Corneal inlays and onlays represent a means of providing patients with permanent refractive error correction. As an alternative to conventional spectacles and contact lens, these techniques are less invasive compared ...Corneal inlays and onlays represent a means of providing patients with permanent refractive error correction. As an alternative to conventional spectacles and contact lens, these techniques are less invasive compared with laser-based refractive surgery and are reversible. In this review, we provide a brief overview of the anatomic microstructure of the human cornea, indicating the primary physiological function for each component. Next, the wide range of biomaterials used as corneal inlays and onlays are considered, from synthetic polymers to biological components derived from the extracellular matrix. The limitations and challenges associated with the most common materials are discussed as is the need to improve their properties to achieve long-term, complication-free intraocular implantation. Finally, the prospect of applying tissue engineering strategies is noted for its potential to generate autologous corneal tissue that could be implanted as the optimal inlay or onlay materials.展开更多
Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive tec...Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive techniques.Methods:From January 2016 to April 2018,17 symptomatic patients with previously failed minimally invasive procedures were enrolled in the study.The diagnosis of urethral stricture was confirmed based on a combination of patients’symptoms,post-void residual urine,video-urodynamics,and cystoscopy.Urethroplasty with lower lip mucosal graft was performed using the modified laterally extended dissection.Patients were evaluated pre-operatively and 12-month post-operatively with the American Urological Association symptom score,post-void residual urine,and maximum flow rate.Results:Despite the previously failed minimally invasive procedures,urethroplasty with lower lip buccal graft and laterally extended dissection resulted in favorable outcomes(success rateZ94%).The meanstandard deviation of American urological association symptom score improved from pre-operative levels at the 12-month post-operative follow-up(25.823.97 to 10.885.57);so did postvoid residual urine(71.1274.98 mL to 15.0028.30 mL),and maximum flow rate(7.881.72 mL/s to 25.825.59 mL/s)with all statistically significant(p<0.05).Conclusion:The current study showed that female urethroplasty with buccal graft could be highly successful in experienced hands.An anterior approach could be superior to the posterior one due to higher mechanical support and lower sacculation rate.A laterally extended incision may improve visualization and better graft placement by providing wider working space.The results should be evaluated in the future studies with larger sample size.展开更多
目的评价3D打印白硅钙石(bredigite,BRT)骨支架材料在大鼠Onlay骨移植中的效果。方法通过3D打印技术制备骨BRT支架材料作为实验组,β⁃磷酸三钙(β⁃tricalcium phosphate,β⁃TCP)骨支架材料作为对照组,通过扫描电镜(scanning electron mi...目的评价3D打印白硅钙石(bredigite,BRT)骨支架材料在大鼠Onlay骨移植中的效果。方法通过3D打印技术制备骨BRT支架材料作为实验组,β⁃磷酸三钙(β⁃tricalcium phosphate,β⁃TCP)骨支架材料作为对照组,通过扫描电镜(scanning electron microscopy,SEM)、X射线衍射(X⁃ray diffraction,XRD)、力学测试和体外降解测试实验对其进行表征观察。建立SD大鼠颅骨Onlay骨移植的动物模型,根据移植物的不同,分为自体骨移植组(Auto组)、β⁃TCP组及BRT组。术后12周获取标本行大体观察、micro⁃CT扫描检测分析、组织学HE染色。结果SEM观察显示,BRT有规则的多孔结构,XRD衍射峰较为锐利。与β⁃TCP组(11.29±1.30)MPa相比,BRT支架材料(46.80±3.44)MPa具有更好的力学强度(P<0.001);在体外第35天时,BRT降解率为27.18%±1.41%,并且在降解过程中释放钙、镁、硅离子。micro⁃CT及组织学染色实验结果提示,Auto组有一定程度的骨吸收,β⁃TCP和BRT组均有一定新骨生成。micro⁃CT和组织学定量结果,BRT组新生骨组织占比分别为16.83%±2.11%和19.08%±2.17%,均高于β⁃TCP组(8.48%±1.85%,10.81%±1.33%)(P<0.05)。结论3D打印BRT骨支架材料促进Onlay骨移植中的骨再生。展开更多
目的本研究通过观察超声骨刀和传统球钻在onlay植骨、上颌窦提升、骨劈开手术中的临床应用效果,探讨超声骨刀在种植手术中的优越性及操作要点。方法对需要进行植骨手术的78例患者,分别使用超声骨刀和传统球钻在Onlay植骨、上颌窦提升、...目的本研究通过观察超声骨刀和传统球钻在onlay植骨、上颌窦提升、骨劈开手术中的临床应用效果,探讨超声骨刀在种植手术中的优越性及操作要点。方法对需要进行植骨手术的78例患者,分别使用超声骨刀和传统球钻在Onlay植骨、上颌窦提升、骨劈开等手术中进行切骨操作;超声骨刀组42例,传统球钻组38例。分别于术后6 h、24 h、3 d进行复查,采用视觉模拟量表(VAS)记录术后疼痛水平,利用SPSS 11.5统计软件将数据进行等级资料秩和检验。结果超声骨刀组与传统球钻组术后6 h VAS均值分别为3.98±2.16、4.79±1.95,24 h VAS均值分别为2.35±1.86、3.21±1.76,2组有统计学差异(P<0.05)。2组术后3 d VAS均值无统计学差异。结论与传统球钻相比,采用超声骨刀进行种植植骨手术可以降低植骨术后短期疼痛发生率。展开更多
Tooth surface loss is a common condition with nearly three-quarter of the population in Trinidad & Tobago exhibiting signs and about one-fifth of those persons have moderate or severe wear. These patients become d...Tooth surface loss is a common condition with nearly three-quarter of the population in Trinidad & Tobago exhibiting signs and about one-fifth of those persons have moderate or severe wear. These patients become difficult to treat due mainly to loss of clinical crown height and also loss of occlusal vertical dimension. This case depicts the use of a conservative approach to treating a patient with moderate tooth surface loss, as assessed via the tooth wear index, with aetiology of acid erosion. The poor appearance of the dentition was the patient’s chief presenting complaint. With the use of 3M Filtek? Z 250 Universal Restorative Composite (St Paul, MN, USA), temporary posterior build-ups were placed to increase the patient’s Occlusal Vertical Dimension (OVD) and were subsequently replaced with metal onlays. Anterior composite veneers were placed to achieve an aesthetically pleasing result at the increased OVD. The combined use of composite and metal onlays allowed for an economical and more conservative treatment modality for dental erosion rather than full coverage posterior and anterior crowns.展开更多
基金the financial support from NIH grants(EY016415)to J.L.FunderburghCore grant(P30-EY08098)+1 种基金Other support was received from the Ocular Tissue Engineering and Regenerative Ophthalmology(OTERO)program of the Louis J Fox Center for Vision Restorationthe McGowan Institute for Regenerative Medicine,Research to Prevent Blindness Inc
文摘Corneal inlays and onlays represent a means of providing patients with permanent refractive error correction. As an alternative to conventional spectacles and contact lens, these techniques are less invasive compared with laser-based refractive surgery and are reversible. In this review, we provide a brief overview of the anatomic microstructure of the human cornea, indicating the primary physiological function for each component. Next, the wide range of biomaterials used as corneal inlays and onlays are considered, from synthetic polymers to biological components derived from the extracellular matrix. The limitations and challenges associated with the most common materials are discussed as is the need to improve their properties to achieve long-term, complication-free intraocular implantation. Finally, the prospect of applying tissue engineering strategies is noted for its potential to generate autologous corneal tissue that could be implanted as the optimal inlay or onlay materials.
文摘Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive techniques.Methods:From January 2016 to April 2018,17 symptomatic patients with previously failed minimally invasive procedures were enrolled in the study.The diagnosis of urethral stricture was confirmed based on a combination of patients’symptoms,post-void residual urine,video-urodynamics,and cystoscopy.Urethroplasty with lower lip mucosal graft was performed using the modified laterally extended dissection.Patients were evaluated pre-operatively and 12-month post-operatively with the American Urological Association symptom score,post-void residual urine,and maximum flow rate.Results:Despite the previously failed minimally invasive procedures,urethroplasty with lower lip buccal graft and laterally extended dissection resulted in favorable outcomes(success rateZ94%).The meanstandard deviation of American urological association symptom score improved from pre-operative levels at the 12-month post-operative follow-up(25.823.97 to 10.885.57);so did postvoid residual urine(71.1274.98 mL to 15.0028.30 mL),and maximum flow rate(7.881.72 mL/s to 25.825.59 mL/s)with all statistically significant(p<0.05).Conclusion:The current study showed that female urethroplasty with buccal graft could be highly successful in experienced hands.An anterior approach could be superior to the posterior one due to higher mechanical support and lower sacculation rate.A laterally extended incision may improve visualization and better graft placement by providing wider working space.The results should be evaluated in the future studies with larger sample size.
文摘目的评价3D打印白硅钙石(bredigite,BRT)骨支架材料在大鼠Onlay骨移植中的效果。方法通过3D打印技术制备骨BRT支架材料作为实验组,β⁃磷酸三钙(β⁃tricalcium phosphate,β⁃TCP)骨支架材料作为对照组,通过扫描电镜(scanning electron microscopy,SEM)、X射线衍射(X⁃ray diffraction,XRD)、力学测试和体外降解测试实验对其进行表征观察。建立SD大鼠颅骨Onlay骨移植的动物模型,根据移植物的不同,分为自体骨移植组(Auto组)、β⁃TCP组及BRT组。术后12周获取标本行大体观察、micro⁃CT扫描检测分析、组织学HE染色。结果SEM观察显示,BRT有规则的多孔结构,XRD衍射峰较为锐利。与β⁃TCP组(11.29±1.30)MPa相比,BRT支架材料(46.80±3.44)MPa具有更好的力学强度(P<0.001);在体外第35天时,BRT降解率为27.18%±1.41%,并且在降解过程中释放钙、镁、硅离子。micro⁃CT及组织学染色实验结果提示,Auto组有一定程度的骨吸收,β⁃TCP和BRT组均有一定新骨生成。micro⁃CT和组织学定量结果,BRT组新生骨组织占比分别为16.83%±2.11%和19.08%±2.17%,均高于β⁃TCP组(8.48%±1.85%,10.81%±1.33%)(P<0.05)。结论3D打印BRT骨支架材料促进Onlay骨移植中的骨再生。
文摘目的本研究通过观察超声骨刀和传统球钻在onlay植骨、上颌窦提升、骨劈开手术中的临床应用效果,探讨超声骨刀在种植手术中的优越性及操作要点。方法对需要进行植骨手术的78例患者,分别使用超声骨刀和传统球钻在Onlay植骨、上颌窦提升、骨劈开等手术中进行切骨操作;超声骨刀组42例,传统球钻组38例。分别于术后6 h、24 h、3 d进行复查,采用视觉模拟量表(VAS)记录术后疼痛水平,利用SPSS 11.5统计软件将数据进行等级资料秩和检验。结果超声骨刀组与传统球钻组术后6 h VAS均值分别为3.98±2.16、4.79±1.95,24 h VAS均值分别为2.35±1.86、3.21±1.76,2组有统计学差异(P<0.05)。2组术后3 d VAS均值无统计学差异。结论与传统球钻相比,采用超声骨刀进行种植植骨手术可以降低植骨术后短期疼痛发生率。
文摘Tooth surface loss is a common condition with nearly three-quarter of the population in Trinidad & Tobago exhibiting signs and about one-fifth of those persons have moderate or severe wear. These patients become difficult to treat due mainly to loss of clinical crown height and also loss of occlusal vertical dimension. This case depicts the use of a conservative approach to treating a patient with moderate tooth surface loss, as assessed via the tooth wear index, with aetiology of acid erosion. The poor appearance of the dentition was the patient’s chief presenting complaint. With the use of 3M Filtek? Z 250 Universal Restorative Composite (St Paul, MN, USA), temporary posterior build-ups were placed to increase the patient’s Occlusal Vertical Dimension (OVD) and were subsequently replaced with metal onlays. Anterior composite veneers were placed to achieve an aesthetically pleasing result at the increased OVD. The combined use of composite and metal onlays allowed for an economical and more conservative treatment modality for dental erosion rather than full coverage posterior and anterior crowns.
