Use of Flexible Periotomes and Conventional Periotomes in Atraumatic Extractions: A Comparative Study

The aim of this study was to compare the efficiency of flexible periotomes versus non-flexible conventional periotomes in atraumatic dental extractions of similar teeth. The study also aimed to evaluate the wound healing, duration of the procedure, and level of gingival laceration associated with the use of these two instruments. The study was a randomized controlled clinical trial involving 26 patients requiring nonsurgical tooth extractions bilaterally. The subjects were randomized into two groups: the study group, where flexible periotomes were used to break the periodontal ligament, and the control group, where conventional periotomes were used. A total of 52 extractions were performed, either for orthodontic or implant placement purposes. After the extractions, the researchers evaluated the level of gingival laceration, duration of the procedure, and wound healing on postoperative days 1 and 7. Any complications that arose were also noted. The study group (flexible periotome) and control group (conventional periotome) were compared, and the results showed that the flexible periotomes required a shorter duration of time (around 4 minutes) compared to conventional periotomes (7 minutes). Additionally, gingival lacerations were found to be less severe in the study group. In conclusion, the use of flexible periotomes was found to be more efficient in atraumatic dental extractions compared to conventional periotomes. This study highlights the importance of using newer technology to perform atraumatic extractions, particularly in the era of implantology where there is an increased demand for such procedures.

Acute atraumatic pinna (auricular) perichondritis

Perichondritis of the external ear is referred to inthe literature as pinna perichondritis as well as auricularperichondritis. Pinna （auricular） perichondritis is aninfection involving cartilage and subcutaneous tissue.The resulting infection produces swelling which canbe severe, and can lead to focal ear necrosis. The termperichondritis may even be considered a misnomer＂as the cartilage is almost always involved.＂[1] Pinna（auricular） perichondritis presents with signs andsymptoms that can include pain。

Atraumatic splenic rupture after cocaine use and acute Epstein-Barr virus infection: A case report and review of literature

BACKGROUND Atraumatic splenic rupture(ASR)accounts for just over 3%of all cases of splenic rupture and is associated with a high mortality rate.The most common culprit is acute infection with Epstein-Barr virus(EBV)but other documented aetiologies include neoplasia,other viral/bacterial infections,acute and chronic pancreatitis,amyloidosis and anticoagulant medications.There are four previous reports of cocaine-associated ASR but never before has it been documented in combination with concurrent acute EBV infection.CASE SUMMARY A 21-year-old man presented to hospital with acute left shoulder pain which radiated to the right shoulder and upper abdomen.He denied any history of recent trauma and had no relevant past medical history.He took no regular prescription medications but had used cocaine within the previous 24 h.Investigations revealed splenomegaly,a Grade 3 subcapsular splenic haematoma,moderate haemoperitoneum and an incidental 9 mm splenic artery pseudoaneurysm.There was also serological evidence of acute EBV infection.Prophylactic endovascular embolisation of the pseudoaneurysm was performed and the splenic rupture was managed non-operatively.The patient remained admitted in hospital for seven days and did not require any transfusion of blood products.Serial imaging showed complete resolution of the haemoperitoneum after 5 wk.The importance of abstinence from illicit drug use was emphasised to the patient but it is unknown whether or not he remains compliant.CONCLUSION This case demonstrates that ASR is a rare condition that can result from acute EBV infection and cocaine ingestion and requires a high index of suspicion to diagnose clinically.

Twelve-month evaluation of the atraumatic restorative treatment approach for class Ⅲ restorations:An interventional study

BACKGROUND Atraumatic restorative treatment(ART)may be appropriate for populations without accessibility and affordability.More data are required regarding the success rate of ART in anterior teeth.AIM To evaluate the clinical performance of restoring class III cavities in anterior teeth of permanent dentition using the ART approach.METHODS A longitudinal interventional field study was carried out at two rural primary health centers,Tumkur district,India.A total of 54 teeth in 39 patients were evaluated for the survival rate of class III restorations in permanent anterior teeth using the ART approach in children and adult populations.Evaluation of ART restoration was carried out using Frencken J criteria,the mean procedure time,patient acceptance and reported pain severity during the ART approach were evaluated using a visual analog scale.Calculation of the cost of ART was also performed.RESULTS The mean time taken to perform the ART procedure was 14.79±5.8 min with the majority of patients reporting only mild pain.At 6 mo follow-up,72.2%remained in a good state,but this reduced to 27%at 12 mo.The cumulative survival rate of the restorations was 94.4%at 6 mo and 80.9%at 12 mo follow-up.Estimation of the direct cost for a single class III restoration was 186.50 INR(2.64 USD).CONCLUSION ART may be a good comprehensive option for basic oral health care for underserved or inaccessible populations,and preventive care for patients.

Atraumatic Acute Compartment Syndrome in Isolated Medial Compartment of Foot, A Rare Case Report

Acute compartment syndrome usually occurs after a traumatic event, typically in association with a fracture, but also from a soft tissue injury such as a direct blow or crush. Acute, isolated, medial compartment syndrome of the foot without a specific major trauma is very rare. I am reporting a rare case with acute compartment syndrome for isolated medial compartment of foot after a traumatic sport event and proper management to prevent long term sequels.

Tietze’s Syndrome in the emergency department: A rare etiology of atraumatic chest pain

Tietze’s Syndrome is an uncommon disorder that presents with painful, tender, non-suppurative swelling of the anterior chest wall. We report a case of a female patient who presented to the emergency department with a chief complaint of atraumatic chest pain and swelling of the anterior chest wall. After a thorough history and physical examination, as well as basic laboratory tests and chest radiography, she was diagnosed with Tietze’s Syndrome. The expedient accurate diagnosis of Tietze’s Syndrome is important for the physical and emotional well-being of a patient, and avoids overlooking more dangerous pathologies. Tietze’s Syndrome needs to be considered in the differential diagnosis of a patient presenting with spontaneous swelling of the anterior chest.

Isolated lateral leg compartment syndrome:A case report

BACKGROUND Acute leg compartment syndrome is a well-known orthopedic emergency associated with potentially devastating consequences if not treated immediately.Multiple compartments are usually involved with a clear history of trauma and classic symptoms and signs.However,isolated lateral leg compartment syndrome is relatively rare and is often misdiagnosed due to the atypical presentation of no trauma and the lack of pathognomonic signs.CASE SUMMARY A 31-year-old male patient presented to our emergency room with excruciating left calf pain and inability to mobilize one-day after participating in a football match despite no clear history of preceding trauma.The patient went to another hospital before presenting to us where he was diagnosed to have a soft tissue injury and was discharged home on simple analgesics.On clinical examination,the left leg showed a tense lateral compartment with severe tenderness.The pain was aggravated by dorsiflexion and ankle inversion.Neurovascular examination of the limb was normal.We suspected a compartment syndrome but as the presentation was atypical and an magnetic resonance imaging(MRI)was readily available in our institution,we immediately performed an MRI and this confirmed a large hematoma in the lateral compartment with a possible partial proximal peroneus longus muscle tear.The patient was taken immediately for an emergency open fasciotomy.The patient is now 18 mo postoperatively having recovered completely and engages fully in sports with no restrictions.CONCLUSION Atypical presentation due to the lack of pathognomonic signs makes the diagnosis of isolated lateral leg compartment syndrome difficult.Pain on passive inversion and dorsiflexion and weak active eversion may be suggested as sensitive signs.

Alveolar Ridge Preservation Utilizing Composite (Bioceramics/Collagen) Graft: A Cone-Beam Computed Tomography Assessment in a Randomized Split-Mouth Controlled Trial

Background: The vast percentage of the alveolar bone resorption process happens within the first 12 to 24 weeks post extraction;however, this phenomenon is chronic, and the alveolar ridge continues to resorb. In order to prevent this reduction or at least recompense the loss of bone dimensions, the alveolar ridge preservation (ARP) technique was developed. Objectives: This research studied the vertical and horizontal bone dimensional changes as a result of non-molar teeth extraction alone against extraction with alveolar ridge preservation utilizing composite (bioceramics/collagen) graft by cone-beam computed tomography radiographies analyses. Material and Methods: This research was a randomized split-mouth controlled trial. 12 patients need extraction of the maxillary non-molar teeth were enrolled and allocated into 2 groups. 12 sockets after atraumatic extraction were filled with a composite graft in the role of the test group, 12 sockets left to unassisted healing after atraumatic extraction without any graft materials in the role of the control group. Two CBCT radiographs were taken at baseline and at 4 months after extraction for comparison. Both vertical and horizontal resorptions of the alveolar ridge were analyzed between test and control group by CBCT radiographs. Results: 4 months after extraction, there was a mean of vertical alveolar bone resorption compared with the baseline (0.56 ± 0.15 mm) in the test group and (1.47 ± 0.30 mm) in the control group. Whereas it was a mean of horizontal alveolar bone resorption compared with the baseline (0.90 ± 0.16 mm) in the test group and (2.26 ± 0.30 mm) in the control group. Therefore, there was a significant difference between the two groups. Conclusions: Within the limitations of this research, we demonstrated that the osteogen-plug technique significantly decreased the reduction of the bone dimensional in comparison to the tooth extraction alone, and showed that the dimensional change of the alveolar ridge after tooth extraction was minimized by using an osteogen-plug.