Surgical Treatment of Anterior Sinus Wall Fracture Due to Sports Accident

Impact on peri-implant connective tissue of laser treated versus traditional healing abutments: a human clinical trials

BACKGROUND

Dental implant is the principal treatment for edentulism and the healthiness of the peri-implant tissue has a pivotal role for its longterm success. In addition, it has been shown that also the topography of the healing abutment can influence the outcome of the restoration. The objective of this human clinical trial was to assess the impact of a novel laser-treated healing abutment on peri-implant connective tissue and extracellular matrix proteins compared to the conventional machined surface, which served as the control group.

METHODS

During second surgical stage a customized healing abutment were inserted on 30 single dental implants. Healing abutments were realized with two alternated different surface (two side laser-treated surfaces and two side machined surfaces) in order to be considered both as test and control on the same implant and reduce positioning bias. Following the soft tissue healing period (30 ± 7 days) a 5 mm circular biopsy was retrieved. Immuno-histochemical and quantitative real-time PCR (qPCR) analyses were performed on Collagen, Tenascin C, Fibrillin I, Metalloproteinases (MMPs) and their inhibitor (TIMPs). 15 were processed for qPCR, while the other 15 were processed for immunohistochemical analysis. Paired t-test between the two groups were performed. A value of p < 0.05 was considered statistically significant.

RESULTS

Results revealed that the connective tissue facing the laser-treated surface expressed statistically significant lower amount of MMPs (p < 0.05) and higher level of TIMPs 3 (p < 0.05), compared to the tissue surrounding the machined implant, which, in turn expressed also altered level of extracellular matrix protein (Tenascin C, Fibrillin I (p < 0.05)) and Collagen V, that are known to be altered also in peri-implantitis.

CONCLUSIONS

In conclusion, the laser-treated surface holds promise in positively influencing wound healing of peri-implant connective tissue. Results demonstrated that topographic nature of the healing abutments can positively influence mucosal wound healing and molecular expression. Previous studies have been demonstrated how laser treatment can rightly influence integrity and functionality of the gingiva epithelium and cell adhesion. Regarding connective tissue different molecular expression demonstrated a different inflammatory pattern between laser treated or machined surfaces where laser treated showed better response. Targeted interventions and preventive measures on peri- implant topography could effectively minimize the risk of peri-implant diseases contributing to the long-term success and durability of restoration. However, new studies are mandatory to better understand this phenomenon and the role of this surface in the peri-implantitis process.  TRIAL REGISTRATION: This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970 ). Registered 06/03/2023, retrospectively registered.

Utility of esthetic eyebrow incision in the management of anterior table fracture of frontal bone: our experience

PURPOSE

The purpose of this study was to provide detailed information about the eyebrow approach for the reduction of the frontal bone and its esthetic results with the help of clinical data available. Thus, suggesting this technique is minimally invasive and highly esthetic for frontal bone management.

METHOD

In this series, 96 cases were studied, and results were based on variable clinical criteria and satisfaction of patients. All the surgeries were performed through eyebrow incision for the management of fractures. Intraoperatively, minimal tissue dissection, less invasion with reduced operating time was observed.

RESULTS

Postoperatively, the eyebrow approach leads to its normal contour and esthetics. No complications related to the procedure were seen with partially recoverable neuropraxia and speedy recovery. This makes it an important technique to consider in carefully selected patients.

CONCLUSION

In craniofacial trauma, frequently involved site is the frontal bone, and its treatment should be completed more esthetically. Eyebrow approach is a good alternative to other surgical approaches, and it is a minimally invasive technique and thus should be practiced for esthetic management of frontal bone fractures.

Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre

Objective

Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons.

Methods

Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010-2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Variables of the study included patients' demographics, mechanism of injury, incidence of cerebrospinal fluid (CSF) leakage, types of associated injuries, imaging findings and operative techniques.

Results

Three-hundred eighty two patients were eligible to be screened in our study and represented the sample size under investigations in the following sections, 206 (53.9%) of patients were treated conservatively while 176 patients (46.1%) were identified as having an indication for surgical intervention. Eighty-four percent of patients were males. The mean age was 36.2±9.4 years (14-86 years). Depressed skull fracture was commonly associated injury (17.61%). Leakage of CSF was found in 32.95% of patients.

Conclusion

Frontal sinus fracture is not an easy scenario. It harbors many proportions and deliver many varieties in which, deep understanding of anatomy, naso-frontal outflow tract status, CSF leakage and neurological injury are of important points in decision. Our institutional algorithm provide rapid, accessible and applicable treatment protocol for resident and young neurosurgeons which minimizes consultations of other specialties.

The European Association for Sports Dentistry, Academy for Sports Dentistry, European College of Sports and Exercise Physicians consensus statement on sports dentistry integration in sports medicine

Sports medicine has a multidisciplinary character which allows different medical specialties to investigate the prevention, etiology, and treatment of athletes' diseases. This leads to a decreased risk of injury and a faster return to play as well as an improvement in the overall health and well-being of athletes of any level and in all sports around the world. The oral health of athletes is now the subject of great attention internationally because of the increased prevalence and incidence of health issues such as dental caries and erosion, periodontal disease, defective occlusion, temporomandibular joint disorders, and orofacial injuries. Scientific evidence and research on these issues have also intensified over recent years. The best way to maintain player's health and performance is to include oral health in sports medicine with physicians and dentists working closely together at the individual level as well as with the cooperation between local and international sports medicine and dentistry associations. The European Association for Sports Dentistry, the Academy for Sports Dentistry, and the European College of Sports and Exercise Physicians are leading the way and have worked together to develop a consensus statement describing the main pillars of oral health integration into sports medicine based on the most common oral diseases found in athletes and linked to exercise, sports, and performance.