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Boot M, Winters R. Managing massive palatial defect secondary to palatoplasty failures: an in-depth analysis. Curr Opin Otolaryngol Head Neck Surg 2024; 32:269-277. [PMID: 38393699 DOI: 10.1097/moo.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
PURPOSE OF REVIEW Massive palatal defects resulting from palatoplasty failures arising from cleft palate repair complications present ongoing challenges in clinical practice. The purpose of this review is to provide up-to-date insights into aetiology, risk factors, surgical techniques, and adjunctive therapies, aiming to enhance the understanding of such complex cases, and optimize patient outcomes. RECENT FINDINGS Primary palatoplasty has fistula recurrence rates ranging from 2.4% to 55%. Factors such as cleft width, surgical repair method, and patient characteristics, influence the likelihood of failure. Classifications such as the Pakistan Comprehensive Classification and Richardson's criteria aid in assessing defects. Surgical options range from local flaps and revision palatoplasty to regional flaps (e.g., buccinator myomucosal, facial artery-based flaps, tongue flaps, nasal septal flaps) to free microvascular flaps. Alternative approaches include obturator prostheses, and acellular dermal matrix has been used as an adjuvant to multiple repair techniques. Hyperbaric oxygen therapy has emerged as an adjunctive therapy to enhance tissue healing. SUMMARY This comprehensive review underscores the intricate challenges associated with massive palatal defects resulting from palatoplasty failures. The diverse range of surgical and nonsurgical options emphasizes the importance of patient-centric, individualized approaches. Practitioners, armed with evidence-based insights, can navigate these complexities, offering tailored interventions for improved patient outcomes.
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Affiliation(s)
- Madison Boot
- John Hunter Hospital Department of Otolaryngology - Head & Neck Surgery, New Lambton Heights, NSW, Australia
| | - Ryan Winters
- John Hunter Hospital Department of Otolaryngology - Head & Neck Surgery, New Lambton Heights, NSW, Australia
- Tulane University Department of Otolaryngology - Head & Neck Surgery
- Tulane University Division of Plastic & Reconstructive Surgery, New Orleans, Louisiana, USA
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Gabhane SS, Pande MS, Thosar NR, Yeluri R, Khubchandani M, Pankey N. Prosthetic Management of Congenital Palatal Defect in a Neonate: A Case Report on Obturator Efficacy. Cureus 2024; 16:e63708. [PMID: 39099894 PMCID: PMC11294489 DOI: 10.7759/cureus.63708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 07/02/2024] [Indexed: 08/06/2024] Open
Abstract
Neonates with cleft palate exhibit a malformed maxillary arch since birth. Newborns with various types of clefts exhibit multiple issues, primarily associated with their feeding habits. Feeding these children is crucial, as evidence indicates that newborns with this congenital deformity exhibit a slower growth rate compared to those without this condition. To mitigate these challenges, the conventional line of treatment for these children is obturator therapy to facilitate sucking or feeding followed by various surgical procedures. The following case report describes a 2-day-old girl, who reported with her parents to the Department of Pediatric Dentistry, to seek treatment for congenital cleft present in her palate as it was interfering with her feeding habits. A feeding appliance was made with a direct technique to help the parents improve feeding habits. It also regulates milk flow by sealing the area separating the oral and nasal cavities. This feeding appliance is placed over the child's hard palate, creating a contact point that facilitates milk expression from the mother's mammary gland and making it easier for the neonate to compress the nipple. It shortens the time needed for feeding, eases feeding, and lessens nasal regurgitation.
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Affiliation(s)
- Swamini S Gabhane
- Pediatric and Preventive Dentistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Meenal S Pande
- Pediatric and Preventive Dentistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nilima R Thosar
- Pediatric and Preventive Dentistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ramakrishna Yeluri
- Pediatric and Preventive Dentistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Monika Khubchandani
- Pediatric and Preventive Dentistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha Pankey
- Pediatric and Preventive Dentistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Soleymanijadidi P, Moradi M, Hamedirad F, Ghanavati Z, Maleki Dizaj S, Salatin S. Nanocurcumin Release from Self-Cured Acrylic Resins; Effects on Antimicrobial Action and Flexural Strength. Bioengineering (Basel) 2023; 10:bioengineering10050559. [PMID: 37237629 DOI: 10.3390/bioengineering10050559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/29/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
The placement of orthodontic appliances into the oral area can lead to infection, inflammatory and gingival collapse. Using an antimicrobial and anti-inflammatory material in the matrix of orthodontic appliance may help to reduce these issues. This study aimed to assess the release pattern, the antimicrobial action and the flexural strength of self-cured acrylic resins after adding different weight percentages of curcumin nanoparticles (nanocurcumin). In this in-vitro study, 60 acrylic resin samples were divided into five groups (n = 12) based on the weight percentage of curcumin nanoparticles added to the acrylic powder (0 for control, 0.5, 1, 2.5, and 5%). Then, the dissolution apparatus was used for the release assessment of nanocurcumin form the resins. For antimicrobial action assessment, the disk diffusion method was used and a three-point bending test was performed with a speed of 5 mm/min to determine the flexural strength. Data were analyzed using one-way analysis of variance (ANOVA) and Post-Hoc Tukey tests (with p < 0.05 as significant level). The microscopic images showed the homogeny distribution of nanocuricumin in self-cured acrylic resins in varied concentrations. The release pattern showed a two-step release pattern for all concentrations of nanocurcumin. The one-way ANOVA outcomes indicated that adding curcumin nanoparticles to self-cured resin increased the diameter of the inhibition zones for the groups against Streptococcus mutans (S. mutans) significantly (p < 0.0001). Additionally, as the weight percentage of curcumin nanoparticles increased, the flexural strength decreased (p < 0.0001). However, all strength values were higher than the standard value (50 MPa). No significant difference was detected between the control group and the group with 0.5 percent (p = 0.57). Considering the proper release pattern and the potent antimicrobial activity of curcumin nanoparticles, then the preparing self-cured resins containing curcumin nanoparticles can be beneficial for antimicrobial aims without damaging the flexural strength to use in orthodontic removable applications.
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Affiliation(s)
- Parsa Soleymanijadidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Meysam Moradi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Fahimeh Hamedirad
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Zahra Ghanavati
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-4774, Iran
| | - Solmaz Maleki Dizaj
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz 51548-53431, Iran
- Department of Dental Biomaterials, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz 51548-53431, Iran
| | - Sara Salatin
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz 51548-53431, Iran
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Liu Q, Li A, Liu S, Fu Q, Xu Y, Dai J, Li P, Xu S. Cytotoxicity of Biodegradable Zinc and Its Alloys: A Systematic Review. J Funct Biomater 2023; 14:206. [PMID: 37103296 PMCID: PMC10144193 DOI: 10.3390/jfb14040206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/18/2023] [Accepted: 03/27/2023] [Indexed: 04/28/2023] Open
Abstract
Zinc-based biodegradable metals (BMs) have been developed for biomedical implant materials. However, the cytotoxicity of Zn and its alloys has caused controversy. This work aims to investigate whether Zn and its alloys possess cytotoxic effects and the corresponding influence factors. According to the guidelines of the PRISMA statement, an electronic combined hand search was conducted to retrieve articles published in PubMed, Web of Science, and Scopus (2013.1-2023.2) following the PICOS strategy. Eighty-six eligible articles were included. The quality of the included toxicity studies was assessed utilizing the ToxRTool. Among the included articles, extract tests were performed in 83 studies, and direct contact tests were conducted in 18 studies. According to the results of this review, the cytotoxicity of Zn-based BMs is mainly determined by three factors, namely, Zn-based materials, tested cells, and test system. Notably, Zn and its alloys did not exhibit cytotoxic effects under certain test conditions, but significant heterogeneity existed in the implementation of the cytotoxicity evaluation. Furthermore, there is currently a relatively lower quality of current cytotoxicity evaluation in Zn-based BMs owing to the adoption of nonuniform standards. Establishing a standardized in vitro toxicity assessment system for Zn-based BMs is required for future investigations.
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Affiliation(s)
- Qian Liu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Shizhen Liu
- The School of Computing Science, University of Glasgow, Glasgow G12 8RZ, UK
| | - Qingyun Fu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Yichen Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jingtao Dai
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
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Wang D, Han X, Luo F, Thieringer FM, Xu Y, Ou G, Spintzyk S. Adhesive Property of 3D-Printed PEEK Abutments: Effects of Surface Treatment and Temporary Crown Material on Shear Bond Strength. J Funct Biomater 2022; 13:jfb13040288. [PMID: 36547548 PMCID: PMC9786111 DOI: 10.3390/jfb13040288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Three-dimensionally printed polyetheretherketone (PEEK) materials are promising for fabricating customized dental abutments. This study aimed to investigate the adhesive property of a 3D-printed PEEK material. The effects of surface treatment and temporary crown materials on shear bond strength were evaluated. A total of 108 PEEK discs were 3D printed by fused-filament fabrication. Surface treatments, including sandblasting, abrasive paper grinding, and CO2 laser ablation, were applied to the PEEK discs, with the untreated specimens set as the control. Afterward, the surface topographies of each group were investigated by scanning electron microscopy (SEM, n = 1) and roughness measurements (n = 7). After preparing the bonding specimens with three temporary crown materials (Artificial teeth resin (ATR), 3M™ Filtek™ Supreme Flowable Restorative (FR), and Cool Temp NATURAL (CTN)), the shear bond strength was measured (n = 6), and the failure modes were analyzed by microscopy and SEM. The results showed that ATR exhibited a significantly higher shear bond strength compared to FR and CTN (p < 0.01), and the PEEK surfaces treated by sandblasting and abrasive paper grinding showed a statistically higher shear bond strength compared to the control (p < 0.05). For clinical application, the ATR material and subtractive surface treatments are recommended for 3D-printed PEEK abutments.
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Affiliation(s)
- Dingjie Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xingting Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Beijing 100081, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Florian M. Thieringer
- Medical Additive Manufacturing Research Group, Hightech Research Center, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
| | - Yichen Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (Y.X.); (G.O.)
| | - Guomin Ou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (Y.X.); (G.O.)
| | - Sebastian Spintzyk
- ADMiRE Research Center—Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9524 Villach, Austria
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