Haraji, Afshin; Rakhshan, Vahid; Khamverdi, Naiemeh; Alishahi, Hadiseh Khanzadeh
2013-01-01
To assess the effects of intra-alveolar application of chlorhexidine gel on the incidence of alveolar osteitis (dry socket) and the severity of postsurgical pain. A total of 160 impacted mandibular third molars were extracted in 80 patients enrolled in this trial. In each subject, a socket was randomly selected and packed to the crest of the alveolar ridge with a gelatin sponge dressing saturated in 0.2% chlorhexidine gel. The contralateral socket was packed with a dry dressing as the placebo. None of the included patients took antibiotics or analgesics. The occurrence of dry socket and patients' pain levels were assessed at the first and third postoperative days. The data were analyzed using Spearman correlation coefficient, McNemar, Wilcoxon, and chi-square tests. Chlorhexidine gel significantly reduced dry socket incidence from 32.6% to 11.3% (P ≤ .001 [McNemar and chi-square], absolute risk reduction = 21.2%, relative risk reduction = 65.4%, odds ratio = 0.263, relative risk = 0.345). It also significantly relieved postoperative pain on both sides in all the patients (P ≤ .001 [Wilcoxon]) and also in the 54 subjects who did not develop dry socket (P ≤ .001 [Wilcoxon]). Besides decreasing the incidence of dry socket, chlorhexidine gel can reduce postsurgical pain in patients with and without dry socket.
Interventions for the prevention of dry socket: an evidence-based update.
Sharif, M O; Dawoud, B E S; Tsichlaki, A; Yates, J M
2014-07-11
This paper reviews the latest evidence for local and systemic interventions for the prevention of alveolar osteitis (dry socket). Dry socket is a painful and common post-operative complication following exodontia. Any interventions for the prevention of dry socket could reduce both its incidence and help avoid this painful complication. Prophylactic measures proposed in the literature are discussed. Furthermore, this article discusses both the clinical and histological stages of a normal healing socket.
Platelet rich fibrin in the management of established dry socket.
Chakravarthi, Srinivas
2017-06-01
Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters. Pain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day. PRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket.
Platelet rich fibrin in the management of established dry socket
2017-01-01
Objectives Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. Materials and Methods Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters. Results Pain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day. Conclusion PRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket. PMID:28770156
Requena-Calla, Silvana; Funes-Rumiche, Italo
2016-04-01
Dry socket is one of the most studied complications in dentistry and several studies have sought an effective and safe method for its prevention and treatment. The aim of this study was to evaluate the effectiveness of intra-alveolar gel chlorhexidine in preventing dry socket after the surgical removal of third molars. The sample involved the treatment of 40 patients who required extraction of third molars impacted, which were randomly assigned to research groups: experimental group (chlorhexidine gel 0.12%) and control group (placebo gel). Performed the extraction was administered 1 mL of chlorhexidine gel or 1 mL of placebo gel within the socket. The removal of suture was on the fifth postoperative day in which the presence or absence of dry socket was evaluated. No relationship between the appearance of dry socket after application of chlorhexidine gel or placebo gel (X2 test, p = 0.311) was found. However, significant differences (U Mann-Whitney test, p = 0.036) in the pain presented on the fifth postoperative day were evident (VAS). The administration of intra-alveolar chlorhexidine gel 0.12% could generate a better response to postoperative pain after the removal of third molars. Third molar surgery, dry socket, chorhexidine gel.
Sharma, Ashish; Aggarwal, Nimish; Rastogi, Sanjay; Choudhury, Rupshikha; Tripathi, Siddhi
2017-01-01
To assess the efficacy of platelet-rich fibrin (PRF) on the pain and healing of the extraction socket related with established alveolar osteitis (dry socket, AO) after the removal of maxillary and mandibular molars. One hundred consecutive adult patients with age group ranging from 18 to 40 years along with established dry socket after maxillary and mandibular molar extractions who have not received any treatment for the same were included in this single-arm clinical trial. PRF was placed in the maxillary and mandibular molar extraction sockets after adequate irrigation of the socket. All the patients evaluated for the various study variables which include pain, degree of inflammation, and healthy granulation tissue formation (wound healing) at the 1 st , 3 rd , 7 th , and 14 th post-PRF placement day in the alveolar socket. Data were analyzed using Shapiro-Wilk's test, Chi-square test and/or Student's t -test, Friedman's test, Wilcoxon signed-rank test, and Bonferroni test, with the significance level set at P < 0.05. There was significant reduction in pain associated with AO at the 3 rd and 7 th post-PRF placement day in the extraction socket along with mark decrease in the degree of inflammation at the 3 rd post-PRF placement day, and there was better wound healing by the end of the 2 nd week. The use of PRF in this clinical trial illustrates the promising results in terms of reduced pain and better healing in the patients with sustained AO.
Effect of plasma rich in growth factors on alveolar osteitis
Haraji, Afshin; Lassemi, Eshagh; Motamedi, Mohammad Hosein Kalantar; Alavi, Maryam; Adibnejad, Saman
2012-01-01
Introduction: The high prevalence of dry socket or alveolar osteitis (AO) is of concern in surgical removal of third molars. The aim of the present study was to assess the preventive effect of plasma rich in growth factors (PRGF) on AO and also its effect on pain management and healing acceleration in third molar extraction sockets of high-risk patients. Materials and Methods: This split-mouth, double-blind clinical trial included 40 bilateral third molar extractions (80 sockets) with at least one identified risk factor for AO. PRGF was obtained from patient's own blood, based on manufacturer's instruction, and blindly placed in one of the two bilateral sockets (PRGF group; n = 20) of each patient. The contralateral socket was treated with a placebo (control group; n = 20). Samples were evaluated for AO and pain incidence on days 2, 3 and 4 and healing and infection on days 3 and 7. Data were analyzed in SPSS v16 using Wilcoxon test. Results: There was a significant difference in dry socket and pain incidence and healing rate between the two groups. Intensity of pain and occurrence of dry socket in the study group was lower than the controls. Also the healing rate was higher (P < 0.05) for the PRGF group. No sign of infection was seen in either group. Conclusion: The application of PRGF may significantly reduce the incidence of AO or its associated pain and may accelerate healing. The prophylactic use of PRGF following third molar extraction may be suggested especially in the patients at risk of AO. PMID:23251056
Efficacy of different methods used for dry socket management: A systematic review.
Taberner-Vallverdú, Maria; Nazir, Mariam; Sánchez-Garcés, M Ángeles; Gay-Escoda, Cosme
2015-09-01
Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but in spite of its high incidence there is not an established treatment for this condition. Analyze the efficacy of different methods used in the management of dry socket regarding results of pain's relief and alveolar mucosa healing compared to conventional surgical treatment of curettage and saline irrigation. A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "post-extraction complications", "alvogyl", "alveolar osteitis" and "fibrynolitic alveolitis", individually and next, using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 10 patients, articles published from 2004 to 2014 written in English. The exclusion criteria were case reports and nonhuman studies. 11 publications were selected from a total of 627. Three of the 11 were excluded after reading the full text. The final review included 8 articles: 3 prospective studies, 2 retrospective studies and 3 clinical trials. They were stratified according to their level of scientific evidence using the SORT criteria (Strenght of Recommendation Taxonomy). All treatments included in the review have the aim to relief patient's pain and promote alveolar mucosa healing in dry socket. Given the heterogeneity of interventions and the type of measurement scale, the results are difficult to compare. Curettage and irrigation should be carried out in dry socket, as well as another therapy such as LLLT, zinc oxide eugenol or plasma rich in growth factors, which are the ones that show better results in pain remission and alveolar mucosa healing. Assessment alveolar bone esposure must be a factor to consider in future research. Taking into account the scientific quality of the articles evaluated, a level B recommendation is given for therapeutic interventions proposed for the treatment of dry socket.
Dry Socket: Frequency, Clinical Picture, and Risk Factors in a Palestinian Dental Teaching Center
Abu Younis, Mohammed H; Abu Hantash, Ra'ed O
2011-01-01
Aims: The objectives of this study were to find out the frequency, clinical picture, and risk factors of dry socket at the Dental Teaching Center of Al-Quds University in Palestine. Methods and Materials: Two previously used questionnaires were accomplished in this study over a one year period. The first questionnaire was completed for every patient who had one or more permanent teeth extracted in the Dental Surgery Clinic. The other one was completed for every patient suffered a postoperative pain and was diagnosed with dry socket. Results: There were 1305 dental extractions performed in 805 patients. The overall frequency of dry socket was 3.2%. The incidence of dry socket following non-surgical extractions was 1.7% while it was 15% following surgical extractions (P< 0.005). The incidence of dry socket was significantly higher in smokers (12%) than in non-smokers (4%) (P < 0.005), however, there is a strong association between the amount of smoking and the incidence of dry socket (P < 0.002). The incidence of dry socket was significantly higher in the single extraction cases (13%) than in the multiple extraction cases (5%) (P = 0.005). Age, sex, medical history, extraction site, amount of local anesthesia and experience of operator play no role in the occurrence of dry socket. Conclusion: Smoking, surgical trauma and single extractions are considered predisposing factors in the occurrence of dry socket. On the other hand, factors like: age, sex, medical history, extraction site, amount of anesthesia, and operator experience have no effect on the observation of dry socket. PMID:21559187
Common risk factors for postoperative pain following the extraction of wisdom teeth
2015-01-01
The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for surgical difficulty and the surgeon's experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies. PMID:25922816
Dutta, Shubha Ranjan; Passi, Deepak; Singh, Purnima; Sharma, Sarang; Singh, Mahinder; Srivastava, Dhirendra
2016-01-01
The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients. Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3 rd , 7 th , and 14 th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients. Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site. Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials.
Dutta, Shubha Ranjan; Passi, Deepak; Singh, Purnima; Sharma, Sarang; Singh, Mahinder; Srivastava, Dhirendra
2016-01-01
Aim: The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients. Materials and Methods: Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3rd, 7th, and 14th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients. Results: Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site. Conclusion: Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials. PMID:28163478
Hasheminia, Dariush; Moaddabi, Amirhossein; Moradi, Saeid; Soltani, Parisa; Moannaei, Mahsa; Issazadeh, Maryam
2018-05-01
Dry socket or alveolar osteitis is a delayed healing of alveolar bone after exodontia causing moderate to severe pain 2-4 days after extraction of teeth. Antibacterial agents such as antibiotics and chlorhexidine have been previously proved to prevent or reduce the incidence of dry socket. Betadine is a mixture of iodine and povidone which has bactericidal, antifungal and antiviral effects. The aim of the present study was to evaluate the effect of preoperative povidone iodine 1% mouthwash before surgical extraction of impacted mandibular third molar, however age, gender and oral hygiene were also considered. 189 patients who needed surgical extraction of Pell and Gregory class A and B mandibular third molars were included in this study. The patients who were not willing to participate in the study, took, women who took oral contraceptives or were in the first 22 days of menstrual cycle were excluded. Patients were randomly assigned to control or test group. 97 patients in the test group took preoperative povidone iodine 1% mouthwash and 92 patients in the control group didn't take any antibiotic or mouthwash. Patients were examined in days 3 and 7 postoperatively for incidence of alveolar osteitis. Chi-square test didn't show any significant relation between dry socket incidence and gender ( p value: 0.848) and Oral hygiene ( p value: 0.866). However, it revealed a significant relation between age and dry socket incidence ( p value: 0.003) and patients older than 30 were reported to have higher incidence of dry socket. Independent T-Test showed a significant difference between the test and control group in incidence of dry socket ( p value: 0.036). Based on the results of this study povidone iodine 1% mouthwash can decrease dry socket incidence also as the age increases, the incidence of dry socket becomes higher. Key words: Dry socket, impaction, betadine, povidone iodine.
Hasheminia, Dariush; Moaddabi, Amirhossein; Moradi, Saeid; Moannaei, Mahsa; Issazadeh, Maryam
2018-01-01
Background Dry socket or alveolar osteitis is a delayed healing of alveolar bone after exodontia causing moderate to severe pain 2-4 days after extraction of teeth. Antibacterial agents such as antibiotics and chlorhexidine have been previously proved to prevent or reduce the incidence of dry socket. Betadine is a mixture of iodine and povidone which has bactericidal, antifungal and antiviral effects. The aim of the present study was to evaluate the effect of preoperative povidone iodine 1% mouthwash before surgical extraction of impacted mandibular third molar, however age, gender and oral hygiene were also considered. Material and Methods 189 patients who needed surgical extraction of Pell and Gregory class A and B mandibular third molars were included in this study. The patients who were not willing to participate in the study, took, women who took oral contraceptives or were in the first 22 days of menstrual cycle were excluded. Patients were randomly assigned to control or test group. 97 patients in the test group took preoperative povidone iodine 1% mouthwash and 92 patients in the control group didn’t take any antibiotic or mouthwash. Patients were examined in days 3 and 7 postoperatively for incidence of alveolar osteitis. Results Chi-square test didn’t show any significant relation between dry socket incidence and gender (p value: 0.848) and Oral hygiene (p value: 0.866). However, it revealed a significant relation between age and dry socket incidence (p value: 0.003) and patients older than 30 were reported to have higher incidence of dry socket. Independent T-Test showed a significant difference between the test and control group in incidence of dry socket (p value: 0.036). Conclusions Based on the results of this study povidone iodine 1% mouthwash can decrease dry socket incidence also as the age increases, the incidence of dry socket becomes higher. Key words:Dry socket, impaction, betadine, povidone iodine. PMID:29849968
Persistent socket pain postenucleation and post evisceration: a systematic review.
Hogeboom, Charlotte S E; Mourits, Daphne L; Ket, Johannes C F; Tan, H Stevie; Hartong, Dyonne T; Moll, Annette C
2018-04-06
To investigate causes, diagnostics and treatment modalities for persistent socket pain (PSP) after enucleation and evisceration. A systematic search was undertaken in accordance with the PRISMA Statement, in PubMed, Embase.com and Thomson Reuters/Web of Science. We searched for relevant papers until the 28th of July 2016. Inclusion criteria were (1) patients with a history of enucleation or evisceration, (2) PSP, (3) report of the cause and/or used diagnostics and/or treatment modality, (4) full text in English, Dutch or Spanish language. Excluded were (1) review articles, (2) comments, and publications concerning, (3) nonhumans, (4) exenterated patients, (5) acute postoperative pain, or (6) periorbital pain without pain in the socket. Given the lack of high quality evidence from randomized controlled trials, we examined all available evidence from primary observational studies and assessed quality within this lower level of evidence. A total of 32 studies were included. Causes of PSP found were prosthesis-related (n = 5), dry socket (n = 2), trochleitis (n = 3), compression of the trigeminal nerve (n = 2), implant-related (n = unknown), inflammation (n = 5), surgery-related (n = 4), neuromas (n = 8), malignant tumours (n = 3), psychiatric/psychosocial (n = 2), phantom pain (n = 149), rarer entities (n = 3) or unknown (n = 14). Nonsurgical treatments suffice for conditions as trochleitis, prosthesis-related pain, dry socket and for phantom pain. Other causes of pain may require more invasive treatments such as implant removal. Careful history and examination can give some direction in the diagnostic procedure; however, PSP is probably multifactorial and the specific origin(s) may remain uncertain. Implant replacement can be an effective treatment. Studies to identifiy less invasive procedures are required. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Systemic review of dry socket: aetiology, treatment, and prevention.
Tarakji, Bassel; Saleh, Lubna Ahmed; Umair, Ayesha; Azzeghaiby, Saleh Nasser; Hanouneh, Salah
2015-04-01
Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words "dry socket, aetiology, treatment and prevention" and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide- eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB. The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence.
Systemic Review of Dry Socket: Aetiology, Treatment, and Prevention
Saleh, Lubna Ahmed; Umair, Ayesha; Azzeghaiby, Saleh Nasser; Hanouneh, Salah
2015-01-01
Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words “dry socket, aetiology, treatment and prevention” and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide– eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB. The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence. PMID:26023661
Pal, U. S.; Singh, Balendra Pratap; Verma, Vikas
2013-01-01
Purpose: The aim of this study was to report a comparison between the zinc oxide eugenol dressing and plasma rich in growth factor (PRGF) with gelatin sponge in the treatment of dry socket. Materials and Methods: This study comprised of 45 patients of dry socket in the span of one year. The patients were randomly divided into three groups on the basis of treatments: Group A (PRGF with gelatin sponge), group B (zinc oxide eugenol group), and group C (irrigation with sterile saline only). The clinical progress was noted at 1st, 2nd, 3rd, 7th, and 15th day after the treatment. Results: Patient's healing was better in group A than in group B but symptomatic pain relief was faster in group B. Group C fared worst in both aspects. Conclusion: We conclude that PRGF with gelatin sponge might be a treatment of choice in the management of dry socket. PMID:23853450
Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques.
Mamoun, John
2018-04-01
Dry socket, also termed fibrinolytic osteitis or alveolar osteitis, is a complication of tooth exodontia. A dry socket lesion is a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium and exists inside or around the perimeter of the socket or alveolus for days after the extraction procedure. This article describes dry socket lesions; reviews the basic clinical techniques of treating different manifestations of dry socket lesions; and shows how microscope level loupe magnification of 6× to 8× or greater, combined with co-axial illumination or a dental operating microscope, facilitate more precise treatment of dry socket lesions. The author examines the scientific validity of the proposed causes of dry socket lesions (such as bacteria, inflammation, fibrinolysis, or traumatic extractions) and the scientific validity of different terminologies used to describe dry socket lesions. This article also presents an alternative model of what causes dry socket lesions, based on evidence from dental literature. Although the clinical techniques for treating dry socket lesions seem empirically correct, more evidence is required to determine the causes of dry socket lesions.
Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques
2018-01-01
Dry socket, also termed fibrinolytic osteitis or alveolar osteitis, is a complication of tooth exodontia. A dry socket lesion is a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium and exists inside or around the perimeter of the socket or alveolus for days after the extraction procedure. This article describes dry socket lesions; reviews the basic clinical techniques of treating different manifestations of dry socket lesions; and shows how microscope level loupe magnification of 6× to 8× or greater, combined with co-axial illumination or a dental operating microscope, facilitate more precise treatment of dry socket lesions. The author examines the scientific validity of the proposed causes of dry socket lesions (such as bacteria, inflammation, fibrinolysis, or traumatic extractions) and the scientific validity of different terminologies used to describe dry socket lesions. This article also presents an alternative model of what causes dry socket lesions, based on evidence from dental literature. Although the clinical techniques for treating dry socket lesions seem empirically correct, more evidence is required to determine the causes of dry socket lesions. PMID:29732309
Alveolar osteitis; Alveolitis; Septic socket ... You may be more at risk for dry socket if you: Have poor oral health Have a ... after having a tooth pulled Have had dry socket in the past Drink from a straw after ...
A retrospective study on the use of a dental dressing to reduce dry socket incidence in smokers.
Murph, James T; Jaques, Susan H; Knoell, Alexander N; Archibald, Geoffrey D; Yang, Stan
2015-01-01
This study assessed the effectiveness of using an oxidized cellulose dental dressing in order to reduce the rate of alveolar osteitis after posterior tooth extraction in smokers. Dry socket incidences of heavy smokers from 4 independent dental clinics, which routinely used oxidized cellulose dental dressings to mitigate dry socket formation between March 2011 and December 2012, were compiled and evaluated. All extraction sites healed uneventfully except for those cases that developed dry sockets. Overall, 1.7% of male patients and 2.2% of female patients developed dry sockets. No conclusive relationship was found between the number of cigarettes smoked and dry socket formation among patients in this study. The results of this study were consistent with the view that gender, age, postextraction regimen, and multiple extractions affect dry socket formation. The results indicate that an oxidized cellulose dental dressing postextraction is a safe and effective method for mitigating dry socket formation among smokers.
Dry socket: incidence, clinical features, and predisposing factors.
Akinbami, Babatunde O; Godspower, Thikan
2014-01-01
Background. Dry socket is a global phenomenon. The purpose of the study was to investigate the incidence of dry socket in recent times in a Nigerian Tertiary Hospital. Methods. Patients who were referred for dental extractions were included in the study. The case files of patients were obtained and information retrieved included biodata, indication for extraction, number and type of teeth extracted, oral hygiene status, compliance to oral hygiene instructions, and development of dry socket. Results. One thousand, one hundred and eighty two patients with total of 1362 teeth extracted during the 4-year period of the study were analyzed, out of which 1.4% teeth developed dry socket. The mean age (SD) was 35.2 (16.0) years. Most of the patients who presented with dry socket were in the fourth decade of life. Mandibular teeth were affected more than maxillary teeth. Molars were more affected. Retained roots and third molars were conspicuous in the cases with dry socket. Conclusion. The incidence of dry socket in our centre was lower than previous reports. Oral hygiene status, lower teeth, and female gender were significantly associated with development of dry socket. Treatment with normal saline irrigation and ZnO eugenol dressings allowed relief of the symptoms.
Dry Socket: Incidence, Clinical Features, and Predisposing Factors
Akinbami, Babatunde O.; Godspower, Thikan
2014-01-01
Background. Dry socket is a global phenomenon. The purpose of the study was to investigate the incidence of dry socket in recent times in a Nigerian Tertiary Hospital. Methods. Patients who were referred for dental extractions were included in the study. The case files of patients were obtained and information retrieved included biodata, indication for extraction, number and type of teeth extracted, oral hygiene status, compliance to oral hygiene instructions, and development of dry socket. Results. One thousand, one hundred and eighty two patients with total of 1362 teeth extracted during the 4-year period of the study were analyzed, out of which 1.4% teeth developed dry socket. The mean age (SD) was 35.2 (16.0) years. Most of the patients who presented with dry socket were in the fourth decade of life. Mandibular teeth were affected more than maxillary teeth. Molars were more affected. Retained roots and third molars were conspicuous in the cases with dry socket. Conclusion. The incidence of dry socket in our centre was lower than previous reports. Oral hygiene status, lower teeth, and female gender were significantly associated with development of dry socket. Treatment with normal saline irrigation and ZnO eugenol dressings allowed relief of the symptoms. PMID:24987419
Wang, Yao-zhong; Guan, Qun-li; Li, Ya-xin; Guo, Ji-lai; Jiang, Ling; Jia, Mu-yun; Deng, Yue
2013-02-01
To study the clinical effect of "gelatamp" colloidal silver gelatin sponge on preventing dry socket after extracting the mandibular impacted teeth. 1350 teeth extracted from 976 patients who needed to extract the mandibular impacted teeth were divided into group A, group B and group C randomly. "Gelatamp" colloidal silver gelatin sponge was implanted into alveolar socket after teeth extraction in group A, with absorbable gelatin sponge was implanted into alveolar socket in group B and nothing was implanted into alveolar socket in group C. The incidence of dry socket was observed, the data was analyzed using SPSS10.0 software package. The incidence of dry socket was 0.44% in group A, 2% in group B and 4.44% in group C. There was significant difference in the incidence of dry socket between group A and group C(P<0.01). There was also significant difference between group B and group C(P<0.05) and between group A and group B(P<0.05). The results demonstrate that "gelatamp" colloidal silver gelatin sponge can prevent the occurrence of dry socket after teeth extraction, which is of wide clinical use.
Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai
2015-08-01
To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (P<0.05). The occurrences of lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation in group A significantly decreased compared with group B (P<0.05). The operation time, integrity of extraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (P<0.05). High-speed handpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.
Mitton, Kay; Kulkarni, Jai; Dunn, Kenneth William; Ung, Anthony Hoang
2017-10-01
This novel case report describes the problems of prescribing a prosthetic socket in a left transfemoral amputee secondary to chronic patellofemoral instability compounded by complex regional pain syndrome. Case Description and Methods: Following the amputation, complex regional pain syndrome symptoms recurred in the residual limb, presenting mainly with oedema. Due to extreme daily volume fluctuations of the residual limb, a conventional, laminated thermoplastic socket fitting was not feasible. Findings and Outcomes: An adjustable, modular socket design was trialled. The residual limb volume fluctuations were accommodated within the socket. Amputee rehabilitation could be continued, and the rehabilitation goals were achieved. The patient was able to wear the prosthesis for 8 h daily and to walk unaided indoors and outdoors. An adjustable, modular socket design accommodated the daily residual limb volume fluctuations and provided a successful outcome in this case. It demonstrates the complexities of socket fitting and design with volume fluctuations. Clinical relevance Ongoing complex regional pain syndrome symptoms within the residual limb can lead to fitting difficulties in a conventional, laminated thermoplastic socket due to volume fluctuations. An adjustable, modular socket design can accommodate this and provide a successful outcome.
Prevention and treatment of dry socket.
Dodson, Tom
2013-03-01
Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases were searched together with reference lists of identified articles. Topic experts and organisations were also contacted. Only randomised controlled trials were considered and there were no restrictions regarding language or date of publication. Data abstraction and risk of bias assessment were conducted in duplicate and Cochrane statistical guidelines were followed. The GRADE tool was used to assess the quality of the body of evidence. Twenty-one trials with 2570 participants were included. Eighteen trials (2376 participants) related to prevention and three to treatment (194 participants). Six studies were at high risk of bias, 14 of unclear risk and one study at low risk. There was moderate evidence (four trials, 750 participants) that chlorhexidine mouthrinses (0.12% and 0.2% concentrations) both before and after extraction(s) prevented approximately 42% of dry socket(s) with a RR of 0.58 (95% CI 0.43 to 0.78; P < 0.001). The number of patients needed to be treated (0.12% and 0.2%) with chlorhexidine rinse to prevent one patient having dry socket (NNT) was 232 (95% CI 176 to 417), 47 (95% CI 35 to 84) and 8 (95% CI 6 to 14) at prevalences of dry socket of 1%, 5% and 30% respectively. Thee was moderate evidence (two trials, in 133 participants) that placing chlorhexidine gel (0.2%) after extractions prevented approximately 58% of dry socket(s) with a RR of 0.42 (95% CI 0.21 to 0.87; P = 0.02) with NNT of 173 (95% CI 127 to 770), 35 (95% CI 25 to 154) and 6 (95% CI 5 to 26) at prevalences of dry socket of 1%, 5% and 30% respectively. There was insufficient evidence to determine the effects of other intrasocket preventive interventions or interventions to treat dry socket. There is some evidence that rinsing with chlorhexidine (0.12% and 0.2%) or placing chlorhexidine gel (0.2%) in the sockets of extracted teeth, provides a benefit in preventing dry socket. There was insufficient evidence to determine the effects of the other 10 preventative interventions each evaluated in single studies. There was insufficient evidence to determine the effects of any of the interventions to treat dry socket. The present review found some evidence for the association of minor adverse reactions with use of 0.12%, 0.2% and 2% chlorhexidine mouthrinses, though most studies were not designed to detect the presence of hypersensitivity reactions to mouthwash as part of the study protocol. No adverse events were reported in relation to the use of 0.2% chlorhexidine gel placed directly into a socket (though previous allergy to chlorhexidine was an exclusion criterion in these trials). In view of recent reports in the UK of two cases of serious adverse events associated with irrigation of dry socket with chlorhexidine mouthrinse, it is recommended that all members of the dental team prescribing chlorhexidine products are aware of the potential for both minor and serious adverse side effects. It is beyond the scope of this review to describe and detail The Cochrane Collaboration. The reader can seek out more information at http://www.cochrane.org/. In brief, a systematic review supported and published by the Cochrane group represents the gold standard to support clinical decision-making.
Taberner-Vallverdú, M; Sánchez-Garcés, M-Á; Gay-Escoda, C
2017-11-01
Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "prevention", "risk factors", "alveolar osteitis" and "fibrynolitic alveolitis", both individually and using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 30 patients, articles published from 2005 to 2015 and written in English. The exclusion criteria were case reports and nonhuman studies. 30 publications were selected from a total of 250. Six of the 30 were excluded after reading the full text. The final review included 24 articles: 9 prospective studies, 2 retrospective studies and 13 clinical trials. They were stratified according to their level of scientific evidence using SIGN criteria (Scottish Intercollegiate Guidelines Network). All treatments included in the review were aimed at decreasing the incidence of dry socket. Locally administering chlorhexidine or applying platelet-rich plasma reduces the likelihood of developing this complication. Antibiotic prescription does not avoid postoperative complications after lower third molar surgery. With regard to risk factors, all of the articles selected suggest that patient age, history of previous infection and the difficulty of the extraction are the most common predisposing factors for developing dry socket. There is no consensus that smoking, gender or menstrual cycles are risk factors. Taking the scientific quality of the articles evaluated into account, a level B recommendation has been given for the proposed-procedures in the prevention of dry socket.
Cai, Yong-hai; Lu, Chang-shou
2008-10-01
To study the clinical effect of Gelatamp colloidal silver gelatin sponge on preventing the complication of teeth extraction. 672 teeth were divided into experimental group and control group semi-randomly. All teeth were extracted after local anesthesia and sockets were cleaned. Gelatamp colloidal silver gelatin sponge was implanted into socket in experimental group and nothing was implanted into alveolar socket in control group. The complication of teeth extraction was observed on 0.5 h, 2 d and 7 d after extraction. The incidence rate of complication was calculated. The incidence rate of complication of teeth extraction in experimental group was 7.72%, which was lower than that of control group (24.43%). There was significant difference in the incidence rates of complication between experimental group and control group (P < 0.05). The incidence rate of bleeding, infection, pain, swelling and dry socket after teeth extraction in experimental group was lower than those of control group, and the difference between them was statistically significant (P < 0.05). The results demonstrate that Gelatamp colloidal silver gelatin sponge can prevent the occurrence of complication of teeth extraction, this can be used in clinic.
Taberner-Vallverdú, Maria; Sánchez-Garcés, Mª Ángeles
2017-01-01
Background Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. Objectives Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. Material and Methods A Cochrane and PubMed-MEDLINE database search was conducted with the search terms “dry socket”, “prevention”, “risk factors”, “alveolar osteitis” and “fibrynolitic alveolitis”, both individually and using the Boolean operator “AND”. The inclusion criteria were: clinical studies including at least 30 patients, articles published from 2005 to 2015 and written in English. The exclusion criteria were case reports and nonhuman studies. Results 30 publications were selected from a total of 250. Six of the 30 were excluded after reading the full text. The final review included 24 articles: 9 prospective studies, 2 retrospective studies and 13 clinical trials. They were stratified according to their level of scientific evidence using SIGN criteria (Scottish Intercollegiate Guidelines Network). Conclusions All treatments included in the review were aimed at decreasing the incidence of dry socket. Locally administering chlorhexidine or applying platelet-rich plasma reduces the likelihood of developing this complication. Antibiotic prescription does not avoid postoperative complications after lower third molar surgery. With regard to risk factors, all of the articles selected suggest that patient age, history of previous infection and the difficulty of the extraction are the most common predisposing factors for developing dry socket. There is no consensus that smoking, gender or menstrual cycles are risk factors. Taking the scientific quality of the articles evaluated into account, a level B recommendation has been given for the proposed-procedures in the prevention of dry socket. Key words:Dry socket, prevention, alveolar osteitis, risk factors. PMID:29053647
Rakhshan, V
2018-04-30
Dry socket is a common complication of dental extraction, especially extraction of third molars. Knowledge of the frequent risk factors of alveolitis osteitis is useful in determining high-risk patients, treatment planning, and preparing the patients mentally. The aim of this narrative review was to summarize the common risk factors of dry socket. Unlike surgery difficulty, surgeon's experience, oral contraception use, and oral hygiene which showed stronger evidence, the influences of age, gender, and smoking were rather inconclusive. The case of female or oral contraceptive effect might relate mainly to estrogen levels (when it comes to dry socket) which can differ considerably from case to case. Many risk factors might be actually a combination of various independent variables, which should be targeted instead, in more comprehensive designs. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Xu, Fang; Zhang, Hui-Xia
2016-10-01
To compare minimally invasive extraction and traditional method in the extraction of impacted mandibular third molar. One hundred and sixty patients with impacted mandibular third molar were equally divided into two groups. Patients in the experimental group were treated with minimally invasive extraction, using implant machine and luxator, while patients in the control group were treated with traditional methods including use of orthodox chisel. The operation time, intraoperative and postoperative complications including deformation of extraction sockets, dry socket, limitation of mouth opening, pain and swelling, and fear were observed and compared between the two groups. The data were analyzed with SPSS18.0 software package. The operation time was (17.32±1.01) min in the experimental group, significantly shorter than the control group which was (33.46±1.12)min (P<0.05); significant difference was found in the incidence of root fracture, medium or severe tooth sockets deformation and incidence of psychological fear during operation between the control group and experimental group(P<0.05); the degree of mouth opening after surgery, the incidence of moderate or severe pain after surgery was significantly lower in the experimental than in the control group(P<0.05). Minimally invasive extraction of mandibular impacted wisdom tooth is better than traditional method, with shorter operation time and less intraoperative and postoperative complications, which should be widely applied in clinic.
The efficacy of hyaluronic acid in postextraction sockets of impacted third molars: A pilot study.
Yilmaz, N; Demirtas, N; Kazancioglu, H O; Bayer, S; Acar, A H; Mihmanli, A
2017-12-01
This study aims to evaluate the effectiveness of local hyaluronic acid (HA) administration to surgically remove impacted third molar sockets and measure pain, swelling, and trismus. The study included a total of 25 healthy patients aged 18-29 years with asymptomatic bilaterally impacted lower third molars. All cases have been performed under local anesthesia. In the study group, 0.8% HA (Gengigel®) was applied in the postextraction sockets of the right third molars and in the control group nothing was applied to the extraction sockets of the left third molars. Postoperative pain, trismus, and swelling were evaluated on the 1st, 3rd, and 7th postoperative days. No difference was determined between groups in facial swelling and maximum mouth opening. However, the amount of pain significantly reduced in HA groups according to visual analog scale (P = 0.001). The results of this study showed that HA can produce an analgesic action in postextraction sockets after surgical removal of impacted teeth and therefore it has a clinical benefit to reduce usage of nonsteroidal anti-inflammatory drugs after dentoalveolar surgery.
Kämmerer, P W; Adubae, A; Buttchereit, I; Thiem, D G E; Daubländer, M; Frerich, B
2018-04-01
The aim of the study was to compare the efficacy of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) for extraction of mandibular posterior teeth. In a prospective clinical trial, a total of 301 mandibular posterior teeth were extracted in 266 patients. Randomization was conducted into those who received ILA (patients n = 98; teeth n = 105) and those who received IANB (patient n = 140; teeth n = 140). Twenty-eight patients were subjected to bilateral mandibular dental extractions and received both ILA und IANB (teeth n = 56 (ILA n = 28; IANB n = 28)). The primary objective was to evaluate the differences in pain during injection, in pain during tooth extraction (numeric rating scale (NRS)), and in anesthetic quality (complete/sufficient vs. insufficient/no effect). Differences in latency time, amount of anesthetic solution, need for second injection, and duration of local numbness as well as in the incidence of dry socket were assessed. ILA had significant lower pain of injection (p < 0.001), shorter latency time (p < 0.001), and shorter duration of local numbness (p < 0.001) and required lesser amount of local anesthetic solution (p < 0.001) together with a similar anesthetic quality (p = 0.082) compared to IANB. Concerning pain during extraction (p = 0.211), frequency of second injection (p = 0.197), and incidence of dry socket (p = 0.178), no significant differences were detected. ILA fulfills the requirements of a minimal invasive and patient-friendly local anesthetic technique. In accordance, it represents a safe and reliable alternative to IANB for extraction of mandibular posterior teeth. ILA can be recommended for routine dental extractions.
Hoda, Nadeemul; Saifi, Aamir Malick; Giraddi, Girish B
2016-01-01
A common sequel of tooth extraction is alveolar bone resorption. It makes the placement of dental implants difficult and creates an esthetic problem for the fabrication of conventional prostheses. Therefore, alveolar bone following tooth extraction should be preserved. The present prospective study was conducted to evaluate the efficacy of the resorbable bioscaffold poly lactic co-glycolic acid (PLGA) in maintaining the alveolar height in post-extraction socket. 20 patients were selected based on inclusion and exclusion criteria and were randomly divided into two groups: cases and control comprising of 10 patients each. Atraumatic tooth extraction was done in all patients. PLGA bioscaffold was placed in cases and socket was closed with 3-0 vicryl. In control group, socket was directly closed with 3-0 vicryl. The patients were kept on follow-up and complications such as dry socket, pain, and swelling were recorded. IOPA were taken at 1st, 4th, 12th, and 24th week to record changes in the height of alveolar bone. The radiographic measurements were compared and the differences were statistically analyzed. Reduction in alveolar bone height after placement of PLGA bioscaffold was significantly less in cases as compared to controls at 4th, 12th, and 24th week following extraction. No complications were observed throughout the follow-up period. PLGA scaffold significantly reduces bone resorption. Application is very simple and can be easily performed in a dental setup. However, PLGA scaffold adds significantly to the cost of treatment.
Ramos, Eva; Santamaría, Joseba; Santamaría, Gorka; Barbier, Luis; Arteagoitia, Icíar
2016-10-01
The use of antibiotics to prevent dry socket and infection is a controversial but widespread practice. The aim of the study is to assess the efficacy of systemic antibiotics in reducing the frequencies of these complications after extraction. A systematic review and meta-analysis, according to the PRISMA statement, based on randomized double-blind placebo-controlled trials evaluating systemic antibiotics to prevent dry socket and infection after third molar surgery. Databases were searched up to June 2015. Relative risks (RRs) were calculated with inverse variance-weighted, fixed-effect, or random-effect models. We included 22 papers in the qualitative and 21 in the quantitative review (3304 extractions). Overall-RR was 0.43 (95% confidence interval [CI] 0.33-0.56; P < .0001); number needed to treat, 14 (95% CI 11-19). Penicillins-RR: 0.40 (95% CI 0.27-0.59). Nitroimidazoles-RR: 0.56 (95% CI 0.38-0.82). No serious adverse events were reported. Systemic antibiotics significantly reduce the risk of dry socket and infection in third molar extraction. Copyright © 2016 Elsevier Inc. All rights reserved.
Tolstunov, L
2012-12-01
The aim of this prospective comparative split-mouth study was to evaluate the role of socket irrigation with a normal saline solution routinely used at the end of extraction on the development of alveolar osteitis (AO) after removal of impacted mandibular third molars (MTMs). Thirty-five patients who satisfied the inclusion criteria were involved in the study and underwent extraction of four third-molars. To be included in the study, the mandibular third molars had to be impacted (partial or full bone) and require an osteotomy for extraction with use of a motorised drill. All surgeries were done under local anaesthesia or IV sedation. This was a prospective split-mouth study. The patient's left (assistant) side was a control side; it had a standard extraction technique of an impacted mandibular third molar that required a buccal full-thickness flap, buccal trough (osteotomy) and extraction of the tooth (with or without splitting the tooth into segments), followed by a traditional end-of-surgery debridement protocol consisting of a gentle curettage, bone filing of the socket walls, socket irrigation with approximately 5 ml of sterile normal saline solution and socket suctioning. The patient's right (operator) side was an experimental side; it also had a standard extraction technique of an impacted mandibular third molar at the beginning with a flap and osteotomy, but it was followed by a modified end-of-surgery protocol. It consisted of gentle curettage but the socket was not irrigated and not suctioned. It was simply left to bleed. The gauze was placed on top of the socket for haemostasis on both sides and the patient was asked to bite. On both sides, the buccal flap was positioned back without the suture. All patients were seen for a follow-up appointment four to seven days after the surgery to assess healing and check for symptoms and signs of alveolar osteitis, if present, on both irrigated and non-irrigated sides. This study followed the ethical guidelines of human subjects based on the Helsinki Declaration. Thirty-five patients or 70 sockets were evaluated. Eleven out of 35 patients in the study were subjected to a dry socket syndrome (31.4%). The higher number of AO was likely related to specifics of MTM selection in this study - only impacted (partial and full bone) MTMs were chosen. Among eleven patients with AO, two patients had a bilateral condition. By excluding two patients with bilateral dry sockets from the study, there were nine patients (18 extraction sites) with unilateral AO in the study. Seven out of nine patients (14 extraction sites) developed unilateral dry socket on the control (irrigated) side (77.8%) and only two (four extraction sites) on the experimental (non-irrigated) side (22.2%). Therefore, in this study there were 3.5 times more patients (extraction sites) with dry socket syndrome on the irrigated (control) side than patients (extraction sites) in the non-irrigated (experimental) side. A noticeable difference of dry socket syndromes (77.8% on the irrigated versus 22.2% on non-irrigated side) was demonstrated between the traditional extraction protocol versus modified approach without the end-of-surgery irrigation. The study demonstrated that the post-extraction socket bleeding is very important for the proper uncomplicated socket healing. If it's not washed away with irrigation solution at the end of extraction, the normal blood clot has a higher likelihood to form, and therefore, can potentially lead to an uncomplicated socket healing without development of alveolar osteitis. Socket bleeding at the extraction site creates a favourable environment for the formation of a blood clot - a protective dressing - necessary for a favourable osseous healing of the socket.
Abd Razak, Nasrul A; Abu Osman, Noor A; Ali, Sadeeq A; Gholizadeh, Hossein
2016-01-15
While considering how important the interface between the amputees with the prostheses socket, we have carried out research to compare the gradient pressure occur at the interface socket that may lead to the discomforting effects to the user using common ICRC polypropylene socket and air splint socket. Not Applicable SETTING: Not Applicable POPULATION: The subject was a 23 year old who suffered a traumatic defect on the right arm caused by higher electrical volt. F-Socket sensors have been used to measure dynamic socket interface pressure for the transradial amputee wearer during static and dynamic movements. The printed circuit with a thickness of 0.18 mm is equipped between the socket and the surface of the residual limb. Two F-Socket sensor is required to cover the entire socket surface attached to the residual limb. The average of 10 trials made on prosthetic user using both type of sockets for static and dynamic movements was recorded. The pressure gradient shows that the circumference of the socket interface for the ICRC polypropylene socket gives the most pressure distributions to the amputees compared to the pressure gradient for the air splint socket. The pressure gradient for ICRC socket increased consistently when the user makes movements while for the air splint socket remain constantly. The specific interface pressure occur at the socket interface help in determine the comfort and pain of the socket design and improve the correlation between the user and the prosthesis.
Karakoç, Mehmet; Batmaz, İbrahim; Sariyildiz, Mustafa Akif; Yazmalar, Levent; Aydin, Abdülkadir; Em, Serda
2017-08-01
Patients with amputation need prosthesis to comfortably move around. One of the most important parts of a good prosthesis is the socket. Currently, the most commonly used method is the traditional socket manufacturing method, which involves manual work; however, computer-aided design/computer-aided manufacturing (CAD/CAM) is also being used in the recent years. The present study aimed to investigate the effects of sockets manufactured by traditional and CAD/CAM method on clinical characteristics and quality of life of patients with transtibial amputation. The study included 72 patients with transtibial amputation using prosthesis, 36 of whom had CAD/CAM prosthetic sockets (group 1) and 36 had traditional prosthetic sockets (group 2). Amputation reason, prosthesis lifetime, walking time and distance with prosthesis, pain-free walking time with prosthesis, production time of the prosthesis, and adaptation time to the prosthesis were questioned. Quality of life was assessed using the 36-item Short Form Health Survey questionnaire and the Trinity Amputation and Prosthesis Experience Scales. Walking time and distance and pain-free walking time with prosthesis were significantly better in group 1 than those in group 2. Furthermore, the prosthesis was applied in a significantly shorter time, and socket adaptation time was significantly shorter in group 1. Except emotional role limitation, all 36-item Short Form Healthy Survey questionnaire parameters were significantly better in group 1 than in group 2. Trinity Amputation and Prosthesis Experience Scales activity limitation scores of group 1 were lower, and Trinity Amputation and Prosthesis Experience Scales satisfaction with the prosthesis scores were higher than those in group 2. Our study demonstrated that the sockets manufactured by CAD/CAM methods yield better outcomes in quality of life of patients with transtibial amputation than the sockets manufactured by the traditional method.
Moghaddas, Hamid; Amjadi, Mohammad Reza; Naghsh, Narges
2012-11-01
Alveolar ridge preservation following tooth extraction has the ability to maintain the ridge dimensions and allow the implant placement in an ideal position fulfilling both functional and aesthetic results. The aim of this study was to evaluate the efficacy of the palatal connective tissue as a biological membrane for socket preservation with demineralized freeze-dried bone allograft (DFDBA). Twelve extraction sites were treated with DFDBA with (case group) and without (control group) using autogenous palatal connective tissue membrane before placement of implants. Alveolar width and height, amount of keratinized tissue, and gingival level were measured at pre-determined points using a surgical stent at two times, the time of socket preservation surgery. In both groups a decrease in all socket dimensions was found. The average decrease in socket width, height, keratinized tissue, and gingival level in case group was 1.16, 0.72, 3.58, and 1.27 mm, and in control group was 2.08, 0.86, 4.52, and 1.58 mm respectively. Statistical analysis showed that decrease in socket width (P = 0.012), keratinized tissue (P ≤ 0.001), and gingival level (P = 0.031) in case group was significantly lower than that of the control group. Results showed no meaningful difference in socket height changes when compared with case and control groups (P = 0.148). Under the limits of this study, connective tissue membrane could preserve socket width, amount of keratinized tissue, and the gingival level more effectively than DFDBA alone.
Hattingh, André C; De Bruyn, Hugo; Ackermann, Andrew; Vandeweghe, Stefan
Immediate implant placement is performed less frequently in molar extraction sockets than in single root sockets. This is mainly due to the tripodal anatomical configuration of molar roots, which is perceived as complex and therefore unsuitable. The mechanical burden of molar sites, combined with much larger socket dimensions, make it amenable to the use of ultrawide-diameter dental implants. This article describes a practical, sequenced technique that can be used predictably for immediate implant placement in maxillary and mandibular first molar sockets, using a dry skull model for clarification. This detailed description is based on the experience of more than 580 clinical cases over a 10-year period.
Khorshidi Khiavi, Reza; Pourallahverdi, Maghsood; Pourallahverdi, Ayda; Ghorani Khiavi, Saadat; Ghertasi Oskouei, Sina; Mokhtari, Hadi
2010-01-01
The surgical removal of the lower third molars is a procedure generally followed by side effects such as postoperative pain. The aim of this study was to evaluate the efficacy of socket irrigation with an anesthetic solution in relieving pain following impacted third molar surgery. Thirty-four patients (17 males and 17 females), aged 18-24 years, with bilateral impacted lower third molars were selected. Both third molars were extracted in one surgical session. Tooth sockets in each patient were rinsed randomly either with 4 mL of 0.5% bupivacaine hydrochloride plain (without vasoconstrictor) anesthetic solu-tion or 4 mL of normal saline, used as control. The patients were instructed not to use analgesics as long as possible, and if not, they were instructed to use an analgesic, and record the time. Pain severity was assessed using a visual analogue pain scale (VAPS) at 1-, 6-, 12-, and 24-hour intervals post-operatively. Data were analyzed using Pearson's chi-square test and P <0.05 was considered statistically significant. Post-operative pain difference between the two groups was statistically significant at 1-, 6-, 12- and 24-hour post-operative intervals (P <0.05). Post-operative pain increased in both groups to a maximum 12 hours after surgery with signif-icant improvements after that. Based on the results, the irrigation of surgery site with bupivacaine after third molar surgery significantly reduces post-operative pain.
Khorshidi Khiavi, Reza; Pourallahverdi, Maghsood; Pourallahverdi, Ayda; Ghorani Khiavi, Saadat; Ghertasi Oskouei, Sina; Mokhtari, Hadi
2010-01-01
Background and aims The surgical removal of the lower third molars is a procedure generally followed by side effects such as postoperative pain. The aim of this study was to evaluate the efficacy of socket irrigation with an anesthetic solution in relieving pain following impacted third molar surgery. Materials and methods Thirty-four patients (17 males and 17 females), aged 18-24 years, with bilateral impacted lower third molars were selected. Both third molars were extracted in one surgical session. Tooth sockets in each patient were rinsed randomly either with 4 mL of 0.5% bupivacaine hydrochloride plain (without vasoconstrictor) anesthetic solu-tion or 4 mL of normal saline, used as control. The patients were instructed not to use analgesics as long as possible, and if not, they were instructed to use an analgesic, and record the time. Pain severity was assessed using a visual analogue pain scale (VAPS) at 1-, 6-, 12-, and 24-hour intervals post-operatively. Data were analyzed using Pearson’s chi-square test and P <0.05 was considered statistically significant. Results Post-operative pain difference between the two groups was statistically significant at 1-, 6-, 12- and 24-hour post-operative intervals (P <0.05). Post-operative pain increased in both groups to a maximum 12 hours after surgery with signif-icant improvements after that. Conclusion Based on the results, the irrigation of surgery site with bupivacaine after third molar surgery significantly reduces post-operative pain. PMID:23346335
Effect of alignment perturbations in a trans-tibial prosthesis user: A pilot study.
Courtney, Anna; Orendurff, Michael S; Buis, Arjan
2016-04-01
A recurring complication in trans-tibial prosthetic limb users is "poor socket fit" with painful residuum-socket interfaces, a consequence of excess pressure. This is due to both poor socket fit and poor socket alignment; however, the interaction of these factors has not been quantified. Through evaluation of kinetic data this study aimed to articulate an interaction uniting socket design, alignment and interface pressures. The results will help to refine future studies and will hopefully help determine whether sockets can be designed, fitted and aligned to maximize mobility whilst minimizing injurious forces. Interface pressures were recorded throughout ambulation in one user with "optimal (reference) alignment" followed by 5 malalignments in a patellar tendon-bearing and a hydrocast socket. Marked differences in pressure distribution were discovered when equating the patellar tendon-bearing against the hydrocast socket and when comparing interface pressures from reference with offset alignment. Patellar tendon-bearing sockets were found to be more sensitive to alignment perturbations than hydrocast sockets. A complex interaction was found, with the most prominent finding demonstrating the requisite for attainment of optimal alignment: a translational alignment error of 10 mm can increase maximum peak pressures by 227% (mean 17.5%). Refinements for future trials are described and the necessity for future research into socket design, alignment and interface pressures has been estabilished.
Alissa, Rami; Esposito, Marco; Horner, Keith; Oliver, Richard
2010-01-01
To investigate the effect of platelet-rich plasma (PRP) on the healing of hard and soft tissues of extraction sockets with a pilot study. Patients undergoing tooth extraction under intravenous sedation were asked to participate in the trial. Autologous platelet concentrates were prepared from the patients' blood and autologous thrombin was produced. Outcome measures were: pain level, analgesic consumption, oral function (ability to eat food, swallowing, mouth opening and speech), general activity, swelling, bruising, bleeding, bad taste or halitosis, food stagnation, patient satisfaction, healing complications, soft tissue healing, trabecular pattern of newly formed bone in extraction sockets, trabecular bone volume, trabecular separation, trabecular length, trabecular width, and trabecular number. Patients were followed up to 3 months post-extraction. Twelve patients (15 sockets) were randomly allocated to the PRP group and 11 patients (14 sockets) to the control group. Two patients from the control group did not attend any of the scheduled appointments following tooth extraction, and were considered dropouts. Additionally, one more patient from the control group and four patients from the PRP group did not attend their 3-month radiographic assessment appointments. Statistically significantly more pain was recorded in the control group for the first (P=0.02), second (P=0.02) and third (P=0.04) post-operative days for Visual Analogue Scale scores, whereas no differences were observed for the fourth (P=0.17), fifth (P=0.38), sixth (P=0.75) and seventh (P=0.75) post-operative days. There was a statistically significantly higher analgesic consumption for the first (P=0.03) and second (P=0.02) post-operative days in the control group and no differences thereafter. Differences in patients' responses in the health-related quality of life questionnaire were statistically significant in favour of PRP treatment only for the presence of bad taste or bad smell in the mouth (P=0.03), and food stagnation in the operation area (P=0.03). The difference between groups was not statistically significant for patient satisfaction with the treatment (P=0.31). Regarding complications, two dry sockets and one acutely inflamed alveolus occurred in patients of the control group, which determined a borderline statistically significant difference in favour of the PRP group (P=0.06). Soft tissue healing was significantly better in patients treated with PRP (P=0.03). Radiographic evaluation carried out by the two blinded examiners revealed a statistically significant difference (P=0.01) for sockets with dense homogeneous trabecular pattern, a borderline statistically significant difference in the trabecular pattern for bone volume (P=0.06) favouring PRP use, and no significant differences for trabecular separation (P=0.66), trabecular length (P=0.16), trabecular width (P=0.16) and trabecular number (P=0.38). PRP may have some benefits in reducing complications such as alveolar osteitis and improving healing of soft tissue of extraction sockets. There were insufficient data to support the use of PRP to promote bone healing or to enhance the quality of life of patients following tooth extraction, although the sample size was too small to detect statistically significant differences.
Samandari, Mohammad Hasan; Haghighat, Abbas; Torabinia, Nakisa; Taghian, Mehdi; Sadri, Leyli; Naemy, Vahid
2016-01-01
Background: Plasma rich in growth factors (PRGF) and freeze-dried bone allograft (FDBA) are shown to promote bone healing. This study was aimed to histologically and histomorphometrically investigate the effect of combined use of PRGF and FDBA on bone formation, and compare it to FDBA alone and control group. Materials and Methods: The distal roots of the lower premolars were extracted bilaterally in four female dogs. Sockets were randomly divided into FDBA + PRGF, FDBA, and control groups. Two dogs were sacrificed after 2 weeks and two dogs were sacrificed after 4 weeks. Sockets were assessed histologically and histomorphometrically. Data were analyzed by Kruskal–Wallis test followed by Mann–Whitney U-tests utilizing the SPSS software version 20. P < 0.05 was considered statistically significant. Results: While the difference in density of fibrous tissue in three groups was not statistically significant (P = 0.343), the bone density in grafted groups was significantly higher than the control group (P = 0.021). The least decrease in all socket dimensions was observed in the FDBA group. However, these differences were only significant in coronal portion at week 4. Regarding socket dimensions and bone density, the difference between FDBA and FDBA+PRGF groups was not significant in middle and apical portions. Conclusion: The superiority of PRGF+FDBA overFDBA in socket preservation cannot be concluded from this experiment. PMID:27857769
Prosthetics socket that incorporates an air splint system focusing on dynamic interface pressure.
Razak, Nasrul Anuar Abd; Osman, Noor Azuan Abu; Gholizadeh, Hossein; Ali, Sadeeq
2014-08-01
The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. This paper presents the design and performance of a new prosthetic socket that uses an air splint system. The air splint prosthetic socket system was implemented by combining the air splint with a pressure sensor that the transhumeral user controls through the use of a microcontroller. The modular construction of the system developed allows the FSR pressure sensors that are placed inside the air splint socket to determine the required size and fitting for the socket used. Fifteen transhumeral amputees participated in the study. The subject's dynamic pressure on the socket that's applied while wearing the air splint systems was recorded using F-socket transducers and microcontroller analysis. The values collected by the F-socket sensor for the air splint prosthetic socket system were determined accordingly by comparing the dynamic pressure applied using statically socket. The pressure volume of the air splint fluctuated and was recorded at an average of 38 kPa (2.5) to 41 kPa (1.3) over three hours. The air splint socket might reduce the pressure within the interface of residual limb. This is particularly important during the daily life activities and may reduce the pain and discomfort at the residual limb in comparison to the static socket. The potential development of an auto-adjusted socket that uses an air splint system as the prosthetic socket will be of interest to researchers involved in rehabilitation engineering, prosthetics and orthotics.
Prosthetics socket that incorporates an air splint system focusing on dynamic interface pressure
2014-01-01
Background The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee’s satisfaction and comfort. This paper presents the design and performance of a new prosthetic socket that uses an air splint system. Methods The air splint prosthetic socket system was implemented by combining the air splint with a pressure sensor that the transhumeral user controls through the use of a microcontroller. The modular construction of the system developed allows the FSR pressure sensors that are placed inside the air splint socket to determine the required size and fitting for the socket used. Fifteen transhumeral amputees participated in the study. Results The subject’s dynamic pressure on the socket that’s applied while wearing the air splint systems was recorded using F-socket transducers and microcontroller analysis. The values collected by the F-socket sensor for the air splint prosthetic socket system were determined accordingly by comparing the dynamic pressure applied using statically socket. The pressure volume of the air splint fluctuated and was recorded at an average of 38 kPa (2.5) to 41 kPa (1.3) over three hours. Conclusion The air splint socket might reduce the pressure within the interface of residual limb. This is particularly important during the daily life activities and may reduce the pain and discomfort at the residual limb in comparison to the static socket. The potential development of an auto-adjusted socket that uses an air splint system as the prosthetic socket will be of interest to researchers involved in rehabilitation engineering, prosthetics and orthotics. PMID:25085005
Mozzati, Marco; Gallesio, Giorgia; Staiti, Giorgio; Iezzi, Giovanna; Piattelli, Adriano; Mortellaro, Carmen
2017-06-01
The aim of the present study was to evaluate the efficacy of biomimetic composite bone substitute composed of equine collagen I and Mg-hydroxyapatite in improving socket preservation after tooth extraction in humans. Thirty-two patients were subjected to a single tooth extraction, performed without elevation of the full-thickness flap. In each patient, socket was grafted with the bone substitute and specimens were retrieved 2 months after surgery and processed for histological observations. The clinical outcome variables were healing index, visual analog score for pain, postsurgery complications, and patient satisfaction evaluated through a questionnaire. No adverse reaction or infection occurred, in which healing index averaged 5.8 (range 4-7). Pain scores were lower. The patients' questionnaire outcomes were unanimously in favor of the test treatment. At low-power magnification, it was possible to see a portion of native bone with small marrow spaces and many areas of bone remodeling. At high-power magnification, it could be observed that small newly formed trabeculae originated from the preexisting bone and bone spicules in the middle of the defect. Grafting the postextraction socket with composite bone substitute may improve the healing process by accelerating socket closure and tissue maturation. Such a product demonstrated excellent biocompatibility as no inflammatory reaction could be detected histologically and was well accepted by patients.
Cho, Byung-Ki; Park, Kyoung-Jin; Choi, Seung-Myung; Kang, Sang-Woo; Lee, Hyung-Ki
2016-12-01
Although a ball and socket ankle deformity is usually congenital and asymptomatic, abnormal inversion and eversion mobility can result in recurrent ankle sprain and osteoarthritis. This retrospective study was performed to evaluate the clinical and radiologic outcomes of ankle fusion combined with calcaneal sliding osteotomy for severe arthritic ball and socket ankle deformity. Fourteen patients with severe arthritic ball and socket ankle deformity were followed for more than 3 years after operation. The clinical evaluation consisted of American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS) for pain, and subjective satisfaction score. The period to fusion and union of osteotomy, the change of hindfoot alignment angle, and complications were evaluated radiologically. AOFAS and FAAM scores were significantly improved from an average of 37.4 and 34.5 points to 74.6 and 78.5 points, respectively. VAS for pain with walking over 20 minutes was significantly improved from an average of 8.4 points to 1.9 points. The average satisfaction score of patients was 88.9 points. The difference in heel alignment angle (compared to contralateral side) was significantly improved from an average of 34.8 to 5.4 degrees. There were 2 cases of progressive arthritis in an adjacent joint and 1 case of failed fusion. Ankle fusion combined with calcaneal sliding osteotomy can be an effective operative option for ball and socket ankle deformity with advanced arthritis. In spite of increased complication rate, reliable pain relief, and restoration of gait ability through correcting hindfoot malalignment could improve the quality of life. Level IV, retrospective case series. © The Author(s) 2016.
8-year survivorship analysis and subjective results of 687 primary Balgrist hip sockets.
Echtler, B; Jacob, H A; Houweling, M; Hersche, O
1999-09-01
The Balgrist hip socket consists of an outer split ring in the form of a truncated cone, made of titanium, which is expanded by a tapered HDPE insert during implantation, thus ensuring firm primary press-fit and the possibility of retightening in the postoperative remodelling phase. Between November 1987 and October 1996, 687 primary Balgrist hip sockets were implanted in 555 patients. Five hundred and thirty-seven patients were investigated. Of these patients, 71.1% never had pain in the operated hip, 88.1% had no problems putting on their shoes, 76.2% were able to walk one or more hours. Furthermore, 91.7% are very or mostly content with the postoperative result. Nineteen hip sockets had to be revised until April 1997. With a 92.1% Kaplan-Meier survivorship rate after 8 years the Balgrist hip socket ranks among the most successful noncemented acetabular components.
Kresnoadi, Utari; Raharjo, Tika; Rostiny, Rostiny
2018-01-01
Tooth extraction will provoke changes in alveolar bone morphology and dimensions. Postextraction bone resorption can lead to significant problems for restorative dentistry. Therefore, the extracted tooth socket needs to be preserved to reduce alveolar ridge bone resorption. This research aimed to analyze the expression and levels of osteocalcin, collagen 1, and osteoblasts in extracted tooth sockets filled with a combination of mangosteen peel extract and demineralized freeze-dried bovine bone xenograft (DFDBBX). Fifty-six Cavia cobaya , whose lower left incisors had been extracted, were divided into eight groups according to the substance used to fill their sockets on days 7 and 30, Poly ethylene glycol, DFDBBX, mangosteen peel extract, or a combination of mangosteen peel extract and DFDBBX. This research was conducted in several stages; the application of mangosteen peel extract combined with graft material was performed as the form of tooth extraction socket preservation. The C. cobaya rats were subsequently examined by immunohistochemical methods to measure osteocalcin and collagen 1 expressions, whereas histological examination was conducted to calculate the number of osteoblasts in accordance with the duration of the research. On days 7 and 30, the group treated with a combination of DFDBBX and mangosteen peel extract which had the highest expression and levels of osteocalcin, collagen 1, and osteoblasts. The administration of mangosteen peel extract combined with DFDBBX as a means of tooth extraction socket preservation can increase osteocalcin and collagen 1 expression. Consequently, osteoblasts as a means of alveolar bone regeneration will increase in number.
The use of hyaluronic and aminocaproic acid in the treatment of alveolar osteitis.
Dubovina, Dejan; Mihailović, Branko; Bukumirić, Zoran; Vlahović, Zoran; Miladinović, Milan; Miković, Nikola; Lazić, Zoran
2016-11-01
Alveolar osteitis (AO), also known as “dry socket”, is relatively common post-extraction complication. It probably occurs due to excessive fibrinolytic activity in the coagulum and is characterized by intense pain sensations. The aim of this clinical study was to examine the role of hyaluronic acid and aminocaproic acid in the treatment of AO. The study included 60 patients with the clinical diagnosis of AO. All the patients were divided into two groups of 30 patients each according to the applied non-pharmacological measure: irrigation – irrigation of dry socket with sterile saline; curettage – careful curettage. Both of these groups were further divided into three subgroups regarding the applied treatment (hyaluronic acid; hyaluronic acid + aminocaproic acid; Alvogyl ®, an anesthetic and antiseptic paste), each with 10 patients, according to the following protocol: 0.2 mL of hyaluronic acid in the form of a 0.8% gel; 2 mL of aminocaproic acid and hyaluronic acid; Alvogyl®. During each visit, scheduled for every two days until complete absence of painful sensations, the patients had the therapeutic method repeated as at the first examination. At each control visit the number of present symptoms and signs of AO was recorded, as well as the level of pain (measured with a visual analogue scale). With the use of hyaluronic acid, with or without aminocaproic one, a statistically significantly faster reduction in pain sensations was achieved, along with the reduction in the number of symptoms and signs of AO compared to the use of Alvogyl®. Hyaluronic acid, applied alone or in combination with aminocaproic acid significantly reduces pain sensation, thus it can be successfully used in the treatment of AO.
Mogharehabed, Ahmad; Birang, Reza; Torabinia, Nakisa; Nasiri, Saman; Behfarnia, Parichehr
2014-01-01
Background: The accelerating effect of plasma rich in growth factors (PRGFs) in the healing of extraction sockets has been demonstrated by some studies. The aim of the present study was to histologically and histomorphometrically evaluate whether bone formation would increase by the combined use of PRGF and demineralized freeze-dried bone allograft (DFDBA). Materials and Methods: In four female dogs, the distal root of the second, third and fourth lower premolars were extracted bilaterally and the mesial roots were preserved. The extraction sockets were randomly divided into DFDBA + PRGF, DFDBA + saline or control groups. Two dogs were sacrificed after 2 weeks and two dogs were sacrificed after 6 weeks. The extraction sockets were evaluated from both histological and histomorphometrical aspects. The data were analyzed by Mann-Whitney followed by Kruskal-Wallis tests using the Statistical Package for the Social Sciences version 20 (SPSS Inc., Chicago, IL, USA). Significant levels were set at 0.05. Results: The least decrease in socket height was observed in the DFDBA + PRGF group (0.73 ± 0.42 mm). The least decrease in the coronal portion was observed in the DFDBA + PRGF group (1.38 ± 1.35 mm²). The least decrease in the middle surface was observed in the DFDBA group (0.61 ± 0.80 mm²). The least decrease in the apical portion was observed in the DFDBA group (0.34 ± 0.39 mm²). Conclusion: The present study showed better socket preservation subsequent to the application of DFDBA and PRGF combination in comparison with the two other groups. However, the difference was not statistically significant. PMID:25225559
Smart Adaptive Socket to Improve Fit and Relieve Pain in Wounded Warriors
2016-10-01
applications were developed for wireless interaction with the socket system firmware. A control algorithm was designed and tested. Clinical trial...interface, Dynamic segmental volume control, Wireless connection, Pressure control system. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...charging jack, and power button are included in the design. A Bluetooth 4 radio is also included to allow for advanced user control via smartphone. The
Nayak, Chitresh; Singh, Amit; Chaudhary, Himanshu; Unune, Deepak Rajendra
2017-10-23
Technological advances in prosthetics have attracted the curiosity of researchers in monitoring design and developments of the sockets to sustain maximum pressure without any soft tissue damage, skin breakdown, and painful sores. Numerous studies have been reported in the area of pressure measurement at the limb/socket interface, though, the relation between amputee's physiological parameters and the pressure developed at the limb/socket interface is still not studied. Therefore, the purpose of this work is to investigate the effects of patient-specific physiological parameters viz. height, weight, and stump length on the pressure development at the transtibial prosthetic limb/socket interface. Initially, the pressure values at the limb/socket interface were clinically measured during stance and walking conditions for different patients using strain gauges placed at critical locations of the stump. The measured maximum pressure data related to patient's physiological parameters was used to develop an artificial neural network (ANN) model. The effects of physiological parameters on the pressure development at the limb/socket interface were examined using the ANN model. The analyzed results indicated that the weight and stump length significantly affects the maximum pressure values. The outcomes of this work could be an important platform for the design and development of patient-specific prosthetic socket which can endure the maximum pressure conditions at stance and ambulation conditions.
Girish Kumar, N; Chaudhary, Rupanzal; Kumar, Ish; Arora, Srimathy S; Kumar, Nilesh; Singh, Hem
2018-06-01
The purpose of this study is to evaluate the efficacy of Platelet Rich Fibrin (PRF) as a socket plug with or without use of Plaster of Paris (POP) as bone substitute to preserve the alveolar ridge post-extraction. A prospective randomised single blind controlled study, was conducted for 18 months from November 2014 to May 2016 on 48 patients requiring extraction. All teeth were extracted atraumatically using periotomes and luxators without raising mucoperiosteal flap. Sockets were randomly allotted to groups A, B and C. Group A sockets were chosen as control, where figure of eight suture was placed. In group B sockets, PRF obtained by centrifugation was used as a socket plug and stabilised with figure of eight suture. Group C sockets were filled with POP and then covered with PRF. The socket was then closed with a figure of eight suture. Patients were informed of need for 6 months follow-up. Ninety sockets in 48 patients were subjected to our study. We found that results in the sockets where we have grafted POP showed better ridge preservation and post-operative comfort even though the difference in ridge resorption between the three groups was not statistically significant. Powered by Editorial Manager® and ProduXion Manager® from the Aries Systems Corporation. Atraumatic extraction may minimise the post-operative pain and discomfort to patient as well as the post-extraction alveolar height and width changes. The use of PRF and/or bone substitute even though clinically contributes to better post-operative healing and minimal loss of alveolar width and height, the values were not statistically significant.
Kresnoadi, Utari; Ariani, Maretaningtias Dwi; Djulaeha, Eha; Hendrijantini, Nike
2017-01-01
Following the extraction of a tooth, bone resorption can cause significant problems for a subsequent denture implant and restorative dentistry. Thus, the tooth extraction socket needs to be maintained to reduce the chance of any alveolar ridge bone resorption. The objective of this study is to determine whether the administration of mangosteen peel extracts (MPEs), combined with demineralized freeze-dried bovine bone xenograft (DFBBX) materials for tooth extraction socket preservation, could potentially reduce inflammation by decreased the expression of nuclear factor κβ (NfKb) and receptor activator of nuclear factor-κβ ligand (RANKL), to inhibit alveolar bone resorption, and increased of bone morphogenetic protein-2 (BMP2) expressions to accelerate alveolar bone regeneration. This study consists of several stages. First, a dosage of MPE combined with graft materials was applied to a preserved tooth extraction socket of a Cavia cobaya . Second, the C. cobaya was examined using immune histochemical expression of NfKb, RANKL, BMP2, as well as histology of osteoblasts and osteoclasts. The research was statistically analyzed, using an analysis of variance test and Tukey honest significant difference test. The results of this research were that it was determined that MPEs combined with graft materials on a preserved tooth extraction socket can reduce NfKb, RANK, and osteoclasts also increase of BMP2 and osteoblast. The induction of MPEs and DFBBX is effective in reducing inflammation, lowering osteoclasts, decreasing alveolar bone resorption, and also increasing BMP2 expression and alveolar bone regeneration.
Pseudosciatica; Wallet sciatica; Hip socket neuropathy; Pelvic outlet syndrome; Low back pain - piriformis ... Sciatica is the main symptom of piriformis syndrome. Other symptoms include: Tenderness or a dull ache in ...
Goyal, Manoj; Marya, Karan; Jhamb, Aakarsh; Chawla, Sonia; Sonoo, Priyanshu Ranjan; Singh, Veenita; Aggarwal, Anuj
2012-09-01
Our aim was to compare the use of a conventional rotary handpiece and a Piezosurgical unit for extraction of lower third molars. We studied 40 patients, who were allocated alternately to have the third molar removed with either the handpiece or the Piezosurgical unit. Pain, trismus, and oedema were evaluated at baseline and then postoperatively, together with paraesthesiae, on postoperative days 1, 3, 5, 7, and 15. Damage to surrounding tissue was checked on the same day whereas dry socket was evaluated from postoperative day 3 onwards. More patients complained of pain in the conventional group, they also required more analgesics, and they developed trismus more often than in the Piezosurgery group. There was also significantly more postoperative swelling in the conventional group. Patients were also evaluated using the subjective Postoperative Symptom Severity (PoSSe) scale. Our results suggest that apart from some inherent limitations with the Piezotome, it is a valuable alternative for extraction of third molars. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Silva, L J; Poi, W R; Panzarini, S R; Rodrigues, T S; Simonato, L E
2006-01-01
In this study, the authors evaluate the use of a 10% metronidazole and 2% lidocaine ointment, using a lanolin base and mint as flavoring, to treat alveolitis in humans. Twenty-five patients, with a diagnosis of alveolitis, were treated in the following way: locoregional anesthesia; surgical cleaning of the socket with alveolar curettes; saline solution irrigation with a 20 ml disposable syringe; and complete filling of the socket with the ointment. The analysis of the results showed that the painful symptoms were severe before and on the day of the treatment in 17 (68%) of the 25 patients treated. Post-treatment analysis presented 2 patients (18%) with severe painful symptoms after 24 h of the treatment and complete remission of painful symptoms after 48 h of the treatment with the ointment. Based on the results, it is possible to conclude that the 10% metronidazole and 2% lidocaine ointment, with mint flavoring and lanolin as a base, can be used to treat alveolitis.
Arteagoitia, M-I; Barbier, L; Santamaría, J; Santamaría, G; Ramos, E
2016-07-01
Prophylactic use of amoxicillin and amoxicillin/clavulanic acid, although controversial, is common in routine clinical practice in third molar surgery. Our objective was to assess the efficacy of prophylactic amoxicillin with or without clavulanic acid in reducing the incidence of dry socket and/or infection after third molar extraction. We conducted a systematic review and meta-analysis consulting electronic databases and references in retrieved articles. We included double-blind placebo-controlled randomized clinical trials published up to June 2015 investigating the efficacy of amoxicillin with or without clavulanic acid on the incidence of the aforementioned conditions after third molar extraction. Relative risks (RRs) were estimated with a generic inverse-variance approach and a random effect model using Stata/IC 13 and Review Manager Version 5.2. Stratified analysis was performed by antibiotic type. We included 10 papers in the qualitative review and in the quantitative synthesis (1997 extractions: 1072 in experimental groups and 925 in controls, with 27 and 74 events of dry socket and/or infection, respectively). The overall RR was 0.350 (p<0.001; 95% CI 0.214 to 0.574). We found no evidence of heterogeneity (I2=0%, p=0.470). The number needed to treat was 18 (95% CI 13 to 29). Five studies reported adverse reactions (RR=1.188, 95% CI 0.658 to 2.146, p =0.567). The RRs were 0.563 for amoxicillin (95% CI 0.295 to 1.08, p=0.082) and 0.215 for amoxicillin/clavulanic acid (95% CI 0.117 to 0.395, p<0.001). Prophylactic use of amoxicillin does not significantly reduce the risk of infection and/or dry socket after third molar extraction. With amoxicillin/clavulanic acid, the risk decreases significantly. Nevertheless, considering the number needed to treat, low prevalence of infection, potential adverse reactions to antibiotics and lack of serious complications in placebo groups, the routine prescription of amoxicillin with or without clavulanic acid is not justified.
Leijendekkers, Ruud A; Staal, J Bart; van Hinte, Gerben; Frölke, Jan Paul; van de Meent, Hendrik; Atsma, Femke; Nijhuis-van der Sanden, Maria W G; Hoogeboom, Thomas J
2016-11-22
Patients with lower extremity amputation frequently suffer from socket-related problems. This seriously limits prosthesis use, level of activity and health-related quality of life (HRQoL). An additional problem in patients with lower extremity amputation are asymmetries in gait kinematics possibly accounting for back pain. Bone-anchored prostheses (BAPs) are a possible solution for socket-related problems. Knowledge concerning the level of function, activity and HRQoL after surgery is limited. The aims of this ongoing study are to: a) describe changes in the level of function, activity, HRQoL and satisfaction over time compared to baseline before surgery; b) examine potential predictors for changes in kinematics, prosthetic use, walking ability, HRQoL, prosthesis comfort over time and level of stump pain at follow-up; c) examine potential mechanisms for change of back pain over time by identifying determinants, moderators and mediators. A prospective 5-year longitudinal study with multiple follow-ups. All adults, between May 2014 and May 2018, with lower extremity amputation receiving a press-fit BAP are enrolled consecutively. Patients with socket-related problems and trauma, tumour resection or stable vascular disease as cause of primary amputation will be included. Exclusion criteria are severe cognitive or psychiatric disorders. Follow-ups are planned at six-months, one-, two- and five-years after BAP surgery. The main study outcomes follow, in part, the ICF classification: a) level of function defined as kinematics in coronal plane, hip abductor strength, prosthetic use, back pain and stump pain; b) level of activity defined as mobility level and walking ability; c) HRQoL; d) satisfaction defined as prosthesis comfort and global perceived effect. Changes over time for the continuous outcomes and the dichotomized outcome (back pain) will be analysed using generalised estimating equations (GEE). Multivariate GEE will be used to identify potential predictors for change of coronal plane kinematics, prosthetic use, walking ability, HRQoL, prosthesis comfort and for the level of post-operative stump pain. Finally, potential mechanisms for change in back pain frequency will be explored using coronal plane kinematics as a potential determinant, stump pain as moderator and hip abductor strength as mediator. This study may identify predictors for clinically relevant outcome measures. NTR5776 . Registered 11 March 2016, retrospectively registered.
Tong, Darryl C; Al-Hassiny, Haidar H; Ain, Adrian B; Broadbent, Jonathan M
2014-06-01
To determine the frequency and correlates associations of post-extraction complications at a dental school. Retrospective review of patient records. Exodontia clinic at the School of Dentistry, University of Otago, Dunedin. Provider characteristics, patient demographic characteristics, patient medical history, teeth extracted and occurrence of postoperative complications. Of the 598 extractions (540 routine and 58 surgical) which were undertaken in the audit period, 74 (12.4%) resulted in post-operative complications. Dry socket and post-operative pain were the major complications. A higher complication rate was found among patients treated by fourth-year undergraduate students than among those treated by more senior students or staff. Post-operative complications were not significantly associated with patients' ethnicity or medical history. The rate of postoperative complications at the Univeristy of Otago's Faculty of Dentistry is consistent with reports in existing literature and inversely associated with operators' experience.
Seifi, Massoud; Ghoraishian, Seyed Ahmad
2012-01-01
Background: Socket preservation after tooth extraction is one of the indications of bone grafting to enhance preorthodontic condition. The aim of this study is to determine the effects of socket preservation on the immediate tooth movement, alveolar ridge height preservation and orthodontic root resorption. Materials and Methods: In a split-mouth technique, twelve sites in three dogs were investigated as an experimental study. Crushed demineralized freeze-dried bone allograft (DFDBA) (CenoBone®) was used as the graft material. The defects were made by the extraction of 3rd premolar. On one side of each jaw, the defects were preserved by DFDBA and defects of the other side left opened as the control group. Simultaneously the teeth adjacent to the defects were pulled together by a NiTi coil spring. After eight weeks, the amount of (OTM), alveolar height, and root resorption were measured. Analysis of variance was used for purpose of comparison. Results: There was a slight increase in OTM at grafted sites as they were compared to the control sites (P<0.05). Also a significant bone resorption in control site and successful socket preservation in experimental site were observed. Reduction of root resorption at the augmented site was significant compared to the normal healing site (P<0.05). Conclusion: Using socket preservation, tooth movement can be immediately started without waiting for the healing of the recipient site. This can provide some advantages like enhanced rate of OTM, its approved effects on ridge preservation that reduces the chance of dehiscence and the reduction of root resorption. PMID:22623939
Leijendekkers, Ruud A; van Hinte, Gerben; Frölke, Jan Paul; van de Meent, Hendrik; Nijhuis-van der Sanden, Maria W G; Staal, J Bart
2017-06-01
This study aimed to provide an overview of a) the used measurement instruments in studies evaluating effects on quality of life (QoL), function, activity and participation level in patients with a lower extremity amputation using bone-anchored prostheses compared to socket prostheses and b) the effects themselves. A systematic literature search was conducted in MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science. Included studies compared QoL, function, activity and/or participation level in patients with bone-anchored or socket prostheses. A best-evidence synthesis was performed. Out of 226 studies, five cohort and two cross-sectional studies were eligible for inclusion, all had methodological shortcomings. These studies used 10 different measurement instruments and two separate questions to assess outcome. Bone-anchored prostheses were associated with better condition-specific QoL and better outcomes on several of the physical QoL subscales, outcomes on the physical bodily pain subscale were inconclusive. Outcomes on function and activity level increased, no change was found at participation level. The level of evidence was limited. There is a need for a standard set of instruments. There was limited evidence that bone-anchored prostheses resulted in higher QoL, function and activity levels than socket prostheses, in patients with socket-related problems. Implications for Rehabilitation Use of bone-anchored prostheses in combination with intensive outpatient rehabilitation may improve QoL, function and activity level compared with socket prosthesis use in patients with a transfemoral amputation and socket-related problems. All clinicians and researchers involved with bone-anchored prostheses should use and publish data on QoL, function, activity and participation level. There needs to be an agreement on a standard set of instruments so that interventions for patients with a lower extremity amputation are assessed consistently.
Guo, Zhao-zhong; Zhang, Heng; Li, Yan; Li, Xin; Liu, Yin; Wang, Yang; Yuan, Chun-xia; Liu, Xue
2012-04-01
To investigate complications in extraction of complicated impacted wisdom teeth whose root apex near to the inferior alveolar nerve(IAN) by using routine method(chisels),high speed turbine handpiece and piezosurgery device respectively. Three hundred qualified patients with impacted wisdom teeth were divided into three groups randomly,one hundred patients in group A were extracted by routine method, one hundred patients in group B were extracted by high speed turbine handpiece, and one hundred patients in group C were extracted by piezosurgery device. The operation time, postoperative pain duration,dry socket and IAN injury were compared between each two groups. All statistical analysis was performed using SPSS 13.0 software package. Differences between groups were compared using a paired t test (quantitative data) or Chi-square test (qualitative data). The operation time in group A was(14.12±0.12)min, (7.22±0.15)min in group B, (25.23±0.32)min in group C; Significant difference was found between group A and group B(P<0.05), group B and group C(P<0.05),group A and group C(P<0.05).Postoperative pain duration was(62.15±1.51)h in group A, (48.23±1.23)h in group B, (14.34±O.80)h in group C; Significant difference was found between group A and group B(P<0.05), group B and group C(P<0.05),group A and group C(P<0.05).9 patients developed dry socket in group A, 2 in group B, and 1 in group C; Significant difference was found between group A and group B(P<0.05), group A and group C(P<0.05). Six patients had IAN injury in group A, 2 in group B, 0 in group C. Significant difference was found between group A and group C. Compared with routine method, high speed turbine is better in extraction of impacted wisdom teeth, which can shorten operation time, lessen postoperative complications. Although there was longer operation time compared with group A and B, piezosurgery device is more effective in reducing postoperative complications.
Haraji, Afshin; Rakhshan, Vahid
2014-02-01
Although dry socket (DS) is commonly investigated, many of its risk factors remain highly controversial. In addition, few studies are available to show the preventive effect of chlorhexidine gel on DS. Moreover, multivariable analyses of DS risk factors are scarce, and their interactions have not been assessed previously. Therefore, the simultaneous effect of chlorhexidine gel and 4 DS risk factors and their interactions were analyzed within a multivariable framework. Using a split-mouth randomized clinical trial design, the investigators enrolled a cohort of patients requiring extraction of 2 mandibular third molars. The primary predictor variable was extraction socket treatment status, classified as experimental or standard. Experimental treatment was the insertion of chlorhexidine gel (0.2%) into the extraction socket. Each patient had 1 third molar randomly selected as the treatment site. The contralateral third molar served as the control socket and was treated in the usual manner. The primary outcome variable was DS status, present or absent, assessed on postoperative day 3. Other study variables were categorized as demographic, smoking, and surgical difficulty according to the Pederson scale. Appropriate bivariate and multiple logistic regression statistics were used to measure the association between risk for DS and chlorhexidine gel use, age, gender, smoking, and surgical difficulty and their interactions (α = 0.05). The sample consisted of 90 bilateral extraction sockets in 45 patients (24 men; 21 smokers; mean age, 21.1 ± 2.7 yr). Regression analysis showed that when other factors and their interactions were controlled for, chlorhexidine gel application lowered the risk of DS (odds ratio [OR] = 0.05; P = .004). Increasing age (OR = 2.9; P = .030) was associated with an increased risk for DS. A similar association existed between increased difficulty level of extraction and DS risk (OR = 3.8; P = .051). The effect of gender was marginally significant (P = .091), whereas smoking did not have a significant influence (P = .4). Intra-alveolar application of chlorhexidine gel and practicing less traumatic surgeries are advocated, particularly in older patients. Smoking seems unlikely to affect DS frequency. The role of gender is inconclusive. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Interpretations of complications following third molar extraction.
Schwartz-Arad, Devorah; Lipovsky, Anat; Pardo, Michal; Adut, Oren; Dolev, Eran
2017-11-21
Surgical removal of third molars is often associated with complications. The aim of the present study was to analyze the incidence of complications following extraction of third molars relative to the risk factors. This retrospective study included 463 patients who had mandibular third molar extraction (performed by a single surgeon, DSA) in the years 2001 to 2011. In total, 665 mandibular third molars were extracted. The average patient's age was 29 ± 11.30 years, median 26 years, and the patient age ranged from 13 to 75 years. Patients' records were obtained for medical/general data. The overall prevalence of postsurgical complications was 17%. Dry sockets showed the highest incidence (11.6%). Partially impacted teeth showed the highest incidence of complications (67.3%). Cigarette smoking correlated with increased complications and dry sockets, and complications were more prevalent on the left side (62.8%). Complications after mandibular third molar extraction increase with age, level of impaction, side of extraction, and cigarette smoking.
Marenzi, Gaetano; Riccitiello, Francesco; Tia, Mariano; di Lauro, Alessandro; Sammartino, Gilberto
2015-01-01
The aim of this study was to evaluate the effects of leukocyte- and platelet-rich fibrin (L-PRF) on the pain and soft tissue healing after tooth extractions. Twenty-six patients (9 males and 17 females) were treated with multiple extractions (2 to 8), with a total of 108 extractions. This was an exploratory single blinded randomized clinical trial with a split-mouth design. The pain after the surgery was assessed in each patient by the VAS scale (1 to 10) at intervals of 24-48-72-96 hours. The soft tissue healing was clinically evaluated at 3, 7, 14, and 21 days after surgery by the same examiner surgeon, using the modified Healing Index (4 to 12). The mean value of postextraction pain was 3.2 ± 0.3 in the experimental sides and 4.1 ± 0.1 in the control sides. After 7 days from the extractions, the values of modified Healing Index in the experimental and control groups were, respectively, 4.8 ± 0.6 and 5.1 ± 0.9. The use of L-PRF in postextraction sockets filling can be proposed as a useful procedure in order to manage the postoperative pain and to promote the soft tissue healing process, reducing the early adverse effects of the inflammation.
Riccitiello, Francesco; Tia, Mariano; di Lauro, Alessandro; Sammartino, Gilberto
2015-01-01
The aim of this study was to evaluate the effects of leukocyte- and platelet-rich fibrin (L-PRF) on the pain and soft tissue healing after tooth extractions. Twenty-six patients (9 males and 17 females) were treated with multiple extractions (2 to 8), with a total of 108 extractions. This was an exploratory single blinded randomized clinical trial with a split-mouth design. The pain after the surgery was assessed in each patient by the VAS scale (1 to 10) at intervals of 24-48-72-96 hours. The soft tissue healing was clinically evaluated at 3, 7, 14, and 21 days after surgery by the same examiner surgeon, using the modified Healing Index (4 to 12). The mean value of postextraction pain was 3.2 ± 0.3 in the experimental sides and 4.1 ± 0.1 in the control sides. After 7 days from the extractions, the values of modified Healing Index in the experimental and control groups were, respectively, 4.8 ± 0.6 and 5.1 ± 0.9. The use of L-PRF in postextraction sockets filling can be proposed as a useful procedure in order to manage the postoperative pain and to promote the soft tissue healing process, reducing the early adverse effects of the inflammation. PMID:26273612
Burgoyne, Corey C; Giglio, James A; Reese, Sarah E; Sima, Adam P; Laskin, Daniel M
2010-01-01
This prospective randomized clinical study assessed the efficacy of pain control for postextraction alveolar osteitis comparing the use of eugenol on a gauze strip versus a thermosetting gel containing 2.5% prilocaine and 2.5% lidocaine. Thirty-five patients who presented with postextraction alveolar osteitis were randomly assigned to either a control group or test group. After irrigation of the extraction site with normal saline solution, the control patients were treated with eugenol on a gauze strip placed in the socket and the test patients were treated with the thermosetting gel placed directly into the socket. All patients were given a series of visual analog scales to record their pretreatment pain and post-treatment pain at 5, 10, and 15 minutes and then at 1-hour increments during waking hours for the next 48 hours. They were also given a prescription for an analgesic to use for breakthrough pain during the 48-hour period, if necessary, and instructed to record the dose and timing of any pain medication taken. All patients were seen for follow-up at 48 hours after treatment. The mean pretreatment pain score was 6.72 on a scale ranging from 1 to 10 for the eugenol group and 6.37 for the prilocaine-lidocaine group (SE, 0.46), and the 2 groups were not different (P = .62). In the immediate post-treatment period (0-15 minutes) the pain levels were significantly reduced in both groups (Ps < .001). However, the thermosetting gel produced a significantly greater reduction in pain (mean, 3.23; SE, 0.62) than the eugenol (mean, 4.83; SE, 0.43) (P = .022). Over the next 48 hours, the pain level was nominally less with the thermosetting gel, but this difference was not statistically significant (Ps = .2). Although the efficacy of the 2 treatments was not significantly different, the nominal superiority and ease of using the thermosetting gel warrant further investigation.
Nathani, Dipesh B; Sequeira, Joyce; Rao, B H Sripathi
2015-01-01
To compare the efficacy of Platelet rich plasma and synthetic graft material for bone regeneration after bilateral third molar extraction. This study was conducted in 10 patients visiting the outpatient department of Oral & Maxillofacial Surgery, Yenepoya Dental College & Hospital. Patients requiring extraction of bilateral mandibular third molars were taken for the study. Following extraction, PRP (Platelet Rich Plasma) was placed in one extraction socket and synthetic graft material in form granules [combination of Hydroxyapatite (HA) and Bioactive glass (BG)] in another extraction socket. The patients were assessed for postoperative pain and soft tissue healing. Radiological assessment of the extraction site was done at 8, 12 and 16 weeks interval to compare the change in bone density in both the sockets. Pain was less on PRP site when compared to HA site. Soft tissue evaluation done using gingival healing index given by Landry et al showed better healing on PRP site when compared to HA site. The evaluation of bone density by radiological assessment showed the grey level values calculated at 4 months at the PRP site were comparatively higher than HA site. The study showed that the platelet rich plasma is a better graft material than synthetic graft material in terms of soft tissue and bone healing. However a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of both the materials.
Holistic Healing Through Herbs: Effectiveness of Aloe Vera on Post Extraction Socket Healing
Talla, Harsha Vardhan; Bairi, Jaya Krishna; Gopaldas, Madhulatha; Bathula, Haritha; Vangdoth, Sandeep
2017-01-01
Introduction Advances in the field of alternative medicine has encouraged the use of various natural products for multiple uses in the field of dentistry for treatment of various oral diseases. A natural herbal product is Aloe vera, which has number of benefits with no reported side effects and gaining considerable importance in clinical research. Aim The aim of this cross-sectional randomized interventional study was to evaluate the effectiveness of Aloe vera in the healing of post extraction sockets. Materials and Methods A sample size of 40 patients undergoing atraumatic extraction was divided into two groups. Group A-patients were prescribed only analgesics and followed for seven consecutive days and socket healing assessment was done. Group B-Patients were given Aloe vera soaked gel foams, followed up to the third and seventh day by two observers and the socket healing was assessed using the standardized index by Landry, Turnbull and Howley. In addition to healing the common complaint associated with extraction wound, the pain was assessed using numerical rating scale. Data obtained was statistically analysed using Mann-whitney U test, Wilcoxon Signed ranks test and Spearman’s rank correlation method. Results Control group on the third and the seventh day showed healing of 60% and 70% respectively and the Aloe vera group showed a better result having a healing potential of 70% on the third day and 90% on the seventh day which was statistically significant with a (p-value<0.001). Aloe vera group showed a significant decrease in pain after two hours on the day of extraction followed by second, third and seventh day which was statistically significant (p-value<0.001) and better than the control group. Conclusion Aloe vera has been proved to have a unique property that is implicated in better healing than other group without any side effects. Aloe vera is economical, effective, powerful nutritional supplement and antioxidant that protects and promotes wound healing. PMID:28511517
Platelet-rich fibrin: the benefits.
Kumar, Yuvika Raj; Mohanty, Sujata; Verma, Mahesh; Kaur, Raunaq Reet; Bhatia, Priyanka; Kumar, Varun Raj; Chaudhary, Zainab
2016-01-01
Current published data presents confusing results about the effects of platelet-rich fibrin on bone, and there is a need for studies that throw light on its effect. Our main objective therefore was to evaluate (by fractal analysis) osseous regeneration in extraction sockets with and without platelet-rich fibrin in a study with a substantial sample and a reliable technique to calibrate its effects on bone cells. We also assessed the soft tissue response. Thirty-four patients had their bilaterally impacted third molars (68 surgical sites) extracted in this split-mouth study, following which platelet-rich fibrin was placed in one of the sockets. Patients were followed up clinically and radiographically, and a pain score and fractal analysis were used to evaluate healing of soft tissue and bone, respectively. We conclude that platelet-rich fibrin improves healing of both soft and hard tissues. Although osseous healing did not differ significantly between the groups, healing of soft tissue as judged by the pain score was significantly better in the experimental group. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Bilginaylar, K; Uyanik, L O
2016-07-01
We compared postoperative outcomes after the removal of 80 impacted mandibular third molars in 59 patients. In the control group, osteotomies were done with traditional burs (n=20). The second group had traditional osteotomies and platelet-rich fibrin (PRF) placed into the socket of the extracted tooth (n=20). The third group had piezosurgery (n=20), and the fourth had piezosurgery and PRF placed in the extraction socket (n=20). Baseline variables were assessed preoperatively and included pain, the number of analgesics taken, trismus, and swelling. These were also assessed on postoperative days 1, 2, 3, and 7. There was a significant reduction (p<0.05) in pain on days 1, 2, and 3, and in the number of analgesics taken on days 2 and 3 in both PRF groups. However, in the piezosurgery alone group this was the case only on day 3. There was no significant difference in swelling and trismus between the control and other groups. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Single element ultrasonic imaging of limb geometry: an in-vivo study with comparison to MRI
NASA Astrophysics Data System (ADS)
Zhang, Xiang; Fincke, Jonathan R.; Anthony, Brian W.
2016-04-01
Despite advancements in medical imaging, current prosthetic fitting methods remain subjective, operator dependent, and non-repeatable. The standard plaster casting method relies on prosthetist experience and tactile feel of the limb to design the prosthetic socket. Often times, many fitting iterations are required to achieve an acceptable fit. Use of improper socket fittings can lead to painful pathologies including neuromas, inflammation, soft tissue calcification, and pressure sores, often forcing the wearer to into a wheelchair and reducing mobility and quality of life. Computer software along with MRI/CT imaging has already been explored to aid the socket design process. In this paper, we explore the use of ultrasound instead of MRI/CT to accurately obtain the underlying limb geometry to assist the prosthetic socket design process. Using a single element ultrasound system, multiple subjects' proximal limbs were imaged using 1, 2.25, and 5 MHz single element transducers. Each ultrasound transducer was calibrated to ensure acoustic exposure within the limits defined by the FDA. To validate image quality, each patient was also imaged in an MRI. Fiducial markers visible in both MRI and ultrasound were used to compare the same limb cross-sectional image for each patient. After applying a migration algorithm, B-mode ultrasound cross-sections showed sufficiently high image resolution to characterize the skin and bone boundaries along with the underlying tissue structures.
Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction.
Bhati, Bharat; Kukreja, Pankaj; Kumar, Sanjeev; Rathi, Vidhi C; Singh, Kanika; Bansal, Shipra
2017-01-01
The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar. Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome. Parameters assessed in this study were - mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1 st , 3 rd , and 7 th postoperative day. Comparing both groups pain scores with ( P < 0.05) a statistically significant difference was found between two groups. Mean surgical time was longer for piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference ( P = 0.002). The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery.
Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction
Bhati, Bharat; Kukreja, Pankaj; Kumar, Sanjeev; Rathi, Vidhi C.; Singh, Kanika; Bansal, Shipra
2017-01-01
Aim: The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar. Materials and Methods: Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome. Results: Parameters assessed in this study were – mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1st, 3rd, and 7th postoperative day. Comparing both groups pain scores with (P < 0.05) a statistically significant difference was found between two groups. Mean surgical time was longer for piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference (P = 0.002). Conclusion: The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery. PMID:28713729
Dynamic elasticity measurement for prosthetic socket design.
Kim, Yujin; Kim, Junghoon; Son, Hyeryon; Choi, Youngjin
2017-07-01
The paper proposes a novel apparatus to measure the dynamic elasticity of human limb in order to help the design and fabrication of the personalized prosthetic socket. To take measurements of the dynamic elasticity, the desired force generated as an exponential chirp signal in which the frequency increases and amplitude is maintained according to time progress is applied to human limb and then the skin deformation is recorded, ultimately, to obtain the frequency response of its elasticity. It is referred to as a Dynamic Elasticity Measurement Apparatus (DEMA) in the paper. It has three core components such as linear motor to provide the desired force, loadcell to implement the force feedback control, and potentiometer to record the skin deformation. After measuring the force/deformation and calculating the dynamic elasticity of the limb, it is visualized as 3D color map model of the limb so that the entire dynamic elasticity can be shown at a glance according to the locations and frequencies. For the visualization, the dynamic elasticities measured at specific locations and frequencies are embodied using the color map into 3D limb model acquired by using 3D scanner. To demonstrate the effectiveness, the visualized dynamic elasticities are suggested as outcome of the proposed system, although we do not have any opportunity to apply the proposed system to the amputees. Ultimately, it is expected that the proposed system can be utilized to design and fabricate the personalized prosthetic socket in order for releasing the wearing pain caused by the conventional prosthetic socket.
Chang, Ching-Wen; Ho, Hsiu-O; Lo, Yi-June; Lee, Sheng-Yang; Yang, You-Ren; Sheu, Ming-Thau
2012-01-01
In this study, hydrogels composed of polyethyleneimine (PEI) and poly(vinyl pyrrolidone) K90 (PVP) cross-linked with various concentrations (0, 0.125, 0.25 and 0.5%) of glutaraldehyde were evaluated as a hydrogel filler for the local delivery of lidocaine after tooth extraction. The drug-release kinetics, swellability, cytotoxicity and wound healing after tooth extraction of these non-cross-linked and cross-linked PEI-PVP hydrogels were examined in male beagles and compared to values using Spongostan(®). Results demonstrated that the extent of cross-linking influenced the swelling of the resulting hydrogel, but the drug-release rates were similar. No significant changes were observed in gingival fibroblasts in contact with the PEI- PVP hydrogels or Spongostan(®). In the in vivo study, PEI-PVP hydrogels showed good retention in the socket for 2 days and showed comparable wound-healing rates within 2 weeks with those of Spongostan(®). In conclusion, PEI-PVP hydrogels are suitable for use as socket-dressing materials, and the release of local anaesthesia from PEI-PVP hydrogels can be sustained for a desirable period of time to prevent pain after a tooth extraction.
Characteristics of ocular pain complaints in patients with idiopathic dry eye symptoms
Kalangara, Jerry P.; Galor, Anat; Levitt, Roy C.; Covington, Derek B.; McManus, Katherine T.; Sarantopoulos, Constantine D.; Felix, Elizabeth R.
2016-01-01
Objective The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Methods Subjects with clinically-relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared to similar measures from published data in other chronic pain populations. Results The study sample consisted of 154 subjects, of which 91% were male and ranged in age from 27 to 89 (mean age = 61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale (NRS) ≥ 4), with specific characteristics (i.e., “burning” spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57 to 0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. Conclusions A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with the majority endorsing descriptors commonly used by patients with non-ocular neuropathic pain conditions. Identifying sub-groups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye sub classification and better individualize treatment strategies. PMID:26925537
Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms.
Kalangara, Jerry P; Galor, Anat; Levitt, Roy C; Covington, Derek B; McManus, Katherine T; Sarantopoulos, Constantine D; Felix, Elizabeth R
2017-05-01
The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Subjects with clinically relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared with similar measures from published data in other chronic pain populations. The study sample consisted of 154 subjects, of which 91% were men and ranged in age from 27 to 89 (mean age=61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale≥4), with specific characteristics (i.e., "burning" spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57-0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with most endorsing descriptors commonly used by patients with nonocular neuropathic pain conditions. Identifying subgroups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye subclassification and better individualize treatment strategies.
Gönül, Onur; Satilmiş, Tülin; Ciftci, Alanur; Sipahi, Aysegül; Garip, Hasan; Göker, Kamil
2015-11-01
This study compared the analgesic efficacy of postoperative tramadol versus ketamine for preventing pain after mandibular molar extraction. Ninety patients who had undergone molar extraction were randomly divided into 3 groups: group T (tramadol 1 mg/kg), group K (ketamine 0.5 mg/kg), and group P (saline 2 mL). The treatment was applied to the extraction sockets using resorbable gelatin sponges. Pain after extraction was evaluated using a visual analog scale (VAS) 0.5, 1, 2, 4, 6, 12, 24, and 48 hours postoperatively. The VAS scores after extraction were statistically higher in group P than in either treatment group. Group K had the lowest pain intensity. This study shows that topical tramadol and ketamine are effective alternatives for decreasing pain after molar extractions. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Isiordia-Espinoza, Mario Alberto; Aragon-Martinez, Othoniel H; Bollogna-Molina, Ronell E; Alonso-Castro, Ángel J
2018-06-01
The aim of this systematic review and meta-analysis was to evaluate the risk of surgical infection, alveolar osteitis, and adverse effects using systemic metronidazole in comparison with placebo in healthy patients undergoing third molar surgery. The eligible reports were identified from diverse science sources. Clinical trials meeting the inclusion and exclusion criteria and an acceptable Oxford Quality Score were included in this study. The evaluation of risk was done using the Risk Reduction Calculator and Review Manager 5.3., from the Cochrane Library. A significant risk reduction was assumed when the upper limit of the 95% confidence intervals was <1 and the lower limit did not cross zero (negative number) alongside a p value of <0.05 for the overall test. Data of 667 patients from five clinical trials were used for the assessment of risk. Our analysis showed no reduction of the risk of infection or dry socket in patients receiving metronidazole compared to whom took placebo. Meanwhile, the adverse effects did not exhibit a difference between the studied groups. The routine use of systemic metronidazole to prevent surgical site infection and/or dry socket in healthy patients undergoing third molar surgery is not recommended.
Al-Hamed, Faez Saleh; Tawfik, Mohamed Abdel-Monem; Abdelfadil, Ehab; Al-Saleh, Mohammed A Q
2017-06-01
To assess the effect of platelet-rich fibrin (PRF) on the healing process of the alveolar socket after surgical extraction of the mandibular third molars. PubMed, the Cochrane Central Register of Controlled Trials, Scopus, and relevant journals were searched using a combination of specific keywords ("platelet-rich fibrin," "oral surgery," and "third molar"). The final search was conducted on November 2, 2015. Randomized controlled clinical trials, as well as controlled clinical trials, aimed at comparing the effect of PRF versus natural healing after extraction of mandibular third molars were included. Five randomized controlled trials and one controlled clinical trial were included. There were 335 extractions (168 with PRF and 167 controls) in 183 participants. Considerable heterogeneity in study characteristics, outcome variables, and estimated scales was observed. Positive results were generally recorded for pain, trismus, swelling, periodontal pocket depth, soft tissue healing, and incidence of localized osteitis, but not in all studies. However, no meta-analysis could be conducted for such variables because of the different measurement scales used. The qualitative and meta-analysis results showed no significant improvement in bone healing with PRF-treated sockets compared with the naturally healing sockets. Within the limitations of the available evidence, PRF seems to have no beneficial role in bone healing after extraction of the mandibular third molars. Future standardized randomized controlled clinical trials are required to estimate the effect of PRF on socket regeneration. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Abdelhamid, Alaa; Omran, Mostafa; Bakhshalian, Neema; Tarnow, Dennis; Zadeh, Homayoun H
2016-06-01
The aims of this study were (i) to evaluate the efficacy of ridge preservation and repair procedures involving the application of SocketKAP(™) and SocketKAGE(™) devices following tooth removal and (ii) to evaluate alveolar bone volumetric changes at 6 months post-extraction in intact sockets or those with facial wall dehiscence defects using 3-dimensional pre- and postoperative CBCT data. Thirty-six patients required 61 teeth extracted. Five cohorts were established: Group A: Intact Socket Negative Control Group B: Intact Socket + SocketKAP(™) Group C: Intact Socket Filled with Anorganic Bovine Bone Mineral (ABBM) + SocketKAP(™) Group D: Facial Dehiscence Socket Negative Control Group E: Facial Dehiscence Socket Filled with ABBM + SocketKAP(™) + SocketKAGE(™) . Preoperative CBCT scans were obtained followed by digital subtraction of the test teeth. At 6 months post-extraction, another CBCT scan was obtained. The pre- and postoperative scans were then superimposed, allowing highly accurate quantitative determination of the 3D volumetric alveolar bone volume changes from baseline through 6 months. Significant volumetric bone loss occurred in all sockets, localized mainly in the 0-3 mm zone apical to the ridge crest. For intact sockets, SocketKAP(™) + ABBM treatment led to a statistically significant greater percentage of remaining mineralized tissue volume when compared to negative control group. A significant difference favoring SocketKAP(™) + SocketKAGE(™) + ABBM treatment was observed for sockets with facial dehiscence defects compared to the negative control group. SocketKAP(™) , with ABBM, appears effective in limiting post-extraction volumetric bone loss in intact sockets, while SocketKAP(™) + SocketKAGE + ABBM appears effective in limiting post-extraction bone loss in sockets with dehiscence defects. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
1974-08-31
c. Perform qualitative tests for fecal fat , bilirubin, urobilirubin and starch granules by staining methods PERFORMANCE OBJECTIVE f (Stimulus) Upon...myocardial infarction, pulmonary embolism Gastrointestinal: gastroenteritis, stomatitis, appendicitis, ulcer, gastritis, intestinal obstruction, cholecystitis... fractured tooth J. Reinsert temporary crown k. Treat dry socket, cellulitis, gingivitis, etc. 1. Evaluate patient’s progress/response to therapeutic regime M
Resnik, Linda; Patel, Tarpit; Cooney, Shane G; Crisco, Joseph J; Fantini, Christopher
2016-01-01
This case study compares the impact of two prosthetic socket designs, a "traditional" transhumeral (TH) socket design and a Compression Released Stabilized (CRS) socket. A CRS socket was compared to the existing socket of two persons with transhumeral amputation. Comparisons included assessments of patient comfort and satisfaction with fit, as well as dynamic kinematic assessment using a novel high-speed, high-resolution, bi-plane video radiography system (XROMM, for X-ray Reconstruction of Moving Morphology). Subjects were more satisfied with the comfort of the traditional sockets, although they had positive impressions about aspects of the fit and style of the CRS socket, and thought that it provided better control. Dynamic kinematic assessment revealed that the CRS socket provided better control of the residual limb within the socket, and had less slippage as compared to a traditional TH socket design. The TH CRS socket provided better control of the residual limb within the socket, and had less slippage. However, participants were less satisfied with the comfort and overall utility of the CRS socket, and stated that additional fitting visits/modifications to the CRS socket were needed. It is possible that satisfaction with the CRS socket may have improved with prosthetic adjustment and more acclimation time. Implications for Rehabilitation A comfortable, good fitting prosthetic socket is the key factor in determining how long (or if) an upper limb amputee can tolerate wearing a prosthesis. This case series was a comparison of two socket designs, a 'traditional' socket design and a Compression Released Stabilized (CRS) socket design in persons with transhumeral amputation. The CRS socket provided better control of the residual limb within the socket, and had less slippage. However, its tightness made it more difficult to don. Both subjects were less satisfied with the comfort and overall utility of the CRS socket. However, satisfaction might have been improved with additional fitting visits and more acclimation time.
Burning Eye Syndrome: Do Neuropathic Pain Mechanisms Underlie Chronic Dry Eye?
Kalangara, Jerry P; Galor, Anat; Levitt, Roy C; Felix, Elizabeth R; Alegret, Ramon; Sarantopoulos, Constantine D
2016-04-01
Dry eye is a multi-factorial disorder that manifests with painful ocular symptoms and visual disturbances, which can only be partly attributed to tear dysfunction. This disorder may also involve neuroplasticity in response to neuronal injury. This review will emphasize the key characteristics of dry eye pain and its pathologic mechanisms, making the argument that a subset of dry eye represents a neuropathic pain disorder of the eye, more appropriately called "burning eye syndrome." A literature review was conducted using a PubMed search focusing on dry eye, corneal nociception, and neuropathic pain. Articles were reviewed and those discussing clinical course, pathophysiology, and neuronal regulation of chronic ocular pain as related to dry eye were summarized. We found that there is a discordance between ocular pain and dryness on the ocular surface. Although tear dysfunction may be one of the initial insults, its persistence may be associated with repeated ocular sensory nerve injury leading to an acute-to-chronic pain transition associated with neuropathologic changes (peripheral and central sensitization), neuronal dysfunction, and spontaneous ocular pain. Dry eye is becoming a major health concern due to its increasing incidence, significant morbidity, and economic burden. Recent evidence suggests that a subset of dry eye may be better represented as a chronic neuropathic pain disorder due to its features of dysesthesia, spontaneous pain, allodynia, and hyperalgesia. Future therapies targeted at the underlying neuroplasticity may yield improved efficacy for patients with this subset of dry eye, which we term "burning eye syndrome." © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Iocca, Oreste; Farcomeni, Alessio; Pardiñas Lopez, Simon; Talib, Huzefa S
2017-01-01
To conduct a traditional meta-analysis and a Bayesian Network meta-analysis to synthesize the information coming from randomized controlled trials on different socket grafting materials and combine the resulting indirect evidence in order to make inferences on treatments that have not been compared directly. RCTs were identified for inclusion in the systematic review and subsequent statistical analysis. Bone height and width remodelling were selected as the chosen summary measures for comparison. First, a series of pairwise meta-analyses were performed and overall mean difference (MD) in mm with 95% CI was calculated between grafted versus non-grafted sockets. Then, a Bayesian Network meta-analysis was performed to draw indirect conclusions on which grafting materials can be considered most likely the best compared to the others. From the six included studies, seven comparisons were obtained. Traditional meta-analysis showed statistically significant results in favour of grafting the socket compared to no-graft both for height (MD 1.02, 95% CI 0.44-1.59, p value < 0.001) than for width (MD 1.52 95% CI 1.18-1.86, p value <0.000001) remodelling. Bayesian Network meta-analysis allowed to obtain a rank of intervention efficacy. On the basis of the results of the present analysis, socket grafting seems to be more favourable than unassisted socket healing. Moreover, Bayesian Network meta-analysis indicates that freeze-dried bone graft plus membrane is the most likely effective in the reduction of bone height remodelling. Autologous bone marrow resulted the most likely effective when width remodelling was considered. Studies with larger samples and less risk of bias should be conducted in the future in order to further strengthen the results of this analysis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Zadeh, Homayoun H; Abdelhamid, Alaa; Omran, Mostafa; Bakhshalian, Neema; Tarnow, Dennis
2016-06-01
The aims of this study were to evaluate (i) the efficacy of ridge preservation and repair involving SocketKAP(™) and SocketKAGE(™) devices following tooth removal; and (ii) ridge contour changes at 6 months post-extraction in intact sockets and sockets with dehiscence defects. Thirty-six patients required a total of 61 teeth to be extracted. Five cohorts were established with groups A-C involving intact sockets and groups D and E involving facial dehiscence: (A) Negative Control; (B) SocketKAP(™) alone; (C) Anorganic Bovine Bone Mineral (ABBM) + SocketKAP(™) ; (D) Negative Control; and (E) ABBM + SocketKAP(™) + SocketKAGE(™) . Preoperative CBCT and laser-scanned casts were obtained. Teeth segmented from preoperative CBCT were merged with study cast images to allow for digital removal of teeth from the casts. Volumetric measurements of ridge contour were performed. Images of preoperative and 6 months post-operative casts were superimposed to measure ridge contour changes. Post-extraction contour loss occurred in all sockets primarily in the crestal 3 mm but was also detected up to 6 mm from alveolar crest. For intact sockets, SocketKAP(™) or SocketKAP(™) + ABBM interventions led to greater percentages of remaining ridge contour when compared to controls. A significant difference favoring SocketKAP(™) + SocketKAGE(™) + ABBM treatment was observed for sockets with facial dehiscence when compared to controls. SocketKAP(™) , with or without ABBM, significantly limited post-extraction ridge contour loss in intact sockets. In the absence of a group treated with only the SocketKAGE(™) , it is not possible to determine its efficacy, although the combination of SocketKAGE(™) + SocketKAP(™) + ABBM was effective in limiting post-extraction ridge contour loss in sockets with dehiscence defects. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Effects of Socket Size on Metrics of Socket Fit in Trans-Tibial Prosthesis Users
Sanders, Joan E; Youngblood, Robert T; Hafner, Brian J; Cagle, John C; McLean, Jake B; Redd, Christian B; Dietrich, Colin R; Ciol, Marcia A; Allyn, Katheryn J
2017-01-01
The purpose of this research was to conduct a preliminary effort to identify quantitative metrics to distinguish a good socket from an oversized socket in people with trans-tibial amputation. Results could be used to inform clinical practices related to socket replacement. A cross-over study was conducted on community ambulators (K-level 3 or 4) with good residual limb sensation. Participants were each provided with two sockets, a duplicate of their as-prescribed socket and a modified socket that was enlarged or reduced by 1.8 mm (~6% of the socket volume) based on the fit quality of the as-prescribed socket. The two sockets were termed a larger socket and a smaller socket. Activity was monitored while participants wore each socket for 4wk. Participants’ gait; self-reported satisfaction, quality of fit, and performance; socket comfort; and morning-to-afternoon limb fluid volume changes were assessed. Visual analysis of plots and estimated effect sizes (measure as mean difference divided by standard deviation) showed largest effects for step time asymmetry, step width asymmetry, anterior and anterior-distal morning-to-afternoon fluid volume change, socket comfort scores, and self-reported measures of utility, satisfaction, and residual limb health. These variables may be viable metrics for early detection of deterioration in socket fit, and should be tested in a larger clinical study. PMID:28373013
Effects of socket size on metrics of socket fit in trans-tibial prosthesis users.
Sanders, Joan E; Youngblood, Robert T; Hafner, Brian J; Cagle, John C; McLean, Jake B; Redd, Christian B; Dietrich, Colin R; Ciol, Marcia A; Allyn, Katheryn J
2017-06-01
The purpose of this research was to conduct a preliminary effort to identify quantitative metrics to distinguish a good socket from an oversized socket in people with trans-tibial amputation. Results could be used to inform clinical practices related to socket replacement. A cross-over study was conducted on community ambulators (K-level 3 or 4) with good residual limb sensation. Participants were each provided with two sockets, a duplicate of their as-prescribed socket and a modified socket that was enlarged or reduced by 1.8mm (∼6% of the socket volume) based on the fit quality of the as-prescribed socket. The two sockets were termed a larger socket and a smaller socket. Activity was monitored while participants wore each socket for 4 weeks. Participants' gait; self-reported satisfaction, quality of fit, and performance; socket comfort; and morning-to-afternoon limb fluid volume changes were assessed. Visual analysis of plots and estimated effect sizes (measured as mean difference divided by standard deviation) showed largest effects for step time asymmetry, step width asymmetry, anterior and anterior-distal morning-to-afternoon fluid volume change, socket comfort score, and self-reported utility. These variables may be viable metrics for early detection of deterioration in socket fit, and should be tested in a larger clinical study. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.
Neuropathic ocular pain: an important yet underevaluated feature of dry eye
Galor, A; Levitt, R C; Felix, E R; Martin, E R; Sarantopoulos, C D
2015-01-01
Dry eye has gained recognition as a public health problem given its prevalence, morbidity, and cost implications. Dry eye can have a variety of symptoms including blurred vision, irritation, and ocular pain. Within dry eye-associated ocular pain, some patients report transient pain whereas others complain of chronic pain. In this review, we will summarize the evidence that chronicity is more likely to occur in patients with dysfunction in their ocular sensory apparatus (ie, neuropathic ocular pain). Clinical evidence of dysfunction includes the presence of spontaneous dysesthesias, allodynia, hyperalgesia, and corneal nerve morphologic and functional abnormalities. Both peripheral and central sensitizations likely play a role in generating the noted clinical characteristics. We will further discuss how evaluating for neuropathic ocular pain may affect the treatment of dry eye-associated chronic pain. PMID:25376119
Fatone, Stefania; Caldwell, Ryan
2017-06-01
Current transfemoral prosthetic sockets are problematic as they restrict function, lack comfort, and cause residual limb problems. Development of a subischial socket with lower proximal trim lines is an appealing way to address this problem and may contribute to improving quality of life of persons with transfemoral amputation. The purpose of this study was to illustrate the use of a new subischial socket in two subjects. Case series. Two unilateral transfemoral prosthesis users participated in preliminary socket evaluations comparing functional performance of the new subischial socket to ischial containment sockets. Testing included gait analysis, socket comfort score, and performance-based clinical outcome measures (Rapid-Sit-To-Stand, Four-Square-Step-Test, and Agility T-Test). For both subjects, comfort was better in the subischial socket, while gait and clinical outcomes were generally comparable between sockets. While these evaluations are promising regarding the ability to function in this new socket design, more definitive evaluation is needed. Clinical relevance Using gait analysis, socket comfort score and performance-based outcome measures, use of the Northwestern University Flexible Subischial Vaccum Socket was evaluated in two transfemoral prosthesis users. Socket comfort improved for both subjects with comparable function compared to ischial containment sockets.
1999-12-01
Infection of an extraction site (dry socket, localized osteitis). Apical abscess /periapical abscess - Collection of purulent exudate around the area...conditions for deployment data were 5.79% higher than the rate during conflicts. Caries, third molar complications, periapical abscesses , and endodontics are...restorations and fractured teeth. The "Periodontal" category was grouped to include periodontal abscess , acute necrotizing gingivitis (ANUG), and
Computer-socket manufacturing error: How much before it is clinically apparent?
Sanders, Joan E.; Severance, Michael R.; Allyn, Kathryn J.
2015-01-01
The purpose of this research was to pursue quality standards for computer-manufacturing of prosthetic sockets for people with transtibial limb loss. Thirty-three duplicates of study participants’ normally used sockets were fabricated using central fabrication facilities. Socket-manufacturing errors were compared with clinical assessments of socket fit. Of the 33 sockets tested, 23 were deemed clinically to need modification. All 13 sockets with mean radial error (MRE) greater than 0.25 mm were clinically unacceptable, and 11 of those were deemed in need of sizing reduction. Of the remaining 20 sockets, 5 sockets with interquartile range (IQR) greater than 0.40 mm were deemed globally or regionally oversized and in need of modification. Of the remaining 15 sockets, 5 sockets with closed contours of elevated surface normal angle error (SNAE) were deemed clinically to need shape modification at those closed contour locations. The remaining 10 sockets were deemed clinically acceptable and not in need modification. MRE, IQR, and SNAE may serve as effective metrics to characterize quality of computer-manufactured prosthetic sockets, helping facilitate the development of quality standards for the socket manufacturing industry. PMID:22773260
Design of a novel prosthetic socket: assessment of the thermal performance.
Webber, Christina M; Davis, Brian L
2015-05-01
Prosthetic liners and sockets insulate the residual limb, causing excessive sweating and concomitant skin maceration. When coupled with atypical loading conditions, further dermatologic problems can arise. This can significantly reduce the quality of life of an amputee patient. Improving the design of the prosthetic socket has been proposed as a means of reestablishing a normal thermal environment around the residual limb. In this study, a prosthetic socket was modified by incorporating a helical cooling channel within the socket wall using additive manufacturing techniques. Two sockets were modeled: a control socket, and a modified socket containing a 0.48 cm diameter cooling channel. Computer simulations and bench-top testing were used to assess the design's ability to create a greater temperature differential across the socket wall. A greater temperature drop across the socket wall suggested that the socket could provide cooling benefits to the residual limb by allowing for heat to be drawn away from the limb. The temperature difference across the socket wall was calculated for both sockets in each aspect of the study. Both socket type (p=0.002) and location on the socket (p=0.014) were statistically significant factors affecting the temperature difference between inner and outer socket walls. Compared with the control socket, the modified socket containing a helical cooling channel exhibited greater temperature differences across its wall of 11.1 °C and 6.4 °C in the computer simulations and bench-top testing, respectively. This finding suggested that socket modifications, such as the cooling channel presented, could provide a beneficial cooling effect to an amputee patient's residual limb. Copyright © 2015 Elsevier Ltd. All rights reserved.
Kumar, Nilima; Prasad, Kavitha; Ramanujam, Laitha; K, Ranganath; Dexith, Jayashree; Chauhan, Abhishek
2015-06-01
To assess the effect of platelet-rich fibrin (PRF) on postoperative pain, swelling, trismus, periodontal healing on the distal aspect of the second molar, and progress of bone regeneration in mandibular third molar extraction sockets. Over a 2-year period, 31 patients (mean age, 26.1 yr) who required surgical extraction of a single impacted third molar and met the inclusion criteria were recruited. After surgical extraction of the third molar, only primary closure was performed in the control group, whereas PRF was placed in the socket followed by primary closure in the case group (16 patients). The outcome variables were pain, swelling, maximum mouth opening, periodontal pocket depth, and bone formation, with a follow-up period of 3 months. Quantitative data are presented as mean. Statistical significance was inferred at a P value less than .05. Pain (P = .017), swelling (P = .022), and interincisal distance (P = .040) were less in the case group compared with the control group on the first postoperative day. Periodontal pocket depth decreased at 3 months postoperatively in the case (P < .001) and control (P = .014) groups, and this decrease was statistically significant. Bone density scores at 3 months postoperatively were higher in the case group than in the control group, but this difference was not statistically important. The application of PRF lessens the severity of immediate postoperative sequelae, decreases preoperative pocket depth, and hastens bone formation. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Gerschutz, Maria J; Haynes, Michael L; Nixon, Derek M; Colvin, James M
2011-01-01
Prosthetic sockets serve as the interface between people with amputations and their prostheses. Although most materials used to make prosthetic sockets have been used for many years, knowledge of these materials' properties is limited, especially after they are subjected to fabrication processes. This study evaluated tensile and impact properties of the current state-of-the-art materials used to fabricate prosthetic check sockets, copolymer sockets, and definitive laminated sockets. Thermolyn Rigid and Orfitrans Stiff check socket materials produced significantly lower tensile strength and impact resistance than polyethylene terephthalate glycol (PETG). Copolymer socket materials exhibited greater resistance to impact forces than the check socket materials but lower tensile strengths than PETG. The heated molding processes, for the check socket and copolymer materials, reduced both tensile strength and elongation at break. Definitive laminated sockets were sorted according to fabrication techniques. Nyglass material had significantly higher elongation, indicating a more ductile material than carbon-based laminations. Carbon sockets with pigmented resin had higher tensile strength and modulus at break than nonpigmented carbon sockets. Elongation at yield and elongation at break were similar for both types of carbon-based laminations. The material properties determined in this study provide a foundation for understanding and improving the quality of prosthetic sockets using current fabrication materials and a basis for evaluating future technologies.
Fatone, Stefania; Caldwell, Ryan
2017-01-01
Background: Current transfemoral prosthetic sockets are problematic as they restrict function, lack comfort, and cause residual limb problems. Development of a subischial socket with lower proximal trim lines is an appealing way to address this problem and may contribute to improving quality of life of persons with transfemoral amputation. Objectives: The purpose of this study was to illustrate the use of a new subischial socket in two subjects. Study design: Case series. Methods: Two unilateral transfemoral prosthesis users participated in preliminary socket evaluations comparing functional performance of the new subischial socket to ischial containment sockets. Testing included gait analysis, socket comfort score, and performance-based clinical outcome measures (Rapid-Sit-To-Stand, Four-Square-Step-Test, and Agility T-Test). Results: For both subjects, comfort was better in the subischial socket, while gait and clinical outcomes were generally comparable between sockets. Conclusion: While these evaluations are promising regarding the ability to function in this new socket design, more definitive evaluation is needed. Clinical relevance Using gait analysis, socket comfort score and performance-based outcome measures, use of the Northwestern University Flexible Subischial Vaccum Socket was evaluated in two transfemoral prosthesis users. Socket comfort improved for both subjects with comparable function compared to ischial containment sockets. PMID:28132589
Improved outcomes for lap-banding using the Insuflow device compared with heated-only gas.
Benavides, Richard; Wong, Alvin; Nguyen, Hoang
2009-01-01
Preconditioning gas by humidification and warming the pneumoperitoneum improves laparoscopic outcomes. This prevents peritoneal desiccation and detrimental events related to traditional cold-dry gas. Few comparisons have been done comparing traditional cold-dry, heated-only, and humidified-warmed carbon dioxide. A prospective, controlled, randomized, double-blind study of laparoscopic gastric banding included 113 patients and compared traditional dry-cold (n=35) versus dry-heated (n=40), versus humidified-warm gas (n=38). Pain medications were standardized for all groups. Endpoints were recovery room length of stay, pain location, pain intensity, and total pain medications used postoperatively for up to 10 days. The humidified-warmed group had statistically significant differences from the other 2 groups with improvement in all end points. The dry-heated group had significantly more pain medication use and increased shoulder and chest pain than the other 2 groups had. Using warm-humidified gas for laparoscopic gastric banding reduces shoulder pain, shortens recovery room length of stay, and decreases pain medication requirements for up to 10 days postoperatively. Dry-heated gas may cause additional complications as is indicated by the increase in pain medication use and pain intensity.
Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms.
Spierer, Oriel; Felix, Elizabeth R; McClellan, Allison L; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J; Sarantopoulos, Constantine D; Levitt, Roy C; Ehrmann, Klaus; Galor, Anat
2016-02-01
To examine associations between corneal mechanical thresholds and metrics of dry eye. This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P < 0.05), implying decreased corneal sensitivity with age. Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = -0.13 to -0.27, P < 0.05 for values between -0.18 and -0.27), suggesting increased corneal sensitivity in those with more severe ocular complaints. Ocular signs, on the other hand, correlated poorly and nonsignificantly with mechanical detection and pain thresholds on the cornea. A multivariable linear regression model found that both posttraumatic stress disorder (PTSD) score (β = 0.21, SE = 0.03) and corneal pain threshold (β = -0.03, SE = 0.01) were significantly associated with self-reported evoked eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints.
Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms
Spierer, Oriel; Felix, Elizabeth R.; McClellan, Allison L.; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J.; Sarantopoulos, Constantine D.; Levitt, Roy C.; Ehrmann, Klaus; Galor, Anat
2016-01-01
Purpose To examine associations between corneal mechanical thresholds and metrics of dry eye. Methods This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. Results A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P < 0.05), implying decreased corneal sensitivity with age. Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = −0.13 to −0.27, P < 0.05 for values between −0.18 and −0.27), suggesting increased corneal sensitivity in those with more severe ocular complaints. Ocular signs, on the other hand, correlated poorly and nonsignificantly with mechanical detection and pain thresholds on the cornea. A multivariable linear regression model found that both posttraumatic stress disorder (PTSD) score (β = 0.21, SE = 0.03) and corneal pain threshold (β = −0.03, SE = 0.01) were significantly associated with self-reported evoked eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Conclusions Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints. PMID:26886896
Antibiotics to prevent complications following tooth extractions.
Lodi, Giovanni; Figini, Lara; Sardella, Andrea; Carrassi, Antonio; Del Fabbro, Massimo; Furness, Susan
2012-11-14
The most frequent indications for tooth extractions are dental caries and periodontal infections, and these extractions are generally done by general dental practitioners. Antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. To determine the effect of antibiotic prophylaxis on the development of infectious complications following tooth extractions. The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 25 January 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1948 to 25 January 2012), EMBASE via OVID (1980 to 25 January 2012) and LILACS via BIREME (1982 to 25 January 2012). There were no restrictions regarding language or date of publication. We included randomised double-blind placebo-controlled trials of antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication. Two review authors independently assessed risk of bias for the included studies and extracted data. We contacted trial authors for further details where these were unclear. For dichotomous outcomes we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. The quality of the body of evidence has been assessed using the GRADE tool. This review included 18 double-blind placebo-controlled trials with a total of 2456 participants. Five trials were assessed at unclear risk of bias, thirteen at high risk, and none at low risk of bias. Compared to placebo, antibiotics probably reduce the risk of infection in patients undergoing third molar extraction(s) by approximately 70% (RR 0.29 (95% CI 0.16 to 0.50) P < 0.0001, 1523 participants, moderate quality evidence) which means that 12 people (range 10-17) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. There is evidence that antibiotics may reduce the risk of dry socket by 38% (RR 0.62 (95% CI 0.41 to 0.95) P = 0.03, 1429 participants, moderate quality evidence) which means that 38 people (range 24-250) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. There is also some evidence that patients who have prophylactic antibiotics may have less pain (MD -8.17 (95% CI -11.90 to -4.45) P < 0.0001, 372 participants, moderate quality evidence ) overall 7 days after the extraction compared to those receiving placebo, which may be a direct result of the lower risk of infection. There is no evidence of a difference between antibiotics and placebo in the outcomes of fever (RR 0.34, 95% CI 0.06 to 1.99), swelling (RR 0.92, 95% CI 0.65 to 1.30) or trismus (RR 0.84, 95% CI 0.42 to 1.71) 7 days after tooth extraction.Antibiotics are associated with an increase in generally mild and transient adverse effects compared to placebo (RR 1.98 (95% CI 1.10 to 3.59) P = 0.02) which means that for every 21 people (range 8-200) who receive antibiotics, an adverse effect is likely. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, there were no trials identified which evaluated the role of antibiotic prophylaxis in this group of patients in this setting. All of the trials included in this review included healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. There is evidence that prophylactic antibiotics reduce the risk of infection, dry socket and pain following third molar extraction and result in an increase in mild and transient adverse effects. It is unclear whether the evidence in this review is generalisable to those with concomitant illnesses or immunodeficiency, or those undergoing the extraction of teeth due to severe caries or periodontitis. However, patients at a higher risk of infection are more likely to benefit from prophylactic antibiotics, because infections in this group are likely to be more frequent, associated with complications and be more difficult to treat. Due to the increasing prevalence of bacteria which are resistant to treatment by currently available antibiotics, clinicians should consider carefully whether treating 12 healthy patients with antibiotics to prevent one infection is likely to do more harm than good.
Electrical grounding prong socket
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leong, R.
1989-09-12
This paper describes a socket for a grounding prong used in a three prong electrical plug. The socket being sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having a ridge to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket. 11 figs.
Smart Adaptive Socket to Improve Fit and Relieve Pain in Wounded Warriors
2017-10-01
compressing the distal element may have an inverse effect on volume accommodation because it would allow the residual limb to sink further into the...connection without restricting vertical movement a custom valve was designed. The new valve can be described as an inverse duckbill. It is a rubber...valve, which is normally closed but will be deformed into an open state by pushing it into a cylindrical hole. The inverse duckbill valve, unlike
Ibrahiem, Mohamed F. K.; Abdelaziz, Sahar T. A.
2016-01-01
Purpose. To evaluate a new surgical technique using fascia lata to deepen the shallow inferior conjunctival fornix in contracted socket and anophthalmic socket syndrome. Methods. A prospective controlled study in which 24 sockets of 24 patients who were unable to wear and retain their ocular prosthesis due to shallow inferior fornix were enrolled and categorized into anophthalmic socket syndromes (9 patients) and contracted sockets (15 patients). Another 24 patients who underwent evisceration or enucleation with healthy sockets and can wear and retain their prosthesis comfortably were chosen as a control group. Deepening of the fornix was performed using fascia lata strips under general anesthesia. Central depth of the inferior fornix was measured preoperatively and postoperatively. Results. A statistically significant improvement of the postoperative central inferior fornix depth was reported which was marked in anophthalmic subgroup. 100% of anophthalmic sockets and 93.3% of contracted sockets achieved satisfactory results during the follow-up period with no postoperative lower eyelid malposition or obvious skin scar. Conclusion. Fascia lata technique is a new alternative and effective procedure to deepen the shallow inferior fornix that can be used in moderate to severe contracted sockets or anophthalmic socket syndrome with minimal lower eyelid or socket complications. PMID:27313868
Ibrahiem, Mohamed F K; Abdelaziz, Sahar T A
2016-01-01
Purpose. To evaluate a new surgical technique using fascia lata to deepen the shallow inferior conjunctival fornix in contracted socket and anophthalmic socket syndrome. Methods. A prospective controlled study in which 24 sockets of 24 patients who were unable to wear and retain their ocular prosthesis due to shallow inferior fornix were enrolled and categorized into anophthalmic socket syndromes (9 patients) and contracted sockets (15 patients). Another 24 patients who underwent evisceration or enucleation with healthy sockets and can wear and retain their prosthesis comfortably were chosen as a control group. Deepening of the fornix was performed using fascia lata strips under general anesthesia. Central depth of the inferior fornix was measured preoperatively and postoperatively. Results. A statistically significant improvement of the postoperative central inferior fornix depth was reported which was marked in anophthalmic subgroup. 100% of anophthalmic sockets and 93.3% of contracted sockets achieved satisfactory results during the follow-up period with no postoperative lower eyelid malposition or obvious skin scar. Conclusion. Fascia lata technique is a new alternative and effective procedure to deepen the shallow inferior fornix that can be used in moderate to severe contracted sockets or anophthalmic socket syndrome with minimal lower eyelid or socket complications.
Fatone, Stefania; Caldwell, Ryan
2017-06-01
Current transfemoral prosthetic sockets restrict function, lack comfort, and cause residual limb problems. Lower proximal trim lines are an appealing way to address this problem. Development of a more comfortable and possibly functional subischial socket may contribute to improving quality of life of persons with transfemoral amputation. The purpose of this study was to (1) describe the design and fabrication of a new subischial socket and (2) describe efforts to teach this technique. Development project. Socket development involved defining the following: subject and liner selection, residual limb evaluation, casting, positive mold rectification, check socket fitting, definitive socket fabrication, and troubleshooting of socket fit. Three hands-on workshops to teach the socket were piloted and attended by 30 certified prosthetists and their patient models. Patient models responded positively to the comfort, range of motion, and stability of the new socket while prosthetists described the technique as "straight forward, reproducible." To our knowledge, this is the first attempt to create a teachable subischial socket, and while it appears promising, more definitive evaluation is needed. Clinical relevance We developed the Northwestern University Flexible Subischial Vacuum (NU-FlexSIV) Socket as a more comfortable alternative to current transfemoral sockets and demonstrated that it could be taught successfully to prosthetists.
29 CFR Appendix II to Part 1918 - Tables for Selected Miscellaneous Auxiliary Gear (Mandatory)
Code of Federal Regulations, 2010 CFR
2010-07-01
... (IWRC), use vales in HT (FC) columns. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1... HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Notes: (1) These... values in HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1) These...
29 CFR Appendix II to Part 1918 - Tables for Selected Miscellaneous Auxiliary Gear (Mandatory)
Code of Federal Regulations, 2014 CFR
2014-07-01
... (IWRC), use vales in HT (FC) columns. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1... HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Notes: (1) These... values in HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1) These...
29 CFR Appendix II to Part 1918 - Tables for Selected Miscellaneous Auxiliary Gear (Mandatory)
Code of Federal Regulations, 2012 CFR
2012-07-01
... (IWRC), use vales in HT (FC) columns. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1... HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Notes: (1) These... values in HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1) These...
29 CFR Appendix II to Part 1918 - Tables for Selected Miscellaneous Auxiliary Gear (Mandatory)
Code of Federal Regulations, 2011 CFR
2011-07-01
... (IWRC), use vales in HT (FC) columns. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1... HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Notes: (1) These... values in HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1) These...
29 CFR Appendix II to Part 1918 - Tables for Selected Miscellaneous Auxiliary Gear (Mandatory)
Code of Federal Regulations, 2013 CFR
2013-07-01
... (IWRC), use vales in HT (FC) columns. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1... HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Notes: (1) These... values in HT columns of Table 3. MS=Mechanical Splice. S=Poured Socket or Swaged Socket. Note: (1) These...
Electrical grounding prong socket
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leong, R.
1990-01-01
The invention is a socket for a grounding prong used in a three prong electrical plug and a receptacle for the three prong plug. The socket being sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having a ridge to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket. 17 figs.
Electrical grounding prong socket
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leong, R.
1990-12-31
The invention is a socket for a grounding prong used in a three prong electrical plug and a receptacle for the three prong plug. The socket being sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having a ridge to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket. 17 figs.
Electrical grounding prong socket
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leong, R.
1991-06-18
This patent describes a socket for a grounding prong used in a three prong electrical plug and a receptacle for the three prong plug. The socket being sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having a ridge to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket.
Electrical grounding prong socket
Leong, Robert
1991-01-01
The invention is a socket for a grounding prong used in a three prong electrical plug and a receptacle for the three prong plug. The socket being sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having a ridge to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket.
Wernke, Matthew M; Schroeder, Ryan M; Haynes, Michael L; Nolt, Lonnie L; Albury, Alexander W; Colvin, James M
2017-07-01
Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit. Approach: A tension compression machine was used to apply repeated controlled forces onto a residual limb model with sockets of different internal volume. Results: The vacuum pressure-displacement relationship was dependent on socket fit. The vacuum pressure data were sensitive enough to detect differences of 1.5% global volume and can likely detect differences even smaller. Limb motion was reduced as surface area of contact between the limb model and socket was maximized. Innovation: The results suggest that elevated vacuum pressure data provide information to quantify socket fit. Conclusions: This study provides evidence that the use of elevated vacuum pressure data may provide a method for prosthetists to quantify and monitor socket fit. Future studies should investigate the relationship between socket fit, limb motion, and limb health to define optimal socket fit parameters.
Comparison of Rectified and Unrectified Sockets for Transtibial Amputees.
Engsberg, Jack R; Sprouse, S Wayne; Uhrich, Mary L; Ziegler, Barbara R; Luitjohan, F Daniel
2008-01-01
The current method for fabricating prosthetic sockets is to modify a positive mold to account for the non-homogeneity of the residual limb to tolerate load (i.e., rectified socket). We tested unrectified sockets by retaining the shape of the residual limb, except for a distal end pad, using an alginate gel process instead of casting. This investigation compared rectified and unrectified sockets. Forty-three adults with unilateral transtibial amputations were tested after randomly wearing both rectified and unrectified sockets for at least 4 weeks. Testing included a gait analysis, energy expenditure and Prosthesis Evaluation Questionnaire (PEQ). Results indicated no differences between sockets for gait speed and timing, gait kinematics and kinetics, and gait energy expenditure. There were also no differences in the Prosthetic Evaluation Questionnaire and 16 subjects selected the rectified socket, 25 selected the unrectified socket, and 2 subjects selected to use both sockets as their exit socket. Results seemed to indicate that more than one paradigm exists for shaping prosthetic sockets, and this paradigm may be helpful in understanding the mechanisms of socket fit. The alginate gel fabrication method was simpler than the traditional method. The method could be helpful in other countries where prosthetic care is lacking, may be helpful with new amputees, and may be helpful in typical clinics to reduce costs and free the prosthetist to focus more time on patient needs.
Comparison of Rectified and Unrectified Sockets for Transtibial Amputees
Engsberg, Jack R.; Sprouse, S. Wayne; Uhrich, Mary L.; Ziegler, Barbara R.; Luitjohan, F. Daniel
2008-01-01
The current method for fabricating prosthetic sockets is to modify a positive mold to account for the non-homogeneity of the residual limb to tolerate load (i.e., rectified socket). We tested unrectified sockets by retaining the shape of the residual limb, except for a distal end pad, using an alginate gel process instead of casting. This investigation compared rectified and unrectified sockets. Forty-three adults with unilateral transtibial amputations were tested after randomly wearing both rectified and unrectified sockets for at least 4 weeks. Testing included a gait analysis, energy expenditure and Prosthesis Evaluation Questionnaire (PEQ). Results indicated no differences between sockets for gait speed and timing, gait kinematics and kinetics, and gait energy expenditure. There were also no differences in the Prosthetic Evaluation Questionnaire and 16 subjects selected the rectified socket, 25 selected the unrectified socket, and 2 subjects selected to use both sockets as their exit socket. Results seemed to indicate that more than one paradigm exists for shaping prosthetic sockets, and this paradigm may be helpful in understanding the mechanisms of socket fit. The alginate gel fabrication method was simpler than the traditional method. The method could be helpful in other countries where prosthetic care is lacking, may be helpful with new amputees, and may be helpful in typical clinics to reduce costs and free the prosthetist to focus more time on patient needs. PMID:18776945
Change in residual limb size over time in the NU-FlexSIV socket: A case study.
Fatone, Stefania; Yohay, Jessica; Caldwell, Ryan
2018-05-01
This case study represented a unique opportunity wherein a long-time user of sub-ischial sockets had kept nearly every socket he wore for a decade. This individual let us borrow these sockets so we could digitize them and indirectly assess change in residual limb size over time by calculating changes in socket volume and circumferences over time. Case Description and Methods: Over a decade, the subject maintained a relatively stable body weight of 84-88 kg and received nine sub-ischial sockets. The internal surface of each socket was scanned using a mechanical digitizer and volume and circumferences calculated. Findings and Outcomes: Socket volume increased 31.3%, from a low of 2659.2 cm 3 for the oldest socket to a high of 3490.6 cm 3 for the most recent socket. Proximal circumferences increased more than distal circumferences with a 15.9% total increase proximally versus 8.9% total increase distally. The results suggest that this individual's residual limb increased in size over time despite the compressive effect of the socket and liner. In addition, the increase in circumference was greater proximally than distally, which is where the remaining muscle bellies are located. Clinical relevance This case study provides insight into the long-term effect of the sub-ischial socket on residual limb volume given compression of the soft tissues by the socket system.
Fatone, Stefania; Caldwell, Ryan
2017-01-01
Background: Current transfemoral prosthetic sockets restrict function, lack comfort, and cause residual limb problems. Lower proximal trim lines are an appealing way to address this problem. Development of a more comfortable and possibly functional subischial socket may contribute to improving quality of life of persons with transfemoral amputation. Objectives: The purpose of this study was to (1) describe the design and fabrication of a new subischial socket and (2) describe efforts to teach this technique. Study design: Development project. Methods: Socket development involved defining the following: subject and liner selection, residual limb evaluation, casting, positive mold rectification, check socket fitting, definitive socket fabrication, and troubleshooting of socket fit. Three hands-on workshops to teach the socket were piloted and attended by 30 certified prosthetists and their patient models. Results: Patient models responded positively to the comfort, range of motion, and stability of the new socket while prosthetists described the technique as “straight forward, reproducible.” Conclusion: To our knowledge, this is the first attempt to create a teachable subischial socket, and while it appears promising, more definitive evaluation is needed. Clinical relevance We developed the Northwestern University Flexible Subischial Vacuum (NU-FlexSIV) Socket as a more comfortable alternative to current transfemoral sockets and demonstrated that it could be taught successfully to prosthetists. PMID:28094686
Review of the socket design and interface pressure measurement for transtibial prosthesis.
Pirouzi, Gh; Abu Osman, N A; Eshraghi, A; Ali, S; Gholizadeh, H; Wan Abas, W A B
2014-01-01
Socket is an important part of every prosthetic limb as an interface between the residual limb and prosthetic components. Biomechanics of socket-residual limb interface, especially the pressure and force distribution, have effect on patient satisfaction and function. This paper aimed to review and evaluate studies conducted in the last decades on the design of socket, in-socket interface pressure measurement, and socket biomechanics. Literature was searched to find related keywords with transtibial amputation, socket-residual limb interface, socket measurement, socket design, modeling, computational modeling, and suspension system. In accordance with the selection criteria, 19 articles were selected for further analysis. It was revealed that pressure and stress have been studied in the last decaeds, but quantitative evaluations remain inapplicable in clinical settings. This study also illustrates prevailing systems, which may facilitate improvements in socket design for improved quality of life for individuals ambulating with transtibial prosthesis. It is hoped that the review will better facilitate the understanding and determine the clinical relevance of quantitative evaluations.
Review of the Socket Design and Interface Pressure Measurement for Transtibial Prosthesis
Pirouzi, Gh.; Abu Osman, N. A.; Eshraghi, A.; Ali, S.; Gholizadeh, H.; Wan Abas, W. A. B.
2014-01-01
Socket is an important part of every prosthetic limb as an interface between the residual limb and prosthetic components. Biomechanics of socket-residual limb interface, especially the pressure and force distribution, have effect on patient satisfaction and function. This paper aimed to review and evaluate studies conducted in the last decades on the design of socket, in-socket interface pressure measurement, and socket biomechanics. Literature was searched to find related keywords with transtibial amputation, socket-residual limb interface, socket measurement, socket design, modeling, computational modeling, and suspension system. In accordance with the selection criteria, 19 articles were selected for further analysis. It was revealed that pressure and stress have been studied in the last decaeds, but quantitative evaluations remain inapplicable in clinical settings. This study also illustrates prevailing systems, which may facilitate improvements in socket design for improved quality of life for individuals ambulating with transtibial prosthesis. It is hoped that the review will better facilitate the understanding and determine the clinical relevance of quantitative evaluations. PMID:25197716
Safari, Mohammad Reza; Tafti, Nahid; Aminian, Gholamreza
2015-01-01
The objectives of the current study were to compare intra-socket pressure differences between comfortable and uncomfortable socket conditions, and the usefulness of subject perception of satisfaction, activity limitations, and socket comfort in distinguishing between these two socket conditions. Five unilateral trans-tibial amputees took part in the study. They answered the Socket Comfort Score (SCS) and Trinity Amputation and Prosthetic Experience Scale (TAPES) questionnaires before the interface pressure (in standing and walking) was measured for the uncomfortable socket condition at five regions of the residual limb. Participants were then provided with a comfortable socket and wore it for two weeks. Participants who were satisfied with the socket fit after two weeks repeated the SCS and TAPES questionnaires and interface pressure measurements. The differences between the test results of the two conditions were not statistically significant, except for the interface pressure at the popliteal region during the early stance phase, TAPES socket fit subscale, and the SCS. Due to large variability of the data and the lack of statistical significance, no firm conclusion can be made on the possible relationship between the interface pressure values and the patient-reported outcomes of the two socket conditions. A larger sample size and longer acclimation period are required to locate significant differences.
Kırzıoğlu, Zuhal; Erken Güngör, Özge; Erdoğan, Yıldırım
2017-07-01
Tooth avulsion is a type of dental injury defined as the complete displacement of a tooth out of the alveolar socket, and the lack of prompt treatment measures can result in the loss of function, poor quality of life, and psychological and social problems. However, several factors may not permit the immediate replantation of an avulsed tooth; therefore, delayed replantation has emerged as an alternative to meet the esthetic, functional, and psychological demands of patients. Here it was described that the successful replantation of an avulsed maxillary central incisor in a 9-year-old boy who presented at the clinic with the tooth stored in unfavorable conditions as dry and then in olive oil-milk mixture almost 10 h after the event. The tooth has remained in its socket healthy for 16 years after treatment. The patient was satisfied with both esthetics and function. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.
[Research progress of conscious pain and neurosensory abnormalities in dry eye disease].
Lin, X; Liu, Z L; Wu, J L; Liu, Z G
2018-02-11
Dry eye is one of the most common ocular problems in ophthalmology clinic. With the change of social environment and people's life style, the prevalence of dry eye disease is increasing. Currently, the diagnosis criteria for dry eye is controversial, diagnosis of dry eye mainly rely on the comprehensive assessment of symptoms and the presence of associated ocular surface signs. However, previous studies have shown a poor correlation between dry eye symptoms and objective clinical signs in patients. Recent studies have found that neuropathic pain plays an important role in the occurrence of discordance between symptoms and signs in dry eye disease. The purpose of this paper is to present the conception of pain, the distribution and function of sensory nerves in ocular surface, the prevalence and mechanism of neuropathic pain and analgesic treatment in dry eye disease. (Chin J Ophthalmol, 2018, 54: 144-148) .
Two degree of freedom camera mount
NASA Technical Reports Server (NTRS)
Ambrose, Robert O. (Inventor)
2003-01-01
A two degree of freedom camera mount. The camera mount includes a socket, a ball, a first linkage and a second linkage. The socket includes an interior surface and an opening. The ball is positioned within an interior of the socket. The ball includes a coupling point for rotating the ball relative to the socket and an aperture for mounting a camera. The first and second linkages are rotatably connected to the socket and slidably connected to the coupling point of the ball. Rotation of the linkages with respect to the socket causes the ball to rotate with respect to the socket.
NASA Technical Reports Server (NTRS)
Barry, Matthew R.
2006-01-01
The X-Windows Socket Widget Class ("Class" is used here in the object-oriented-programming sense of the word) was devised to simplify the task of implementing network connections for graphical-user-interface (GUI) computer programs. UNIX Transmission Control Protocol/Internet Protocol (TCP/IP) socket programming libraries require many method calls to configure, operate, and destroy sockets. Most X Windows GUI programs use widget sets or toolkits to facilitate management of complex objects. The widget standards facilitate construction of toolkits and application programs. The X-Windows Socket Widget Class encapsulates UNIX TCP/IP socket-management tasks within the framework of an X Windows widget. Using the widget framework, X Windows GUI programs can treat one or more network socket instances in the same manner as that of other graphical widgets, making it easier to program sockets. Wrapping ISP socket programming libraries inside a widget framework enables a programmer to treat a network interface as though it were a GUI.
Mahesh, Lanka; Narayan, Tv; Kostakis, Georgios; Shukla, Sagrika
2014-03-01
To measure implant stability using periotest values of implants placed in sockets augmented with calcium phospho-silicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. Twenty two sockets were implanted with CPS Putty immediately after extraction. The sockets were re-entered after a healing period at 5 to 6 months (average 5.3 months) for implant placement. Periotest values were recorded during implant insertion to assess primary stability. These were compared with the Periotest values of 26 implants placed in 22 patients, with naturally healed sockets. Periotest values were significantly lower in the grafted group, indicating better implant stability in sites grafted with CPS putty. Implant stability seems to be significantly higher in sockets augmented using CPS putty when compared to nongrafted sites. This suggests that socket grafting with CPS putty may enhance the quality of available bone for implantation.
Gerschutz, Maria J; Haynes, Michael L; Nixon, Derek; Colvin, James M
2012-01-01
A prosthesis encounters loading through forces and torques exerted by the person with amputation. International Organization for Standardization (ISO) standard 10328 was designed to test most lower-limb prosthetic components. However, this standard does not include prosthetic sockets. We measured static failure loads of prosthetic sockets using a modified ISO 10328 and then compared them with the criteria set by this standard for other components. Check socket (CS) strengths were influenced by thickness, material choice, and fabrication method. Copolymer socket (CP) strengths depended on thickness and fabrication methods. A majority of the CSs and all of the CPs failed to pass the ISO 10328 ductile loading criterion. In contrast, the strengths of definitive laminated sockets (DLs) were influenced more by construction material and technique. A majority of the DLs failed to pass the ISO 10328 brittle loading criterion. Analyzing prosthetic sockets from a variety of facilities demonstrated that socket performance varies considerably between and within facilities. The results from this article provide a foundation for understanding the quality of prosthetic sockets, some insight into possible routes for improving the current care delivered to patients, and a comparative basis for future technology.
Wernke, Matthew M.; Schroeder, Ryan M.; Haynes, Michael L.; Nolt, Lonnie L.; Albury, Alexander W.; Colvin, James M.
2017-01-01
Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit. Approach: A tension compression machine was used to apply repeated controlled forces onto a residual limb model with sockets of different internal volume. Results: The vacuum pressure–displacement relationship was dependent on socket fit. The vacuum pressure data were sensitive enough to detect differences of 1.5% global volume and can likely detect differences even smaller. Limb motion was reduced as surface area of contact between the limb model and socket was maximized. Innovation: The results suggest that elevated vacuum pressure data provide information to quantify socket fit. Conclusions: This study provides evidence that the use of elevated vacuum pressure data may provide a method for prosthetists to quantify and monitor socket fit. Future studies should investigate the relationship between socket fit, limb motion, and limb health to define optimal socket fit parameters. PMID:28736683
Treatment of temporomandibular myofascial pain with deep dry needling
Gonzalez-Perez, Luis M.; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco J.
2012-01-01
Objectives: The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. Study Design: We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6,5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. Results: We found a statistically significant relationship (p<0,01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Conclusions: Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle. Key words:Temporomandibular joint, myofascial pain, external pterygoid muscle, trigger point, deep dry needling. PMID:22549679
2016-10-01
satisfaction with device’’ (i.e. prosthesis) than the IC Socket. During year 1, we received all required IRB approvals, registered the clinical... satisfaction with device” (i.e. prosthesis) than the IC Socket. 2. KEYWORDS: Prosthetic Socket, Artificial Limbs, Prosthesis, Transfemoral Amputee, Gait...FlexSIV Socket will result in better quality of life and “ satisfaction with device” (i.e. prosthesis) than the IC socket. Accomplishments under
Ntounis, Athanasios; Geurs, Nico; Vassilopoulos, Philip; Reddy, Michael
2015-01-01
The study was conducted to evaluate the effect of mineralized freeze-dried bone allograft (FDBA), alone or in combination with growth factors in extraction sockets, on subjective assessment of bone quality during implant placement. Forty-one patients whose treatment plan involved extraction of anterior or premolar teeth were randomized into four groups: Group 1, collagen plug (control); Group 2, FDBA/β-tricalcium phosphate (β-TCP)/collagen plug; Group 3, FDBA/β-TCP/platelet-rich plasma (PRP)/collagen plug; Group 4, FDBA/β-TCP/recombinant human platelet-derived growth factor BB (rhPDGF-BB)/collagen plug. After 8 weeks of healing, implants were placed. The clinicians assessed bone quality according to the Misch classification. A benchtop calibration exercise test was conducted to evaluate agreement and accuracy of operators in recognizing different bone qualities. Differences were analyzed using one-way analysis of variance (ANOVA) or chi-square tests for continuous and categorical data. Pairwise comparisons were tested using least squares means (LS means). Spearman correlation coefficients were used to evaluate the relationship of bone growth with potential confounders. P < .05 was considered statistically significant. A simple (not weighted) kappa statistic was used to assess the agreement between raters. To assess accuracy in identifying bone quality, a chi-square test was used to compare the percent correct for each rater. The benchtop calibration exercise test demonstrated agreement among clinicians (0.75 and 0.92 between raters 1 and 2 and raters 1 and 3, respectively). Raters were more likely to identify the correct bone quality (P > .05). Inclusion of bone grafting is associated with a shift from D4 quality to D3 quality bone. Inclusion of PRP in bone grafting eliminates the incidence of D4 bone, establishing D3 and D2 quality bone as prevalent (56% vs. 42%, respectively). Inclusion of rhPDGF-BB and β-TCP in combination with the bone grafting has the same effect, although D2 quality is less prevalent. When compared to sockets grafted with FDBA/β-TCP/collagen plug alone, the sockets with growth factors demonstrated fewer residual bone graft particles. (1) Inclusion of bone grafting enhanced bone quality as assessed during implant placement. (2) Overall inclusion of PRP and rhPDGF-BB enhanced subjective bone quality, eliminating incidence of D4 quality in human extraction sockets. (3) The use of PRP or rhPDGF-BB may enhance healing within extraction sockets and decrease the healing time prior to dental implant placement.
Cervera-Espert*, Juan; Pérez-Martínez*, Sara; Cervera-Ballester, Juan; Penarrocha-Oltra, David
2016-01-01
Background Coronectomy is an alternative to complete removal of an impacted mandibular third molar. Most authors have recommended coronectomy to prevent damage to the inferior alveolar nerve during surgical extraction of lower third molars. The present study offers a systematic review and metaanalysis of the coronectomy technique. Material and Methods A systematic review and meta-analysis was performed based on a PubMed and Cochrane databases search for articles published from 2014 and involving coronectomy of mandibular third molars located near the inferior alveolar nerve canal, with a minimum of 10 cases and a minimum follow-up period of 6 months. After application of the inclusion and exclusion criteria, a total of 12 articles were included in the study. Results and Discussion Coronectomy results in significantly lesser loss of sensitivity of the inferior alveolar nerve and prevents the occurrence of dry socket. No statistically significant differences were observed in the incidence of pain and infection between coronectomy and complete surgical extraction. After coronectomy, the remaining tooth fragment migrates an average of 2 mm within two years. Conclusions Coronectomy is indicated when the mandibular third molar is in contact with the inferior alveolar nerve and complete removal of the tooth may cause nerve damage. Key words:Coronectomy, included third molar, inferior alveolar nerve injury. PMID:27031064
Hachisuka, K; Matsushima, Y; Ohmine, S; Shitama, H; Shinkoda, K
2001-09-01
The purpose of this study was to examine the moisture permeability properties of materials used for total surface bearing (TSB) socket with a silicone liner, a combination of Silicone Suction Socket or Icelandic Roll-On Silicone Socket (ICEROSS) and an acrylic plastic sheet (Degaplast), patella-tendon bearing (PTB) socket, a combination of Pe-Lite and Degaplast, and wooden socket made of poplar. Moisture permeability of the socket materials was measured as the diminution of water in a container after 12 hours in a climatic chamber. Eight containers with their open, top side were uncovered (no material) or sealed with one of the socket materials; the experiment was repeated four times. One-way analysis of variance followed by Bonferroni's test was applied to examine the differences in moisture permeability. Moisture permeability levels were as follows: no material, 85.9 +/- 1.3 g; poplar, 4.3 +/- 0.4 g; Silicone Suction Socket, 1.1 +/- 0.2 g; ICEROSS, 1.0 +/- 0.2 g; Pe-Lite, 0.8 +/- 0.1 g; 3S + Degaplast, 0.8 +/- 0.1 g; ICEROSS + Degaplast, 0.8 +/- 0.2 g; and Pe-Lite + Degaplast, 0.8 +/- 0.1 g. There were significant differences between the uncovered container and the others, and between poplar and the others (P < 0.05). We concluded that the TSB socket with a silicone liner is not superior to the PTB socket with regard to moisture permeability, and that it is necessary to develop a new prosthetic socket that allows heat release and drainage of sweat.
Healing of ungrafted and grafted extraction sockets after 12 weeks: a prospective clinical study.
Heberer, Susanne; Al-Chawaf, Bassem; Jablonski, Carlo; Nelson, John J; Lage, Hermann; Nelson, Katje
2011-01-01
In this prospective study, bone formation in human extraction sockets augmented with Bio-Oss Collagen after a 12-week healing period was quantified and compared to bone formation in unaugmented extraction sockets. Selected patients with four-walled extraction sockets were included in this prospective study. After extraction, the sockets were randomly augmented using Bio-Oss Collagen or left to heal unfilled without raising a mucoperiosteal flap. At the time of implant placement, histologic specimens were obtained from the socket and analyzed. Statistical analysis was performed using the Wilcoxon signed-rank test. Twenty-five patients with a total of 39 sockets (20 augmented, 19 unaugmented) were included in the study and the histologic specimens analyzed. All specimens were free of inflammatory cells. The mean overall new bone formation in the augmented sites was 25% (range, 8%-41%) and in the unaugmented sockets it was 44% (range, 3%-79%). There was a significant difference in the rate of new bone formation between the grafted and ungrafted sockets and a significant difference in the bone formation rate in the apical compared to the coronal regions of all sockets, independent of the healing mode. This descriptive study demonstrated that bone formation in Bio-Oss Collagen-grafted human extraction sockets was lower than bone formation in ungrafted sockets. Bone formation occurred in all specimens with varying degrees of maturation independent of the grafting material and was initiated from the apical region.
Pecos-Martín, Daniel; Montañez-Aguilera, F Javier; Gallego-Izquierdo, Tomás; Urraca-Gesto, Alicia; Gómez-Conesa, Antonia; Romero-Franco, Natalia; Plaza-Manzano, Gustavo
2015-05-01
To evaluate the effect of dry needling into a myofascial trigger point (MTrP) in the lower trapezius muscle of patients with mechanical idiopathic neck pain. A single-center, randomized, double-blinded controlled study. Patients were recruited from the student population of a local hospital by advertisement in the university clinic from January 2010 to December 2011. Patients (N=72) with unilateral neck pain, neck pain for ≥3 months, and active trigger points in the lower trapezius muscle were randomly assigned to 1 of 2 treatment groups. All the patients completed the study. Dry needling in an MTrP in the lower trapezius muscle, or dry needling in the lower trapezius muscle but not at an MTrP. The visual analog scale (VAS), Neck Pain Questionnaire (NPQ), and pressure-pain threshold (PPT) were assessed before the intervention and 1 week and 1 month postintervention. Treatment with dry needling of the lower trapezius muscle close to the MTrP showed decreases in pain and PPT as well as an improvement in the degree of disability (P<.001) compared with the baseline and control group measurements (P<.001). The dry-needling technique performed in the MTrP showed more significant therapeutic effects (P<.001). The application of dry needling into an active MTrP of the lower trapezius muscle induces significant changes in the VAS, NPQ, and PPT levels compared with the application of dry needling in other locations of the same muscle in patients with mechanical neck pain. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Al-Fakih, Ebrahim A; Abu Osman, Noor Azuan; Mahmad Adikan, Faisal Rafiq
2016-07-20
The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket.
Al-Fakih, Ebrahim A.; Abu Osman, Noor Azuan; Mahmad Adikan, Faisal Rafiq
2016-01-01
The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket. PMID:27447646
King, Elizabeth M; Cerajewska, Tanya L; Locke, Matthew; Claydon, Nicholas C A; Davies, Maria; West, Nicola X
2018-06-01
To investigate the efficacy of plasma rich in growth factors (PRGF; BTI Biotechnology Institute, San Antonio, Spain) for the treatment of alveolar osteitis compared with a positive control (Alvogyl; Septodont, Maidstone, Kent, UK). This single-center, single-blinded, randomized, 2-treatment, parallel study was conducted in a UK dental hospital. All healthy adults who presented with alveolar osteitis after tooth extraction over a 3-month period were invited to participate. Each socket was randomized and treated with 1 of 2 treatment modalities, a test treatment (PRGF) or a positive control (Alvogyl). After treatment, patients were reviewed at 3 and 7 days by a second clinician blinded to the treatment given. Outcome measures included pain, exposed bone, inflammation, halitosis, dysgeusia, and quality-of-life assessment. Thirty-eight patients with data from 44 sockets (22 in the PRGF group and 22 in the Alvogyl group) were analyzed. The PRGF group showed significantly faster bone coverage and significantly decreased inflammation and halitosis (P < .05) compared with the control group receiving Alvogyl. There was no significant difference for pain, quality-of-life measures, or dysgeusia between groups. PRGF predictably treated alveolar osteitis after tooth extraction compared with the conventional standard treatment of Alvogyl, which has been used for many years. PRGF could be considered an alternative treatment for alveolar osteitis and indeed appears to have considerable advantages over Alvogyl. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Koppenhaver, Shane L; Walker, Michael J; Rettig, Charles; Davis, Joel; Nelson, Chenae; Su, Jonathan; Fernández-de-Las-Peñas, Cesar; Hebert, Jeffrey J
2017-06-01
To investigate the relationship between dry needling-induced twitch response and change in pain, disability, nociceptive sensitivity, and lumbar multifidus muscle function, in patients with low back pain (LBP). Quasi-experimental study. Department of Defense Academic Institution. Sixty-six patients with mechanical LBP (38 men, 28 women, age: 41.3 [9.2] years). Dry needling treatment to the lumbar multifidus muscles between L3 and L5 bilaterally. Examination procedures included numeric pain rating, the Modified Oswestry Disability Index, pressure algometry, and real-time ultrasound imaging assessment of lumbar multifidus muscle function before and after dry needling treatment. Pain pressure threshold (PPT) was used to measure nocioceptive sensitivity. The percent change in muscle thickness from rest to contraction was calculated to represent muscle function. Participants were dichotomized and compared based on whether or not they experienced at least one twitch response on the most painful side and spinal level during dry needling. Participants experiencing local twitch response during dry needling exhibited greater immediate improvement in lumbar multifidus muscle function than participants who did not experience a twitch (thickness change with twitch: 12.4 [6]%, thickness change without twitch: 5.7 [11]%, mean difference adjusted for baseline value, 95%CI: 4.4 [1 to 8]%). However, this difference was not present after 1-week, and there were no between-groups differences in disability, pain intensity, or nociceptive sensitivity. The twitch response during dry needling might be clinically relevant, but should not be considered necessary for successful treatment. Published by Elsevier Ltd.
Dry cupping for plantar fasciitis: a randomized controlled trial.
Ge, Weiqing; Leson, Chelsea; Vukovic, Corey
2017-05-01
[Purpose] The purpose of this study was to determine the effects of dry cupping on pain and function of patients with plantar fasciitis. [Subjects and Methods] Twenty-nine subjects (age 15 to 59 years old, 20 females and 9 males), randomly assigned into the two groups (dry cupping therapy and electrical stimulation therapy groups), participated in this study. The research design was a randomized controlled trial (RCT). Treatments were provided to the subjects twice a week for 4 weeks. Outcome measurements included the Visual Analogue Pain Scale (VAS) (at rest, first in the morning, and with activities), the Foot and Ankle Ability Measure (FAAM), the Lower Extremity Functional Scale (LEFS), as well as the pressure pain threshold. [Results]The data indicated that both dry cupping therapy and electrical stimulation therapy could reduce pain and increase function significantly in the population tested, as all the 95% Confidence Intervals (CIs) did not include 0 except for the pressure pain threshold. There was no significant difference between the dry cupping therapy and electrical stimulation groups in all the outcome measurements. [Conclusion] These results support that both dry cupping therapy and electrical stimulation therapy could reduce pain and increase function in the population tested.
Dry cupping for plantar fasciitis: a randomized controlled trial
Ge, Weiqing; Leson, Chelsea; Vukovic, Corey
2017-01-01
[Purpose] The purpose of this study was to determine the effects of dry cupping on pain and function of patients with plantar fasciitis. [Subjects and Methods] Twenty-nine subjects (age 15 to 59 years old, 20 females and 9 males), randomly assigned into the two groups (dry cupping therapy and electrical stimulation therapy groups), participated in this study. The research design was a randomized controlled trial (RCT). Treatments were provided to the subjects twice a week for 4 weeks. Outcome measurements included the Visual Analogue Pain Scale (VAS) (at rest, first in the morning, and with activities), the Foot and Ankle Ability Measure (FAAM), the Lower Extremity Functional Scale (LEFS), as well as the pressure pain threshold. [Results]The data indicated that both dry cupping therapy and electrical stimulation therapy could reduce pain and increase function significantly in the population tested, as all the 95% Confidence Intervals (CIs) did not include 0 except for the pressure pain threshold. There was no significant difference between the dry cupping therapy and electrical stimulation groups in all the outcome measurements. [Conclusion] These results support that both dry cupping therapy and electrical stimulation therapy could reduce pain and increase function in the population tested. PMID:28603360
Mohd Hawari, Nurhanisah; Jawaid, Mohammad; Md Tahir, Paridah; Azmeer, Raja Ahmad
2017-11-01
The aim of this case study was to explore patient satisfaction with the quality of prosthetic leg sockets intended for persons with lower limb amputations. A qualitative study based on in-depth interviews, preceded by a questionnaire session, was carried out with patients from the Rehabilitation Center and Hospital in Malaysia. Twelve out-patient and in-patient amputees with lower limb amputations, specifically below-knee amputations, were chosen randomly. The analysis of patients' narratives aimed to identify the functional and esthetic characteristics of currently used prosthetic leg sockets and any problems related to them. The obtained results indicated that out of the 12 participants, 41.7% and 25% were satisfied and somewhat satisfied with their current prosthetic sockets. Durability and comfort were rated by the participants as the most important characteristics of prosthetic sockets, with 83.3%. As regards the esthetic appearance of the socket, 66.7% of the respondents considered that the most important feature was the material from which the socket was fabricated. Thus, we conclude that current satisfaction levels with the quality of prosthetic sockets among amputees in Malaysia are suitable, prosthesis being preferred by many amputees. The results can be used to direct future research on cosmesis and functionality of prosthetic socket design. Implications for Rehabilitation Case study will help participants to get cost effective prosthetic leg socket. Develop prosthetic leg socket comfortable as comparative to existing one. Help Malaysian government to make policy to develop local prosthetic leg socket at affordable price.
Evidence that dry eye is a comorbid pain condition in a U.S. veteran population
Lee, Charity J.; Levitt, Roy C.; Felix, Elizabeth R.; Sarantopoulos, Constantine D.; Galor, Anat
2017-01-01
Abstract Introduction: Recent evidence suggests that dry eye (DE) may be comorbid with other chronic pain conditions. Objectives: To evaluate DE as a comorbid condition in the U.S. veteran population. Methods: Retrospective review of veterans seen in the Veterans Administration Healthcare System (Veteran Affairs) between January 1, 2010, and December 31, 2014. Dry eye and nonocular pain disorders were ascertained by International Classification of Diseases, Ninth Revision (ICD-9) codes. Dry eye was further separated into ICD-9 codes representing tear film dysfunction or ocular pain. χ2 and logistic regression analyses were used to examine frequency and risk of DE, ocular pain, and tear film dysfunction by pain disorders. Results: Of 3,265,894 veterans, 959,881 had a DE diagnosis (29.4%). Dry eye frequency increased with the number of pain conditions reported (P < 0.0005). Ocular pain was most strongly associated with headache (odds ratio [OR] 2.98; 95% confidence interval [CI] 2.95–3.01), tension headache (OR 2.64; 95% CI 2.58–2.71), migraine (OR 2.58; 95% CI 2.54–2.61), temporomandibular joint dysfunction (OR 2.39; 95% CI 2.34–2.44), pelvic pain (OR 2.30; 95% CI 2.24–2.37), central pain syndrome (OR 2.24; 95% CI 1.94–2.60), and fibromyalgia/muscle pain (OR 2.23; 95% CI 2.20–2.26), all P < 0.0005. Tear film dysfunction was most closely associated with osteoarthritis (OR 1.97; 95% CI 1.96–1.98) and postherpetic neuralgia (OR 1.95; 95% CI 1.90–2.00), both P < 0.0005. Conclusions: Dry eye, including both ocular pain and tear film dysfunction, is comorbid with pain conditions in this nationwide population, implying common mechanisms. PMID:29392243
Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason
2016-01-01
The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface socket in the accommodation of volume fluctuation. A prospective experimental case study using repeated measures of subjective and performance outcome measures between socket conditions was employed. In the baseline volume condition, the adjustable socket improved subjective and performance measures 19% to 37% over SOC, whereas the two-minute walk test demonstrated equivalence. In the volume loss condition, the adjustable socket improved all subjective and performance measures 22% to 93%. All aggregated data improved 16% to 50% compared with the SOC. In simulated volume gain, the SOC socket failed, while the subject was able to complete the protocol using the adjustable socket. In this case study, the SOC socket was inferior to the comparative adjustable transfemoral amputation interface in subjective and performance outcomes. There is a lack of clinical trials and evidence comparing socket functional outcomes related to volume fluctuation. PMID:28066526
Komatsu, Teruya; Sakaguchi, Yasuto; Muranishi, Yusuke; Yutaka, Yojiro; Date, Hiroshi; Nakamura, Tatsuo
2018-01-01
Background Costal coaptation pins made of poly-L-lactide (PLA) are clinically available for fixing surgically divided ribs. However, the clinical results of such rib fixation have not been completely satisfactory. We aimed to develop a new rib coaptation socket system and explore its clinical applicability. Methods We surgically divided three consecutive ribs of each beagle dog, and rib coaptation sockets were implanted to stabilize each rib. Fifteen 3-dimensional (3D)-printed and 30 PLA fiber knitted sockets were implanted in five and ten dogs, respectively, to stabilize the artificially divided ribs. Mechanical analysis of the sockets and radiographical examination of costal fixation were performed to evaluate the effectiveness of the newly developed socket system for rib stabilization. Results All 15 ribs with 3D-printed sockets had displaced 1 month after the operation. Three ribs in one dog with implanted PLA fiber knitted sockets were displaced radiographically after 1 month, and the grade of displacement remained unchanged after 6 months. The remaining 27 ribs fixed with PLA fiber knitted sockets did not show any displacement. Conclusions The PLA fiber knitted rib coaptation socket system was sufficiently durable for the stabilization of divided ribs with biocompatibility. This promising finding can be applied for clinical stabilization of divided ribs. PMID:29850125
Laing, Sheridan; Lythgo, Noel; Lavranos, Jim; Lee, Peter Vee Sin
2017-10-01
This study compared the physical function and comfort level of patients with unilateral transtibial amputation after being fitted with a hand-cast Patella Tendon Bearing (PTB) socket and a pressure-cast (PCAST) hydrocast socket. The latter technique aims to reduce the skill dependency currently required for socket manufacture and fit. The study was conducted at the Vietnamese Training Centre for Orthopaedic Technologies and involved seventeen Vietnamese participants with unilateral transtibial amputation, all of whom were long term users of prosthetics. All participants were fitted with two sockets manufactured using both hand-cast and PCAST techniques with International Committee of the Red Cross components. Walking tests (timed up and go test and six-minute-walk-test), spatio-temporal gait analyses and subjective comfort assessments were completed after a short acclimatisation period with each socket. The participant-preferred socket was also noted. No significant differences were found for the measures of mobility, functional capacity, spatio-temporal gait parameters, gait symmetry, perceived comfort or participant socket preference. The results show the initial patient outcomes are similar when participants are fitted with a hand-cast PTB socket and a PCAST hydrocast sockets. Future work should confirm these findings in a longer trial. Copyright © 2017 Elsevier B.V. All rights reserved.
Komatsu, Teruya; Sato, Toshihiko; Sakaguchi, Yasuto; Muranishi, Yusuke; Yutaka, Yojiro; Date, Hiroshi; Nakamura, Tatsuo
2018-04-01
Costal coaptation pins made of poly-L-lactide (PLA) are clinically available for fixing surgically divided ribs. However, the clinical results of such rib fixation have not been completely satisfactory. We aimed to develop a new rib coaptation socket system and explore its clinical applicability. We surgically divided three consecutive ribs of each beagle dog, and rib coaptation sockets were implanted to stabilize each rib. Fifteen 3-dimensional (3D)-printed and 30 PLA fiber knitted sockets were implanted in five and ten dogs, respectively, to stabilize the artificially divided ribs. Mechanical analysis of the sockets and radiographical examination of costal fixation were performed to evaluate the effectiveness of the newly developed socket system for rib stabilization. All 15 ribs with 3D-printed sockets had displaced 1 month after the operation. Three ribs in one dog with implanted PLA fiber knitted sockets were displaced radiographically after 1 month, and the grade of displacement remained unchanged after 6 months. The remaining 27 ribs fixed with PLA fiber knitted sockets did not show any displacement. The PLA fiber knitted rib coaptation socket system was sufficiently durable for the stabilization of divided ribs with biocompatibility. This promising finding can be applied for clinical stabilization of divided ribs.
Xu, J-L; Sun, L; Liu, C; Sun, Z-H; Min, X; Xia, R
2015-09-01
The aim of this comprehensive meta-analysis was to provide evidence-based data to test whether oral contraceptive (OC) use can promote the incidence of dry socket (DS) in females following impacted mandibular third molar extraction. PubMed, the Cochrane Library, and Elsevier Science Direct databases were searched. The pooled risk ratio (RR) with 95% confidence interval (CI) was calculated using fixed-effects or random-effects model analysis. Heterogeneity among studies was evaluated with the Cochran test and I(2) statistic. Study quality was assessed with the Newcastle-Ottawa scale. Of 70 articles identified in the search, 12 reporting 16 clinical controlled trials were included in this study. The incidence of DS was significantly greater in the OC groups than in the control groups (RR 1.80, 95% CI 1.33-2.43). Subgroup analyses showed that the unit assessed (tooth or patient), the region in which the study was conducted, and the intervention were not related to the incidence of DS in females taking OC after impacted mandibular third molar extraction. The sensitivity analysis showed no significant change when any one study was excluded. Publication bias was also not detected. This study suggests that OC use may promote the incidence of DS in females following impacted mandibular third molar extraction. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Flügge, Tabea; Nelson, Katja; Nack, Claudia; Stricker, Andres; Nahles, Susanne
2015-04-01
This study identified the soft tissue changes of the alveolar ridge at different time points within 12 weeks after tooth extraction with and without socket augmentation. In 38 patients with single tooth extractions, 40 sockets were augmented and 39 extraction sockets were not augmented. At 2, 4, 6, 8 and 12 weeks impressions were taken and casts digitized with a laser scanner. The horizontal and vertical changes were compared between augmented and non-augmented sites. A p-value <0.05 was considered statistically significant. The mean changes of augmented sockets were between 0.4 mm (2 weeks) and 0.8 mm (12 weeks). In non-augmented sockets changes of 0.7 mm (2 weeks) and of 1.0 mm (12 weeks) were demonstrated. The mean values differed significantly between the buccal and oral region (p < 0.01). Overall, there were significant differences of the mean dimensional changes regarding time (p < 0.01) and augmentation (p < 0.01). Augmented sockets showed less resorption within 4 weeks after extraction compared to non-augmented sockets. Non-augmented sockets showed a continuous dimensional loss with a great variation over 12 weeks whereas augmented sockets had the highest degree of resorption between 4 and 6 weeks. At 12 weeks a comparable resorption in augmented and non-augmented sockets was observed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Continuity tester screens out faulty socket connections
NASA Technical Reports Server (NTRS)
Golding, G.
1964-01-01
A device, used before and after assembly, tests the continuity of an electrical circuit through each pin and socket of multiple connector sockets. Electrically insulated except at the contact area, a test probe is dimensioned to make contact only in properly formed sockets.
Dry eye symptoms align more closely to non-ocular conditions than to tear film parameters.
Galor, Anat; Felix, Elizabeth R; Feuer, William; Shalabi, Nabeel; Martin, Eden R; Margolis, Todd P; Sarantopoulos, Constantine D; Levitt, Roy C
2015-08-01
To evaluate the relationship between dry eye symptoms, non-ocular conditions and tear film parameters. Cross-sectional study. The study population consisted of patients who were seen in the Miami Veterans Affairs eye clinic. Patients filled out standardised questionnaires assessing dry eye symptoms (dry eye questionnaire 5 (DEQ5) and ocular surface disease index (OSDI)), non-ocular pain, depression and post-traumatic stress disorder (PTSD), and also underwent measurement of tear film parameters. Correlations between dry eye symptoms and non-ocular conditions as compared with tear film parameters. 136 patients with a mean age of 65 (SD 11) years participated in the study. All correlations between the dry eye questionnaire scores (DEQ5 and OSDI) and (A) self-reported non-ocular pain measures (numerical rating scale and pain history), (B) depression and (C) PTSD were significant and moderate in strength (Pearson's coefficient 0.24 to 0.60, p<0.01 for all). All correlations between the dry eye questionnaires and tear film measures were weak (Pearson's coefficient -0.10 to 0.18) and most were not significant. Multivariable linear regression analyses revealed that PTSD and non-ocular pain more closely associated with dry eye symptoms than did tear film parameters. Specifically, non-ocular pain and PTSD accounted for approximately 36% of the variability in DEQ5 scores (R=0.60) and approximately 40% of variability in OSDI scores (R=0.64). Of note, none of the tear parameters remained significantly associated with dry eye symptoms in either model. Dry eye symptoms more closely align to non-ocular pain, depression and PTSD than to tear film parameters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Darter, Benjamin J; Sinitski, Kirill; Wilken, Jason M
2016-10-01
Elevated vacuum suspension systems use a pump to draw air from the socket with the intent of reducing bone-socket motion as compared to passive suction systems. However, it remains unknown if elevated vacuum suspension systems decrease limb displacement uniformly during transitions from unloaded to full-body-weight support. To compare limb-socket motion between elevated vacuum and passive suction suspension sockets using a controlled loading paradigm. Comparative analysis. Persons with transtibial amputation were assessed while wearing either an elevated vacuum or passive suction suspension socket. Digital video fluoroscopy was used to measure axial bone-socket motion while the limb was loaded in 20% body-weight increments. An analysis of variance model was used to compare between suspension types. Total axial displacement (0%-100% body weight) was significantly lower using the elevated vacuum (vacuum: 1.3 cm, passive suction: 1.8 cm; p < 0.0001). Total displacement decreased primarily due to decreased motion during initial loading (0%-20%; p < 0.0001). Other body-weight intervals were not significantly different between systems. Elevated vacuum suspension reduced axial limb-socket motion by maintaining position of the limb within the socket during unloaded conditions. Elevated vacuum provided no meaningful improvement in limb-socket motion past initial loading. Excessive bone-socket motion contributes to poor residual limb health. Our results suggest elevated vacuum suspensions can reduce this axial displacement. Visual assessment of the images suggests that this occurs through the reduction or elimination of the air pocket between the liner and socket wall while the limb is unloaded. © The International Society for Prosthetics and Orthotics 2015.
Reverse shoulder arthroplasty.
Jarrett, Claudius D; Brown, Brandon T; Schmidt, Christopher C
2013-07-01
The reverse shoulder arthroplasty is considered to be one of the most significant technological advancements in shoulder reconstructive surgery over the past 30 years. It is able to successfully decrease pain and improve function for patients with rotator cuff-deficient shoulders. The glenoid is transformed into a sphere that articulates with a humeral socket. The current reverse prosthesis shifts the center of rotation more medial and distal, improving the deltoid's mechanical advantage. This design has resulted in successful improvement in both active shoulder elevation and in quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.
Coronal plane socket stability during gait in persons with transfemoral amputation: Pilot study.
Fatone, Stefania; Dillon, Michael; Stine, Rebecca; Tillges, Robert
2014-01-01
Little research describes which transfemoral socket design features are important for coronal plane stability, socket comfort, and gait. Our study objectives were to (1) relate socket comfort during gait to a rank order of changes in ischial containment (IC) and tissue loading and (2) compare socket comfort during gait when tissue loading and IC were systematically manipulated. Six randomly assigned socket conditions (IC and tissue compression) were assessed: (1) IC and high, (2) IC and medium, (3) IC and low, (4) no IC and high, (5) no IC and medium, and (6) no IC and low. For the six subjects in this study, there was a strong, negative relationship between comfort and changes in IC and tissue loading (rho = -0.89). With the ischium contained, tissue loading did not influence socket comfort (p = 0.47). With no IC, the socket was equally comfortable with high tissue loading (p = 0.36) but the medium (p = 0.04) and low (p = 0.02) tissue loading conditions decreased comfort significantly. Coronal plane hip moments, lateral trunk lean, step width, and walking speed were invariant to changes in IC and/or tissue loading. Our results suggest that in an IC socket, medial tissue loading mattered little in terms of comfort. Sockets without IC required high tissue loading to be as comfortable as those with IC, while suboptimal tissue loading compromised comfort.
Single-Rooted Extraction Sockets: Classification and Treatment Protocol.
El Chaar, Edgar; Oshman, Sarah; Fallah Abed, Pooria
2016-09-01
Clinicians have many treatment techniques from which to choose when extracting a failing tooth and replacing it with an implant-supported restoration and when successful management of an extraction socket during the course of tooth replacement is necessary to achieve predictable and esthetic outcomes. This article presents a straightforward, yet thorough, classification for extraction sockets of single-rooted teeth and provides guidance to clinicians in the selection of appropriate and predictable treatment. The presented classification of extraction sockets for single-rooted teeth focuses on the topography of the extraction socket, while the protocol for treatment of each socket type factors in the shape of the remaining bone, the biotype, and the location of the socket whether it be in the mandible or maxilla. This system is based on the biologic foundations of wound healing and can help guide clinicians to successful treatment outcomes.
Martín-Pintado-Zugasti, Aitor; Rodríguez-Fernández, Ángel Luis; Fernandez-Carnero, Josue
2016-04-27
Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.
Modular socket system versus traditionally laminated socket: a cost analysis.
Normann, Elna; Olsson, Anna; Brodtkorb, Thor-Henrik
2011-03-01
Using the new modular socket system (MSS) to produce a prosthetic socket directly on the patient has the potential of being easier and quicker to manufacture but also incurring higher costs. The purpose of the study was to compare the costs of manufacturing a transtibial prosthetic socket using either a MSS or a standard laminated socket (PC). Concurrent controlled trial. A total of 20 patients at two orthopaedic facilities were followed with regards to the cost of manufacturing a prosthetic socket using either MSS or PC. Time aspects and material costs were considered in the cost analysis. Other factors studied include delivery time and number of visits. For the cost analysis, only direct costs pertaining to the prosthetic socket were considered. The total cost of MSS was found to be significantly higher (p < 0.01) compared to PC. However, the production and time cost was significantly lower. Delivery time to the patient was 1 day for MSS compared to 17 days for PC. Our study shows that the direct prosthetic cost of treating a patient using MSS is significantly higher than treating a patient using PC. However, the MSS prosthesis can be delivered significantly faster and with fewer visits. Further studies taking the full societal costs of MSS into account should therefore be performed. This study shows that the direct prosthetic cost of treating a patient with Modular Socket System is significantly higher than treating a patient with plastercasting with standard laminated socket. However, the Modular Socket System prosthesis can be delivered significantly faster and with fewer visits.
An Amino Acid Code for Irregular and Mixed Protein Packing
Joo, Hyun; Chavan, Archana; Fraga, Keith; Tsai, Jerry
2015-01-01
To advance our understanding of protein tertiary structure, the development of the knob-socket model is completed in an analysis of the packing in irregular coil and turn secondary structure packing as well as between mixed secondary structure. The knob-socket model simplifies packing based on repeated patterns of 2 motifs: a 3 residue socket for packing within 2° structure and a 4 residue knob-socket for 3° packing. For coil and turn secondary structure, knob-sockets allow identification of a correlation between amino acid composition and tertiary arrangements in space. Coil contributes almost as much as α-helices to tertiary packing. Irregular secondary structure involves 3 residue cliques of consecutive contacting residues or XYZ sockets. In irregular sockets, Gly, Pro, Asp and Ser are favored, while Cys, His, Met and Trp are not. For irregular knobs, the preference order is Arg, Asp, Pro, Asn, Thr, Leu, and Gly, while Cys, His, Met and Trp are not. In mixed packing, the knob amino acid preferences are a function of the socket that they are packing into, whereas the amino acid composition of the sockets does not depend on the secondary structure of the knob. A unique motif of a coil knob with an XYZ β-sheet socket may potentially function to inhibit β-sheet extension. In addition, analysis of the preferred crossing angles for strands within a β-sheet and mixed α-helices/β-sheets identifies canonical packing patterns useful in protein design. Lastly, the knob-socket model abstracts the complexity of protein tertiary structure into an intuitive packing surface topology map. PMID:26370334
Sodium hyaluronate accelerates the healing process in tooth sockets of rats.
Mendes, Renato M; Silva, Gerluza A B; Lima, Miguel F; Calliari, Marcelo V; Almeida, Alvair P; Alves, José B; Ferreira, Anderson J
2008-12-01
In this study we evaluated the effects of sodium hyaluronate (HY) in the healing process of tooth sockets of rats. Immediately after the extraction of the upper first molars of male Holtzman rats, right sockets were treated with 1% HY gel (approximately 0.1 ml), while left sockets were used as control (blood clot). The animals were sacrificed at 2, 7, and 21 days after tooth extraction and upper maxillaries processed for histological and morphometric analysis of the apical and medium thirds of the sockets. Carbopol, an inert gel, was used to evaluate the mechanical effect of gel injection into sockets. Expression of bone morphogenetic protein-2 (BMP-2) and osteopontin (OPN) was determined by immunohistochemistry at 1, 2, 3, 4, 5, and 7 days after tooth extraction. Histological analysis showed that HY treatment induced earlier trabecular bone deposition resulting in a bone matrix more organized at 7 and 21 days after tooth extraction. Also, HY elicited significant increase in the amount of bone trabeculaes at 7 and 21 days after tooth extraction (percentage of trabecular bone area at 7 days: 13.21+/-4.66% vs. 2.58+/-1.36% in the apical third of control sockets) and in the vessels counting at 7 days. Conversely, the number of cell nuclei was decreased in HY-treated sockets. Additionally, expression of BMP-2 and OPN was enhanced in HY-treated sockets compared with control sockets. These findings suggest that HY accelerates the healing process in tooth sockets of rats stimulating the expression of osteogenic proteins.
30 CFR 57.12035 - Weatherproof lamp sockets.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Weatherproof lamp sockets. 57.12035 Section 57.12035 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12035 Weatherproof lamp sockets. Lamp sockets shall be of a weatherproof type...
30 CFR 57.12035 - Weatherproof lamp sockets.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Weatherproof lamp sockets. 57.12035 Section 57.12035 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12035 Weatherproof lamp sockets. Lamp sockets shall be of a weatherproof type...
30 CFR 57.12035 - Weatherproof lamp sockets.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Weatherproof lamp sockets. 57.12035 Section 57.12035 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12035 Weatherproof lamp sockets. Lamp sockets shall be of a weatherproof type...
30 CFR 57.12035 - Weatherproof lamp sockets.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Weatherproof lamp sockets. 57.12035 Section 57.12035 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12035 Weatherproof lamp sockets. Lamp sockets shall be of a weatherproof type...
30 CFR 57.12035 - Weatherproof lamp sockets.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Weatherproof lamp sockets. 57.12035 Section 57.12035 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12035 Weatherproof lamp sockets. Lamp sockets shall be of a weatherproof type...
Factors affecting the stability of reverse shoulder arthroplasty: a biomechanical study.
Clouthier, Allison L; Hetzler, Markus A; Fedorak, Graham; Bryant, J Tim; Deluzio, Kevin J; Bicknell, Ryan T
2013-04-01
Despite the success of reverse shoulder arthroplasty (RSA) in treating patients with painful pseudoparalytic shoulders, instability is a common complication and currently the factors affecting stability are not well understood. The objective of this study was to investigate a number of factors as well as the interactions between factors to determine how they affect the stability of the prosthesis. These factors included: active arm posture (abduction and abduction plane angles), loading direction, glenosphere diameter and eccentricity, and humeral socket constraint. Force required to dislocate the joint, determined using a biomechanical shoulder simulator, was used as a measure of stability. A factorial design experiment was implemented to examine the factors and interactions. Actively increasing the abduction angle by 15° leads to a 30% increase in stability and use of an inferior-offset rather than a centered glenosphere improved stability by 17%. Use of a more constrained humeral socket also increased stability; but the effect was dependent on loading direction, with a 88% improvement for superior loading, 66% for posterior, 36% for anterior, and no change for inferior loading. Abduction plane angle and glenosphere diameter had no effect on stability. Increased glenohumeral abduction and the use of an inferior-offset glenosphere were found to increase the stability of RSA. Additionally, use of a more constrained humeral socket increased stability for anterior, posterior, and superior loading. These identified factor effects have the potential to decrease the risk of dislocation following RSA. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
2009-01-01
A 42-year-old Mediterranean male presented complaining of inability to sustain good oral care at the posterior aspect of the lower right jaw. The main problems were food impaction in the area and the subsequent malodor. The patient reported remarkable medical history. Clinical examination revealed local erytherma with noticeable bone defect distal to the second molar with obvious defect in the mesial wall of the third molar; the penetration depth was found to be up to 6 mm. Radiological evaluation confirmed the defect and it was attributed to the mesioangularly partially impacted lower third molar. It was decided that third molar should be extracted and concentrate of the patient's growth factors (PRGF) to be applied into the bony defect to stimulate bone regeneration and promote healing. The third molar tooth was, then, removed surgically and the PRGF, which was prepared preoperatively, was implanted in the socket. At the first postoperative day, moderate pain was the main complaint and was controlled by NSAIDs. One week postoperatively, the sutures were removed and there was good tissue healing on examination. On the fiftieth postoperative day, radiographic evaluation took place and showed noticeable enhancement of density and radio-opacity in the third molar socket area, in comparison with the baseline image. Further, clinical examination showed significant reduction of periodontal pocketing and evidence of new bone formation. In conclusion, PRGF was very successful in stimulating bone regeneration and promote healing following dental extraction. PMID:20062651
46 CFR 56.30-30 - Brazed joints.
Code of Federal Regulations, 2010 CFR
2010-10-01
....75). Brazed socket-type joints shall be made with suitable brazing alloys. The minimum socket depth shall be sufficient for the intended service. Brazing alloy shall either be end-fed into the socket or shall be provided in the form of a preinserted ring in a groove in the socket. The brazing alloy shall...
46 CFR 56.30-30 - Brazed joints.
Code of Federal Regulations, 2013 CFR
2013-10-01
....75). Brazed socket-type joints shall be made with suitable brazing alloys. The minimum socket depth shall be sufficient for the intended service. Brazing alloy shall either be end-fed into the socket or shall be provided in the form of a preinserted ring in a groove in the socket. The brazing alloy shall...
46 CFR 56.30-30 - Brazed joints.
Code of Federal Regulations, 2011 CFR
2011-10-01
....75). Brazed socket-type joints shall be made with suitable brazing alloys. The minimum socket depth shall be sufficient for the intended service. Brazing alloy shall either be end-fed into the socket or shall be provided in the form of a preinserted ring in a groove in the socket. The brazing alloy shall...
46 CFR 56.30-30 - Brazed joints.
Code of Federal Regulations, 2014 CFR
2014-10-01
....75). Brazed socket-type joints shall be made with suitable brazing alloys. The minimum socket depth shall be sufficient for the intended service. Brazing alloy shall either be end-fed into the socket or shall be provided in the form of a preinserted ring in a groove in the socket. The brazing alloy shall...
46 CFR 56.30-30 - Brazed joints.
Code of Federal Regulations, 2012 CFR
2012-10-01
....75). Brazed socket-type joints shall be made with suitable brazing alloys. The minimum socket depth shall be sufficient for the intended service. Brazing alloy shall either be end-fed into the socket or shall be provided in the form of a preinserted ring in a groove in the socket. The brazing alloy shall...
Dutta, Shubha Ranjan; Singh, Purnima; Passi, Deepak; Patter, Pradeep
2015-09-01
To evaluate the efficacy of autologous platelet rich plasma (PRP) in regeneration of bone and to assess clinical compatibility of the material in mandibular third molar extraction socket. To compare the healing of mandibular third molar extraction wounds with and without PRP. Group A consists of the 30 patients where PRP will be placed in the extraction socket before closure of the socket. Group B consists of 30 patients who will be the control group where the extraction sockets will be closed without any intra socket medicaments. The patients would be allocated to the groups randomly. Soft tissue healing was better in study site compared to control site. The result of the study shows rapid bone regeneration in the extraction socket treated with PRP when compared with the socket without PRP. Evaluation for bone blending and trabecular bone formation started earlier in PRP site compared to control, non PRP site. Also there was less postoperative discomfort on the PRP treated side. Autologous PRP is biocompatible and has significant improved soft tissue healing, bone regeneration and increase in bone density in extraction sockets.
Clinical outcome and complications of thoracic and pelvic limb stump and socket prostheses.
Phillips, Andrew; Kulendra, Elvin; Bishop, Edith; Monk, Michelle; Parsons, Kevin; House, Arthur
2017-07-20
To describe the use, quality of life, compliance, complications, and outcome of animals fitted with stump socket prostheses. Medical records of dogs fitted with a stump socket prosthesis were reviewed. Functional outcome, quality of life and complications were retrospectively assessed from an owner questionnaire. Thirteen stump socket prostheses (12 dogs) were fitted for a variety of reasons including trauma, congenital abnormalities, and neoplasia. Eight dogs had a good outcome overall and four a poor outcome. Quality of life (QOL) remained good or excellent in 10/12 dogs. Nine complications were seen in 7/12 dogs, most were manageable; surgical wound complications (n = 2) and pressures sores (n = 4) were the most frequently encountered. One dog suffered multiple complications. Thoracic and pelvic limb stump socket prostheses had a similar complication rate, however all animals with a poor outcome had a thoracic limb stump socket prosthesis; two were small breed dogs (under 10 kg) and two had bilateral thoracic limb abnormalities. Stump socket prostheses are feasible and versatile in animals. In correctly selected cases, good to excellent outcomes are possible. However, complications are frequent but often manageable. Further investigations are required into the risk factors for poor outcomes and prospective studies are required to assess changes in biomechanics, function, and QOL before and after fitting of a stump socket prosthesis. Until further evidence is available, careful consideration should be given before fitting bilateral thoracic limb stump socket prostheses or thoracic limb stump socket prostheses to small breed dogs.
Boone, David A; Kobayashi, Toshiki; Chou, Teri G; Arabian, Adam K; Coleman, Kim L; Orendurff, Michael S; Zhang, Ming
2013-04-01
Alignment - the process and measured orientation of the prosthetic socket relative to the foot - is important for proper function of a transtibial prosthesis. Prosthetic alignment is performed by prosthetists using visual gait observation and amputees' feedback. The aim of this study was to investigate the effect of transtibial prosthesis malalignment on the moments measured at the base of the socket: the socket reaction moments. Eleven subjects with transtibial amputation were recruited from the community. An instrumented prosthesis alignment component was used to measure socket reaction moments during ambulation under 17 alignment conditions, including nominally aligned using conventional clinical methods, and angle perturbations of 3° and 6° (flexion, extension, abduction, and adduction) and translation perturbations of 5mm and 10mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. Coronal alignment perturbations caused systematic changes in the coronal socket reaction moments. All angle and translation perturbations revealed statistically significant differences on coronal socket reaction moments compared to the nominal alignment at 30% and 75% of stance phase (P<0.05). The effect of sagittal alignment perturbations on sagittal socket reaction moments was not as responsive as that of the coronal perturbations. The sagittal angle and translation perturbations of the socket led to statistically significant changes in minimum moment, maximum moment, and moments at 45% of stance phase in the sagittal plane. Therefore, malalignment affected the socket reaction moments in amputees with transtibial prostheses. Copyright © 2012 Elsevier B.V. All rights reserved.
An Amino Acid Packing Code for α-helical Structure and Protein Design
Joo, Hyun; Chavan, Archana G.; Phan, Jamie; Day, Ryan; Tsai, Jerry
2012-01-01
This work demonstrates that all packing in α-helices can be simplified to repetitive patterns of a single motif: the knob-socket. Using the precision of Voronoi Polyhedra/Deluaney Tessellations to identify contacts, the knob-socket is a 4 residue tetrahedral motif: a knob residue on one α-helix packs into the 3 residue socket on another α-helix. The principle of the knob-socket model relates the packing between levels of protein structure: the intra-helical packing arrangements within secondary structure that permit inter-helix tertiary packing interactions. Within an α-helix, the 3 residue sockets arrange residues into a uniform packing lattice. Inter-helix packing results from a definable pattern of interdigitated knob-socket motifs between 2 α-helices. Furthermore, the knob-socket model classifies 3 types of sockets: 1) free: favoring only intra-helical packing, 2) filled: favoring inter-helical interactions and 3) non: disfavoring α-helical structure. The amino acid propensities in these 3 socket classes essentially represent an amino acid code for structure in α-helical packing. Using this code, a novel yet straightforward approach for the design of α-helical structure was used to validate the knob-socket model. Unique sequences for 3 peptides were created to produce a predicted amount of α-helical structure: mostly helical, some helical, and no-helix. These 3 peptides were synthesized and helical content assessed using CD spectroscopy. The measured α-helicity of each peptide was consistent with the expected predictions. These results and analysis demonstrate that the knob-socket motif functions as the basic unit of packing and presents an intuitive tool to decipher the rules governing packing in protein structure. PMID:22426125
Das, Swati; Jhingran, Rajesh; Bains, Vivek Kumar; Madan, Rohit; Srivastava, Ruchi; Rizvi, Iram
2016-01-01
Objectives: This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets. Materials and Methods: For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. Results: Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. Conclusion: The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration. PMID:27095909
Das, Swati; Jhingran, Rajesh; Bains, Vivek Kumar; Madan, Rohit; Srivastava, Ruchi; Rizvi, Iram
2016-01-01
This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets. For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.
Quantification of rectifications for the Northwestern University Flexible Sub-Ischial Vacuum Socket.
Fatone, Stefania; Johnson, William Brett; Tran, Lilly; Tucker, Kerice; Mowrer, Christofer; Caldwell, Ryan
2017-06-01
The fit and function of a prosthetic socket depend on the prosthetist's ability to design the socket's shape to distribute load comfortably over the residual limb. We recently developed a sub-ischial socket for persons with transfemoral amputation: the Northwestern University Flexible Sub-Ischial Vacuum Socket. This study aimed to quantify the rectifications required to fit the Northwestern University Flexible Sub-Ischial Vacuum Socket to teach the technique to prosthetists as well as provide a computer-aided design-computer-aided manufacturing option. Development project. A program was used to align scans of unrectified and rectified negative molds and calculate shape change as a result of rectification. Averaged rectifications were used to create a socket template, which was shared with a central fabrication facility engaged in provision of Northwestern University Flexible Sub-Ischial Vacuum Sockets to early clinical adopters. Feedback regarding quality of fitting was obtained. Rectification maps created from 30 cast pairs of successfully fit Northwestern University Flexible Sub-Ischial Vacuum Sockets confirmed that material was primarily removed from the positive mold in the proximal-lateral and posterior regions. The template was used to fabricate check sockets for 15 persons with transfemoral amputation. Feedback suggested that the template provided a reasonable initial fit with only minor adjustments. Rectification maps and template were used to facilitate teaching and central fabrication of the Northwestern University Flexible Sub-Ischial Vacuum Socket. Minor issues with quality of initial fit achieved with the template may be due to inability to adjust the template to patient characteristics (e.g. tissue type, limb shape) and/or the degree to which it represented a fully mature version of the technique. Clinical relevance Rectification maps help communicate an important step in the fabrication of the Northwestern University Flexible Sub-Ischial Vacuum Socket facilitating dissemination of the technique, while the average template provides an alternative fabrication option via computer-aided design-computer-aided manufacturing and central fabrication.
Sewell, Philip; Noroozi, Siamak; Vinney, John; Amali, Ramin; Andrews, Stephen
2012-01-01
It has been recognised in a review of the developments of lower-limb prosthetic socket fitting processes that the future demands new tools to aid in socket fitting. This paper presents the results of research to design and clinically test an artificial intelligence approach, specifically inverse problem analysis, for the determination of the pressures at the limb/prosthetic socket interface during stance and ambulation. Inverse problem analysis is based on accurately calculating the external loads or boundary conditions that can generate a known amount of strain, stresses or displacements at pre-determined locations on a structure. In this study a backpropagation artificial neural network (ANN) is designed and validated to predict the interfacial pressures at the residual limb/socket interface from strain data collected from the socket surface. The subject of this investigation was a 45-year-old male unilateral trans-tibial (below-knee) traumatic amputee who had been using a prosthesis for 22 years. When comparing the ANN predicted interfacial pressure on 16 patches within the socket with actual pressures applied to the socket there is shown to be 8.7% difference, validating the methodology. Investigation of varying axial load through the subject's prosthesis, alignment of the subject's prosthesis, and pressure at the limb/socket interface during walking demonstrates that the validated ANN is able to give an accurate full-field study of the static and dynamic interfacial pressure distribution. To conclude, a methodology has been developed that enables a prosthetist to quantitatively analyse the distribution of pressures within the prosthetic socket in a clinical environment. This will aid in facilitating the "right first time" approach to socket fitting which will benefit both the patient in terms of comfort and the prosthetist, by reducing the time and associated costs of providing a high level of socket fit. Copyright © 2011 Elsevier B.V. All rights reserved.
Bouquot, J E; LaMarche, M G
1999-02-01
Previous studies have identified focal areas of alveolar tenderness, elevated mucosal temperature, radiographic abnormality, and increased radioisotope uptake or "hot spots" within the quadrant of pain in most patients with chronic, idiopathic facial pain (phantom pain, atypical facial neuralgia, and atypical facial pain). This retrospective investigation radiographically and microscopically evaluated intramedullary bone in a certain subset of patients with histories of endodontics, extraction, and fixed partial denture placement in an area of "idiopathic" pain. Patients from 12 of the United States were identified through tissue samples, histories, and radiographs submitted to a national biopsy service. Imaging tests, coagulation tests, and microscopic features were reviewed. Of 38 consecutive idiopathic facial pain patients, 32 were women. Approximately 90% of subpontic bone demonstrated either ischemic osteonecrosis (68%), chronic osteomyelitis (21%), or a combination (11%). More than 84% of the patients had abnormal radiographic changes in subpontic bone, and 5 of 9 (56%) patients who underwent radioisotope bone scan revealed hot spots in the region. Of the 14 patients who had laboratory testing for coagulation disorders, 71% were positive for thrombophilia, hypofibrinolysis, or both (normal: 2% to 7%). Ten pain-free patients with abnormal subpontic bone on radiographs were also reviewed. Intraosseous ischemia and chronic inflammation were suggested as a pathoetiologic mechanism for at least some patients with atypical facial pain. These conditions were also offered as an explanation for poor healing of extraction sockets and positive radioisotope scans.
Socket welds in nuclear facilities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Anderson, P.A.; Torres, L.L.
1995-12-31
Socket welds are easier and faster to make than are butt welds. However, they are often not used in nuclear facilities because the crevices between the pipes and the socket sleeves may be subject to crevice corrosion. If socket welds can be qualified for wider use in facilities that process nuclear materials, the radiation exposures to welders can be significantly reduced. The current tests at the Idaho Chemical Processing Plant (ICPP) are designed to determine if socket welds can be qualified for use in the waste processing system at a nuclear fuel processing plant.
Leong, R.
1993-06-22
The invention is a receptacle for a three prong electrical plug which has either a tubular or U-shaped grounding prong. The inventive receptacle has a grounding prong socket which is sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having two ridges to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket. The two ridges are made to prevent the socket from expanding when either the U-shaped grounding prong or the tubular grounding prong is inserted.
Leong, Robert
1993-01-01
The invention is a receptacle for a three prong electrical plug which has either a tubular or U-shaped grounding prong. The inventive receptacle has a grounding prong socket which is sufficiently spacious to prevent the socket from significantly stretching when a larger, U-shaped grounding prong is inserted into the socket, and having two ridges to allow a snug fit when a smaller tubular shape grounding prong is inserted into the socket. The two ridges are made to prevent the socket from expanding when either the U-shaped grounding prong or the tubular grounding prong is inserted.
Ahn, Jae-Jin; Shin, Hong-In
2008-01-01
To investigate postextraction bone formation over time in both diseased and healthy sockets. Core specimens of healing tissues following tooth extraction were obtained at the time of implant placement in patients treated between October 2005 and December 2007. A disease group and a control group were classified according to socket examination at the time of extraction. The biopsy specimens were analyzed histomorphometrically to measure the dimensional changes among 3 tissue types: epithelial layer, connective tissue area, and new bone tissue area. Fifty-five specimens from sites of previously advanced periodontal disease from 45 patients were included in the disease group. Another 12 specimens of previously healthy extraction sockets were collected from 12 different patients as a control. The postextraction period of the disease group varied from 2 to 42 weeks. In the disease group, connective tissue occupied most of the socket during the first 4 weeks. New bone area progressively replaced the connective tissue area after the first 4 weeks. The area proportion of new bone tissue exceeded that of connective tissue by 14 weeks. After 20 weeks, most extraction sockets in the disease group demonstrated continuous new bone formation. The control group exhibited almost complete socket healing after 10 weeks, with no more new bone formation after 20 weeks. Osseous regeneration in the diseased sockets developed more slowly than in the disease-free sockets. After 16 weeks, new bone area exceeded 50% of the total newly regenerated tissue in the sockets with severe periodontal destruction. In the control group, after 8 weeks, new bone area exceeded 50% of the total tissue.
Kobayashi, Toshiki; Orendurff, Michael S; Boone, David A
2013-09-27
The alignment of a lower-limb prosthesis is critical to the successful prosthetic fitting and utilization by the wearer. Loads generated by the socket applied to the residual limb while walking are thought to be different in transfemoral and knee-disarticulation prostheses. The aim of this case series was to compare the socket reaction moments between transfemoral and knee-disarticulation prostheses and to investigate the effect of alignment changes on them. Two amputees, one with a transfemoral prosthesis and another with a knee-disarticulation prosthesis, participated in this study. A Smart Pyramid™ was used to measure socket reaction moments while walking under 9 selected alignment conditions; including nominally aligned, angle malalignments of 6° (flexion, extension, abduction and adduction) and translation malalignments of 15 mm (anterior, posterior, medial and lateral) of the socket relative to the foot. This study found that the pattern of the socket reaction moments was similar between transfemoral and knee-disarticulation prostheses. An extension moment in the sagittal plane and a varus moment in the coronal plane were dominant during stance under the nominally aligned condition. This study also demonstrated that alignment changes might have consistent effects on the socket reaction moments in transfemoral and knee-disarticulation prostheses. Extension and posterior translation of the socket resulted in increases in an extension moment, while abduction and lateral translation of the socket resulted in increases in a varus moment. The socket reaction moments may potentially serve as useful biomechanical parameters to evaluate alignment in transfemoral and knee-disarticulation prostheses. Copyright © 2013 Elsevier Ltd. All rights reserved.
Characterization of interfacial socket pressure in transhumeral prostheses: A case series.
Schofield, Jonathon S; Schoepp, Katherine R; Williams, Heather E; Carey, Jason P; Marasco, Paul D; Hebert, Jacqueline S
2017-01-01
One of the most important factors in successful upper limb prostheses is the socket design. Sockets must be individually fabricated to arrive at a geometry that suits the user's morphology and appropriately distributes the pressures associated with prosthetic use across the residual limb. In higher levels of amputation, such as transhumeral, this challenge is amplified as prosthetic weight and the physical demands placed on the residual limb are heightened. Yet, in the upper limb, socket fabrication is largely driven by heuristic practices. An analytical understanding of the interactions between the socket and residual limb is absent in literature. This work describes techniques, adapted from lower limb prosthetic research, to empirically characterize the pressure distribution occurring between the residual limb and well-fit transhumeral prosthetic sockets. A case series analyzing the result of four participants with transhumeral amputation is presented. A Tekscan VersaTek pressure measurement system and FaroArm Edge coordinate measurement machine were employed to capture socket-residual limb interface pressures and geometrically register these values to the anatomy of participants. Participants performed two static poses with their prosthesis under two separate loading conditions. Surface pressure maps were constructed from the data, highlighting pressure distribution patterns, anatomical locations bearing maximum pressure, and the relative pressure magnitudes. Pressure distribution patterns demonstrated unique characteristics across the four participants that could be traced to individual socket design considerations. This work presents a technique that implements commercially available tools to quantitatively characterize upper limb socket-residual limb interactions. This is a fundamental first step toward improved socket designs developed through informed, analytically-based design tools.
Characterization of interfacial socket pressure in transhumeral prostheses: A case series
Schoepp, Katherine R.; Williams, Heather E.; Carey, Jason P.; Marasco, Paul D.
2017-01-01
One of the most important factors in successful upper limb prostheses is the socket design. Sockets must be individually fabricated to arrive at a geometry that suits the user’s morphology and appropriately distributes the pressures associated with prosthetic use across the residual limb. In higher levels of amputation, such as transhumeral, this challenge is amplified as prosthetic weight and the physical demands placed on the residual limb are heightened. Yet, in the upper limb, socket fabrication is largely driven by heuristic practices. An analytical understanding of the interactions between the socket and residual limb is absent in literature. This work describes techniques, adapted from lower limb prosthetic research, to empirically characterize the pressure distribution occurring between the residual limb and well-fit transhumeral prosthetic sockets. A case series analyzing the result of four participants with transhumeral amputation is presented. A Tekscan VersaTek pressure measurement system and FaroArm Edge coordinate measurement machine were employed to capture socket-residual limb interface pressures and geometrically register these values to the anatomy of participants. Participants performed two static poses with their prosthesis under two separate loading conditions. Surface pressure maps were constructed from the data, highlighting pressure distribution patterns, anatomical locations bearing maximum pressure, and the relative pressure magnitudes. Pressure distribution patterns demonstrated unique characteristics across the four participants that could be traced to individual socket design considerations. This work presents a technique that implements commercially available tools to quantitatively characterize upper limb socket-residual limb interactions. This is a fundamental first step toward improved socket designs developed through informed, analytically-based design tools. PMID:28575012
Dry needling — peripheral and central considerations
Dommerholt, Jan
2011-01-01
Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture. PMID:23115475
A smartphone photogrammetry method for digitizing prosthetic socket interiors.
Hernandez, Amaia; Lemaire, Edward
2017-04-01
Prosthetic CAD/CAM systems require accurate 3D limb models; however, difficulties arise when working from the person's socket since current 3D scanners have difficulties scanning socket interiors. While dedicated scanners exist, they are expensive and the cost may be prohibitive for a limited number of scans per year. A low-cost and accessible photogrammetry method for socket interior digitization is proposed, using a smartphone camera and cloud-based photogrammetry services. 15 two-dimensional images of the socket's interior are captured using a smartphone camera. A 3D model is generated using cloud-based software. Linear measurements were comparing between sockets and the related 3D models. 3D reconstruction accuracy averaged 2.6 ± 2.0 mm and 0.086 ± 0.078 L, which was less accurate than models obtained by high quality 3D scanners. However, this method would provide a viable 3D digital socket reproduction that is accessible and low-cost, after processing in prosthetic CAD software. Clinical relevance The described method provides a low-cost and accessible means to digitize a socket interior for use in prosthetic CAD/CAM systems, employing a smartphone camera and cloud-based photogrammetry software.
Fatigue evaluation of socket welded piping in nuclear power plant
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vecchio, R.S.
1996-12-01
Fatigue failures in piping systems occur, almost without exception, at the welded connections. In nuclear power plant systems, such failures occur predominantly at the socket welds of small diameter piping ad fillet attachment welds under high-cycle vibratory conditions. Nearly all socket weld fatigue failures are identified by leaks which, though not high in volume, generally are costly due to attendant radiological contamination. Such fatigue cracking was recently identified in the 3/4 in. diameter recirculation and relief piping socket welds from the reactor coolant system (RCS) charging pumps at a nuclear power plant. Consequently, a fatigue evaluation was performed to determinemore » the cause of cracking and provide an acceptable repair. Socket weld fatigue life was evaluated using S-N type fatigue life curves for welded structures developed by AASHTO and the assessment of an effective cyclic stress range adjacent to each socket weld. Based on the calculated effective tress ranges and assignment of the socket weld details to the appropriate AASHTO S-N curves, the socket weld fatigue lives were calculated and found to be in excellent agreement with the accumulated cyclic life to-date.« less
Computer design synthesis of a below knee-Syme prosthesis
NASA Technical Reports Server (NTRS)
Elangovan, P. T.; Ghista, D. N.; Alwar, R. S.
1979-01-01
A detailed design synthesis analysis of the BK Syme prosthesis is provided, to determine the socket's cutout orientation size and shape, cutout fillet shape, socket wall thickness distribution and the reinforced fiber distribution in the socket wall, for a minimally stressed structurally safe lightweight prosthesis. For analysis purposes, the most adverse socket loading is obtained at the push-off stage of gait; this loading is idealized as an axial in-plane loading on the bottom edge of the circular cylindrical socket shell whose top edge is considered fixed. Finite element stress analysis of the socket shell (with uniform and graded wall thickness) are performed for various orientations of the cutout and for various types of corner fillets. A lateral cutout with a streamline fillet is recommended. The wall material (i.e., thickness) distribution is determined so as to minimize the stresses, while ensuring that the wall material's stress limits are not exceeded. For such a maximally stressed lightweight socket shell, the panels in the neighborhood of the cutout are checked to ensure that they do not buckle under their acquired stresses. A fiber-reinforced laminated composite socket shell is also analyzed in order to recommend optimum variables in orientations and densities of reinforcing fibers.
Socket stars: UBVRJIK radial profiles
NASA Astrophysics Data System (ADS)
Schaefer, Bradley E.
1995-05-01
Visual inspectin of stars embedded in H II nebulae has shown a significant fraction to be surrounded by nearly symmetric extended regions within which the nebular brightness is apparently significantly fainter than is typical for the surrounding area. These 'socket stars' might be caused by a bubble in the nebula blown out by a stellar wind or they might be caused by a circumstellar envelope of dust hiding the emission behind the star. As such, the sockets could be the first manifestation of a previously unknown component of pre-main-sequence stars. Unfortunately, no quantitative proof of the existence of sockets has been presented. To fill this need, I have imaged 10 socket stars and six background stars with CCD cameras and infrared array cameras. From these images, I have constructed radial plots which should reveal dips in brightness immediately outside the seeing disk. The radial plots do not show any evidence for the existence of sockets. A detailed examination of the photographs orginally used to identify the sockets show that the causes of these reports are (1) artifacts resulting from the photographic process of dodging and (2) random coincidence of stars with local minima in nebular brightness. Thus, I conclude that 'socket stars' do not exist.
Robot friendly probe and socket assembly
NASA Technical Reports Server (NTRS)
Nyberg, Karen L. (Inventor)
1994-01-01
A probe and socket assembly for serving as a mechanical interface between structures is presented. The assembly comprises a socket having a housing adapted for connection to a first supporting structure and a probe which is readily connectable to a second structure and is designed to be easily grappled and manipulated by a robotic device for insertion and coupling with the socket. Cooperable automatic locking means are provided on the probe shaft and socket housing for automatically locking the probe in the socket when the probe is inserted a predetermined distance. A second cooperable locking means on the probe shaft and housing are adapted for actuation after the probe has been inserted the predetermined distance. Actuation means mounted on the probe and responsive to the grip of the probe handle by a gripping device, such as a robot for conditioning the probe for insertion and are also responsive to release of the grip of the probe handle to actuate the second locking means to provide a hard lock of the probe in the socket.
Jambhekar, Shantanu; Kernen, Florian; Bidra, Avinash S
2015-05-01
Several biomaterials and techniques have been reported for socket grafting and alveolar ridge preservation. However, the evidence for clinical and histologic outcomes for socket grafting with different types of materials in flapless extraction is not clear. The purpose of this systematic review was to analyze the outcomes of a socket grafting procedure performed with flapless extraction of teeth in order to determine which graft material results in the least loss of socket dimensions, the maximum amount of vital bone, the least remnant graft material, and the least amount of connective tissue after a minimum of 12 weeks of healing. Secondary outcomes, including the predictability of regenerating deficient buccal bone, necessity of barrier membranes, and coverage with autogenous soft tissue graft, were also evaluated. An electronic search for articles in the English-language literature was performed independently by multiple investigators using a systematic search process with the PubMed search engine. After applying predetermined inclusion and exclusion criteria, the final list of randomized controlled clinical trials (RCTs) for flapless extraction and socket grafting was analyzed to derive results for the various objectives of the study. The initial electronic search resulted in 2898 titles. The systematic application of inclusion and exclusion criteria resulted in 32 RCTs studying 1354 sockets, which addressed the clinical and histologic outcomes of flapless extraction with socket grafting and provided dimensional and histologic information at or beyond the 12-week reentry period. From these RCTs, the mean loss of buccolingual width at the ridge crest was lowest for xenografts (1.3 mm), followed by allografts (1.63 mm), alloplasts (2.13 mm), and sockets without any socket grafting (2.79 mm). Only 3 studies reported on loss of width at 3 mm below the ridge crest. The mean loss of buccal wall height from the ridge crest was lowest for xenografts (0.57 mm) and allografts (0.58 mm), followed by alloplasts (0.77 mm) and sockets without any grafting (1.74 mm). The mean histologic outcomes at or beyond the 12-week reentry period revealed the highest vital bone content for sockets grafted with alloplasts (45.53%), followed by sockets with no graft material (41.07%), xenografts (35.72%), and allografts (29.93%). The amount of remnant graft material was highest for sockets grafted with allografts (21.75%), followed by xenografts (19.3%) and alloplasts (13.67%). The highest connective tissue content at the time of reentry was seen for sockets with no grafting (52.53%), followed by allografts (51.03%), xenografts (44.42%), and alloplast (38.39%). Data for new and emerging biomaterials such as cell therapy and tissue regenerative materials were not amenable to calculations because of biomaterial heterogeneity and small sample sizes. After flapless extraction of teeth, and using a minimum healing period of 12 weeks as a temporal measure, xenografts and allografts resulted in the least loss of socket dimensions compared to alloplasts or sockets with no grafting. Histologic outcomes after a minimum of 12 weeks of healing showed that sockets grafted with alloplasts had the maximum amount of vital bone and the least amount of remnant graft material and remnant connective tissue. There is a limited but emerging body of evidence for the predictable regeneration of deficient buccal bone with socket grafting materials, need for barrier membranes, use of tissue engineering, and use of autogenous soft tissue grafts from the palate to cover the socket. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Tethering sockets and wrenches
NASA Technical Reports Server (NTRS)
Johnson, E. P.
1990-01-01
The tethering of sockets and wrenches was accomplished to improve the safety of working over motor segments. To accomplish the tethering of the sockets to the ratchets, a special design was implemented in which a groove was machined into each socket. Each socket was then fitted with a snap ring that can spin around the machined groove. The snap ring is tethered to the handle of the ratchet. All open end wrenches are also tethered to the ratchet or to the operator, depending upon the type. Tests were run to ensure that the modified tools meet torque requirements. The design was subsequently approved by Space Safety.
Fee, L
2017-04-21
Socket preservation maintains bone volume post-extraction in anticipation of an implant placement or fixed partial denture pontic site. This procedure helps compensate for the resorption of the facial bone wall. Socket preservation should be considered when implant placement needs to be delayed for patient or site-related reasons. The ideal healing time before implant placement is six months. Socket preservation can reduce the need for later bone augmentation. By reducing bone resorption and accelerating bone formation it increases implant success and survival. Biomaterials for socket grafting including autograft, allograft, xenograft and alloplast. A bone substitute with a low substitution rate is recommended.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-15
... with medium screw base sockets, as well as pin-based sockets. (42 U.S.C. 6295(ff)(2)-(3)) The statute... (including candelabra screw base sockets) by January 1, 2007, and if DOE failed to issue such standards by... standards for light kits with sockets other than medium-screw base or pin-based fluorescent lamps in the CFR...
León-Hernández, Jose V.; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G.; Alguacil-Diego, Isabel M.; de la Llave-Rincón, Ana I.; Fernandez-Carnero, Josue
2016-01-01
ABSTRACT Background Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain. PMID:27410163
Timeframe of socket cortication after tooth extraction: A retrospective radiographic study.
Bertl, Kristina; Kukla, Edmund Benjamin; Albugami, Rajaa; Beck, Florian; Gahleitner, André; Stavropoulos, Andreas
2018-01-01
To assess the timeframe between tooth extraction and radiographically detectable socket cortication in humans. Two hundred and fifty patients with a CT scan ≤36 months after tooth extraction were included. First, three orthoradial multiplanar reconstruction slices, representing the major part of the extraction socket, were scored regarding the degree of bone healing as (i) healed, that is, complete/continuous cortication of the socket entrance, or (ii) non-healed. Thereafter, based on the results of all three slices, the stage of cortication of the extraction socket, as one unit, was classified as (i) non-corticated, that is, all three slices judged as non-healed, (ii) partially corticated, that is, 1 or 2 slices judged as non-healed, or (iii) completely corticated, that is, all three slices judged as healed. The possible effect of several independent parameters, that is, age, gender, timeframe between tooth extraction and CT scan, tooth type, extent of radiographic bone loss of the extracted tooth, tooth-gap type, smoking status, presence of any systemic disease, and medication intake, on cortication status was statistically evaluated. Three to 6 months after tooth extraction, 27% of the sockets were judged as non-corticated and 53% were judged as partially corticated. After 9-12 months, >80% of the sockets were corticated, while some incompletely corticated sockets were detected up to 15 months after extraction. Each additional month after tooth extraction contributed significantly to a higher likelihood of a more advanced stage of cortication, while radiographic bone loss ≥75% significantly prolonged cortication time; no other independent variable had a significant effect. The results indicate a considerably long timeframe until complete cortication of an extraction socket, that is, 3-6 months after tooth extraction 3 of 4 sockets were still not completely corticated, and only after 9-12 months, complete cortication was observed in about 80% of the sockets. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Finite element analysis of the contact interface between trans-femoral stump and prosthetic socket.
Zhang, Linlin; Zhu, Ming; Shen, Ling; Zheng, Feng
2013-01-01
Transfemoral amputees need prosthetic devices after amputation surgery, and the interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. The purpose of this study was to build a nonlinear finite element model to investigate the interface pressure between the above-knee residual limb and its prosthetic socket. The model was three-dimensional (3D) with consideration of nonlinear boundary conditions. Contact analysis was used to simulate the friction conditions between skin and the socket. The normal stresses up to 80.57 kPa at the distal end of the soft tissue. The longitudinal and circumferential shear stress distributions at the limb-socket interface were also simulated. This study explores the influences of load transfer between trans-femoral residual limb and its prosthetic socket.
CAD/CAM transtibial prosthetic sockets from central fabrication facilities: How accurate are they?
Sanders, Joan E.; Rogers, Ellen L.; Sorenson, Elizabeth A.; Lee, Gregory S.; Abrahamson, Daniel C.
2014-01-01
This research compares transtibial prosthetic sockets made by central fabrication facilities with their corresponding American Academy of Orthotists and Prosthetists (AAOP) electronic shape files and assesses the central fabrication process. We ordered three different socket shapes from each of 10 manufacturers. Then we digitized the sockets using a very accurate custom mechanical digitizer. Results showed that quality varied considerably among the different manufacturers. Four of the companies consistently made sockets within +/−1.1% volume (approximately 1 sock ply) of the AAOP electronic shape file, while six other companies did not. Six of the companies showed consistent undersizing or oversizing in their sockets, which suggests a consistent calibration or manufacturing error. Other companies showed inconsistent sizing or shape distortion, a difficult problem that represents a most challenging limitation for central fabrication facilities. PMID:18247236
Clinical and histologic outcomes of calcium sulfate in the treatment of postextraction sockets.
Ruga, Emanuele; Gallesio, Cesare; Chiusa, Luigi; Boffano, Paolo
2011-03-01
The aim of this prospective study was to assess the clinical and histologic outcomes obtained with calcium sulfate (CS) used as a filler material in fresh premolar and molar postextraction sockets. Sixty premolar or molar postextraction sockets were filled with CS. Among the 60 grafted sockets, after 3 months, 50 underwent implant placement and clinical assessment. The removal of a sample core of newly generated intrasocket tissue was performed in 19 sockets. Collected samples were sent for histologic examination. The percentage of vital bone, nonvital bone, residual CS, amorphous material, and connective areas in every sample was calculated and recorded. Fifty postextraction regenerated sockets that underwent implant placement 3 months after tooth removal were included in this study.A partial postoperative exposition of the graft was observed in 12 of 50 sockets. At the surgical reentry, the augmented extraction sockets were completely filled by a hard material with an adequate alveolar crest in 41 cases. Histologic examination of the cores revealed that 63.16% of the intrasocket tissue was new vital bone, 2.1% was nonvital bone, 4.74% was fibrous tissue, and 30% was amorphous material. No residual CS was identified in bone cores. This study confirmed that CS is an ideal grafting material. The clinical adequacy aspect of filled sockets at surgical reentry seemed to be indicative of a qualitatively better bone regeneration. Postoperative exposition of graft material after a first intervention seemed to constitute an important risk factor for a worse bone regeneration.
NASA Technical Reports Server (NTRS)
Green, Chris; Greenwell, Chris; Brusse, jay; Krus, Dennis; Leidecker, Henning
2009-01-01
During system level testing intermittent and permanent open circuit failures of mated, crimp removable, electrical contact pairs were experienced. The root cause of the failures was determined to be low (but not zero) contact forces applied by the socket contact tines against the engaging pin. The low contact force reduces the effectiveness of the wiping action of the socket tines against the pin. The observed failure mode may be produced when insufficient wiping during mate, demate and small relative movement in use allows for the accumulation of debris or insulating films that electrically separate the contact pair. The investigation identified at least three manufacturing process control problems associated with the socket contacts that enabled shipment of contacts susceptible to developing low contact forces: (1) Improper heat treatment of the socket tines resulting in plastic rather than elastic behavior; (2) Overly thinned socket tines at their base resulting in reduced pin retention forces; (3) insufficient screening tests to identify parts susceptible to the aforementioned failure mechanisms. The results from an extensive screening program of socket contacts utilizing the industry standard contact separation force test procedures are described herein. The investigation shows this method to be capable of identifying initially weak sockets. However, sockets whose contact retention forces may degrade during use may not be screened out by pin retention testing alone. Further investigations are required to correlate low contact retention forces with increased electrical contact resistance in the presence of insulating films that may accumulate in the use environment.
Kobayashi, Toshiki; Orendurff, Michael S; Zhang, Ming; Boone, David A
2014-05-01
The alignment of transtibial prostheses has a systematic effect on the mean socket reaction moments in amputees. However, understanding their individual differences in response to alignment perturbations is also important for prosthetists to fully utilize the socket reaction moments for dynamic alignment in each unique patient. The aim of this study was to investigate individual responses to alignment perturbations in transtibial prostheses with solid-ankle-cushion-heel feet. A custom instrumented prosthesis alignment component was used to measure the socket reaction moments while walking in 11 amputees with transtibial prostheses under 17 alignment conditions, including 3° and 6° of flexion, extension, abduction, and adduction of the socket, 5mm and 10mm of anterior, posterior, lateral, and medial translation of the socket, and an initial baseline alignment. Coronal moments at 30% of stance and maximum sagittal moments were extracted for comparisons from each amputee. In the coronal plane, varus moment at 30% of stance was generally reduced by adduction or medial translation of the socket in all the amputees. In the sagittal plane, extension moment was generally increased by posterior translation or flexion of the socket; however, this was not necessarily the case for all the amputees. Individual responses to alignment perturbations are not always consistent, and prosthetists would need to be aware of this variance when addressing individual socket reaction moments during dynamic alignment in clinical setting. Copyright © 2014 Elsevier Ltd. All rights reserved.
Histologic effects of intentional-socket-assisted orthodontic movement in rabbits.
Yu, Ji-Yeon; Lee, Won; Park, Jae Hyun; Bayome, Mohamed; Kim, Yong; Kook, Yoon-Ah
2012-08-01
This study aimed to evaluate the effect of an intentionally created socket on bone remodeling with orthodontic tooth movement in rabbits. Eighteen male rabbits weighing 3.8 - 4.25 kg were used. An 8-mm deep and 2-mm wide socket was drilled in the bone 1 mm mesial to the right mandibular first premolar. The left first premolar was extracted to serve as an extraction socket. A traction force of 100 cN was applied to the right first premolar and left second premolar. Sections were obtained at the middle third of the moving tooth for both the drilled and extraction sockets and evaluated with hematoxylin and eosin staining and immunohistochemical analyses. The amount of tooth movement and tartrate-resistant acid phosphatase (TRAP)-positive cell count were compared between the 2 groups using the Mann-Whitney U test. At week 2, the distance of tooth movement was significantly higher in the intentional socket group (p < 0.05) than in the extraction socket group. The number of TRAP-positive cells decreased in week 2 but increased in week 3 (p < 0.05). However, there were no significant differences between the groups. Furthermore, results of transforming growth factor (TGF)-β staining revealed no significant differences. The intentional socket group showed greater distance of tooth movement than did the extraction socket group at week 2. Osteoclast counts and results of immunohistochemical analyses suggested elevated bone remodeling in both the groups. Thus, osteotomy may be an effective modality for enhancing tooth movement in orthodontic treatment.
Fickl, Stefan; Zuhr, Otto; Wachtel, Hannes; Kebschull, Moritz; Hürzeler, Markus B
2009-10-01
The aim of this study was to histometrically assess alterations of the ridge following socket preservation alone and socket preservation with additional buccal overbuilding. In five beagle dogs four extraction sites were randomly subjected to one of the following treatments: Tx 1: The socket was filled with BioOss Collagen and covered with a free gingival graft from the palate. Tx 2: The buccal bone plate was augmented using the GBR-technique, the socket was filled with BioOss Collagen and covered with a free gingival graft. Tx 3: The buccal bone plate was forced into a buccal direction using a manual bone spreader. The socket was filled with BioOss Collagen and covered with a free gingival graft from the palate. Tx 4: The socket was filled with BioOss Collagen and a combined free gingival/connective tissue graft was used to cover the socket and for buccal tissue augmentation. For each experimental site, two histological sections were subjected to histometric analysis and evaluated for (i) vertical bone dimensions and (ii) horizontal bone dimensions. All treatment groups showed horizontal and vertical bone loss. The mean vertical bone loss of the buccal bone plate was significantly lower in Tx 4 than in the other groups, while no statistical significant differences could be detected among the groups in the horizontal dimension. Overbuilding the buccal aspect in combination with socket preservation does not seem to be a suitable technique to compensate for the alterations after tooth extraction.
2014-10-01
Award Number: W81XWH-10-1-0744 TITLE: Development of Subischial Prosthetic Sockets with Vacuum...REPORT TYPE Annual 3. DATES COVERED 15 Sep 2013 – 14 Sep 2014 4. TITLE AND SUBTITLE Development of Subischial Prosthetic Sockets with Vacuum...to develop a highly flexible sub-ischial prosthetic socket with assisted-vacuum suspension for highly active persons with transfemoral amputation. The
Tang, Jinghua; McGrath, Michael; Laszczak, Piotr; Jiang, Liudi; Bader, Dan L; Moser, David; Zahedi, Saeed
2015-12-01
Design and fitting of artificial limbs to lower limb amputees are largely based on the subjective judgement of the prosthetist. Understanding the science of three-dimensional (3D) dynamic coupling at the residuum/socket interface could potentially aid the design and fitting of the socket. A new method has been developed to characterise the 3D dynamic coupling at the residuum/socket interface using 3D motion capture based on a single case study of a trans-femoral amputee. The new model incorporated a Virtual Residuum Segment (VRS) and a Socket Segment (SS) which combined to form the residuum/socket interface. Angular and axial couplings between the two segments were subsequently determined. Results indicated a non-rigid angular coupling in excess of 10° in the quasi-sagittal plane and an axial coupling of between 21 and 35 mm. The corresponding angular couplings of less than 4° and 2° were estimated in the quasi-coronal and quasi-transverse plane, respectively. We propose that the combined experimental and analytical approach adopted in this case study could aid the iterative socket fitting process and could potentially lead to a new socket design. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.
Safari, Mohammad Reza; Meier, Margrit Regula
2015-01-01
This review is an attempt to untangle the complexity of transtibial prosthetic socket fit and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. In addition, we identified knowledge gaps, thus providing direction for possible future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design and type of outcome measure used. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that included the Downs and Black risk of bias assessment checklist. This article presents the results from the systematic review of the quantitative outcomes (n = 27 articles). Trends indicate that vacuum-assisted suction sockets improve gait symmetry, volume control, and residual limb health more than other socket designs. Hydrostatic sockets seem to create less inconsistent socket fittings, reducing a problem that greatly influences outcome measures. Knowledge gaps exist in the understanding of clinically meaningful changes in socket fit and its effect on biomechanical outcomes. Further, safe and comfortable pressure thresholds under various conditions should be determined through a systematic approach.
[Osseointegration as a method of direct stabilization of amputation prostheses to the bone].
Rochmiński, Robert; Sibński, Marcin; Synder, Marek
2011-01-01
This article summarizes important advantages, disadvantages and the process of treatment of patients after lower limb amputation on the level of the femur, with osseointegrated prosthesis. In the process of treatment bone-integrated material is implanted to the femur, with allows for structural and functional connection between live tissue and the prosthesis. This solution allows the patient for easy usage and direct steerage of the prosthesis, transferring of body weight to the floor and detection of sensation in the moment of contact between prosthesis and the ground. Osseointegrated prostheses in the femur gives the opportunity not to use the traditional solutions and socket-related problems as: mobility difficulties, skin sores, rush, pain during weight bearing, temporary changes of the stump volume, difficulty donning the prosthesis, unreliability of prosthesis being securely suspended. Osseointegration is possible even in cases, when quality of skin and short stump enables to use the traditional prosthetic socket. It is used after lower and upper limbs amputations. This kind of prosthetic solutions has some disadvantages and limitations. It is expensive and demanding. It can be used in cooperative patients, who take active part in the process of implantation, rehabilitation and in future usage if the prosthesis.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schmitz, Roger William; Oh, Yunje
A heating assembly configured for use in mechanical testing at a scale of microns or less. The heating assembly includes a probe tip assembly configured for coupling with a transducer of the mechanical testing system. The probe tip assembly includes a probe tip heater system having a heating element, a probe tip coupled with the probe tip heater system, and a heater socket assembly. The heater socket assembly, in one example, includes a yoke and a heater interface that form a socket within the heater socket assembly. The probe tip heater system, coupled with the probe tip, is slidably receivedmore » and clamped within the socket.« less
[HEART RHYTHM VARIABILITY ANALYSIS AND ASSESSMENT OF THE SPINAL PAIN SYNDROME DURING DRY IMMERSION].
Sun, I; Voronkov, Yu I; Ardashev, V N; Glukhova, S I
2015-01-01
The spinal pain syndrome appears in cosmonauts on both short and long-duration missions. This untoward factor may affect body systems functioning and complicate the successful accomplishment of space mission. Purpose of the investigation was to examine the lumbar spine and to elucidate whether its condition relates to the spinal pain development and changes in heart rate variability (HRV) in the microgravity environment. The experiment was conducted in dry immersion as a method of microgravity effects simulation. It was shown that in dry immersion locomotion reproduces the patterns peculiar for significant gravitational unloading. Spinal pain intensity, angles and heights of the lumbar intervertebral discs and HRV were measured in 19 selected volunteers. During the experiment, all the volunteers developed pains in the back that abated gradually. Pain dependence on the height of intervertebral discs and cardiac regulatory mechanisms were investigated.
Seifi, Massoud; Atri, Faezeh; Yazdani, Mohammad Masoud
2014-01-01
Low- level laser therapy has been used to stimulate the orthodontic tooth movements (OTM) previously. Furthermore, in the orthodontic treatments accompanying tooth extractions, the adjacent teeth move towards the extraction sites and close the space in some cases. Then, the adjacent tooth movements must be prevented in the treatments requiring space. Laser stimulates and at some doses decelerates tooth movement; it also improves healing process and enhances osteogenesis. Hence, it can prevent movement by osteogenesis adjacent to the tooth. The present study investigated the effects of low-level laser therapy on the OTM and root resorption following artificial socket preservation. In this experimental animal trial, 16 male albino rabbits were selected with similar characteristics and randomly divided in two groups. Under general anesthesia, an artificial socket, 8 mm in height, was created in the mesial aspect of the first premolars of the rabbits and filled with demineralized freeze dried bone allograft (DFDBA). The first premolars were connected to the incisors using nickel titanium coil springs. In experimental group, gallium-aluminum-arsenide (GaAlAs) laser was irritated mesial to first premolar where artificial socket was created continuously (808 nm). The cycle was 10 days irritation, 14 days rest, 10 days irritation, 14 days rest (Biostimulation mode). Control group was not laser irradiated. All animals were sacrificed after 48 days and the distance between the distal aspect of the first premolars, and the mesial surface of the second premolars was measured with leaf gauge. The specimens underwent histological assessments. Integrity of root and its resorption was observed under microscope calibration. The size of resorption lacunae was calculated in mm(2). Normality of data was proved according to Kolmogorov-Smirnov analysis, and Student's t-test was done. P value less than 0.05 was considered as significant. The mean OTM were 5.68 ± 1.21 mm in the control group and 6.0 ± 0.99 mm in the laser irradiated teeth with no statistically significant differences(P > 0.75). The mean root resorption was 1.61 ± 0.43 mm(2) and 0.18 ± 0.07 mm(2) in the control and experimental groups respectively being significantly lower in the laser irradiated teeth (P < 0.0001). The findings of the present study show that GaAlAs irradiation together with the application of DFDBA led to limited amount of the stimulated OTM. The laser beam irradiation in combination with alloplastic materials used for socket preservation could reduce the degree of root resorption significantly.
Kuroshima, Shinichiro; Al-Salihi, Zeina; Yamashita, Junro
2013-02-01
The quality and quantity of bone formed in tooth extraction sockets impact implant therapy. Therefore, the establishment of a new approach to enhance bone formation and to minimize bone resorption is important for the success of implant therapy. In this study, we investigated whether intermittent parathyroid hormone (PTH) therapy enhanced bone formation in grafted sockets. Tooth extractions of the maxillary first molars were performed in rats, and the sockets were grafted with xenograft. Intermittent PTH was administered either for 7 days before extractions, for 14 days after extractions, or both. The effect of PTH therapy on bone formation in the grafted sockets was assessed using microcomputed tomography at 14 days after extractions. PTH therapy for 7 days before extractions was not effective to augment bone fill, whereas PTH therapy for 14 days after operation significantly augmented bone formation in the grafted sockets. Intermittent PTH therapy starting right after tooth extractions significantly enhanced bone fill in the grafted sockets, suggesting that PTH therapy can be a strong asset for the success of the ridge preservation procedure.
Instrumented socket inserts for sensing interaction at the limb-socket interface.
Swanson, Eric C; McLean, Jake B; Allyn, Katheryn J; Redd, Christian B; Sanders, Joan E
2018-01-01
The objective of this research was to investigate a strategy for designing and fabricating computer-manufactured socket inserts that were embedded with sensors for field monitoring of limb-socket interactions of prosthetic users. An instrumented insert was fabricated for a single trans-tibial prosthesis user that contained three sensor types (proximity sensor, force sensing resistor, and inductive sensor), and the system was evaluated through a sequence of laboratory clinical tests and two days of field use. During in-lab tests 3 proximity sensors accurately distinguish between don and doff states; 3 of 4 force sensing resistors measured gradual pressure increases as weight-bearing increased; and the inductive sensor indicated that as prosthetic socks were added the limb moved farther out of the socket and pistoning amplitude decreased. Multiple sensor types were necessary in analysis of field collected data to interpret how sock changes affected limb-socket interactions. Instrumented socket inserts, with sensors selected to match clinical questions of interest, have the potential to provide important insights to improve patient care. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.
Del Fabbro, Massimo; Bucchi, Cristina; Lolato, Alessandra; Corbella, Stefano; Testori, Tiziano; Taschieri, Silvio
2017-08-01
The true benefit of autologous platelet concentrates (APCs) for enhancing the healing of postextraction sites is still a matter of debate, and in recent years several clinical trials have addressed this issue. The purpose of this study was to determine the effectiveness of an APC adjunct in the preservation of fresh extraction sockets. An electronic search was performed on Medline, Embase, Scopus, and the Cochrane Central Register of Controlled Trials. Only controlled clinical trials or randomized clinical trials were included. Selected articles underwent risk-of-bias assessment. The outcomes were complications and adverse events, discomfort and quality of life, bone healing and remodeling assessed by histologic and radiographic techniques, and soft tissue healing. Thirty-three comparative studies were included. Nine articles had a parallel design and 24 had a split-mouth design. Twenty studies were considered to have a low risk of bias and 13 were considered to have a high risk. Overall, 1,193 teeth were extracted from 911 patients. Meta-analysis showed that soft tissue healing, probing depth at 3 months, and bone density at 1, 3, and 6 months were statistically better for the APC group. Qualitative analysis suggested that APCs might be associated with a decrease in swelling and trismus. However, no relevant difference among groups was found for probing depth at 1 month, incidence of alveolar osteitis, acute inflammation or infection, percentage of new bone, and indirect measurement of bone metabolism. APCs should be used in postextraction sites to improve clinical and radiographic outcomes such as bone density and soft tissue healing and postoperative symptoms. The actual benefit of APCs on decreasing pain in extraction sockets is still not quantifiable. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Nakaya, Yuka; Tsuboi, Yoshiyuki; Okada-Ogawa, Akiko; Shinoda, Masamichi; Kubo, Asako; Chen, Jui Yen; Noma, Noboru; Batbold, Dulguun; Imamura, Yoshiki; Sessle, Barry J; Iwata, Koichi
2016-01-01
Dry mouth is known to cause severe pain in the intraoral structures, and many dry mouth patients have been suffering from intraoral pain. In development of an appropriate treatment, it is crucial to study the mechanisms underlying intraoral pain associated with dry mouth, yet the detailed mechanisms are not fully understood. To evaluate the mechanisms underlying pain related to dry mouth, the dry-tongue rat model was developed. Hence, the mechanical or heat nocifensive reflex, the phosphorylated extracellular signal-regulated kinase and phosphorylated GluR1-IR immunohistochemistries, and the single neuronal activity were examined in the trigeminal spinal subnucleus caudalis of dry-tongue rats. The head-withdrawal reflex threshold to mechanical, but not heat, stimulation of the tongue was significantly decreased on day 7 after tongue drying. The mechanical, but not heat, responses of trigeminal spinal subnucleus caudalis nociceptive neurons were significantly enhanced in dry-tongue rats compared to sham rats on day 7. The number of phosphorylated extracellular signal-regulated kinase-immunoreactive cells was also significantly increased in the trigeminal spinal subnucleus caudalis following noxious stimulation of the tongue in dry-tongue rats compared to sham rats on day 7. The decrement of the mechanical head-withdrawal reflex threshold (HWT) was reversed during intracisternal administration of the mitogen-activated protein kinase kinase 1 inhibitor, PD98059. The trigeminal spinal subnucleus caudalis neuronal activities and the number of phosphorylated extracellular signal-regulated kinase-immunoreactive cells following noxious mechanical stimulation of dried tongue were also significantly decreased following intracisternal administration of PD98059 compared to vehicle-administrated rats. Increased number of the phosphorylated GluR1-IR cells was observed in the trigeminal spinal subnucleus caudalis of dry-tongue rats, and the number of phosphorylated GluR1-IR cells was significantly reduced in PD98059-administrated rats compared to the vehicle-administrated tongue-dry rats. These findings suggest that the pERK-pGluR1 cascade is involved in central sensitization of trigeminal spinal subnucleus caudalis nociceptive neurons, thus resulting in tongue mechanical hyperalgesia associated with tongue drying. © The Author(s) 2016.
Medicinal plants in the healing of dry socket in rats: microbiological and microscopic analysis.
de Melo Júnior, E J M; Raposo, M J; Lisboa Neto, J A; Diniz, M F A; Marcelino Júnior, C A C; Sant'Ana, A E G
2002-03-01
The effectiveness of medicinal herbs as antimicrobial agents was tested on isolated microorganisms from an induced alveolitis and on alveolitis in rats. Sixteen ethanolic extracts from plants were prepared and tested. The plant materials were selected from ethnobotanic data and the best result was obtained with Schinus terebinthifolius Raddi. The activity on Enterococcus, Bacillus corineforme, Streptococcus viridans and S. beta-hemolytic was better than the one presented by the antibiotic currently used for the treatment of alveolitis. The extract of Schinus terebinthifolius Raddi has shown good wound-healing activity by histological analysis.
Corneal pain without stain: is it real?
Rosenthal, Perry; Baran, Inna; Jacobs, Deborah S
2009-01-01
Clinicians often encounter patients who report corneal pain suggestive of dry eye disease, yet lack equivalent signs. These patients represent a diagnostic and therapeutic challenge that is more easily dismissed than addressed. We review the physiology of pain and the pathophysiological mechanisms of neuropathic corneal pain and speculate on the mechanisms of certain etiopathogenic triggers, such as LASIK, severe dry eye disease, and Sjogren syndrome. Recognizing corneal neuropathic pain as a disease in its own right is the first step toward developing more effective treatments for these severely disabled and presently inadequately served patients.
Osaki, Kanji; Okazaki, Ken; Matsubara, Hirokazu; Kuwashima, Umito; Murakami, Koji; Iwamoto, Yukihide
2015-12-01
To investigate the mismatch between the length at the center and the length on the shortest and longest peripheral sides of the femoral tunnel socket, reamed with the transportal (TP), outside-in (OI), and modified transtibial (TT) techniques, in anterior cruciate ligament (ACL) reconstruction. Femoral tunnel drilling was simulated on 3-dimensional bone models from 40 subjects. The tunnel directions used with the TP, OI, and modified TT techniques were previously described. By use of the resulting angle, a femoral tunnel socket of 9 mm in diameter was drilled from the center of the femoral ACL insertion. The virtual femoral tunnel was extracted, and the length mismatch was measured between the center and the shortest and longest peripheral sides of the tunnel socket. The mean socket length mismatch between the center and the shortest peripheral part of the femoral tunnel socket was 4.2 ± 0.9 mm with the TP technique, 5.2 ± 1.3 mm with the OI technique, and 3.2 ± 0.8 mm with the modified TT technique. The mean socket length mismatch between the center and the longest peripheral part of the femoral tunnel socket was 3.5 ± 0.9 mm with the TP technique, 4.8 ± 1.5 mm with the OI technique, and 3.3 ± 1.2 mm with the modified TT technique. The length mismatch was significantly higher when the tunnel socket was created by the OI technique (P < .01). A length mismatch with the tunnel socket exists after reaming with either the TP, OI, or modified TT technique. In particular, there was a significant increase in length mismatch when the tunnel socket was created by the OI technique, and the length mismatch would easily become greater than 5 mm. The surgeon should recognize this mismatch when it is created and measure the femoral tunnel socket. In anatomic ACL reconstruction, a mismatch between the length at the center and the length at periphery of the femoral tunnel socket occurs, and this is increased particularly when using the OI technique. The discrepancy in tunnel length between its center and its periphery could cause an overestimation of the tunnel length that could result in an error in length during graft preparation. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Mantovani, Edoardo; Arduino, Paolo Giacomo; Schierano, Gianmario; Ferrero, Luca; Gallesio, Giorgia; Mozzati, Marco; Russo, Andrea; Scully, Crispian; Carossa, Stefano
2014-10-01
The surgical removal of mandibular third molars is frequently accompanied by significant postsurgical sequelae, and different protocols have been described to decrease such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. A single-center, randomized, split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on 1 side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling, and surgical duration; secondary outcomes were gender, age, and possible adverse events. Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup, and categorical variables were analyzed by χ(2) test. The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with piezosurgery was significantly lower than that reported after bur (conventional) removal, reaching statistical difference after 4 days (P = .043). The clinical value of orofacial swelling at day 7, normalized to baseline, was lower in the piezosurgery group (P < .005). The average surgical duration was significantly shorter in the bur group than in the piezosurgery group (P < .05). Three patients having bur removal developed short-term complications (2 dry sockets and 1 temporary paraesthesia), which totally resolved by 4 weeks. To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal. This study also compared surgeons with different degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Kim, Jung-Ju; Song, Hyun Young; Ben Amara, Heithem; Kyung-Rim, Kang; Koo, Ki-Tae
2016-07-01
Previous studies on ridge preservation focusing on fresh extraction sockets using graft materials for ridge preservation procedures have reported a delay in the tissue modeling and remodeling phases. The objective of this study is to evaluate the effect of hyaluronic acid (HA) on healing of infected sockets. Six beagle dogs were used in this study. Both mandibular third premolars were hemisected, and the distal roots were extracted. Subsequently, periodontal and endodontic lesions were induced at the remaining mesial root. After communication of the periodontal lesion, an endodontic periapical lesion was observed at 4 months, and the mesial roots of both the right and left sides were extracted. HA was applied into the socket of the test group, and no treatment was administered to the other group (control group). Three months after extraction of the mesial roots, the dogs were sacrificed, and histologic evaluations were performed. The sockets were filled by mineralized bone (47.80% ± 6.60%) and bone marrow (50.47% ± 6.38%) in the control group, whereas corresponding values were 63.29% ± 9.78% and 34.73% ± 8.97% for the test group, respectively. There was a statistically significant difference between the groups. Reversal lines and a copious lineup of osteoblasts were observed in the middle and apical parts of the sockets in the test group. An infected socket shows delayed healing of the socket wound, and HA, because of its osteoinductive, bacteriostatic, and anti-inflammatory properties, may improve bone formation and accelerate wound healing in infected sockets.
Nasser, Qasiem J.; Gombos, Dan S.; Williams, Michelle D.; Guadagnolo, B. Ashleigh; Morrison, William H.; Garden, Adam S.; Beadle, Beth M.; Canseco, Elvia; Esmaeli, Bita
2012-01-01
Purpose High-dose radiotherapy can cause contracture of the anophthalmic socket, but the incidence of this complication in patients with enucleation for uveal melanoma has not previously been reported. We reviewed the surgical management and outcomes in terms of successful prosthesis wear in patients with severe contracture of the anophthalmic socket treated with high-dose radiotherapy for high-risk uveal melanoma and estimated the relative risk of this complication. Methods The medical records of all consecutive patients enrolled in a prospective uveal-melanoma tissue-banking protocol at our institution who underwent enucleation between January 2003 and December 2010 were reviewed. Patients who underwent adjuvant radiotherapy of the enucleated socket were further studied. Results Of the 68 patients enrolled in the prospective tissue banking protocol, 12 had high-risk histologic features (e.g., extrascleral spread or vortex vein invasion) and were treated with 60 Gy of external-beam radiotherapy after enucleation. Five of these patients (41.7%) experienced severe socket contracture precluding prosthesis wear. The median time to onset of contracture following completion of radiotherapy was 20 months. Three patients underwent surgery, which entailed scar tissue release, oral mucous membrane grafting, and socket reconstruction; 2 patients declined surgery. All 3 patients who had surgery experienced significant improvement of socket contracture that enabled patients to wear a prosthesis again. Conclusion High-dose radiotherapy after enucleation in patients with uveal melanoma caused severe socket contracture and inability to wear a prosthesis in approximately 40% of patients. Surgical repair of the contracted socket using oral mucous membrane grafting can allow resumption of prosthesis wear. PMID:22581085
Prosthetic limb sockets from plant-based composite materials.
Campbell, Andrew I; Sexton, Sandra; Schaschke, Carl J; Kinsman, Harry; McLaughlin, Brian; Boyle, Martin
2012-06-01
There is a considerable demand for lower limb prostheses globally due to vascular disease, war, conflict, land mines and natural disasters. Conventional composite materials used for prosthetic limb sockets include acrylic resins, glass and carbon fibres, which produce harmful gasses and dust in their manufacture. To investigate the feasibility of using a renewable plant oil-based polycarbonate-polyurethane copolymer resin and plant fibre composite, instead of conventional materials, to improve safety and accessibility of prosthetic limb manufacture. Experimental, bench research. Test pieces of the resin with a range of plant fibres (10.0% by volume) were prepared and tensile strengths were tested. Test sockets of both conventional composite materials and plant resin with plant fibres were constructed and tested to destruction. Combinations of plant resin and either banana or ramie fibres gave high tensile strengths. The conventional composite material socket and plant resin with ramie composite socket failed at a similar loading, exceeding the ISO 10328 standard. Both wall thickness and fibre-matrix adhesion played a significant role in socket strength. From this limited study we conclude that the plant resin and ramie fibre composite socket has the potential to replace the standard layup. Further mechanical and biocompatibility testing as well as a full economic analysis is required. Using readily sourced and renewable natural fibres and a low-volatile bio-resin has potential to reduce harm to those involved in the manufacture of artificial limb sockets, without compromising socket strength and benefitting clinicians working in poorer countries where safety equipment is scarce. Such composite materials will reduce environmental impact.
Tüzün, Emİne Handan; Gıldır, Sıla; Angın, Ender; Tecer, Büşra Hande; Dana, Kezban Öztürk; Malkoç, Mehtap
2017-09-01
[Purpose] We compared the effectiveness of dry needling with a classical physiotherapy program in patients with chronic low-back pain caused by lumbar disc hernia (LHNP). [Subjects and Methods] In total, 34 subjects were allocated randomly to the study (n=18) and control groups (n=16). In the study group, dry needling was applied using acupuncture needles. The control group performed a home exercise program in addition to hot pack, TENS, and ultrasound applications. Pain was assessed with the short form of the McGill Pain Questionnaire. The number of trigger points and their pressure sensitivity were evaluated with a physical examination (palpation). The Beck Depression Inventory was used to assess depression. The Tampa Kinesiophobia Scale was used to assess fear of movement. [Results] In the study group, the calculated Cohen's effect sizes were bigger than those in the control group in terms of pain, trigger point-related variables, and fear of movement. Effect sizes for reducing depressive symptoms were similar in both groups. [Conclusion] These results suggest that dry needling can be an effective treatment for reducing pain, number of trigger points, sensitivity, and kinesiophobia in patients with chronic low-back pain caused by lumbar disc hernia.
Sultana, Arshiya; Ur Rahman, Khaleeq; Farzana, Muzn; Lone, Azad
2010-10-01
Waje rehm (Dysmenorrhoea) means painful menstruation. Since ancient times, hijamat bila shurt (Dry cupping) is a method of treatment of for this disease. Therefore, objective of this preliminary study was to evaluate the efficacy of hijamat bila shurt on intensity of pain in waje rehm by using Visual Analogue Scale for pain. It was conducted from May 2009 to July 2010 on 25 patients in National Institute of Unani Medicine, Bangalore. Patients suffering from primary and secondary dysmenorrhoea with regular cycles, age group 12-37years were selected. For dry cupping, two glass cup of medium size were applied below the umbilicus for 15 minutes on day land/or day 2 of the menstrual phase for one cycle and pain intensity was assessed by Visual Analogue Scale score for pain before and after the treatment. The Mean and Standard Error Mean for pain intensity before and after the treatment was 6.48 (0.32) and 2.12 (0.32) respectively with P<0.001, considered significant. Thus, hijamat bila shurt was effective in reducing pain intensity in dysmenorrhoea.
The Use of Tooth Particles as a Biomaterial in Post-Extraction Sockets. Experimental Study in Dogs.
Calvo-Guirado, José Luis; Maté-Sánchez de Val, José Eduardo; Ramos-Oltra, María Luisa; Pérez-Albacete Martínez, Carlos; Ramírez-Fernández, María Piedad; Maiquez-Gosálvez, Manuel; Gehrke, Sergio A; Fernández-Domínguez, Manuel; Romanos, Georgios E; Delgado-Ruiz, Rafael Arcesio
2018-05-06
Objectives : The objective of this study was to evaluate new bone formation derived from freshly crushed extracted teeth, grafted immediately in post-extraction sites in an animal model, compared with sites without graft filling, evaluated at 30 and 90 days. Material and Methods : The bilateral premolars P2, P3, P4 and the first mandibular molar were extracted atraumatically from six Beagle dogs. The clean, dry teeth were ground immediately using the Smart Dentin Grinder. The tooth particles obtained were subsequently sieved through a special sorting filter into two compartments; the upper container isolating particles over 1200 μm, the lower container isolated particles over 300 μm. The crushed teeth were grafted into the post-extraction sockets at P3, P4 and M1 (test group) (larger and smaller post-extraction alveoli), while P2 sites were left unfilled and acted as a control group. Tissue healing and bone formation were evaluated by histological and histomorphometric analysis after 30 and 90 days. Results : At 30 days, test site bone formation was greater in the test group than the control group ( p < 0.05); less immature bone was observed in the test group (25.71%) than the control group (55.98%). At 90 days, significant differences in bone formation were found with more in the test group than the control group. No significant differences were found in new bone formation when comparing the small and large alveoli post-extraction sites. Conclusions : Tooth particles extracted from dog’s teeth, grafted immediately after extractions can be considered a suitable biomaterial for socket preservation.
Reusable vibration resistant integrated circuit mounting socket
Evans, Craig N.
1995-01-01
This invention discloses a novel form of socket for integrated circuits to be mounted on printed circuit boards. The socket uses a novel contact which is fabricated out of a bimetallic strip with a shape which makes the end of the strip move laterally as temperature changes. The end of the strip forms a barb which digs into an integrated circuit lead at normal temperatures and holds it firmly in the contact, preventing loosening and open circuits from vibration. By cooling the contact containing the bimetallic strip the barb end can be made to release so that the integrated circuit lead can be removed from the socket without damage either to the lead or to the socket components.
Antetomaso, Jordan; Kumar, Satish
2018-03-01
Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: a systematic review and meta-analysis. Mello CC, Lemos CAA, Verri FR, Dos Santos DM, Goiato MC, Pellizzer EP. Int J Oral Maxillofac Surg 2017; 46(9):1162-77. None TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data. Copyright © 2017 Elsevier Inc. All rights reserved.
2016-10-01
laminated rigid frame to reduce thermal layers, increase flexibility and comfort while retaining ischial containment. In contrast, a Sub-I design has...design is comprised of a flexible interface and minimal laminated rigid frame to reduce thermal layers, increase flexibility and comfort while...AWARD NUMBER: W81XWH-15-1-0410 TITLE: The Effect of Prosthetic Socket Interface Design on Socket Comfort , Residual Limb Health, and Function
Cerezo-Téllez, Ester; Torres-Lacomba, María; Fuentes-Gallardo, Isabel; Perez-Muñoz, Milagros; Mayoral-Del-Moral, Orlando; Lluch-Girbés, Enrique; Prieto-Valiente, Luis; Falla, Deborah
2016-09-01
Chronic neck pain attributed to a myofascial pain syndrome is characterized by the presence of muscle contractures referred to as myofascial trigger points. In this randomized, parallel-group, blinded, controlled clinical trial, we examined the effectiveness of deep dry needling (DDN) of myofascial trigger points in people with chronic nonspecific neck pain. The study was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2010 to December 2014. A total of 130 participants with nonspecific neck pain presenting with active myofascial trigger points in their cervical muscles were included. These participants were randomly allocated to receive: DDN plus stretching (n = 65) or stretching only (control group [n = 65]). Four sessions of treatment were applied over 2 weeks with a 6-month follow-up after treatment. Pain intensity, mechanical hyperalgesia, neck active range of motion, neck muscle strength, and perceived neck disability were measured at baseline, after 2 sessions of intervention, after the intervention period, and 15, 30, 90, and 180 days after the intervention. Significant and clinically relevant differences were found in favour of dry needling in all the outcomes (all P < 0.001) at both short and long follow-ups. Deep dry needling and passive stretching is more effective than passive stretching alone in people with nonspecific neck pain. The results support the use of DDN in the management of myofascial pain syndrome in people with chronic nonspecific neck pain.
Improving socket design to prevent difficult removal of locking screws.
Lin, Chen-Huei; Chao, Ching-Kong; Tang, Yi-Hsuan; Lin, Jinn
2018-03-01
Reports of driver slippage leading to difficult locking screw removals have increased since the adoption of titanium for screw fabrication; the use of titanium is known to cause cross-threading and cold welding. Such problems occur most frequently in screws with hex sockets, and may cause serious surgical complications. This study aimed to improve screw socket design to prevent slippage and difficult screw removal. Three types of small sockets (hex, Torx, and cruciate) and six types of large sockets (hex, Torx, Octatorx, Torx+ I, Torx+ II, and Torx+ III) with screw head diameters of 5.5 mm were manufactured from titanium, and corresponding screwdrivers were manufactured from stainless steel. The screw heads and drivers were mounted on a material testing machine, and torsional tests were conducted to simulate screw usage in clinical settings at two insertion depths: 1 and 2 mm. Ten specimens were tested from each design, and the maximum torque and failure patterns were recorded and compared. For small sockets in 2 mm conditions, the hex with the largest driver core had the highest torque, followed by Torx and cruciate. In these tests, the drivers were twisted off in all specimens. However, under the 1 mm condition, the hex slipped and the torque decreased markedly. Overall, torque was higher for large sockets than for small sockets. The Octatorx, with a large core and simultaneous deformation of the driver and socket lobes, had the highest torque at almost twice that of the small hex. The hex had the lowest torque, a result of slippage in both the 1 and 2 mm conditions. Torx plus designs, with more designed degrees of freedom, were able to maintain a higher driving angle and larger core for higher torque. The hex design showed slipping tendencies with a marked decrease in torque, especially under conditions with inadequate driver engagement. Large sockets allowed for substantial increases in torque. The Torx, Octatorx, and Torx plus designs displayed better performance than the hexes. Improvements to the socket design could effectively prevent slippage and solve difficult screw removal problems. Copyright © 2018. Published by Elsevier Ltd.
Möbius, R; Schleifenbaum, S; Grunert, R; Löffler, S; Werner, M; Prietzel, T; Hammer, N
2016-10-01
The removal of well-fixed acetabular components following THA (total hip arthroplasty) is a difficult operation and could be accompanied by the loss of acetabular bone stock. The optimal method for fixation is still under debate. The aim of this pilot study was to compare the tear-out resistance and failure behavior between osseo-integrated and non-integrated screw cups. Furthermore, we examined whether there are differences in the properties mentioned between screw sockets and cemented polyethylene cups. Tear-out resistance and related mechanical work required for the tear-out of osseo-integrated screw sockets are higher than in non-integrated screw sockets. Ten human coxal bones from six cadavers with osseo-integrated screw sockets (n=4), non-integrated (implanted post-mortem, n=3) screw sockets and cemented polyethylene cups (n=3) were used for tear-out testing. The parameters axial failure load and mechanical work for tear-out were introduced as measures for determining the stability of acetabular components following THA. The osseo-integrated screw sockets yielded slightly higher tear-out resistance (1.61±0.26kN) and related mechanical work compared to the non-integrated screw sockets (1.23±0.39kN, P=0.4). The cemented polyethylene cups yielded the lowest tear-out resistance with a failure load of 1.18±0.24kN. Compared to the screw cups implanted while alive, they also differ on a non-significant level (P=0.1). Osseous failure patterns differed especially for the screw sockets compared to the cemented polyethylene cups. Osseo-integration did not greatly influence the tear-out stability in cementless screw sockets following axial loading. Furthermore, the strength of the bone-implant-interface of cementless screw sockets appears to be similar to cemented polyethylene cups. However, given the high failure load, high mechanical load and because of the related bone failure patterns, removal should not be performed by means of tear-out but rather by osteotomes or other curved cutting devices to preserve the acetabular bone stock. Level III, case-control-study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
29 CFR 1926.1414 - Wire rope-selection and installation criteria.
Code of Federal Regulations, 2014 CFR
2014-07-01
... sockets must be attached to the unloaded dead end of the rope only, except that the use of devices specifically designed for dead-ending rope in a wedge socket is permitted. (g) Socketing must be done in the...
29 CFR 1926.1414 - Wire rope-selection and installation criteria.
Code of Federal Regulations, 2012 CFR
2012-07-01
... sockets must be attached to the unloaded dead end of the rope only, except that the use of devices specifically designed for dead-ending rope in a wedge socket is permitted. (g) Socketing must be done in the...
29 CFR 1926.1414 - Wire rope-selection and installation criteria.
Code of Federal Regulations, 2013 CFR
2013-07-01
... sockets must be attached to the unloaded dead end of the rope only, except that the use of devices specifically designed for dead-ending rope in a wedge socket is permitted. (g) Socketing must be done in the...
Dry Needling for Patients With Neck Pain: Protocol of a Randomized Clinical Trial
Cleland, Joshua A; Snodgrass, Suzanne J
2017-01-01
Background Neck pain is a costly and common problem. Current treatments are not adequately effective for a large proportion of patients who continue to experience recurrent pain. Therefore, new treatment strategies should be investigated in an attempt to reduce the disability and high costs associated with neck pain. Dry needling is a technique in which a fine needle is used to penetrate the skin, subcutaneous tissues, and muscle with the intent to mechanically disrupt tissue without the use of an anesthetic. Dry needling is emerging as a treatment modality that is widely used clinically to address a variety of musculoskeletal conditions. Recent studies of dry needling in mechanical neck pain suggest potential benefits, but do not utilize methods typical to clinical practice and lack long-term follow-up. Therefore, a clinical trial with realistic treatment time frames and methods consistent with clinical practice is needed to examine the effectiveness of dry needling on reducing pain and enhancing function in patients presenting to physical therapy with mechanical neck pain. Objective The aim of this trial will be to examine the short- and long-term effectiveness of dry needling delivered by a physical therapist on pain, disability, and patient-perceived improvements in patients with mechanical neck pain. Methods We will conduct a randomized, double-blind, placebo-controlled trial in accordance with the CONSORT guidelines. A total of 76 patients over the age of 18 with acute or chronic mechanical neck pain resulting from postural dysfunction, trauma, or insidious onset who are referred to physical therapy will be enrolled after meeting the eligibility criteria. Subjects will be excluded if they have previous history of surgery, whiplash in the last 6 weeks, nerve root compression, red flags, or contraindications to dry needling or manual therapy. Participants will be randomized to receive (1) dry needling, manual therapy, and exercise or (2) sham dry needling, manual therapy, and exercise. Participants will receive seven physical therapy treatments lasting 45 minutes each over a maximum of 4 weeks. The primary outcome will be disability as measured by the Neck Disability Index. Secondary outcomes include the following: pain, patient-perceived improvement, patient expectations, and successful blinding to the needling intervention. Outcome measures will be assessed at 4 weeks, 6 months, and 12 months by an assessor who is blind to the group allocation of the participants to determine the short- and long-term treatment effects. We will examine the primary aim with a two-way, repeated-measures analysis of variance with treatment group as the between-subjects variable and time as the within-subjects variable. The hypothesis of interest will be the two-way group by time interaction. An a priori alpha level of .05 will be used for all analyses. Results Recruitment is currently underway and is expected to be completed by the end of 2017. Data collection for long-term outcomes will occur throughout 2017 and 2018. Data analysis, preparation, and publication submission is expected to occur throughout the final three quarters of 2018. Conclusions The successful completion of this trial will provide evidence to demonstrate whether dry needling is effective for the management of mechanical neck pain when used in a combined treatment approach, as is the common clinical practice. Trial Registration ClinicalTrials.gov NCT02731014; https://clinicaltrials.gov/ct2/show/NCT02731014 (Archived by WebCite at http://www.webcitation.org/6ujZgbhsq) PMID:29167092
An assessment technique for computer-socket manufacturing
Sanders, Joan; Severance, Michael
2015-01-01
An assessment strategy is presented for testing the quality of carving and forming of individual computer aided manufacturing facilities. The strategy is potentially useful to facilities making sockets and companies marketing manufacturing equipment. To execute the strategy, an evaluator fabricates a collection of test models and sockets using the manufacturing suite under evaluation, and then measures their shapes using scanning equipment. Overall socket quality is assessed by comparing socket shapes with electronic file shapes. Then model shapes are compared with electronic file shapes to characterize carving performance. Socket shapes are compared with model shapes to characterize forming performance. The mean radial error (MRE), which is the average difference in radii between the two shapes being compared, provides insight into sizing quality. Inter-quartile range (IQR), the range of radial error for the best matched half of the points on the surfaces being compared, provides insight into shape quality. By determining MRE and IQR for carving and forming separately, the source(s) of socket shape error may be pinpointed. The developed strategy may provide a useful tool to the prosthetics community and industry to help identify problems and limitations in computer aided manufacturing and insight into appropriate modifications to overcome them. PMID:21938663
HOW DOES ADDING AND REMOVING LIQUID FROM SOCKET BLADDERS AFFECT RESIDUAL LIMB FLUID VOLUME?
Sanders, JE; Cagle, JC; Harrison, DS; Myers, TR; Allyn, KJ
2015-01-01
Adding and removing liquid from socket bladders is a means for people with limb loss to accommodate residual limb volume change. Nineteen people with trans-tibial amputation using their regular prosthetic socket fitted with fluid bladders on the inside socket surface underwent cycles of bladder liquid addition and removal. In each cycle, subjects sat, stood, and walked for 90s with bladder liquid added and then sat, stood, and walking for 90s again with the bladder liquid removed. The amount of bladder liquid added was increased in each cycle. Bioimpedance analysis was implemented to measure residual limb fluid volume. Results showed that the preferred bladder liquid volume was 16.8 mL (s.d.8.4), corresponding to 1.7% (s.d.0.8%) of the average socket volume between the bioimpedance voltage-sensing electrodes. Limb fluid volume driven out of the residual limb when bladder liquid was added was typically not recovered upon subsequent bladder liquid removal. Fifteen of nineteen subjects experienced a gradual limb fluid volume loss over the test session. Care should be taken when implementing adjustable socket technologies in people with limb amputation. Reducing socket volume may accentuate limb fluid volume loss. PMID:24203546
Biswas, Sondip K; Lee, Jai Eun; Brako, Lawrence; Jiang, Jean X; Lo, Woo-Kuen
2010-11-09
Ball-and-sockets and protrusions are specialized interlocking membrane domains between lens fibers of all species studied. Ball-and-sockets and protrusions are similar in their shape, size, and surface morphology, and are traditionally believed to play a key role in maintaining fiber-to-fiber stability. Here, we evaluate the hypothesis that ball-and-sockets and protrusions possess important structural and functional differences during fiber cell differentiation and maturation. Intact lenses of leghorn chickens (E7 days to P62 weeks old) and rhesus monkeys (1.5-20 years old) were studied with SEM, freeze-fracture TEM, freeze-fracture immunogold labeling (FRIL), and filipin cytochemistry for membrane cholesterol detection. SEM showed that ball-and-sockets were distributed along the long and short sides of hexagonal fiber cells, whereas protrusions were located along the cell corners, from superficial to deep cortical regions in both chicken and monkey lenses. Importantly, by freeze-fracture TEM, we discovered the selective association of gap junctions with all ball-and-sockets examined, but not with protrusions, in both species. In the embryonic chicken lens (E18), the abundant distribution of ball-and-socket gap junctions was regularly found in an approximate zone extending at least 300 μm deep from the equatorial surface of the superficial cortical fibers. Many ball-and-socket gap junctions often protruded deeply into neighboring cells. However, in the mature fibers of monkey lenses, several ball-and-sockets exhibited only partial occupancy of gap junctions with disorganized connexons, possibly due to degradation of gap junctions during fiber maturation and aging. FRIL analysis confirmed that both connexin46 (Cx46) and connexin50 (Cx50) antibodies specifically labeled ball-and-socket gap junctions, but not protrusions. Furthermore, filipin cytochemistry revealed that the ball-and-socket gap junctions contained different amounts of cholesterol (i.e., cholesterol-rich versus cholesterol-free) as seen with the filipin-cholesterol-complexes (FCC) in different cortical regions during maturation. In contrast, the protrusions contained consistently high cholesterol amounts (i.e., 402 FCCs/μm2 membrane) which were approximately two times greater than that of the cholesterol-rich gap junctions (i.e., 188 FCCs/μm2 membrane) found in ball-and-sockets. Gap junctions are regularly associated with all ball-and-sockets examined in metabolically active young cortical fibers, but not with protrusions, in both chicken and monkey lenses. Since these unique gap junctions often protrude deeply into neighboring cells to increase membrane surface areas, they may significantly facilitate cell-to-cell communication between young cortical fiber cells. In particular, the large number of ball-and-socket gap junctions found near the equatorial region may effectively facilitate the flow of outward current toward the equatorial surface for internal circulation of ions in the lens. In contrast, a consistent distribution of high concentrations of cholesterol in protrusions would make the protrusion membrane less deformable and would be more suitable for maintaining fiber-to-fiber stability during visual accommodation. Thus, the ball-and-sockets and protrusions are two structurally and functionally distinct membrane domains in the lens.
Biswas, Sondip K.; Lee, Jai Eun; Brako, Lawrence; Jiang, Jean X.
2010-01-01
Purpose Ball-and-sockets and protrusions are specialized interlocking membrane domains between lens fibers of all species studied. Ball-and-sockets and protrusions are similar in their shape, size, and surface morphology, and are traditionally believed to play a key role in maintaining fiber-to-fiber stability. Here, we evaluate the hypothesis that ball-and-sockets and protrusions possess important structural and functional differences during fiber cell differentiation and maturation. Methods Intact lenses of leghorn chickens (E7 days to P62 weeks old) and rhesus monkeys (1.5–20 years old) were studied with SEM, freeze-fracture TEM, freeze-fracture immunogold labeling (FRIL), and filipin cytochemistry for membrane cholesterol detection. Results SEM showed that ball-and-sockets were distributed along the long and short sides of hexagonal fiber cells, whereas protrusions were located along the cell corners, from superficial to deep cortical regions in both chicken and monkey lenses. Importantly, by freeze-fracture TEM, we discovered the selective association of gap junctions with all ball-and-sockets examined, but not with protrusions, in both species. In the embryonic chicken lens (E18), the abundant distribution of ball-and-socket gap junctions was regularly found in an approximate zone extending at least 300 μm deep from the equatorial surface of the superficial cortical fibers. Many ball-and-socket gap junctions often protruded deeply into neighboring cells. However, in the mature fibers of monkey lenses, several ball-and-sockets exhibited only partial occupancy of gap junctions with disorganized connexons, possibly due to degradation of gap junctions during fiber maturation and aging. FRIL analysis confirmed that both connexin46 (Cx46) and connexin50 (Cx50) antibodies specifically labeled ball-and-socket gap junctions, but not protrusions. Furthermore, filipin cytochemistry revealed that the ball-and-socket gap junctions contained different amounts of cholesterol (i.e., cholesterol-rich versus cholesterol-free) as seen with the filipin-cholesterol-complexes (FCC) in different cortical regions during maturation. In contrast, the protrusions contained consistently high cholesterol amounts (i.e., 402 FCCs/μm2 membrane) which were approximately two times greater than that of the cholesterol-rich gap junctions (i.e., 188 FCCs/μm2 membrane) found in ball-and-sockets. Conclusions Gap junctions are regularly associated with all ball-and-sockets examined in metabolically active young cortical fibers, but not with protrusions, in both chicken and monkey lenses. Since these unique gap junctions often protrude deeply into neighboring cells to increase membrane surface areas, they may significantly facilitate cell-to-cell communication between young cortical fiber cells. In particular, the large number of ball-and-socket gap junctions found near the equatorial region may effectively facilitate the flow of outward current toward the equatorial surface for internal circulation of ions in the lens. In contrast, a consistent distribution of high concentrations of cholesterol in protrusions would make the protrusion membrane less deformable and would be more suitable for maintaining fiber-to-fiber stability during visual accommodation. Thus, the ball-and-sockets and protrusions are two structurally and functionally distinct membrane domains in the lens. PMID:21139982
... end of the femur, which fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. This is because you have a ball ... of your femur, and it fits into a socket in your pelvis. This makes your hips very ...
Residual-stress measurement in socket welded joints by neutron diffraction
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hayashi, M.; Ishiwata, M.; Minakawa, N.
1994-12-31
Neutron diffraction measurements of lattice strains provide spatial maps of residual stress near welds in ferritic steel socket joints. The highest tensile stresses in the welds are found in axial, radial and hoop direction at the weld root. However, the highest tensile stress in the axial direction is about 110MPa. Balancing compressive stresses are found near the surface of the socket weld fusion zone. Heat treatment at 600 C for 2 hours is sufficient to relieve residual stress in socket welds.
Detachable connection for a nuclear reactor fuel assembly
Christiansen, D.W.; Karnesky, R.A.
1983-08-29
A locking connection for releasably attaching a handling socket to the duct tube of a fuel assembly for a nuclear reactor. The connection comprises a load pad housing mechanically attached to the duct tube and a handling socket threadably secured within the housing. A retaining ring is interposed between the housing and the handling socket and is formed with a projection and depression engagable within a cavity and groove of the housing and handling socket, respectively, to form a detachable interlocked connection assembly.
Detachable connection for a nuclear reactor fuel assembly
Christiansen, David W.; Karnesky, Richard A.
1986-01-01
A locking connection for releasably attaching a handling socket to the duct tube of a fuel assembly for a nuclear reactor. The connection comprises a load pad housing mechanically attached to the duct tube and a handling socket threadably secured within the housing. A retaining ring is interposed between the housing and the handling socket and is formed with a projection and depression engageable within a cavity and groove of the housing and handling socket, respectively, to form a detachable interlocked connection assembly.
The effect of cancer therapies on pediatric anophthalmic sockets.
Shildkrot, Yevgeniy; Kirzhner, Maria; Haik, Barrett G; Qaddoumi, Ibrahim; Rodriguez-Galindo, Carlos; Wilson, Matthew W
2011-12-01
To determine the impact of chemotherapy or external beam radiotherapy (EBRT) on pediatric anophthalmic sockets. A retrospective, nonrandomized, interventional cohort study. A total of 135 sockets of 133 children undergoing enucleation from late 1999 to early 2009 at the St. Jude Children's Research Hospital were included. A retrospective chart review of outcomes after enucleation in patients treated with systemic chemotherapy or orbital EBRT either before or after removal of the eye compared with patients who received no other treatment. Incidence of implant exposure, migration, extrusion, socket contracture, and pyogenic granuloma formation. Retinoblastoma was the primary diagnosis in 128 eyes (95%). Median follow-up was 3.6 years (range, 0.1-9.3 years). Event-free course was observed in 94 sockets (69.6%). Complications included implant exposure (n = 28, 20.7%), socket contracture (n = 16, 11.9%), pyogenic granuloma (n = 9, 6.7%), implant extrusion (n = 3, 2.2%), and migration (n = 2, 1.5%). Exposure resolved in 21 sockets (77.8%) and improved in 2 sockets (11.1%); 1 patient with exposure died. Use of prior, adjuvant, or subsequent chemotherapy increased the long-term risk of exposure (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.4-9.4), and contracture (OR could not be calculated, P<0.0001). External beam radiotherapy greatly increased the risk of contracture (OR 24.0; 95% CI, 6.9-82.8) and exposure (OR 2.89; 95% CI, 1.1-7.9). In this unique pediatric population with cancer, chemotherapy and EBRT had an additive effect, significantly increasing the incidence of exposure and socket contracture. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
The Effect of Cancer Therapies on Pediatric Anophthalmic Sockets
Shildkrot, Yevgeniy; Kirzhner, Maria; Haik, Barrett G.; Qaddoumi, Ibrahim; Rodriguez-Galindo, Carlos; Wilson, Matthew W.
2012-01-01
Purpose To determine the impact of chemotherapy or external beam radiotherapy (EBRT) on pediatric anophthalmic sockets. Design A retrospective, nonrandomized, interventional cohort study. Participants A total of 135 sockets of 133 children undergoing enucleation from late 1999 to early 2009 at the St. Jude Children’s Research Hospital were included. Methods A retrospective chart review of outcomes after enucleation in patients treated with systemic chemotherapy or orbital EBRT either before or after removal of the eye compared with patients who received no other treatment. Main Outcome Measures Incidence of implant exposure, migration, extrusion, socket contracture, and pyogenic granuloma formation. Results Retinoblastoma was the primary diagnosis in 128 eyes (95%). Median follow-up was 3.6 years (range, 0.1–9.3 years). Event-free course was observed in 94 sockets (69.6%). Complications included implant exposure (n = 28, 20.7%), socket contracture (n = 16, 11.9%), pyogenic granuloma (n = 9, 6.7%), implant extrusion (n = 3, 2.2%), and migration (n = 2, 1.5%). Exposure resolved in 21 sockets (77.8%) and improved in 2 sockets (11.1%); 1 patient with exposure died. Use of prior, adjuvant, or subsequent chemotherapy increased the long-term risk of exposure (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.4–9.4), and contracture (OR could not be calculated, P<0.0001). External beam radiotherapy greatly increased the risk of contracture (OR 24.0; 95% CI, 6.9–82.8) and exposure (OR 2.89; 95% CI, 1.1–7.9). Conclusions In this unique pediatric population with cancer, chemotherapy and EBRT had an additive effect, significantly increasing the incidence of exposure and socket contracture. PMID:21856015
Kurtul, Bengi Ece; Erdener, Ugur; Mocan, Mehmet Cem; Irkec, Murat; Orhan, Mehmet
2014-01-01
To investigate and compare the cytopathological and clinical effects of amniotic membrane transplantation (AMT) and oral mucosal membrane transplantation (OMMT) in socket contraction. Twelve patients who could not be fitted with ocular prosthesis due to socket contracture were included in this study. Seven patients underwent AMT and 5 patients underwent OMMT. Thirteen patients who had healthy sockets were included as control group. Depth of inferior fornix, degree of inflammation, extent of the socket contracture and socket volume were measured in the preoperative period and at sixth and twelfth weeks postoperatively. Impression cytology of conjunctival fornices and tear transforming growth factor beta-1 (TGFβ1) levels were determined. In the AMT group, socket volume and lower fornix depth values were significantly higher (P=0.030 and P=0.004 respectively) and inflammation levels and impression cytology stages (P=0.037 and P=0.022 respectively) were significantly lower in postoperative period compared to preoperative period. In the OMMT group, no statistical differences were found in terms of clinical parameters, inflammation levels and impression cytology stages of preoperative versus postoperative values. Preoperative tear TGFβ1 levels were higher in AMT and OMMT groups compared to the control group (25.5 ng/mL, 26.3 ng/mL and 21.7 ng/mL respectively). Decreased tear TGFβ1 levels were observed in both the AMT and OMMT groups postoperatively (median decrease value=2.1 ng/mL and 2.7 ng/mL respectively). AMT is associated with postoperative improvement in inferior fornix depth, socket volume, inflammation and impression cytology levels and may be a more proper alternative method than OMMT in the management of socket contracture.
Poulias, Evmenios; Greenwell, Henry; Hill, Margaret; Morton, Dean; Vidal, Ricardo; Shumway, Brian; Peterson, Thomas L
2013-11-01
Previous studies of ridge preservation showed a loss of ≈18% or 1.5 mm of crestal ridge width in spite of treatment. The primary aim of this randomized, controlled, masked clinical trial is to compare a socket graft to the same treatment plus a buccal overlay graft, both with a polylactide membrane, to determine if loss of ridge width can be prevented by use of an overlay graft. Twelve patients who served as positive controls received an intrasocket mineralized cancellous allograft (socket group), and 12 patients received the same socket graft procedure plus buccal overlay cancellous xenograft (overlay group). Horizontal ridge dimensions were measured with a digital caliper, and vertical ridge changes were measured from a stent. Before implant placement, at 4 months, a trephine core was obtained for histologic analysis. The mean horizontal ridge width at the crest for the socket group decreased from 8.7 ± 1.0 to 7.1 ± 1.5 mm for a mean loss of 1.6 ± 0.8 mm (P <0.05), whereas the same measurement for the overlay group decreased from 8.4 ± 1.4 to 8.1 ± 1.4 mm for a mean loss of 0.3 ± 0.9 mm (P >0.05). The overlay group was significantly different from the socket group (P <0.05). Histologic analysis revealed that the socket group had 35% ± 16% vital bone, and the overlay group had 40% ± 16% (P >0.05). The overlay treatment significantly prevented loss of ridge width and preserved or augmented the buccal contour. The socket and overlay groups healed with a high percentage of vital bone.
The modular socket system in a rural setting in Indonesia.
Giesberts, Bob; Ennion, Liezel; Hjelmstrom, Olle; Karma, Agusni; Lechler, Knut; Hekman, Edsko; Bergsma, Arjen
2018-06-01
Prosthetic services are inaccessible to people living in rural areas. Systems like the modular socket system have the potential to be fabricated outside of the prosthetic workshop. This study aimed to evaluate the patient's performance and satisfaction with the use of the modular socket system, and the technical feasibility of its implementation in a rural setting. A quantitative longitudinal descriptive study design was followed. A total of 15 persons with a lower limb amputation were fitted with the modular socket system and followed over 4-6 months. Performance was measured using a 2-min walk test, 10-m walk test and mobility and function questionnaire. Satisfaction was measured by the Socket Fit Comfort Score, Prosthesis Evaluation Questionnaire and EuroQoL 5 Dimensions 5 Levels. Notes on technical feasibility were taken at the moment of fitting ( t 0 ), at 1-3 months post fitting ( t 1 ) and at the end evaluation at 4-6 months post fitting ( t 2 ). Performance did not change between t 0 and t 2 . The comfort of the socket fit reduced between t 0 and t 2 . Satisfaction with prosthesis and general health status stayed constant over time. The average fitting-time for the modular socket system was 6.4 h. The modular socket system can be considered a useful alternative for use in rural settings. Clinical relevance The use of the modular socket system is feasible and can improve accessibility to prosthetic technology in rural areas. Experienced prosthetic users were satisfied with the performance and the device. The shorter manufacturing time and use of only hand-held tools makes it an ideal alternative for use in remote and rural settings.
Kobayashi, Toshiki; Orendurff, Michael S; Zhang, Ming; Boone, David A
2013-04-26
Alignment is important for comfortable and stable gait of lower-limb prosthesis users. The magnitude of socket reaction moments in the multiple planes acting simultaneously upon the residual limb may be related to perception of comfort in individuals using prostheses through socket interface pressures. The aim of this study was to investigate the effect of prosthetic alignment changes on sagittal and coronal socket reaction moment interactions (moment-moment curves) and to characterize the curves in 11 individuals with transtibial amputation using novel moment-moment interaction parameters measured by plotting sagittal socket reaction moments versus coronal ones under various alignment conditions. A custom instrumented prosthesis alignment component was used to measure socket reaction moments during walking. Prosthetic alignment was tuned to a nominally aligned condition by a prosthetist, and from this position, angular (3° and 6° of flexion, extension, abduction or adduction of the socket) and translational (5mm and 10mm of anterior, posterior, medial or lateral translation of the socket) alignment changes were performed in either the sagittal or the coronal plane in a randomized manner. A total of 17 alignment conditions were tested. Coronal angulation and translation alignment changes demonstrated similar consistent changes in the moment-moment curves. Sagittal alignment changes demonstrated more complex changes compared to the coronal alignment changes. Effect of sagittal angulations and translations on the moment-moment curves was different during 2nd rocker (mid-stance) with extension malalignment appearing to cause medio-lateral instability. Presentation of coronal and sagittal socket reaction moment interactions may provide useful visual information for prosthetists to understand the biomechanical effects of malalignment of transtibial prostheses. Copyright © 2013 Elsevier Ltd. All rights reserved.
The reconstruction of a contracted eye socket using a post-auricular full-thickness skin graft.
Wei, Yi Hsuan; Liao, Shu Lang
2014-05-01
To report the efficacy of a full-thickness skin graft (FTSG) for the reconstruction of a contracted eye socket. A retrospective, non-comparative, interventional case series. This was a retrospective review of patients with a contracted eye socket who underwent socket reconstruction using a post-auricular FTSG from 2001 to 2011 at the National Taiwan University Hospital. The postoperative results including prosthetic fitting, the cosmetic result, and eyelid function were assessed. There were 11 male and 15 female patients, with a mean age of 52.3 ± 15.6 years (range 21 to 76). The duration of the socket contracture varied from three months to three years (average 7.4 ± 8.1 months). The severity of the socket contracture ranged from grade 2 to grade 4, based on Tawfik's classification. The mean follow-up time was 35.7 ± 9.6 months. After socket reconstruction, using a post-auricular FTSG, 96% of the cases (25 of 26) demonstrated a successful prosthetic fitting and a satisfactory cosmetic outcome. Both good eyelid function and a stable fornix depth were maintained during the follow-up time. One case received a second socket reconstruction three months after the first operation, using a FTSG, because of an inadequate lateral fornix. The final result was satisfactory. There were no serious complications, but a granuloma formed in one case, and there was prolonged discharge in one case. The reconstruction of a contracted eye socket using a post-auricular FTSG is an effective method with a high success rate, which causes less discomfort to donor sites and results in few complications.
Kotsakis, Georgios A; Joachim, Frederic P C; Saroff, Stephen A; Mahesh, Lanka; Prasad, Hari; Rohrer, Michael D
2014-01-01
The objective of this study was to evaluate bone regeneration in 24 sockets grafted with a calcium phosphosilicate putty alloplastic bone substitute. A core was obtained from 17 sockets prior to implant placement for histomorphometry at 5 to 6 months postextraction. Radiographic analysis during the same postextraction healing period showed radiopaque tissue in all sockets. Histomorphometric analysis revealed a mean vital bone content of 31.76% (± 14.20%) and residual graft content of 11.47% (± 8.99%) after a mean healing period of 5.7 months. The high percentage of vital bone in the healed sites in combination with its timely absorption rate suggest that calcium phosphosilicate putty can be a reliable choice for osseous regeneration in extraction sockets.
Reusable vibration resistant integrated circuit mounting socket
DOE Office of Scientific and Technical Information (OSTI.GOV)
Evans, C.N.
1993-12-31
This invention discloses a novel form of socket for integrated circuits to be mounted on printed circuit boards. The socket uses a novel contact which is fabricated out of a bimetallic strip with a shape which makes the end of the strip move laterally as temperature changes. The end of the strip forms a barb which digs into an integrated circuit lead at normal temperatures and hold it firmly in the contact, preventing loosening and open circuits from vibration. By cooling the contact containing the bimetallic strip the barb end can be made to release so that the integrated circuitmore » lead can be removed from the socket without damage either to the lead or to the socket components.« less
Reusable vibration resistant integrated circuit mounting socket
DOE Office of Scientific and Technical Information (OSTI.GOV)
Evans, C.N.
1995-08-29
This invention discloses a novel form of socket for integrated circuits to be mounted on printed circuit boards. The socket uses a novel contact which is fabricated out of a bimetallic strip with a shape which makes the end of the strip move laterally as temperature changes. The end of the strip forms a barb which digs into an integrated circuit lead at normal temperatures and holds it firmly in the contact, preventing loosening and open circuits from vibration. By cooling the contact containing the bimetallic strip the barb end can be made to release so that the integrated circuitmore » lead can be removed from the socket without damage either to the lead or to the socket components. 11 figs.« less
Prosthetic Correction of Postenucleation Socket Syndrome: A Case Report.
Kamble, Vikas B
2014-12-01
Postenucleation socket syndrome is a frequent late complication of enucleation of eye globe. Several pathophysiological mechanisms have been proposed to account for the symptoms of postenucleation socket syndrome, which include lost orbital volume, superior sulcus deformity, upper eyelid ptosis, lower eyelid laxity, and backward tilt of the prosthesis. The goal of postenucleation socket syndrome treatment is to achieve the best possible functional and esthetic result. The treatment can be either conservative or surgical. For the patient interested in a non-surgical correction, the conservative treatment is simple and non invasive and can be done with prosthesis modification for good positioning, comfort, and mobility. This paper describes prosthetic correction of a patient with postenucleation socket syndrome by modified ocular prosthesis.
Shakibaie-M, Behnam
2013-01-01
The aim of this study was to compare the effectiveness of two bone substitute materials for socket preservation after tooth extraction. Extraction sockets in 10 patients were filled with either inorganic bovine bone material (Bio-Oss) or with synthetic material consisting of hydroxyapatite and silicon dioxide (NanoBone). Extraction sockets without filling served as the control. The results demonstrate the effectiveness of the presented protocol for socket preservation and that the choice of a suitable bone substitute material is crucial. The dimensions of the alveolar ridge were significantly better preserved with Bio-Oss than with NanoBone or without treatment. Bio-Oss treatment resulted in better bone quality and quantity for successful implant placement.
Castro Sánchez, Adelaida M; García López, Hector; Fernández Sánchez, Manuel; Pérez Mármol, José Manuel; Aguilar-Ferrándiz, María Encarnación; Luque Suárez, Alejandro; Matarán Peñarrocha, Guillermo Adolfo
2018-04-23
To compare the effectiveness of dry needling versus myofascial release on myofascial trigger points pain in cervical muscles, quality of life, impact of symptoms pain, quality of sleep, anxiety, depression, and fatigue in patients with fibromyalgia syndrome. A single-blind randomized controlled trial was conducted. Sixty-four subjects with fibromyalgia were randomly assigned to a dry needling group or a myofascial release group. Pain pressure thresholds of myofascial trigger points were evaluated in the cervical muscles. In addition, quality of life, impact of fibromyalgia symptoms, quality of sleep, intensity of pain, anxiety and depression symptoms, impact of fatigue at baseline and post treatment after four weeks of intervention were evaluated. Significant improvement was found in most pain pressure thresholds of the myofascial trigger points in cervical muscles in the dry needling group compared to myofascial release (p < 0.05). Similarly, these differences between groups were found for the components of quality of life of physical function (F = 12.74, p = 0.001), physical role (F = 11.24, p = 0.001), body pain (F =30.26, p < 0.001), general health (F = 15.83, p < 0.001), vitality (F = 13.51, p = 0.001), social function (F = 4.73, p = 0.034), emotional role (F = 8.01, p = 0.006), and mental health (F = 4.95, p = 0.030). Similar results were achieved for total impact of FMS symptoms (F = 42.91, p < 0.001), quality of sleep (F = 11.96, p = 0.001), state anxiety (F = 7.40, p = 0.009), and trait anxiety (F = -14.63, p < 0.001), hospital anxiety and depression (F = 20.60, p < 0.001), general pain intensity (F = 29.59, p < 0.001), and fatigue (F = -25.73, p < 0.001). The dry needling therapy showed higher improvements in comparison with myofascial release therapy for pain pressure thresholds, the components of quality of life of physical role, body pain, vitality and social function, as well as the total impact of FMS symptoms, quality of sleep, state and trait anxiety, hospital anxiety-depression, general pain intensity and fatigue. Implications for rehabilitation Dry needling therapy reduces myofascial trigger point pain in the short term in patients with fibromyalgia syndrome. This therapeutic approach improves anxiety, depression, fatigue symptoms, quality of life, and sleep after treatment. Dry needling and myofascial release therapies decrease intensity of pain, and the impact of fibromyalgia symptoms in this population. These intervention approaches should be considered in an independent manner as complementary therapies within a multidisciplinary setting.
2012-10-01
materials to facilitate dissemination of this technique. 15. SUBJECT TERMS Transfemoral amputation, sub-ischial socket, prosthesis , vacuum-assisted...an appropriate mechanical pump to create suitable vacuum for suspension of the prosthesis ...sockets of highly active prosthesis users
Zhou, Fengjuan; Zheng, Xiaofei; Xie, Meng; Mo, Anchun; Wu, Hongkun
2017-06-01
To evaluate the microenvironment changes in the sockets substituted with bovine-derived xenografts during the early healing period. After extraction of the right maxillary incisor of Sprague Dawley rats, 48 rats were randomly divided into 2 groups. The extraction sockets of the test group were filled with Bio-Oss, whereas the control group was allowed to heal without intervention. The bone quality of the extraction sockets was observed through micro-CT and immunohistochemistry. Micro-CT scanning showed that the bone mineral density in the test group was significantly higher than that in the control group during the early healing period, whereas immunohistochemistry showed that the bone formation-related factors were significantly different between the test and control groups. The bovine-derived xenografts may interfere with the healing process of the extraction socket in the early healing stage. Bone formation of the extraction socket was delayed after grafting with bone substitute.
Reis-Filho, Cláudio R; Silva, Elisângela R; Martins, Adalberto B; Pessoa, Fernanda F; Gomes, Paula V N; de Araújo, Mariana S C; Miziara, Melissa N; Alves, José B
2012-05-01
In this study we investigated the possible use of human demineralised dentine matrix (DHDM), obtained from the extracted teeth, as bone graft material and evaluated the expression of vascular endothelial growth factor (VEGF) induced by this material in the healing process of tooth sockets of rats. To evaluate bone regeneration and expression of VEGF induced by DHDM, thirty-two male Wistar rats weighing approximately 200 g were used. After maxillary second molar extraction, the left sockets were filled with DHDM and the right sockets were naturally filled by blood clot (control). The animals were sacrificed at 3, 7, 14 and 21 days after surgery and upper maxillaries were processed for histological, morphometric and immunohistochemical analyses. DHDM was used to evaluate the mechanical effect of bone graft material into sockets. Expression of VEGF was determined by immunohistochemistry in all groups. Our results demonstrated a significant increase in the newly formed bone tissue in sockets of 7, 14 and 21 days and a significant increase in VEGF expression at days 7 and 14 on treated sockets. Our results showed that DHDM increases the expression of VEGF and accelerates the healing process in rats tooth sockets, by stimulating bone deposition and also vessels formation. These results suggest that DHDM has osteoinductive/osteoconductive potential and may represent an efficient grafting material on guided bone regeneration. Copyright © 2011 Elsevier Ltd. All rights reserved.
Fatigue strength of socket welded pipe joint
DOE Office of Scientific and Technical Information (OSTI.GOV)
Higuchi, Makoto; Hayashi, Makoto; Yamauchi, Takayoshi
1995-12-01
Fully reversed four point bending fatigue tests were carried out on small diameter socket welded joints made of carbon steels. Experimental parameters were pipe diameter, thicknesses of pipe and socket wall, throat depth and shape of fillet welds, slip-on and diametral gaps in the socket welding, lack of penetration at the root of fillet welds, and peening of fillet welds. In most cases a fatigue crack started from the root of the fillet, but in the case of higher stress amplitude, it tended to start from the toe of fillet. The standard socket welded joint for a pipe with amore » 50 mm nominal diameter showed a relatively low fatigue strength of 46 MPa in stress amplitude at the 10{sup 7} cycles failure life. This value corresponds to about 1/5 of that for the smoothed base metal specimens in axial fatigue. The fatigue strength decreased with increasing pipe diameter, and increased with increasing thickness of the pipe and socket wall. The effects of throat depth and shape of fillet welds on fatigue strength were not significant. Contrary to expectation, the fatigue strength of a socket welded joint without slip-on gap is Higher than that of the joint with a normal gap. A lack of penetration at the root deleteriously reduced fatigue strength, showing 14 MPa in stress amplitude at the 10{sup 7} cycles failure life for the 50 mm diameter socket joint.« less
46 CFR 161.006-4 - Requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... parts: Yoke and pedestal. Housing. Front door. Reflector. Lamp socket. Supply cable. (c) Weight and... socket. The motor lifeboat searchlight shall be provided with a lamp of not less than 80 watts nor more than 100 watts, and a suitable lamp socket. Means shall be provided for adjusting and securing the lamp...
46 CFR 161.006-4 - Requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... parts: Yoke and pedestal. Housing. Front door. Reflector. Lamp socket. Supply cable. (c) Weight and... socket. The motor lifeboat searchlight shall be provided with a lamp of not less than 80 watts nor more than 100 watts, and a suitable lamp socket. Means shall be provided for adjusting and securing the lamp...
46 CFR 161.006-4 - Requirements.
Code of Federal Regulations, 2014 CFR
2014-10-01
... parts: Yoke and pedestal. Housing. Front door. Reflector. Lamp socket. Supply cable. (c) Weight and... socket. The motor lifeboat searchlight shall be provided with a lamp of not less than 80 watts nor more than 100 watts, and a suitable lamp socket. Means shall be provided for adjusting and securing the lamp...
46 CFR 161.006-4 - Requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... parts: Yoke and pedestal. Housing. Front door. Reflector. Lamp socket. Supply cable. (c) Weight and... socket. The motor lifeboat searchlight shall be provided with a lamp of not less than 80 watts nor more than 100 watts, and a suitable lamp socket. Means shall be provided for adjusting and securing the lamp...
46 CFR 161.006-4 - Requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... parts: Yoke and pedestal. Housing. Front door. Reflector. Lamp socket. Supply cable. (c) Weight and... socket. The motor lifeboat searchlight shall be provided with a lamp of not less than 80 watts nor more than 100 watts, and a suitable lamp socket. Means shall be provided for adjusting and securing the lamp...
2013-10-01
15. SUBJECT TERMS Transfemoral amputation, sub-ischial socket, prosthesis , vacuum-assisted suspension 16. SECURITY CLASSIFICATION OF: 17...vacuum for suspension of the prosthesis ...14 Task 6 Determine range of volumes to be evacuated from transfemoral sockets of highly active prosthesis users
Convertible socket for pressure gauge
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bissell, R.D.
1990-01-01
This patent describes a pressure gauge having a case in which is disposed a Bourdon tube and a base socket connected to the Bourdon tube for placing the tube in pressure communication with a fluid pressure source. Base socket has a rearward face and a bottom face with respect to the gauge adjacent openings defined through the case and an internal passage communication with the tube. It includes means for connecting a source of fluid pressure to the socket selectively through one of the case openings to the bottom face or the rearward face.
The possible nature of socket stars in H II regions
NASA Technical Reports Server (NTRS)
Castelaz, Michael W.
1990-01-01
Close inspection of faint stars (V of about 14 mag) in H II regions show that they appear to be surrounded by circumstellar envelopes of about 10 arcsecs in diameter (as reported by Feibelman in 1989). The present premise is that the sockets are envelopes of obscuring dust which should emit a measurable amount of infrared radiation based on a simple thermal equilibrium model. A search of literature shows that, of 36 socket stars listed by Feibelman, 17 have been measured in the infrared. Of the 17, 14 show excess IR emission. This is very strong evidence that the socket stars are really stars with circumstellar envelopes. Socket stars may be a new type of astronomical object or well-known astronomical objects in environments or evolutionary states not previously seen.
Double arch mirror study. Part 1: Preliminary engineering report
NASA Technical Reports Server (NTRS)
Vukobratovich, D.; Hillman, D.
1983-01-01
In the proposed design, the NASA AMES 20-in double arch mirror is supported by three clamp and flexure assemblies. The mirror clamp consists of a T-shaped Invar-36 member that goes into a similarly shaped socket in the back of the mirror. The mirror socket is made oversize and contacts the clamp only along the conical surface. The clamp is preloaded by a spring washer and pulls the mirror into contact with the flexure. The clamp is then inserted into the mirror socket through a cutout, is rotated 90 deg, and is then pinned in place. Loading conditions considered in socket design are discussed as well as stress in the socket and clamp. Flexure geometry and stress are examined as well as the effects of flexure error and of mirror cell error.
Manavella, Valeria; Romano, Federica; Garrone, Federica; Terzini, Mara; Bignardi, Cristina; Aimetti, Mario
2017-06-01
The aim of this study was to present and validate a novel procedure for the quantitative volumetric assessment of extraction sockets that combines cone-beam computed tomography (CBCT) and image processing techniques. The CBCT dataset of 9 severely resorbed extraction sockets was analyzed by means of two image processing software, Image J and Mimics, using manual and automated segmentation techniques. They were also applied on 5-mm spherical aluminum markers of known volume and on a polyvinyl chloride model of one alveolar socket scanned with Micro-CT to test the accuracy. Statistical differences in alveolar socket volume were found between the different methods of volumetric analysis (P<0.0001). The automated segmentation using Mimics was the most reliable and accurate method with a relative error of 1.5%, considerably smaller than the error of 7% and of 10% introduced by the manual method using Mimics and by the automated method using ImageJ. The currently proposed automated segmentation protocol for the three-dimensional rendering of alveolar sockets showed more accurate results, excellent inter-observer similarity and increased user friendliness. The clinical application of this method enables a three-dimensional evaluation of extraction socket healing after the reconstructive procedures and during the follow-up visits.
Vignoletti, Fabio; Discepoli, Nicola; Müller, Anna; de Sanctis, Massimo; Muñoz, Fernando; Sanz, Mariano
2012-01-01
The purpose of this investigation is to describe histologically the undisturbed healing of fresh extraction sockets when compared to immediate implant placement. In eight beagle dogs, after extraction of the 3P3 and 4P4, implants were inserted into the distal sockets of the premolars, while the mesial sockets were left to heal spontaneously. Each animal provided four socket sites (control) and four implant sites (test). After 6 weeks, animals were sacrificed and tissue blocks were dissected, prepared for ground sectioning. The relative vertical buccal bone resorption in relation to the lingual bone was similar in both test and control groups. At immediate implant sites, however, the absolute buccal bone loss observed was 2.32 (SD 0.36) mm, what may indicate that while an apical shift of both the buccal and lingual bone crest occurred at the implant sites, this may not happen in naturally healing sockets. The results from this investigation showed that after tooth extraction the buccal socket wall underwent bone resorption at both test and control sites. This resorption appeared to be more pronounced at the implant sites, although the limitations of the histological evaluation method utilized preclude a definite conclusion. © 2011 John Wiley & Sons A/S.
Ball and Socket Ankle: Mechanism and Computational Evidence of Concept.
Jastifer, James R; Gustafson, Peter A; Labomascus, Aaron; Snoap, Tyler
The ball and socket ankle joint is a morphologically abnormal joint characterized by rounding of the articular surface of the talus. Other than anecdotal observation, little evidence has been presented to describe the development of this deformity. The purpose of the present study was to review ankle and subtalar joint mechanics and to kinematically examine the functional combination of these joints as a mechanism of the ball and socket ankle deformity. We reviewed functional representations of the ankle joint, subtalar joint, and ball and socket ankle deformity. A computational study of joint kinematics was then performed using a 3-dimensional model derived from a computed tomography scan of a ball and socket deformity. The joint kinematics were captured by creating a "virtual map" of the combined kinematics of the ankle and subtalar joints in the respective models. The ball and socket ankle deformity produces functionally similar kinematics to a combination of the ankle and subtalar joints. The findings of the present study support the notion that a possible cause of the ball and socket deformity is bony adaptation that compensates for a functional deficit of the ankle and subtalar joints. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Jiang, Xi; Zhang, Yu; Chen, Bo; Lin, Ye
2017-04-01
Extraction socket remodeling and ridge preservation strategies have been extensively explored. To evaluate the efficacy of applying a micro-titanium stent as a pressure bearing device on extraction socket remodeling of maxillary anterior tooth. Twenty-four patients with a extraction socket of maxillary incisor were treated with spontaneous healing (control group) or by applying a micro-titanium stent as a facial pressure bearing device over the facial bone wall (test group). Two virtual models obtained from cone beam computed tomography data before extraction and 4 months after healing were 3-dimenionally superimposed. Facial bone wall resorption, extraction socket remodeling features and ridge width preservation rate were determined and compared between the groups. Thin facial bone wall resulted in marked resorption in both groups. The greatest palatal shifting distance of facial bone located at the coronal level in the control group, but middle level in the test group. Compared with the original extraction socket, 87.61 ± 5.88% ridge width was preserved in the test group and 55.09 ± 14.46% in the control group. Due to the facial pressure bearing property, the rigid micro-titanium stent might preserve the ridge width and alter the resorption features of extraction socket. © 2016 Wiley Periodicals, Inc.
Gerard, David A; Carlson, Eric R; Gotcher, Jack E; Pickett, David O
2014-01-01
This study was conducted with 2 purposes. The first was to determine the effect of a single dose of zoledronic acid (ZA) on the healing of a tooth extraction socket in dogs. The second was to determine if placement of recombinant human bone morphogenetic protein-2 (rhBMP-2)/absorbable collagen sponge (ACS) - INFUSE, (Medtronic, Memphis, TN) into these extraction sockets would inhibit the inhibition on bone healing and remodeling by ZA. Nine adult female beagle dogs (2 to 3 yr old) were placed into 3 groups of 3 dogs each. Group I received 15 mL of sterile saline intravenously; group II received 2.5 mg of ZA intravenously; and group III received 5 mg of ZA intravenously. Forty-five days after treatment, all dogs underwent extraction of noncontiguous right and left mandibular first molars and second premolars. In group I, the right mandibular extraction sockets had nothing placed in them, whereas the left mandibular sockets had only ACS placed in them. In groups II and III, the right mandibular sockets had rhBMP-2/ACS placed in them, whereas the left mandibular sockets had only ACS placed. All extraction sockets were surgically closed. Tetracycline was given intravenously 5 and 12 days later, and all animals were euthanized 15 days after tooth extraction. The extraction sockets and rib and femur samples were harvested immediately after euthanasia, processed, and studied microscopically. A single dose of ZA significantly inhibited healing and bone remodeling in the area of the tooth extractions. The combination of rhBMP-2/ACS appeared to over-ride some of the bone remodeling inhibition of the ZA and increased bone fill in the extraction sites, and remodeling activity in the area was noted. The effects of rhBMP-2/ACS were confined to the area of the extraction sockets because bone activity at distant sites was not influenced. A single dose of ZA administered intravenously inhibits early healing of tooth extraction sockets and bone remodeling in this animal model. The combination of rhBMP-2/ACS significantly increased bone fill and bone remodeling in these areas, negating much of the effect of the ZA. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Heberer, Susanne; Wustlich, Alexander; Lage, Hermann; Nelson, John J; Nelson, Katja
2012-01-01
The aim of the present clinical study was the evaluation of the osteogenic potential of mesenchymal cells embedded in the provisional matrix of non-augmented and with Bio-Oss collagen-augmented human extraction sockets after 6 weeks of healing time. Twenty-five patients with 47 extraction sites participated in the present study. After tooth removal, the extraction sockets were augmented with Bio-Oss collagen or not augmented. At implant placement, bone biopsies of the extraction sockets were obtained. The immunohistochemical analysis of the osteogenic potential of the mesenchymal cells in the provisional matrix was performed using three monoclonal antibodies: core-binding factor α1 (Cbfa1)/runt-related protein (Runx)2, osteonectin (OSN/secreted protein acidic and rich in cyst [SPARC]) and osteocalcin (OC). The statistical analysis was performed using two-factorial analysis for repeated measures, Mann-Whitney U-test and Spearman's rank-order correlation coefficient. Of 47 extraction sockets examined, 17 sockets demonstrated an almost complete ossification. Hence, the provisional matrix of the 30 remaining extraction sockets (21 non-augmented, 9 augmented) was immunohistochemically investigated. No evidence of acute or chronic inflammation was noted in any of the specimens. In the provisional matrix of the non-grafted socket, the median amount of Cbfa1/Runx2-positive cells was 72.3%, of OSN (SPARC) 66.9% and of OC 23.4%, whereas in the grafted sockets the median rate of immunopositive cells staining with Cbfa1/Runx2 was 73.3%, of OSN (SPARC) 61.4% and of OC 20.1%. There was no significant difference in the proportion of positive cells expressed by Cbfa1/Runx2, OSN/SPARC and OC between the grafted and non-grafted socket. Furthermore, the cell density did not correlate to the quantity of stained cells independent of the used proteins. After a 6-week healing period, the provisional matrix was demonstrated to have a high proportion of cells displaying a maturation of mature osteoprogenitor cells to osteoblasts. The grafting procedure did not influence the quantity of osteogenic cells in the extraction socket. © 2011 John Wiley & Sons A/S.
Samitier, C Beatriz; Guirao, Lluis; Costea, Maria; Camós, Josep M; Pleguezuelos, Eulogio
2016-02-01
Lower limb amputation leads to impaired balance, ambulation, and transfers. Proper fit of the prosthesis is a determining factor for successful ambulation. Vacuum-assisted socket systems extract air from the socket, which decreases pistoning and probability of soft-tissue injuries and increases proprioception and socket comfort. To investigate the effect of vacuum-assisted socket system on transtibial amputees' performance-based and perceived balance, transfers, and gait. Quasi-experimental before-and-after study. Subjects were initially assessed using their prosthesis with the regular socket and re-evaluated 4 weeks after fitting including the vacuum-assisted socket system. We evaluated the mobility grade using Medicare Functional Classification Level, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, the 6-Min Walk Test, the Locomotor Capabilities Index, Satisfaction with Prosthesis (SAT-PRO questionnaire), and Houghton Scale. A total of 16 unilateral transtibial dysvascular amputees, mean age 65.12 (standard deviation = 10.15) years. Using the vacuum-assisted socket system, the patients significantly improved in balance, gait, and transfers: scores of the Berg Balance Scale increased from 45.75 (standard deviation = 6.91) to 49.06 (standard deviation = 5.62) (p < 0.01), Four Square Step Test decreased from 18.18 (standard deviation = 3.84) s to 14.97 (3.9) s (p < 0.01), Timed Up and Go Test decreased from 14.3 (standard deviation = 3.29) s to 11.56 (2.46) s (p < 0.01). The distance walked in the 6-Min Walk Test increased from 288.53 (standard deviation = 59.57) m to 321.38 (standard deviation = 72.81) m (p < 0.01). Vacuum-assisted socket systems are useful for improving balance, gait, and transfers in over-50-year-old dysvascular transtibial amputees. This study gives more insight into the use of vacuum-assisted socket systems to improve elderly transtibial dysvascular amputees' functionality and decrease their risk of falls. The use of an additional distal valve in the socket should be considered in patients with a lower activity level. © The International Society for Prosthetics and Orthotics 2014.
Landucci, A; Wosny, A C; Uetanabaro, L C; Moro, A; Araujo, M R
2016-03-01
The clinical efficacy of low-level laser therapy (LLLT) for the reduction of pain, swelling, and trismus following the surgical extraction of third molars was evaluated. Mandibular third molars, with similar radiographic positions on two distinct sections, were extracted from 22 patients. Immediately after extraction from the randomly selected right or left side, LLLT was applied (study group). The same extraction procedure was performed 21 days later on the other third molar, without the application of LLLT (control group). LLLT was applied at 10 points: four intraoral in close proximity to the socket and six extraoral along the masseter muscle. Pain intensity was assessed using a visual analogue scale, swelling was measured as the distance from the tragus to the median base of the mentum, and trismus was assessed by the extent of mouth opening. Data were collected at four time points: before surgery, immediately after surgery, 48h postoperatively, and 7 days postoperatively. Compared with the control group, the study group showed significant reductions in pain, swelling, and trismus at 48h and 7 days postoperatively. In conclusion, a single dose of LLLT was effective at reducing the postoperative discomforts (pain, swelling, and trismus) associated with third molar extraction surgery. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Wang, Song; Wang, Fei; Liao, Zhenhua; Wang, Qingliang; Liu, Yuhong; Liu, Weiqiang
2015-10-01
A ball-on-socket contact configuration was designed to simulate an artificial cervical disk in structure. UHMWPE (ultra high molecular weight polyethylene) hot pressed by powders and Ti6Al4V alloy were selected as the material combination of ball and socket. The socket surface was coated by a ~500 nm C-DLC (carbon ion implantation-diamond like carbon) mixed layer to improve its surface nano hardness and wear resistance. The torsional fretting wear behavior of the ball-on-socket model was tested at different angular displacements under 25% bovine serum lubrication with an axial force of 100 N to obtain more realistic results with that in vivo. The fretting running regimes and wear damage characteristics as well as wear mechanisms for both ball and socket were studied based on 2D (two dimension) optical microscope, SEM (scanning electron microscope) and 3D (three dimension) profiles. With the increase of angular displacement amplitude from 1° to 7°, three types of T-θ (Torsional torque-angular displacement amplitude) curves (i.e., linear, elliptical and parallelogram loops) corresponding to running regimes of PSR (partial slip regime), MR (mixed regime) and SR (slip regime) were observed and analyzed. Both the central region and the edge zone of the ball and socket were damaged. The worn surfaces were characterized by wear scratches and wear debris. In addition, more severe wear damage and more wear debris appeared on the central region of the socket at higher angular displacement amplitude. The dominant damage mechanism was a mix of surface scratch, adhesive wear and abrasive wear for the UHMWPE ball while that for the coated socket was abrasive wear by PE particles and some polishing and rolling process on the raised overgrown DLC grains. The frictional kinetic behavior, wear type, damage region and damage mechanism for the ball-on-socket model revealed significant differences with those of a ball-on-flat contact while showing better consistency with that of in vitro cervical prosthesis simulations according to the literature. Copyright © 2015. Published by Elsevier B.V.
An Amino Acid Code for β-sheet Packing Structure
Joo, Hyun; Tsai, Jerry
2014-01-01
To understand the relationship between protein sequence and structure, this work extends the knob-socket model in an investigation of β-sheet packing. Over a comprehensive set of β-sheet folds, the contacts between residues were used to identify packing cliques: sets of residues that all contact each other. These packing cliques were then classified based on size and contact order. From this analysis, the 2 types of 4 residue packing cliques necessary to describe β-sheet packing were characterized. Both occur between 2 adjacent hydrogen bonded β-strands. First, defining the secondary structure packing within β-sheets, the combined socket or XY:HG pocket consists of 4 residues i,i+2 on one strand and j,j+2 on the other. Second, characterizing the tertiary packing between β-sheets, the knob-socket XY:H+B consists of a 3 residue XY:H socket (i,i+2 on one strand and j on the other) packed against a knob B residue (residue k distant in sequence). Depending on the packing depth of the knob B residue, 2 types of knob-sockets are found: side-chain and main-chain sockets. The amino acid composition of the pockets and knob-sockets reveal the sequence specificity of β-sheet packing. For β-sheet formation, the XY:HG pocket clearly shows sequence specificity of amino acids. For tertiary packing, the XY:H+B side-chain and main-chain sockets exhibit distinct amino acid preferences at each position. These relationships define an amino acid code for β-sheet structure and provide an intuitive topological mapping of β-sheet packing. PMID:24668690
Evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin
Tumer, Celal; Ugur, Omer; Vatankulu, Betul
2015-01-01
Objective: The aim of this study was to determine whether the use of platelet rich fibrin (PRF) improved the healing of extraction sockets. Study Design: A total of 20 patients with bilateral soft tissue impacted mandibular third molars were included in this study. The left and right third molars were extracted during the same session. Subsequently, the PRF membrane was randomly administered to one of the extraction sockets, whereas the contra lateral sockets were left without treatment. On postoperative 30. and 90. days, panoramic images and bone scintigrams were taken to evaluate the bone healing between PRF-treated and non-PRF-treated sockets. Also, periodontal evaluation was performed in the same control sessions. Dependent group t test for paired samples was used for statistical analysis. Results: The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 30 and 90 days post operatively. Radio opacity that can show the bone healing on panoramic images were measured by Image J programmer and they did not differ significantly. Also periodontal values did not differ significantly. Conclusions: PRF might not lead to enhanced bone healing in impacted mandibular third molar extraction sockets 30 and 90 days after surgery. It is thought that PRF has the potential characteristics of an autologous fibrin matrix and can accelerate the healing. To better understand the effects of PRF on healing, further research is warranted with larger sample sizes. Key words:PRF, scintigraphy, healing, extraction sockets. PMID:25475771
Kobayashi, Toshiki; Arabian, Adam K.; Orendurff, Michael S.; Rosenbaum-Chou, Teri G.; Boone, David A.
2014-01-01
Background Energy storage and return feet are designed for active amputees. However, little is known about the socket reaction moments in transtibial prostheses with energy storage and return feet. The aim of this study was to investigate the effect of alignment changes on the socket reaction moments during gait while using the energy storage and return feet. Methods A Smart Pyramid™ was used to measure the socket reaction moments in 10 subjects with transtibial prostheses while walking under 25 alignment conditions, including a nominal alignment (as defined by conventional clinical methods), as well as angle malalignments of 2°, 4° and 6° (flexion, extension, abduction, and adduction) and translation malalignments of 5mm, 10mm and 15mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. The socket reaction moments of the nominal alignment were compared with each malalignment. Findings Both coronal and sagittal alignment changes demonstrated systematic effects on the socket reaction moments. In the sagittal plane, angle and translation alignment changes demonstrated significant differences (P<0.05) in the minimum moment, the moment at 45% of stance and the maximum moment for some comparisons. In the coronal plane, angle and translation alignment changes demonstrated significant differences (P<0.05) in the moment at 30% and 75% of stance for all comparisons. Interpretation The alignment may have systematic effects on the socket reaction moments in transtibial prostheses with energy storage and return feet. The socket reaction moments could potentially be a useful biomechanical parameter to evaluate the alignment of the transtibial prostheses. PMID:24315709
Kobayashi, Toshiki; Orendurff, Michael S.; Arabian, Adam K.; Rosenbaum-Chou, Teri G.; Boone, David A.
2014-01-01
The alignment of a lower limb prosthesis affects the way load is transferred to the residual limb through the socket, and this load is critically important for the comfort and function of the prosthesis. Both magnitude and duration of the moment are important factors that may affect the residual limb health. Moment impulse is a well-accepted measurement that incorporates both factors via moment–time integrals. The aim of this study was to investigate the effect of alignment changes on the socket reaction moment impulse in transtibial prostheses. Ten amputees with transtibial prostheses participated in this study. The socket reaction moment impulse was measured at a self-selected walking speed using a Smart Pyramid™ in 25 alignment conditions, including a nominal alignment (clinically aligned by a prosthetist), as well as angle malalignments of 2°, 4° and 6° (abduction, adduction, extension and flexion) and translation malalignments of 5 mm, 10 mm and 15 mm (lateral, medial, anterior and posterior). The socket reaction moment impulse of the nominal alignment was compared for each condition. The relationship between the alignment and the socket reaction moment impulse was clearly observed in the coronal angle, coronal translation and sagittal translation alignment changes. However, this relationship was not evident in the sagittal angle alignment changes. The results of this study suggested that the socket reaction moment impulse could potentially serve as a valuable parameter to assist the alignment tuning process for transtibial prostheses. Further study is needed to investigate the influence of the socket reaction moment impulse on the residual limb health. PMID:24612718
Surface EMG and intra-socket force measurement to control a prosthetic device
NASA Astrophysics Data System (ADS)
Sanford, Joe; Patterson, Rita; Popa, Dan
2015-06-01
Surface electromyography (SEMG) has been shown to be a robust and reliable interaction method allowing for basic control of powered prosthetic devices. Research has shown a marked decrease in EMG-classification efficiency throughout activities of daily life due to socket shift and movement and fatigue as well as changes in degree of fit of the socket throughout the subject's lifetime. Users with the most severe levels of amputation require the most complex devices with the greatest number of degrees of freedom. Controlling complex dexterous devices with limited available inputs requires the addition of sensing and interaction modalities. However, the larger the amputation severity, the fewer viable SEMG sites are available as control inputs. Previous work reported the use of intra-socket pressure, as measured during wrist flexion and extension, and has shown that it is possible to control a powered prosthetic device with pressure sensors. In this paper, we present data correlations of SEMG data with intra-socket pressure data. Surface EMG sensors and force sensors were housed within a simulated prosthetic cuff fit to a healthy-limbed subject. EMG and intra-socket force data was collected from inside the cuff as a subject performed pre-defined grip motions with their dominant hand. Data fusion algorithms were explored and allowed a subject to use both intra-socket pressure and SEMG data as control inputs for a powered prosthetic device. This additional input modality allows for an improvement in input classification as well as information regarding socket fit through out activities of daily life.
A new directly moulded patellar-tendon-bearing socket.
Boot, D A; Young, N J
1985-08-01
Silicone rubbers and casting tapes individually have previously been used in the manufacture of sockets (Swanson, 1972; Sweitzer, 1973; Ruder, 1977; Graves, 1980; Aqualite, 1982). The authors believe that the present combination of these materials to manufacture a directly moulded socket with a complete silicone rubber lining of variable thickness has not previously been described. The new socket, after addition of the modular components, allows fitting of an aligned below-knee prosthesis within three hours. The socket (Fig. 1.) is made directly on the below-knee stump, can be completed with experience in an hour and does not require the use of specialized equipment. The socket consists of an outer supportive Scotchflex layer inside which is a lining of soft smooth biocompatible silicone rubber of deliberately variable thickness to allow pressure tolerant areas to accept more load and pressure sensitive areas to accept less load (Fig.2). The thicker areas of silicone are produced by applying carefully cut Plastazote pads to the pressure sensitive areas. The thickness and extent of the pads is individually assessed according to the estimated sensitivity of the particular area (Fig. 3). The Scotchflex socket is then manufactured directly on the below-knee stump with these pads applied. The pads are then removed prior to insertion of a semi-liquid silicone rubber. Thus, when the socket with the liquid silicone rubber is re-applied to the stump, the space produced by the pads is filled by the rubber which then sets at room temperature. In this way a layer of variable thickness is produced.(ABSTRACT TRUNCATED AT 250 WORDS)
Mozzati, Marco; Gallesio, Giorgia; di Romana, Sara; Bergamasco, Laura; Pol, Renato
2014-03-01
To evaluate the efficacy of plasma-rich growth factor (PRGF) in improving socket healing after tooth extraction in diabetic patients. This was a split-mouth study in which each patient also served as the control: the study socket was treated with PRGF, whereas the control socket underwent natural healing. The outcome variables were the Healing Index, residual socket volume, visual analog scale score, postsurgical complications, and outcome of a patient questionnaire. The investigation considered the impact of hyperglycemia, glycated hemoglobin, End Organ Disease Score, and smoking habits. Follow-up included 4 postextraction checkups over a 21-day period. Pairs of correlated continuous variables were analyzed with the Wilcoxon test, independent continuous variables with the Mann-Whitney test, and categorical variables with the χ(2) test or Fisher test. From January 2012 to December 2012, 34 patients affected by insulin-dependent diabetes mellitus underwent contemporary bilateral extractions of homologous teeth. The treatment-versus-control postoperative comparison showed that PRGF resulted in significantly smaller residual socket volumes and better Healing Indices from days 3 to 14. The patients' questionnaire outcomes were unanimously in favor of PRGF treatment. The small sample of patients with glycemia values of at least 240 mg/dL showed worse Healing Index and minor socket decreases. PRGF application after extraction improved the healing process in diabetic patients by accelerating socket closure (epithelialization) and tissue maturation, proving the association between PRGF use and improved wound healing in diabetic patients. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
46 CFR 56.75-30 - Pipe joining details.
Code of Federal Regulations, 2010 CFR
2010-10-01
... be either of the socket or butt type. When butt joints are employed the edges to be joined shall be.... Circumferential joints may be either of the butt or socket type. Where butt joints are employed, the included... annular clearance of socket joints shall be held to small clearances which experience indicates is...
A Microprocessor Development System for the Intel 8748 Microcomputer.
1979-12-01
their ready availability, it was decided to build the system on a 4 x 6 Vector plugboard with a 44 pin connect- or and which was predrilled for wirewrap...8748, additional sockets were provided in a 4 socket mother board. These sockets accept the standard 44 pin Vector plugboard . It is recommended that
46 CFR 56.75-30 - Pipe joining details.
Code of Federal Regulations, 2014 CFR
2014-10-01
... be either of the socket or butt type. When butt joints are employed the edges to be joined shall be.... Circumferential joints may be either of the butt or socket type. Where butt joints are employed, the included... annular clearance of socket joints shall be held to small clearances which experience indicates is...
46 CFR 56.75-30 - Pipe joining details.
Code of Federal Regulations, 2013 CFR
2013-10-01
... be either of the socket or butt type. When butt joints are employed the edges to be joined shall be.... Circumferential joints may be either of the butt or socket type. Where butt joints are employed, the included... annular clearance of socket joints shall be held to small clearances which experience indicates is...
46 CFR 56.75-30 - Pipe joining details.
Code of Federal Regulations, 2012 CFR
2012-10-01
... be either of the socket or butt type. When butt joints are employed the edges to be joined shall be.... Circumferential joints may be either of the butt or socket type. Where butt joints are employed, the included... annular clearance of socket joints shall be held to small clearances which experience indicates is...
46 CFR 56.75-30 - Pipe joining details.
Code of Federal Regulations, 2011 CFR
2011-10-01
... be either of the socket or butt type. When butt joints are employed the edges to be joined shall be.... Circumferential joints may be either of the butt or socket type. Where butt joints are employed, the included... annular clearance of socket joints shall be held to small clearances which experience indicates is...
Development of socketed foundations for S3X5.7 posts.
DOT National Transportation Integrated Search
2015-04-01
The objective of this study was to develop a socketed foundation for use with the S3x5.7 (S76x8.5) weak : post. The design focused on cylindrical, reinforced concrete foundations with a steel tube placed in the center for : use as the socket. The fou...
Extraction socket sealing using palatal gingival grafts and resorbable collagen membranes.
Kim, Sang-Yun; Kim, Young-Kyun; Kim, Hyun-Suk; Yun, Pil-Young; Kim, Su-Gwan; Choi, Yong-Hun
2017-12-01
Socket sealing surgery is performed for the preservation of the form and volume of the soft tissue by covering the resulting socket with autogenous soft tissue graft or membrane barriers. This procedure is usually necessary to improve the esthetic results of the maxillary anterior or premolar areas. This study retrospectively investigated cases involving the open membrane technique or socket sealing surgery with a palatal gingival graft or collagen membrane where implant placement and bone grafting were performed immediately after tooth extraction. From January 2005 to December 2008, socket sealing surgery was performed in 24 patients, and 25 implants were placed. All implants were successful in the follow-up period. In the palatal gingival graft group, the mean marginal bone loss was 1.17 mm during the mean follow-up period of 81.0 months. In the collagen membrane group, the mean marginal bone loss was 1.23 mm during the mean follow-up period of 76.9 months. There was no significant difference between the two groups. Consequently, socket sealing surgery is effective at minimizing the loss of soft tissue and alveolar bone.
Development of a residuum/socket interface simulator for lower limb prosthetics.
McGrath, Michael Paul; Gao, Jianliang; Tang, Jinghua; Laszczak, Piotr; Jiang, Liudi; Bader, Dan; Moser, David; Zahedi, Saeed
2017-03-01
Mechanical coupling at the interface between lower limb residua and prosthetic sockets plays an important role in assessing socket fitting and tissue health. However, most research lab-based lower limb prosthetic simulators to-date have implemented a rigid socket coupling. This study describes the fabrication and implementation of a lower limb residuum/socket interface simulator, designed to reproduce the forces and moments present during the key loading phases of amputee walking. An artificial residuum made with model bones encased in silicone was used, mimicking the compliant mechanical loading of a real residuum/socket interface. A 6-degree-of-freedom load cell measured the overall kinetics, having previously been incorporated into an amputee's prosthesis to collect reference data. The developed simulator was compared to a setup where a rigid pylon replaced the artificial residuum. A maximum uniaxial load of 850 N was applied, comparable to the peak vertical ground reaction force component during amputee walking. Load cell outputs from both pylon and residuum setups were compared. During weight acceptance, when including the artificial residuum, compression decreased by 10%, while during push off, sagittal bending and anterior-posterior shear showed a 25% increase and 34% decrease, respectively. Such notable difference by including a compliant residuum further highlighted the need for such an interface simulator. Subsequently, the simulator was adjusted to produce key load cell outputs briefly aligning with those from amputee walking. Force sensing resistors were deployed at load bearing anatomic locations on the residuum/socket interface to measure pressures and were compared to those cited in the literature for similar locations. The development of such a novel simulator provides an objective adjunct, using commonly available mechanical test machines. It could potentially be used to provide further insight into socket design, fit and the complex load transfer mechanics at the residuum/socket interface, as well as to evaluate the structural performance of prostheses.
Improved Ball-and-Socket Docking Mechanism
NASA Technical Reports Server (NTRS)
Cloyd, Richard; Bryan, Tom
2004-01-01
A proposed docking mechanism would form a ball-and-socket joint in the docked condition. The mechanism could tolerate significant initial misalignment because it would include an alignment cone that would guide the ball into the socket. Like other ball-and-socket joints, the joint would have three rotational degrees of freedom. This docking mechanism would be a successor to the one described in Passive Capture Joint With Three Degrees of Freedom (MFS-31146), NASA Tech Briefs, Vol. 22, No. 7 (July 1998), page 65. It would contain most of the components of the prior mechanism, plus some additional components that would expand its capabilities.
Probe-And-Socket Fasteners For Robotic Assembly
NASA Technical Reports Server (NTRS)
Nyberg, Karen
1995-01-01
Self-alignment and simplicity of actuation make mechanism amenable to robotic assembly. Includes socket, mounted on structure at worksite, and probe, mounted on piece of equipment to be attached to structure at socket. Probe-and-socket mechanism used in conjunction with fixed target aiding in placement of end effector of robot during grasping, and with handle or handles on structure. Intended to enable robot to set up workstation in hostile environment. Workstation then used by astronaut, aquanaut, or other human, spending minimum time in environment. Human concentrates on performing quality work rather than on setting up equipment, with consequent reduction of risk.
El Chaar, Edgard; Oshman, Sarah; Cicero, Giuseppe; Castano, Alejandro; Dinoi, Cinzia; Soltani, Leila; Lee, Yoonjung Nicole
Localized ridge resorption, the consequence of socket collapse, following tooth extraction in the anterior maxilla can adversely affect esthetics, function, and future implant placement. Immediate grafting of extraction sockets may help preserve natural ridge contours, but a lack of available soft tissue can compromise the final esthetic outcome. The presented modified rotated palatal pedicle connective tissue flap is a useful technique for simultaneous soft tissue coverage and augmentation of grafted sockets to improve esthetic outcome. This article delineates its advantages through the presentation of a four-case series using this new technique.
A case series of anophthalmic socket cysts excised utilising fibrin sealant.
Wong, Yun; Clarke, Lucy; Lau, Gordon
2017-10-23
Anophthalmic socket cysts are challenging to remove and incomplete excision has been shown to increase the risk of recurrence. This case series describes a novel technique utilising the fibrin sealant Tisseel (Baxter AG, Vienna, Austria) to retain the socket cyst integrity during surgical removal to facilitate its complete excision. Five patients were included and followed up for a minimum of 1 year, and there were no signs of recurrence in any of the cases. The surgical technique is described and illustrated. This technique is a safe way of simplifying challenging socket cyst surgery.
Postoperative Complications of Dermis-Fat Autografts in the Anophthalmic Socket.
Starks, Victoria; Freitag, Suzanne K
2018-01-01
Reconstruction of the anophthalmic socket allows the use of an ocular prosthesis and rehabilitation of facial appearance. Dermis-fat grafting is one option in volume augmentation of the anophthalmic socket and presents unique benefits, including increased surface area within the socket and the ability to grow with pediatric patients. Postoperative complications of this procedure are relatively common. Minor complications, such as graft hirsutism, keratinization, and conjunctival cysts or granulomas, are managed easily by observation or simple intervention. Major complications, such as graft atrophy, infection, or ulceration, may prevent good prosthesis fit and may require return to the operating room.
Incomplete response to artificial tears is associated with features of neuropathic ocular pain.
Galor, Anat; Batawi, Hatim; Felix, Elizabeth R; Margolis, Todd P; Sarantopoulos, Konstantinos D; Martin, Eden R; Levitt, Roy C
2016-06-01
Artificial tears are first-line therapy for patients with dry eye symptoms. It is not known, however, which patient factors associate with a positive response to therapy. The purpose of this study was to evaluate whether certain ocular and systemic findings are associated with a differential subjective response to artificial tears. Cross-sectional study of 118 individuals reporting artificial tears use (hypromellose 0.4%) to treat dry eye-associated ocular pain. An evaluation was performed to assess dry eye symptoms (via the dry eye questionnaire 5 and ocular surface disease index), ocular and systemic (non-ocular) pain complaints and ocular signs (tear osmolarity, tear breakup time, corneal staining, Schirmer testing with anaesthesia, and eyelid and meibomian gland assessment). The main outcome measures were factors associated with differential subjective response to artificial tears. By self-report, 23 patients reported no improvement, 73 partial improvement and 22 complete improvement in ocular pain with artificial tears. Patients who reported no or partial improvement in pain with artificial tears reported higher levels of hot-burning ocular pain and sensitivity to wind compared with those with complete improvement. Patients were also asked to rate the intensity of systemic pain elsewhere in the body (other than the eye). Patients who reported no or incomplete improvement with artificial tears had higher systemic pain scores compared with those with complete improvement. Both ocular and systemic (non-ocular) pain complaints are associated with a differential subjective response to artificial tears. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Chang, Hao-Hueng; Wang, Yin-Lin; Chiang, Yu-Chih; Chen, Yen-Liang; Chuang, Yu-Horng; Tsai, Shang-Jye; Heish, Kuo-Huang; Lin, Feng-Huei; Lin, Chun-Pin
2014-01-01
A novel chitosan-γPGA polyelectrolyte complex hydrogel (C-PGA) has been developed and proven to be an effective dressing for wound healing. The purpose of this study was to evaluate if C-PGA could promote new bone formation in the alveolar socket following tooth extraction. An animal model was proposed using radiography and histomorphology simultaneously to analyze the symmetrical sections of Wistar rats. The upper incisors of Wistar rats were extracted and the extraction sockets were randomly treated with gelatin sponge, neat chitosan, C-PGA, or received no treatment. The extraction sockets of selected rats from each group were evaluated at 1, 2, 4, or 6 wk post-extraction. The results of radiography and histopathology indicated that the extraction sockets treated with C-PGA exhibited lamellar bone formation (6.5%) as early as 2 wk after the extraction was performed. Moreover, the degree of new bone formation was significantly higher (P < 0.05) in the extraction sockets treated with C-PGA at 6 wk post-extraction than that in the other study groups. In this study, we demonstrated that the proposed animal model involving symmetrical sections and simultaneous radiography and histomorphology evaluation is feasible. We also conclude that the novel C-PGA has great potential for new bone formation in the alveolar socket following tooth extraction. PMID:24658174
Yu, H J; Jia, P; Lv, Z; Qiu, L X
2017-04-01
The aim of this study was to analyze and compare the long-term clinical outcomes of mature third molar autotransplantation in surgically created sockets and fresh extraction sockets with regard to survival and functional success rates. A total of 65 third molars with completely formed roots were autotransplanted in 60 patients (average age 33.1 years). Thirty-six of the teeth were autotransplanted into surgically created sockets with or without guided bone regeneration (GBR; delayed autotransplantation), while 29 were autotransplanted into fresh extraction sockets (immediate autotransplantation; control group). All patients underwent annual clinical and radiographic examinations (average follow-up 9.9 years, range 7-13 years). The survival rates for the control, GBR, and no GBR groups were 93.1%, 95.2%, and 80.0%, respectively, with no significant differences among the groups. There were no statistically significant differences among the groups with regard to the frequency of inflammatory root resorption or root ankylosis. Age did not influence the clinical outcomes. These results suggest that the autotransplantation of third molars with completely formed roots is effective in both surgically created and fresh extraction sockets and provides a high long-term success rate if cases are selected and treated appropriately. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
LaPrè, A K; Price, M A; Wedge, R D; Umberger, B R; Sup, Frank C
2018-04-01
Musculoskeletal modeling and marker-based motion capture techniques are commonly used to quantify the motions of body segments, and the forces acting on them during human gait. However, when these techniques are applied to analyze the gait of people with lower limb loss, the clinically relevant interaction between the residual limb and prosthesis socket is typically overlooked. It is known that there is considerable motion and loading at the residuum-socket interface, yet traditional gait analysis techniques do not account for these factors due to the inability to place tracking markers on the residual limb inside of the socket. In the present work, we used a global optimization technique and anatomical constraints to estimate the motion and loading at the residuum-socket interface as part of standard gait analysis procedures. We systematically evaluated a range of parameters related to the residuum-socket interface, such as the number of degrees of freedom, and determined the configuration that yields the best compromise between faithfully tracking experimental marker positions while yielding anatomically realistic residuum-socket kinematics and loads that agree with data from the literature. Application of the present model to gait analysis for people with lower limb loss will deepen our understanding of the biomechanics of walking with a prosthesis, which should facilitate the development of enhanced rehabilitation protocols and improved assistive devices. Copyright © 2017 John Wiley & Sons, Ltd.
Safari, Mohammad Reza; Meier, Margrit Regula
2015-01-01
This review is an attempt to untangle the complexity of transtibial prosthetic socket fit, determine the most important characteristic for a successful fitting, and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. Further, it is intended to provide directions for future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design or type of outcome measure. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that incorporated the Downs and Black risk of bias assessment checklist. Results for the qualitative outcomes (n = 19 articles) are synthesized. Total surface bearing sockets lead to greater activity levels and satisfaction in active persons with amputation, those with a traumatic cause of amputation, and younger persons with amputation than patellar tendon bearing sockets. Evidence on vacuum-assisted suction and hydrostatic sockets is inadequate, and further studies are much needed. To improve the scientific basis for prescription, comparison of and correlation between mechanical properties of interface material, socket designs, user characteristics, and outcome measures should be conducted and reported in future studies.
Mandour, Sameh S; Elmazar, Hesham M; Marey, Hatem M; Rahman, Ahmed K Abdel; Sakr, Rokia A
2016-12-01
To evaluate the use of intraoperative topical application of mitomycin C (MMC) for managing cases of recurrent socket contraction. A prospective comparative randomized study was carried out on 40 patients suffering from contracted sockets. They were randomly enrolled into 2 groups. Group A included 20 patients who had a surgery to treat contracted socket without augmentation with MMC. Group B patients had an MMC-augmented repair for the contracted socket. Patients were followed up over a period of 12 months for changes in inferior fornix (IF) depth and ability to retain the ocular prosthesis. At the end of the follow-up period, postoperative IF depth was significantly deeper in group B (with MMC) than in group A (without MMC). As well, 75% of the patients in group B could maintain the prosthetic eye shell, whereas only 35% of group A could maintain the prosthesis. This study shows that using intraoperative MMC (0.2 mg/mL) in contracted socket reconstruction plays a significant role in maintaining prosthetic eye. To the best of our knowledge, this study is the first to use MMC on a relatively large scale of patients with contracted socket. However, the follow-up period was relatively short and further work is required to verify the effect of MMC on a longer follow-up period.
46 CFR 56.30-5 - Welded joints.
Code of Federal Regulations, 2010 CFR
2010-10-01
... systems and should be checked when designing for these systems. (c) Socket welds (Modifies 127.3.3A.). (1) Each socket weld must conform to ASME B16.11 (incorporated by reference; see 46 CFR 56.01-2), to... approximately one-sixteenth inch between the end of the pipe and the bottom of the socket must be provided...
46 CFR 56.30-5 - Welded joints.
Code of Federal Regulations, 2012 CFR
2012-10-01
... systems and should be checked when designing for these systems. (c) Socket welds (Modifies 127.3.3A.). (1) Each socket weld must conform to ASME B16.11 (incorporated by reference; see 46 CFR 56.01-2), to... approximately one-sixteenth inch between the end of the pipe and the bottom of the socket must be provided...
46 CFR 56.30-5 - Welded joints.
Code of Federal Regulations, 2011 CFR
2011-10-01
... systems and should be checked when designing for these systems. (c) Socket welds (Modifies 127.3.3A.). (1) Each socket weld must conform to ASME B16.11 (incorporated by reference; see 46 CFR 56.01-2), to... approximately one-sixteenth inch between the end of the pipe and the bottom of the socket must be provided...
46 CFR 56.30-5 - Welded joints.
Code of Federal Regulations, 2013 CFR
2013-10-01
... systems and should be checked when designing for these systems. (c) Socket welds (Modifies 127.3.3A.). (1) Each socket weld must conform to ASME B16.11 (incorporated by reference; see 46 CFR 56.01-2), to... approximately one-sixteenth inch between the end of the pipe and the bottom of the socket must be provided...
21 CFR 888.3510 - Knee joint femorotibial metal/polymer constrained cemented prosthesis.
Code of Federal Regulations, 2012 CFR
2012-04-01
...-and-socket joint located between a stemmed femoral and a stemmed tibial component and a runner and track joint between each pair of femoral and tibial condyles. The ball-and-socket joint is composed of a...-molybdenum. The ball of the tibial component is held within the socket of the femoral component by the...
46 CFR 56.30-5 - Welded joints.
Code of Federal Regulations, 2014 CFR
2014-10-01
... systems and should be checked when designing for these systems. (c) Socket welds (Modifies 127.3.3A.). (1) Each socket weld must conform to ASME B16.11 (incorporated by reference; see 46 CFR 56.01-2), to... approximately one-sixteenth inch between the end of the pipe and the bottom of the socket must be provided...
21 CFR 888.3510 - Knee joint femorotibial metal/polymer constrained cemented prosthesis.
Code of Federal Regulations, 2011 CFR
2011-04-01
...-and-socket joint located between a stemmed femoral and a stemmed tibial component and a runner and track joint between each pair of femoral and tibial condyles. The ball-and-socket joint is composed of a...-molybdenum. The ball of the tibial component is held within the socket of the femoral component by the...
Preliminary evaluation of hermetic JT/LJT/R P connector socket contact design
DOE Office of Scientific and Technical Information (OSTI.GOV)
Baca, J.R.F.
1991-10-01
This report presents a precursory examination of a number of issues pertaining to socket contacts in hermetic connectors. The principal issues addressed are high-contact resistance and contact chatter (circuit discontinuities). Efforts examining the characteristics of the existing socket contact design, the possibility of connector/contact rework, quick-fix solutions, and contact redesigns are summarized.
21 CFR 888.3510 - Knee joint femorotibial metal/polymer constrained cemented prosthesis.
Code of Federal Regulations, 2013 CFR
2013-04-01
...-and-socket joint located between a stemmed femoral and a stemmed tibial component and a runner and track joint between each pair of femoral and tibial condyles. The ball-and-socket joint is composed of a...-molybdenum. The ball of the tibial component is held within the socket of the femoral component by the...
21 CFR 888.3510 - Knee joint femorotibial metal/polymer constrained cemented prosthesis.
Code of Federal Regulations, 2014 CFR
2014-04-01
...-and-socket joint located between a stemmed femoral and a stemmed tibial component and a runner and track joint between each pair of femoral and tibial condyles. The ball-and-socket joint is composed of a...-molybdenum. The ball of the tibial component is held within the socket of the femoral component by the...
Jee, Jeong-Hyun; Lee, Wan; Lee, Byung Do
2010-08-01
Many dental patients take bisphosphonates to reduce the risk of hip and vertebral fractures. In vivo micro-computed tomography (micro-CT) was used to examine the longitudinal inhibitory effect of alendronate on the healing of extraction sockets in ovariectomized rats. Twenty 5-week-old Sprague-Dawley rats were assigned randomly to 1 of 3 groups: sham-operated (n = 5), and 2 ovariectomized (OVX) groups: saline treated (0.1 mL/100 g/d, n = 7) and alendronate treated (1 mg/kg/d, n = 8). Before micro-CT scanning, the left maxillary first molars of the rats were extracted. In vivo micro-CT (spatial resolution 50 x 50 mum) of the jaw was performed at baseline and at 2-week intervals for 6 weeks. Alveolar-bone radiographic densities and dimensions were analyzed with repeated measures analysis of variance. The bony healing patterns of the extraction sockets were also evaluated in each group. The radiographic socket densities of the sham-treated and OVX-alendronate groups significantly increased during the first 4 weeks after extraction (P < .05). At 2 weeks, the radiographic densities of the sockets in the OVX-saline group increased, but the increase was significantly lower than for the other groups at 4 weeks (P < .05). Newly formed bone was identified in the extraction sockets in all groups 2 to 6 weeks after extraction. There was a significant loss of alveolar ridge height at the second week postextraction compared with baseline, and at the fourth week compared with the second week (P < .05) except in the alendronate group. Alendronate appears to promote the healing of extraction sockets in estrogen-deficient rats and helps resist the loss of alveolar bone adjacent to extraction sockets. Copyright 2010 Mosby, Inc. All rights reserved.
Kobayashi, Toshiki; Orendurff, Michael S; Arabian, Adam K; Rosenbaum-Chou, Teri G; Boone, David A
2014-04-11
The alignment of a lower limb prosthesis affects the way load is transferred to the residual limb through the socket, and this load is critically important for the comfort and function of the prosthesis. Both magnitude and duration of the moment are important factors that may affect the residual limb health. Moment impulse is a well-accepted measurement that incorporates both factors via moment-time integrals. The aim of this study was to investigate the effect of alignment changes on the socket reaction moment impulse in transtibial prostheses. Ten amputees with transtibial prostheses participated in this study. The socket reaction moment impulse was measured at a self-selected walking speed using a Smart Pyramid in 25 alignment conditions, including a nominal alignment (clinically aligned by a prosthetist), as well as angle malalignments of 2°, 4° and 6° (abduction, adduction, extension and flexion) and translation malalignments of 5 mm, 10 mm and 15 mm (lateral, medial, anterior and posterior). The socket reaction moment impulse of the nominal alignment was compared for each condition. The relationship between the alignment and the socket reaction moment impulse was clearly observed in the coronal angle, coronal translation and sagittal translation alignment changes. However, this relationship was not evident in the sagittal angle alignment changes. The results of this study suggested that the socket reaction moment impulse could potentially serve as a valuable parameter to assist the alignment tuning process for transtibial prostheses. Further study is needed to investigate the influence of the socket reaction moment impulse on the residual limb health. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kobayashi, Toshiki; Arabian, Adam K; Orendurff, Michael S; Rosenbaum-Chou, Teri G; Boone, David A
2014-01-01
Energy storage and return feet are designed for active amputees. However, little is known about the socket reaction moments in transtibial prostheses with energy storage and return feet. The aim of this study was to investigate the effect of alignment changes on the socket reaction moments during gait while using the energy storage and return feet. A Smart Pyramid™ was used to measure the socket reaction moments in 10 subjects with transtibial prostheses while walking under 25 alignment conditions, including a nominal alignment (as defined by conventional clinical methods), as well as angle malalignments of 2°, 4° and 6° (flexion, extension, abduction, and adduction) and translation malalignments of 5mm, 10mm and 15mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. The socket reaction moments of the nominal alignment were compared with each malalignment. Both coronal and sagittal alignment changes demonstrated systematic effects on the socket reaction moments. In the sagittal plane, angle and translation alignment changes demonstrated significant differences (P<0.05) in the minimum moment, the moment at 45% of stance and the maximum moment for some comparisons. In the coronal plane, angle and translation alignment changes demonstrated significant differences (P<0.05) in the moment at 30% and 75% of stance for all comparisons. The alignment may have systematic effects on the socket reaction moments in transtibial prostheses with energy storage and return feet. The socket reaction moments could potentially be a useful biomechanical parameter to evaluate the alignment of the transtibial prostheses. Copyright © 2013 Elsevier Ltd. All rights reserved.
Cooled electronic system with thermal spreaders coupling electronics cards to cold rails
Chainer, Timothy J; Gaynes, Michael A; Graybill, David P; Iyengar, Madhusudan K; Kamath, Vinod; Kochuparambil, Bejoy J; Schmidt, Roger R; Schultz, Mark D; Simco, Daniel P; Steinke, Mark E
2013-07-23
Liquid-cooled electronic systems are provided which include an electronic assembly having an electronics card and a socket with a latch at one end. The latch facilitates securing of the card within the socket or removal of the card from the socket. A liquid-cooled cold rail is disposed at the one end of the socket, and a thermal spreader couples the electronics card to the cold rail. The thermal spreader includes first and second thermal transfer plates coupled to first and second surfaces on opposite sides of the card, and thermally conductive extensions extending from end edges of the plates, which couple the respective transfer plates to the liquid-cooled cold rail. The thermally conductive extensions are disposed to the sides of the latch, and the card is securable within or removable from the socket using the latch without removing the cold rail or the thermal spreader.
Mourits, Daphne L; Remmers, Jelmer S; Tan, Stevie H; Moll, Annette C; Hartong, Dyonne T
2018-04-03
To introduce a novel technique to design individually customized conformers for postenucleation sockets with dermis fat implants. We use a 3-dimensional scan of the frontal face/orbit and eyelid contour to design an individualized conformer. This polymethylmetacrylate printed conformer is adapted to patients' socket, palpebral fissures, horizontal eyelid aperture, curvature of the eyelids, and mean diameter of patients' contralateral eye. Sutures through holes in the inferior part of the conformer and in the extension can be placed to fixate the conformer and anchor fornix deepening sutures. A correct fitting conformer can be printed and attached to the socket and eyelids. The shape of this conformer can be used subsequently postsurgically to design the ocular prosthesis. Presurgical planning is important to anticipate for a functional socket to adequately fit an artificial eye. The presented technique using 3-dimensional imaging, designing, and printing promises to prevent conformer extrusion and forniceal shortening.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Higuchi, Makoto; Nakagawa, Akira; Chujo, Noriyuki
1996-12-01
Rotating bending fatigue tests were conducted on socket welded joints of a nominal diameter 20 mm, and effects of root defect and other various factors, including post-weld heat treatment (PWHT), pipe wall thickness, and socket wall thickness, were investigated. The socket joints exhibited, in the rotating bending fatigue mode, fatigue strengths that were markedly lower than the same 20 mm diameter joints in four-point bending fatigue. Also, where the latter specimens failed always at the toe, root-failures occurred in rotating bending fatigue. When PWHT`d, however, the fatigue strength showed a remarkable improvement, while the failure site reverted to toe. Thickermore » pipe walls and socket walls gave rise to higher fatigue strength. A formula relating the size of root defects to the fatigue strength reduction has been proposed.« less
Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue.
Al-Juboori, Mohammed Jasim
2016-01-01
Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.
Aggarwal, Himanshi; Singh, Saumyendra V; Kumar, Pradeep; Kumar Singh, Arun
2015-06-01
One of the most common tumors of the eye diagnosed in childhood is retinoblastoma, which mandates enucleation with adjunctive chemotherapy and radiotherapy to save the patient's life. The most common late enucleation complication is post-enucleation socket syndrome (PESS), which poses a management dilemma for the prosthodontist and surgeon, along with being a major esthetic concern for the patient. The reconstruction of such sockets is complex. The purpose of this clinical report is to describe the rehabilitation of such a pediatric patient with severe PESS. The patient was successfully rehabilitated by presurgical conformer therapy, socket reconstruction surgery with non-meshed intermediate split thickness skin graft (STSG)/Blair-Brown graft, and postsurgical conformer stent. This was followed by fabrication of a custom ocular prosthesis, to achieve favorable functional, physical, and psychological effects. © 2014 by the American College of Prosthodontists.
Simpson, G; Fisher, C; Wright, D K
2001-01-01
Continuing earlier studies into the relationship between the residual limb, liner and socket in transtibial amputees, we describe a geometrically accurate non-linear model simulating the donning of a liner and then a socket. The socket is rigid and rectified and the liner is a polyurethane geltype which is accurately described using non-linear (Mooney-Rivlin) material properties. The soft tissue of the residual limb is modelled as homogeneous, non-linear and hyperelastic and the bone structure within the residual limb is taken as rigid. The work gives an indication of how the stress induced by the process of donning the rigid socket is redistributed by the liner. Ultimately we hope to understand how the liner design might be modified to reduce discomfort. The ANSYS finite element code, version 5.6 is used.
Properties and Types of Significant Thermal Skin Burn Injuries
2018-02-01
Dry , red, painful Blanches with pressure (similar to sunburn) Generally heals within 6 days without scarring Superficial 2nd Degree...pressure only Almost always blisters Wet or waxy Dry Variable mottled colorization Heals in 3-9 weeks if no infection present Causes...Subcutaneous tissue Entire dermis destroyed No to low pain due to nerve destruction Waxy white to leathery gray to charred black skin Dry
76 FR 56279 - Airworthiness Directives; Airbus Model A318, A319, A320, and A321 Series Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-13
... to socket arcing at the Integrated Drive Generator (IDG) feeder cable pylon/nacelle interface connector. The fretting corrosion phenomenon was identified to be the root cause of the pin to socket arcing... products. The MCAI states: In service experience has shown a number of events of pin to socket arcing at...
Code of Federal Regulations, 2010 CFR
2010-01-01
... with ceiling fan light kits that have medium screw base sockets shall conform to the requirements... testing pin-based fluorescent lamps packaged with ceiling fan light kits that have pin-based sockets shall... base sockets, measure the efficacy, expressed in lumens per watt, in accordance with the test...
NASA Technical Reports Server (NTRS)
Aperlo, P. J. A.; Buck, P. A.; Weldon, V. A.
1981-01-01
In ball and socket joint where electrical insulator such as polytetrafluoroethylene is used as line to minimize friction, good electrical contact across joint may be needed for lightning protection or to prevent static-charge build-up. Electrical contact is maintained by ring of spring-loaded fingers mounted in socket. It may be useful in industry for cranes, trailers, and other applications requiring ball and socket joint.
Carbon nanotubes functionalized with sodium hyaluronate restore bone repair in diabetic rat sockets.
Sá, M A; Andrade, V B; Mendes, R M; Caliari, M V; Ladeira, L O; Silva, E E; Silva, G A B; Corrêa-Júnior, J D; Ferreira, A J
2013-07-01
We evaluated the effects of sodium hyaluronate (HY) and carbon nanotubes functionalized with HY (HY-CNT) on bone repair in the tooth sockets of diabetic rats. Diabetes was induced by streptozotocin (50 mg kg(-1) i.v.), and the sockets were divided into normal control, diabetic control, diabetic treated with HY (1%), and diabetic treated with HY-CNT (100 μg ml(-1)) groups. The sockets were analyzed according to the percentage of bone formation and the number of cell nuclei. The percentage of bone trabeculae was lower in diabetic control animals (11.16 ± 5.10% vs 41.92 ± 6.34% in normal animals) after 14 days. Treating diabetic animals with HY or HY-CNT significantly increased the percentage of neoformed trabeculae (HY: 29.43 ± 3.29%; HY-CNT: 36.90 ± 3.07%). Moreover, the sockets of diabetic animals had an increased number of cell nuclei and HY or HY-CNT reduced this parameter. Our results indicate that HY and HY-CNT restore bone repair in the tooth sockets of diabetic rats, suggesting that these biomaterials are potential adjuvant therapies for the management of diabetes. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Bone implant sockets made using three different procedures: a stability study in dogs
Campo, Julián
2012-01-01
Objective: This study compared the effects of three different methods of preparing bone implant sockets (drilling, osteotomes, and piezoelectric device) on osseointegration using resonance frequency analysis (RFA). Study Design: An experimental prospective study was designed. Material and Methods: Ten adult beagle dogs were studied. After 5 weeks, 23 out of 28 initially placed implants in the iliac crest were evaluated, comparing these three different procedures of bone implant socket. Student’s t-test (paired, two-tailed) was used to reveal differences among the three groups at each time point (SPSS 16.0, IL, USA). Results: After a 5-week healing period, the implants placed in sockets that were made using an osteotome or piezoelectric device were slightly more stable than those made by drilling. Reduced mechanical and heat injury to the bone is beneficial for maintaining and improving stability during the critical early healing period. Conclusion: Using RFA, there was evidence of a slight increase in implant stability in the iliac crest after 5 weeks of healing when the implant socket was made using a piezoelectric device or expansion procedure as compare with the drilling method. Key words:Bone implant sockets, drilling, osteotomes, piezoelectric, resonance frequency analysis, stability. PMID:24558558
Alveolar socket healing: what can we learn?
Araújo, Mauricio G; Silva, Cléverson O; Misawa, Mônica; Sukekava, Flavia
2015-06-01
Tooth extraction induces a series of complex and integrated local changes within the investing hard and soft tissues. These local alterations arise in order to close the socket wound and to restore tissue homeostasis, and are referred to as '"socket healing". The aims of the present report were twofold: first, to describe the socket-healing process; and, second, to discuss what can be learned from the temporal sequence of healing events, in order to improve treatment outcomes. The socket-healing process may be divided into three sequential, and frequently overlapping, phases: inflammatory; proliferative; and modeling/remodeling. Several clinical and experimental studies have demonstrated that the socket-healing process promotes up to 50% reduction of the original ridge width, greater bone resorption at the buccal aspect than at the lingual/palatal counterpart and a larger amount of alveolar bone reduction in the molar region. In conclusion, tooth extraction, once a simple and straightforward surgical procedure, should be performed in the knowledge that ridge reduction will follow and that further clinical steps should be considered to compensate for this, when considering future options for tooth replacement. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Al-Fakih, Ebrahim A.; Abu Osman, Noor Azuan; Eshraghi, Arezoo; Adikan, Faisal Rafiq Mahamd
2013-01-01
This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ∼0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction. PMID:23941909
Al-Fakih, Ebrahim A; Osman, Noor Azuan Abu; Eshraghi, Arezoo; Adikan, Faisal Rafiq Mahamd
2013-08-12
This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.
Piezoelectric Bimorphs' Characteristics as In-Socket Sensors for Transfemoral Amputees
El-Sayed, Amr M.; Hamzaid, Nur Azah; Osman, Noor Azuan Abu
2014-01-01
Alternative sensory systems for the development of prosthetic knees are being increasingly highlighted nowadays, due to the rapid advancements in the field of lower limb prosthetics. This study presents the use of piezoelectric bimorphs as in-socket sensors for transfemoral amputees. An Instron machine was used in the calibration procedure and the corresponding output data were further analyzed to determine the static and dynamic characteristics of the piezoelectric bimorph. The piezoelectric bimorph showed appropriate static operating range, repeatability, hysteresis, and frequency response for application in lower prosthesis, with a force range of 0–100 N. To further validate this finding, an experiment was conducted with a single transfemoral amputee subject to measure the stump/socket pressure using the piezoelectric bimorph embedded inside the socket. The results showed that a maximum interface pressure of about 27 kPa occurred at the anterior proximal site compared to the anterior distal and posterior sites, consistent with values published in other studies. This paper highlighted the capacity of piezoelectric bimorphs to perform as in-socket sensors for transfemoral amputees. However, further experiments are recommended to be conducted with different amputees with different socket types. PMID:25513823
Shokry, Mohamed; Aboelsaad, Nayer
2016-01-01
The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing. Material and Methods. This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively. Results. Test and control sites were compared using paired t-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results. Conclusion. Piezosurgery technique improves quality of patient's life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar. PMID:27597866
Bi, Xiaoping; Fan, Xianqun; Zhou, Huifang; Shi, Wodong; Xiao, Caiwen; Lin, Min; Li, Zhenkang
2011-05-01
Retinoblastoma is a common malignant intraocular tumor in childhood, and most patients require enucleation or exenteration even with irradiation. Severe anophthalmic orbits and atresic eye sockets are not rare. We conducted a retrospective study to evaluate the results of surgical management of reconstruction of severe anophthalmic orbits and atresic eye sockets with vascular anastomosed free dorsalis pedis flap transplantation. There were 5 patients (5 eyes) who underwent reconstructive surgery of severe anophthalmic orbits and atresic eye sockets after enucleation and irradiation of retinoblastoma in our hospital during the 3 years. All patients had enucleation and irradiation immediately after the retinoblastoma was diagnosed and had never worn artificial eyes because of the atresic eye sockets. Vascular anastomosed free dorsalis pedis flaps, whose dimensions were typically 6.5 × 5.5 cm(2), were transplanted to reconstruct the severe anophthalmic orbits and atresic eye sockets. The donor sites were covered by free abdominal skin flaps. All the vascular anastomosed free dorsalis pedis flaps were valid after more than 6 months of follow-up. And then all the 5 patients underwent secondary autogenous dermal fat implantation to augment the supraorbital area depression. After the 2-stage reconstruction surgery, the dimensions of the eye sockets were adequate, and all patients were able to wear their prosthesis and had a satisfactory cosmetic result. Implantation of alloplastic materials is not recommended because of insufficient blood supply of the irradiated orbital area.
Evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin.
Baslarli, Ozgur; Tumer, Celal; Ugur, Omer; Vatankulu, Betul
2015-01-01
The aim of this study was to determine whether the use of platelet rich fibrin (PRF) improved the healing of extraction sockets. A total of 20 patients with bilateral soft tissue impacted mandibular third molars were included in this study. The left and right third molars were extracted during the same session. Subsequently, the PRF membrane was randomly administered to one of the extraction sockets, whereas the contralateral sockets were left without treatment. On postoperative 30. and 90. days, panoramic images and bone scintigrams were taken to evaluate the bone healing between PRF-treated and non-PRF-treated sockets. Also, periodontal evaluation was performed in the same control sessions. Dependent group t test for paired samples was used for statistical analysis. The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 30 and 90 days postoperatively. Radio-opacity that can show the bone healing on panoramic images were measured by Image J programme and they did not differ significantly. Also periodontal values did not differ significantly. PRF might not lead to enhanced bone healing in impacted mandibular third molar extraction sockets 30 and 90 days after surgery. It is thought that PRF has the potential characteristics of an autologous fibrin matrix and can accelerate the healing. To better understand the effects of PRF on healing, further research is warranted with larger sample sizes.
Alveolar socket preservation with demineralised bovine bone mineral and a collagen matrix
2017-01-01
Purpose The aim of the present study was to evaluate the healing of post-extraction sockets following alveolar ridge preservation clinically, radiologically, and histologically. Methods Overall, 7 extraction sockets in 7 patients were grafted with demineralised bovine bone mineral and covered with a porcine-derived non-crosslinked collagen matrix (CM). Soft tissue healing was clinically evaluated on the basis of a specific healing index. Horizontal and vertical ridge dimensional changes were assessed clinically and radiographically at baseline and 6 months after implant placement. For histological and histomorphometric analysis, bone biopsies were harvested from the augmented sites during implant surgery 6 months after the socket preservation procedure. Results Clinically, healing proceeded uneventfully in all the sockets. A trend towards reduced horizontal and vertical socket dimensions was observed from baseline to the final examination. The mean width and height of resorption were 1.21 mm (P=0.005) and 0.46 mm (P=0.004), respectively. Histologically, residual xenograft particles (31.97%±3.52%) were surrounded by either newly formed bone (16.02%±7.06%) or connective tissue (50.67%±8.42%) without fibrous encapsulation. The CM underwent a physiological substitution process in favour of well-vascularised collagen-rich connective tissue. Conclusions Socket preservation using demineralised bovine bone mineral in combination with CM provided stable dimensional changes of the alveolar ridge associated with good re-epithelialisation of the soft tissues during a 6-month healing period. PMID:28861284
Madan, Rohit; Mohan, Ranjana; Bains, Vivek K; Gupta, Vivek; Singh, G P; Madan, Mani
2014-01-01
The aim of this study was to evaluate the extraction socket healing and dimensional changes following alveolar ridge preservation using polylactide and polyglycolide (PLA-PGA) sponge. Fifteen patients were selected for alveolar socket preservation immediately following tooth extraction. Monoradicular maxillary and mandibular teeth were evaluated. The selected sockets had intact sockets walls with a minimum of 7 mm of residual alveolar bone height. The test sites were thoroughly debrided and grafted with PLA-PGA sponge, while the control sites underwent natural healing. Computed tomography (CT) measurements were taken at baseline and 6 months. After 6 months of healing, final CT measurements were performed, and trephine core biopsy specimens were obtained for histologic analysis. Implants were placed immediately after biopsy harvesting. All subjects completed the study, and all sites healed without adverse events and allowed for implant placement. The mean difference in socket height, width, and density after 6 months was statistically significantly higher in the test sites compared with control sites. Clinical measurement at the midbuccal site of the alveolar socket showed a mean loss of 2.45 ± 0.67 mm in the control group, compared with a mean gain of 1.28 ± 0.58 mm in the test group. All test sites showed minimal ridge alterations, and statistically significant differences were observed between the test and control sites with respect to bone composition and horizontal and vertical bone loss, indicating that PLA-PGA sponge is suitable for alveolar ridge preservation.
[Pneumothorax following dry needling treatment: legal and ethical aspects].
Ronconi, Gianpaolo; De Giorgio, Fabio; Ricci, Eleonora; Maggi, Loredana; Spagnolo, Antonio G; Ferrara, Paola Emilia
2016-01-01
Trigger point "dry needling" is a technique used to treat myofascial pain. It involves using filiform needles which are inserted into muscles to give local pain relief. Few cases of serious adverse events following this treatment have been reported in the literature. In this paper we describe the case of a professional swimmer who developed pneumothorax after dry needling treatment and discuss the medicolegal and ethical aspects related to competencies and responsibilities of medical doctors and physiotherapists performing the procedure.
Rastegar, Shirvan; Baradaran Mahdavi, Sadegh; Hoseinzadeh, Babak; Badiei, Sajad
2018-01-01
Plantar fasciitis is a common cause of heel pain. Considering different interventions which are applied for patients with plantar fasciitis, dry needling is proposed as a new modality of treatment recently. The aim of this study is to evaluate the effectiveness of dry needling versus steroid injection for plantar fasciitis. Sixty-six patients were recruited to this single-blind clinical trial study. Participants were randomly allocated to receive 1 ml (40 mg) of Depo-Medrol (methylprednisolone acetate) or dry needling. They were followed up for 12 months and monitored for total perception of pain using the visual analogue scale (VAS), with data obtained in baseline and at three weeks, six weeks, three months, six months and one year after treatment. Mean VAS score before treatment was 6.96 ± 0.87 for the steroid group and 6.41 ± 0.83 for the dry-needling group (P value = 0.54). Steroid injection reduced VAS scores rapidly until three weeks after treatment compared with dry needling (0.32 ± 0.71 and 3.47 ± 1.32, respectively; P value < 0.001). However, patients who were underwent dry needling reported lower VAS scores at the end of follow-up compared with the steroid group (0.69 ± 0.93 and 2.09 ± 1.58, respectively; P value = 0.004). Over the long term, 82.3% and 17.6% of changes in pain were contributed to time since treatment and treatment method, respectively (P values < 0.001). Steroid injection can palliate plantar heel pain rapidly but dry needling can provide more satisfactory results for patients with plantar fasciitis in the long term.
Ghaeminia, H; Hoppenreijs, Th J M; Xi, T; Fennis, J P; Maal, T J; Bergé, S J; Meijer, G J
2017-01-01
The primary aim of the present study was to evaluate the effectiveness of postoperative irrigation of the socket with drinking tap water on inflammatory complications following lower third molar removal. A multicenter randomized controlled trial was carried out from June 2013 to June 2014. In one arm of the study, patients were instructed to irrigate the tooth socket and surgical site with a Monoject® Curved 412 Tip Syringe (Tyco/healthcare-Kendall, Mansfield, MA, USA) with tap water. In a second arm of the study, the standard postoperative instructions did not include irrigation instructions. The incidences of alveolar osteitis and wound infection were recorded for each group and analyzed by the Fisher's exact test. A total of 280 patients with 333 mandibular third molars were analyzed. According to the intention-to-treat (ITT) analysis, inflammatory complications occurred in 18 cases in the Monoject® group (11.4 %) compared to 34 cases (19.1 %) in the control group (p = 0.04). These complications were associated with significant worse outcomes regarding quality of life, pain, and trismus and caused significantly more missed days of work or study. Female gender, age >26, bone removal, deep impacted third molars, less experienced surgeons, and a high amount of debris at the surgical site were also identified as risk factors for developing inflammatory complications following lower third molar removal. Irrigation of the surgical site with drinking tap water using a curved syringe following removal of third molars is effective in reducing the risk of inflammatory complications. Water is a very accessible, cost-effective irrigant without side effects and the results from this study have proven that it can be used to reduce the risk of inflammatory complications and associated morbidity following lower third molar removal.
A preliminary open-label study of moclobemide treatment of pain disorder.
Pirildar, Sebnem; Sezgin, Ulku; Elbi, Hayriye; Uyar, Meltem; Zileli, Berna
2003-01-01
Antidepressants appear to be useful in the treatment of pain disorders, although the exact underlying mechanisms are unknown. In this preliminary study, we examined the utility of moclobemide, a reversible inhibitor of monoamine oxidase, in the treatment of 14 patients with pain disorder. The drug was administered in doses up to 450 mg/day for 8 weeks. Assessments of perceived pain and psychological evaluations of patients were carried out weekly using visual assessment scores of pain, depression, anxiety, sleep, difficulty in concentration, dry mouth, sweating, and fatigue. The therapeutic effects of moclobemide on the sense of pain, depression, anxiety, sleepless, difficulty in concentration, dry mouth, sweating, and fatigue were analyzed using a repeated measures analysis of variance. Our findings suggest that moclobemide therapy may be an effective, useful option in the management of perceived pain, in addition to its beneficial effects on depression, somatization, and anxiety.
Dunning, James; Butts, Raymond; Young, Ian; Mourad, Firas; Galante, Victoria; Bliton, Paul; Tanner, Michelle; Fernández-de-Las-Peñas, César
2018-05-28
To compare the effects of adding electrical dry needling into a manual therapy and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA). Two hundred and forty-two participants (n=242) with painful knee OA were randomized to receive 6 weeks of electrical dry needling, manual therapy and exercise (n=121) or manual therapy and exercise (n=121). The primary outcome was related-disability as assessed by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index at 3 months. Individuals receiving the combination of electrical dry needling, manual therapy and exercise experienced significantly greater improvements in related-disability (WOMAC: F=35.504; P<0.001) than those receiving manual therapy and exercise alone at 6 weeks and 3 months. Patients receiving electrical dry needling were 1.7 times more likely to have completely stopped taking medication for their pain at 3 months than individuals receiving manual therapy and exercise (OR: 1.6; 95%CI: 1.24-2.01; P=0.001). Based on the cutoff score of +5 on the Global Rating of Change (GROC), significantly (X =14.887; P<0.001) more patients (n=91, 75%) within the dry needling group achieved a successful outcome compared to the manual therapy and exercise group (n=22, 18%) at 3 months. Effect sizes were large (SMD>0.82) for all outcome measures in favor of the electrical dry needling group at 3 months. The inclusion of electrical dry needling into a manual therapy and exercise program was more effective for improving pain, function and related-disability than the application of manual therapy and exercise alone in individuals with painful knee OA. Therapy, Level 1b. Prospectively registered February 10, 2015 on http://www.clinicaltrials.gov (NCT02373631)This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.
2017-10-01
AWARD NUMBER: W81XWH-16-1-0785 TITLE: Prosthetic Smart Socket Technology to Improve Patient Interaction, Usability, Comfort, Fit and Function...2016 - 29 Sep 2017 4. TITLE AND SUBTITLE Prosthetic Smart Socket Technology to Improve Patient Interaction, Usability, Comfort, Fit and Function 5a...discomfort. 2. KEYWORDS: Provide a brief list of keywords (limit to 20 words). Prosthesis, prosthesis fit, technology , skin problems, amputee
Mello, C C; Lemos, C A A; Verri, F R; Dos Santos, D M; Goiato, M C; Pellizzer, E P
2017-09-01
The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for. The searches identified 30 eligible studies. A total of 3,049 implants were installed in a total of 1,435 patients with a mean age of 46.68 years and a minimum of 6 months of follow-up. The survival rate of delayed implants (98.38%) was significantly greater than immediate implants (95.21%) (p=.001). For the marginal bone loss (p=.32), implant stability quotients values (p=.44), and pocket probing depth (p=.94) there was no significant difference between the analysed groups. The immediate implants placed in fresh sockets should be performed with caution because of the significantly lower survival rates than delayed implants inserted in healed sockets. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
[The effect of osteogenic inducer on healing of tooth extraction sockets].
Chen, Junliang; Shan, Chuncheng; He, Yun; Xia, Delin
2012-06-01
To study the effect of osteogenic inducer (dexamethasone, beta-sodium glycerophosphate and Vitamin C) carried by gelatin sponge on healing and remodeling of tooth extraction sockets. Fifty rabbits were selected. After extracting the first premolars of bilateral maxillary, the right side tooth extraction sockets were filled with gelatin sponge containing osteogenic inducer as experimental side, tooth extraction sockets on left side were filled with gelatin sponge as control. Every ten rabbits were executed at the end of 1, 2, 4, 8, 12 weeks after tooth extraction. Bone density was measured through digital X-ray images. The specimens were examined by histology. The absorption height of alveolar bone at 12 weeks was measured. X-ray measurement showed that the bone density of experimental side was higher than that of control side at 2, 4, 8, 12 weeks, the difference had statistical significance (P<0.01). The histology examination showed that new bone formation in tooth extraction sockets of experimental side was earlier than that in control side. The absorptional height of alveolar bone had significant difference between experimental side and control side (P<0.01), of which experimental side was less. Filling the osteogenic inducer in tooth extraction sockets can promote the healing and new bone formation and prevent from alveolar bone absorption.
Hefferman, Gerald M; Zhang, Fan; Nunnery, Michael J; Huang, He
2015-04-01
In recent years, there has been an increased interest in recording high-quality electromyographic signals from within the sockets of lower-limb amputees. However, successful recording presents major challenges to both researchers and clinicians. This article details and compares four prototypical integrated socket-sensor designs used to record electromyographic signals from within the sockets of transfemoral amputees. Four prototypical socket-sensor configurations were constructed and tested on a single transfemoral amputee asked to perform sitting/standing, stair ascent/descent, and level ground walking. The number of large-amplitude motion artifacts generated using each prototype was quantified, the amount of skin irritation documented, and the comfort level of each assembly subjectively assessed by the amputee subject. Of the four configurations tested, the combination of a suction socket with integrated wireless surface electrodes generated the lowest number of large-amplitude motion artifacts, the least visible skin irritation, and was judged to be most comfortable by the amputee subject. The collection of high-quality electromyographic signals from an amputee's residual limb while maximizing patient comfort holds substantial potential to enhance neuromuscular clinical assessment and as a method of intuitive control of powered lower-limb prostheses. © The International Society for Prosthetics and Orthotics 2014.
Detection of Prosthetic Knee Movement Phases via In-Socket Sensors: A Feasibility Study
El-Sayed, Amr M.; Tan, Kenneth Y. S.; Abu Osman, Noor Azuan
2015-01-01
This paper presents an approach of identifying prosthetic knee movements through pattern recognition of mechanical responses at the internal socket's wall. A quadrilateral double socket was custom made and instrumented with two force sensing resistors (FSR) attached to specific anterior and posterior sites of the socket's wall. A second setup was established by attaching three piezoelectric sensors at the anterior distal, anterior proximal, and posterior sites. Gait cycle and locomotion movements such as stair ascent and sit to stand were adopted to characterize the validity of the technique. FSR and piezoelectric outputs were measured with reference to the knee angle during each phase. Piezoelectric sensors could identify the movement of midswing and terminal swing, pre-full standing, pull-up at gait, sit to stand, and stair ascent. In contrast, FSR could estimate the gait cycle stance and swing phases and identify the pre-full standing at sit to stand. FSR showed less variation during sit to stand and stair ascent to sensitively represent the different movement states. The study highlighted the capacity of using in-socket sensors for knee movement identification. In addition, it validated the efficacy of the system and warrants further investigation with more amputee subjects and different sockets types. PMID:25945365
Chen, J; He, Y; Shan, C; Pan, Q; Li, M; Xia, D
2015-10-01
An osteogenic inducer (OI) consisting of dexamethasone, vitamin C, and β-sodium glycerophosphate has the capacity to induce bone formation in vitro. The aim of this study was to assess the efficacy of the application of this OI on extraction socket healing. The bilateral first mandibular premolars were extracted from 75 New Zealand rabbits. Gelatin sponges carrying OI were implanted into the sockets. Sockets undergoing implantation of gelatin sponges alone were also evaluated, as well as non-implantation sockets. Specimens from each group were evaluated radiographically, histologically, and histomorphometrically using haematoxylin-eosin staining. Results showed earlier new bone formation and higher bone quality and quantity in the OI group compared to the other groups, and the differences were significant at 2, 4, 8, and 12 weeks postoperative. The OI significantly reduced the absorption of alveolar bone in terms of height; however, changes in the width were not significantly different between the three groups (P>0.05). The OI was shown to have a positive effect on healing of the tooth extraction sockets, was inexpensive, and was convenient to use during the operational procedure; therefore this could represent a promising implant material for human clinical application. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Arun, S; Kanagaraj, S
2016-06-01
A socket plays a vital role in giving the comfort to the amputees. However, the accumulation of heat inside the socket and its weight led to increase their metabolic cost. Hence, an attempt was made to increase the performance of the epoxy based sandwich composites to be used for the socket by reinforcing multiwalled carbon nanotubes (MWCNT), which was varied from 0.1 to 0.5wt%. It was homogeneously dispersed in epoxy to obtain the desired properties, where the enhancement of thermal conductivity, compressive strength and modulus of epoxy was observed to be 76.7%, 62.6% and 20.2%, respectively at 0.3wt% of MWCNT concentration beyond which the mechanical properties were found to be decreased. Hence, the epoxy, E-glass plain fabric, 2-10 layers of stockinet and 0.3wt% of MWCNT were used to prepare the sandwich composites. The flexural strength and thermal conductivity of 0.3wt% of MWCNT reinforced sandwich composites were found to be improved by 11.38±1.5% and 29.8±1.3% for the 4-10 layers and up to 10 layers of stockinet, respectively compared to unreinforced sandwich composites, which helped to reduce the weight of the socket and decrease the heat accumulation inside the socket. Thus, it is suggested to be explored for the application of socket in trans-femoral amputees to increase their comfort level by decreasing the metabolic cost. Copyright © 2015 Elsevier Ltd. All rights reserved.
Sequential healing of open extraction sockets. An experimental study in monkeys.
Scala, Alessandro; Lang, Niklaus P; Schweikert, Michael T; de Oliveira, José Américo; Rangel-Garcia, Idelmo; Botticelli, Daniele
2014-03-01
To describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made. The third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90 and 180 days was morphometrically studied. After 4 days of healing, a blood clot mainly occupied the extraction sockets, with the presence of an inflammatory cells' infiltrate. A void was confined in the central zones of the coronal and middle regions, in continuity with the entrance of the alveoli. At 10 days, the alveolus was occupied by a provisional matrix, with new bone formation lining the socket bony walls. At 20 days, the amount of woven bone was sensibly increasing. At 30 days, the alveolar socket was mainly occupied by mineralized immature bone at different stages of healing. At 90 and 180 days, the amount of mineralized bone decreased and substituted by trabecular bone and bone marrow. Bundle bone decreased from 95.5% at 4 days to 7.6% at 180 days, of the whole length of the inner alveolar surface. Modeling processes start from the lateral and apical walls of the alveolus, leading to the closure of the socket with newly formed bone within a month from extraction. Remodeling processes will follow the previous stages, resulting in trabecular and bone marrow formation and in a corticalization of the socket access. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
Gürbüzer, Bahadir; Pikdöken, Levent; Tunali, Mustafa; Urhan, Muammer; Küçükodaci, Zafer; Ercan, Feriha
2010-05-01
To evaluate the effect of platelet-rich fibrin (PRF) on the early bone healing process with bone scintigraphy based on technetium-99m methylene diphosphonate uptake in third molar extraction sockets. Fourteen patients with bilaterally soft tissue impacted third mandibular molars were included in the study. The right and left impacted third molars were surgically extracted in the same session. PRF was randomly administered into one of the extraction sockets, whereas the contralateral sockets were left without treatment. Four weeks after surgery, scintigrams were obtained to evaluate scintigraphic differences between PRF-treated and non-PRF-treated sockets. After completion of the clinical study, PRF samples were evaluated by light and scanning electron microscopy. The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 4 weeks postoperatively (P > .05). Abundant fibrin and inflammatory cells were observed by light microscopic examination of PRF samples. Scanning electron microscopic analysis of PRF revealed the existence of platelet aggregates in a fibrin network and crystalline particles on the outer surface of PRF. PRF might not lead to enhanced bone healing in soft tissue impacted mandibular third molar extraction sockets 4 weeks after surgery. PRF exhibits the potential characteristics of an autologous fibrin matrix. However, whether the presence of crystal-like particles on the outer surface of PRF alters bone healing should be investigated further. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Discharge and infection in retinoblastoma post-enucleation sockets
Mourits, Daphne L; Hartong, Dyonne T; Budding, Andries E; Bosscha, Machteld I; Tan, H Stevie; Moll, Annette C
2017-01-01
Purpose To investigate the causes and treatment options for socket discharge and infection in patients enucleated for retinoblastoma (Rb). Methods A questionnaire was filled out by (parents of) ocular prosthesis-wearing patients with a history of enucleation as treatment for Rb. We collected data on patients’ characteristics, cleaning habits of the prosthesis, frequency of socket irritation, discharge, and infection, and use of antibiotics. With ordinal logistic regression analysis, factors related to the outcome parameters (frequency of irritation, mucoid and purulent discharge) were identified. In a subset of young asymptomatic and symptomatic patients, a swab culture of the socket was performed to determine the presence of microorganisms. Results A total of 186 patients or their parents (mean age of the patients: 17.3 years, ranging from 0.8 to 88.3 years) filled out the questionnaire. Irritation, mucoid discharge, and purulent discharge were frequently (once a month or more often) experienced in 75 (39.5%), 127 (66.8%), and 15 (13.2%) sockets, respectively. Younger age was associated with a higher frequency of mucoid and purulent discharge. Radiation therapy, chemotherapy, gender, age at surgery, cleaning frequency, and nocturnal wear were not associated with the outcome parameters. In a subgroup of 26 patients, the sockets were swabbed and cultured. All symptomatic patients had a positive bacterial culture versus 15% (2/13) of the asymptomatic patients (P<0.001). Common cold was correlated with both symptoms and presence of bacteria. Haemophilus influenzae and Staphylococcus aureus were the species most frequently cultured. Conclusion Ocular prosthesis-wearing patients often experienced mucoid discharge, and less often irritation and socket infection. These complaints were found to decrease with increasing age, but did not seem to be influenced by cleaning or wearing habits. Symptomatic sockets, with and without discharge, were correlated with the presence of pathogenic bacteria for which local antibiotic treatment seemed effective in most cases. PMID:28280296
Cooper, Lyndon F; Reside, Glenn J; Raes, Filiep; Garriga, Joan Soliva; Tarrida, Luis Giner; Wiltfang, Jörg; Kern, Matthias; De Bruyn, Hugo
2014-01-01
This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm). After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets.
Discharge and infection in retinoblastoma post-enucleation sockets.
Mourits, Daphne L; Hartong, Dyonne T; Budding, Andries E; Bosscha, Machteld I; Tan, H Stevie; Moll, Annette C
2017-01-01
To investigate the causes and treatment options for socket discharge and infection in patients enucleated for retinoblastoma (Rb). A questionnaire was filled out by (parents of) ocular prosthesis-wearing patients with a history of enucleation as treatment for Rb. We collected data on patients' characteristics, cleaning habits of the prosthesis, frequency of socket irritation, discharge, and infection, and use of antibiotics. With ordinal logistic regression analysis, factors related to the outcome parameters (frequency of irritation, mucoid and purulent discharge) were identified. In a subset of young asymptomatic and symptomatic patients, a swab culture of the socket was performed to determine the presence of microorganisms. A total of 186 patients or their parents (mean age of the patients: 17.3 years, ranging from 0.8 to 88.3 years) filled out the questionnaire. Irritation, mucoid discharge, and purulent discharge were frequently (once a month or more often) experienced in 75 (39.5%), 127 (66.8%), and 15 (13.2%) sockets, respectively. Younger age was associated with a higher frequency of mucoid and purulent discharge. Radiation therapy, chemotherapy, gender, age at surgery, cleaning frequency, and nocturnal wear were not associated with the outcome parameters. In a subgroup of 26 patients, the sockets were swabbed and cultured. All symptomatic patients had a positive bacterial culture versus 15% (2/13) of the asymptomatic patients ( P <0.001). Common cold was correlated with both symptoms and presence of bacteria. Haemophilus influenzae and Staphylococcus aureus were the species most frequently cultured. Ocular prosthesis-wearing patients often experienced mucoid discharge, and less often irritation and socket infection. These complaints were found to decrease with increasing age, but did not seem to be influenced by cleaning or wearing habits. Symptomatic sockets, with and without discharge, were correlated with the presence of pathogenic bacteria for which local antibiotic treatment seemed effective in most cases.
Three-Dimensional Wiring for Extensible Quantum Computing: The Quantum Socket
NASA Astrophysics Data System (ADS)
Béjanin, J. H.; McConkey, T. G.; Rinehart, J. R.; Earnest, C. T.; McRae, C. R. H.; Shiri, D.; Bateman, J. D.; Rohanizadegan, Y.; Penava, B.; Breul, P.; Royak, S.; Zapatka, M.; Fowler, A. G.; Mariantoni, M.
2016-10-01
Quantum computing architectures are on the verge of scalability, a key requirement for the implementation of a universal quantum computer. The next stage in this quest is the realization of quantum error-correction codes, which will mitigate the impact of faulty quantum information on a quantum computer. Architectures with ten or more quantum bits (qubits) have been realized using trapped ions and superconducting circuits. While these implementations are potentially scalable, true scalability will require systems engineering to combine quantum and classical hardware. One technology demanding imminent efforts is the realization of a suitable wiring method for the control and the measurement of a large number of qubits. In this work, we introduce an interconnect solution for solid-state qubits: the quantum socket. The quantum socket fully exploits the third dimension to connect classical electronics to qubits with higher density and better performance than two-dimensional methods based on wire bonding. The quantum socket is based on spring-mounted microwires—the three-dimensional wires—that push directly on a microfabricated chip, making electrical contact. A small wire cross section (approximately 1 mm), nearly nonmagnetic components, and functionality at low temperatures make the quantum socket ideal for operating solid-state qubits. The wires have a coaxial geometry and operate over a frequency range from dc to 8 GHz, with a contact resistance of approximately 150 m Ω , an impedance mismatch of approximately 10 Ω , and minimal cross talk. As a proof of principle, we fabricate and use a quantum socket to measure high-quality superconducting resonators at a temperature of approximately 10 mK. Quantum error-correction codes such as the surface code will largely benefit from the quantum socket, which will make it possible to address qubits located on a two-dimensional lattice. The present implementation of the socket could be readily extended to accommodate a quantum processor with a (10 ×10 )-qubit lattice, which would allow for the realization of a simple quantum memory.
Biomechanical Analysis of a Filiform Mechanosensory Hair Socket of Crickets.
Joshi, Kanishka; Mian, Ahsan; Miller, John
2016-08-01
Filiform mechanosensory hairs of crickets are of great interest to engineers because of the hairs' highly sensitive response to low-velocity air-currents. In this study, we analyze the biomechanical properties of filiform hairs of the cercal sensory system of a common house cricket. The cercal sensory system consists of two antennalike appendages called cerci that are situated at the rear of the cricket's abdomen. Each cercus is covered with 500-750 flow sensitive filiform mechanosensory hairs. Each hair is embedded in a complex viscoelastic socket that acts as a spring and dashpot system and guides the movement of the hair. When a hair deflects due to the drag force induced on its length by a moving air-current, the spiking activity of the neuron that innervates the hair changes and the combined spiking activity of all hairs is extracted by the cercal sensory system. Filiform hairs have been experimentally studied by researchers, though the basis for the hairs' biomechanical characteristics is not fully understood. The socket structure has not been analyzed experimentally or theoretically from a mechanical standpoint, and the characterization that exists is mathematical in nature and only provides a very rudimentary approximation of the socket's spring nature. This study aims to understand and physically characterize the socket's behavior and interaction with the filiform hair by examining hypotheses about the hair and socket biomechanics. A three-dimensional computer-aided design (CAD) model was first created using confocal microscopy images of the hair and socket structure of the cricket, and then finite-element analyses (FEAs) based on the physical conditions that the insect experiences were simulated. The results show that the socket can act like a spring; however, it has two-tier rotational spring constants during pre- and postcontacts of iris and hair bulge due to its constitutive nonstandard geometric shapes.
Evora® chromium-cobalt dual mobility socket: results at a minimum 10 years' follow-up.
Leclercq, S; Benoit, J Y; de Rosa, J P; Tallier, E; Leteurtre, C; Girardin, P H
2013-12-01
The Evora chromium-cobalt alloy dual mobility socket claims to display a large articulation tribology different from that of stainless steel models, limiting the risk of intraprosthetic dislocation and wear. The present study reports a minimum of 10years' follow-up in a multicenter prospective series of 200 sockets previously reported on at 5years. The use of chromium-cobalt in dual mobility sockets provides a low rate of failure at 10years, especially as regards to osteolysis and intraprosthetic dislocation. Two hundred hydroxyapatite-coated molded chromium-cobalt sockets without titanium interface were implanted without cement in 194 patients with a mean age of 70 years (range, 32-91 years). Clinical results were assessed on Postel Merle d'Aubigné and Harris scores, plain radiographs and survival analysis. At a mean 11 years' follow-up (10-13 years), 56 patients had died and 31 were lost to follow-up. Four underwent surgical revision (3 femoral components, and 1 socket for migration at 9 years with complete disappearance of the hydroxyapatite). A total of 109 implants were analyzable in 107 patients with a mean age of 81 years (55-93 years). At follow-up, the mean Harris score was 90 (75-96) and the PMA score 16.3 (14-18). There were no cases of loosening (except for the case reoperated on at 9 years) and no acetabular radiolucency or cysts. There were 2 cases of non-evolutive femoral radiolucency and 10 of femoral granuloma, involving head size > 22 mm (P<0.0001) and a cemented titanium stem (P=0.004) as risk factors. There were no dislocations in the large or small articulation. Ten-year survival was 99% (95% CI: 97.3%-100%) with socket revision as censorship criterion. The absence of dislocation in both small and large articulations confirmed the efficacy of the dual mobility concept and suggested an advantage for chromium-cobalt sockets in reducing the rate of intraprosthetic dislocation and preventing blockage of the large articulation by a better performance in the friction couple. Granulomas were associated with wear in cemented titanium stems and with heads greater than 22 mm in diameter. Ten-year survival was 99% (censorship criterion: revision for socket failure); there was, however, one case of socket loosening with disappearance of the hydroxyapatite, indicating that surveillance should be continued in this cohort. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Prosthetics & Orthotics Manufacturing Initiative (POMI)
2012-12-21
could also allow for ‘virtual innovation,’ the testing of very novel socket designs without ever risking a patient’s well-being. In order to inform...that RL so that a computer aided design (CAD) socket can be fabricated for that individual. 3. Test the fit of the CAD socket through...developed a 4 layer braid laminate design that worked for manufacturing purposes but there was no testing of the laminate to determine if all strength
Measurement of Forces and Moments Transmitted to the Residual Limb
2008-08-01
leg and residual limb, the condition of your residual limb including touch and pressure sensation, and the type of components used in your prosthesis ...measured by a tri-axial transducer mounted on the pylon of a transtibial prosthesis distal to the socket can be used to estimate the intra-socket...alignment has been developed, and IRB approval has been obtained. 15. SUBJECT TERMS Amputees, prosthesis alignment, socket pressure, gait, force and moment
2012-01-01
Background A cursory review of the current socket preservation literatures well depicts the necessity of further esthetic considerations through the corrective procedures of the alveolar ridge upon and post extraction. A new technique has been described here is a rotational pedicle combined epithelialized and connective tissue graft (RPC graft) adjunct with immediate guided tissue regeneration (GBR) procedure. Results We reviewed this technique through a case report and discuss it’s benefit in compare to other socket preservation procedures. Conclusion The main advantages of RPC graft would be summarized as follows: stable primary closure during bone remodeling, saving or crating sufficient vestibular depth, making adequate keratinized gingiva on the buccal surface, and being esthetically pleasant. PMID:22540920
Vane segment support and alignment device
McLaurin, L.D.; Sizemore, J.D.
1999-07-13
A support and alignment assembly for supporting and aligning a vane segment is provided. The support and alignment assembly comprises a torque plate which defines an opening for receiving an eccentric pin and a locking end member for receiving a lock socket member. An eccentric pin adjustably supported by the torque plate opening for supporting and aligning a vane segment is provided. A lock socket member adapted to securely receive the eccentric pin and rotated therewith, and adjustably engage the torque plate locking end is provided. The lock socket member receives the eccentric pin, such that when the eccentric pin is adjusted to align the vane segment, the lock socket member engages the torque plate locking end to secure the vane segment in the desired position. 5 figs.
Vane segment support and alignment device
McLaurin, Leroy Dixon; Sizemore, John Derek
1999-01-01
A support and alignment assembly for supporting and aligning a vane segment is provided. The support and alignment assembly comprises a torque plate which defines an opening for receiving an eccentric pin and a locking end member for receiving a lock socket member. An eccentric pin adjustably supported by the torque plate opening for supporting and aligning a vane segment is provided. A lock socket member adapted to securely receive the eccentric pin and rotated therewith, and adjustably engage the torque plate locking end is provided. The lock socket member receives the eccentric pin, such that when the eccentric pin is adjusted to align the vane segment, the lock socket member engages the torque plate locking end to secure the vane segment in the desired position.
Daas, M.; Assaf, A.; Dada, K.; Makzoumé, J.
2015-01-01
Statement of Problem. Low scientific evidence is identified in the literature for combining implant placement in fresh extraction sockets with immediate function. Moreover, the few studies available on immediate implants in postextraction sites supporting immediate full-arch rehabilitation clearly lack comprehensive protocols. Purpose. The purpose of this study is to report outcomes of a comprehensive protocol using CAD-CAM technology for surgical planning and fabrication of a surgical template and to demonstrate that immediate function can be easily performed with immediate implants in postextraction sites supporting full-arch rehabilitation. Material and Methods. 14 subjects were consecutively rehabilitated (13 maxillae and 1 mandible) with 99 implants supporting full-arch fixed prostheses followed between 6 and 24 months (mean of 16 months). Outcome measures were prosthesis and implant success, biologic and prosthetic complications, pain, oedema evaluation, and radiographic marginal bone levels at surgery and then at 6, 12, 18, and 24 months. Data were analyzed with descriptive statistics. Results. The overall cumulative implant survival rate at mean follow-up time of 16 months was 97.97%. The average marginal bone loss was 0,9 mm. Conclusions. Within the limitations of this study, the results validate this treatment modality for full-arch rehabilitations with predictable outcomes and high survival rate after 2 years. PMID:26064119
Effects of Design Variants in Lower-Limb Prostheses on Gait Synergy
Pitkin, Mark R.
2016-01-01
A lower-limb prosthesis is the mechanical device with which an amputee’s residual limb interacts with the walking surface. The pressure and shear forces that affect the residuum due to prosthesis use are the sources of pain, residual-limb skin problems and gait deviations. Direct approaches to reducing these problems include improving fit, alignment technique and socket design as well as increasing cushioning with socket liners. A summary of typical malalignments and their consequences is presented. The malalignments are considered sources of excessive moments applied to the residuum, which simplifies the analysis of a patient’s gait. A better design of prosthetic joints could improve prosthetic gait. This article addresses the key mechanical parameter of prosthetic joints, namely the dependence “moment of resistance/angle of deflection.” A mathematical model has been developed that links stresses on the residuum in transtibial amputees with the moment of resistance in the prosthetic ankle at the critical gait phases. Analysis of the model yields a substantial decrease in stresses on the residuum during the most demanding, load-bearing phase of stance if the moment of resistance in the ankle is similar to that seen in the biological ankle joint. Gait study shows use of the experimental rolling-joint prosthetic foot more closely simulates normal gait synergy than the SACH foot. PMID:27087763
Lauche, Romy; Cramer, Holger; Choi, Kyung-Eun; Rampp, Thomas; Saha, Felix Joyonto; Dobos, Gustav J; Musial, Frauke
2011-08-15
In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas. Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT. A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. The trial was registered at clinicaltrials.gov (NCT01289964).
2011-01-01
Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas. Results Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT. Conclusions A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. Trial registration The trial was registered at clinicaltrials.gov (NCT01289964). PMID:21843336
Dry needling: a literature review with implications for clinical practice guidelines1
Dunning, James; Butts, Raymond; Mourad, Firas; Young, Ian; Flannagan, Sean; Perreault, Thomas
2014-01-01
Background: Wet needling uses hollow-bore needles to deliver corticosteroids, anesthetics, sclerosants, botulinum toxins, or other agents. In contrast, dry needling requires the insertion of thin monofilament needles, as used in the practice of acupuncture, without the use of injectate into muscles, ligaments, tendons, subcutaneous fascia, and scar tissue. Dry needles may also be inserted in the vicinity of peripheral nerves and/or neurovascular bundles in order to manage a variety of neuromusculoskeletal pain syndromes. Nevertheless, some position statements by several US State Boards of Physical Therapy have narrowly defined dry needling as an ‘intramuscular’ procedure involving the isolated treatment of ‘myofascial trigger points’ (MTrPs). Objectives: To operationalize an appropriate definition for dry needling based on the existing literature and to further investigate the optimal frequency, duration, and intensity of dry needling for both spinal and extremity neuromusculoskeletal conditions. Major findings: According to recent findings in the literature, the needle tip touches, taps, or pricks tiny nerve endings or neural tissue (i.e. ‘sensitive loci’ or ‘nociceptors’) when it is inserted into a MTrP. To date, there is a paucity of high-quality evidence to underpin the use of direct dry needling into MTrPs for the purpose of short and long-term pain and disability reduction in patients with musculoskeletal pain syndromes. Furthermore, there is a lack of robust evidence validating the clinical diagnostic criteria for trigger point identification or diagnosis. High-quality studies have also demonstrated that manual examination for the identification and localization of a trigger point is neither valid nor reliable between-examiners. Conclusions: Several studies have demonstrated immediate or short-term improvements in pain and/or disability by targeting trigger points (TrPs) using in-and-out techniques such as ‘pistoning’ or ‘sparrow pecking’; however, to date, no high-quality, long-term trials supporting in-and-out needling techniques at exclusively muscular TrPs exist, and the practice should therefore be questioned. The insertion of dry needles into asymptomatic body areas proximal and/or distal to the primary source of pain is supported by the myofascial pain syndrome literature. Physical therapists should not ignore the findings of the Western or biomedical ‘acupuncture’ literature that have used the very same ‘dry needles’ to treat patients with a variety of neuromusculoskeletal conditions in numerous, large scale randomized controlled trials. Although the optimal frequency, duration, and intensity of dry needling has yet to be determined for many neuromusculoskeletal conditions, the vast majority of dry needling randomized controlled trials have manually stimulated the needles and left them in situ for between 10 and 30 minute durations. Position statements and clinical practice guidelines for dry needling should be based on the best available literature, not a single paradigm or school of thought; therefore, physical therapy associations and state boards of physical therapy should consider broadening the definition of dry needling to encompass the stimulation of neural, muscular, and connective tissues, not just ‘TrPs’. PMID:25143704
Dry needling for the management of thoracic spine pain
Fernández-de-las-Peñas, César; Layton, Michelle; Dommerholt, Jan
2015-01-01
Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine. There is a lack of evidence reporting the presence of TrPs in the region of the thoracic spine, but clinical evidence suggests that TrPs can be a potential source of thoracic spine pain. The current paper discusses the role of TrPs in the thoracic spine and dry needling (DN) for the management of TrPs in the thoracic multifidi and longissimus thoracis. This paper also includes a brief discussion of the application of DN in other tissues such as tendons, ligaments and scars. PMID:26309385
New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine.
Rozenfeld, Evgeni; Kalichman, Leonid
2016-01-01
Cupping is an ancient technique used in treating pain and various disorders. Different techniques have been developed over time, however, applying a cup to create suction over a painful area, is common to all. Dry or fire cupping, used on the intact skin, leaves bluish circular hematomas. Recently, interest in cupping has re-emerged and subsequently, several studies have begun to investigate the mechanisms of cupping therapy. Mechanically, cupping increases blood circulation, whereas physiologically it activates the immune system and stimulates the mechanosensitive fibers, thus leading to a reduction in pain. There is initial scientific evidence that dry cupping is able to reduce musculoskeletal pain. Since cupping is an inexpensive, noninvasive and low-risk (if performed by a trained practitioner) therapeutic modality, we believe that it should be included in the arsenal of musculoskeletal medicine. It is essential to perform additional studies clarifying the biological mechanism and clinical effects of cupping. Copyright © 2015 Elsevier Ltd. All rights reserved.
Delayed replantation of rat teeth after use of reconstituted powdered milk as a storage medium.
dos Santos, Cláudia Letícia Vendrame; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sundefeld, Maria Lúcia Marçal Mazza; Negri, Márcia Regina
2009-02-01
Minimal extraoral dry storage period and moist storage for the avulsed tooth are identified as key steps for the treatment protocol of tooth replantation. Among the possible moist storage media, bovine milk has stood out because of its capacity of preserving the integrity of the periodontal ligament (PDL) fibers. This condition has attracted the attention to investigate the use of powdered milk, which is one of the presentation forms of bovine milk, as a feasible storage medium in cases of delayed tooth replantation. The aim of this study was to evaluate the healing process after delayed replantation of rat teeth stored in reconstituted powdered milk and long shelf-life (ultra high temperature) whole milk. Forty maxillary right rat incisors were assigned to four groups (n = 10): group I--the teeth were extracted and immediately replanted into theirs sockets; group II--the teeth were stored for 60 min in 200 ml of freshly reconstituted powdered milk; group III--the teeth were stored for 60 min in 200 ml of long shelf-life whole milk; group IV--the teeth were kept dry for the same time. All procedures were performed at room temperature. Next, the root canals of teeth in groups II, III, and IV were instrumented, filled with a calcium hydroxide-based paste, and replanted into their sockets. All animals received systemic antibiotic therapy and were killed by anesthetic overdose 60 days after replantation. The pieces containing the replanted teeth were removed, fixed, decalcified, and paraffin-embedded. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histomorphological analysis. There was statistically significant difference (P < 0.05) between groups I and IV regarding the presence of replacement resorption and PDL remnants on root surface. The powdered milk and long shelf-life whole milk presented similar results to each other and may be indicated as storage media for avulsed teeth.
Wood, Sarah A; Strait, David S; Dumont, Elizabeth R; Ross, Callum F; Grosse, Ian R
2011-07-07
Several finite element models of a primate cranium were used to investigate the biomechanical effects of the tooth sockets and the material behavior of the periodontal ligament (PDL) on stress and strain patterns associated with feeding. For examining the effect of tooth sockets, the unloaded sockets were modeled as devoid of teeth and PDL, filled with teeth and PDLs, or simply filled with cortical bone. The third premolar on the left side of the cranium was loaded and the PDL was treated as an isotropic, linear elastic material using published values for Young's modulus and Poisson's ratio. The remaining models, along with one of the socket models, were used to determine the effect of the PDL's material behavior on stress and strain distributions under static premolar biting and dynamic tooth loading conditions. Two models (one static and the other dynamic) treated the PDL as cortical bone. The other two models treated it as a ligament with isotropic, linear elastic material properties. Two models treated the PDL as a ligament with hyperelastic properties, and the other two as a ligament with viscoelastic properties. Both behaviors were defined using published stress-strain data obtained from in vitro experiments on porcine ligament specimens. Von Mises stress and strain contour plots indicate that the effects of the sockets and PDL material behavior are local. Results from this study suggest that modeling the sockets and the PDL in finite element analyses of skulls is project dependent and can be ignored if values of stress and strain within the alveolar region are not required. Copyright © 2011 Elsevier Ltd. All rights reserved.
Kim, Jung-Ju; Schwarz, Frank; Song, Hyun Young; Choi, YoonMi; Kang, Kyung-Rim; Koo, Ki-Tae
2017-06-01
This study aimed to evaluate the dynamics of newly bone formation and dimensional change in diseased extraction sockets using Bio-Oss ® Collagen with or without a collagen membrane. In six beagle dogs, right and left 3rd and 4th mandibular premolars were hemisected and the distal roots were removed. Combined endodontic-periodontic lesions were induced in all sites using black silk, collagen sponge, endodontic files, and application of Porphyromonas gingivalis. After 4 months, among 4 premolars, three teeth were randomly selected per dog and allocated to the following experimental groups: Control group (no treatment but debridement), Test 1 group (only Bio-Oss ® Collagen graft), and Test 2 group (Bio-Oss ® Collagen graft with a collagen membrane). After 7 months from the baseline, the beagle dogs were sacrificed for histomorphometric and Micro-CT analysis. The vertical distance between buccal and lingual crests in the Control group (2.22 ± 0.26 mm) and Test 2 group (1.80 ± 0.16 mm) was significantly different. The socket of the Test 2 group (27.04 ± 5.25%) was occupied by a greater quantity of bone graft compared to the Test 1 group (18.49 ± 2.11%). Ridge preservation in diseased extraction sockets could compensate for buccal bone resorption by contact osteogenesis surrounding the bone graft particles at the bucco-coronal area during socket healing, and the application of a collagen membrane at the entrance of the socket is useful for preserving graft material at the coronal part of the socket. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ennion, Liezel; Johannesson, Anton; Rhoda, Anthea
2017-10-01
Challenges exist with the provision of appropriate mobility assistive devices in rural areas. The use of the direct manufacturing prosthetic socket system is a possible solution to these challenges. The objective of this study was to test and explore the clients' perspectives with the application of this device. Within a mixed-methods approach, a longitudinal sequential explanatory design was applied. The Orthotic and Prosthetic User's Survey was administered to explore the use of the direct manufacturing prosthetic socket system in terms of function, health-related quality of life and client satisfaction. A conveniently selected sample of 21 individuals who suffered a unilateral trans-tibial amputation was included. Data were collected at 1, 3 and 6 months post fitting, and two focus group discussions were also administered. Of the 21 participants recruited, 11 returned for follow up. Although participants reported favourably about the prosthesis, their scores were generally worse than the norms with regard to function and quality of life. Participants highlighted the need for improvement in the cosmetic appearance of the prosthesis. The direct manufacturing prosthetic socket system could be considered as an alternative technique of socket manufacturing for individuals living in rural areas due to the shorter manufacture time and promising initial results, but further research on this topic with a bigger sample is recommended. Clinical relevance The direct manufacturing prosthetic socket system may be considered as an alternative to the traditional prosthetic socket manufacturing technique used in South Africa. As this device requires only one visit and therefore decreased travel by the patients to the hospitals, it could be applicable to more amputees who cannot return to hospital post discharge.
Childers, Walter Lee; Siebert, Steven
2016-12-01
Limb movement between the residuum and socket continues to be an underlying factor in limb health, prosthetic comfort, and gait performance yet techniques to measure this have been underdeveloped. Develop a method to measure motion between the residual limb and a transtibial prosthetic socket. Single subject, repeated measures with mathematical modeling. The gait of a participant with transtibial amputation was recorded using a motion capture system using a marker set that included arrays on the anterior distal tibia and the lateral epicondyle of the femur. The proximal or distal translation, anterior or posterior translation, and angular movements were quantified. A random Monte Carlo simulation based on the precision of the motion capture system and a model of the bone moving under the skin explored the technique's accuracy. Residual limb tissue stiffness was modeled as a linear spring based on data from Papaioannou et al. Residuum movement relative to the socket went through ~30 mm, 18 mm, and 15° range of motion. Root mean squared errors were 5.47 mm, 1.86 mm, and 0.75° when considering the modeled bone-skin movement in the proximal or distal, anterior or posterior, and angular directions, respectively. The measured movement was greater than the root mean squared error, indicating that this method can measure motion between the residuum and socket. The ability to quantify movement between the residual limb and the prosthetic socket will improve prosthetic treatment through the evaluation of different prosthetic suspensions, socket designs, and motor control of the prosthetic interface. © The International Society for Prosthetics and Orthotics 2015.
Choi, Jisoo; Shin, Dong-Ah; Kim, Sohee
2017-03-15
A three-dimensional finite element model of intact lumbar spine was constructed and four surgical finite element models implanted with ball-and-socket artificial discs with four different radii of curvature were compared. To investigate biomechanical effects of the curvature of ball-and-socket artificial disc using finite element analysis. Total disc replacement (TDR) has been accepted as an alternative treatment because of its advantages over spinal fusion methods in degenerative disc disease. However, the influence of the curvature of artificial ball-and-socket discs has not been fully understood. Four surgical finite element models with different radii of curvature of ball-and-socket artificial discs were constructed. The range of motion (ROM) increased with decreasing radius of curvature in extension, flexion, and lateral bending, whereas it increased with increasing radius of curvature in axial torsion. The facet contact force was minimum with the largest radius of curvature in extension, flexion, and lateral bending, whereas it was maximum with the largest radius in axial torsion. It was also affected by the disc placement, more with posterior placement than anterior placement. The stress in L4 cancellous bone increased when the radius of curvature was too large or small. The geometry of ball-and-socket artificial disc significantly affects the ROM, facet contact force, and stress in the cancellous bone at the surgical level. The implication is that in performing TDR, the ball-and-socket design may not be ideal, as ROM and facet contact force are sensitive to the disc design, which may be exaggerated by the individual difference of anatomical geometry. N/A.
De Meulemeester, Kayleigh E; Castelein, Birgit; Coppieters, Iris; Barbe, Tom; Cools, Ann; Cagnie, Barbara
2017-01-01
The aim of this study was to investigate short-term and long-term treatment effects of dry needling (DN) and manual pressure (MP) technique with the primary goal of determining if DN has better effects on disability, pain, and muscle characteristics in treating myofascial neck/shoulder pain in women. In this randomized clinical trial, 42 female office workers with myofascial neck/shoulder pain were randomly allocated to either a DN or MP group and received 4 treatments. They were evaluated with the Neck Disability Index, general numeric rating scale, pressure pain threshold, and muscle characteristics before and after treatment. For each outcome parameter, a linear mixed-model analysis was applied to reveal group-by-time interaction effects or main effects for the factor "time." No significant differences were found between DN and MP. In both groups, significant improvement in the Neck Disability Index was observed after 4 treatments and 3 months (P < .001); the general numerical rating scale also significantly decreased after 3 months. After the 4-week treatment program, there was a significant improvement in pain pressure threshold, muscle elasticity, and stiffness. Both treatment techniques lead to short-term and long-term treatment effects. Dry needling was found to be no more effective than MP in the treatment of myofascial neck/shoulder pain. Copyright © 2016. Published by Elsevier Inc.
2017-10-01
significantly lower trim lines, without ischial containment compared with a traditional interface. However, these alternative designs could compromise...overall function compared to the standard of care interface design . Therefore the focus of this clinical trial is to determine if the DS and Sub-I...alternative interface designs will improve socket comfort, residual limb health and function compared to the standard of care IRC interface design . 15
Chu, Stephen J; Sarnachiaro, Guido O; Hochman, Mark N; Tarnow, Dennis P
2015-01-01
Immediate implant therapy involving implants placed into intact Type 1 extraction sockets has become a consistent clinical technique. The classification of Type 2 extraction sockets, where the mucosal tissues are present but there is a midfacial osseous dehiscence defect, has been described according to the extent of the buccal bone plate absence. The literature has offered different techniques in the treatment of Type 2 sockets; however, the extent of the defect has never been defined or delineated. In this article, the authors describe a subclassification of Type 2 sockets: Type 2A presents with a dehiscence defect roughly 5 mm to 6 mm from the free gingival margin (FGM) involving the coronal one-third of the labial bone plate; Type 2B presents with a dehiscence defect involving the middle one-third of the labial plate, approximately 7 mm to 9 mm from the FGM; and in Type 2C the dehiscence defect involves the apical one-third of the labial osseous plate roughly 10 mm or greater from the FGM. The authors also offer a protocol and technique employing immediate implant placement, guided bone regeneration, and bone graft containment with a custom two-piece healing abutment that can lead to consistent and satisfactory clinical outcomes in low-smile-line patients. The treatment protocol and sequence is outlined in a clinical case presentation involving a Type 2B socket.
Lee, Jungwon; Park, Dueun; Koo, Ki-Tae; Seol, Yang-Jo; Lee, Yong-Moo
2018-04-03
This review aimed to investigate the feasibility of immediate implant placement in infected extraction sockets. We performed electronic and manual searches up to March 2017 to obtain data from randomized controlled trials (RCTs) and nonrandomized controlled clinical trials (CCTs). Using a fixed-effects model to assess the difference in survival rate (primary outcome), we evaluated the risk difference for immediate implant placement in infected and non-infected sites. We estimated the weighted mean differences (WMDs) of the change in marginal bone loss (MBL), probing depth (PD), modified bleeding index (mBI), marginal gingival level (MGL) and width of keratinized gingiva (WKG) at baseline and latest follow-up. In total, five studies (0 RCT, five CCTs) were included in the systematic review and three studies were included in the meta-analysis. The risk difference for immediate implant placement in an infected extraction socket compared with that in a non-infected socket was -0.02. WMDs for MBL, PD, mBI, MGL and WKG between the two groups were 0.32, 0.12, 0.07, -0.06, 0.20 and 0.51, respectively. No statistical differences were observed between the two groups, except for the change in WKG. Implants can be placed in infected extraction sockets after thorough socket debridement. For aesthetics, WKG should be considered when performing immediate implant placement in infected sites.
Tomasi, Cristiano; Donati, Mauro; Cecchinato, Denis; Szathvary, Isacco; Corrà, Enrico; Lindhe, Jan
2018-05-01
To examine if (i) characteristics of the fresh extraction socket site influenced subsequent dimensional alterations and (ii) placement of deproteinized bovine mineral in the socket affected volumetric change during healing. Twenty seven subjects and 28 extraction sites were included. Immediately after the removal of the tooth and after 6 months of healing, stone and virtual models of the jaw were produced. A cone beam computerized tomography scan was obtained immediately after extraction and the thickness of the buccal bone wall at the extraction site was measured. Extraction sites were randomly assigned to test or control group. In the test group, extraction sockets were filled with deproteinized bone mineral and covered with a collagen membrane. In the control group, only a collagen membrane was placed. The thickness of the buccal bone wall at the extraction site influenced the amount of volume reduction that occurred. Socket grafting influenced the degree of ridge diminution only at sites where the buccal bone wall was thin (≤ 1 mm). A graft comprised of collagen-enriched deproteinized bovine bone mineral, placed to fill extraction sockets failed to influence the overall diminution of the ridge that occurred during healing. The thickness of the buccal bone wall apparently had a significant influence on volumetric alterations of the edentulous ridge following tooth extraction. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
A pressure and shear sensor system for stress measurement at lower limb residuum/socket interface.
Laszczak, P; McGrath, M; Tang, J; Gao, J; Jiang, L; Bader, D L; Moser, D; Zahedi, S
2016-07-01
A sensor system for measurement of pressure and shear at the lower limb residuum/socket interface is described. The system comprises of a flexible sensor unit and a data acquisition unit with wireless data transmission capability. Static and dynamic performance of the sensor system was characterised using a mechanical test machine. The static calibration results suggest that the developed sensor system presents high linearity (linearity error ≤ 3.8%) and resolution (0.9 kPa for pressure and 0.2 kPa for shear). Dynamic characterisation of the sensor system shows hysteresis error of approximately 15% for pressure and 8% for shear. Subsequently, a pilot amputee walking test was conducted. Three sensors were placed at the residuum/socket interface of a knee disarticulation amputee and simultaneous measurements were obtained during pilot amputee walking test. The pressure and shear peak values as well as their temporal profiles are presented and discussed. In particular, peak pressure and shear of approximately 58 kPa and 27 kPa, respectively, were recorded. Their temporal profiles also provide dynamic coupling information at this critical residuum/socket interface. These preliminary amputee test results suggest strong potential of the developed sensor system for exploitation as an assistive technology to facilitate socket design, socket fit and effective monitoring of lower limb residuum health. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
Bramanti, Ennio; Norcia, Antonio; Cicciù, Marco; Matacena, Giada; Cervino, Gabriele; Troiano, Giuseppe; Zhurakivska, Khrystyna; Laino, Luigi
2018-06-01
The aim of this randomized controlled trial was to evaluate the survival rate, the marginal bone level, and the aesthetic outcome; at 3 years' follow-up, of dental implants placed into a high-esthetic aesthetic zone by comparing 2 techniques of postextraction implant with immediate loading: the socket shied technique and the conventional insertion technique.Several clinical studies suggested that the avulsion of a dental element causes dimensional alterations of both soft and hard tissues at the postextractive site. To increase the aesthetic outcomes, the "socket-shield technique" has been proposed. This method involves maintaining the vestibular root portion and immediate insertion of the dental implant in close proximity to the root.Patients enrolled in this study were randomized to receive a postextraction implant in the aesthetic zone, either with the socket shied technique or with the conventional insertion technique. Implant survival, marginal bone level, and the pink aesthetic score were the outcomes evaluated.Implant survival rate was 100% in both the groups at 3 years. Implants inserted with the socket shield technique showed better values of both marginal bone level and pink aesthetic score (P < 0.05).Although such preliminary results need to be further confirmed, the socket shield technique seems to be a safe surgical technique that allows an implant rehabilitation characterized by better aesthetic outcomes.
Fickl, Stefan; Schneider, David; Zuhr, Otto; Hinze, Marc; Ender, Andreas; Jung, Ronald E; Hürzeler, Markus B
2009-05-01
The aim of the study was to volumetrically assess alterations of the ridge contour after socket preservation and buccal overbuilding. In five beagle dogs, four extraction sites were subjected to one of the following treatments: Tx 1: The socket was filled with BioOss Collagen and covered with a free gingival autograft from the palate (SP). Tx 2: The buccal bone plate was forced into a buccal direction using a manual bone spreader and SP was performed. Tx 3: The buccal bone plate was forced into a buccal direction using a manual bone spreader; SP was performed. Tx 4: The socket was filled with BioOss Collagen and a combined free gingival/connective tissue graft was used to cover the socket and for buccal tissue augmentation. Impressions were obtained at baseline, 2 weeks and 4 months post-operatively. Casts were optically scanned and superimposed in one common coordinate system. Using digital image analysis, the volumetric differences per area among the different treatment time points and among the treatment groups were calculated. Four months after tooth extraction, no statistically significant differences with regard to the buccal volume per area could be assessed among the treatment groups. Overbuilding the buccal aspect in combination with socket preservation is not a suitable technique to compensate for the alterations after tooth extraction.
Socket with built-in valves for the interconnection of microfluidic chips to macro constituents.
Yang, Zhen; Maeda, Ryutaro
2003-09-26
This paper reports a prototype for a standard connector between a microfluidic chip and the macro world. This prototype demonstrate a fully functioning socket for a microchip to access the outside world by means of fluids, data signals and energy supply. It supports up to 10 channels for the input and output of liquids or gases, as well as compressed air or vacuum lines for pneumatic power lines. The socket has built-in valves for each flow channel. It also contains 28 pins for the connection of electrical signals and power. Built-in valves make it possible to control the flow in each channel independently. A chip ( 11.0 x 11.0 x 0.9 mm) can be mounted into or dismounted from the socket with one touch. The fluidic connectors of the socket are designed to contact vertically on the top of chip. And the electrical connectors (the spring array) of that physically support the chip and contact lead pads at the bottom of chip. No adhesives or solders are used at any contact points. The pressure limit for the connection of working fluids was 0.2 MPa and the current limit for the electrical connections was 1 A. This socket supports both serial and parallel processing applications. It exhibits great potential for developing microfluidic systems efficiently.
... of the joint, is called the condyle. The socket is called the articular fossa. Between the condyle ... that is located between the jawbone and the socket. A displaced disk may produce clicking or popping ...
Rosenthal, Perry; Borsook, David
2016-01-01
As the biological alarm of impending or actual tissue damage, pain is essential for our survival. However, when it is initiated and/or sustained by dysfunctional elements in the nociceptive system, it is itself a disease known as neuropathic pain. While the critical nociceptive system provides a number of protective functions, it is unique in its central role of monitoring, preserving and restoring the optical tear film in the face of evaporative attrition without which our vision would be non-functional. Meeting this existential need resulted in the evolution of the highly complex, powerful and sensitive dry eye alarm system integrated in the peripheral and central trigeminal sensory network. The clinical consequences of corneal damage to these nociceptive pathways are determined by the type and location of its pathological elements and can range from the spectrum known as dry eye disease to the centalised oculofacial neuropathic pain syndrome characterised by a striking disparity between the high intensity of symptoms and paucity of external signs. These changes parallel those observed in somatic neuropathic pain. When seen through the neuroscience lens, diseases responsible for inadequately explained chronic eye pain (including those described as dry eye) can take on new meanings that may clarify long-standing enigmas and point to new approaches for developing preventive, symptomatic and disease-modifying interventions for these currently refractory disorders. PMID:25943558
Cordasco, Frank A
2018-05-01
I believe that the distal femoral approach for anterior cruciate ligament reconstruction in the skeletally immature athlete with 3 to 6 years of remaining growth is best performed with an all-inside, all-epiphyseal technique using sockets rather than an outside-in approach creating tunnels. A shorter socket rather than a longer tunnel exposes a smaller surface area of the lateral distal femoral physis to potential compromise and resultant valgus malalignment. In addition, exiting the lateral femoral aspect of the epiphysis with a full-diameter tunnel as compared with a smaller diameter drill hole used to prepare a socket places the posterior articular cartilage, the lateral collateral ligament and anterolateral ligament footprints, and the popliteus tendon insertion at risk. My preference for sockets is also related to my belief that they provide a superior biologic milieu for graft incorporation compared with a full-length tunnel with the attendant violation of the lateral femoral cortex of the epiphysis. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Al-Fakih, Ebrahim; Arifin, Nooranida; Pirouzi, Gholamhossein; Mahamd Adikan, Faisal Rafiq; Shasmin, Hanie Nadia; Abu Osman, Noor Azuan
2017-08-01
This paper presents a fiber Bragg grating (FBG)-instrumented prosthetic silicone liner that provides cushioning for the residual limb and can successfully measure interface pressures inside prosthetic sockets of lower-limb amputees in a simple and practical means of sensing. The liner is made of two silicone layers between which 12 FBG sensors were embedded at locations of clinical interest. The sensors were then calibrated using a custom calibration platform that mimics a real-life situation. Afterward, a custom gait simulating machine was built to test the liner performance during an amputee's simulated gait. To validate the findings, the results were compared to those obtained by the commonly used F-socket mats. As the statistical findings reveal, both pressure mapping methods measured the interface pressure in a consistent way, with no significant difference (P-values ≥0.05). This pressure mapping technique in the form of a prosthetic liner will allow prosthetics professionals to quickly and accurately create an overall picture of the interface pressure distribution inside sockets in research and clinical settings, thereby improving the socket fit and amputee's satisfaction.
Hamada, Yusuke; Prabhu, Srividya; John, Vanchit
2016-01-01
As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as "erratic healing," may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications.
Prabhu, Srividya
2016-01-01
As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as “erratic healing,” may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications. PMID:27807485
NASA Astrophysics Data System (ADS)
Tabik, S.; Romero, L. F.; Mimica, P.; Plata, O.; Zapata, E. L.
2012-09-01
A broad area in astronomy focuses on simulating extragalactic objects based on Very Long Baseline Interferometry (VLBI) radio-maps. Several algorithms in this scope simulate what would be the observed radio-maps if emitted from a predefined extragalactic object. This work analyzes the performance and scaling of this kind of algorithms on multi-socket, multi-core architectures. In particular, we evaluate a sharing approach, a privatizing approach and a hybrid approach on systems with complex memory hierarchy that includes shared Last Level Cache (LLC). In addition, we investigate which manual processes can be systematized and then automated in future works. The experiments show that the data-privatizing model scales efficiently on medium scale multi-socket, multi-core systems (up to 48 cores) while regardless of algorithmic and scheduling optimizations, the sharing approach is unable to reach acceptable scalability on more than one socket. However, the hybrid model with a specific level of data-sharing provides the best scalability over all used multi-socket, multi-core systems.
... This type of implant is an artificial hip socket that is created by fitting a metal ball ... particles (ions) can get released into the hip socket and sometimes the bloodstream, causing cobalt toxicity. This ...
... the opening at the end of the shoulder blade, called the socket. This type of joint allows ... head. The socket part (glenoid) of your shoulder blade will be replaced with a smooth plastic shell ( ...
Vane segment support and alignment device
DOE Office of Scientific and Technical Information (OSTI.GOV)
McLaurin, L.D.; Sizemore, J.D.
1999-07-13
A support and alignment assembly for supporting and aligning a vane segment is provided. The support and alignment assembly comprises a torque plate which defines an opening for receiving an eccentric pin and a locking end member for receiving a lock socket member. An eccentric pin adjustably supported by the torque plate opening for supporting and aligning a vane segment is provided. A lock socket member adapted to securely receive the eccentric pin and rotated therewith, and adjustably engage the torque plate locking end is provided. The lock socket member receives the eccentric pin, such that when the eccentric pinmore » is adjusted to align the vane segment, the lock socket member engages the torque plate locking end to secure the vane segment in the desired position. 5 figs.« less
... top of the thighbone (femoral head) and its socket (acetabulum) in the pelvic bone. It can be ... hip, the femoral head rests comfortably in its socket. In babies with DDH, the femoral head moves ...
... and pituitary gland for neurosurgeons, or to the orbits (eye sockets) for certain ophthalmology procedures. Each individual ... that the sinuses are located next to the orbits (eye sockets) and directly beneath the bottom of ...
2016-12-01
of the frame from the combined image files and ensure total contact between the frame geometry, ultimately modeled independently as a solid, and...fitting with a rigid PETG check socket to ensure correct volumes and total contact at the distal end has been achieved, a second check socket can be...from dynamically conforming to changes in residual limb shape and volume during gait (Sanders, 2009). The ensuing separation (i.e. loss of contact
Ball-and-Socket Joint Can Be Disassembled
NASA Technical Reports Server (NTRS)
Totah, R. S.
1982-01-01
Ball-and-socket joint originally developed for construction of large platforms in zero g could be used in such Earth-based temporary structures as scaffolding, camping equipment, tent posts, trade shows and displays. New joint consists of a socket mounted on central hub or union and ball-ended bolt or fitting mounted at end of a column or any structural member. Unit is self-contained, requires no loose hardware and is engaged or disengaged without tools manually, or remotely by a manipulator.
Autologous Platelet-rich Plasma after Third Molar Surgery
Gandevivala, Adil; Sangle, Amit; Shah, Dinesh; Tejnani, Avneesh; Sayyed, Aatif; Khutwad, Gaurav; Patel, Arpit Arunbhai
2017-01-01
Aim and Objective: The aim of this study is to compare the efficacy of autologous platelet-rich plasma (PRP) in the third molar impactions, with respect to: pain, swelling, healing, and periodontal status distal to the second molar in patients who need surgical removal of bilateral impacted mandibular third molars. Materials and Methods: Twenty-five patients of both sexes aged between 16 and 60 years who required bilateral surgical removal of their impacted third molars and met the inclusion criteria were included in the study. After surgical extraction of the third molar, primary closure was performed in the control group, whereas PRP was placed in the socket followed by primary closure in the case group. The outcome variables were pain, swelling, wound healing, and periodontal probe depth that were follow-up period of 2 months. Quantitative data are presented as mean. Statistical significance was checked by t-test. Results: There was a difference in the pain (0.071) and facial swelling (0.184), reduction between test and control on day 3, but it was not found to be significant. Periodontal pocket depth (0.001) and wound healing (0.001) less in case group compared with the control group was found to be significant. Conclusion: The use of PRP lessens the severity of immediate postoperative sequelae and decreases preoperative pocket depth. PMID:29264293
Alzahrani, Ahmed Abdullah; Murriky, Afraa; Shafik, Sami
2017-10-01
The aim of this study was to evaluate clinically and radiographically, extraction socket healing using autologous platelet rich fibrin (PRF). Twenty-four subjects needing single tooth simple extractions were selected. Twenty-four extraction sockets were divided into test group (PRF, n = 12) and control group (blood clot, n = 12). PRF was prepared with blood drawn from individuals after extraction using standard technique. PRF was placed in test group sockets followed by pressure application and figure 8 sutures. Sockets in control group were allowed to heal in the presence of blood clot and received a figure 8 suture. Ridge width was assessed using cast analysis with the help of acrylic stent and a pair of calipers. Radiographic analysis of socket surface area was performed using computer graphic software program. The clinical follow up assessments were performed at 1, 4 and 8 weeks. Collected data was assessed using ANOVA and multiple comparisons test. Subjects were aged between 25 and 50 (mean 37.8) years, including 15 females. The mean horizontal ridge width for sockets in the test group were 11.70 ± 2.37 mm, 11.33 ± 2.30 mm and 10.97 ± 2.33 mm at 1, 4 and 8 weeks respectively. Ridge width proportions were significantly higher among test group as compared to control group between baseline to 4 and 8 weeks respectively. The mean radiographic bone fill (RBF) percentage in the test group, was 74.05 ± 1.66%, 81.54 ± 3.33% and 88.81 ± 1.53% at 1, 4 and 8 weeks respectively. The mean RBF was significantly higher in the test group than control group at all time intervals. The study outcomes demonstrate that the use of PRF accelerate socket wound healing after tooth extraction as noticed by increased bone fill and reduced alveolar bone width resorption using clinical and radiographic methods.
46 CFR 56.15-1 - Pipe joining fittings.
Code of Federal Regulations, 2013 CFR
2013-10-01
... subpart 50.25 of this subchapter are acceptable for use in piping systems. (b) Threaded, flanged, socket-welding, buttwelding, and socket-brazing pipe joining fittings, made in accordance with the applicable...
46 CFR 56.15-1 - Pipe joining fittings.
Code of Federal Regulations, 2011 CFR
2011-10-01
... subpart 50.25 of this subchapter are acceptable for use in piping systems. (b) Threaded, flanged, socket-welding, buttwelding, and socket-brazing pipe joining fittings, made in accordance with the applicable...
46 CFR 56.15-1 - Pipe joining fittings.
Code of Federal Regulations, 2014 CFR
2014-10-01
... subpart 50.25 of this subchapter are acceptable for use in piping systems. (b) Threaded, flanged, socket-welding, buttwelding, and socket-brazing pipe joining fittings, made in accordance with the applicable...
46 CFR 56.15-1 - Pipe joining fittings.
Code of Federal Regulations, 2012 CFR
2012-10-01
... subpart 50.25 of this subchapter are acceptable for use in piping systems. (b) Threaded, flanged, socket-welding, buttwelding, and socket-brazing pipe joining fittings, made in accordance with the applicable...
Dislocated Shoulder: Symptoms and Causes
... arm bone pops out of the cup-shaped socket that's part of your shoulder blade. The shoulder ... your upper arm bone out of your shoulder socket. Partial dislocation — in which your upper arm bone ...
Bakhshalian, Neema; Freire, Marcelo; Min, Seiko; Wu, Ivy; Zadeh, Homayoun H
A total of 68 extraction sockets were grafted with anorganic bovine bone mineral and covered by dense polytetrafluoroethylene membrane. Quantitative analysis of three-dimensional microcomputed tomography imaging of core samples retrieved after a mean of 21.0 ± 14.2 weeks revealed 40.1% bone volume fraction (bone volume [BV]/total volume [TV]) and 12% residual graft. Evidence of de novo bone formation was observed in the form of discrete islands of newly formed bone in direct apposition to graft particles, separated from parent bone. Anterior sockets exhibited a significantly higher percentage of residual graft compared to premolar sockets (P = .05). The BV/TV and percentage of residual graft correlated well with histomorphometric analysis of the same sites, but not with implant outcomes.
The possible nature of socket stars in H II regions
DOE Office of Scientific and Technical Information (OSTI.GOV)
Castelaz, M.W.
1990-01-01
Close inspection of faint stars (V of about 14 mag) in H II regions show that they appear to be surrounded by circumstellar envelopes of about 10 arcsecs in diameter (as reported by Feibelman in 1989). The present premise is that the sockets are envelopes of obscuring dust which should emit a measurable amount of infrared radiation based on a simple thermal equilibrium model. A search of literature shows that, of 36 socket stars listed by Feibelman, 17 have been measured in the infrared. Of the 17, 14 show excess IR emission. This is very strong evidence that the socketmore » stars are really stars with circumstellar envelopes. Socket stars may be a new type of astronomical object or well-known astronomical objects in environments or evolutionary states not previously seen. 22 refs.« less
Robin, Brett N; Lubowitz, James H
2014-10-01
Anterior cruciate ligament (ACL) femoral socket techniques have distinct advantages and disadvantages when considering the following techniques: transtibial, anteromedial portal, outside-in, and outside-in retroconstruction. There is no one perfect technique and we have an incomplete understanding of anatomical, biomechanical, isometry, stability, and clinical outcomes. Our primary focus is transtibial technique for creating the ACL femoral socket. Advantages include less invasive, isometric graft placement, stable Lachman exam, and minimal graft impingement with the tunnel and notch. Disadvantages include nonanatomic vertical graft placement that can cause rotational instability and positive pivot shift, interference screw divergence, graft-tunnel length mismatch, femoral socket constraint, posterior cruciate ligament impingement, and a short, oblique tibial tunnel that may undermine the medial plateau in an attempt to achieve anatomic ACL reconstruction. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Liu, Chang; Wu, Zhe; Sun, Hong-chen
2009-01-01
Aim To determine the effect of local simvastatin application on the mRNA expression level of transforming growth factor-β1 (TGF-β1), bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) in the tooth sockets of rat. Methodology Forty-eight male Wistar rats were randomly divided into experimental and control groups (n=24). Polylactic acid/polyglycolic acid copolymer carriers, with or without simvastatin, were implanted into extraction sockets of right mandibular incisors. The expression of TGF-β1, BMP-2 and VEGF mRNA was determined by in situ hybridization in the tooth extraction socket at five days, one week, two weeks and four weeks after implantation. Results The fusiform stroma cells in the tooth extraction socket began to express TGF-β1, BMP-2 and VEGF mRNA in both experimental and control groups from one week after tooth extraction until the end of experiment. The expression of TGF-β1 and BMP-2 mRNA in the experimental group was significantly up-regulated after one, two and four weeks, and expression of VEGF mRNA was significantly increased after one and two weeks compared with that in the control group. Conclusion The findings indicate that local administration of simvastatin can influence alveolar bone remodeling by regulating the expression of a school of growth factors which are crucial to osteogenesis in the tooth extraction socket. PMID:20687301
Periapical cemento-osseous dysplasia: clinicopathological features.
Roghi, Marco; Scapparone, Chiara; Crippa, Rolando; Silvestrini-Biavati, Armando; Angiero, Francesca
2014-05-01
Periapical cemento-osseous dysplasia (PCOD) is a rare benign lesion, often asymptomatic, in which fibrous tissue replaces the normal bone tissue, with metaplasic bone and neo-formed cement. We present a rare case of mandibular PCOD in a woman of 55 years, who presented with moderate swelling and mobility of teeth 32-33-34. Endoral radiography showed that these teeth had been devitalized; they had deep periodontal pockets and marked radicular radiotransparency; the root apices exhibited mixed radiotransparency and radio-opacity. Clinical and radiographical findings led to a diagnosis of periapical rarefying osteitis, and the three teeth were thus extracted. Due to the persistence of swelling and slight pain post-extraction, a cone-beam computed tomographic scan was taken; this showed a mixed radiotransparent and radio-opaque lesion in the area of the extracted teeth. A bone biopsy of the affected area was taken for histopathological evaluation; a diagnosis of PCOD was rendered. This case demonstrates the importance of a full investigation when a patient presents after tooth extraction with non-healing socket, pain, and swelling. A multidisciplinary approach is required to manage these rare cases.
Aridici, Rifat; Yetisgin, Alparslan; Boyaci, Ahmet; Tutoglu, Ahmet; Bozdogan, Erol; Sen Dokumaci, Dilek; Kilicaslan, Nihat; Boyaci, Nurefsan
2016-10-01
The aim of this study was to compare the therapeutic efficacy of high-power pain threshold (HPPT) ultrasound therapy applied to the trigger points and dry needling (DN) in myofascial pain syndrome. Sixty-one patients were randomly assigned to an HPPT (n = 30) and dry needling (n = 31) groups. The primary outcome measures were the Visual Analog Scale (VAS) and Neck Pain and Disability Scale (NPDS), both at 1 week and 4 weeks after treatment. The secondary outcome measures were the number of painful trigger points, range of the tragus-acromioclavicular joint, the Short Form-36, the Beck Depression Inventory, the Beck Anxiety Inventory, and sonoelastographic tests after a 1-week treatment. More improvement was seen in anxiety in the HPPT group (P < 0.05). However, no significant differences were found between the groups with regard to other parameters (P > 0.05). A decrease in tissue stiffness was only seen in the HPPT group (P < 0.05). Significant posttreatment improvements were seen on all clinical scales in both groups (P < 0.05). After a treatment period of 4 weeks, a significant improvement was also observed on the visual analog scale and NPDS (P < 0.05). Our study favors the efficacy of both treatment methods in myofascial pain syndrome. Although a significant decrease was shown in tissue stiffness with HPPT, neither of these treatments had an apparent superiority.
Rha, Dong-wook; Park, Gi-Young; Kim, Yong-Kyun; Kim, Min Tae; Lee, Sang Chul
2013-02-01
To compare the effects of platelet-rich plasma injection with those of dry needling on shoulder pain and function in patients with rotator cuff disease. A single-centre, prospective, randomized, double-blinded, controlled study. University rehabilitation hospital. Thirty-nine patients with a supraspinatus tendon lesion (tendinosis or a partial tear less than 1.0 cm, but not a complete tear) who met the inclusion criteria recruited between June 2010 and February 2011. Two dry needling procedures in the control group and two platelet-rich plasma injections in the experimental group were applied to the affected shoulder at four-week intervals using ultrasound guidance. The Shoulder Pain and Disability Index, passive range of motion of the shoulder, a physician global rating scale at the six-month follow-up, adverse effects monitoring and an ultrasound measurement were used as outcome measures. The clinical effect of the platelet-rich plasma injection was superior to the dry needling from six weeks to six months after initial injection (P < 0.05). At six months the mean Shoulder Pain and Disability Index was 17.7 ± 3.7 in the platelet-rich plasma group versus 29.5 ± 3.8 in the dry needling group (P < 0.05). No severe adverse effects were observed in either group. Autologous platelet-rich plasma injections lead to a progressive reduction in the pain and disability when compared to dry needling. This benefit is certainly still present at six months after treatment. These findings suggest that treatment with platelet-rich plasma injections is safe and useful for rotator cuff disease.
Al-Fakih, Ebrahim; Arifin, Nooranida; Pirouzi, Gholamhossein; Mahamd Adikan, Faisal Rafiq; Shasmin, Hanie Nadia; Abu Osman, Noor Azuan
2017-08-01
This paper presents a fiber Bragg grating (FBG)-instrumented prosthetic silicone liner that provides cushioning for the residual limb and can successfully measure interface pressures inside prosthetic sockets of lower-limb amputees in a simple and practical means of sensing. The liner is made of two silicone layers between which 12 FBG sensors were embedded at locations of clinical interest. The sensors were then calibrated using a custom calibration platform that mimics a real-life situation. Afterward, a custom gait simulating machine was built to test the liner performance during an amputee's simulated gait. To validate the findings, the results were compared to those obtained by the commonly used F-socket mats. As the statistical findings reveal, both pressure mapping methods measured the interface pressure in a consistent way, with no significant difference (P-values ≥0.05). This pressure mapping technique in the form of a prosthetic liner will allow prosthetics professionals to quickly and accurately create an overall picture of the interface pressure distribution inside sockets in research and clinical settings, thereby improving the socket fit and amputee's satisfaction. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).
Congenital anophthalmia: current concepts in management.
Quaranta-Leoni, Francesco M
2011-09-01
The introduction of hydrogel socket and orbital expanders has modified the approach towards the rehabilitation of congenital anophthalmia. This study highlights the most recent advances for the treatment of congenital anophthalmia based on personal experience and the review of recent literature. Hydrogel socket expanders may be positioned as an out-patient procedure with topical anaesthesia, using cyanoacrylate glue as opposed to temporary tarsorraphy. Increased orbital volume has been confirmed by computed tomography (CT) scan or magnetic resonance imaging (MRI) following early dermis-fat graft in children with congenital anophthalmia. An orbital tissue expander made of an inflatable silicone globe sliding on a titanium T-plate and secured to the lateral orbital rim appears to be effective to stimulate orbital bone growth and development. Congenital anophthalmia has a complex cause with both genetic and environmental factors involved. The ideal treatment is simultaneous expansion of the eyelids, socket and orbital bones, and it should begin after birth as soon as possible. Socket expansion with self-inflating expanders is a useful technique, although custom-made conformers may produce similar results. Dermis-fat grafts are another reasonable option as an orbital implant, following adequate lid and socket expansion.
Conjunctival Blue Naevus in an Anophthalmic Socket.
Quhill, Hibba; Rundle, Paul A; Mudhar, Hardeep Singh
2017-09-01
To describe an unusual brown pigmented lesion of the conjunctiva in an anophthalmic socket in a 16-year-old male. A 16-year-old male patient presented with socket irritation whilst wearing an artificial eye due to meibomian gland dysfunction. An area of flat, subepithelial, dark brown pigmentation with irregular and indistinct borders on the bulbar conjunctiva of the anophthalmic socket was seen. The patient believed it had been present for at least 2 years. His past ocular history was of childhood trauma to the right eye at the age of 9 years, and he underwent primary enucleation and hydroxyapatite orbital implant insertion at that time. Unfortunately, the implant extruded and was removed a year later. An incisional biopsy of the pigmented lesion showed a conjunctival, subepithelial bland spindle cell melanocytic lesion, with uniform-sized and -shaped melanosomes. Immunohistochemistry showed the cells to express Melan A and HMB45 and they were negative for CD68 and pan-cytokeratins. The features were of a common blue naevus. This is the first documentation of a post-enucleation conjunctival naevus in an anophthalmic socket. We propose a pathogenesis and suggest surveillance as there is a risk of transformation to melanoma.
Central fabrication: Carved positive assessment
Sanders, Joan E; Severance, Michael R; Myers, Timothy R; Ciol, Marcia A
2015-01-01
In this research we investigated the degree of error during the carving phase of central fabrication of prosthetic sockets for people with limb amputation. Three different model shapes were ordered from each of ten central fabrication companies. Using an accurate custom mechanical digitizer and alignment algorithm, we digitized the models and then compared the model shapes with the electronic file shapes. Results showed that 24 of the 30 models had volumes larger than the electronic file shapes while 24 had volumes that were smaller. 29 of the 30 models were oversized at the proximal aspect of the tibial tuberosity and undersized at the patellar tendon and popliteal areas. This error would result in a socket that had less tibial tubercle relief than intended in addition to a larger anterior-posterior dimension than desired. Comparison of the model shapes with socket shapes assessed for nine of the companies in a previous study showed that for five of the companies the sockets were relatively undersized over the tibial crest and fibular head. The results indicate that the socket the prosthetist receives will not always fit as planned, and that errors in the carving process are a source of the discrepancies. PMID:21515893
Arruda, Thiago; Sukekava, Flávia; de Souza, André B; Rasmusson, Lars; Araújo, Maurício G
2013-07-01
The aim of the present study was to evaluate the effect of the placement of titanium granules in fresh extraction sockets on early bone formation. The mesial roots of the third maxillary premolars of five adult beagle dogs were removed. On one side of the maxilla (Test group) the fresh extraction socket was grafted with titanium granules, while the contra-lateral socket was left non-grafted (Control group). After 1 month of healing, the dogs were euthanized and biopsies were obtained. The healing tissues were described, and histometric measurements were performed to obtain the percentage area occupied by connective tissue, new mineralized bone, bone marrow, and biomaterial particles. After 1 month of healing the findings from the histological examination revealed the titanium graft to be well incorporated into the provisional connective tissue or newly formed woven bone. The histometric measurements showed, however, that less mineralized bone was formed in the Test group than in the Control group. The present study suggests that the use of titanium granules in fresh extraction sockets was conducive to new bone formation. The graft of titanium granules seems, however, to delay the early phase of the healing process. Copyright © 2012 Wiley Periodicals, Inc.
Hip Resurfacing: An Alternative to Conventional Hip Replacement?
... and capped with a metal prosthesis. The hip socket is fitted with a metal cup. As these ... problem, but higher levels may be problematic. The socket prosthesis for a traditional hip replacement is usually ...
33 CFR 154.106 - Incorporation by reference.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 20, Switzerland. (1) IEC 60309-1 Plugs, Socket-Outlets and Couplers for Industrial Purposes—Part 1: General Requirements, Edition 4.2 2012-06, IBR approved for § 154.2102(b). (2) IEC 60309-2 Plugs, Socket...
40. DETAIL OF BRIDGE NO. 9 ROCKER BEARING AND SOCKET, ...
40. DETAIL OF BRIDGE NO. 9 ROCKER BEARING AND SOCKET, SEPARATED. LOOKING NORTH. - Greenville Yard, Transfer Bridge System, Port of New York/New Jersey, Upper New York Bay, Jersey City, Hudson County, NJ
19. CUSHMAN DAM SPILLWAY FLASHBOARD SOCKETS. March 1927 Reference ...
19. CUSHMAN DAM SPILLWAY - FLASHBOARD SOCKETS. March 1927 Reference No. BA-056 - Cushman No. 1 Hydroelectric Power Plant, Spillway, North Fork of Skokomish River, 5 miles West of Hood Canal, Hoodsport, Mason County, WA
... of metal and the socket is made of plastic (polyethylene) or has a plastic lining. Ceramic-on-Polyethylene: The ball is made of ceramic and the socket is made of plastic (polyethylene) or has a plastic lining. Metal-on- ...
Barone, Antonio; Marchionni, Francesco S; Cinquini, Chiara; Cipolli Panattoni, Andrea; Toti, Paolo; Marconcini, Simone; Covani, Ugo; Gabriele, Mario
2017-08-01
Tooth extraction is a very common procedure in oral surgery. Despite this, very little information is available in the literature as to the antibiotic management of the patient. The aim of this study is to evaluate whether the antibiotic prophylaxis could be beneficial in preventing postextraction local complications and whether the use of a probiotic could help reduce the antibiotic gastro-intestinal side effects. One hundred eleven patients meeting the inclusion criteria were initially included in this randomized clinical trial and randomly allocated to one of the three experimental groups according to a computer-generated randomization list. Patients allocated to the group 1 were given amoxicillin+clavulanic acid (2 g/day for 6 days), patients allocated to the group 2 received antibiotic + probiotic (Bifidobacterium longum+lactoferrin) and patients allocated to the group 3 received no antibiotic therapy after the extraction. To evaluate post-extractive complications, controls were performed at days 7, 14 and 21 after the extraction. At T1 pain at the surgical site was present in the 48%, 30% and 71.4% of the patients belonging respectively to the antibiotic alone group, to the antibiotic+probiotic group and to the control group. The mean Numeric Rating Score (NRS) score was 1.56±1.91, 1.08±1.93, 2.02±2.27 respectively (P=0.0498). Two patients belonging to the control group experienced dry socket. In addition, 9 patients (33.3%) in the antibiotic-alone group and 1 patient (2.7%) in the antibiotic+probiotic group reported intestinal distension (P=0.0012), 7 days after surgery. Finally, diarrhea was recorded in 5 patients of the antibiotic alone group (18.5%), on the other hand, no patients of the antibiotic+probiotic group and the control group reported diarrhea. Postextractive complications observed in each group have been mild and fast to resolve. The antibiotic administration showed a decrease in pain suffered by patients but a higher incidence of gastrointestinal side effects, such as abdominal distension and diarrhea, which seemed to be relieved by the concomitant use of the probiotic.
Changes in PGE2 signaling after submandibulectomy alter post-tooth extraction socket healing.
Mohn, Claudia Ester; Troncoso, Gastón Rodolfo; Bozzini, Clarisa; Conti, María Inés; Fernandez Solari, Javier; Elverdin, Juan Carlos
2018-03-10
Saliva is very important to oral health, and a salivary deficit has been shown to bring serious problems to oral health. There is scant information about the mechanisms through which salivary glands participate in post-tooth extraction socket healing. Therefore, the aim of the present study was to investigate the effect of submandibulectomy (SMx), consisting of the ablation of submandibular and sublingual glands (SMG and SLG, respectively), on PGE 2 signaling and other bone regulatory molecules, such as OPG and RANKL, involved in tooth extraction socket healing. Male Wistar rats, 70 g body weight, were assigned to an experimental (subjected to SMx) or a control group (sham operated). One week later, the animals in both groups underwent bilateral extraction of the first mandibular molars. The effect of SMx on different stages of socket healing after tooth extraction (7, 14, and 30 days) was studied by evaluating some parameters of inflammation, including PGE 2 and its receptors, and of bone metabolism, as well as by performing bone biomechanical studies. SMx increased TNFα and PGE 2 content as well as cyclooxygenase-II (COX-II) expression in tooth socket tissue at almost all the studied time points. SMx also had an effect on mRNA expression of PGE 2 receptors at the different time points, but did not significantly alter osteoprotegerin (OPG) and RANKL mRNA expression at any of the studied time points. In addition, an increase in bone mass density was observed in SMx rats compared with matched controls, and the structural and mechanical bone properties of the mandibular socket bone were also affected by SMx. Our results suggest that the SMG/SLG complex regulates cellular activation and differentiation by modulating the production of molecules intervening in tooth extraction socket repair, including the PGE 2 signaling system, which would therefore account for the higher density and resistance of the newly formed bone in SMx rat. © 2018 by the Wound Healing Society.
Cardaropoli, Daniele; Tamagnone, Lorenzo; Roffredo, Alessandro; Gaveglio, Lorena; Cardaropoli, Giuseppe
2012-08-01
After tooth extraction, varying amounts of bone resorption occur because of qualitative and quantitative changes at the edentulous site of the alveolar process. The aims of this randomized controlled clinical trial were (1) to compare the postextraction changes in residual ridge dimensions during spontaneous healing with those during socket preservation, (2) to analyze the histologic and histomorphometric aspects of the grafted sockets, and (3) to compare probing procket depth (PPD) and clinical attachment level (CAL) changes at teeth adjacent to extraction sites. Forty-eight teeth were extracted from 41 patients referred for extraction of 1 or more maxillary or mandibular premolars or molars. The edentulous sites were randomly assigned to the control (EXT, extraction alone) or experimental groups (SP, extraction and socket preservation). In the SP group, the sockets were filled with bovine bone mineral and covered with porcine collagen membrane. At baseline and after 4 months, PPD, gingival recession (REC), and CAL were measured at teeth adjacent to the edentulous sites. The changes in ridge dimensions from baseline to 4 months were assessed on dental casts. At 4 months, bone was harvested from the grafted areas in the SP group and the edentulous areas in the EXT group. PPD, REC, and CAL were comparable between groups. However, from baseline to 4 months, the SP group showed significantly less reduction in ridge width (1.04 ± 1.08 mm vs 4.48 ± 0.65 mm, P < .001) and height (0.46 ± 0.46 mm vs 1.54 ± 0.33 mm, P < .001). Histologically, the grafted sockets exhibited various stages of bone maturation and formation without inflammatory responses. No significant difference in the mineralized and nonmineralized fractions was noted between the groups. Socket preservation using bovine bone mineral and porcine collagen membrane considerably limits the amount of horizontal and vertical bone resorption when compared with extraction alone.
Design of rock socketed drilled shafts
DOT National Transportation Integrated Search
1998-09-01
Three field load tests of drilled shafts socketed in Burlington limestone were conducted using the Osterberg load cell. The objective of these tests was to compare the shaft capacities obtained from the field load tests with capacities predicted usin...
21 CFR 872.3680 - Polytetrafluoroethylene (PTFE) vitreous carbon materials.
Code of Federal Regulations, 2010 CFR
2010-04-01
... the sockets in which teeth are rooted) or intended to coat metal surgical implants to be placed in the alveoli (sockets in which the teeth are rooted) or the temporomandibular joints (the joint between the...
21 CFR 872.3680 - Polytetrafluoroethylene (PTFE) vitreous carbon materials.
Code of Federal Regulations, 2013 CFR
2013-04-01
... the sockets in which teeth are rooted) or intended to coat metal surgical implants to be placed in the alveoli (sockets in which the teeth are rooted) or the temporomandibular joints (the joint between the...
21 CFR 872.3680 - Polytetrafluoroethylene (PTFE) vitreous carbon materials.
Code of Federal Regulations, 2014 CFR
2014-04-01
... the sockets in which teeth are rooted) or intended to coat metal surgical implants to be placed in the alveoli (sockets in which the teeth are rooted) or the temporomandibular joints (the joint between the...
21 CFR 872.3680 - Polytetrafluoroethylene (PTFE) vitreous carbon materials.
Code of Federal Regulations, 2011 CFR
2011-04-01
... the sockets in which teeth are rooted) or intended to coat metal surgical implants to be placed in the alveoli (sockets in which the teeth are rooted) or the temporomandibular joints (the joint between the...
21 CFR 872.3680 - Polytetrafluoroethylene (PTFE) vitreous carbon materials.
Code of Federal Regulations, 2012 CFR
2012-04-01
... the sockets in which teeth are rooted) or intended to coat metal surgical implants to be placed in the alveoli (sockets in which the teeth are rooted) or the temporomandibular joints (the joint between the...
Method of fabricating a cooled electronic system
Chainer, Timothy J; Gaynes, Michael A; Graybill, David P; Iyengar, Madhusudan K; Kamath, Vinod; Kochuparambil, Bejoy J; Schmidt, Roger R; Schultz, Mark D; Simco, Daniel P; Steinke, Mark E
2014-02-11
A method of fabricating a liquid-cooled electronic system is provided which includes an electronic assembly having an electronics card and a socket with a latch at one end. The latch facilitates securing of the card within the socket. The method includes providing a liquid-cooled cold rail at the one end of the socket, and a thermal spreader to couple the electronics card to the cold rail. The thermal spreader includes first and second thermal transfer plates coupled to first and second surfaces on opposite sides of the card, and thermally conductive extensions extending from end edges of the plates, which couple the respective transfer plates to the liquid-cooled cold rail. The extensions are disposed to the sides of the latch, and the card is securable within or removable from the socket using the latch without removing the cold rail or the thermal spreader.
NASA Technical Reports Server (NTRS)
Meyers, D. G.
1984-01-01
Aquatic microcrustaceans of the genus Daphnia are known to orient to light during the day. At night, in the absence of visual cues, daphnids were suspected of maintaining equilibrium by monitoring the direction of gravity through their swimming antennae. Recent investigations using simulated, weightlessness conditions coupled with absence of illumination revealed hair like structures or setae on the basal, articulating socket of the antennae that, when surgically removed, resulted in disorientation. Given the simulated weightlessness or neutrally buoyant condition that eliminated sinking of the normally negatively buoyant Daphnia, it was proposed that the antennal socket setae function as rheoceptors stimulated by the upward rush of water currents during gravity induced, sinking phase of daphnid swimming movements. This rheoceptively mediated, gravity perception hypothesis is further supported by morphological investigations. Scanning electron micrographs indicate that antennal socket setae are anatomically similar to proprioceptors used by higher crustaceans to monitor gravitational direction.
Langley Research Center Standard for the Evaluation of Socket Welds
NASA Technical Reports Server (NTRS)
Berry, R. F., Jr.
1985-01-01
A specification utilized for the nondestructive evaluation of socket type pipe joints at Langley Research Center (LaRC) is discussed. The scope of hardware shall include, but is not limited to, all common pipe fittings: tees, elbows, couplings, caps, and so forth, socket type flanges, unions, and valves. In addition, the exterior weld of slip on flanges shall be inspected using this specification. At the discretion of the design engineer, standard practice engineer, Fracture Mechanics Engineering Section, Pressure Systems Committee, or other authority, four nondestructive evaluation techniques may be utilized exclusively, or in combination, to inspect socket type welds. These techniques are visual, radiographic, magnetic particle, and dye penetrant. Under special circumstances, other techniques (such as eddy current or ultrasonics) may be required and their application shall be guided by the appropriate sections of the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (B&PVC).
Laboratory Investigation of a Leaking Type 316 Socket Weld in a Boron Injection Tank Sampling Line
NASA Astrophysics Data System (ADS)
Xu, Hongqing; Fyfitch, Steve; Hosier, Ryan; Hyres, James
A leak was discovered in a Type 316 stainless steel socket weld in the sampling line for the boron injection tank. A section of the pipeline containing the leaking weld was removed for laboratory investigation that included visual and Stereovisual inspections, liquid penetrant (PT) testing, metallography, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and ferrite content determinations. The leak path was a through-wall transgranular crack in the socket weld. Cracking initiated along the weld-metal-to-base-metal interface at the tip of the crevice between the socket and pipe. The crevice was exposed to oxygenated boron solution at <180°F. Shallow intergranular attack (IGA) was found in the exposed base metal inside the crevice. Based on the investigation results, it was concluded that transgranular stress corrosion cracking (TGSCC) is the primary cracking mechanism.
Yun, Pil-Young; Um, In-Woong; Lee, Hyo-Jung; Yi, Yang-Jin; Bae, Ji-Hyun; Lee, Junho
2014-01-01
This case series evaluated the clinical efficacy of autogenous tooth bone graft material (AutoBT) in alveolar ridge preservation of an extraction socket. Thirteen patients who received extraction socket graft using AutoBT followed by delayed implant placements from Nov. 2008 to Aug. 2010 were evaluated. A total of fifteen implants were placed. The primary and secondary stability of the placed implants were an average of 58 ISQ and 77.9 ISQ, respectively. The average amount of crestal bone loss around the implant was 0.05 mm during an average of 22.5 months (from 12 to 34 months) of functional loading. Newly formed tissues were evident from the 3-month specimen. Within the limitations of this case, autogenous tooth bone graft material can be a favorable bone substitute for extraction socket graft due to its good bone remodeling and osteoconductivity. PMID:25551013
Neuropathic ocular pain due to dry eye is associated with multiple comorbid chronic pain syndromes
Galor, Anat; Covington, Derek; Levitt, Alexandra E.; McManus, Katherine T.; Seiden, Benjamin; Felix, Elizabeth R.; Kalangara, Jerry; Feuer, William; Patin, Dennis J.; Martin, Eden R.; Sarantopoulos, Konstantinos D.; Levitt, Roy C.
2015-01-01
Recent data demonstrate that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome and pelvic pain, may share common heritable factors. Previously, we showed that DE patients describing more severe symptoms tended to report features of neuropathic ocular pain (NOP). We hypothesize that patients with a greater number of CPS would have a different DE phenotype compared to those with fewer CPS. We recruited a cohort of 154 DE patients from the Miami Veterans Affairs Hospital and defined high and low CPS groups by cluster analysis. In addition to worse non-ocular pain complaints and higher PTSD and depression scores (P<0.01), we found that the high CPS group reported more severe neuropathic-type DE symptoms compared to the low CPS group, including worse ocular pain assessed via 3 different pain scales (P<0.05), with similar objective corneal DE signs. This is the first study to demonstrate DE patients who manifest a greater number of comorbid CPS report more severe DE symptoms and features of NOP. These findings provide further evidence that NOP may represent a central pain disorder, and that shared mechanistic factors may underlie vulnerability to some forms of DE and other comorbid CPS. PMID:26606863
Herrmann, Anja; De Wilde, Rudy Leon
2015-01-01
Background. We tested the hypothesis that warm-humidified carbon dioxide (CO2) insufflation would reduce postoperative pain and morphine requirement compared to cold-dry CO2 insufflation. Methods. A double-blinded, randomized, controlled trial was conducted to compare warm, humidified CO2 and cold-dry CO2. Patients with benign uterine diseases were randomized to either treatment (n = 48) or control (n = 49) group during laparoscopically assisted vaginal hysterectomy. Primary endpoints of the study were rest pain, movement pain, shoulder-tip pain, and cough pain at 2, 4, 6, 24, and 48 hours postoperatively, measured by visual analogue scale. Secondary outcomes were morphine consumption, rejected boli, temperature change, recovery room stay, and length of hospital stay. Results. There were no significant differences in all baseline characteristics. Shoulder-tip pain at 6 h postoperatively was significantly reduced in the intervention group. Pain at rest, movement pain, and cough pain did not differ. Total morphine consumption and rejected boli at 24 h postoperatively were significantly higher in the control group. Temperature change, recovery room stay, and length of hospital were similar. Conclusions. Warm, humidified insufflation gas significantly reduces postoperative shoulder-tip pain as well as morphine demand. This trial is registered with Clinical Trial Registration Number DRKS00003853 (German Clinical Trials Register (DRKS)). PMID:25722977
Noronha Oliveira, Miguel; Rau, Levy Hermes; Marodin, Aline; Corrêa, Márcio; Corrêa, Letícia Ruhland; Aragones, Aguedo; Magini, Ricardo de Souza
2017-12-01
To evaluate clinically and radiographically, in humans, the healing of maxillary third molars postextraction sockets after application of different ridge preservation techniques 3 months after tooth extraction. Twenty-six sockets (13 patients) were randomly assigned to 4 treatment modalities: deproteinized bovine bone mineral with 10% collagen (DBBM-C), poly(D,L-lactide-co-glycolide) with hydroxyapatite/β-TCP scaffold (PLGA/HA), PLGA/HA/β-TCP with 2.0% simvastatin scaffold (PLGA/HA/S), and spontaneous healing (control). Clinical complications were assessed, and cone-beam computed tomographies were taken in 5 patients 3 months after surgeries. For statistical purposes, the Fisher exact test was used (P < 0.05). After 3 months, 6 of 9 grafts from the PLGA/HA group were lost (P < 0.05). PLGA/HA/S' loss was only 2 of 8 (P > 0.05), but no loss was observed in the DBBM-C group. Pain was present in 3 of 8 sites that lost the graft (37.5%) (P > 0.05) and infection in 1 of 8 (12.5%) (P > 0.05), with these only occurring in the PLGA/HA group. Poly (D, L-lactide-co-glycolide) with hydroxyapatite/β-TCP (PLGA/HA/β-TCP) scaffolds, with and without simvastatin, failed to obtain the initial expected results and presented more complications. Scaffolds with simvastatin showed to be superior, with less clinical complications than scaffolds without simvastatin.
Kaido, Minako; Kawashima, Motoko; Ishida, Reiko; Tsubota, Kazuo
2016-03-01
The purpose of this prospective comparative study was to investigate corneal sensitivity in subjects with unstable tear film, with and without dry eye (DE) symptoms. Forty-one eyes of 41 volunteers (mean age: 45.1 ± 9.4 years; age range, 23-57 years), with normal tear function and ocular surface except for tear stability, were studied. The eyes were divided into two groups depending on the presence or absence of DE symptoms: 21 eyes with DE symptoms (symptomatic group); and 20 eyes without DE symptoms (asymptomatic group). Three types of corneal sensitivity values were measured using a Cochet-Bonnet esthesiometer: the sensitivity for perception of touch (S-touch), the sensitivity for blinking (S-blink), and the sensitivity for pain (S-pain). Mean S-blink and S-pain were significantly higher in the symptomatic group than in the asymptomatic group (P < 0.05), whereas there was no significant difference in mean S-touch between these groups (P > 0.05). Corneal sensitivity for blinking and pain evoked by increased stimuli was higher in the symptomatic group (subjects with short break-up time DE) compared with subjects who have no DE symptoms despite decreased tear stability. The presence of both tear instability and hyperesthesia, rather than tear instability alone, may contribute to DE pathogenesis.
Effects of Temperature on Chronic Trapezius Myofascial Pain Syndrome during Dry Needling Therapy
2014-01-01
The purpose of this study was to investigate the effects of temperature on chronic trapezius myofascial pain syndrome during dry needling therapy. Sixty patients were randomized into two groups of dry needling (DN) alone (group A) and DN combined with heat therapy group (group B). Each patient was treated once and the therapeutic effect was assessed by the visual analogue scale (VAS), pressure pain threshold (PPT), and the 36-item short form health survey (SF-36) at seven days, one month, and three months after treatment. Evaluation based on VAS and PPT showed that the pain of patients in groups A and B was significantly (P < 0.05) relieved at seven days, one month, and three months after treatment Compared to before treatment. There was significantly (P < 0.05) less pain in group B than group A at one and three months after treatment. The SF-36 evaluation demonstrated that the physical condition of patients in both groups showed significant (P < 0.05) improvement at one month and three months after treatment than before treatment. Our study suggests that both DN and DN heating therapy were effective in the treatment of trapezius MPS, and that DN heating therapy had better long-term effects than DN therapy. PMID:25383083
Manavella, Valeria; Romano, Federica; Corano, Lisa; Bignardi, Cristina; Aimetti, Mario
The primary aim of the study was to describe a novel technique to evaluate volumetric hard tissue dimensional changes after ridge augmentation procedures. The secondary aim was to apply this newly developed measuring method to compromised alveolar sockets grafted with a slowly resorbing biomaterial covered with a collagen membrane. Eleven patients (6 men and 5 women, mean age 52.7 ± 8.3 years) requiring extraction of one hopeless tooth for severe periodontitis in the maxillary anterior area were consecutively treated with a ridge augmentation procedure. All experimental sockets showed advanced buccal bone plate deficiency and were grafted with deproteinized bovine bone mineral with 10% collagen covered with a collagen membrane. Sockets healed by secondary intention. Three-dimensional volumetric alveolar bone changes were calculated by superimposing cone beam computed tomography scans obtained before and 12 months after the augmentation procedure. After 12 months, the alveolar mineralized tissue filled 91.20% ± 7.96% of the maximum volume for regeneration. The augmentation procedure appeared not only to compensate for bone remodeling in most alveolar regions but also to repair a significant portion of the buccal wall. The most significant ridge width changes occurred 1 mm apical to the bone crest (2.33 ± 1.46 mm, P < .001). Within present limitations, this radiographic measuring methodology can be a useful tool to evaluate changes in socket volume. A ridge preservation technique performed with collagenated bovine bone and a collagen membrane was able to improve ridge shape and dimensions in compromised alveolar sockets.
46 CFR 39.10-5 - Incorporation by reference-TB/ALL.
Code of Federal Regulations, 2010 CFR
2010-10-01
..., 1 rue de Varembé, Geneva, Switzerland IEC 309-1—Plugs, Socket-Outlets and Couplers for Industrial Purposes: Part 1, General Requirements, 1979 39.20-9 IEC 309-2—Plugs, Socket-Outlets and Couplers for...
46 CFR 39.10-5 - Incorporation by reference-TB/ALL.
Code of Federal Regulations, 2012 CFR
2012-10-01
..., 1 rue de Varembé, Geneva, Switzerland IEC 309-1—Plugs, Socket-Outlets and Couplers for Industrial Purposes: Part 1, General Requirements, 1979 39.20-9 IEC 309-2—Plugs, Socket-Outlets and Couplers for...
46 CFR 39.10-5 - Incorporation by reference-TB/ALL.
Code of Federal Regulations, 2011 CFR
2011-10-01
..., 1 rue de Varembé, Geneva, Switzerland IEC 309-1—Plugs, Socket-Outlets and Couplers for Industrial Purposes: Part 1, General Requirements, 1979 39.20-9 IEC 309-2—Plugs, Socket-Outlets and Couplers for...
... larger than normal spleen Anemia Burning, itchy, or dry eyes Fainting Heart palpitations Joint pain Muscle weakness Problems ... problems with the nervous system; burning, itching, or dry eyes; swollen salivary glands; swollen lymph nodes in the ...
2015-05-19
reported by U.S. Army aviators using NVG for night flights (Glick and Moser, 1974). It was initially, and incorrectly, called “brown eye syndrome ...112 FREQUENCY Never Rarely Occasionally Often Eye irritation Eye pain Blurred vision Dry eye ... Eye pain Blurred vision Dry eye Light sensitivity j. Since your last contact lens review, did you experience any of the following
34. DETAIL OF APRONTOFLOAT LOCKING PIN SOCKETS AND SUSPENSION CABLES ...
34. DETAIL OF APRON-TO-FLOAT LOCKING PIN SOCKETS AND SUSPENSION CABLES ON BRIDGE NO. 9. LOOKING NORTH. - Greenville Yard, Transfer Bridge System, Port of New York/New Jersey, Upper New York Bay, Jersey City, Hudson County, NJ
Development of a socketed foundation for the Midwest Weak Post (MWP) v1.
DOT National Transportation Integrated Search
2014-07-01
A socketed foundation was designed and evaluated for use with the Midwest Weak Post (MWP), Version 1. : Dynamic component testing was conducted on five different design configurations with varying embedment : depths, steel reinforcement, and soil con...
Implementing TCP/IP and a socket interface as a server in a message-passing operating system
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hipp, E.; Wiltzius, D.
1990-03-01
The UNICOS 4.3BSD network code and socket transport interface are the basis of an explicit network server for NLTSS, a message passing operating system on the Cray YMP. A BSD socket user library provides access to the network server using an RPC mechanism. The advantages of this server methodology are its modularity and extensibility to migrate to future protocol suites (e.g. OSI) and transport interfaces. In addition, the network server is implemented in an explicit multi-tasking environment to take advantage of the Cray YMP multi-processor platform. 19 refs., 5 figs.
NASA Technical Reports Server (NTRS)
Goetz, C.; Ingle, W. M. (Inventor)
1980-01-01
A ball valve particularly suited for use in the handling of highly corrosive fluids is described. It is characterized by a valve housing formed of communicating segments of quartz tubing, a pair of communicating sockets disposed in coaxial alignment with selected segments of tubing for establishing a pair of inlet ports communicating with a common outlet port, a ball formed of quartz material supported for displacement between the sockets and configured to be received alternately thereby, and a valve actuator including a rod attached to the ball for selectively displacing the ball relative to each of the sockets for controlling fluid flow through the inlet ports.
Buis, Arjan
2016-01-01
Elevated skin temperature at the body/device interface of lower-limb prostheses is one of the major factors that affect tissue health. The heat dissipation in prosthetic sockets is greatly influenced by the thermal conductive properties of the hard socket and liner material employed. However, monitoring of the interface temperature at skin level in lower-limb prosthesis is notoriously complicated. This is due to the flexible nature of the interface liners used which requires consistent positioning of sensors during donning and doffing. Predicting the residual limb temperature by monitoring the temperature between socket and liner rather than skin and liner could be an important step in alleviating complaints on increased temperature and perspiration in prosthetic sockets. To predict the residual limb temperature, a machine learning algorithm – Gaussian processes is employed, which utilizes the thermal time constant values of commonly used socket and liner materials. This Letter highlights the relevance of thermal time constant of prosthetic materials in Gaussian processes technique which would be useful in addressing the challenge of non-invasively monitoring the residual limb skin temperature. With the introduction of thermal time constant, the model can be optimised and generalised for a given prosthetic setup, thereby making the predictions more reliable. PMID:27695626
Mathur, Neha; Glesk, Ivan; Buis, Arjan
2016-06-01
Elevated skin temperature at the body/device interface of lower-limb prostheses is one of the major factors that affect tissue health. The heat dissipation in prosthetic sockets is greatly influenced by the thermal conductive properties of the hard socket and liner material employed. However, monitoring of the interface temperature at skin level in lower-limb prosthesis is notoriously complicated. This is due to the flexible nature of the interface liners used which requires consistent positioning of sensors during donning and doffing. Predicting the residual limb temperature by monitoring the temperature between socket and liner rather than skin and liner could be an important step in alleviating complaints on increased temperature and perspiration in prosthetic sockets. To predict the residual limb temperature, a machine learning algorithm - Gaussian processes is employed, which utilizes the thermal time constant values of commonly used socket and liner materials. This Letter highlights the relevance of thermal time constant of prosthetic materials in Gaussian processes technique which would be useful in addressing the challenge of non-invasively monitoring the residual limb skin temperature. With the introduction of thermal time constant, the model can be optimised and generalised for a given prosthetic setup, thereby making the predictions more reliable.
Dry eye in vitamin D deficiency: more than an incidental association.
Yildirim, Pelin; Garip, Yeşim; Karci, Ayse Aslihan; Guler, Tuba
2016-01-01
The aim of this article is two-fold: (i) to demonstrate the relation between vitamin D deficiency and dry eye and impaired tear function; and (ii) to investigate the possible associations among clinical parameters of hypovitaminosis D with dry eye parameters. Fifty premenopausal women with vitamin D deficiency (serum vitamin D levels < 20 ng/mL) and 48 controls were included. Participants were assessed by Schirmer's test, tear break-up time test (TBUT), ocular surface disease index (OSDI), Stanford Health Assessment Questionnaire (HAQ), fatigue severity scale (FSS), and visual analogue scale-pain (VAS-pain). Lower scores in Schirmer's test and TBUT, and higher in OSDI were detected in patients with vitamin D deficiency than in controls (P < 0.05). FSS was negatively correlated with Schirmer's test (r = -0,29; P = 0.038) and TBUT scores (r = -0,43; P = 0.002); VAS-pain was negatively correlated with TBUT scores (r = -0.32; P = 0.023). HAQ scores showed no significant correlation with dry eye parameters (P > 0.05). Vitamin D level was negatively correlated with OSDI (r = -0.49; P < 0.001), and positively with Schirmer's test (r = 0.45; P = 0.001) and TBUT scores (r = 0.30; P = 0.029). Dry eye and impaired tear function in patients with vitamin D deficiency may indicate a protective role of vitamin D in the development of dry eye, probably by enhancing tear film parameters and reducing ocular surface inflammation. Patients with vitamin D deficiency should be evaluated for dry eye syndromes. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
46 CFR 52.01-3 - Definitions of terms used in this part.
Code of Federal Regulations, 2012 CFR
2012-10-01
...) Flexible staybolt. A flexible staybolt is a bar made with ball-and-socket joint on one end, the cup of the socket being screwed into the outside sheet and covered with a removable cap, the plain end of the...
46 CFR 154.528 - Piping joints: Flange type.
Code of Federal Regulations, 2014 CFR
2014-10-01
... following types: (1) Welding neck. (2) Slip-on. (3) Socket weld. (b) If the piping is designed for a... nominal pipe size is 100 mm (4 in.) or less; (2) Socket weld, if the nominal pipe size is 50 mm (2 in.) or...
46 CFR 154.528 - Piping joints: Flange type.
Code of Federal Regulations, 2011 CFR
2011-10-01
... following types: (1) Welding neck. (2) Slip-on. (3) Socket weld. (b) If the piping is designed for a... nominal pipe size is 100 mm (4 in.) or less; (2) Socket weld, if the nominal pipe size is 50 mm (2 in.) or...
46 CFR 52.01-3 - Definitions of terms used in this part.
Code of Federal Regulations, 2013 CFR
2013-10-01
...) Flexible staybolt. A flexible staybolt is a bar made with ball-and-socket joint on one end, the cup of the socket being screwed into the outside sheet and covered with a removable cap, the plain end of the...
46 CFR 154.528 - Piping joints: Flange type.
Code of Federal Regulations, 2012 CFR
2012-10-01
... following types: (1) Welding neck. (2) Slip-on. (3) Socket weld. (b) If the piping is designed for a... nominal pipe size is 100 mm (4 in.) or less; (2) Socket weld, if the nominal pipe size is 50 mm (2 in.) or...
46 CFR 52.01-3 - Definitions of terms used in this part.
Code of Federal Regulations, 2014 CFR
2014-10-01
...) Flexible staybolt. A flexible staybolt is a bar made with ball-and-socket joint on one end, the cup of the socket being screwed into the outside sheet and covered with a removable cap, the plain end of the...
46 CFR 154.528 - Piping joints: Flange type.
Code of Federal Regulations, 2013 CFR
2013-10-01
... following types: (1) Welding neck. (2) Slip-on. (3) Socket weld. (b) If the piping is designed for a... nominal pipe size is 100 mm (4 in.) or less; (2) Socket weld, if the nominal pipe size is 50 mm (2 in.) or...
Continuation of down-hole geophysical testing for rock sockets : [technical summary].
DOT National Transportation Integrated Search
2013-11-01
The rock socket is critical to a drilled shaft : foundation because it lies within a rock stratum : and accounts for much of the capacity of the : foundational unit. Consistency of the rocks : structure and composition must be identifed : because ...
AlHassan, Sultan; Galindo-Ferreiro, Alicia; Khandekar, Rajiv; AlShaikh, Osama; Schellini, Silvana Artioli
2018-05-08
The aim of thhis study was to present the outcomes of postauricular split-medium thickness skin graft (SMTSG) to treat anophthalmic sockets with contracted fornices. This case series enrolled patients with grade 2 or 3 anophthalmic sockets between 2015 and 2016. Data were collected on patient demographics, objective and subjective parameters preoperatively and 180 days postoperatively. Success of the surgery was graded on the height of the graft, the depth of the superior and inferior fornices, and presence/abscence of lagophthalmos, entropion, and ability to retain an external prosthesis. Eighteen patients were enrolled with a mean age of 35.9 ± 18 years. The median height of the graft was 22 mm (25% quartile = 18.75) when removed and 20 mm (25% quartile = 16) postoperatively. The median depth of the superior fornix was 6.5 mm (25% quartile = 4.5 mm) preoperatively and 10 mm (25% quartile = 8 mm) postoperatively (P = 0.5). The median inferior fornix depth was 7 mm (25% quartile = 3.5 mm) preoperatively and 8 mm (25% quartile = 5 mm) (P = 0.27) postoperatively. Preoperatively, there were 13 (72.2%) patients with lagophthalmos, 10 (44.4%) with entropion, 3 (37.5%) with poor prosthesis retention, and 5 (62.5%) who were unable to retain the prosthesis. Postoperatively, 7 (38.9%) patients had lagophthamos, 1 (5.6%) had entropion, and all the patients could retain the prosthesis. None of the sockets had a foul odor postoperatively. Postauricular SMTSG achieves successful outcomes for the treatment of contracted anophthalmic sockets, reshaping the anterior socket surface and deepening the fornices.
Hu, Chen; Gong, Ting; Lin, Weimin; Yuan, Quan; Man, Yi
2017-10-01
To evaluate bone reconstruction and soft tissue reactions at immediate implants placed into intact sockets and those with buccal bone dehiscence defects. Fifty-nine internal connection implants from four different manufacturers were immediately placed in intact sockets(non-dehiscence group, n=40), and in alveoli with buccal bone dehiscence defects: 1) Group 1(n= N10), the defect depth measured 3-5 mm from the gingival margin. 2) Group 2(n=9), the depth ranged from 5mm to 7mm. The surrounding bony voids were grafted with deproteinized bovine bone mineral (DBBM) particles. Cone beam computed tomography(CBCT) was performed immediately after surgery (T1), and at 6 months later(T2). Radiographs were taken at prosthesis placement and one year postloading(T3). Soft tissue parameters were measured at baseline (T0), prosthesis placement and T3. No implants were lost during the observation period. For the dehiscence groups, the buccal bone plates were radiographically reconstructed to comparable horizontal and vertical bone volumes compared with the non-dehiscence group. Marginal bone loss occurred between the time of final restoration and 1-year postloading was not statistically different(P=0.732) between groups. Soft tissue parameters did not reveal inferior results for the dehiscence groups. Within the limitations of this study, flapless implant placement into compromised sockets in combination with DBBM grafting may be a viable technique to reconstitute the defected buccal bone plates due to space maintenance and primary socket closure provided by healing abutments and bone grafts. Immediate implants and DBBM grafting without using membranes may be indicated for sockets with buccal bone defects. Copyright © 2017 Elsevier Ltd. All rights reserved.
De Coster, Peter; Browaeys, Hilde; De Bruyn, Hugo
2011-03-01
Various grafting materials have been designed to minimize edentulous ridge volume loss following tooth extraction by encouraging new bone formation in healing sockets. BoneCeramic® is a composite of hydroxyapatite and bèta-tricalcium phosphate with pores of 100-500 microns. The aim of this study was to evaluate bone regeneration in healing sockets substituted with BoneCeramic® prior to implant procedures. Fifteen extraction sockets were substituted with BoneCeramic® and 14 sockets were left to heal naturally in 10 patients (mean age 59.6 years). Biopsies were collected only from the implant recipient sites during surgery after healing periods ranging from 6-74 weeks (mean 22). In total, 24 biopsies were available; 10 from substituted and 14 from naturally healed sites. In one site, the implant was not placed intentionally and, in four substituted sites, implant placement had to be postponed due to inappropriate healing, hence from five sites biopsies were not available. Histological sections were examined by transmitted light microscope. At the time of implant surgery, bone at substituted sites was softer than in controls, compromising initial implant stability. New bone formation at substituted sites was consistently poorer than in controls, presenting predominantly loose connective tissue and less woven bone. The use of BoneCeramic® as a grafting material in fresh extraction sockets appears to interfere with normal healing processes of the alveolar bone. On the basis of the present preliminary findings, its indication as a material for bone augmentation, when implant placement is considered within 6-38 weeks after extraction, should be revised. © 2009, Copyright the Authors. Journal Compilation © 2011, Wiley Periodicals, Inc.
Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results.
Sabir, Mohammad; Alam, Mohammad Nazish
2015-06-01
The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved.
Koutouzis, Theofilos; Lipton, David
2016-01-01
The aim of this study was to evaluate the necessity for additional regenerative procedures following healing of compromised and noncompromised extraction sockets with alveolar ridge preservation procedures through the use of virtual implant imaging software. The cohort was comprised of 87 consecutive patients subjected to a single maxillary tooth extraction with an alveolar ridge preservation procedure for subsequent implant placement. Patients were divided into two main groups based on the integrity of the buccal bone plate following teeth extraction. Patients in the compromised socket (CS) group (n = 52) had partial or complete buccal bone plate loss, and patients in the noncompromised socket (NCS) group (n = 35) exhibited no bone loss of their socket walls following tooth extraction. Following 4 to 6 months of healing, all patients had a cone beam computed tomography (CBCT) study. Root-formed implants were placed virtually in an ideal prosthetic position. The number of implants per group and location (anterior, premolar, molar) exhibiting exposed buccal implant surface was calculated. In the CS group, 5 out of 19 anterior implants (26.3%), 4 out of 14 premolar implants (28.5%), and 7 out of 19 molar implants (36.8%) had exposed buccal surfaces. In the NCS group, 4 out of 9 anterior implants (44.4%), 2 out of 9 premolar implants (22.2%), and 4 out of 17 molar implants (23.5%) had exposed buccal surfaces. There were no statistically significant differences for intragroup and intergroup comparisons (χ² test, P > .05). This study failed to find statistically significant differences in the frequency of implants with exposed buccal surfaces placed virtually, following treatment of compromised and noncompromised sockets. A high proportion (22% to 44%) of sites had implants that potentially needed additional regenerative procedures.
Schellini, Silvana; Jorge, Eliane; Sousa, Roberta; Burroughs, John; El-Dib, Regina
2016-01-01
To assess the efficacy and safety of porous and nonporous implants for management of the anophthalmic socket. Case series meta-analysis was conducted with no language restriction, including studies from: PUBMED, EMBASE and LILACS. Study eligibility criteria were case series design with more than 20 cases reported, use of porous and/or nonporous orbital implants, anophthalmic socket and, treatment success defined as no implant exposure or extrusion. Complications rates from each included study were quantified. Proportional meta-analysis was performed on both outcomes with a random-effects model and the 95% confidential intervals were calculated. A total of 35 case series studies with a total of 3,805 patients were included in the meta-analysis. There are no studies comparing porous and nonporous implants in the anophthalmic socket treatment. There was no statistically significant difference between porous polyethylene (PP) and hydroxyapatite (HA) on implant exposure: 0.026 (0.012-0.045) vs 0.054 (0.041-0.070), respectively and, neither on implant extrusion: 0.0042 (0.0008-0.010) vs. 0.018 (0.004-0.042), respectively. However, there was a significant difference supporting the use of PP when compared to bioceramic implant: 0.026 (0.012 -0.045) vs. 0.12 (0.06-0.20), respectively, on implant exposure. PP implants showed lower chance of exposure than bioceramic implant for anophthalmic socket reconstruction, although we cannot rule out the possibility of heterogeneity bias due to the nature and level of evidence of the included studies. Clinical trials are necessary to expand the knowledge of porous and nonporous orbital implants in the anophthalmic socket management.
Bhattacharjee, Kasturi; Bhattacharjee, Harsha; Kuri, Ganesh; Das, Jayanta Kr; Dey, Debleena
2014-01-01
Purpose: The purpose of our study is to present a surgical technique of primary porous orbital ball implantation with overlying mucus membrane graft (MMG) for reconstruction of severely contracted socket and to evaluate prosthesis retention and motility in comparison to dermis fat graft (DFG). Study Design: Prospective comparative study. Materials and Methods: A total of 24 patients of severe socket contracture (Grade 2-4 Krishna's classification) were subdivided into two groups, 12 patients in each group. In Group I, DFG have been used for reconstruction. In Group II, porous polyethylene implant with MMG has been used as a primary procedure for socket reconstruction. In Group I DFG was carried out in usual procedure. In case of Group II, vascularized scar tissues were separated 360° and were fashioned into four strips. A scleral capped porous polyethylene implant was placed in the intraconal space and four strips of scar tissue were secured to the scleral cap and extended part overlapped the implant to make a twofold barrier between the implant and MMG. Patients were followed-up as per prefixed proforma. Prosthesis motility and retention between the two groups were measured. Results: In Group I, four patients had recurrence of contracture with fall out of prosthesis. In Group II stable reconstruction was achieved in all the patients. In terms of prosthesis motility, maximum in Group I was 39.2% and Group II, was 59.3%. The difference in prosthesis retention (P = 0.001) and motility (P = 0.004) between the two groups was significant. Conclusion: Primary socket reconstruction with porous orbital implant and MMG for severe socket contracture is an effective method in terms of prosthesis motility and prosthesis retention. PMID:24618485
Study of conjunctival flora in anophthalmic patients: influence on the comfort of the socket.
Toribio, Alvaro; Marrodán, Teresa; Fernández-Natal, Isabel; Martínez-Blanco, Honorina; Rodríguez-Aparicio, Leandro; Ferrero, Miguel Á
2017-08-01
To investigate the relationship between conjunctival flora and comfort of the socket in anophthalmic patients. A cross-sectional clinical study including 60 patients with unilateral anophthalmia who wear a prosthetic eye. From each patient three microbiological samples were taken from the lower conjunctival sac (healthy eye, pre-prosthesis, and retro-prosthesis space of socket). The 180 samples obtained were cultured. Samples from a randomized subgroup of 29 patients were measured by spectrophotometry at 540 nm after 48 h of growth, to determine their microbial density (MD). The grade of comfort of the socket (GCS) of each patient was established by a questionnaire. Epidemiological and clinical data of the anophthalmic socket and artificial eye care of each patient were also collected. MD decreased in healthy eyes (0.213 ± 0.201, P = 0.004) compared with the pre-prosthesis (0.402 ± 0.323) and retro-prosthesis (0.438 ± 0.268) samples. Pre-prosthesis MD correlated with retro-prosthesis MD (R = 0.401, P = 0.031) and healthy eye MD (R = 0.482, P = 0.008), and it was also related to poor GCS (P = 0.017). Aerobic Gram-negative bacteria in retro-prosthesis samples of patients with poor GCS was higher than in patients with good or fair GCS (P = 0.008). In the same samples, coagulase-negative staphylococci proportion (excluding S. epidermidis) increased in patients with good GCS (P = 0.030). Socket microflora is related to GCS. Increased pathogenic flora, especially Gram-negative bacteria, and high MD are related to discomfort, while coagulase-negative staphylococci (other than S. epidermidis) are associated with comfort.
Tomaszewski, P K; Verdonschot, N; Bulstra, S K; Rietman, J S; Verkerke, G J
2012-11-01
Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditions, namely immediate post-amputation implantation and the conventional implantation after considerable time of socket prosthesis use. We questioned the difference in bone modeling response the implants provoked and if it could lead to premature bone fracture. Generic CT-based finite element models of an intact femoral bone and amputated bone implanted with models of two existing direct-fixation implants, the OPRA system (Integrum AB) and the ISP Endo/Exo prosthesis (ESKA Implants AG) were created for this study. Adaptive bone-remodeling simulations used the heel-strike and toe-off loads from a normal walking cycle. The bone loss caused by prolonged use of socket prosthesis had more severe effects on the ultimate bone quality than adaptation induced by the direct-fixation implants. Both implants showed considerable bone remodeling; the titanium screw implant (OPRA system) provoked more bone loss than the porous coated CoCrMo stem (ISP implant). The chance of the peri-prosthetic bone fracture remained higher for the post-socket case as compared to the direct amputation cases. In conclusion, both direct-fixation implants lead to considerable bone loss and bone loss is more severe after a prolonged period of post-socket use. Hence, from a biomechanical perspective it is better to limit the post-socket time and to re-design direct fixation devices to reduce bone loss and the probability of peri-prosthetic bone fractures. Copyright © 2012 Elsevier Ltd. All rights reserved.
Campa-Moran, Irene; Rey-Gudin, Etelvina; Fernández-Carnero, Josué; Paris-Alemany, Alba; Gil-Martinez, Alfonso; Lerma Lara, Sergio; Prieto-Baquero, Almudena; Alonso-Perez, José Luis; La Touche, Roy
2015-01-01
Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group. PMID:26640708
Acute effects of one session dry needling on a chronic golfer’s elbow disability
Shariat, Ardalan; Noormohammadpour, Pardis; Memari, Amir Hossein; Ansari, Noureddin Nakhostin; Cleland, Joshua A.; Kordi, Ramin
2018-01-01
A 40-year-old retired male elite athlete with more than 20 years’ experience in wrestling and bodybuilding with mild elbow pain and disability of 2 years presented to our clinic reporting an acute pain in medial aspect of the elbow. Physical examination revealed symptoms of left Golfer’s elbow during target-directed movements. The results of sonography in left elbow showed low level of hypo echo irregularity and increased blood flow in color Doppler mode in the common flexor origin. The pain amplitude was moderate at rest and extremely high during kinetic and intentional movements. During last 2 years, the patient tried different types of therapy including manual therapy, Transcutaneous electrical nerve stimulation and also received a variety of injections none of which were effective for reducing pain and disability. This is the first study showed that one sessions of dry needling improved both pain and disability and helped to return to a normal life and exercise training. PMID:29511665
Development of a socketed foundation for cable barrier posts : phase I.
DOT National Transportation Integrated Search
2012-02-01
Four socketed foundation designs were evaluated for use as a new reusable base for high-tension, cable barrier : systems. Each foundation was a reinforced concrete cylindrical shape. The top of the foundation had an open steel tube to : accept the po...
49 CFR 231.23 - Unidirectional passenger-train cars adaptable to van-type semi-trailer use.
Code of Federal Regulations, 2013 CFR
2013-10-01
... (when possible) and riveted over, or with not less than one-half (1/2) inch rivets. When marker sockets... shall be provided for men to reach such sockets or brackets. (g) Uncoupling levers. Each car shall be...
49 CFR 231.23 - Unidirectional passenger-train cars adaptable to van-type semi-trailer use.
Code of Federal Regulations, 2014 CFR
2014-10-01
... (when possible) and riveted over, or with not less than one-half (1/2) inch rivets. When marker sockets... shall be provided for men to reach such sockets or brackets. (g) Uncoupling levers. Each car shall be...
49 CFR 231.23 - Unidirectional passenger-train cars adaptable to van-type semi-trailer use.
Code of Federal Regulations, 2012 CFR
2012-10-01
... (when possible) and riveted over, or with not less than one-half (1/2) inch rivets. When marker sockets... shall be provided for men to reach such sockets or brackets. (g) Uncoupling levers. Each car shall be...
Lateral capacity of rock sockets in limestone under cyclic and repeated loading.
DOT National Transportation Integrated Search
2010-08-01
This report contains the results from full scale lateral load testing of two short rock socketed shafts in : limestone, and the development of recommendations for p-y analysis using those results. Two short shafts 42 : inches in diameter were constru...
Lauer, S A; Rizzuto, P R; Goodrich, J; Adamo, A
1995-01-01
This article is a retrospective clinical and radiographic analysis of four patients who survived high caliber orbitocraniofacial gunshot injuries. Early multidisciplinary craniofacial reconstruction included repair of comminuted orbital fractures with multiple autogenous bone grafts and/or porous polyethylene implants, enucleation, and insertion of a hollow silicone sphere as an anophthalmic socket implant. Migration of the silicone implant occurred in one case, requiring replacement with an autogenous dermis fat graft. There were no cases of extrusion or infection. Socket motility remained limited in all cases, despite reapposition of the extraocular muscles. In two cases with autogenous bone grafts along the orbital roof, there was no radiographic evidence of graft resorption after three years. Soft tissue volume deficiency and superior sulcus deformity developed in the three cases which were followed for more than six months. Despite these limitations, all four patients are wearing comfortable ocular prostheses. The postoperative results support immediate preparation of the anophthalmic socket after craniofacial reconstruction of these injuries.
The Quantum Socket: Wiring for Superconducting Qubits - Part 3
NASA Astrophysics Data System (ADS)
Mariantoni, M.; Bejianin, J. H.; McConkey, T. G.; Rinehart, J. R.; Bateman, J. D.; Earnest, C. T.; McRae, C. H.; Rohanizadegan, Y.; Shiri, D.; Penava, B.; Breul, P.; Royak, S.; Zapatka, M.; Fowler, A. G.
The implementation of a quantum computer requires quantum error correction codes, which allow to correct errors occurring on physical quantum bits (qubits). Ensemble of physical qubits will be grouped to form a logical qubit with a lower error rate. Reaching low error rates will necessitate a large number of physical qubits. Thus, a scalable qubit architecture must be developed. Superconducting qubits have been used to realize error correction. However, a truly scalable qubit architecture has yet to be demonstrated. A critical step towards scalability is the realization of a wiring method that allows to address qubits densely and accurately. A quantum socket that serves this purpose has been designed and tested at microwave frequencies. In this talk, we show results where the socket is used at millikelvin temperatures to measure an on-chip superconducting resonator. The control electronics is another fundamental element for scalability. We will present a proposal based on the quantum socket to interconnect a classical control hardware to a superconducting qubit hardware, where both are operated at millikelvin temperatures.
Dimensional Changes of Fresh Sockets With Reactive Soft Tissue Preservation: A Cone Beam CT Study.
Crespi, Roberto; Capparé, Paolo; Crespi, Giovanni; Gastaldi, Giorgio; Gherlone, Enrico Felice
2017-06-01
The aim of this study was to assess dimensional changes of the fresh sockets grafted with collagen sheets and maintenance of reactive soft tissue, using cone beam computed tomography (CBCT). Tooth extractions were performed with maximum preservation of the alveolar housing, reactive soft tissue was left into the sockets and collagen sheets filled bone defects. Cone beam computed tomography were performed before and 3 months after extractions. One hundred forty-five teeth, 60 monoradiculars and 85 molars, were extracted. In total, 269 alveoli were evaluated. In Group A, not statistically significant differences were found between monoradiculars, whereas statistically significant differences (P < 0.05) were found between molars, both for mesial and distal alveoli. In Group B, not statistically significant differences were found between maxillary and mandibular bone changes values (P > 0.05) for all types of teeth. This study reported an atraumatic tooth extraction, reactive soft tissue left in situ, and grafted collagen sponge may be helpful to reduce fresh socket collapse after extraction procedures.
Technical Note: Computer-Manufactured Inserts for Prosthetic Sockets
Sanders, Joan E.; McLean, Jake B.; Cagle, John C.; Gardner, David W.; Allyn, Katheryn J.
2016-01-01
The objective of this research was to use computer-aided design software and a tabletop 3-D additive manufacturing system to design and fabricate custom plastic inserts for trans-tibial prosthesis users. Shape quality of inserts was tested right after they were inserted into participant’s test sockets and again after four weeks of wear. Inserts remained properly positioned and intact throughout testing. Right after insertion the inserts caused the socket to be slightly under-sized, by a mean of 0.11 mm, approximately 55% of the thickness of a nylon sheath. After four weeks of wear the under-sizing was less, averaging 0.03 mm, approximately 15% of the thickness of a nylon sheath. Thus the inserts settled into the sockets over time. If existing prosthetic design software packages were enhanced to conduct insert design and to automatically generate fabrication files for manufacturing, then computer manufactured inserts may offer advantages over traditional methods in terms of speed of fabrication, ease of design, modification, and record keeping. PMID:27212209
NASA Astrophysics Data System (ADS)
tongqing, Wu; liang, Li; xinjian, Liu; Xu, nianchun; Tian, Mao
2018-03-01
Self-balanced method is carried out on the large diameter rock-socketed filling piles of high-pile wharf at Inland River, to explore the distribution laws of load-displacement curve, pile internal force, pile tip friction resistance and pile side friction resistance under load force. The results showed that: the tip resistance of S1 and S2 test piles accounted for 53.4% and 53.6% of the pile bearing capacity, respectively, while the total side friction resistance accounted for 46.6% and 46.4% of the pile bearing capacity, respectively; both the pile tip friction resistance and pile side friction resistance can be fully played, and reach to the design requirements. The reasonability of large diameter rock-socketed filling design is verified through test analysis, which can provide basis for the optimization of high-pile wharf structural type, thus reducing the wharf project cost, and also providing reference for the similar large diameter rock-socketed filling piles of high-pile wharf at Inland River.
Rosen, Paul S; Rosen, Adam D
2013-01-01
This retrospective case series reports on the use of a polylactic acid barrier that was left exposed in the process of socket preparation for the placement of dental implants. A retrospective chart review found 43 patients with 48 extraction sockets that were treated in this manner. Teeth were removed and the sockets were thoroughly debrided, with 40 of them receiving a bone replacement graft covered by the polylactic acid barrier and the additional 8 receiving the membrane alone. Suturing left the barrier exposed, and the sites were re-entered on average at 23 weeks for the placement of a dental implant. All sites were able to receive a dental implant, demonstrating the ability to leave a polylactic acid barrier exposed and achieve successful guided bone regeneration (GBR) results. This ultimately helped avoid some of the negative sequelae of trying to achieve primary closure of the flaps at the time of tooth extraction.
Mixed Lubrication Simulation of Hydrostatic Spherical Bearings for Hydraulic Piston Pumps and Motors
NASA Astrophysics Data System (ADS)
Kazama, Toshiharu
Mixed and fluid film lubrication characteristics of hydrostatic spherical bearings for swash-plate-type axial piston pumps and motors are studied theoretically under non-steady-state conditions. The basic equations incorporating interference and contact of surface roughness are derived fundamentally through combination of the GW and PC models. Furthermore, a programming code that is applicable to the caulked-socket-type and open-socket-type bearings is developed. Effects of caulking, operating conditions, and the bearing dimension on the motion of the sphere and tribological performance of the bearings are examined. Salient conclusions are the following: The sphere's eccentricity increases in the low supply pressure period. The time-lag of the load change engenders greater motion of the sphere. Caulking of the bearing socket suppresses the sphere's motion. The bearing stiffness increases and power loss decreases for smaller recess angles. Minimum power loss is given under the condition that the bearing socket radius nearly equals the equivalent load radius.
Bertulat, S; Isaka, N; de Prado, A; Lopez, A; Hetreau, T; Heuwieser, W
2017-04-01
In recent years, relationships between high milk yield at dry off, higher prevalence for new intramammary infections, and stress were evaluated. Considering increasing milk yield, dry off methods need to be refined to ensure udder health and animal welfare, especially in high-yielding dairy cows. The present work evaluated the effect of a single cabergoline injection (Velactis, Ceva Santé Animale, Libourne, France) at dry off on udder pressure, milk leakage, and signs of udder pain after dry off. A total of 234 high-yielding (≥16 kg of milk/d) dairy cows was enrolled 7 d before and followed up until 14 d after dry off. Cows were dried off without preparation (i.e., no feed change or intermittent milking before dry off) and treated with a single i.m. injection of 5.6 mg of cabergoline (n = 115) or placebo (n = 119) after last milking. Udder characteristics were measured 4 d before (i.e., before and after milking) and 1, 2, 3, 7, 10, and 14 d after dry off. Udder pressure was evaluated utilizing a hand-held dynamometer. Milk leakage and signs of udder pain were noted as binary variables. Whereas udder pressure baseline values after last milking did not differ between treatment groups (0.541 ± 0.15 kg), cabergoline significantly reduced udder pressure in primiparous but not in multiparous cows after dry off. Differences between cabergoline- and placebo-treated primiparous cows could be evaluated until 3 d after dry off. The first day after dry off, udder pressure in placebo- and cabergoline-treated cows increased by 115% and 42.3%, respectively. Whereas pressure values in placebo cows were highest on the first day after dry off (1.16 ± 0.61 kg) and slowly decreased afterward, udder pressure in cows treated with cabergoline had a slower increase and peak only 2 d after dry off (0.94 ± 0.44 kg). Furthermore, cabergoline caused a reduction of milk leakage, a known factor for new intramammary infections. Only 11.3% of cows treated with cabergoline showed milk leakage compared with 21.0% placebo-treated cows. Additionally, cows with placebo treatment were 2.8 times as likely to show signs of udder pain compared with cows treated with cabergoline. An effect of cabergoline on udder pressure, milk leakage, and udder pain was limited to the first week after dry off. Our data provide evidence that a single injection of cabergoline reduces risk factors for udder health and animal welfare problems around dry off in high-yielding dairy cows with more than 16 kg of milk/d. Further research is warranted, however, to investigate if cabergoline at dry off can also be used to reduce new intramammary infection rates and improve animal welfare after dry off. The Authors. Published by the Federation of Animal Science Societies and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
Delgado-Ruiz, Rafael; Romanos, Georgios E; Alexandre Gerhke, Sergio; Gomez-Moreno, Gerardo; Maté-Sánchez de Val, José Eduardo; Calvo-Guirado, José Luis
2016-08-02
To compare different compressive forces exerted on a particulate graft material during socket preservation and their effects on bone regeneration. Six male dogs were used. The second, third, and fourth premolars, and the first molar were extracted bilaterally at the lower jaws. A particulate synthetic biphasic grafting material (60% HA and 40% β-tricalcium phosphate) was used. Three different standardized compressive forces were applied randomly during the socket preservation. The sample was divided into four experimental groups Test A (10 g), Test B (50 g), Test C (200 g), and Control (empty sockets). Collagen membranes were placed, and primary closure was obtained. Two months after the surgery the animals were sacrificed, and histomorphometric analysis of non-decalcified samples was performed at the coronal, middle, and apical thirds. Grafted sockets resulted in higher bony contour (3 ± 0.43 mm 2 ; P < 0.05). The particles penetrated up to the apical third in the group C but not in the other test groups and controls (P < 0.05). The percentage of new bone were higher at the coronal and apical thirds for Controls and group C compared to A and B groups (P < 0.05). The residual graft was higher for group C (53 ± 1.4%), followed by group B (45 ± 3.1%) and group A (35 ± 1.9%; P < 0.05). The percentages of connective tissue were higher at the middle third without differences between groups (P > 0.05). Within the limitations of this experimental animal study, it might be concluded that grafted sockets compressed with 200 g force will have higher bony contours; higher compressive forces facilitate the penetration of the particulate graft material into the apical area of the socket and results in more bone formation at the coronal, middle, and apical thirds. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Nuclear reactor fuel rod attachment system
Not Available
1980-09-17
A reusable system is described for removably attaching a nuclear reactor fuel rod to a support member. A locking cap is secured to the fuel rod and a locking strip is fastened to the support member. The locking cap has two opposing fingers shaped to form a socket having a body portion. The locking strip has an extension shaped to rigidly attach to the socket's body portion. The locking cap's fingers are resiliently deflectable. For attachment, the locking cap is longitudinally pushed onto the locking strip causing the extension to temporarily deflect open the fingers to engage the socket's body portion. For removal, the process is reversed.