创优势明显,安全性高,对内分泌影响较轻.     

Prevalence of Apical Periodontitis and Conventional Nonsurgical Root Canal Treatment in General Adult Population: An Updated Systematic Review and Meta-analysis of Cross-sectional Studies Published between 2012 and 2020

IntroductionThis study aimed to summarize data on apical periodontitis (AP) and nonsurgical root canal treatment (NSRCT) prevalence and risk factors related to age, gender, and quality of restorative and endodontic treatment in the general population from cross-sectional studies published between 2012 and 2020.MethodsAn electronic search was performed in the following databases: Web of Science, Scopus, and PubMed. The conducted literature search covered studies published between 2012 and 2020, without restrictions on language. The STROBE and NOS tools were used for quality assessment of the included studies.ResultsSixteen articles were included in the review. In total, 200,041 teeth were examined. On average, 6.3% of teeth had AP, and 7.4% had NSRCT. Forty-one percent of RCT teeth had AP, and 3.5% of untreated teeth had AP. Female patients were less prone to AP in endodontically treated teeth only, compared with male patients (P < .001). Variable stratification of age subgroups among included studies prevented us from conducting a meta-analysis. An increase in AP frequency was found in teeth with inadequate restorative and endodontic treatment (P < .001 and P < .001, respectively). Because of high heterogeneity, these results should be taken with caution.ConclusionsThere is an increased AP prevalence in the adult general population compared with data from 2012 (6.3% versus 5.4%) in both endodontically treated (41.3% versus 35.9%) and untreated teeth (3.5% versus 2.1%). In addition, AP developed less frequently in female patients with endodontically treated teeth and in teeth with inadequate compared with adequate restorative and endodontic treatment.     

Periapical radiographic techniques during endodontic diagnosis and treatment

The objective of this article is to describe various radiographic projections which can be used during endodontic therapy. Changes to the angulation of the X-ray beam in relation to the teeth and film can help diagnosis and treatment by producing images which provide additional information not always visible on radiographs taken with standard angulations. For example, changes in angulation can be useful to determine the number and curvature of roots and canals, to identify superimposed roots and to distinguish between anatomical landmarks and apical pathology. Although use of such techniques increases the diagnostic yield of films, it must be appreciated that such views lead to images that are less distinct because of inherent image distortion. Nevertheless, use of the various techniques during endodontics can provide substantial benefit for clinicians in their daily practice.     

老年人根管治疗疗效的相关因素

目的:研究老年人根管治疗疗效及其影响因素.方法:对56例65岁以上老年人,根管治疗后2年以上的126颗牙齿进行检查,按治疗后年限分3组:2～3年组,4～5年组,6年以上组.应用根尖周指数(Periodicalindex)评定X线片和综合临床检查,对其治疗进行评价.结果:老年人根管治疗成功率为72.2%;三组间根管治疗成功率差异无显著性.恰填根管治疗的成功率(82.2%)比欠填和超填的成功率(47.2%)要高;恰填病例中,冠方修复体质量好的患牙比质量差的患牙根尖周炎发病率低(25.7%和58.4%);去除欠填和超填病例后,桩冠修复患牙的根管治疗成功率为58.8%,而未做桩冠修复的患牙成功率为87.5%.结论:根充质量、冠方修复体质量、桩冠修复是影响老年人根管治疗疗效的主要因素.     

根管治疗术远期疗效的影响因素

根管治疗术（root canal therapy,RCT）是治疗牙髓病、根尖周病的主要方法.影响根管治疗术远期疗效的因素较多,而RCT前根尖周状态和根充位置是两大主要因素.     

宫腔镜辅助下分段诊刮术与单纯分段诊刮术诊断子宫内膜癌的比较

为比较宫腔镜辅助下分段诊刮术与单纯分段诊刮术在诊断子宫内膜癌中的临床意义 ,将经手术后病理证实的子宫内膜癌患者分为 2组 :宫腔镜辅助下分段诊刮组 (A组 ) 3 1例 ;单纯分段诊刮组 (B组 ) 3 9例。比较 2组术前诊断子宫内膜癌的准确性及开腹手术时腹水细胞学的检查结果。 2组患者的年龄、临床病理分期、病理分级及组织学类型差异无显著性。A组诊断宫颈受累的准确率为 96.77% (3 0 / 3 1 ) ,假阳性率为 3 .2 3 % (1 / 3 1 ) ;B组分别为 79.49%(3 1 / 3 9) ,1 5 .3 8% (6/ 3 9)。 2组准确率比较 ,差异有显著性 (P <0 .0 5 )。取腹水或腹腔冲洗液行细胞学检查。A组细胞学阳性率为 6.45 % (2 / 3 1 ) ,B组为 1 4.2 9% (3 / 2 1 ) ,2组间差异无显著性 (P >0 .0 5 )。提示 :宫腔镜辅助下分段诊刮术可提高术前诊断子宫内膜癌的准确性 ,从而避免不必要地扩大手术范围 ,而且不增加腹腔内播散的危险。     

晚期产后出血问题的探讨(附52例临床分析)

本文对52例晚期产后出血病例进行了分析,结果认为晚期产后出血与感染密切有关;在处理上诊断性刮宫仍是重要措施之一,并提出对存在感染因素的产妇,术前、产前应用抗菌素预防感染.在剖宫产过程中,可用含抗生素的溶液冲洗宫腔,以达到预防感染的目的。     

Periapical actinomycosis: report of a case and review of the literature

Abstract This case of periapical actinomycosis presented the clinical picture of chronic periapical inflammation. The diagnosis was based on the histological examination of the periapical lesions suggesting the necessity for routine histological examination. Although root canals provide a primary port of entry the Actinomyces organisms into the periapical tissue, periapical actinomycosis, is considered extremely rare. This may be due to the omission of routine histological examination of periapical lesions and the clinical behavior of the disease. The large number of cases reported during the last decade indicates that periapical actinomycosis is more frequent than what it is believed and this is important in the daily dental practice.