Advances in diagnosis and non-surgical treatment of Bell's palsy

Bell’s palsy is a commonly seen cranial nerve disease and can result in compromised facial appearance and functions. Its etiology, prognosis and treatment are still being debated. This paper is a review of recent development in the understanding of etiology, diagnosis and non-surgical treatment of Bell’s palsy.

Multidisciplinary non-surgical treatment of advanced periodontitis:A case report

BACKGROUND Patients with severe periodontitis often require multidisciplinary treatment to achieve healthy periodontal tissue,normal occlusion,and optimal aesthetics.In the present study,we aimed to evaluate the efficacy of multidisciplinary non-surgical treatment in a patient with stage IV/grade C periodontitis,malocclusion,and dentition defects.CASE SUMMARY A 47-year-old woman visited our periodontology department due to teeth mobility problems and difficulties chewing food.The patient had no history of drug allergies or systemic disease.Initial therapy involved scaling and root planning with a Gracey scaler and periodontal ultrasonic therapeutic apparatus using a periodontal endoscope(Perioscopy,Zest Dental Solutions,United States)to control the periodontal inflammation prior to treatment.Five months later,orthodontic treatment was then performed to treat occlusion and overall aesthetics.After completion,a Maryland bridge was used to restore Nos.22,31,and 41 teeth.Florida probing(Florida probe,United States)was performed every 2-3 mo to evaluate the periodontal condition throughout treatment.Overall,multidisciplinary non-surgical treatment resulted in satisfactory aesthetic results with healthy periodontal tissue and stable occlusion.CONCLUSION In some patients with stage IV/grade C periodontitis,systematic and sequential non-surgical treatment can provide excellent therapeutic results.

Non-Surgical Orthodontic Treatment of Class III Adult with Posterior Crossbite, Anterior Open Bite and Asymmetric Occlusion, Using TADs and Auxiliary Wires: A Case Report

Class III malocclusion associated with posterior crossbite, anterior open bite pattern with asymmetric occlusion in adults can be a challenging orthodontic problem, especially for the nonsurgical treatment. Skeletal Class III anteroposterior discrepancies in adult patients are generally managed either by surgical-orthodontic treatment or by orthodontic camouflage through dentoalveolar compensation. Although correction with surgery may be the most effective and stable way, many patients refuse surgical treatment plan because of the costs and traumas it may bring. This case report describes the successful use of TADs with expansion auxiliary wire to treat a 24-year-old man with skeletal class III malocclusion, posterior crossbite, anterior open-bite and asymmetric occlusion, mild upper and lower dental spacing and a chief manifestation of anterior crossbite. The patient refused surgery. A treatment plan was formulated consisting of using auxiliary expansion wire to expand the maxillary arch, 8 mm mini-screws between the roots of the mandibular canines and first premolars, preadjusted edgewise brackets to align the teeth, Class III and asymmetric elastics to correct the canines, premolars, and molars relationship and midline deviation, reverse curve of the nickel-titanium wire combined with anterior vertical elastics to intrude molars and correct the anterior open-bite. In this case, without going through surgery, the posterior cross-bite was corrected, and ideal overjet and overbite relationships, midline coincidence and functional occlusion were all achieved. Satisfactory occlusal, functional, esthetic and stable results were obtained.

Non-Surgical Treatment with Chemical Peeling and Subsequent Vitamin C Iontophoresis for Rolling Scars in Acne Vulgaris

A 19-year-old man had atrophic scars on bilateral temple for several years. The atrophic scars were composed of rolling scars (three depressions, 8 × 4 mm in diameter), ice pick scars and boxcar scar. The patient was treated with chemical peeling (CP) using 20% glycolic acid (GA) (pH 3.2) and subsequent iontophoresis with vitamin C derivative at one month’s interval twice. Remarkable improvement was observed;the rolling scars almost disappeared with traces of hypopigmented macule. However, the ice pick scars and boxcar scar did not improve. CP and subsequent vitamin C iontophoresis can be an alternative non-surgical and non-invasive treatment for rolling scar in acne.

Conservative treatment of knee osteoarthritis:A review of the literature

Knee osteoarthritis(KOA)is a common chronic debilitating disease with an estimated prevalence of 23.9%in the general adult population.The condition is characterised by joint pain,functional impairment and significant reduction in quality of life.Management for KOA can generally be divided into conservative(non-operative)and surgical(operative)measures.Conservative management broadly compromises pharmacological and non-pharmacological options and is conventionally the first line treatment to avoid or delay the need for surgical management.The aim of this study is to provide an overview of the current recommendations,efficacy and safety profile of different conservative treatments through a review of the literature.

Treatment of bilateral granulomatous lobular mastitis during lactation with traditional Chinese medicine: A case report

BACKGROUND Granulomatous lobular mastitis(GLM)is a type of benign chronic inflammatory disease that poses therapeutic challenges to healthcare providers.The diagnosis of GLM relies on tissue biopsy,and incorrect treatment may lead to delayed diagnosis,considerable aesthetic damage,and even mastectomy.CASE SUMMARY We report the case of a 37-year-old Chinese woman who was lactating and had GLM in both breasts.At the time of treatment,the right breast had a mass of approximately 15 cm×11 cm,which was hard and had poor mobility.Multiple skin ulcerations and pus spills were also observed on the surface of the breast.The left breast had a mass of about 13 cm×9 cm,which was hard and had poor mobility.CONCLUSION Herein,we report a case of bilateral GLM in a lactating woman that was successfully treated with traditional Chinese medicine(TCM),without the requirement for surgery or other treatments.Therefore,TCM may have advantages in the nonsurgical treatment of GLM.

Concurrent Multi-Modality Treatment of Keloids (CMTK) Not Manageable by Conventional Postoperative Radiotherapy

Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age. Design Setting: A prospective cohort study. Setting: Two major postgraduate teaching hospitals: one in Tripoli, Libya and the other in Jeddah, Saudi Arabia. Participants: Fifty-seven patients with 79 keloids, referred from Plastic Surgery Units between April 1996 and January 2005. Main Outcome Measure: Degree of flattening of the keloidal lesion and symptomatic recovery. Results: Result of treatment has been analyzed using unified set criteria. Seventy-seven percent of this cohort had complete response. 19% of cases had partial response, 50% acknowledged the treatment outcome had been “satisfactory” and 44% had an “acceptable” outcome. There was no significant acute or delayed reaction. Conclusion: The technique appears universally adaptable, cost effective, and can safely be prescribed for children and women of child-bearing age. In spite of prolonged treatment course, compliance was excellent.

Spontaneous External Digestive Fistula of Tuberculosis Origin, Medical Treatment: About a Case at the Timbuktu Hospital

In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (Itra-Dermo-Reaction (IDR) to tubercria, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.

两面针含漱液联合牙周基础治疗在牙周病患者中的应用效果

目的:观察两面针含漱液联合牙周基础治疗在牙周病患者中的应用效果。方法:选取2021年1月至2022年12月该院收治的120例牙周病患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各60例。两组均进行牙周基础治疗,在此基础上,对照组给予复方氯己定含漱液治疗,观察组给予两面针含漱液治疗,两组均连续治疗1个月。比较两组治疗前后牙周病指标[出血指数(BI)、牙龈指数(GI)、菌斑指数(PLI)、探诊深度(PD)]水平、龈沟液炎性因子[白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)]水平、临床疗效和不良反应发生率。结果:治疗后,观察组PLI、GI、BI评分和PD值,以及IL-1β、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);两组治疗总有效率、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:两面针含漱液联合牙周基础治疗应用于牙周病患者可降低牙周病指标与龈沟液炎性因子水平,在临床疗效与不良反应发生率方面与复方氯己定含漱液相当。

Modern blepharoplasty:From bench to bedside

The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.

即刻种植修复联合牙周基础治疗在慢性牙周炎患者中的应用效果

目的:观察即刻种植修复联合牙周基础治疗在慢性牙周炎患者中的应用效果。方法:选取2020年3月至2021年1月该院收治的80例慢性牙周炎患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各40例。对照组予以牙周基础治疗,观察组在对照组基础上联合即刻种植修复治疗。比较两组治疗前和治疗后6个月牙周指标[探诊深度(PD)、菌斑指数(PLI)、出血指数(BI)、附着丧失(AL)]水平、龈沟液炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]水平和红色美学指数(PES)评分。结果:治疗后6个月,两组PLI、BI评分和PD、AL值均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组龈沟液TNF-α、IL-1β、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组PES评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:即刻种植修复联合牙周基础治疗应用于慢性牙周炎患者可提高PES评分,降低牙周指标和龈沟液炎性因子水平,效果优于单纯牙周基础治疗。

Thrombosis of the Transverse Sinus: About a Clinical Observation and Review of the Literature

Cerebral venous thrombosis has an unfavorable prognosis. It is a rather rare pathology concerning 3 to 5 cases per million inhabitants. The clinical symptomatology also varies according to the topography of the venous thrombosis and, in some cases, the CVT can have an unusual presentation. Progress and accessibility of non-invasive imaging currently allow early diagnosis of CVT. Brain MRI is the reference method for the diagnosis of CVT. We report a case of transverse sinus thrombosis in a 32-year-old male patient who consulted for headaches through which we want to study the etiological, clinical, paraclinical, therapeutic aspects as well as the evolutionary profile. The clinical history dates back to 2 weeks ago with frontal headaches radiating to the occipital region, throbbing of severe intensity, progressive onset and permanent evolution associated with right unilateral anterior purulent rhinorrhea. He had no nasal obstruction, epistaxis, hearing loss or other otological symptoms;no neurological deficit or notion of head trauma. Cerebral and maxillofacial computed tomography showed right maxillary sinusitis and right transverse sinus thrombosis. We carried out medical treatment based on antibiotics and analgesics without the use of anticoagulants. The evolution was favorable after four weeks of treatment. Conclusion: Transverse sinus thrombosis has a non-specific and heterogeneous clinical presentation. Headaches are the first sign. MRI and CT can help establish the diagnosis. The treatment is both etiological and symptomatic.

牙周基础治疗在侵袭性牙周炎中的应用效果观察

目的探讨牙周基础治疗在侵袭性牙周炎中的应用效果。方法选取本院2012年12月-2014年5月收治的68例（患牙142颗）侵袭性牙周炎患者作为研究对象,所有患者均给予牙周基础治疗。观察并记录牙周基础治疗前和治疗后6个月的患牙探诊深度（PD）、临床附着丧失（CAL）、出血指数（BI）、菌斑指数（PLI）和牙齿松动度（TM）情况。结果牙周基础治疗6个月后,PD、CAL、BI、PLI显著低于治疗前,差异有统计学意义（P〈0.05）。与治疗前比较,治疗6个月后的牙齿松动程度显著好转,差异有统计学意义（P〈0.01）。结论牙周基础治疗在侵袭性牙周炎中的应用效果显著,能明显减少PD、CAL、PLI,有效控制牙龈出血,明显改善牙齿松动情况,值得临床推广应用。

牙周基础治疗对牙周炎患者龈沟液肿瘤坏死因子-α含量的影响

目的观察牙周基础治疗慢性牙周炎患者的临床牙周指数和龈沟液肿瘤坏死因子-α水平的影响。方法 30例慢性牙周炎患者,于治疗前、牙周基础治疗后2周及10周滤纸条法收集患牙龈沟液,并记录相关的临床指标,包括菌斑指数、牙龈指数、探诊出血、探诊深度和临床附着丧失水平;放免法检测中龈沟液TNF-α水平。结果牙周基础治疗后2周及10周慢性牙周炎患者的临床牙周指数和龈沟液TNF-α水平显著低于治疗前。结论牙周基础治疗能改善慢性牙周炎患者的临床牙周指数,并降低龈沟液TNF-α的含量。

80例二次龈下刮治与牙周翻瓣术治疗慢性牙周炎的临床疗效比较

目的比较二次龈下刮治与牙周翻瓣术在慢性牙周炎基础治疗后效果欠佳的患牙中的应用效果。方法选择2011年8月~2014年8月期间我院诊治的慢性牙周炎患者共80例,同名牙分别随机分为翻瓣组和刮治组,翻瓣组给予改良Widman翻瓣术,局部浸润麻醉下首先作内斜切口将袋内壁上皮组织切除,清理肉芽组织,保留健康组织瓣并翻起,暴露根面牙石,术者在直视条件下将牙石刮净,并平整根面。刮治组给予二次龈下刮治术,采用手用牙周治疗器械,将牙周袋内残存上皮及炎性肉芽组织以及在牙根表面附着的牙石和菌斑刮净,同时将病变牙本质一并刮除,平整根面,尖探针确认根面光洁。比较两组患牙治疗前后探诊深度、附着丧失、龈沟出血指数、菌斑指数等牙周临床指标以及牙槽骨的吸收情况等。结果两组患牙再次治疗术前的探诊深度、附着丧失、龈沟出血指数以及菌斑指数等无统计学差异（t=0.002、0.001、0.003、0.004,均P〉0.05）。术后1个月及术后3个月均较术前明显好转（均P〈0.05）,但组间比较差异无统计学意义（均P〉0.05）。翻瓣组术后控制牙槽骨吸收有效率为91.25%,刮治组的有效率为88.75%,两组有效率组间比较无统计学差异（χ2=0.163,P〉0.05）。结论对于未累及根分叉的中度牙周炎患牙,采用二次龈下刮治术能获得理想治疗效果,手术操作更为简单,对患者造成损伤更小,更易于被患者所接受,值得临床推广。

邦沃磁致伸缩牙周治疗仪与传统牙周基础治疗的对比研究

目的 比较邦沃磁致伸缩牙周治疗仪治疗慢性牙周炎与传统牙周基础治疗的效果及主观评价。方法 选取我院2014年11月~2016年5月收治的慢性牙周炎患者56例,根据患者入院编号分为观察组和对照组,各28例。观察组采用邦沃磁致伸缩牙周治疗仪治疗,对照组采用传统超声多功能牙科治疗仪（Suprasson P5 newtron）进行龈下刮除术。比较和观察两组术前及术后3个月的牙周检查指标：牙龈指数（GI）、牙周探诊深度（PD）、探诊出血指数（BOP）和牙科畏惧量表（DFS）评分。结果 两组患者治疗3个月后的GI、PD及BOP值均较治疗前明显下降,差异均有统计学意义（P〈0.05）,但组间差异无统计学意义（P〉0.05）。治疗前两组DFS评分差异无统计学意义（P〉0.05）;治疗后,观察组DFS评分低于对照组,差异有统计学意义（P〈0.05）。结论 邦沃磁致伸缩牙周治疗仪治疗慢性牙周炎可获得良好的效果,并可减轻患者的疼痛,患者易于接受。

Florida探针与普通牙周探针对慢性牙周炎基础治疗疗效的评价

目的评价牙周基础治疗对慢性牙周炎的疗效,评价Florida探针和普通牙周探针测量牙周袋深度的可重复性。方法对10例慢性牙周炎患者在牙周基础治疗前后,分别使用Florida探针和普通牙周探针重复测量牙周袋深度,记录探诊深度、出血指数和松动度,分别比较两种探针在治疗前和治疗后PD值的可重复性,并比较治疗前后患者PD、BI和MOB的变化。结果在牙周基础治疗前后,两种探针测量的PD值均具有较好的重复性(P>0.05),牙周基础治疗能够有效控制牙周炎症,明显降低患牙的PD、BI和MOB(P<0.05)。结论 Florida探针和普通牙周探针测量PD值均具有良好的可重复性,能够可靠的应用于牙周临床研究;牙周基础治疗能够有效控制牙周炎症,是治疗牙周炎的有效措施。

牙周基础治疗对2型糖尿病伴慢性牙周炎患者血糖代谢指标及血清生化指标的影响探讨

目的探究在2型糖尿病伴慢性牙周炎患者治疗的过程中,使用牙周基础治疗对于患者的影响。方法针对方便选取50例2型糖尿病伴慢性牙周炎患者进行牙周基础治疗,治疗后对患者的糖代谢指标及血清生化指标进行检验,并评价治疗产生的影响,该次入选患者均为该院2014年9月—2016年10月间收治。结果血糖代谢情况和血清生化指标经过治疗,其中Hb A1c(%)、P(mmol/L)、TBil(μmol/L)、脂蛋白a(mg/L)、TG(mmol/L)、Ca/P(mmol/L)差异有统计学意义,其他指标改善差异无统计学意义。其中患者治疗前的出血指数为(2.25±0.49),治疗后为(1.42±0.41);患者治疗前菌斑指数为(2.32±0.36),治疗后菌斑指数为(1.48±0.35);患者治疗前探诊后出血百分数为(59.20±25.29),治疗后为(31.51±19.68),治疗前后比较差异有统计学意义(P<0.05)。结论牙周基础治疗对2型糖尿病伴慢性牙周炎患者血糖代谢指标及血清生化指标的影响探讨发现,牙周基础治疗后能够帮助患者的牙周情况得到改善,同时对患者的血糖代谢指标及血清生化指标均具有一定改善作用,且影响相对积极,因此值得临床借鉴使用。

手术治疗牙龈瘤(附78例疗效观察)

目的 观察应用牙周外科手术治疗牙龈瘤的临床疗效。方法 在牙周病治疗的基础上 ,将瘤体彻底切除 ,对病变周围骨组织和牙周组织进行修整 ,保留患牙的手术方法。结果 经术后 3年随访 ,76例患者牙龈无炎症 ,X线片示骨质吸收静止 ,硬骨板恢复 ,骨密度略有增加 ,75例患牙稳固 ,总有效率为 97%。结论 对较小的瘤体 (直径 <2cm) ,经过牙周外科手术治疗 ,疗效满意。可广泛应用于临床。

侵袭性牙周炎患者牙周基础治疗分析与研究

目的探讨牙周基础治疗针对不同类型侵袭性牙周炎患者的临床治疗效果。方法筛选2012年8月~2013年8月我院收治的侵袭性牙周炎患者128例,作为研究对象。应用牙周基础治疗法对不同类型侵袭性牙周炎患者进行治疗。治疗后2、4、6个月进行随访复查,与治疗前患者的牙探诊深度（PD）、附着丧失（CAL）、出血指数（BI）、牙齿松动程度（TM）进行比较并讨论研究。结果治疗后较治疗前患者病情明显具有改善（P〈0.05）,广泛侵袭性牙周炎与局限侵袭性牙周炎治疗后各时期TM比较具有显著差异（P〈0.05）,治疗后以第一恒磨牙的治疗效果最为显著（P〈0.05）。结论应用牙周基础治疗法对不同类型侵袭性牙周炎均具有显著的临床效果,值得临床应用及推广,同时不同类型的侵袭性牙周炎其康复时间可能存在差异性,需患者与医务工作者正确理解并耐心治疗。