Achieving accurate implant positioning and restoring native hip biomechanics are key surgeon-controlled technical objectives in total hip arthroplasty (THA). The primary objective of this study was ...to compare the reproducibility of the planned preoperative centre of hip rotation (COR) in patients undergoing robotic arm-assisted THA versus conventional THA.
This prospective randomized controlled trial (RCT) included 60 patients with symptomatic hip osteoarthritis undergoing conventional THA (CO THA) versus robotic arm-assisted THA (RO THA). Patients in both arms underwent pre- and postoperative CT scans, and a patient-specific plan was created using the robotic software. The COR, combined offset, acetabular orientation, and leg length discrepancy were measured on the pre- and postoperative CT scanogram at six weeks following surgery.
There were no significant differences for any of the baseline characteristics including spinopelvic mobility. The absolute error for achieving the planned horizontal COR was median 1.4 mm (interquartile range (IQR) 0.87 to 3.42) in RO THA versus 4.3 mm (IQR 3 to 6.8; p < 0.001); vertical COR mean 0.91 mm (SD 0.73) in RO THA versus 2.3 mm (SD 1.3; p < 0.001); and combined offset median 2 mm (IQR 0.97 to 5.45) in RO THA versus 3.9 mm (IQR 2 to 7.9; p = 0.019). Improved accuracy was observed with RO THA in achieving the desired acetabular component positioning (root mean square error for anteversion and inclination was 2.6 and 1.3 vs 8.9 and 5.3, repectively) and leg length (mean 0.6 mm vs 1.4 mm; p < 0.001). Patient-reported outcome measures were comparable between the two groups at baseline and one year. Participants in the RO THA group needed fewer physiotherapy sessions postoperatively (median six (IQR 4.5 to 8) vs eight (IQR 6 to 11; p = 0.005).
This RCT suggested that robotic-arm assistance in THA was associated with improved accuracy in restoring the native COR, better preservation of the combined offset, leg length correction, and superior accuracy in achieving the desired acetabular component positioning. Further evaluation through long-term and registry data is necessary to assess whether these findings translate into improved implant survival and functional outcomes.
Objectives. The aim of this study was to investigate the subsequent dental treatment needs of children who had dental extractions under general anaesthesia (GA) in 1997 in the Day Case Unit at Leeds ...Dental Institute (LDI), Leeds, UK, and the reasons for repeat dental GAs (DGAs).
Study design. The authors conducted a retrospective longitudinal analysis.
Subjects and methods. Information collected from hospital records for the 6‐year period following the first DGA included: reasons for the DGA in 1997 and teeth extracted; the number of subsequent DGAs, reasons and treatment; incidents of and reasons for toothache or swelling after 1997; treatment under local anaesthesia (LA) or inhalation sedation (IS) at LDI during the 6 years following the DGA in 1997.
Results. The study population consisted of 484 children, who received GA exodontia at LDI with a mean age of 6·35 years 95% confidence interval (CI) = 6·1, 6·6 and age range of 1–16 years. The most common reason for extractions at the original DGA in 1997 was dental caries, and the mean number of extractions was 4·24 (95% CI = 4·05, 4·43). Primary teeth extractions accounted for 82% of the cases. In total, 143 children (27·5%) had a record of follow‐up treatment at LDI. Of these children, 32% had treatment under LA, 7% under LA and IS, and 15% received preventive care only. The overall repeat rate for DGA was 10·7%, with caries (84%) being the main reason for this. Of the teeth subsequently extracted, 72% were recorded as caries‐free or unerupted at the time of the DGA in 1997.
Conclusions. A large proportion of the follow‐up visits were to treat newly developed dental disease during the 6 years following the DGA in 1997. A more proactive approach towards preventive care may have resulted in the reduction of the development of new dental disease.
Objective. To determine whether or not drooling in children with cerebral palsy is due to hypersalivation.
Population and methods. The study population consisted of 10 children with cerebral palsy ...who were identified as having severe drooling, and a matched control group composed of 10 unaffected children who had no known physical or mental disabilities. Salivary flow rate was compared between the cerebral palsied children and the control group using the chin‐cup collection drool quantification method described by Sochanjwskyj. Components of the system included a cup‐like collection device, a vacuum pump, plastic tubing, an airtight collection chamber, and calibrated test tubes held against the subject's chin with elastic straps attached to an orthodontic head bonnet. Statistical analysis was completed using the Student's t‐test and Fisher's Exact Probability test.
Results. The ages of the population ranged from 5·2 to 15·6 years, mean age (± SE) of 10·56 ± 1·13 years. There was no statistically significant difference in the rate of salivary flow rate between the two groups’ mean ± SE: cerebral palsy group 0·220 ± 0·018; control group 0·334 ± 0·052 (P = 0·053). The results were further confirmed by comparing the buffering capacity (P = 1·00) and concentrations of the sodium (P = 0·065) and potassium ions (P = 0·058) in the saliva of the study groups.
Conclusions. Children with cerebral palsy who drool do not appear to produce excess saliva. Their salivation is similar to the control children.
High vitamin D deficiency prevalence has been found in hip and knee osteoarthritis, and a correlation between low vitamin D levels and worse functional outcome after hip arthroplasty was published ...before. Our goal was to examine the relation between vitamin D levels and outcome after knee arthroplasty on short and long term. In 138 patients with knee replacements preoperative vitamin D levels were recorded. 33 patients were vitamin D deficient (median 32 nmol/l, range 6-40 nmol/l) and 105 patients were vitamin D sufficient (median 65 nmol/l, range 41-177 nmol/l). After correction for confounders, vitamin D deficient patients had significant (p = 0.03) longer hospital stay (+1.0 day, range 0.2-1.6 day), and significant (p = 0.04) worse functional outcome also at long term follow up after eight years (WOMAC : +5.0, range 0.2-9.8). More research is needed to evaluate if rehabilitation and postoperative outcome can be improved by preoperative vitamin D suppletion.
The concept of constant and low levels of F intra-orally has been applied in dentistry using a controlled release delivery system in different forms of slow-release F intra-oral devices.
To ...investigate the effect of newly shaped plastic brackets on the level of fluoride released by the devices in vitro and to compare the level of fluoride released by unilateral versus bilateral slow-release fluoride glass devices in adults in vivo.
The phase I, in vitro assessment involved 15 slow-release fluoride glass devices divided into three groups. Group A contained five glass beads, Group B, five fluoride devices placed with the plastic brackets facing down, and Group C, five fluoride devices placed with the plastic brackets facing up. Evaluation of fluoride release was carried out daily for a week, weekly for a month, and monthly for 18 months. The In vivo phase II involved 20 adults (mean age 29.7+/-2.3 years) randomly divided and had unilateral or bilateral slow-release fluoride glass devices placed for six months.
Groups A and B released fluoride for up to ten months. In Group C, the glass beads became loose at the end of the first month and were excluded from further analysis. There was no statistical significant difference in the mean of total fluoride released by Groups A and B. All participants showed higher salivary fluoride levels than at baseline. There was no statistically significant difference in the level of fluoride released by the bilateral and unilateral groups.
The newly shaped slow-release fluoride glass devices showed continuous, safe, and effective fluoride release.
BACKGROUND:
The concept of constant and low levels of F intra-orally has been applied in dentistry using a controlled-release delivery system in different forms of slow-release F intra-oral devices.
...AIM:
To investigate the effect of newly shaped plastic brackets on the level of fluoride released by the devices in vitro and to compare the level of fluoride released by unilateral versus bilateral slow-release fluoride glass devices in adults in vivo.
STUDY DESIGN
: The phase I, in vitro assessment involved 15 slow-release fluoride glass devices divided into three groups. Group A contained five glass beads, Group B, five fluoride devices placed with the plastic brackets facing down, and Group C, five fluoride devices placed with the plastic brackets facing up. Evaluation of fluoride release was carried out daily for a week, weekly for a month, and monthly for 18 months. The In vivo phase II involved 20 adults (mean age 29.7 ± 2.3 years) randomly divided and had unilateral or bilateral slow-release fluoride glass devices placed for six months.
RESULTS
: Groups A and B released fluoride for up to ten months. In Group C, the glass beads became loose at the end of the first month and were excluded from further analysis. There was no statistical significant difference in the mean of total fluoride released by Groups A and B. All participants showed higher salivary fluoride levels than at baseline. There was no statistically significant difference in the level of fluoride released by the bilateral and unilateral groups.
CONCLUSIONS:
The newly shaped slow-release fluoride glass devices showed continuous, safe, and effective fluoride release.
Early childhood caries--a review Misra, Sangeeta; Tahmassebi, Jinous F; Brosnan, Michael
Dental update
34, Številka:
9
Journal Article
Recenzirano
Early childhood caries (ECC) is rampant caries of the primary dentition of infants and toddlers. It represents a serious problem in dentistry as it progresses rapidly and affects young children. ...There is a need to identify risk factors for ECC so that targeted, cost-effective interventions can be designed. The literature indicates that immediate intervention is necessary to prevent further dental destruction, as well as more widespread health problems.
Currently, some 4 out of 10 children starting school have decay in their primary dentition. It is prudent for dentists who diagnose ECC to provide therapy or, if treatment is not possible as a result of the young age of the child and limited co-operation, then it is important to refer the patient to an appropriately trained individual for therapy.
This was to determine whether there is any relationship between lip position and drooling in children with cerebral palsy (CP).
One hundred and sixty individuals with CP (aged 4-18 years) agreed to ...take part in the study. The following data were collected in two ways. Firstly the presence or absence of drooling, the dental age, the incisal relationship and lip position were obtained by direct observation of the children. Secondly other data for age, sex, learning disability and type of CP were collected using a questionnaire/form.
This was by simple Chi squared analysis.
A significantly greater number of CP children who drooled had incompetent lips (p<0.002). When comparing CP children with drooling (mild + moderate + severe) and those without drooling there was a clear difference in distribution of it between those with and those without competent lips. This difference was found to be highly significant (p<0.005).
Lip position and oral seal share a potentially important association with drooling.
Amongst the duties of the paediatric dentist is the provision of oral care to patients with the problem of drooling. Many, but certainly not all, of these patients have physical and/or learning ...disabilities. Various methods have been advocated for the management of drooling in the paediatric patient and older patients with disabilities, including behavioural programmes, biofeedback techniques, physiotherapy, biofunctional oral appliances, medication and surgery. It is of paramount importance that the patients and/or carers understand the advantages and disadvantages of any treatment method being considered. The paediatric dentist has an important role to play in explaining the different options to the patients and carers, and in implementing some treatment modalities, particularly non‐surgical approaches. Referral to surgical specialists should be seen as ‘a last resort’ and suggested only if other treatment methods have been exhausted. If pharmacological or surgical treatment is carried out, careful monitoring for the development of dental caries and other problems is essential. The aim of this paper is to provide the paediatric dentist with concise overall knowledge of the causes of drooling and treatment options available.
