MedNEXT Journal of Medical and Health Sciences

Major evidence of the relationship of cardiovascular disease and tooth extraction: a systematic review

2024-03-27T14:20:13+00:00

Introduction: Cardiovascular diseases can present a congenital origin, that is present from birth, such as interatrial and interventricular communication, defects of the artery, coronary arteries, or acquired coronary artery anomalies that involve several risk factors such as smoking, alcohol, old age, and sedentary lifestyle. Thus, the acquired ones are the most frequent in the routine of a dental practice, so the dentist should be able to attend to those patients who need special care, regarding the correct use of medications due to the risk of drug interactions, the type of local anesthetic to be used and the management of patients who use anticoagulant therapy. Objective: It was to develop a concise systematic review to highlight the main clinical outcomes of the relationship between cardiovascular diseases and tooth extraction. Methods: The research and development of the work were carried out from December 2023 to February 2024 in the databases Scopus, PubMed, Science Direct, and Scielo, following the PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was based on the Cochrane instrument (Funnel Plot). Results and Conclusion: A total of 112 studies were found that were subjected to eligibility analysis. The final sample had 36 eligible studies and 21 studies were described in the systematic review. Most studies showed homogeneity in their results, with X² =63.9% >50%, with p<0.05. It was concluded that the virtual reality technique was effective in controlling blood pressure and heart rate within an acceptable range and can help in the management of blood pressure and heart rate during tooth extraction in patients with hypertension. It is necessary for the dental treatment of these patients with heart disease a good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.

Major clinical approaches to tooth whitening techniques and differences in terms of sensitivity and protection: a systematic review

2024-03-26T20:11:38+00:00

Introduction: Tooth whitening is an initial step in the analysis and reproduction of the aesthetics of the smile, so the dentist must know how to diagnose the causes of color changes, and recommend whitening before proposing the appropriate dental procedure. With technological advances, tooth whitening techniques have emerged to facilitate their use improve comfort and safety, and reduce time spent performing the technique. The conventional means of external tooth whitening is with carbamide peroxides or light-activated hydrogen or not. However, both at-home and in-office whitening procedures cause tooth sensitivity. There is a new whitening proposal on the market without the use of whitening gels, thus reducing post-treatment sensitivity. This proposal highlights ultraviolet light as a whitening agent. Objective: It was to carry out a concise systematic review of the main clinical approaches to tooth whitening techniques, to point out the differences between them in terms of sensitivity and tooth protection. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 178 articles were found, 40 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=67.4%>50%. It was concluded that tooth whitening can be indicated in practically all situations in which tooth darkening occurs, such as pulp tissue decomposition, internal hemorrhage, trauma, use of medications, restorative materials, and systemic conditions such as fluorosis, jaundice, and fetal erythroblastosis, among others. others. Contraindications for tooth whitening treatment occur in children under 10 years of age. Whitening using the home technique uses products with lower concentrations, between 10% and 22% carbamide peroxide. In-office, 16% carbamide peroxide was effective. In office-based tooth whitening, higher concentrations of whitening substances are used and laser, LED, ultraviolet, and halogen light can be used to intensify the whitening process. Patients undergoing vital teeth whitening report sensitivity or discomfort during treatment. Oxidative stress generated by bleaching agents can cause apoptosis and damage to periodontium DNA (genotoxicity) and cellular cytotoxicity. A new generation of whitening agents with low concentrations of hydrogen peroxide (3.5% and 15%) was introduced on the market for in-office teeth whitening, aiming to achieve greater safety and efficiency in tooth whitening.

Major clinical outcomes of the alveolar ridge preservation post-extraction sockets: a systematic review

2024-03-23T13:55:06+00:00

Introduction: After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes can be difficult or even impede the placement of dental implants and prosthetic rehabilitation. Minimizing bone remodeling means optimizing the esthetics and functional aspects, and mainly, the success of implant treatment. To avoid residual ridge resorption different techniques and bone graft materials have been proposed. Objective: It was to evaluate the efficiency of the many techniques of extraction socket treatment in the alveolar ridge dimension preservation. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 158 articles were found, 62 articles were evaluated in full and 34 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=63.6%>50%. It was concluded that the application of autologous growth factor concentrate after surgical extraction offers an easy, low-cost, and efficient option for preserving the alveolar ridge. Therefore, the use of autologous growth factor concentrate by dentists during tooth extractions can be encouraged, especially when preservation of the alveolar ridge is necessary. The present study suggests that the alveolar graft technique may increase the risk of disease transmission, cost, and time of treatment. Several studies have stated that the graft material is not fully incorporated into the newly formed bone, indicating less vital bone tissue. Spontaneous scarring is still the most used feature since, in intact alveoli and small defects, it is a procedure that does not present significant losses that justify the use of edge preservation techniques. In larger defects, techniques after spontaneous healing, such as a block graft, can be used without the drawbacks of alveolar grafting, such as delayed healing and poor bone qualit.

Major clinical approaches of dental treatment in cancer patients: a systematic review

2024-03-18T23:32:14+00:00

Introduction: According to the National Cancer Institute, a total of 16,290 new cases of oral cancer were estimated in Brazil in 2017, with 12,370 new cases of oral cavity cancer in men and 4,010 in women corresponding to an estimated risk of 11.54 cases new for every 100 thousand men and 3.92 for each 100 thousand women. In this sense, oral cancer therapy is associated with a multitude of head and neck sequelae including hyposalivation, increased risk of tooth decay, osteoradionecrosis of the jaw, radiation fibrosis syndrome, mucositis, chemotherapy-induced neuropathy, dysgeusia, dysphagia, mucosal lesions, trismus, and infections. Objective: It was to present the main clinical approaches to dental treatment in cancer patients through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 156 articles were found, 58 articles were evaluated in full and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=61.8%>50%. It was concluded that preparing a comprehensive treatment plan for cancer patients is essential to help minimize the risks of developing these oral and dental complications. Additionally, dentists should consider the patient's ongoing oncology therapy for those patients who see the dentist while receiving cancer treatment.

Main processes of bone formation and regeneration through molecules and cells as biostimulators in buccomaxillofacial surgery: a systematic review

2024-03-12T20:33:55+00:00

Introduction: At a cellular and molecular level, tissue engineering offers numerous advantages that meet the needs of the injured tissue or organ for the bone regeneration process in buccomaxillofacial surgeries. To achieve this, it is necessary to understand the chemical, physical, and biological processes of both the biological material and the target biological niche. Objective: It was to carry out a concise systematic review of the main processes of bone formation and regeneration using molecules and cells as biostimulators in buccomaxillofacial surgeries. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 182 articles were found, 60 articles were evaluated in full and 36 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=54.7%>50%. The bone regeneration process occurs through the activation of osteoblasts and vascular control guided by PDGFs and TGF-β. These growth factors also promote matrix formation and osteoblast differentiation. Some biodegradable natural polymers (chitosan®) associated with inorganic materials such as tricalcium phosphate were tested as spongy carriers for PDGF-BB. Chitosan® has been attributed to hemostatic properties, inducing bone formation and regulating the release of bioactive agents. The use of platelet-rich plasma and mesenchymal stem cells (exosomes and microRNAs) has been indicated and used in other areas of oral and buccomaxillofacial surgery, accelerating a process of bone regeneration that normally already occurs and this process continues its path until the formation of bone mature.

Use of platelet-rich plasma isolated or in combination in osteoarthritis of the temporomandibular joint: a systematic review

2024-03-11T22:11:05+00:00

Introduction: Temporomandibular joint osteoarthritis (TMJ-OA) is a common disease in the oral and maxillofacial regions and is the most serious type. Among temporomandibular disorders, TMJ-OA accounts for 18% to 85% of all cases. The use of platelet-rich plasma (PRP) has been highlighted, as well as in combination with other types of treatments such as hyaluronic acid, arthrocentesis, and corticosteroids. Objective: to highlight the main clinical outcomes of the treatment of osteoarthritis of the temporomandibular joint through the injectable use of platelet-rich plasma, alone or in combination with other types of treatment. Methods: The research and development of the work were carried out from December 2023 to February 2024 in the databases Scopus, PubMed, Science Direct, and Scielo, using scientific articles from 2013 to 2023, following the PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was based on the Cochrane instrument (Funnel Plot). Results and Conclusion: A total of 178 studies were found that were subjected to eligibility analysis. The final sample had 45 eligible studies and 31 studies were described in the systematic review. Most studies showed homogeneity in their results, with X² =66.7% >50%, with p<0.05. The symmetric funnel plot did not suggest a risk of bias among studies with a small sample size. The results showed that platelet-rich plasma performed better than hyaluronic acid in the treatment of osteoarthritis of the temporomandibular joint during longterm follow-up in terms of reducing pain and increasing interincisal distance. Combined injection of hyaluronic acid and platelet-rich plasma after arthrocentesis is more effective than hyaluronic acid or platelet-rich plasma alone in the treatment of osteoarthritis of the temporomandibular joint, as well as platelet-rich plasma with hyaluronic acid after arthrocentesis showed significant clinical efficacy long-term concerning pain relief. Furthermore, it was found that intra-articular injections of platelet-rich plasma reduced pain on palpation of the temporomandibular joint more effectively compared to hyaluronic acid and corticosteroids. Platelet-rich plasma injection can significantly improve pain, mouth opening, abnormal joint sound, and jaw function in patients with temporomandibular joint osteoarthritis, and has a good repair effect on condylar bone defects. Furthermore, platelet-rich plasma injection combined with physical therapy can effectively control medium and long-term pain in patients.

Clinical results of orthognatic surgery in the treatment of obstructive sleep apnea syndrome: a systematic review

2024-03-11T12:57:03+00:00

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent partial or complete obstruction of the airways during sleep and is called OSAS syndrome when associated with day/night symptoms and/or comorbidities, such as systemic arterial hypertension or diabetes mellitus. The prevalence reaches 32% in the general population, varies between 1% and 20% when associated with COPD (overlap syndrome), and is described as above 60% in populations with COPD and obesity. Orthognathic surgery (OC) can correct deformities of the maxillary and mandibular bones in OSAS. Objective: It was to develop the main approaches and clinical results of orthognathic surgery for the treatment of obstructive sleep apnea syndrome through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 146 articles were found, 58 articles were evaluated and 26 were included in this systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 32 studies with a high risk of bias and 22 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X² =65.8%>50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about cosmetic results due to the major advances involved. Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and contracted superficial areas, which remain stable between 6 months and 1 year postoperatively.

Major clinical approaches at the aesthetic level and complications of bichectomy: a systematic review

2024-03-08T12:21:22+00:00

Introduction: According to the Brazilian Society of Plastic Surgery in 2016, 7,362 people underwent bichectomy (BC), which represents 0.5% of the total number of aesthetic surgeries. In an attempt to achieve facial harmonization, BC surgery presents little complexity and is based on some well-defined steps. Even when appropriately indicated, it is still a controversial procedure, as there is no surgical technique adequately systematized in current literature, aiming to make it safe and reproducible. Objective: It was to present the main aesthetic considerations and complications of bichectomy, as well as discuss its safe management to avoid and treat problems. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 96 articles were found, 40 articles were evaluated in full and 28 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=67.9%>50%. It was concluded that on an aesthetic level, performing a bichectomy thins the middle third of the face, outlining and highlighting the bone angulations of the zygomatic region, contributing to a more pleasant facial aesthetics. Surgical removal of the Bichat ball induces a mild inflammatory process controlled by rescue medication, significantly reduces facial volume, and improves the quality of life and satisfaction with facial aesthetics 3 months postoperatively. Several studies have presented the importance of using the Bichat ball as an oral layer to close fistulas and also to cover bone grafts in implant dentistry.

Major clinical outcomes of laser therapy in endodontic treatments: a systematic review

2024-03-05T11:49:38+00:00

Introduction: In the setting of endodontic treatment, postoperative pain continues to be a problem in up to 58% of patients. This is due to the release of inflammatory mediators whenever the pulp or periradicular tissues are injured during root canal treatment or retreatment. The application of lasers in endodontics has increased due to their safety and effectiveness in dental treatments. Objective: It was to develop a systematic review to present the main clinical outcomes of the use of laser therapy in endodontic treatments. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 98 articles were found, 35 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=72.7% <50%. It was concluded that low-level laser therapy has been used in endodontics to promote analgesia, modulation of inflammation, and tissue healing. Analgesia mediated by low-level laser therapy results in vasodilation, and increased levels of adenosine triphosphate and cortisol, inhibiting the production of inflammatory factors. Recent studies reported that the use of low-level lasers enabled the treatment of post-endodontic pain compared to control. Furthermore, studies have shown that laser therapy can increase collagen synthesis and, concerning bone, modulate inflammation, accelerate cell proliferation, as well as stimulate bone stem cells, and accelerate their repair process.

Major approaches of inflammatory processes and peri-implant infections in the cellular and molecular scenario of mesenchymal stem cells, exosomes, and microRNAs: a systematic review

2024-03-01T22:01:22+00:00

Introduction: Bone diseases are denoted by fractures, osteoporosis, and osteoarthritis that affect a large number of individuals, with a rising prevalence of osteopenia for 64.3 million American individuals and osteoporosis for 11.9 million by the year 2030. Dental implants are not free from possible complications with consequent failure, the causes of which are still the subject of debate in the dental scientific community. In particular, peri-implant infections are multifactorial pathological conditions characterized by inflammation of the peri-implant mucosa with or without progressive loss of supporting bone. Specific expression profiles of microRNAs (miRNAs) extracted from peri-implant tissues are predictive of specific clinical outcomes of dental implants and can be used as biomarkers in implant dentistry for diagnostic and prognostic purposes. Objective: It was to address the main approaches to inflammatory processes and peri-implant infections and dental implants in the cellular and molecular scenarios of mesenchymal stem cells, exosomes, and microRNAs, emphasizing the main biomarkers in the therapeutic control of harmful dental implant processes. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 138 articles were found, 44 articles were evaluated in full and 34 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=67.9%>50%. It was concluded that specific expression profiles of miRNAs extracted from peri-implant tissues are predictive of specific clinical outcomes of dental implants and can be used as biomarkers in implant dentistry for diagnostic and prognostic purposes. Studies have shown that many of the miRNAs extracted from the implant's peri-crevicular fluid were common to those detected in soft tissues taken from the same peri-implant sites. Evidence suggests that exosomes derived from adipose-derived stem cells exhibit similar functions to those cells, with low immunogenicity and no tumorization. Insufficient bone volume directly impacts the placement of dental implants. Adipose-derived stem cells can accelerate bone healing when combined with dental implants. An increase in the concentration of exosomes with negative expression of miRNA-21-3p and miRNA-150-5p may be related to the development of peri-implantitis.

Immediate dental implants and major approaches: a systematic review

2024-02-28T14:27:21+00:00

Introduction: The use of dental implants in the rehabilitation of partially or completely edentulous patients followed a protocol of submerging the implant for 3-6 months during osseointegration to reduce the risk of implant failure caused by movements at the interface. In this context, subsequent improvements in surgical techniques such as implant structure and masticatory forces have led to evidence that immediate loading procedures can be successful (immediately loaded dental implant -ILI). Objective: It was to demonstrate, through a systematic review, the main clinical approaches of immediate dental implants with other types of dental implants, presenting the indication criteria and follow-up of the procedures. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 133 articles were found, 45 articles were evaluated in full and 37 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 23 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=59.9%>50%. It was concluded that success rates with the ILI technique are compatible with those of delayed loading, as long as certain guidelines are followed, which were divided into factors related to the patient, surgical technique, implant, prosthesis, and aesthetics. The high success rate is a consequence of correct surgical and prosthetic planning, and harmony between the implant system, patient, and dental surgeon. Regarding the region, it can currently be said that ILI in total jaw rehabilitation is a procedure with high success rates that should and can be applied in all cases in which the technique is efficient in providing adequate primary stability to the implants. Furthermore, the immediate provisional restoration did not have a significant peri-implant impact on the soft and hard tissues surrounding the immediately placed single dental implants.

Major characteristics and clinical results of the all-on-four technique in implant dentistry: a systematic review

2024-02-27T14:57:49+00:00

Introduction: In the context of dental implant methods, the all-on-four technique has proven to be beneficial in reducing stress around dental implants and is a very effective treatment option for edentulous patients. Objective: A systematic review was carried out to present the main characteristics and clinical results of the all-in-four technique in implant dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 82 articles were found, 40 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=55.7%>50%. It was concluded that technical knowledge and anatomical understanding in all-on-four mandibular surgery are essential for predictable and consistent surgical results. The all-on-four configuration proved to be biomechanically superior to parallel implants, considering the radial stresses on the implants and cortical bone. All-on-four treatments are based on the insertion of two anterior implants and two angled ones to cover a larger area. Therefore, implant-supported prostheses may have higher success and survival rates. The cost of treatment can be reduced. Chewing stress can also be minimized to a greater extent. It was observed that the lowest stress was observed in both lateral and vertical loads in the peri-implant region

The alcohol effect on the performance of athletes of a Medical School in the Northwest of São Paulo: a cross-sectional observational study

2024-02-27T12:45:40+00:00

Introduction: The medical schools of the São Paulo region perform sports competitions as a way of socialization and integration between them. Thus, each medical school has its training routine and focuses on performance during the year. However, these study places also have parties, which have as a characteristic the high consumption of alcoholic drinks. Objective: The present study aims to analyze the constancy of alcohol consumption by the students of a medical school in the northwest of São Paulo who practice physical exercises, as well as to evaluate the reasons and possible consequences of this substance in the organism of these academics. Methods: The research is observational and transversal, done by a virtual formulary, via "Google Forms". Results: It observed the ingest of alcohol, mostly, twice a week by 75% of the interviewed, as approximately 74% reported loss or failure in the efficiency at the next day's activities. Some of the symptoms by the majority were tiredness, sleepiness, fatigue, dehydration, and low concentration, and in the minority, cramps, spasms, and photosensitivity. Furthermore, 94% of the academics practice some exercise in their daily, third times a week. Finally, 86% of the interviewees who are competitors and ingest alcohol don’t consume it when the competition date is close. Conclusion: The medical students' routine has parties and sports, as well as the incentive for alcohol consumption. In this way, the alcohol effects, one day after ingestion, already show up and are malefic not only to the sports performance but also to the academic and personal performances. It can also be concluded that sports competitions are very important to some students since they don't consume alcoholic drinks days before the championship.

Major clinical and surgical approaches to treating orbitozygomatic and zygomatic maxillary complex fractures: a systematic review

2024-02-27T12:42:42+00:00

Introduction: In the scenario of orbitozygomatic fractures, facial and head injuries account for half of deaths due to trauma, and thousands are left with long-term or permanent injuries. Fractures of the zygomatic-maxillary complex (ZMC) and zygomatic arch are common athletic injuries. Operative treatment is indicated in cases of significant displacement or functional disturbance. Technology such as virtual surgical planning, intraoperative navigation, and intraoperative imaging has the potential to improve the accuracy of treatment of challenging fractures. Objective: It was to develop a systematic review of the main clinical and surgical approaches to the treatment of orbitozygomatic and zygomatic maxillary complex fractures. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 102 articles were found, 26 articles were evaluated in full and 25 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 12 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.9%>50%. A single-piece fracture of the fronto-orbito-zygomatic-maxillary bone connected to a temporoparietal bone may require additional osteotomy to achieve successful results in an acute setting. Orbital volume analysis offers a valid modality for objectively evaluating the efficiency of the management of orbitozygomatic complex fractures. The success rate of the fixation procedure at 1 point of the zygomaticomaxillary complex is high, with minimal complications. Intraoperative CT/three-dimensional imaging should be used in the treatment of ZMC fractures requiring orbital floor reconstruction, where adjacent fractures require fixation and/or when ≥ 2 axes are displaced ≥ 5 mm.

Evidence of the relationship between periodontal diseases/caries and cardiovascular diseases: a systematic review

2024-02-21T11:54:19+00:00

Introduction: Dental caries is highly prevalent worldwide and is responsible for significant morbidity. Metabolic diseases such as diabetes and obesity share several common environmental determinants with tooth decay. Cardiovascular disease is a common and complex disease, with high morbidity and mortality rates, representing a serious threat to human health. Objective: It was to develop a systematic review to present, through clinical studies and systematic reviews/meta-analyses, evidence of the relationship between periodontal diseases/cavities and cardiovascular diseases. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found, 36 articles were evaluated in full and 17 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 24 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR2. Most studies did not show homogeneity in their results, with X²=64.7%<50%. It was concluded that dental diseases such as periodontitis and tooth decay increase the risk of cardiovascular diseases. The number of missing teeth is significantly associated with selfreported history of stroke. The bacterium Streptococcus mutans, harboring the Cnm gene encoding the Cnm collagen-binding protein, is associated with the development of hypertensive intracerebral hemorrhage.

Clinical significance of the main methods of root canal irrigation in endodontics: a systematic review

2024-02-17T00:21:21+00:00

Introduction: In the context of endodontic treatments, irrigation is one of the most important aspects of the biomechanical preparation of the root canal. The arsenal of irrigation solutions designed for endodontic treatment and commercially available is broad. The choice of the correct solution depends on the combination of the properties of the solution associated with the effects to be obtained with irrigation, according to the clinical condition. Objective: It was to carry out a systematic review of the different endodontic irrigation methods, as well as to show the different clinical indications for use, comparing the effectiveness, biocompatibility, and influence on the dentin surface of irrigation solutions. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 115 articles were found, 50 articles were evaluated in full and 41 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.8%<50%. It was concluded that irrigation plays a fundamental role in the success of endodontic treatment. Although hypochlorite is the most important irrigating solution, no irrigant can perform all of the tasks required by irrigation. A detailed understanding of the mode of action of various solutions is important for optimal irrigation. New developments such as mechanical devices will help promote safe and effective irrigation. Within the limitations of this study, the use of the selfadjusting file system with the combination of EDTA and NaOCl improved Ca(OH)₂ removal. The passive ultrasonic irrigation and the self-adjusting file system were more effective in removing Ca(OH)₂ from the lateral grooves in the apical parts of the root canal than the EndoVac and conventional syringe irrigation systems.

Major clinical outcomes of the relationship of metabolic syndrome with the success of dental implants: the systematic review

2024-02-09T14:42:29+00:00

Introduction: Studies show that around 55% of dental implants can be affected by peri-implantitis, a chronic inflammatory process induced by bacteria, which promotes osteoclast-mediated bone resorption and inhibits bone formation, leading to progressive bone loss around the implants. implants. Current evidence points to an increased risk of developing peri-implantitis in both obesity/metabolic syndrome (MS) and diabetes mellitus (DM) conditions compared to the healthy population. Objective: It was to develop a systematic review to present the main clinical outcomes of the relationship between metabolic syndrome and the success of dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 92 articles were found, 26 articles were evaluated in full and 19 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 12 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=53.5%>50%. It was concluded that there is a correlation between the presence of metabolic syndrome and a higher prevalence of some bacterial species in the peri-implant groove, regardless of the peri-implant status. Metabolic syndrome has been shown to significantly reduce bone formation in the periimplant area in the short term. Metabolic syndrome and diabetes mellitus represent an increased risk of developing peri-implantitis. Peri-implantitis requires treatment to induce new bone formation around an implant. However, this is challenging as peri-implantitis, particularly in obese or diabetic conditions, has a microenvironment that is characterized by increased inflammation.

Major clinical outcomes of the use of biostimulators (L-PRF and coenzyme Q10) in the optimization of buccomaxillofacial surgery: a systematic review

2024-02-07T19:02:49+00:00

Introduction: Tissue engineering combines three key elements matrix (three-dimensional structures that support growth, collagen cell, bone mineral), signaling molecules (growth factors (GF) and leukocyte cytokines), and cells (osteoblasts, fibroblasts or other adequate populations for tissue regeneration. Many studies suggest that antioxidants act as inhibitors of osteoclastogenesis and the inhibitory effect of CoQ10 on osteoclast differentiation. These findings highlight the potential therapeutic applications of CoQ10 for the treatment of bone diseases. Objective: The present study highlighted the main approaches to the use of fibrin-rich plasma (L-PRF) and coenzyme Q10 in buccomaxillofacial surgery through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2006 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 104 articles were found, 38 articles were evaluated and 23 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 36 studies with a high risk of bias and 20 studies that did not meet GRADE. The use of platelet and leukocyte-rich fibrin can reduce bone absorption, infection, pain, local edema, and wound healing. L-PRF presents itself as an autogenous biomaterial with great versatility, low cost, easy acquisition and wide use, and infinite possibilities. It can be combined with other materials in the most diverse areas of dentistry. Also, CoQ10 concentrations can suppress ROS, which is needed as a signaling intermediate. CoQ10 acts as an enhancer of all stages of osteoblastic differentiation. Thus, CoQ10 suppresses osteoclast differentiation by eliminating generated intracellular ROS. Furthermore, CoQ10 enhances bone regeneration in all differentiation processes through transcription factor activity.

Enucleation of a solitary pancreatic tail insulinoma: a case report and review of the literature

2024-01-30T05:53:37+00:00

Introduction: Insulinomas are the most common pancreatic neuroendocrine tumors. They secrete insulin and result in endogenous hyperinsulinaemic hypoglycemia. The diagnosis of insulinoma was classically based on the fulfillment of Whipple’s triad; hypoglycaemia (plasma glucose <50mg/dL), neuroglycopaenic symptoms, and the prompt relief of such symptoms with the administration of glucose. Preoperative localization of the insulinoma will help to plan the type of surgery necessary, either enucleation or pancreatic resection, and also decide on the approach, either open or laparoscopic. Case description: A 53-year-old farmer presented with neuroglycopenia symptoms with biochemical evidence of endogenous hyperinsulinaemic hypoglycemia during the mixed meal test. Imaging evidence in the form of CT and MRI showed a benign, approximately 1cm, solitary pancreatic tail insulinoma. Intraoperative ultrasonography confirmed the findings and the patient underwent enucleation of the tumor. Histology revealed a grade 2 pancreatic neuroendocrine tumor with confirmation of an insulinoma on immunohistochemistry. Conclusion: Pancreatic insulinomas, a rare pancreatic tumor, the commonest of the pNET present with neuroglycopenia. Diagnosis entails biochemical confirmation of endogenous hyperinsulinaemic hypoglycemia on a 72-hour prolonged fasting test. Noninvasive imaging in the form of CT as the first line, followed by MRI is used for localization and assessment of resectability. EUS and ASVS are additional invasive imaging in diagnostic difficulty. Enucleation and intraoperative ultrasonography is the treatment of choice for small, benign, pancreatic insulinomas.

Major microRNAs and regulation of gut microbiota in patients with obesity: a systematic review

2024-01-27T01:49:09+00:00

Introduction: Obesity represents a pandemic represented as a chronic, long-term imbalance between calorie intake and energy expenditure. MicroRNAs (miRNAs) stand out. They are a class of small non-coding RNAs that regulate gene expression, and changes in their expression and functions have been associated with many diseases, including metabolic disorders and obesity. Objective: It was to present the main considerations and results of clinical studies on the relationship between obesity, gut microbiota, and microRNAs in inflammatory and immunological processes through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to September 2023 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found, and 44 articles were evaluated in full and 30 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=77.5%>50%. It was concluded that microRNAs regulate gene expression in adipose tissue, impact the regulation of metabolism and energy homeostasis, and regulate adipogenesis signaling pathways in white, beige, and brown adipose tissue. For example, microRNA (miR-143) promotes brown adipose tissue thermogenesis and inhibits white adipose tissue adipogenesis. Some miRNAs have been implicated in the control of body weight gain, glucose homeostasis, insulin resistance, and lipid metabolism, with crosstalk with the gut microbiota. Furthermore, an association was found between B. eggerthi abundance, miR-183-5p expression, and adiponectin levels. Expression of miR-15a-5p was found to be associated with H. parainfluenzae abundance and insulin levels.

Prevalence and associated factors of substance use disorders among people who use drugs: a population-based cross-sectional study in the Western Province of Sri Lanka

2024-01-25T14:54:16+00:00

Introduction: This study aimed to assess the prevalence of substance use disorders and associated factors among people who use drugs in the Western Province of Sri Lanka. Methods: A cross-sectional study was conducted in the Western Province of Sri Lanka, using a respondent-driven sampling technique. Sampling was initiated with 20 seeds and peers were recruited by peers through handing out coupons. The number of recruited participants was proportional to the estimated number of people who use drugs in each district of Western Province. A total of 870 people who use drugs participated in the study. A validated Sinhala version of the Drug Abuse Screening Test was used to assess the drug use severity among the participants and a pre-tested validated questionnaire was used to collect data to assess the associated factors. RDS Analyst software version 0.64 was used to assess frequency estimates. To assess factors associated with substance use disorders multiple logistic regression analysis was performed using SPSS software version 22. Results: The median age of the study sample was 39 years. The incidence of substance use disorder among the sample was 88.4%. Being employed, using heroin as a psychoactive drug, using drugs daily, using more than one drug, being a heavy alcohol user, buying drugs, stealing money or exchanging goods to get drugs, spending a substantial amount per month on drugs (Rs > 40,001), past or present medical history of tuberculosis and those who had disclosed their drug use behavior to their immediate family were found to be significantly associated with an increased risk of having a substance use disorder. Conclusion: A high prevalence of substance use disorder was found in the sample with multiple economic, behavioral, and health-related risk factors.

Relationship between bruxism and orofacial dysfunction and psychosocial problems developed by the SARS-CoV-2 pandemic: a literature review

2024-01-23T16:08:15+00:00

In 2019, the world was struck by a viral pathology that affected not only people's physiological health but their mental health. The coronavirus directly affects the respiratory system of an infected individual, causing serious breathing problems that have led to many deaths. However, not only respiratory complications were a consequence of COVID-19, but the development of psychological illnesses was quite common, a result of the drastic change in life that people had to go through and face the fear of uncertainty. This directly affected people's oral health, causing problems such as temporomandibular disorders (TMD) and bruxism to occur more frequently in people. This work aims to carry out a literature review, of articles taken from online databases, such as PubMed, Scielo, and Google Academic, to analyze the increase in cases of occlusion problems generated in the pandemic as a result of stress, anxiety, and depression. developed by people during the pandemic, in addition to showing diagnosis and treatment carried out by dental surgeons on the front line of contamination (the oral cavity).

Maxillary sinus surgery and use of fibrin-rich plasma: a systematic review

2024-01-11T13:05:22+00:00

Introduction: In around 25% of all maxillary sinuses, there is an accessory bone that is located in a lower portion than the main ostium, and all the mucus produced and the particles trapped in this mucus are directed through the ciliary beat to the ostium. When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and at the same time, pneumatization of the maxillary sinus occurs. Objective: It was to carry out a systematic review to elucidate the main clinical approaches to the use of fibrin-rich plasma in the bone regeneration process in maxillary sinus surgeries. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 115 articles were found, 40 articles were evaluated in full and 25 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=55.5%<50%. It was concluded that to improve osseointegration and bone anchorage, surface modifications can be chemical, such as calcium phosphate (Ca-P), or physical impregnation, being related to the microtopography of the implant. Several variables affect the biological activity of FRP preparations, such as the number of centrifuges used, centrifugation speed, and other protocols that result in preparations with various volumes, platelet numbers, amount of growth factors, and concentration of fundamental white blood cells and erythrocytes. Some researchers recommend avoiding tissue exposure to FRP-containing leukocytes, arguing that an inflammatory reaction may occur. On the other hand, other authors have described beneficial effects due to increased immunological and antibacterial resistance, although there is no clinical evidence to support its effect. FRP has gained prominence in the scientific community because it does not require the addition of an activator or anticoagulant, making the product more autologous, and featuring a fibrin network that protects growth factors, keeping them in place for longer.

Emergency surgery for penetrating neck trauma and common carotid artery laceration presenting with shock: a case report

2024-01-11T12:38:32+00:00

Introduction: The neck is an important anatomical junction connecting the head and limbs to the trunk and several vital neurovascular and aerodigestive structures pass through it. Zone II is the commonest site of penetrating neck injuries (PNI) and is commonly associated with vascular injury. The mortality rate following PNI is approximately 10%, increasing to 20% with concomitant penetrating carotid injury. Case description: A 43-year-old was brough to the emergency department in class III haemorrhagic shock with a 5mm, bleeding, penetrating neck injury in zone II of the neck. He had soft signs of vascular injury, bleeding was controlled with direct pressure, and resuscitation was commenced with intravenous crystalloids and blood products. Surgical exploration revealed a 5mm laceration in the distal common carotid artery which was repaired primarily. Postoperative computed tomography (CT) angiogram was normal and the patient had an uneventful recovery. Discussion: Traumatic disruption of the platysma is described as PNI and accounts for 10% of all penetrating injuries. Vascular injuries are most commonly seen in zone II and are usually associated with hard and soft signs of vascular injury. Zone II injuries require operative exploration with preoperative CT angiography recommended in haemodynamically stable patients to identify the type of injury. Small defects in the carotid artery can be repaired primarily. Conclusions: Open surgical exploration is mandatory for all patients with penetrative neck injury and haemodynamic instability. CT angiogram is recommended prior to open exploration is stable patients with zone II PNI.

Current evidence on the use of pocus in the diagnosis of pneumothorax in emergency rooms: a systematic review

2024-01-10T17:12:28+00:00

Introduction: Point of Care Ultrasound (POCUS) is currently recognized as useful and, in some cases, mandatory, such as during invasive procedures. Its bedside application includes differential diagnosis and therapeutic management of complex clinical conditions during hemodynamic instability. The emergence of portable devices with superior image quality and their applicability in emergency rooms and intensive care units has demonstrated high diagnostic effectiveness. Objective: It was to highlight the use of POCUS in the diagnosis of pneumothorax in emergency rooms, through a systematic review of meta-analytic articles, systematic reviews, and observational studies from the last 11 years (2012 to 2023). Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, 43 articles were evaluated in full and 31 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=61.5%<50%. It was concluded that the POCUS method is operator-dependent and has greater sensitivity (78 to 90%) and specificity greater than 98% in chest radiography. However, when performed correctly by trained professionals, following protocols, it proved to be useful for identifying and treating pneumothorax. POCUS is a portable, fast, and low-cost bedside examination that does not involve ionizing radiation, in addition to identifying a precise location for performing thoracentesis in cases of pneumothorax, which assists clinical physicians in urgent and emergency rooms, as well as in external environments such as rescue helicopters. There is a consensus among the authors researched that, to obtain clinical evidence on the use of POCUS in the diagnosis of pneumothorax, more randomized controlled studies are necessary, which reinforce the use of this versatile equipment in different urgent and emergency scenarios

Highlights of orthognathic surgery in class II patients: a systematic review

2024-01-09T04:23:06+00:00

Introduction: Orthognathic surgery is indicated to modify the position of the maxillomandibular structure, which may cause changes in the sagittal position of the mandibular condyle in individuals with retrognathism and mandibular prognathism. In the context of orthognathic surgery, anterior open bite (AOB) is an easily recognized malocclusion and presents only aesthetic and functional problems. Objective: Iven this, the present study developed a systematic review to present the main considerations of orthognathic surgery in class II patients. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 88 articles were found, 40 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.5%>50%. The etiology of anterior open bite is multifactorial and may be caused by environmental and hereditary factors. Class II patients may have significantly greater amounts of lateral and inferior translation than class III patients. Two-jaw surgery for open bite correction led to different directions and amounts of condylar rotational displacement in patients with skeletal class II malocclusion. Treatment can be carried out through preventive, interceptive, corrective, or even surgical treatments. The differentiated bonding of brackets to the anterior teeth is also a very useful resource for the treatment of anterior open bite.

Major factors for the effectiveness of apical endodontic microsurgery: a systematic review

2024-01-05T15:35:34+00:00

Introduction: Apical endodontic microsurgery is a technique developed by the evolution of traditional apical endodontic surgery approaches and technologies. This enhancement was possible since the introduction of equipment like cone beam computed tomography, microscope, ultrasonic instruments, and biocompatibility root-end material filling, increasing the predictability and long-term success rates and survival of teeth. Objective: It explored and developed the main factors for the effectiveness of apical endodontic microsurgery. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 118 articles were found, 43 articles were evaluated in full and 36 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.5%<50%. It was concluded that the success of apical endodontic surgery in terms of healing existing periapical pathology, together with a good long-term prognosis, depends on correct diagnosis and planning, as well as the association of surgical techniques, well-executed protocols, and biocompatible materials. The apical endodontic microsurgical approach is predictable and has a high success rate, which resulted from the introduction of cone beam computed tomography, microscope, ultrasonic instruments, and materials such as MTA and bioceramics for retro-fillings.

Geometric variability in radiological appearance of third ventricle in congenital hydrocephalus- is it really so pliable? Or do we need to visualize it differently? A two-case study and literature review

2023-12-27T20:42:47+00:00

Enlargement of third ventricle is seen due to multiple causes, usually associated with hydrocephalus. Raised intracranial pressure (ICP) is the most common indication for a cerebrospinal fluid diversion procedure. However, congenital anomalies like Dandy walker malformation (DWM) may not always manifest with raised ICP. Identifying neurological delay and neurocognitive parameters and correlating this with existing anatomical features is extremely important. We discuss this report of two cases of patients with DWM where abnormal morphology of the third ventricle was analysed and used to interpret clinical neurological delay.

Antimicrobial activity of pomegranate peel extract against various type of microorganism

2023-12-27T15:51:16+00:00

Background: Multidrug-resistant bacteria pose a significant threat, necessitating the development of new antimicrobial agents. Medicinal plants have been explored for their antimicrobial potential, with pomegranate peel being a rich source of bioactive compounds. Studies in Palestine and elsewhere have highlighted the antimicrobial properties of pomegranate peel extract (PPE) against various pathogens. Objective: It was to evaluate the antimicrobial activity of aqueous, ethanolic and methanolic extract of Pomegranate peel on some species of Gram-positive and Gram-negative pathogenic bacteria and Candida albicans. Methods: Aqueous, ethanolic, and methanolic extracts of pomegranate peel were prepared and tested against Gram-positive and Gram-negative bacteria, including clinical isolates, and Candida albicans. Antimicrobial activity was assessed using well diffusion, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) methods. Results: PPE exhibited good antibacterial activity against Gram-positive bacteria, including S. aureus and MRSA, with the methanolic extract being the most effective. However, VRSA remained resistant to all extracts. Variable results were observed for Gramnegative bacteria, with P. aeruginosa being the most susceptible P. vulgaris showed sensitivity to the ethanolic extract. Notably, all extract types demonstrated antimicrobial activity against Candida albicans, with the methanolic extract being the most potent. Conclusion: Pomegranate peel extract possesses antimicrobial activity against a range of pathogens, with variations based on the type of extract and the target microorganism. Methanolic PPE, in particular, showed strong activity against Candida albicans. These findings suggest the potential use of PPE as an alternative antimicrobial agent in combating infectious diseases, particularly those caused by Gram-positive bacteria and Candida albicans.

Lipotaping technique pos cervicofacial liposculpture: a guideline

2023-12-27T00:24:11+00:00

Background and Significance

In the scenario of cervicofacial and aesthetic liposculpture, the majority of patients who undergo these procedures seek an increasingly faster recovery, to return to their daily routine. Previously, several physiotherapy sessions were mandatory for a satisfactory result [1,2].

In this sense, LipoTaping is a great innovation in postoperative physiotherapy, especially cervicofacial. Kinesiotaping is a technique created by Kenso Kase in 1976, using an elastic, porous, adhesive, hypoallergenic tape without active ingredients, which can remain in contact with the skin for several days. Its material, texture, and elasticity are very similar to skin. It is a scientifically based method whose main objectives are to minimize edema (swelling), avoid bruises (purple), and reduce or prevent the formation of fibrosis. Furthermore, LipoTaping improves function and reduces tension in tissues close to scars, helping to prevent dehiscence (opening of points in the scar) [3].

In this aspect, LipoTaping decompresses tissues that have suffered damage in a surgical procedure. The skin is elevated and thus anchoring filaments (which ''open'' the lymphatic vessels) are pulled, allowing greater drainage of the liquid that until then was congested in the interstitium (space between the tissues below the skin), favoring its absorption [4].

The application of LipoTaping reduces pain and improves the mobilization of scar tissue, since the pain caused by the pressure exerted on sensory receptors is relieved through the ripples that the bandage promotes, due to the elevation of the skin. The elastic bandage can remain on the skin for 5 to 7 days and does not replace the modeling belt, and the techniques must be combined. It is up to the specialized professional to assess the best cut to be applied and the tensions that will be used on the tapes. In post-surgical lymphatic drainage, a cut known as “octopus” is used, which is applied following the lymphatic system, called Lymphotaping [5].

Also, patients also benefit from minimizing postoperative muscle pain and correcting some surgical complications. The application prevents complications, accelerates recovery, allows greater autonomy for the patient, and reduces the number of physiotherapy sessions, making it an excellent therapeutic option. The technique can be applied in the first 24 hours of surgery, as the earlier the application, the greater the benefits [1-3].