Laboratory investigation of the efficacy of holmium:YAG laser irradiation in removing intracanal debris

NASA Astrophysics Data System (ADS)

Nuebler-Moritz, Michael; Gutknecht, Norbert; Sailer, Hermann F.; Hering, Peter; Prettl, Wilhelm

1997-05-01

Current endodontic therapy involves debridement and disinfection of the root canal by means of mechanical instrumentation and chemical irrigation. However, several studies have shown that these techniques fail to achieve complete cleansing. Recently, lasers have been suggested for use within root canals. This study was conducted to determine the efficacy of Holmium:YAG laser irradiation in removing intracanal debris and smear layer. Root canal surfaces of freshly-extracted human teeth were exposed to pulsed Ho:YAG laser radiation. Subsequently, laser induced structural changes were investigated using scanning electron microscopy. Temperature measurements during irradiation were performed by means of thermocouples. The result of this survey give a preliminary indication of the ability of the Ho:YAG laser to improve current endodontic treatment survey give a preliminary indication of the ability of the Ho:YAG laser to improve current endodontic treatment modalities. However, limitations exist with regard to circumscribed and well-quantified irradiation of root canal surfaces, due to the lack of perpendicular delivery of the laser beam. Additional studies will be required to develop suitable optical transmission systems, in order to achieve complete cleansing and to avoid damage to the periradicular tissues, respectively.

Effectiveness of supplementary irrigant agitation with the Finisher GF Brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments.

PubMed

Neelakantan, P; Khan, K; Li, K Y; Shetty, H; Xi, W

2018-07-01

To examine the efficacy of a novel supplementary irrigant agitating brush (Finisher GF Brush, MedicNRG, Kibbutz Afikim, Israel) on the debridement of root canals prepared with a novel stainless steel rotary instrumentation system (Gentlefile; MedicNRG), or nickel titanium rotary instruments in oval root canals. Mandibular premolars (n = 72) were selected and divided randomly into three experimental groups (n = 24) after microCT scanning: group 1, canal preparation to rotary NiTi size 20, .04 taper (R20); group 2, rotary NiTi to size 25, .04 taper (R25) and group 3, Gentlefile size 23, .04 taper (GF). Specimens were subdivided into two subgroups: subgroup A, syringe-and-needle irrigation (SNI); subgroup B, Finisher GF Brush (GB). Ten untreated canals served as controls. Specimens were processed for histological evaluation, and the remaining pulp tissue (RPT) was measured. Data were analysed using Mann-Whitney and Kruskal-Wallis tests (P = 0.05). All experimental groups had significantly less RPT than the control (P < 0.05). Group 3B (GF-GB) had significantly less RPT than groups 1B (R20-GB) and 2B (R25-GF; P < 0.05). When irrigated with SNI, there was no significant difference in the RPT between the three groups (P > 0.05). When instrumented with R20, there was no significant difference between SNI and GF (P < 0.05) whilst GB had significantly less RPT than SNI for R25 (P < 0.05). Supplementary irrigant agitation with the Finisher GF Brush improved the debridement of canals prepared with Gentlefile and size 25, .04 taper rotary NiTi. Root canal debridement did not significantly differ between the instruments when syringe irrigation was used. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Endodontic implications of the variability of the root canal systems of posterior teeth.

PubMed

Biggs, J T; Benenati, F W

1995-01-01

Variations in the morphology of roots and root canal systems create challenges which the dental practitioner must be able to recognize. Endodontic therapy is predictable and successful only to the extent that the root canal system can be debrided, disinfected and sealed against future contamination. In order to accomplish these goals it is necessary to become familiar with the variability of the system we seek to treat.

Adjunctive use of antibiotics in periodontal therapy

PubMed Central

Barca, Ece; Cifcibasi, Emine; Cintan, Serdar

2015-01-01

Periodontal diseases are infectious diseases with a mixed microbial aetiology and marked inflammatory response leading to destruction of underlying tissue. Periodontal therapy aims to eliminate pathogens associated with the disease and attain periodontal health. Periodontitis is generally treated by nonsurgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface; however, mechanical debridement alone may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach microorganisms at the base of the deep periodontal pockets and furcation areas via serum, and also affects organisms residing within gingival epithelium and connective tissue. This review aims to provide an update on clinical issues regarding when and how to prescribe systemic antibiotics in periodontal therapy. The points discussed are the mode of antibiotic action, susceptible periodontal pathogens, antibiotic dosage, antibiotic use in treatment of periodontal disease, and mechanism of bacterial resistance to each antibiotic. PMID:28955547

Guided surgical debridement: staining tissues with methylene blue.

PubMed

Dorafshar, Amir H; Gitman, Marina; Henry, Ginard; Agarwal, Shailesh; Gottlieb, Lawrence J

2010-01-01

Precise surgical debridement of wounds is required to achieve wound closure. The authors describe their experience with a technique using topical methylene blue to facilitate precise surgical debridement. In this technique, methylene blue dye is applied topically to the wound surface at the onset of surgery. The stained wound site is then wiped to remove dye from the surface of normal epithelium; eschar, nonviable tissue, and granulation tissue remain stained. The methylene blue-stained tissue is surgically removed, and the newly debrided surface of the wound is assessed for adequate vascularity and biopsied to verify presence of bacteriologic balance before closure. The authors have used this technique in more than 200 wound debridements during the past year, including acute surgical or traumatic wounds, acute and subacute burn wounds, chronic granulating wounds, partially epithelialized wounds, sinus tracts, and fistulae. No adverse reactions have been noted, even on patients undergoing multiple applications through serial operations. Topical application of methylene blue to wounds with mixed tissue content helps to distinguish between viable and nonviable tissue and between epithelialized and nonepithelialized areas, facilitating more precise and complete wound debridement.

Influence of handling-relevant factors on the behaviour of a novel calculus-detection device.

PubMed

Meissner, Grit; Oehme, Bernd; Strackeljan, Jens; Kocher, Thomas

2005-03-01

The aim of periodontal therapy is always the complete debridement of root surfaces with the removal of calculus and without damaging cementum. We have recently demonstrated the feasibility of a surface recognition device that discriminates dental surfaces by mathematical analysis of reflected ultrasound waves. This principle should enable the construction of calculus detecting ultrasonic device. Pre-clinical test results are presented here. An impulse generator, coupled to a conventional piezo-driven ultrasonic scaler, sends signals to the cementum via the tip of an ultrasound device. The oscillation signal reflected from the surface contains the information necessary to analyse its characteristics. In order to discriminate different surfaces, learning sets were generated from 70 extracted teeth using standardized tip angle/lateral force combinations. The complete device was then used to classify root surfaces unknown to the system. About 80% of enamel and cementum was correctly identified in vivo (sensitivity: 75%, specificity: 82%). The surface discrimination method was not influenced by the application conditions examined. A new set of 200 tests on 10 teeth was correctly recognized in 82% of the cases (sensitivity: 87%, specificity: 76%). It was shown in vitro that the tooth surface recognition system is able to function correctly, independent of the lateral forces and the tip angle of the instrument. Copyright 2005 Blackwell Munksgaard.

Role of "diseased" root cementum in healing following treatment of periodontal disease. A clinical study.

PubMed

Nyman, S; Westfelt, E; Sarhed, G; Karring, T

1988-08-01

This clinical trial was undertaken to examine whether root debridement in the treatment of periodontal disease must include the removal of the exposed cementum in order to achieve periodontal health. The study included 11 adult patients with moderate to advanced periodontal disease. In a split-mouth design, the dentition of each patient was by random selection divided into test- and control quadrants comprising the incisors, canines and premolars. Following a baseline examination, all patients were given a case presentation and a detailed instruction in self-performed oral hygiene measures. The patients were then subjected to periodontal surgery. Following reverse bevel incisions, buccal and lingual mucoperiosteal flaps were elevated and all granulation tissue was removed. In 2 jaw quadrants (control quadrants) in each patient, the denuded root surfaces were carefully scaled and planed in order to remove soft and hard deposits as well as all cementum, using hand instruments and flame-formed diamond stones. In the contralateral quadrants (test quadrants) the roots were not scaled and planed but soft microbial deposits were removed by polishing the root surfaces with the but soft microbial deposits were removed by polishing the root surfaces with the use of rubber cups, interdental rubber tips and a polishing paste. Calculus in the test quadrants was removed by the use of a curette, but precaution was taken to avoid the removal of cementum. The flaps were repositioned to their original level and sutured. The patients were following active treatment enrolled in a supervised maintenance care program including "professional tooth cleaning" once every 2 weeks for a 3-month period.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of commercially available biodegradable tetracycline fiber therapy in chronic periodontitis

PubMed Central

Sachdeva, Surinder; Agarwal, Vipin

2011-01-01

Background: Chronic periodontitis is an inflammatory disorder caused by dental plaque having mixed microbial flora. The different treatment modalities available to treat this disease are aimed at removal of micro-organisms from both hard and soft tissues. Systemic as well as local anti-microbial agents are helpful adjuncts in reducing microbes especially in inaccessible areas along with mechanical debridement therapy. Materials and Methods: The study was conducted in a split mouth design. Thirty-five patients having at least two non-adjacent sites in different quadrants with periodontal pockets ≥5 mm and with bleeding on probing at initial visit were selected. The selected sites were treated with both scaling and root planing plus tetracycline fibers or with scaling and root planing alone. Baseline and follow-up measurements included plaque index, gingival index, probing pocket depth, and clinical attachment level. Result: Both treatment modalities were affective in improving clinical parameters over three months’ observation period. The combined antimicrobial and mechanical debridement therapy has shown better results as compared with scaling and root planing alone. Conclusion: Application of tetracycline in modified collagen matrix following scaling and root planing might be beneficial in treatment of chronic periodontitis and improving periodontal parameters for 3-month duration. PMID:21976836

Serial Surgical Debridement of Common Pressure Injuries in the Nursing Home Setting: Outcomes and Findings.

PubMed

Anvar, Bardia; Okonkwo, Henry

2017-07-01

This study examined the efficacy of bedside surgical debridement in a nursing home population. A retrospective chart review was performed of sacrum, sacrococcyx, coccyx, ischium, and trochanter (SSCIT) region pressure injuries in the Skilled Wound Care practice (Los Angeles, CA). The patient population was refined from 2128 to 227 patients visited 8 or more times during nursing home stays found to have 1 or more SSCIT pressure injuries. Of the 227 patients, there were approximately 319 individual SSCIT wounds, with an average of 1.4 SSCIT wounds per patient. Bedside surgical debridement was performed using a sharp excisional technique on 190 of 319 (59.5%) SSCIT wounds. An analysis of the square surface area of the 190 debrided wound sites revealed a mean ulcer surface area of 20.76 cm2. Of those 190 wound sites, 138 (73%) had a reduction in square surface area, and 52 (27%) had no change or an increase in square surface area and were categorized as nonresponders. Of the wounds that did improve by a reduction in wound surface area, the average wound surface area reduction was 6.81 cm2 at 4 weeks (25%), 8.91 cm2 reduction at 8 weeks (33%), and 10.87 cm2 reduction at 12 weeks (40%). From the 190 wound sites, there were a total of 43 (23%) wounds that had a square surface area of 0 (reepithelialized), which has a healing rate of 23%. Traditional bedside debridement provides excellent results in reducing the square surface area for a majority of wounds. Whether used alone or as an adjunct to any treatment plan, the use of surgical sharp equipment aids in achieving good wound healing and advancing the rate of wound closure. Although wound healing requires many components, sharp debridement can effectively remove devitalized tissue and is a proven significant component to advancing wound closure.

Comparing the Effectiveness of Polymer Debriding Devices Using a Porcine Wound Biofilm Model.

PubMed

Wilkinson, Holly N; McBain, Andrew J; Stephenson, Christian; Hardman, Matthew J

2016-11-01

Objective: Debridement to remove necrotic and/or infected tissue and promote active healing remains a cornerstone of contemporary chronic wound management. While there has been a recent shift toward less invasive polymer-based debriding devices, their efficacy requires rigorous evaluation. Approach: This study was designed to directly compare monofilament debriding devices to traditional gauze using a wounded porcine skin biofilm model with standardized application parameters. Biofilm removal was determined using a surface viability assay, bacterial counts, histological assessment, and scanning electron microscopy (SEM). Results: Quantitative analysis revealed that monofilament debriding devices outperformed the standard gauze, resulting in up to 100-fold greater reduction in bacterial counts. Interestingly, histological and morphological analyses suggested that debridement not only removed bacteria, but also differentially disrupted the bacterially-derived extracellular polymeric substance. Finally, SEM of post-debridement monofilaments showed structural changes in attached bacteria, implying a negative impact on viability. Innovation: This is the first study to combine controlled and defined debridement application with a biologically relevant ex vivo biofilm model to directly compare monofilament debriding devices. Conclusion: These data support the use of monofilament debriding devices for the removal of established wound biofilms and suggest variable efficacy towards biofilms composed of different species of bacteria.

Short-term clinical and microbiologic effects of pocket debridement with an Er:YAG laser during periodontal maintenance.

PubMed

Tomasi, Cristiano; Schander, Kerstin; Dahlén, Gunnar; Wennström, Jan L

2006-01-01

The erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser is considered a useful tool for subgingival debridement because the laser treatment creates minimal damage to the root surface and has potential antimicrobial effects. The aim of this randomized controlled clinical trial was to evaluate clinical and microbiologic effects of pocket debridement using an Er:YAG laser in patients during periodontal maintenance. Twenty patients at a recall visit for maintenance were consecutively recruited if presenting at least four teeth with residual probing depth (PD) > or = 5 mm. Two pockets in each of two jaw quadrants were randomly assigned to subgingival debridement using 1) an Er:YAG laser (test) or 2) an ultrasonic scaler (control). The laser beam was set at 160 mJ with a pulse frequency of 10 Hz. Clinical variables were recorded at baseline, 1 month, and 4 months after treatment. Primary clinical outcome variables were changes in PD and clinical attachment level (CAL). Microbiologic analysis of subgingival samples was performed at baseline, 2 days, and 30 days after treatment using a checkerboard DNA-DNA hybridization technique against 12 periodontal disease-associated species. The mean initial PD was 6.0 mm (SD: 1.2) in the test group and 5.8 mm (SD: 0.9) in the control group. At 1 month post-treatment, the PD reduction was significantly greater for test than control sites (0.9 versus 0.5 mm; P <0.05). The CAL gain also was significantly greater (0.5 versus 0.06 mm; P <0.01). At the 4-month examination, no significant differences were detected in PD reduction (1.1 versus 1.0 mm) or CAL gain (0.6 versus 0.4 mm). Both treatments resulted in reduction of the subgingival microflora. No significant differences in microbiologic composition were identified between the treatment groups at various time intervals. Degree of treatment discomfort scored significantly lower for the test than the control treatment modality. The results of the trial failed to demonstrate any apparent advantage of using an Er:YAG laser for subgingival debridement, except less treatment discomfort perceived by the patients.

Comparing the Effectiveness of Polymer Debriding Devices Using a Porcine Wound Biofilm Model

PubMed Central

Wilkinson, Holly N.; McBain, Andrew J.; Stephenson, Christian; Hardman, Matthew J.

2016-01-01

Objective: Debridement to remove necrotic and/or infected tissue and promote active healing remains a cornerstone of contemporary chronic wound management. While there has been a recent shift toward less invasive polymer-based debriding devices, their efficacy requires rigorous evaluation. Approach: This study was designed to directly compare monofilament debriding devices to traditional gauze using a wounded porcine skin biofilm model with standardized application parameters. Biofilm removal was determined using a surface viability assay, bacterial counts, histological assessment, and scanning electron microscopy (SEM). Results: Quantitative analysis revealed that monofilament debriding devices outperformed the standard gauze, resulting in up to 100-fold greater reduction in bacterial counts. Interestingly, histological and morphological analyses suggested that debridement not only removed bacteria, but also differentially disrupted the bacterially-derived extracellular polymeric substance. Finally, SEM of post-debridement monofilaments showed structural changes in attached bacteria, implying a negative impact on viability. Innovation: This is the first study to combine controlled and defined debridement application with a biologically relevant ex vivo biofilm model to directly compare monofilament debriding devices. Conclusion: These data support the use of monofilament debriding devices for the removal of established wound biofilms and suggest variable efficacy towards biofilms composed of different species of bacteria. PMID:27867752

Histologic comparison of the CO2 laser and Nd:YAG with and without water/air surface cooling on tooth root structure

NASA Astrophysics Data System (ADS)

Cobb, Charles M.; Spencer, Paulette; McCollum, Mark H.

1995-05-01

Specimens consisted of 18 extracted single rooted teeth unaffected by periodontal disease. After debriding roots, specimens were randomly divided into 4 treatment groups and subjected to a single pass, at varying energy densities, of a CO2, Nd:YAG, and Nd:YAG with air/water surface cooling (Nd:YAG-C). The rate of exposure was controlled at 4 mm/sec. Approximate energy densities were: CO2, 138, 206, 275, and 344 J/cm2; Nd:YAG, 114, 171, 229, and 286 J/cm2; Nd:YAG-C, 286, 343, 514, and 571 J/cm2. The CO2 laser was used both in continuous and pulsed beam modes (20 Hz, 0.01 sec pulse length and 0.8 mm dia spot size) whereas the Nd:YAG and Nd:YAG-C were preset at 50 Hz, 0.08 sec pulse length and 0.6 mm dia spot size. Specimen examination by SEM revealed, for all lasers, a direct correlation between increasing energy densities and depth of tissue ablation and width of tissue damage. However, to achieve the same relative dept of tissue ablation, the Nd:YAG-C required higher energy densities than either the CO2 or Nd:YAG lasers. The Nd:YAG-C generated a cavitation with sharply defined margins. Furthermore, regardless of energy density, and in contrast with other laser types, areas treated with the Nd:YAG-C did not exhibit collateral zones of heat damaged surface tissue.

Periodontal tissue healing following flap surgery using an Er:YAG laser in dogs.

PubMed

Mizutani, Koji; Aoki, Akira; Takasaki, Aristeo Atsushi; Kinoshita, Atsuhiro; Hayashi, Chie; Oda, Shigeru; Ishikawa, Isao

2006-04-01

The purpose of this study was to compare periodontal tissue healing following flap surgery using an Er:YAG laser with that of conventional surgery. Bilateral premolars with experimentally induced periodontitis in six dogs were treated by periodontal flap surgery. Degranulation and root debridement in the furcation were performed using an Er:YAG laser or curet. At 3 months postsurgery, animals were sacrificed and decalcified specimens were prepared for histological and histometric analysis. Degranulation and root debridement were effectively performed with an Er:YAG laser without major thermal damage and significantly faster than with a curet. Histologically, the amount of newly formed bone was significantly greater in the laser group than in the curet group, although both groups showed similar amounts of cementum formation and connective tissue attachment. The Er:YAG laser irradiation can be safely and effectively utilized in periodontal flap surgery, and has the potential to promote new bone formation. Copyright 2006 Wiley-Liss, Inc.

[Root canal treatment of mandibular first premolar with 4 root canals: a case report].

PubMed

Liu, Xin-yang; Zhan, Fu-Liang

2015-10-01

The mandibular first premolar can be considered one of the most challenging teeth to treat, due to the complexity of its root canal morphology and increased incidence of multiple canals. A case of endodontic treatment of a mandibular first premolar exhibiting a total of 4 distinct root canals and 4 apical foramina was described. Anatomic variation of root canal morphology should be considered in endodontic treatment to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation might allow the flow of sealer into the narrowed but unprepared part of the canal, thereby facilitating optimum chemo-mechanical debridement of the root canal system.

Enzymatic debridement of deeply burned faces: Healing and early scarring based on tissue preservation compared to traditional surgical debridement.

PubMed

Schulz, Alexandra; Fuchs, Paul Christian; Rothermundt, Irene; Hoffmann, Alexandra; Rosenberg, Lior; Shoham, Yaron; Oberländer, Henrik; Schiefer, Jennifer

2017-09-01

Facial burns occur frequently and depending on the injured skin layers often heal with scars which may cause permanent functional and cosmetic sequelae. Preservation of the sensitive facial skin layers, especially of the dermis is essential for scarless epithelialisation. Enzymatic debridement of deep thermal burns has already been shown to assist with preserving viable dermis. However, up to date, there are no published reports on wound healing and in the long term aesthetic outcome after enzymatic debridement of facial burns. Therefore we performed a-single centre clinical trial that included 26 subjects aged 18-78 years with facial burns clinically evaluated as deep dermal or deeper. Burns were treated either with enzymatic debridement or excisional surgical debridement. Then we compared both groups regarding debridement selectivity, wound closure and scar quality after more than 12 months. Enzymatic debridement significantly reduced time to complete wound closure after admission (19.85 days versus 42.23 days, p=0.002), and after enzymatic eschar removal (18.92 days versus 35.62 days, p=0.042). The number of procedures to complete debridement were significantly lower in the enzymatic debridement group (1.00 versus 1.77, p=0.003). 77% of facial burns that had been debrided enzymatically were found to be more superficially burned than initially estimated. Wounds undergoing autografting of any size were significantly reduced by enzymatic debridement (15% versus 77%, p=0.002). Scar quality after enzymatic debridement was superior compared to surgical debridement after 12 months regarding pigmentation (p=0.016), thickness (p=0.16), relief (p=0.10), pliability (p=0.01), surface area (p=0.004), stiffness (p=0.023), thickness (0.011) and scar irregularity (p=0.011). Regarding erythema and melanin, viscoelasticity and pliability, trans-epidermal water loss or laser tissue oxygen saturation, haemoglobin level and microcirculation we found no significant differences for treated and untreated skin in the EDNX group. In our current study we found Bromelain based enzymatic debridement better in some aspects of tissue preservation in deep dermal facial burn. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Canal and isthmus debridement efficacies of two irrigant agitation techniques in a closed system

PubMed Central

Susin, L.; Yoon, J. C.; Liu, Y.; Parente, J. M.; Loushine, R. J.; Ricucci, D.; Bryan, T.; Weller, R. N.; Pashley, D. H.; Tay, F. R.

2010-01-01

Aim To compare canal and isthmus debris debridement efficacies of the manual dynamic irrigation (MDI) and apical negative pressure (ANP) techniques in the mesial root of mandibular first molars with narrow isthmi, using a closed canal design. Methodology Micro-computed tomography was employed to select 20 teeth, each containing a narrow isthmus. Each root was sealed at the apex with hot glue and embedded in polyvinylsiloxane to simulate a closed canal system. The teeth were submitted to a standardised instrumentation protocol. Final irrigation was performed with either the MDI or the ANP technique using the EndoVac system (N=10). Masson trichrome-stained sections were prepared from completely demineralised roots at ten canal levels between 1–2.8 mm of the anatomical apices. Areas occupied by canals and isthmus of each root and debris in the corresponding regions were digitised by the NIH Image J software and statistically analysed using two-way repeated measures ANOVA. Results For the instrumented canals, there were no differences between the two groups (p=0.131) in the area occupied by debris at all canal levels (p=0.343). Conversely, for the isthmus, less debris was found in the ANP group (p<0.001) but no differences were seen in each group with respect to the ten canal levels (p=0.352). Conclusion Neither technique produce completely removed debris from the isthmus regions. However the EndoVac system, which encompasses the ANP concept, removed considerably more debris from narrow isthmi of the mandibular mesial roots. PMID:20726910

Intermediate-level disinfection with accelerated hydrogen peroxide prevents accumulation of bacteria in Versajet™ tubing during repeated daily debridement using simulated-use testing with an inoculated pork hock.

PubMed

Gawaziuk, J P; Alfa, M J; Olson, N; Logsetty, S

2014-05-01

This study assesses the feasibility of using the Versajet™ system (VJS) on an inoculated pork hock (PH) skin surface sequentially for 8 days with daily cleaning and intermediate-level disinfection (ILD). Daily, PHs were inoculated with bacteria suspended in artificial test soil (ATS). An ILD protocol with accelerated hydrogen peroxide (AHP, OxivirTB(®)) was employed to clean and disinfect the VJS between debridements. PH skin contains 6.1-6.8×10(6)cfu/cm(2) bacteria. Bacterial counts in the handpiece and discharge hoses immediately after debridement of the PHs, and before cleaning, increased throughout the study period (5.19-6.43log10cfu/mL). Cleaning with the ILD protocol was reduced bacterial counts on the VJS by 6-log. Protein, a surrogate marker of organic contamination, was also reduced post-cleaning and ILD. Compared to a maximum post-debridement level of protein (57.9 μg/mL) obtained before ILD, VJS protein levels dropped to 9.8 (handpiece) and 13.8 μg/mL (discharge hose). Disinfection of the handpiece and discharge hose after debridement with AHP resulted in a 6-log reduction in bacterial count and 4.2 fold reduction in protein. An ILD protocol with an AHP may be a feasible method for serial skin surface debridements with the VJS for up to eight days. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Effective removal of calcified deposits on microstructured titanium fixture surfaces of dental implants with erbium lasers.

PubMed

Takagi, Toru; Aoki, Akira; Ichinose, Shizuko; Taniguchi, Yoichi; Tachikawa, Noriko; Shinoki, Takeshi; Meinzer, Walter; Sculean, Anton; Izumi, Yuichi

2018-03-13

Recently, the occurrence of peri-implantitis has been increasing. However, a suitable method to debride the contaminated surface of titanium implants has not been established. The aim of this study was to investigate the morphological changes of the microstructured fixture surface after erbium laser irradiation, and to clarify the effects of the erbium lasers when used to remove calcified deposits from implant fixture surfaces. In experiment 1, sandblasted, large grit, acid etched surface implants were treated with Er:YAG laser or Er,Cr:YSGG laser at 30-60 mJ/pulse and 20 Hz with water spray. In experiments 2 and 3, the effects of erbium lasers used to remove calcified deposits (artificially prepared deposits on virgin implants and natural calculus on failed implants) were investigated and compared with mechanical debridement using either a titanium curette or cotton pellets. After the various debridement methods, all specimens were analyzed by stereomicroscopy (SM), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). Stereomicroscopy and SEM showed that erbium lasers with optimal irradiation parameters did not have an effect on titanium microstructures. Compared to mechanical debridement, erbium lasers were more capable of removing calcified deposits on the microstructured surface without surface alteration using a non-contact sweeping irradiation at 40 mJ/pulse (ED 14.2 J/cm 2 /pulse) and 20 Hz with water spray. These results indicate that Er:YAG and Er,Cr:YSGG lasers are more advantageous in removing calcified deposits on the microstructured surface of titanium implants without inducing damage, compared to mechanical therapy by cotton pellet or titanium curette. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Periodontal-endodontic lesion of a three-rooted maxillary premolar: report of a case.

PubMed

Blanchard, Steven B; Almasri, Amjad; Gray, Jonathon L

2010-05-01

A 43-year-old African American male initially presented for a dental evaluation of a recurrent swelling on the buccal aspect of tooth #12. His medical history was unremarkable except for a 20-pack year history of smoking. He was eventually diagnosed as having a necrotic pulp #12, and received root canal treatment. The patient's problem was unresolved, and he was subsequently referred for a periodontal evaluation with a presumptive diagnosis of a periodontal abscess. A flap was reflected from teeth #11 through #15. A buccal furcation invasion was discovered on #12. Shortly thereafter, three distinct roots with three grade III furcation invasions were located. The tooth was deemed untreatable, and was extracted. The thin buccal plate of the extraction socket was preserved using freeze-dried bone allograft to facilitate future prosthodontic replacement. Healing was uneventful. Periodontal open flap debridement surgery was provided for the remainder of the mouth, and the patient was placed on a 3-month recall program. Periodontitis associated with endodontic lesions are among the most daunting diagnostic and therapeutic challenges faced by periodontists. This is particularly true for maxillary premolars with multiple roots. The tooth in this case, once periodontally involved, had a very poor prognosis. The prognosis was further compromised by the pulpal involvement. Therapy consisted of extraction of the tooth to relieve the patient's discomfort and treating the adjacent teeth with periodontal open flap debridement surgery. A review of the literature pertinent to the diagnosis and management of periodontal-endodontic lesions is also presented.

Minimally invasive burn care: a review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (Nexobrid®)

PubMed Central

Rosenberg, L.; Shoham, Y.; Krieger, Y.; Rubin, G.; Sander, F.; Koller, J.; David, K.; Egosi, D.; Ahuja, R.; Singer, A.J.

2015-01-01

Summary Current surgical and non-surgical eschar removal-debridement techniques are invasive or ineffective. A bromelainbased rapid and selective enzymatic debriding agent was developed to overcome these disadvantages and compared with the standard of care (SOC). The safety and efficacy of a novel Debriding Gel Dressing (DGD) was determined in patients with deep partial and full thickness burns covering up to 67% total body surface area (TBSA). This review summarizes data from seven studies, four of which were randomized clinical trials that included a SOC or control vehicle. DGD eschar debridement efficacy was >90% in all studies, comparable to the SOC and significantly greater than the control vehicle. The total area excised was less in patients treated with DGD compared with the control vehicle (22.9% vs. 73.2%, P<0.001) or the surgical/non-surgical SOC (50.5%, P=0.006). The incidence of surgical debridement in patients treated with DGD was lower than the SOC (40/163 [24.5%] vs. 119/170 [70.0%], P0.001). Less autografting was used in all studies. Long-term scar quality and function were similar in DGD- and SOCtreated. DGD is a safe and effective method of burn debridement that offers an alternative to surgical and non-surgical SOC. PMID:27777547

Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement.

PubMed

Topcu, K Meltem; Karatas, Ertugrul; Ozsu, Damla; Ersoy, Ibrahim

2014-07-01

The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P < 0.001). The ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups.

Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement

PubMed Central

Topcu, K. Meltem; Karatas, Ertugrul; Ozsu, Damla; Ersoy, Ibrahim

2014-01-01

Objectives: The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Materials and Methods: Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. Results: An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P < 0.001). The ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). Conclusions: None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups. PMID:25202211

Management of 2 teeth diagnosed with dens invaginatus with regenerative endodontics and apexification in the same patient: a case report and review.

PubMed

Kumar, Harleen; Al-Ali, Muna; Parashos, Peter; Manton, David J

2014-05-01

This review and case report present the treatment of a 10-year-old boy with both permanent maxillary lateral incisors demonstrating Oehlers type II dens invaginatus and pulpal involvement. Treatment was complicated by dental anxiety, supraventricular tachycardia, immature tooth development, and facial cellulitis. An infected necrotic pulp of the permanent maxillary left lateral incisor was treated by apexification and endodontic treatment with mineral trioxide aggregate. The necrotic pulp of the permanent maxillary right lateral incisor was treated with canal debridement and dressing under general anesthesia. Periapical healing of both teeth occurred, with the right lateral incisor showing continued root growth, thickening of the dentinal root walls, and completed apex formation. This tooth responded normally to pulp testing. Twenty-eight months after initial treatment, the right lateral incisor displayed progressive sclerosis of the canal. This case demonstrates possible pulpal regeneration of an infected maxillary right lateral incisor with dens invaginatus and an immature apex after minimal canal debridement. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Optimal Er:YAG laser irradiation parameters for debridement of microstructured fixture surfaces of titanium dental implants.

PubMed

Taniguchi, Yoichi; Aoki, Akira; Mizutani, Koji; Takeuchi, Yasuo; Ichinose, Shizuko; Takasaki, Aristeo Atsushi; Schwarz, Frank; Izumi, Yuichi

2013-07-01

Er:YAG laser (ErL) irradiation has been reported to be effective for treating peri-implant disease. The present study seeks to evaluate morphological and elemental changes induced on microstructured surfaces of dental endosseous implants by high-pulse-repetition-rate ErL irradiation and to determine the optimal irradiation conditions for debriding contaminated microstructured surfaces. In experiment 1, dual acid-etched microstructured implants were irradiated by ErL (pulse energy, 30-50 mJ/pulse; repetition rate, 30 Hz) with and without water spray and for used and unused contact tips. Experiment 2 compared the ErL treatment with conventional mechanical treatments (metal/plastic curettes and ultrasonic scalers). In experiment 3, five commercially available microstructures were irradiated by ErL light (pulse energy, 30-50 mJ/pulse; pulse repetition rate, 30 Hz) while spraying water. In experiment 4, contaminated microstructured surfaces of three failed implants were debrided by ErL irradiation. After the experiments, all treated surfaces were assessed by stereomicroscopy, scanning electron microscopy (SEM), and/or energy-dispersive X-ray spectroscopy (EDS). The stereomicroscopy, SEM, and EDS results demonstrate that, unlike mechanical treatments, ErL irradiation at 30 mJ/pulse and 30 Hz with water spray induced no color or morphological changes to the microstructures except for the anodized implant surface, which was easily damaged. The optimized irradiation parameters effectively removed calcified deposits from contaminated titanium microstructures without causing substantial thermal damage. ErL irradiation at pulse energies below 30 mJ/pulse (10.6 J/cm(2)/pulse) and 30 Hz with water spray in near-contact mode seems to cause no damage and to be effective for debriding microstructured surfaces (except for anodized microstructures).

Endodontic management of maxillary first molar with seven root canals diagnosed using Cone Beam Computed Tomography scanning

PubMed Central

Raghavendra, Srinidhi Surya; Hindlekar, Ajit Narayan; Desai, Niranjan Nanasaheb; Vyavahare, Nishant Kishor; Napte, Bandu Devrao

2014-01-01

The main objective of root canal treatment is thorough cleaning and shaping of the entire pulp space and its complete filling with an inert filling material. A major cause of post-treatment disease is the inability to locate, debride or adequately fill all canals of the root canal system. The form, configuration, and number of root canals in the maxillary first molars have been discussed for more than half a century. Maxillary first molars commonly present with three roots and three canals, with a second mesiobuccal canal (MB2) also present. With the advent of improved magnification there are reports of multiple root canals in the maxillary first molars. Nonsurgical endodontic therapy of a left maxillary first molar with three roots and seven root canals was successfully performed under a dental operating microscope. The diagnosis of multiple root canals was confirmed with the help of Cone Beam Computed Tomography (CBCT) images. PMID:25565745

Heat propagation in dentin during instrumentation with different sonic scaler tips.

PubMed

Kocher, T; Plagmann, H C

1996-04-01

It is important to know how much heat is generated when a root surface is debrided with sonic scalers and if that heat can be released satisfactorily into the environment. The temperature changes that occurred in dentinal specimens treated with two different sonic scaler tips, used with and without coolant, were studied. Temperature increases of up to 4 degrees C were observed for both tips when a coolant was used. Heat propagation during instrumentation was dependent to a considerable degree on the temperature of the coolant. Sonic scalers should not be used without coolant, because the dentinal temperature may increase up to 35 degrees C, depending on the force of application. A high positive linear correlation was found between increase in temperature and force of application.

Effects of different sonic activation protocols on debridement efficacy in teeth with single-rooted canals

PubMed Central

Niu, Li-na; Luo, Xiao-juan; Li, Guo-hua; Bortoluzzi, Eduardo A.; Mao, Jing; Chen, Ji-hua; Gutmann, James L.; Pashley, David H.; Tay, Franklin R.

2014-01-01

Objectives The effects of different EndoActivator® (EA) sonic activation protocols on root canal debridement efficacy were examined. Methods Root canals in 48 single-rooted teeth were instrumented, irrigated initially with NaOCl and divided into 6 groups (N=8) based on the application time of QMix (antimicrobial calcium-chelating irrigant), and the time and sequence of EA irrigant activation - Positive Control: 90 sec QMix; Negative Control: 90 sec saline; Group 1A: 15 sec QMix + 15 sec QMix with EA-activation; Group 1B: 30 sec QMix + 30 sec of QMix with EA-activation; Group 2A: 15 sec QMix with EA-activation + 15 sec QMix; Group 2B: 30 sec QMix with EA-activation + 30 sec QMix. Split roots were examined with scanning electron microscopy for assignment of smear and debris scores in locations along the coronal, middle and apical thirds of the canals. The overall cleanliness of pooled canal locations in the Positive Control and the 4 experimental groups were compared with chi-square tests. Results Significant differences were detected among the 5 groups (p<0.001). Post-hoc pairwise comparisons indicated that the overall canal cleanliness was in the order (from best to worst): 1B = 2B > 2A > 1A > Positive Control. Completely clean canals could not be achieved due to the absence of continuous irrigant flow for EA to clear intraradicular debris. Conclusions Irrespective of the sonic activation sequence, irrigant activation for 30 seconds during a 60-second period of QMix application appears to maximize the smear layer and debris removal potential of the EndoActivator® system. PMID:24878251

Mandibular first premolar with four canals.

PubMed

Du, Yi; Lee, Angeline H C; Zhang, Chengfei

2013-02-01

A case of endodontic treatment of a mandibular first premolar exhibiting a total of four distinct root canals and four apical foramina is described. This occurrence in mandibular first premolar has rarely been reported in the endodontic literature. Endodontic treatment that considers the anatomic variation of root canal morphology is important to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation with ethylenediaminetetraacetic acid might allow the flow of sealer into the narrowed but unprepared part of the canal. This offers valuable adjuncts for the successful negotiation of calcified main canals, thereby facilitating optimum chemo-mechanical debridement of the root canal system. © 2013 Blackwell Publishing Asia Pty Ltd.

Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

PubMed

Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

2016-02-01

Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting, and internal fixation can be completed with only one incision and surgical position, and the deformity correction efficiency is higher than anterior surgery. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

The use of lasers for periodontal debridement: marketing tool or proven therapy?

PubMed

Chanthaboury, Rachel; Irinakis, Tassos

2005-10-01

The use of lasers in dentistry has recently received much attention, in both clinical practice and research; their unique properties produce favourable clinical results in some cases and encourage patient acceptance. Various types of lasers have been investigated as an adjunct to periodontal therapy; these include carbon dioxide (CO₂), diode, neodymium:yttrium-aluminium-garnet (Nd:YAG) and erbium:yttrium-aluminium-garnet (Er:YAG) lasers.However, adverse results have been associated with each type, including thermal damage to root surfaces, increases in pulpal temperature and the production of toxic by-products. The Er:YAG laser has produced the most promising results, as it can ablate effectively with minimal adverse effects. More research is needed to determine the ideal settings and methods for using the laser safely and effectively in clinical practice.

A rare case of prosthetic endocarditis and dehiscence in a mechanical valved conduit

PubMed Central

Kannan, Arun; Smith, Cristy; Subramanian, Sreekumar; Janardhanan, Rajesh

2014-01-01

A middle-aged adult patient with a history of aortic root replacement with a mechanical valved conduit and remote chest trauma was referred to our institution with prosthetic endocarditis. Transoesophageal echocardiogram at our institution confirmed a near-complete dehiscence of the prosthetic aortic valve from the conduit, with significant perivalvular flow forming a pseudoaneurysm. The patient underwent a high-risk re-operation, involving redo aortic root replacement with a homograft after extensive debridement of the infected tissue. The patient was discharged to an outside facility after an uncomplicated hospital course, and remains stable. PMID:24510692

A rare case of prosthetic endocarditis and dehiscence in a mechanical valved conduit.

PubMed

Kannan, Arun; Smith, Cristy; Subramanian, Sreekumar; Janardhanan, Rajesh

2014-02-07

A middle-aged adult patient with a history of aortic root replacement with a mechanical valved conduit and remote chest trauma was referred to our institution with prosthetic endocarditis. Transoesophageal echocardiogram at our institution confirmed a near-complete dehiscence of the prosthetic aortic valve from the conduit, with significant perivalvular flow forming a pseudoaneurysm. The patient underwent a high-risk re-operation, involving redo aortic root replacement with a homograft after extensive debridement of the infected tissue. The patient was discharged to an outside facility after an uncomplicated hospital course, and remains stable.

Limited Versus Total Epithelial Debridement Ocular Surface Injury: Live Fluorescence Imaging of Hemangiogenesis and Lymphangiogenesis in Prox1-GFP/Flk1::myr-mCherry Mice

PubMed Central

Chang, Jin-Hong; Putra, Ilham; Huang, Yu-hui; Chang, Michael; Han, Kyuyeon; Zhong, Wei; Gao, Xinbo; Wang, Shuangyong; Dugas-Ford, Jennifer; Nguyen, Tara; Hong, Young-Kwon; Azar, Dimitri T.

2016-01-01

Background Immunohistochemical staining experiments have shown that both hemangiogenesis and lymphangiogenesis occur following severe corneal and conjunctival injury and that the neovascularization of the cornea often has severe visual consequences. To better understand how hemangiogenesis and lymphangiogenesis are induced by different degrees of ocular injury, we investigated patterns of injury-induced corneal neovascularization in live Prox1-GFP/Flk1::myr-mCherry mice, in which blood and lymphatic vessels can be imaged simultaneously in vivo. Methods The eyes of Prox1-GFP/Flk1::myr-mCherry mice were injured according to four models based on epithelial debridement of the: A) central cornea (a 1.5-mm-diameter circle of tissue over the corneal apex), B) total cornea, C) bulbar conjunctiva, and D) cornea+bulbar conjunctiva. Corneal blood and lymphatic vessels were imaged on days 0, 3, 7, and 10 post-injury, and the percentages of the cornea containing blood and lymphatic vessels were calculated. Results Neither central corneal nor bulbar conjunctival debridement resulted in significant vessel growth in the mouse cornea, whereas total corneal and corneal+bulbar conjunctival debridement did. On day 10 in the central cornea, total cornea, bulbar conjunctiva, and corneal+bulbar conjunctival epithelial debridement models, the percentage of the corneal surface that was occupied by blood vessels (hemangiogenesis) was 1.9±0.8%, 7.14±2.4%, 2.29±1%, and 15.05±2.14%, respectively, and the percentage of the corneal surface that was occupied by lymphatic vessels (lymphangiogenesis) was 2.45±1.51%, 4.85±0.95%, 2.95±1.27%, and 4.15±3.85%, respectively. Conclusions Substantial corneal debridement was required to induce corneal neovascularization in the mouse cornea, and the corneal epithelium may therefore be partially responsible for maintaining corneal avascularity. General significance Our study demonstrates that GFP/Flk1::myr-mCherry mice are a useful model for studying coordinated hemangiogenic and lymphangiogenic responses. PMID:27233452

Reconstruction of supracrestal alveolar bone lost as a result of severe chronic periodontitis. Five-year outcome: case report.

PubMed

Kotschy, Peter; Laky, Markus

2006-10-01

This patient presented with generalized severe chronic periodontitis. Conventional periodontal therapy would have left her compromised esthetically and anatomically, with growing interdental "black triangles." This prompted the authors to try to reconstruct the maxillary alveolar bone that had been lost in the previous three decades because of untreated periodontitis. To maintain the level and quality of the gingival margin, open flap surgery was performed in the maxilla soon after scaling and root planing. To gain access to the roots and bone surfaces, a flap was raised by intrasulcular incisions and the modified and simplified papilla preservation technique. After debridement, the root surfaces were conditioned and enamel matrix proteins were applied. Bovine bone mineral was placed in the infrabony defects and supracrestally (buccally, lingually, and interdentally) to help regenerate the lost alveolar bone. In addition, the defects around the maxillary anterior teeth were covered with a membrane. To prevent shrinkage of the gingiva, suspensory sutures were placed on the right central incisor and both left incisors so that the anterior flap would be positioned approximately 3 mm coronally. After surgery, the patient was advised to apply 1% chlorhexidine gel twice a day and to avoid brushing the surgical site for 4 weeks. Professional maintenance care was administered twice a week for 2 months and the patient was instructed to maintain a liquid diet for 4 weeks. The treatment outcome was evaluated clinically and radiographically at regular intervals for 5 years postsurgically. Periodontal conditions were stable and fulfilled the patient's desire to eliminate the pockets without compromising esthetics, particularly in the maxillary anterior.

A novel rapid and selective enzymatic debridement agent for burn wound management: a multi-center RCT.

PubMed

Rosenberg, Lior; Krieger, Yuval; Bogdanov-Berezovski, Alex; Silberstein, Eldad; Shoham, Yaron; Singer, Adam J

2014-05-01

Excisional debridement followed by autografting is the standard of care (SOC) for deep burns, but is associated with serious potential complications. Conservative, non-surgical and current enzymatic debridement methods are inefficiently slow. We determined whether a non-surgical option of rapid enzymatic debridement with the debriding enzyme NexoBrid™ (NXB) would reduce need for surgery while achieving similar esthetic and functional outcomes as SOC. We conducted a multi-center, open-label, randomized, controlled clinical trial including patients aged 4-55 years with deep partial and full thickness burns covering 5-30% of their total body surface area (TBSA). Patients were randomly assigned to burn debridement with NXB (applied for 4h) or SOC, which included surgical excisional or non-surgical debridement. NXB significantly reduced the time from injury to complete débridement (2.2 vs. 8.7 days, P<0.0001), need for surgery (24.5% vs. 70.0%, P<0.0001), the area of burns excised (13.1% vs. 56.7%, P<0.0001) and the need for autografting (17.9% vs. 34.1%, P=0.01). Scar quality and quality of life scores were similar in both study groups as were the rates of adverse events. Enzymatic débridement with NXB resulted in reduced need for and extent of surgery compared with SOC while achieving comparable long-term results in patients with deep burns. Clinical Trials.gov NCT00324311. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Review of ultrasonic irrigation in endodontics: increasing action of irrigating solutions

PubMed Central

Mozo, Sandra; Llena, Carmen

2012-01-01

Introduction: Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Ultrasonic irrigation can be performed with or without simultaneous ultrasonic instrumentation. Existing literature reveals that ultrasonic irrigation may have a very positive effect on chemical, biological and physical debridement of the root canal system as investigated in many in vitro studies. Objective: The purpose of this review article was to summarize and discuss the available information concerning ultrasonic irrigation in endodontics. Methods: This article presents an overview of ultrasonic irrigation methods and their debridement efficacy. In this paper the relevant literature on passive ultrasonic irrigation is reviewed. Information from original scientific papers or reviews listed in MEDLINE and Cochrane were included in the review. Results: The use of ultrasound in the irrigation procedure results in improved canal cleanliness, better irrigant transfer to the canal system, soft tissue debridement, and removal of smear layer and bacteria. There are many in vitro studies, but there is a need to standardize protocols, and correlate the clinical efficacy of ultrasonic devices with improved treatment outcomes. Understanding the basis of ultrasonic irrigation is fundamental for clinicians and researchers to improve the design and use of ultrasonic irrigation. Key words:Ultrasonic irrigation, ultrasound, smear layer, endodontics. PMID:22143738

Coblation technology for surgical wound debridement: principle, experimental data, and technical data.

PubMed

Trial, Chloé; Brancati, Antonio; Marnet, Olivier; Téot, Luc

2012-12-01

Debridement is required to prepare the wound bed, essentially in removing undesired tissues observed both in acute wound after burns or trauma and in chronic wounds such as pressure ulcers, leg ulcers, and diabetic foot ulcers. Surgical debridement has been described as one of the most effective methods but can be contraindicated in the elderly, arteriopathic context, or patients under effective anticoagulation. Recently described debridement technologies are based on application of important mechanical severing forces over the wound surface using high-power hydrojets. High water flux acts as a vector for separating necrotic and sloughy tissues from the wound bed and aspirates them out of the wound immediately. Electrical powered techniques and lasers were also scarcely described. The Coblation debridement technology presented here is based on the local induction of a focused plasma field chemically deleting undesired tissues. This technique is a modification of conventional electrosurgical devices, developed in 1928 where tissue excision and coagulation of tissues were observed. Principles of plasma-mediated debridement are based on a bipolar radiofrequency energizing the molecules, thus creating a plasma field. This glow discharge plasma produces chemically active radical species from dissociation of water, breaking molecular bonds, and causing tissue dissolution. The thermal effects are a by-product, which can be modulated by modifying the electrode construction, limiting the local temperature to less than 50°C in order not to induce wound bed renecrosis. The authors describe here the principle, the first technical adaptation for wound debridement, and the potential clinical interest of the Coblation technology.

Diagnosis and Treatment of Odontogenic Cutaneous Sinus Tracts in an 11-Year-Old Boy

PubMed Central

Chen, Ke; Liang, Yun; Xiong, Huacui

2016-01-01

Abstract Odontogenic cutaneous sinus tracts (OCSTs) are generally primarily misdiagnosed and inappropriately treated by virtue of their rarity and the absence of dental symptoms. Accurate diagnosis and treatment and the elimination of the source of infection can reduce the incidence of complications and relieve the pain of the patient. In this case report, we present the case of an 11-year-old patient with an apparent abscess but an unobvious draining sinus tract in his left cheek. Intraorally, a glass-ionomer-cement filling on the occlusal surface of the left mandibular first molar (tooth 36) was noted. Radiographic examination revealed a radiopaque mass inside the crown and pulp chamber and an irregular, radiolucent periapical lesion surrounding the distal root apex. He was diagnosed with an OCTS secondary to a periapical abscess of tooth 36. Precise root canal therapy (RCT) and chronic granuloma debridement was performed; 6 months later, the abscess and sinus had healed completely, and the periapical lesion had resolved. Odontogenic cutaneous sinus tracts are uncommon in the clinic. This case report reminds us of the significance of OCSTs and provides some implications for their diagnosis and treatment. PMID:27196471

Periodontal Therapy in Dogs Using Bone Augmentation Products Marketed for Veterinary Use.

PubMed

Angel, Molly

Periodontal disease is extremely common in companion animal practice. Patients presenting for a routine oral examination and prophylaxis may be found to have extensive periodontal disease and attachment loss. Vertical bone loss is a known sequela to periodontal disease and commonly involves the distal root of the mandibular first molar. This case report outlines two dogs presenting for oral examination and prophylaxis with general anesthesia. Both patients did not have any clinical symptoms of periodontal disease other than halitosis. Both patients were diagnosed with three-walled vertical bone loss defects of one or both mandibular first molars utilizing dental radiography as well as periodontal probing, measuring, and direct visual inspection. These defects were consistent with periodontal disease index stage 4 (>50% attachment loss). The lesions were treated with appropriate root planing and debridement. Bone augmentation products readily available and marketed for veterinary use were then utilized to fill the defects to promote both the re-establishment of normal alveolar bone height and periodontal ligament reattachment to the treated surface. Follow-up assessment and owner dedication is critical to treatment outcome. Both patients' 6 mo follow-up examinations radiographically indicated bone repair and replacement with visible periodontal ligament space.

A Review of Antibacterial Agents in Endodontic Treatment

PubMed Central

Rahimi, Saeed; Janani, Maryam; Lotfi, Mehrdad; Shahi, Shahriar; Aghbali, Amirala; Vahid Pakdel, Mahdi; Salem Milani, Amin; Ghasemi, Negin

2014-01-01

Microorganisms play a major role in initiation and perpetuation of pulpal and periapical diseases. Therefore, elimination of the microorganisms present in the root canal system is the fundamental objective of endodontic treatment. The use of mechanical debridement, chemical irrigation or other antimicrobial protocols and intra-canal medicaments are critical to attain this goal. The aim of this article was to review the antimicrobial agents and their properties in endodontics. PMID:25031587

Our initial learning curve in the enzymatic debridement of severely burned hands-Management and pit falls of initial treatments and our development of a post debridement wound treatment algorithm.

PubMed

Schulz, A; Perbix, W; Shoham, Y; Daali, S; Charalampaki, C; Fuchs, P C; Schiefer, J

2017-03-01

Excisional surgical debridement (SD) is still the gold standard in the treatment of deeply burned hands, though the intricate anatomy is easily damaged. Previous studies demonstrated that enzymatic debridement with the bromelain debriding agent NexoBrid ® (EDNX) is more selective and thus can preserve viable tissue with excellent outcome results. So far no method paper has been published presenting different treatment algorithms in this new field. Therefore our aim was to close this gap by presenting our detailed learning curve in EDNX of deeply burned hands. We conducted a single-center prospective observational clinical trial treating 20 patients with deeply burned hands with EDNX. Different anaesthetic procedures, debridement and wound treatment algorithms were compared and main pitfalls described. EDNX was efficient in 90% of the treatments though correct wound bed evaluation was challenging and found unusual compared to SD. Post EDNX surprisingly the majority of the burn surface area was found overestimated (18 wounds). Finally we simplified our process and reduced treatment costs by following a modified treatment algorithm and treating under plexus anaesthesia bedside through a single nurse and one burn surgeon solely. Suprathel ® could be shown to be an appropriate dressing for wound treatment after EDNX. Complete healing (less 5% rest defect) was achieved at an average of day 28. EDNX in deep burned hands is promising regarding handling and duration of the treatment, efficiency and selectivity of debridement, healing potential and early rehabilitation. Following our treatment algorithm EDNX can be performed easily and even without special knowledge in burn wound depth evaluation. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Comparison of the EndoVac system to needle irrigation of root canals.

PubMed

Nielsen, Benjamin A; Craig Baumgartner, J

2007-05-01

Past studies have shown that current irrigation methods are effective at cleaning root canals coronally but less effective apically. To be effective, endodontic irrigants should ideally be delivered near working length. The purpose of this study was to compare the efficacy of the EndoVac irrigation system and needle irrigation to debride root canals at 1 and 3 mm from working length. One tooth of each matched pair was instrumented and irrigated by using the EndoVac, which uses negative pressure to deliver irrigating solutions to working length. The other tooth of the matched pair was instrumented and irrigated with a 30-gauge ProRinse irrigating needle. All teeth were irrigated with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) for a predetermined amount of time, and total volume of irrigant used was recorded. After instrumentation and irrigation, the teeth were fixed, decalcified, and sectioned at 1 mm and 3 mm from working length. Serial sections were made and digitally photographed. The amount of remaining debris was determined as a percentage of the area of the canal lumen. Remaining debris and total irrigant were analyzed by using the Wilcoxon signed rank test at the 5% confidence level. At the 1-mm level, significantly less debris was found in the EndoVac group (p=0.0347). At the 3-mm level, there was no significant difference between groups. Significantly more irrigant was delivered with the EndoVac (p<0001). This study showed significantly better debridement at 1 mm from working length by using the EndoVac compared with needle irrigation.

Prevalence of Three-Rooted Mandibular First Molars among Indians Using SCT

PubMed Central

Garg, Amit Kumar; Tewari, Rajendra Kumar; Agrawal, Neha

2013-01-01

Undetected extra roots or root canals are a major reason for failure of endodontic treatment. Failure to recognize an extra distolingual (DL) root in mandibular first molar may lead to incomplete debridement of the root canal system and eventually treatment failure. Therefore, it is crucial that atypical anatomy is identified before and during dental treatment. Spiral computed tomography (SCT) images can show 3D images, and therefore much detail can be used when traditional methods prevent adequate endodontic treatment. The overall incidence of DL roots on the mandibular first molars was 6.40% for all patients and 5.00% for all teeth, respectively. The occurrence of DL roots on the right side and on the left side showed a statistically significant difference. The bilateral incidence of symmetrical distribution of DL roots was 56.25%. The DL root canal orifice was separated from DB canal orifice by 2.79 ± 0.34 mm, from the MB canal orifice by 4.23 ± 0.81 mm, and from the ML canal orifice by 3.29 ± 0.52 mm. The high prevalence of the DL root in permanent mandibular first molars among the Indian population by using SCT and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments. PMID:23840212

Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin

PubMed Central

Abuhaimed, Tariq S.

2017-01-01

Effective shaping and cleaning of root canals are essential for the success of endodontic treatment. Due to the complex anatomy of root canal spaces, the use of various instrumentation techniques alone is not effective in producing bacteria-free root canal spaces. Irrigation, disinfectants, rinses, and intervisit medications are used in conjunction with the mechanical instrumentation to ensure the success of endodontic treatment. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. NaOCl has been known for its antibacterial action, proteolytic and dissolution capacity, and debridement properties. NaOCl, however, can alter the composition of dentin and hence its interaction with the adhesive resins used to bond the restorative materials to treated dentin. This review therefore covers in depth the action of NaOCl on dentin-adhesive resin bond strength including both enhancement and reduction, then mechanisms proposed for such action, and finally how the adverse action of NaOCl on dentin can be reversed. PMID:28904947

Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin.

PubMed

Abuhaimed, Tariq S; Abou Neel, Ensanya A

2017-01-01

Effective shaping and cleaning of root canals are essential for the success of endodontic treatment. Due to the complex anatomy of root canal spaces, the use of various instrumentation techniques alone is not effective in producing bacteria-free root canal spaces. Irrigation, disinfectants, rinses, and intervisit medications are used in conjunction with the mechanical instrumentation to ensure the success of endodontic treatment. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. NaOCl has been known for its antibacterial action, proteolytic and dissolution capacity, and debridement properties. NaOCl, however, can alter the composition of dentin and hence its interaction with the adhesive resins used to bond the restorative materials to treated dentin. This review therefore covers in depth the action of NaOCl on dentin-adhesive resin bond strength including both enhancement and reduction, then mechanisms proposed for such action, and finally how the adverse action of NaOCl on dentin can be reversed.

Intracanal medications and antibiotics in the control of interappointment flare-ups.

PubMed

Rimmer, A

1991-12-01

Acute exacerbation of symptoms, or "flare-up," after the debridement of the root canals and provisional restoration is a well-known postoperative complication of endodontic treatment. In this clinical study, various types of intracanal medications were compared for their ability to decrease interappointment flare-ups. The result showed that use of intracanal medicaments containing anti-inflammatory agents in combination with the administration of prophylactic systematic antibiotics was the most effective method of controlling interappointment flare-ups.

Treatment of plaque-induced gingivitis, chronic periodontitis, and other clinical conditions.

PubMed

2001-12-01

The inflammatory components of plaque induced gingivitis and chronic periodontitis can be managed effectively for the majority of patients with a plaque control program and non-surgical and/or surgical root debridement coupled with continued periodontal maintenance procedures. Some patients may need additional therapeutic procedures. All of the therapeutic modalities reviewed in this position paper may be utilized by the clinician at various times over the long-term management of the patient's periodontal condition.

Treatment of plaque-induced gingivitis, chronic periodontitis, and other clinical conditions.

PubMed

The inflammatory components of plaque induced gingivitis and chronic periodontitis can be managed effectively for the majority of patients with a plaque control program and nonsurgical and/or surgical root debridement coupled with continued periodontal maintenance procedures. Some patients may need additional therapeutic procedures. All of the therapeutic modalities reviewed in this position paper may be utilized by the clinician at various times over the long-term management of the patient's periodontal condition.

Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection.

PubMed

Garcez, Aguinaldo S; Ribeiro, Martha S; Tegos, George P; Núñez, Silvia C; Jorge, Antonio O C; Hamblin, Michael R

2007-01-01

To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment. Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. (c) 2006 Wiley-Liss, Inc.

Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years.

PubMed

van den Bekerom, Michel P J; Patt, Thomas W; Rutten, Sjoerd; Raven, Eric E J; van de Vis, Harm M V; Albers, G H Rob

2007-10-01

Arthroscopic debridement has been used to treat patients with degenerative knee osteoarthritis, although there is sometimes conflicting evidence documenting its efficacy. This study evaluates the success of arthroscopic debridement in elderly patients with grade III and IV chondromalacia of the knee as measured by patient satisfaction and the need for additional surgery. From December 1998 to August 2001, a total of 102 consecutive cases of knee arthroscopy in 99 patients > 60 years were performed. Average follow-up was 34 months (range: 7-104 months). Patients were asked about their satisfaction using a visual analog scale, and the presence of meniscal lesions during arthroscopy and the treatment for these lesions were evaluated. Knees also were assessed for articular surface degeneration using Outerbridge's classification for chondromalacia. The need for and type of additional surgery was evaluated. During arthroscopy, meniscal lesions requiring a partial meniscectomy were found in 95 knees. Chondromalacia was found in 92 knees; 53 knees had grade I or II chondromalacia and 39 knees had grade III or IV chondromalacia. Additional surgery was performed in 17 knees. Mean patient satisfaction score was 73 (range: 50-100) in the 39 knees with grade III or IV chondromalacia after arthroscopic debridement was performed. These findings suggest arthroscopic debridement in elderly patients has a place in the treatment algorithm for grade III or IV chondromalacia of the knee.

[Hyperbaric oxygen therapy adjunctive to surgical debridement in management of Fournier's gangrene: usefulness of a severity index score in predicting disease gravity and patient survival].

PubMed

Janane, A; Hajji, F; Ismail, T O; Chafiqui, J; Ghadouane, M; Ameur, A; Abbar, M; Albouzidi, A

2011-06-01

Hyperbaric oxygen therapy (HBOT) concomitant to surgery has been reported to reduce Fournier's gangrene (FG) mortality compared to exclusive surgical debridement. Most report from centers with relatively few patients using only surgical procedure. To assess efficiency of aggressive debridement with adjunctive HBOT. To evaluate Fournier's gangrene severity score index (FGSI) predictive value. 70 Fournier's gangrene (FG) treated by surgical debridement and HBOT. Data were evaluated physical examination findings, admission and final laboratory tests, surgical debridement extent, and antibiotic used. Patients had adjunctive (HBOT). FGSI, developed to assign a score describing the acuity of disease, was used. This index presents patients' vital signs, metabolic parameters (sodium, potassium, creatinine, and bicarbonate levels, and white blood cell count) and computes a score relating to the severity of disease at that time. Data were assessed according to whether the patient survived or died. All patients underwent surgical debridement. Wound debridement was regularly performed in the post operative period. Of 70 patients, 8 died (11.4%) and 62 survived (88.5%). Difference in age between survivors (median age, 50.0 yr) and non survivors (median age, 54.5 yr) was not significant (p=0.321). Median extent of body surface area involved in necrotizing process in patients who survived and did not survive was 2.4% and 4.9%, respectively (p=0.001). Except for albumin, no significant differences were found between survivors and nonsurvivors. Median admission FGSI scores for survivors and non survivors were 2.1±2.0 and 4.2±3.8, (p=0.331). FGSI score did not predict disease severity and the patient's survival. Metabolic aberrations, extent of disease seemed to be important risk factors for predicting FG severity and patient survival. Copyright © 2010 AEU. Published by Elsevier Espana. All rights reserved.

Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite.

PubMed

Tenore, Gianluca; Palaia, Gaspare; Ciolfi, Chiara; Mohsen, Mohamed; Battisti, Andrea; Romeo, Umberto

2017-01-01

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva manoeuvre. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. Presented here is a case of subcutaneous emphysema that occurred after sodium hypochlorite irrigation during endodontic treatment, and the description of its etiologies and prevention during nonsurgical endodontic treatment. Endodontic success can be essentially achieved via good debridement of a root canal, and an ideal endodontic irrigant is effective in removing the smear layer, opening the dentinal tubules, and producing a clean surface for closer obturation. A 60-years-old woman had an abnormal swelling and pain during an endodontic treatment accompanied by her dentist to the emergency room and was referred to our observation for complaining of severe pain, ecchymosis and severe swelling on the left side of her face. The aforementioned symptoms appeared after sodium hypochlorite irrigation and aggressive use of air spray for drying the root canal during the endodontic treatment of the upper left lateral incisor. An extrusion during an inappropriate endodontic treatment may occasionally be reported and can cause tissue damage. NaOCl is one of the best and most commonly used irrigating solutions because of its efficacy, but it can also negatively affect the periapical tissues. Determining the correct working length, even when performing an intraoperative periapical radiograph and confirming the root canal integrity, could help avoid these kinds of accidents.

A comparative evaluation of the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instruments - an in vitro profilometric and SEM study

PubMed Central

SINGH, Sumita; UPPOOR, Ashita; NAYAK, Dilip

2012-01-01

Objectives The debridement of diseased root surface is usually performed by mechanical scaling and root planing using manual and power driven instruments. Many new designs in ultrasonic powered scaling tips have been developed. However, their effectiveness as compared to manual curettes has always been debatable. Thus, the objective of this in vitro study was to comparatively evaluate the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instrumentation on periodontally involved extracted teeth using profilometer and scanning electron microscope (SEM). Material and Methods 30 periodontally involved extracted human teeth were divided into 3 groups. The teeth were instrumented with hand and ultrasonic instruments resembling clinical application. In Group A all teeth were scaled with a new universal hand curette (Hu Friedy Gracey After Five Vision curette; Hu Friedy, Chicago, USA). In Group B CavitronTM FSI - SLITM ultrasonic device with focused spray slimline inserts (Dentsply International Inc., York, PA, USA) were used. In Group C teeth were scaled with an EMS piezoelectric ultrasonic device with prototype modified PS inserts. The surfaces were analyzed by a Precision profilometer to measure the surface roughness (Ra value in µm) consecutively before and after the instrumentation. The samples were examined under SEM at magnifications ranging from 17x to 300x and 600x. Results The mean Ra values (µm) before and after instrumentation in all the three groups A, B and C were tabulated. After statistically analyzing the data, no significant difference was observed in the three experimental groups. Though there was a decrease in the percentage reduction of Ra values consecutively from group A to C. Conclusion Within the limits of the present study, given that the manual, magnetostrictive and piezoelectric ultrasonic instruments produce the same surface roughness, it can be concluded that their efficacy for creating a biologically compatible surface of periodontally diseased teeth is similar. PMID:22437673

Variable permanent mandibular first molar: Review of literature

PubMed Central

Ballullaya, Srinidhi V; Vemuri, Sayesh; Kumar, Pabbati Ravi

2013-01-01

Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals. PMID:23716959

Papain incorporated chitin dressings for wound debridement sterilized by gamma radiation

NASA Astrophysics Data System (ADS)

Singh, Durgeshwer; Singh, Rita

2012-11-01

Wound debridement is essential for the removal of necrotic or nonviable tissue from the wound surface to create an environment conducive to healing. Nonsurgical enzymatic debridement is an attractive method due to its effectiveness and ease of use. Papain is a proteolytic enzyme derived from the fruit of Carica papaya and is capable of breaking down a variety of necrotic tissue substrates. The present study was focused on the use of gamma radiation for sterilization of papain dressing with wound debriding activity. Membranes with papain were prepared using 0.5% chitin in lithium chloride/dimethylacetamide solvent and sterilized by gamma radiation. Fluid absorption capacity of chitin-papain membranes without glycerol was 14.30±6.57% in 6 h. Incorporation of glycerol resulted in significant (p<0.001) increase in the absorption capacity. Moisture vapour transmission rate of the membranes was 4285.77±455.61 g/m2/24 h at 24 h. Gamma irradiation at 25 kGy was found suitable for sterilization of the dressings. Infrared (IR) spectral scanning has shown that papain was stable on gamma irradiation at 25-35 kGy. The irradiated chitin-papain membranes were impermeable to different bacterial strains and also exhibited strong bactericidal action against both Gram-positive and Gram-negative bacteria. The fluid handling characteristics and the antimicrobial properties of chitin-papain membranes sterilized by gamma radiation were found suitable for use as wound dressing with debriding activity.

Location of unaccessible implant surface areas during debridement in simulated peri-implantitis therapy.

PubMed

Steiger-Ronay, Valerie; Merlini, Andrea; Wiedemeier, Daniel B; Schmidlin, Patrick R; Attin, Thomas; Sahrmann, Philipp

2017-11-28

An in vitro model for peri-implantitis treatment was used to identify areas that are clinically difficult to clean by analyzing the pattern of residual stain after debridement with commonly employed instruments. Original data from two previous publications, which simulated surgical (SA) and non-surgical (NSA) implant debridement on two different implant systems respectively, were reanalyzed regarding the localization pattern of residual stains after instrumentation. Two blinded examiners evaluated standardized photographs of 360 initially ink-stained dental implants, which were cleaned at variable defect angulations (30, 60, or 90°), using different instrument types (Gracey curette, ultrasonic scaler or air powder abrasive device) and treatment approaches (SA or NSA). Predefined implant surface areas were graded for residual stain using scores ranging from one (stain-covered) to six (clean). Score differences between respective implant areas were tested for significance by pairwise comparisons using Wilcoxon-rank-sum-tests with a significance level α = 5%. Best scores were found at the machined surface areas (SA: 5.58 ± 0.43, NSA: 4.76 ± 1.09), followed by the tips of the threads (SA: 4.29 ± 0.44, NSA: 4.43 ± 0.61), and areas between threads (SA: 3.79 ± 0.89, NSA: 2.42 ± 1.11). Apically facing threads were most difficult to clean (SA: 1.70 ± 0.92, NSA: 2.42 ± 1.11). Here, air powder abrasives provided the best results. Machined surfaces at the implant shoulder were well accessible and showed least amounts of residual stain. Apically facing thread surfaces constituted the area with most residual stain regardless of treatment approach.

[Debridement- crucial procedure in the treatment of chronic wounds].

PubMed

Huljev, Dubravko

2013-10-01

Debridement is the process of removing dead tissue from the wound bed. Devitalized tissue can obstruct or completely stop healing of the wound. The aim of debridement is to transform a chronic wound into an acute wound and to initiate the process of healing. Debridement is the basis of each wound treatment and it has to be repeated, depending on the necrotic tissue formation. There are several types of debridement, as follows: mechanical, autolytic, chemical, enzymatic, biological, and new debridement techniques. With advances in technology, new types of debridement have been introduced. Besides standard methods, methods of pulsed lavage debridement (hydro-surgery, water-jet) and ultrasound-assisted wound treatment are ever more frequently introduced. The method of debridement the clinician will choose depends on the amount of necrotic (devitalized) tissue in the wound bed, size and depth of the wound, underlying disease, possible comorbidity, and the patient general condition. Frequently, the methods of debridement are combined in order to achieve better removal of devitalized tissue. In addition, debridement significantly reduces bacterial burden.

Perforating internal root resorption repaired with mineral trioxide aggregate caused complete resolution of odontogenic sinus mucositis: a case report.

PubMed

Bendyk-Szeffer, Maja; Łagocka, Ryta; Trusewicz, Matylda; Lipski, Mariusz; Buczkowska-Radlińska, Jadwiga

2015-02-01

An extensive perforating internal root resorption accompanied by apical periodontitis and odontogenic sinus mucositis was detected on preoperative cone-beam computed tomographic scans in a first maxillary molar. After the chemomechanical debridement of the root canals, calcium hydroxide was placed as a temporary dressing for 7 days. Mineral trioxide aggregate was used to fill the perforation site with the aid of a surgical microscope. At the next visit, the root with the resorption defect was filled with warm vertical compaction of gutta-percha. A control cone-beam computed tomographic scan acquired 6 months after the endodontic treatment revealed complete resolution of the sinus retention cyst. Moreover, the patient's frequent otolaryngologic disturbances ceased. The tooth was functional with satisfactory clinical and radiographic results after 12 months. Based on the results of this case, successful repair of an extensive, perforating internal resorption with mineral trioxide aggregate may lead to complete resolution of apical periodontitis and maxillary sinus retention cyst. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Antimicrobial Photodynamic Therapy Combined With Conventional Endodontic Treatment to Eliminate Root Canal Biofilm Infection

PubMed Central

Garcez, Aguinaldo S.; Ribeiro, Martha S.; Tegos, George P.; Núñez, Silvia C.; Jorge, Antonio O.C.; Hamblin, Michael R.

2011-01-01

Background and Objective To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Study Design/Materials and Methods Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-µ fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Results Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment. Conclusions Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. PMID:17066481

[Role of debridement in treatment of chronic wounds].

PubMed

Huljev, Dubravko; Gajić, Aleksandar; Triller, Ciril; Leskovec, Nada Kecelj

2012-10-01

Debridement is the process of removing dead tissue from the wound bed. Since devitalized tissue can obstruct or completely stop healing of the wound, it is indicated to debride wound bed as part of the treatment process. The aim of debridement is to transform a chronic wound into an acute wound and to initiate the process of healing. Debridement is the foundation of each wound treatment and it has to be repeated, depending on the necrotic tissue formation. There are several types of debridement: surgical, autolytic, chemical, enzymatic, mechanical, and biological. Using previous knowledge and advances in technology, new types of debridement have been introduced. Besides standard methods, methods of pulsed lavage debridement (hydro-surgery, water-jet) and ultrasound-assisted wound treatment (UAW) are ever more widely introduced. The method of debridement the clinician will choose depends on the amount of necrotic (devitalized) tissue in the wound bed, the size and depth of the wound, the underlying disease, the possible comorbidity, as well as on the general condition of the patient. Frequently, the methods of debridement are combined in order to achieve better removal of devitalized tissue. Debridement in addition significantly reduces bacterial burden. Regardless of the method of debridement, it is essential to take pain to the lowest point.

Comparison of efficacy of pulverization and sterile paper point techniques for sampling root canals.

PubMed

Tran, Kenny T; Torabinejad, Mahmoud; Shabahang, Shahrokh; Retamozo, Bonnie; Aprecio, Raydolfo M; Chen, Jung-Wei

2013-08-01

The purpose of this study was to compare the efficacy of the pulverization and sterile paper point techniques for sampling root canals using 5.25% NaOCl/17% EDTA and 1.3% NaOCl/MTAD (Dentsply, Tulsa, OK) as irrigation regimens. Single-canal extracted human teeth were decoronated and infected with Enterococcus faecalis. Roots were randomly assigned to 2 irrigation regimens: group A with 5.25% NaOCl/17% EDTA (n = 30) and group B with 1.3% NaOCl/MTAD (n = 30). After chemomechanical debridement, bacterial samplings were taken using sterile paper points and pulverized powder of the apical 5 mm root ends. The sterile paper point technique did not show growth in any samples. The pulverization technique showed growth in 24 of the 60 samples. The Fisher exact test showed significant differences between sampling techniques (P < .001). The sterile paper point technique showed no difference between irrigation regimens. However, 17 of the 30 roots in group A and 7 of the 30 roots in group B resulted in growth as detected by pulverization technique. Data showed a significant difference between irrigation regimens (P = .03) in pulverization technique. The pulverization technique was more efficacious in detecting viable bacteria. Furthermore, this technique showed that 1.3% NaOCl/MTAD regimen was more effective in disinfecting root canals. Published by Elsevier Inc.

[REVIEW OF 30 YEARS OF RESEARCH AND DEVELOPMENT OF AN ENZYMATIC DEBRIDEMENT AGENT FOR BURNS].

PubMed

Krieger, Yuval; Shoham, Yaron; Bogdanov-Berezovsky, Alexander; Silberstein, Eldad; Sagi, Amiram; Levy, Avraham; Rosenberg, Nir; Rubin, Guy; Egozi, Dana; Ullman, Yehuda; Haik, Josef; Rosenberg, Lior

2016-05-01

Early removal of burn eschar is a cornerstone of burn care. The most commonly practiced eschar removal technique for deep burns in modern burn care is surgical debridement but this technique is associated with surgical burden and leads to unnecessary excision of viable tissue. To review 30 years of research and development of an enzymatic debridement agent for burns. Studies performed during the last 30 years are reviewed in this manuscript. Patients who underwent enzymatic debridement had a significantly shorter time to complete debridement, the surgical burden was significantly lower, hand burns did not necessitate escharotomy, and the long term results were favorable. Early enzymatic debridement leads to an efficient debridement, preservation of viable tissue, a reduction in surgical burden and favorable long term results. We believe early enzymatic debridement will lead to better care for burn victims and perhaps, even to a paradigm shift in the treatment of burns.

Comparison of healing rate in diabetes-related foot ulcers with low frequency ultrasonic debridement versus non-surgical sharps debridement: a randomised trial protocol

PubMed Central

2014-01-01

Background Foot ulceration has been reported as the leading cause of hospital admission and amputation in individuals with diabetes. Diabetes-related foot ulcers require multidisciplinary management and best practice care, including debridement, offloading, dressings, management of infection, modified footwear and management of extrinsic factors. Ulcer debridement is a commonly applied management approach involving removal of non-viable tissue from the ulcer bed. Different methods of debridement have been reported in the literature including autolytic debridement via moist wound healing, mechanical debridement utilising wet to dry dressings, theatre based sharps debridement, biological debridement, non-surgical sharps debridement and newer technology such as low frequency ultrasonic debridement. Methods People with diabetes and a foot ulcer, referred to and treated by the Podiatry Department at Monash Health and who meet the inclusion criteria will be invited to participate in this randomised controlled trial. Participants will be randomly and equally allocated to either the non-surgical sharps debridement (control) or low frequency ultrasonic debridement (intervention) group (n = 322 ulcers/n = 108 participants). Where participants have more than one ulcer, only the participant will be randomised, not the ulcer. An investigator not involved in participant recruitment or assessment will be responsible for preparing the random allocation sequence and envelopes. Each participant will receive weekly treatment for six months including best practice podiatric management. Each ulcer will be measured on a weekly basis by calculating total area in centimetres squared. Measurement will be undertaken by a trained research assistant to ensure outcomes are blinded from the treating podiatrist. Another member of the research team will assess the final primary outcome. Discussion The primary aim of this study is to compare healing rates for diabetes-related foot ulcers using non-surgical sharps debridement versus low frequency ultrasonic debridement over a six month period. The primary outcome measure for this study is the proportion of ulcers healed by the six month follow-up period. Secondary outcomes will include a quality of life measure, assessment of pain and health care resource use between the two treatment modalities. Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12612000490875. PMID:24423411

An estimate of pocket closure and avoided needs of surgery after scaling and root planing with systemic antibiotics: a systematic review.

PubMed

Kolakovic, Mirela; Held, Ulrike; Schmidlin, Patrick R; Sahrmann, Philipp

2014-12-22

Relevant benefits of adjunctive medication of antibiotica after conventional root surface debridement in terms of enhanced pocket depth (PD) reduction have been shown. However, means and standard deviations of enhanced reductions are difficult to translate into clinical relevant treatment outcomes such as pocket resolution or avoidance of additional surgical interventions. Accordingly, the aim of this systematic review was to calculate odds ratios for relevant cut-off values of PD after mechanical periodontal treatment with and without antibiotics, specifically the combination of amoxicilline and metronidazol, from published studies. As clinical relevant cut-off values "pocket closure" for PD ≤ 3mm and "avoidance of surgical intervention" for PD ≤ 5 mm were determined. The databases PubMed, Embase and Central were searched for randomized clinical studies assessing the beneficial effect of the combination of amoxicillin and metronidazole after non-surgical mechanical debridement. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. From published means and standard deviations for PD after therapy, odds ratios for the clinically relevant cut-off values were calculated using a specific statistical approach. Meta-analyses were performed for the time points 3 and 6 month after mechanical therapy. Generally, a pronounced chance for pocket closure from 3 to 6 months of healing was shown. The administration of antibiotics resulted in a 3.55 and 4.43 fold higher probability of pocket closure after 3 and 6 months as compared to mechanical therapy alone. However, as the estimated risk for residual pockets > 5 mm was 0 for both groups, no odds ratio could be calculated for persistent needs for surgery. Generally, studies showed a moderate to high quality and large heterogeneity regarding treatment protocol, dose of antibiotic medication and maintenance. With the performed statistical approach, a clear benefit in terms of an enhanced chance for pocket closure by co-administration of the combination of amoxicillin and metronidazole as an adjunct to non-surgical mechanical periodontal therapy has been shown. However, data calculation failed to show a benefit regarding the possible avoidance of surgical interventions.

Excimer laser debridement of necrotic erosions of skin without collateral damage

NASA Astrophysics Data System (ADS)

Wynne, James J.; Felsenstein, Jerome M.; Trzcinski, Robert; Zupanski-Nielsen, Donna; Connors, Daniel P.

2011-07-01

Pulsed ArF excimer laser radiation at 6.4 eV, at fluence exceeding the ablation threshold, will debride burn eschar and other dry necrotic erosions of the skin. Debridement will cease when sufficiently moist viable tissue is exposed, due to absorption by aqueous chloride ions (Cl-) through the non-thermal process of electron photodetachment, thereby inhibiting collateral damage to the viable tissue. ArF excimer laser radiation debrides/ablates ~1 micron of tissue with each pulse. While this provides great precision in controlling the depth of debridement, the process is relatively time-consuming. In contrast, XeCl excimer laser radiation debrides ~8 microns of tissue with each pulse. However the 4.0 eV photon energy of the XeCl excimer laser is insufficient to photodetach an electron from a Cl- ion, so blood or saline will not inhibit debridement. Consequently, a practical laser debridement system should incorporate both lasers, used in sequence. First, the XeCl excimer laser would be used for accelerated debridement. When the necrotic tissue is thinned to a predetermined thickness, the ArF excimer laser would be used for very precise and well-controlled debridement, removing ultra-thin layers of material with each pulse. Clearly, the use of the ArF laser is very desirable when debriding very close to the interface between necrotic tissue and viable tissue, where the overall speed of debridement need not be so rapid and collateral damage to viable tissue is undesirable. Such tissue will be sterile and ready for further treatment, such as a wound dressing and/or a skin graft.

Debridement and wound bed preparation.

PubMed

Falabella, Anna F

2006-01-01

Debridement can play a vital role in wound bed preparation and the removal of barriers that impair wound healing. In accordance with the TIME principles, debridement can help remove nonviable tissue, control inflammation or infection, decrease excess moisture, and stimulate a nonadvancing wound edge. There are many types of debridement, each with a set of advantages and disadvantages that must be clearly understood by the healthcare team. Failure to use the correct debridement method for a given type of wound may lead to further delays in healing, increase patient suffering, and unnecessarily increase the cost of care. This review article discusses the various methods of debridement, describes currently available debriding agents, evaluates the clinical data regarding their efficacy and safety, and describes strategies for the management of problematic nonhealing wounds.

ArF excimer laser debrides burns without destruction of viable tissue: A pilot study.

PubMed

Prasad, Atulya; Sawicka, Katarzyna M; Pablo, Kelly B; Macri, Lauren K; Felsenstein, Jerome; Wynne, James J; Clark, Richard A F

2018-05-01

Recent evidence indicates that early removal of eschar by tangential debridement can promote healing. Laser debridement can be used for debridement of areas that prove challenging for debridement using tangential excision. In particular, irradiation with an ArF excimer laser ablates desiccated eschar and is self-terminating, preserving hydrated or viable tissue. Thermal burns were created on the flanks of two outbred, female Yorkshire pigs using aluminum bars heated to 70°C and applied for different lengths of time. Three days after injury, burns were debrided using an ArF excimer laser (193nm). Tissue was harvested immediately after debridement and 7days after debridement (10days after burn). Data from a pilot study demonstrates that ArF excimer laser irradiation removes burn eschar and promotes healing at 10days after burn. ArF excimer laser debridement is self-terminating and preserves underlying and adjacent perfused tissue. Potentially, this modality would be ideal for the complex curvilinear structures of the body. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

The wound debrider: a new monofilament fibre technology.

PubMed

Haemmerle, Gilbert; Duelli, Heinz; Abel, Martin; Strohal, Robert

Debridement is a basic necessity to induce the functional process of tissue repair, especially in chronic wounds. In this pilot study the authors used a new debrider technology with specific monofilament fibres in a unique texture to evaluate its efficacy, safety and tolerability. In eleven patients, exhibiting all types of wound-associated debris (biofilms, slough, necrotic crusts and hyperkeratotic plaques), the debrider, wetted with physiological solution, was wiped without specific force over the wound for about 2-4 minutes. This led to removal of almost all debris leaving healthy granulation tissue intact, including small epithelialized islands of vital tissue. The procedure was without pain and adverse events. Scanning electron microscopic analyses identified the majority of the removed debris tightly packed within the monofilament texture. A surgeon who blindly assessed pictures taken before and after the debridement categorized all except one wound without the need for surgical debridement and ranked all the debridement results with the new debrider as 'very good' (best category). This formulates the basic concept that the new debrider-based technology is easy, fast, highly efficient, well tolerated and cost effective.

The cost of wound debridement: a Canadian perspective.

PubMed

Woo, Kevin Y; Keast, David; Parsons, Nancy; Sibbald, R Gary; Mittmann, Nicole

2015-08-01

Debridement is integral to wound bed preparation by removing devitalised tissue, foreign material, senescent cells, phenotypically abnormal/dysfunctional cells (cellular burden) and bacteria sequestrum (biofilm). While the body of evidence to substantiate the benefits of debridement is growing, little is known about the cost-effectiveness of each debridement method. The purpose of this analysis was to compare cost-effectiveness of various debridement methods and clinical outcomes to help inform clinicians and policy makers of the cost-effectiveness associated with the various types of therapies and the impact they can have on the Canadian health care system. Results indicated that sharp debridement was the most cost-effective followed by enzymatic debridement method. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Gunshot-induced fractures of the extremities: a review of antibiotic and debridement practices.

PubMed

Sathiyakumar, Vasanth; Thakore, Rachel V; Stinner, Daniel J; Obremskey, William T; Ficke, James R; Sethi, Manish K

2015-09-01

The use of antibiotic prophylaxis and debridement is controversial when treating low- and high-velocity gunshot-induced fractures, and established treatment guidelines are currently unavailable. The purpose of this review was to evaluate the literature for the prophylactic antibiotic and debridement policies for (1) low-velocity gunshot fractures of the extremities, joints, and pelvis and (2) high-velocity gunshot fractures of the extremities. Low-velocity gunshot fractures of the extremities were subcategorized into operative and non-operative cases, whereas low-velocity gunshot fractures of the joints and pelvis were evaluated based on the presence or absence of concomitant bowel injury. In the absence of surgical necessity for fracture care such as concomitant absence of gross wound contamination, vascular injury, large soft-tissue defect, or associated compartment syndrome, the literature suggests that superficial debridement for low-velocity ballistic fractures with administration of antibiotics is a satisfactory alternative to extensive operative irrigation and debridement. In operative cases or those involving bowel injuries secondary to pelvic fractures, the literature provides support for and against extensive debridement but does suggest the use of intravenous antibiotics. For high-velocity ballistic injuries, the literature points towards the practice of extensive immediate debridement with prophylactic intravenous antibiotics. Our systematic review demonstrates weak evidence for superficial debridement of low-velocity ballistic fractures, extensive debridement for high-velocity ballistic injuries, and antibiotic use for both types of injury. Intra-articular fractures seem to warrant debridement, while pelvic fractures with bowel injury have conflicting evidence for debridement but stronger evidence for antibiotic use. Given a relatively low number of studies on this subject, we recommend that further high-quality research on the debridement and antibiotic use for gunshot-induced fractures of the extremities should be conducted before definitive recommendations and guidelines are developed.

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement.

PubMed

Traber, Juerg; Held, Ulrike; Signer, Maria; Huebner, Tobias; Arndt, Stefan; Neff, Thomas A

2017-08-01

Chronic foot and leg ulcers are a common health problem worldwide. A mainstay of chronic ulcer therapy is sharp mechanical wound debridement requiring potent analgesia. In this prospective, controlled, single-centre, crossover design study, patients were assigned to either the administration of topical analgesia with 5% lidocaine/prilocaine cream or the inhalation of an analgesic 50% N 2 O/O 2 gas premix. Primary outcome parameter was level of pain at maximum wound depth during debridement as measured by a visual analogue scale. Secondary outcomes included level of pain after debridement, overall duration of treatment session, duration and completeness of debridement, and the patient's subjective perception of analgesic quality during debridement. Pain level increased from 0·60/0·94 (first/second debridement; baseline) to 1·76/2·50 (debridement) with 5% lidocaine/prilocaine and from 1·00/1·35 (baseline) to 3·95/3·29 (debridement) with 50% N 2 O/O 2 gas premix. Patient satisfaction was 90·48%/94·44% (first/second debridement) with topical 5% lidocaine/prilocaine analgesia and 90·48%/76·47% with the inhalation of 50% N 2 O/O 2 gas premix. Debridement was completed in a significantly higher percentage of 85·71%/88·89% (first/second debridement) with 5% lidocaine/prilocaine than with 50% N 2 O/O 2 gas premix (42·86%/58·82%) (odds ratio 6·7; P = 0·001). This study provides sound evidence that analgesia with topically administered 5% lidocaine/prilocaine cream is superior to the use of inhaled 50% N 2 O/O 2 gas premix in chronic leg ulcer debridement. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Photoacoustic imaging of teeth for dentine imaging and enamel characterization

NASA Astrophysics Data System (ADS)

Periyasamy, Vijitha; Rangaraj, Mani; Pramanik, Manojit

2018-02-01

Early detection of dental caries, cracks and lesions is needed to prevent complicated root canal treatment and tooth extraction procedures. Resolution of clinically used x-ray imaging is low, hence optical imaging techniques such as optical coherence tomography, fluorescence imaging, and Raman imaging are widely experimented for imaging dental structures. Photoacoustic effect is used in photon induced photoacoustic streaming technique to debride the root canal. In this study, the extracted teeth were imaged using photoacoustic tomography system at 1064 nm. The degradation of enamel and dentine is an indicator of onset of dental caries. Photoacoustic microscopy (PAM) was used to study the tooth enamel. Images were acquired using acoustic resolution PAM system. This was done to identify microscopic cracks and dental lesion at different anatomical sites (crown and cementum). The PAM tooth profile is an indicator of calcium distribution which is essential for demineralization studies.

Debridement: controlling the necrotic/cellular burden.

PubMed

Ayello, Elizabeth A; Cuddigan, Janet E

2004-03-01

To provide physicians and nurses with an overview of the options for debriding a chronic wound to improve wound healing. This continuing education activity is intended for physicians and nurses with an interest in learning about methods for debriding chronic wounds to promote wound healing. After reading the article and taking the test, the participant will be able to: 1. Describe the 4 types of debridement most commonly used in clinical practice. 2. Describe when to debride a wound and how to determine which method to use.

Comparative evaluation of rotary ProTaper, Profile, and conventional stepback technique on reduction in Enterococcus faecalis colony-forming units and vertical root fracture resistance of root canals.

PubMed

Singla, Mamta; Aggarwal, Vivek; Logani, Ajay; Shah, Naseem

2010-03-01

The purpose of this in vitro study was to evaluate the effect of various root canal instrumentation techniques with different instrument tapers on cleaning efficacy and resultant vertical root fracture (VRF) strength of the roots. Fifty human mandibular first premolar roots were enlarged to ISO size 20, inoculated with Enterococcus faecalis [ATCC2912] for 72 hours and divided into 5 groups: group I: prepared with .02 taper hand instruments ISO size 40; group II: Profile .04 taper size 40; group III: Profile .06 taper size 40; group IV: ProTaper size F4; and group V (control group) further divided into: Va: with bacterial inoculation and no mechanical instrumentation; and Group Vb: neither bacterial inoculation nor mechanical instrumentation. Cleaning efficacy was evaluated in terms of reduction of colony forming units (CFUs). The VRF strength was evaluated using D11 spreader as wedge in an Instron testing machine. Root canals instrumented with ProTaper and 6% Profile instruments showed maximum reduction in CFUs, with statistically insignificant difference between them. The VRF resistance decreased in all instrumented groups. The difference of VRF between 2% and 4% taper Profile groups was statistically insignificant (P = .195). One-way analysis of variance showed that canals instrumented with ProTaper F4 showed maximum reduction in VRF resistance compared with control uninstrumented group. Profile 6% taper instruments offer the advantage of maximum debridement without significant reduction in root fracture resistance. Copyright 2010 Mosby, Inc. All rights reserved.

[Comparative study of the efficacy of larva therapy for debridement and control of bacterial burden compared to surgical debridement and topical application of an antimicrobial].

PubMed

Contreras-Ruiz, José; Fuentes-Suárez, Adán; Arroyo-Escalante, Sara; Moncada-Barron, David; Sosa-de-Martínez, María Cristina; Maravilla-Franco, Ernesto; Domínguez-Cherit, Judith Guadalupe

2016-10-01

Maggot debridement therapy (MDT) is the use of medical grade maggots of the fly Lucilia sericata for wound debridement. Recent observations show that MDT decreases bacterial burden as well. Venous ulcers are the most commonly seen in wound clinics and require, besides adequate treatment of venous hypertension, proper wound bed preparation with debri dement of necrotic tissue and control of potential infections. To evaluate the efficacy of MDT in venous ulcers a randomized controlled trial was designed to compare MDT to surgical debridement and topical application of silver sulfadiazine (SSD) in 19 patients for 4 weeks. The study variables were area reduction, wound bed characteristics, pain, odor, anxiety and bacterial burden using quantitative tissue biopsies. MDT was effective as surgical debridement associated with topical SDD in the debridement of the wound and in reducing its size. A significant difference was observed in the reduction of bacterial burden in favor of the MDT group. Odor and anxiety increased in the MDT group without any difference in the pain intensity between groups. In conclusion, this study suggests that MDT is as effective as surgical debridement for the debridement of necrotic tissue and promote wound healing in venous ulcers and better at reducing bacterial burden.

Maggot debridement: an alternative method for debridement.

PubMed

Gottrup, Finn; Jørgensen, Bo

2011-01-01

Debridement is an essential component to promote healing in a problem wound. Several techniques are available including maggot debridement therapy (MDT). To describe the efficacy of MDT for treating problem wound especially diabetic foot ulcers. The topic is elucidated from different points of view: the mode of action, when to use, use in a practice, clinical results, and discussing the problem of creating evidence for the clinical effect. Literature and own results demonstrate that MDT is a safe method with few side effects. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. However, the evidence of these effects of MDT on the highest level is presently lacking. A detailed description of how to use MDT in practice is provided including a visual demonstration in a video. In spite of lacking clinical evidence, MDT clinical experience strongly suggests that this technique is effective and safe. It can be used for most types of problem wounds, but our indication is primarily diabetic foot ulcers, because of its selectivity for debriding necrotic dead tissue. It may be a valuable alternative surgical/sharp debridement.

Maggot Debridement: An Alternative Method for Debridement

PubMed Central

Gottrup, Finn; Jørgensen, Bo

2011-01-01

Debridement is an essential component to promote healing in a problem wound. Several techniques are available including maggot debridement therapy (MDT). Objective: To describe the efficacy of MDT for treating problem wound especially diabetic foot ulcers. Methods: The topic is elucidated from different points of view: the mode of action, when to use, use in a practice, clinical results, and discussing the problem of creating evidence for the clinical effect. Results: Literature and own results demonstrate that MDT is a safe method with few side effects. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. However, the evidence of these effects of MDT on the highest level is presently lacking. A detailed description of how to use MDT in practice is provided including a visual demonstration in a video. Conclusion: In spite of lacking clinical evidence, MDT clinical experience strongly suggests that this technique is effective and safe. It can be used for most types of problem wounds, but our indication is primarily diabetic foot ulcers, because of its selectivity for debriding necrotic dead tissue. It may be a valuable alternative surgical/sharp debridement. PMID:21776326

Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

PubMed Central

McCallon, Stanley K.; Weir, Dorothy; Lantis, John C.

2015-01-01

Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%–50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation. PMID:26442207

[Evaluation of root canal isthmus debridement efficacy of Er:YAG laser in combination with sodium hypochlorite].

PubMed

Zhou, Meng-Qi; Wang, Hao-Ming; Xiao, Jia-Qi; Hong, Jin

2016-10-01

To histologically evaluate the efficacy of sodium hypochlorite (NaClO) in combination with Er:YAG (erbium-doped yttrium aluminium garnet) laser in dissolving necrotic tissue and cleaning root canals as well as canal isthmuses. After scanned by cone-beam CT (CBCT), 50 well-prepared premolars with root canal isthmuses were selected and randomly assigned into 5 groups. They were subsequently subjected to different regimens as followed: group A-irrigated with 1% NaClO for 1 minute, group B- irradiated by Er:YAG laser at 0.5 W combined with 1% NaClO irrigation for 1 minute, group C- irradiated by Er:YAG laser at 1.0 W combined with 1% NaClO irrigation for 1 minute, group D- irradiated by Er:YAG laser at 2.0 W combined with 1% NaClO irrigation for 1 minute,group E- negative control. After histological preparation and staining, the cross-sections were evaluated for percentage of tissue removal from root canals and isthmuses. The cleanliness values were calculated using SPSS 13.0 software package. The mean percentage of root canals in group A, B, C and D was 95.24%, 96.53%、97.63% and 98.22%, respectively, and the mean percentage of isthmuses was 16.50%, 51.48%, 52.56% and 53.83%, respectively. The mean percentage of root canal and isthmus cleanliness values were significantly higher in group B, C and D (P<0.05) than that in group A. There was no significant differences of root canal and isthmus cleanliness among group B, C and D. Er:YAG laser combined with 1% NaClO irrigation may be used effectively in root canal and root canal isthmus cleanliness as a new method.

On the causes of persistent apical periodontitis: a review.

PubMed

Nair, P N R

2006-04-01

Apical periodontitis is a chronic inflammatory disorder of periradicular tissues caused by aetiological agents of endodontic origin. Persistent apical periodontitis occurs when root canal treatment of apical periodontitis has not adequately eliminated intraradicular infection. Problems that lead to persistent apical periodontitis include: inadequate aseptic control, poor access cavity design, missed canals, inadequate instrumentation, debridement and leaking temporary or permanent restorations. Even when the most stringent procedures are followed, apical periodontitis may still persist as asymptomatic radiolucencies, because of the complexity of the root canal system formed by the main and accessory canals, their ramifications and anastomoses where residual infection can persist. Further, there are extraradicular factors -- located within the inflamed periapical tissue -- that can interfere with post-treatment healing of apical periodontitis. The causes of apical periodontitis persisting after root canal treatment have not been well characterized. During the 1990s, a series of investigations have shown that there are six biological factors that lead to asymptomatic radiolucencies persisting after root canal treatment. These are: (i) intraradicular infection persisting in the complex apical root canal system; (ii) extraradicular infection, generally in the form of periapical actinomycosis; (iii) extruded root canal filling or other exogenous materials that cause a foreign body reaction; (iv) accumulation of endogenous cholesterol crystals that irritate periapical tissues; (v) true cystic lesions, and (vi) scar tissue healing of the lesion. This article provides a comprehensive overview of the causative factors of non-resolving periapical lesions that are seen as asymptomatic radiolucencies post-treatment.

In vitro resistance to fracture of roots obturated with Resilon or gutta-percha.

PubMed

Monteiro, Jeanne; de Ataide, Ida de Noronha; Chalakkal, Paul; Chandra, Pavan Kumar

2011-06-01

There have been varied results from studies comparing postendodontic fracture resistance between teeth obturated with Resilon or gutta-percha. This study was performed to evaluate the fracture resistance of roots obturated by using Resilon (RealSeal system) or gutta-percha (with AH Plus sealer). Eighty extracted human mandibular single-rooted premolars stored in 10% formalin were used in the study. They were prepared by using a crown-down technique, debrided with NaOCl, ethylenediaminetetraacetic acid, and sterile water and divided into 4 groups. Obturation was performed by using the lateral condensation method. The negative control group consisted of unfilled specimens, and the positive control group consisted of those obturated with flowable, dual-cure composite resin. All root specimens were stored for 2 weeks in 100% humidity to allow complete setting of the sealer. Each specimen was mounted in acrylic in a polyvinyl ring and tested for fracture resistance with the Universal testing machine. The loading fixture of the machine was mounted with its spherical tip aligned with the center of the canal opening of each root. A vertical loading force was applied until it fractured the root. The force values were subjected to statistical analysis including analysis of variance and Fisher least significant difference testing. Teeth obturated with Resilon were more resistant to fracture than those obturated with gutta-percha. The difference was found to be highly significant (P=.00001). Resilon increased the resistance to fracture of single-rooted teeth in vitro. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

MTA apical plugs in the treatment of traumatized immature teeth with large periapical lesions.

PubMed

Cehreli, Zafer C; Sara, Sezgi; Uysal, Serdar; Turgut, Melek D

2011-02-01

This case report describes the management of a late-referral case of periapically involved, traumatized immature permanent incisors by endodontic treatment and the use of mineral trioxide aggregate (MTA) apical plugs. A 10-year-old boy was referred to the clinic with a chief complaint of pain in his maxillary central incisors, which had experienced subluxation trauma 2 years earlier. Periapical radiograph of the teeth showed incomplete root development with wide-open apices and large periradicular lesions. The canals were gently debrided using K-files in conjunction with 2.5% NaOCl irrigation and 2% chlorhexidine for final flush. The root canals became asymptomatic after employing the same endodontic regimen for three visits. MTA plugs were placed in the apical area of the root canals, and the rest of the canal space was obturated by warm compaction of gutta-percha and AH Plus sealer. Resolution of the large periapical lesions was observed 2 months after treatment. At 18 months, the periapical areas revealed radiographic evidence of bone healing. Following successful removal of the toxic content of the root canal, placement of MTA plugs resulted in both healing of the periradicular radiolucency and regeneration of the periapical tissue. © 2010 John Wiley & Sons A/S.

Failure of endodontic treatment: The usual suspects.

PubMed

Tabassum, Sadia; Khan, Farhan Raza

2016-01-01

Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. With an ever increasing number of endodontic treatments being done each day, it has become imperative to avoid or minimize the most fundamental of reasons leading to endodontic failure. This paper reviews the most common causes of endodontic failure along with radiographic examples.

Failure of endodontic treatment: The usual suspects

PubMed Central

Tabassum, Sadia; Khan, Farhan Raza

2016-01-01

Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. With an ever increasing number of endodontic treatments being done each day, it has become imperative to avoid or minimize the most fundamental of reasons leading to endodontic failure. This paper reviews the most common causes of endodontic failure along with radiographic examples. PMID:27011754

Management of Surfing Injuries: A Plastic Surgeon's Viewpoint. Case Reports.

ERIC Educational Resources Information Center

Rudolph, Ross

1989-01-01

Describes plastic surgery techniques used to irrigate, debride, and close lacerations caused by surfboards. Head lacerations and nose fractures are the most common injuries. According to a survey, lacerations may be deeper than expected from their surface appearance and wounds may contain surfboard fragments. Injury prevention is discussed. (SM)

[debridement algorithm].

PubMed

Marinović, Marin; Fumić, Nera; Laginja, Stanislava; Aldo, Ivanicić

2014-10-01

Prolonged life expectancy increases the proportion of elderly population. The incidence of injury increases with older age. A variety of comorbidities (circulation disorders, diabetes mellitus, metabolic imbalances, etc.) and reduced biological tissue regeneration potential that accompanies older age, lead to a higher prevalence of chronic wounds. This poses a significant health, social and economic burden upon the society. Injuries in the elderly demand significant involvement of medical and non-medical staff in the prehospital and hospital treatment of the injured, with high material consumption and reduced quality of life in these patients, their families and caregivers. Debridement is a crucial medical procedure in the treatment of acute and chronic wounds. The aim of debridement is removal of all residues in wound bed and environment. Debridement can be conducted several times when there is proper indication. There are several ways of debridement procedure, each having advantages and disadvantages. The method of debridement is chosen by the physician or other medical professional. It is based on wound characteristics and the physician's expertise and capabilities. In the same type of wound, various types of debridement can be combined, all with the aim of faster and better wound healing.

The feasibility of characterising the effects of dental post-operative discomfort and sensitivity over time.

PubMed

Sear, Rose; Rees, Jeremy; Buller, Zairah; Moore, Simon C

2018-05-01

To assess the feasibility of using short message service text messages to solicit dental patients' experiences of post-operative dental discomfort and sensitivity (PODDS) and whether responses characterise change in PODDS over time. Patients were recruited from clinics following routine dental procedures, such as simple restorations or root surface debridement. They completed a short questionnaire collecting information on socio-economic circumstances, their recent experience of PODDS, the acceptability of receiving text message questions and their telephone number. Participants received a short question by text to their telephone for five consecutive days that asked them to respond with an indication (on a 1 to 10 scale) of their experience of PODDS at that time. Questionnaires were completed by 34 participants, of whom text message responses were received from an average of 23.4 participants (min 20, max 26) across the five follow-up days. Regression analyses indicated that PODDS decreased over time (β = -0.24, 95% CI -0.36 to -0.12). Text messaging to solicit PODDS is feasible and can potentially be used to assess the efficacy of treatments designed to minimise or reduce PODDS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clinical observations on the use of honcrivine in the chemical debridement of wounds.

PubMed

Efem, S E E

2009-12-01

Chronic and non healing wounds, necrotic wounds and contused and devitalized wounds require debridement to rid the wounds of all these impediments that encourage bacterial growth and multiplications with consequent impairment of wound healing. Whereas there are several methods of wound debridement with their peculiar indications, merits and demerits, the ideal method of debridement is yet to be discovered. The aim of this study is to investigate clinically the ability of honcrivine (honey plus acriflavine 0.1%) to chemically debride various wounds in routine clinical practice. One hundred and eighty nine consecutive patients managed by the author between June 1995 and June 2005 were included in this study. They were 125 males and 64 females and their ages ranged between 6 and 78 years. Initially swab was taken for bacterial culture from each wound before being cleaned with normal saline, then dressed daily with gauze soaked in honcrivine. Bacterial culture was repeated fortnightly. Antibiotics were administered as dictated by culture and sensitivity report. Wound debridement progressed rapidly and impressively with necrotic and devitalized tissues as well as tenacious pus and fibrin deposits being replaced with healthy granulation tissue. Patients age, sex and bacterial burden did not influence the rate of debridement, rather wound age and necrotic burden were inversely proportional to the debridement rate. Honcrivine did not provoke any inflammatory response nor was any allergic reaction observed. It is one of the oldest remedies known to mankind and is still useful and versatile today as it was 2000 years ago. It is a very effective chemical wound debridant.

Collagenase Santyl ointment: a selective agent for wound debridement.

PubMed

Shi, Lei; Carson, Dennis

2009-01-01

Enzymatic debridement is a frequently used technique for removal of necrotic tissue from wounds. Proteases with specificity to break down the collagenous materials in necrotic tissues can achieve selective debridement, digesting denatured collagen in eschar while sparing nonnecrotic tissues. This article provides information about the selectivity of a collagenase-based debriding agent, including evidence of its safe and efficacious uses. Recent research has been conducted, investigating the chemical and biological properties of collagenase ointment, including healing in animal models, digestion power on different collagen types, cell migration activity from collagen degradation products, and compatibility with various wound dressings and metal ions. Evidence presented demonstrates that collagenase ointment is an effective, selective, and safe wound debriding agent.

Pulp Revascularization on Permanent Teeth with Open Apices in a Middle-aged Patient.

PubMed

Wang, Yu; Zhu, Xiaofei; Zhang, Chengfei

2015-09-01

Pulp revascularization is a promising procedure for the treatment of adolescents' immature permanent teeth with necrotic pulp and/or apical periodontitis. However, the ability to successfully perform pulp revascularization in a middle-aged patient remains unclear. A 39-year-old woman was referred for treatment of teeth #20 and #29 with necrotic pulp, extensive periapical radiolucencies, and incomplete apices. Pulp revascularization procedures were attempted, including root canal debridement, triple antibiotic paste medication, and platelet-rich plasma transplantation to act as a scaffold. Periapical radiographic and cone-beam computed tomographic examinations were used to review the changes in the apical lesions and root apex configuration. The patient remained asymptomatic throughout the 30-month follow-up. Periapical radiographic examination revealed no change in the apical lesions of either tooth at 8 months. The periapical radiolucency disappeared on tooth #20 and significantly decreased on tooth #29 by the 30-month follow-up, findings that were also confirmed by cone-beam computed tomographic imaging. No evidence of root lengthening or thickening was observed. Successful revascularization was achieved in a middle-aged patient's teeth. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Regenerative treatment of an immature, traumatized tooth with apical periodontitis: report of a case.

PubMed

Cotti, Elisabetta; Mereu, Manuela; Lusso, Daniela

2008-05-01

This case report describes the treatment of a necrotic immature permanent central incisor with complete crown fracture, suspected root fracture, and sinus tract, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the trauma literature's methods for revascularization was provided. The root canal was gently debrided of necrotic tissue with a sharp spoon excavator and irrigated for only one third of its length with NaOCl and then medicated with calcium hydroxide. After 15 days the sinus tract had healed, and the tooth was asymptomatic. The tooth was accessed, calcium hydroxide was removed, bleeding was stimulated to form an intracanal blood clot, and mineral trioxide aggregate was placed coronally to the blood clot. After 8 months, a coronal calcified barrier was radiographically evident and accompanied with progressive thickening of the root wall and apical closure. Two and a half years after treatment was initiated, the tooth remained asymptomatic, and the sinus tract had not reappeared. The progressive increase in the thickness of the dentinal walls and subsequent apical development suggest that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth with sinus tract.

Maggots as a wound debridement agent for chronic venous leg ulcers under graduated compression bandages: A randomised controlled trial.

PubMed

Davies, C E; Woolfrey, G; Hogg, N; Dyer, J; Cooper, A; Waldron, J; Bulbulia, R; Whyman, M R; Poskitt, K R

2015-12-01

Slough in chronic venous leg ulcers may be associated with delayed healing. The purpose of this study was to assess larval debridement in chronic venous leg ulcers and to assess subsequent effect on healing. All patients with chronic leg ulcers presenting to the leg ulcer service were evaluated for the study. Exclusion criteria were: ankle brachial pressure indices <0.85 or >1.25, no venous reflux on duplex and <20% of ulcer surface covered with slough. Participants were randomly allocated to either 4-layer compression bandaging alone or 4-layer compression bandaging + larvae. Surface areas of ulcer and slough were assessed on day 4; 4-layer compression bandaging was then continued and ulcer size was measured every 2 weeks for up to 12 weeks. A total of 601 patients with chronic leg ulcers were screened between November 2008 and July 2012. Of these, 20 were randomised to 4-layer compression bandaging and 20 to 4-layer compression bandaging + larvae. Median (range) ulcer size was 10.8 (3-21.3) cm(2) and 8.1 (4.3-13.5) cm(2) in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Mann-Whitney U test, P = 0.184). On day 4, median reduction in slough area was 3.7 cm(2) in the 4-layer compression bandaging group (P < 0.05) and 4.2 cm(2) (P < 0.001) in the 4-layer compression bandaging + larvae group. Median percentage area reduction of slough was 50% in the 4-layer compression bandaging group and 84% in the 4-layer compression bandaging + larvae group (Mann-Whitney U test, P < 0.05). The 12-week healing rate was 73% and 68% in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Kaplan-Meier analysis, P = 0.664). Larval debridement therapy improves wound debridement in chronic venous leg ulcers treated with multilayer compression bandages. However, no subsequent improvement in ulcer healing was demonstrated. © The Author(s) 2014.

[Application of a hydrosurgery system in debridement of various types of burn wounds].

PubMed

Li, M Y; Mao, Y G; Guo, G H; Liu, D W

2016-09-20

Burn wound healing is closely associated with the depth of wound and early debridement. The traditional ways of debridement have certain limitations and often result in poor appearance and function of repaired area. At present, the hydrosurgery system has been applied clinically in burn field. This paper summarizes advantages and disadvantages of application of the hydrosurgery system in debridement of burn wound with different depths, different periods, extraordinary region, and uncommon agent.

Efficacy of enzymatic debridement of deeply burned hands.

PubMed

Krieger, Yuval; Bogdanov-Berezovsky, Alexander; Gurfinkel, Reuven; Silberstein, Eldad; Sagi, Amiram; Rosenberg, Lior

2012-02-01

The burned hand is a common and difficult to care-for entity in the field of burns. Due to the anatomy of the hand (important and delicate structures crowded in a small limited space without sub-dermal soft tissue), surgical debridement of the burned tissue is technically difficult and may cause considerable complications and, therefore, should be performed judiciously. Selective enzymatic debridement of the burn wound can preserve the spontaneous epithelialisation potential and reduce the added injury to the traumatised tissue added by a surgical debridement. The aim of the study was to assess the implication of a selective enzymatic compound (Debrase(®) - Ds) in the special field of deep hand burns, by comparing the actual burn area that required surgical coverage after enzymatic debridement to the burn area clinically judged to require skin grafting prior to debridement. This was a retrospective data collection and analysis from 154 complete files of prospective, open-label study in 275 hospitalised, Ds-treated burn patients. A total of 69 hand burns diagnosed as 'deep' was analysed; 36% of the wounds required surgical intervention after enzymatic debridement; 28.6% of the total burned area estimated initially as deep was covered by skin graft (statistically significant p<0.001). Debridement of deep-hand burns with a selective enzymatic agent decreased the perceived full-thickness wound area and skin-graft use. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Relationship between probability of future shoulder arthroplasty and outcomes of arthroscopic debridement in patients with advanced osteoarthritis of glenohumeral joint.

PubMed

Henry, Patrick; Razmjou, Helen; Dwyer, Tim; Slade Shantz, Jesse A; Holtby, Richard

2015-10-05

Arthroscopic glenohumeral debridement for symptom control has shown promising short term results in the young active population, when arthroplasty may not be a practical option due to the recommended activity restrictions, potential for complications and/or early wear, and a need for revision. The purpose of this study was twofold: 1) to examine the impact of arthroscopic debridement with or without subacromial decompression on clinical outcomes in patients with severe glenohumeral osteoarthritis (OA), and 2) to explore the differences in post-debridement outcomes between patients who eventually progressed to arthroplasty vs. those who did not. The role of an active worker's compensation claim was examined. Prospectively collected data of patients who were not good candidates for shoulder arthroplasty and had subsequently undergone arthroscopic shoulder debridement were used for analysis. Disability was measured using the relative Constant-Murley score (CMS), the American Shoulder and Elbow Surgeon's (ASES) assessment form, pain free range of motion (ROM), and strength. Fifty-six patients were included in the final analysis. Eighteen (32 %) patients underwent arthroplasty surgery (arthroplasty group) over a period of 11 years. The arthroplasty group was comparable with the non-arthroplasty group prior to debridement but was more disabled at post-debridement surgery follow-up, functioning at less than 50 % of normal based on ASES, relative CMS, and active painfree ROM. In the multivariable analysis, the post-debridement relative CMS was affected by having a compensation claim and having a future arthroplasty. Arthroscopic debridement improved clinical outcome in 68 % of patients suffering from advanced OA of glenohumeral joint. Having less than 50 % of normal score in ASES, relative CMS and painfree ROM post- debridement within a period of two years may be an indication for future arthroplasty. Role of worker's compensation claims should not be underestimated.

The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers.

PubMed

Eneroth, Magnus; van Houtum, William H

2008-01-01

Treatment of diabetic foot ulcers includes a number of different regimes such as glycaemic control, re-vascularization, surgical, local wound treatment, offloading and other non-surgical treatments. Although considered the standard of care, the scientific evidence behind the various debridements used is scarce. This presentation will focus on debridement and V.A.C. Therapy, two treatments widely used in patients with diabetes and foot ulcers. A review of existing literature on these treatments in diabetic foot ulcers, with focus on description of the various types of debridements used, the principles behind negative pressure wound therapy (NPWT) using the V.A.C. Therapy system and level of evidence. Five randomized controlled trials (RCT) of debridement were identified; three assessed the effectiveness of a hydrogel as a debridement method, one evaluated surgical debridement and one evaluated larval therapy. Pooling the three hydrogel RCTs suggested that hydrogels are significantly more effective than gauze or standard care in healing diabetic foot ulcers. Surgical debridement and larval therapy showed no significant benefit. Other debridement methods such as enzyme preparations or polysaccharide beads have not been evaluated in RCTs of people with diabetes. More than 300 articles have been published on negative pressure wound therapy, including several small RCTs and a larger multi-centre RCT of diabetic foot ulcers. Negative pressure wound therapy seems to be a safe and effective treatment for complex diabetic foot wounds, and could lead to a higher proportion of healed wounds, faster healing rates, and potentially fewer re-amputations than standard care. Although debridement of the ulcer is considered a prerequisite for healing of diabetic foot ulcers, the grade of evidence is quite low. This may be due to a lack of studies rather than lack of effect. Negative pressure wound therapy seems to be safe and effective in the treatment of some diabetic foot ulcers, although there is still only one well-performed trial that evaluates the effect.

Atypical anatomy of maxillary second premolar with three roots and four canals

PubMed Central

Izaz, Shaik; Mandava, Pragna; Bolla, Nagesh; Dasari, Bhargavi

2017-01-01

Knowledge and understanding the anatomical configuration of individual tooth play a significant role in success of endodontic treatment, in addition to through debridement and obturation of the canals. The canal anatomy of maxillary second premolar has been studied extensively, and the presence of a significant variety of multirooted canals is relatively rare in it. A 27-year-old female reported with a chief complaint of pain in her upper right posterior region for 10 days. On intraoral hard tissue examination, ill-defined access preparation was seen in maxillary right second premolar with exposed pulp. An intraoral periapical radiograph reveals radiolucency involving the pulp space and varied morphology in the same tooth. The occurrence of three roots with four canals in the maxillary second premolar is rare and not documented in the literature so far. This case report describes the nonsurgical endodontic management of such varied anatomical configuration using cone beam computed tomography as an evaluating diagnostic tool. PMID:29386789

New techniques for wound debridement.

PubMed

Madhok, Brijesh M; Vowden, Kathryn; Vowden, Peter

2013-06-01

Debridement is a crucial component of wound management. Traditionally, several types of wound debridement techniques have been used in clinical practice such as autolytic, enzymatic, biodebridement, mechanical, conservative sharp and surgical. Various factors determine the method of choice for debridement for a particular wound such as suitability to the patient, the type of wound, its anatomical location and the extent of debridement required. Recently developed products are beginning to challenge traditional techniques that are currently used in wound bed preparation. The purpose of this review was to critically evaluate the current evidence behind the use of these newer techniques in clinical practice. There is some evidence to suggest that low frequency ultrasound therapy may improve healing rates in patients with venous ulcers and diabetic foot ulcers. Hydrosurgery debridement is quick and precise, but the current evidence is limited and further studies are underway. Debridement using a monofilament polyester fibre pad and plasma-mediated bipolar radiofrequency ablation are both very new techniques. The initial evidence is limited, and further studies are warranted to confirm their role in management of chronic wounds. © 2013 The Authors. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

A case report of low intensity laser therapy (LILT) in the management of venous ulceration: potential effects of wound debridement upon efficacy.

PubMed

Lagan, K M; Mc Donough, S M; Clements, B A; Baxter, G D

2000-02-01

This single case report (ABA design) was undertaken as a preliminary investigation into the clinical effects of low intensity laser upon venous ulceration, applied to wound margins only, and the potential relevance of wound debridement and wound measurement techniques to any effects observed. Ethical approval was granted by the University of Ulster's Research Ethical Committee and the patient recruited was required to attend 3 times per week for a total of 8 weeks. Treatments were carried out using single source irradiation (830 nm; 9 J/cm2, CB Medico, Copenhagen, Denmark) in conjunction with dry dressings during each visit. Assessment of wound surface area, wound appearance, and current pain were completed by an independent investigator. Planimetry and digitizing were completed for wound tracings and for photographs to quantify surface areas. Video image analysis was also performed on photographs of wounds. The primary findings were changes in wound appearance, and a decrease in wound surface area (range 33.3-46.3%), dependent on the choice of measurement method. Video image analysis was used, but rejected as an accurate method of wound measurement. Treatment intervention produced a statistically significant reduction in wound area using the C statistic on digitizing data for photographs (at Phase one only; Z = 2.412; p < 0.05). Wound debridement emerged as an important procedure to be carried out prior to measuring wounds. Despite fluctuating pain levels recorded throughout the duration of the study, VAS scores showed a decrease of 15% at the end of the study. This hypoalgesic effect was, however, statistically significant (using the C statistic) at Phase one only (Z = 2.554; p < 0.05). Low intensity laser therapy at this dosage, and using single source irradiation would seem to be an effective treatment for patients suffering venous ulceration. Further group studies are indicated to establish the most effective therapeutic dosage for this and other types of ulceration.

Effectiveness of DIAGNOdent in Detecting Root Caries Without Dental Scaling Among Community-dwelling Elderly.

PubMed

Zhang, Wen; McGrath, Colman; Lo, Edward C M

The purpose of this clinical research was to analyze the effectiveness of DIAGNOdent in detecting root caries without dental scaling. The status of 750 exposed, unfilled root surfaces was assessed by visual-tactile examination and DIAGNOdent before and after root scaling. The sensitivity and specificity of different cut-off DIAGNOdent values in diagnosing root caries with reference to visual-tactile criteria were evaluated on those root surfaces without visible plaque/calculus. The DIAGNOdent values from sound and carious root surfaces were compared using the nonparametric Mann-Whitney U-test. The level of statistical significance was set at 0.05. On root surfaces without plaque/calculus, significantly different (p < 0.05) DIAGNOdent readings were obtained from sound root surfaces (12.2 ± 11.1), active carious root surfaces (37.6 ± 31.7) and inactive carious root surfaces (20.9 ± 10.5) before scaling. On root surfaces with visible plaque, DIAGNOdent readings obtained from active carious root surfaces (29.6 ± 20.8) and inactive carious root surfaces (27.0 ± 7.2) were not statistically significantly different (p > 0.05). Furthermore, on root surfaces with visible calculus, all DIAGNOdent readings obtained from sound root surfaces were > 50, which might be misinterpreted as carious. After scaling, the DIAGNOdent readings obtained from sound root surfaces (8.1 ± 11.3), active carious root surfaces (37.9 ± 31.9) and inactive carious root surfaces (24.9 ± 11.5) presented significant differences (p < 0.05). A cut-off value between 10 and 15 yielded the highest combined sensitivity and specificity in detecting root caries on root surfaces without visible plaque/calculus before scaling, but the combined sensitivity and specificity are both around 70%. These findings suggest that on exposed, unfilled root surfaces without visible plaque/calculus, DIAGNOdent can be used as an adjunct to the visual-tactile criteria in detecting root-surface status without pre-treatment by dental scaling.

Delayed Surgical Debridement and Use of Semiocclusive Dressings for Salvage of Fingers After Purpura Fulminans.

PubMed

Pino, Paula A; Román, Javier A; Fernández, Felipe

2016-12-01

Background: Purpura fulminans is a condition characterized by rapidly evolving skin necrosis and disseminated intravascular coagulation. Early recognition and aggressive supportive management has led to a decrease in its mortality rate, but most of these patients must undergo extensive soft tissue debridement and partial or total limb amputation. There is controversial evidence about the timing of surgery, suggesting that some patients may benefit from delayed debridement with limb preservation. Methods: We present a case of an 86-year-old patient who developed skin necrosis of his four limbs after infectious purpura fulminans. He was treated in the ICU with supportive measures and antibiotic treatment. Surgical debridement was delayed for 4 weeks until necrosis delimitation. Results: Only upper extremity debridement was necessary. Four fingers, including one thumb, were salvaged and successfully treated with semi-occlusive dressing without complications. Conclusion: Early recognition of infectious PF and timely supportive management are important pillars of its treatment. Delayed surgical debridement allows for less aggressive resection and good functional outcome.

Inflammatory and Physiological Consequences of Debridement of Fibrous Tissue after Volumetric Muscle Loss Injury

PubMed Central

Corona, Benjamin T.; Rivera, Jessica C.

2017-01-01

Abstract Volumetric muscle loss (VML) injuries present chronic loss of muscle fibers followed by expansive fibrotic tissue deposition. Regenerative medicine therapies are under development to promote regeneration. However, mitigation of the expansive fibrous tissue is required for integration with the remaining muscle. Using a porcine VML model, delayed debridement of injury fibrosis was performed 3 months post‐VML and observed for an additional 4 weeks. A second group underwent the initial VML and was observed for 4 weeks, allowing comparison of initial fibrosis formation and debrided groups. The following salient observations were made: (i) debridement neither exacerbated nor ameliorated strength deficits; (ii) debridement results in recurrent fibrotic tissue deposition of a similar magnitude and composition as acute VML injury; and (iii) similarly upregulated transcriptional fibrotic and transcriptional pathways persist 4 weeks after initial VML or delayed debridement. This highlights the need for future studies to investigate adjunctive antifibrotic treatments for the fibrosed musculature. PMID:29193769

Corneal Epitheliopathy After Trauma by Fake Snow Powder in a 7-year-old Child

PubMed Central

Al-Amry, Mohammad A.; Al-Ghadeer, Huda A.

2016-01-01

Fake snow is a polymer of sodium polyacrylates used in games and celebrations. Despite the product leaflet that indicates safety, contact with the ocular surface can cause injury. We report a case of a child with corneal epitheliopathy due to a chemical burn injury after ocular surface contact with fake snow. The case was managed with epithelial debridement and a bandage contact lenses and topical antibiotics with complete resolution. PMID:27555717

Distinct signatures of dental plaque metabolic byproducts dictated by periodontal inflammatory status

PubMed Central

Sakanaka, Akito; Kuboniwa, Masae; Hashino, Ei; Bamba, Takeshi; Fukusaki, Eiichiro; Amano, Atsuo

2017-01-01

Onset of chronic periodontitis is associated with an aberrant polymicrobial community, termed dysbiosis. Findings regarding its etiology obtained using high-throughput sequencing technique suggested that dysbiosis holds a conserved metabolic signature as an emergent property. The purpose of this study was to identify robust biomarkers for periodontal inflammation severity. Furthermore, we investigated disease-associated metabolic signatures of periodontal microbiota using a salivary metabolomics approach. Whole saliva samples were obtained from adult subjects before and after removal of supragingival plaque (debridement). Periodontal inflamed surface area (PISA) was employed as an indicator of periodontal inflammatory status. Based on multivariate analyses using pre-debridement salivary metabolomics data, we found that metabolites associated with higher PISA included cadaverine and hydrocinnamate, while uric acid and ethanolamine were associated with lower PISA. Next, we focused on dental plaque metabolic byproducts by selecting salivary metabolites significantly decreased following debridement. Metabolite set enrichment analysis revealed that polyamine metabolism, arginine and proline metabolism, butyric acid metabolism, and lysine degradation were distinctive metabolic signatures of dental plaque in the high PISA group, which may be related to the metabolic signatures of disease-associated communities. Collectively, our findings identified potential biomarkers of periodontal inflammatory status and also provide insight into metabolic signatures of dysbiotic communities. PMID:28220901

A Rabbit Model of Acanthamoeba Keratitis: Use of Infected Soft Contact Lenses After Corneal Epithelium Debridement With a Diamond Burr.

PubMed

Ortillés, Ángel; Goñi, Pilar; Rubio, Encarnación; Sierra, Marta; Gámez, Ekaterina; Fernández, María T; Benito, María; Cristóbal, José Á; Calvo, Begoña

2017-02-01

To develop a rabbit model of Acanthamoeba keratitis (AK) as the best method to reproduce the natural course of this disease. To induce AK, infected contact lenses (1000 amoebae/mm2, 90% trophozoites) were placed over the previously debrided corneal surface, in combination with a temporary tarsorrhaphy. Environmental and clinical strains of Acanthamoeba spp. (genotype T4) were used. Three groups (1L, n = 32; 2L-21d, n = 5; 2L-3d, n = 23) were established according to the number of contact lenses used (1L, 1 lens; 2L-21d and 2L-3d, 2 lenses) and the placement day of these (1L, day 1; 2L-21d, days 1 and 21; 2L-3d, days 1 and 3). The infection was quantified by a clinical score system and confirmed using corneal cytology and culture, polymerase chain reaction and histopathologic analysis. The infection rate obtained was high (1L, 87.5%; 2L-21d, 100%; 2L-3d, 82.6%), although no clinical signs were observed in the 50% of the infected animals in group 1L. Among groups, group 2L-3d showed more cases of moderate and severe infection. Among strains, no statistically significant differences were found in the infection rate. In the control eyes, cross infection was confirmed when a sterile contact lens was placed in the previously debrided corneas but not if the eye remained intact. The combination of two infected contact lenses after corneal debridement seems to be an alternative model, clinically and histopathologically similar to its human counterpart, to induce the different AK stages and reproduce the course of the disease in rabbits.

The Cdk5 inhibitor olomoucine promotes corneal debridement wound closure in vivo

PubMed Central

Tripathi, Brajendra K.; Stepp, Mary A.; Gao, Chun Y.

2008-01-01

Purpose To investigate the effect of the Cdk5 inhibitor olomoucine on corneal debridement wound healing in vivo. Methods Corneal debridement wounds of 1.5 mm were made on the ocular surface of CD-1 mice. A 20 μl drop of 15 µM olomoucine in 1% DMSO was applied to the wound area immediately after wounding and again after 6 h. Control mice received identical applications of 1% DMSO. Mice were euthanized after 18 h, two weeks, and three weeks for evaluation of wound healing and restratification. Corneas were stained with Richardson’s dye, photographed, and processed for histology and immunofluorescence as whole mounts or paraffin sections. The remaining wound area at 18 h was measured by image analysis. Scratch wounded cultures of human corneal-limbal epithelial cells (HCLE) were used to examine the effect of olomoucine on matrix metalloproteinase (MMP) expression in vitro. MMP-2 and MMP-9 were detected by immunofluorescence and immunoblotting. Results Olomoucine treatment significantly enhanced corneal wound closure without increasing inflammation or infiltration of polymorphonuclear leukocytes 18 h after wounding (p<0.05). The increased localization of MMP-9 within epithelial cells at the wound edge was further enhanced by olomoucine while the expression of MMP-2 was reduced. Olomoucine treatment of scratch wounded HCLE cells produced similar changes in MMP-9 and MMP-2 expression. The examination of treated corneas two and three weeks after wounding showed normal epithelial restratification with no evidence of inflammation or stromal disorganization. Conclusions Topical application of olomoucine in 1% DMSO significantly enhances closure of small epithelial debridement wounds without increasing inflammation or impairing reepithelialization. PMID:18385789

Selectivity of a bromelain based enzymatic debridement agent: a porcine study.

PubMed

Rosenberg, Lior; Krieger, Yuval; Silberstein, Eldad; Arnon, Ofer; Sinelnikov, Igor A; Bogdanov-Berezovsky, Alex; Singer, Adam J

2012-11-01

Debridement of the burn eschar is a cornerstone of burn wound care. Rapid enzymatic debridement with a bromelain-based agent (Debriding Gel Dressing-DGD) has recently been investigated. The current study was designed to further investigate the selectivity of DGD to burned eschar in a larger number and more varied types of wounds. A systematic animal experiment was conducted to determine the effects of DGD on normal, non-injured skin, burns, exposed dermis of donor sites, and skin punch biopsy wells. Partial thickness dermal burns and partial thickness skin graft donor sites were created on a pig and treated with a 4-h application of DGD or its control hydrating vehicle that does not have any activity except hydration. Punch biopsy samples were taken before and after treatment and microscopically assessed for evidence of tissue viability and its respective components thickness. Rapid dissolution of the burn eschar was noted in all DGD but not vehicle treated burns. There was no apparent damage to the underlying sub eschar dermis, donor sites, normal skin or punch biopsy wells after exposure to DGD. While the thickness of the treated tissues slightly increased due to edema, the increase in dermal thickness was similar after treatment with DGD or its vehicle. The increase in the cross section surface area of the treated punch biopsy wells was similar after treatment with DGD and its control vehicle. Exposure of the burn eschar to DGD results in its rapid dissolution. Exposure of normal skin or non-burned dermis to DGD has no effects demonstrating its selectivity to eschar. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

An updated overview and clarification of the principle role of debridement.

PubMed

Strohal, R; Dissemond, J; Jordan O'Brien, J; Piaggesi, A; Rimdeika, R; Young, T; Apelqvist, J

2013-01-01

Routine care of non-healing acute and chronic wounds often comprises either cleaning or debridement. Consequently, debridement is a basic necessity to induce the functional process of tissue repair, which makes it a central medical intervention in the management of acute and chronic, non-healing wounds.

Timing of Operative Debridement in Open Fractures.

PubMed

Rozell, Joshua C; Connolly, Keith P; Mehta, Samir

2017-01-01

The optimal treatment of open fractures continues to be an area of debate in the orthopedic literature. Recent research has challenged the dictum that open fractures should be debrided within 6 hours of injury. However, the expedient administration of intravenous antibiotics remains of paramount importance in infection prevention. Multiple factors, including fracture severity, thoroughness of debridement, time to initial treatment, and antibiotic administration, among other variables, contribute to the incidence of infection and complicate identifying an optimal time to debridement. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of epidermal debridement of partial-thickness burns on infection and reepithelialization in swine.

PubMed

Singer, A J; Thode, H C; McClain, S A

2000-02-01

Early postburn debridement of burn blisters is controversial. This study was conducted to compare rates of infection and reepithelialization in debrided vs nondebrided second-degree burns in swine. This was a prospective, blinded, controlled, experimental trial using isoflurane-anesthetized swine. Standardized partial-thickness burns were inflicted by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of two young pigs for 20 seconds. In half of the burns the necrotic epidermis was manually debrided. All burns were randomly treated with octylcyanoacrylate spray (OCA) or dry gauze (C). Full-thickness biopsies were taken at 7, 10, and 14 days for blinded histopathologic evaluation. The primary outcomes were the proportions of infected burns at days 7 and 10 and the proportion of completely reepithelialized burns at day 14. Burns were considered infected in the presence of intradermal neutrophils containing bacteria (intraobserver agreement, K = 1.00). A secondary outcome was the proportion of burns with the presence of scar tissue (abnormal collagen under polarized light; intraobserver correlation, K = 0.93). Chi-square tests were used for group comparisons. This study had 90% power to detect a 40-percentage-point difference in infection rates (alpha = 0.05). A total of 126 biopsies from 42 burns were available for review. Infection rates were higher in the debrided burns both at day 7 (55% vs 4.5%, p < 0.001) and at day 10 (65% vs 9%, p < 0.001) after injury. The proportion of nondebrided burns that were completely reepithelialized was higher at days 10 (68% vs 0%, p < 0.001) and 14 (100% vs 65%, p = 0.003). The presence of scar tissue was more common in debrided burns (75% vs 4.5%, p < 0.001). Burns treated with OCA had fewer infections than controls (4% vs 55%, p < 0.001). Fewer OCA-treated debrided burns were reepithelialized at 14 days than those that were not debrided (30% vs 100%, p = 0.001). Under the current study conditions, early postburn epidermal debridement of second-degree burns resulted in more infections and slower reepithelialization rates in swine. The effects of early postburn epidermal debridement in humans should be explored.

Systematic Review and Meta-analysis of Osteochondral Autograft Transplantation versus Debridement in the Treatment of Osteochondritis Dessicans of the Capitellum

PubMed Central

Bowman, Seth; Braunstein, Jacob; Rabinowitz, Justin; Barfield, William R.; Chhabra, Bobby; Haro, Marc Scott

2016-01-01

Objectives: The purpose of this systematic review and meta- analysis is to compare clinical results and functional outcomes in patients with osteochondritis dessicans (OCD) lesions of the capitellum treated with either osteochondral autograft transplantation (OATS) or debridement with or without microfracture. Methods: Systematic review of multiple medical databases was performed after PROSPERO registration and using PRISMA guidelines. A literature search was performed using the multiple medical databases and the methodological quality of the individual studies was assessed by two review authors using the Cochrane Collaboration’s “Risk of Bias” tool. Case reports were excluded and only case series of more than five patients and higher level of evidence were included. All study, subject, and surgery parameters were collected. Data was analyzed using statistical software. Odds ratios (OR) were calculated when possible. Data were compared using Pearson Chi-Square and independent sample T tests when applicable. Results: Fifteen studies were included involving 368 patients (326 males and 42 females). There were a total of 197 patients in the debridement group and 171 patients in the OATS group. The mean age was 16.9 +/-4.1 for the debridement group and 14.6 +/-1.2 for the OATS group. Mean follow up was 29.0 +/-24.3 and 38.0 +/-12.8 for the debridement and OATS groups, respectively. Patients that underwent an OATS procedure had a statistically significant improvement in overall arc range of motion compared to patients that had a debridement (P≤0.001). When compared to patients with debridement, patients with OATS were 5.6 times more likely to return to at least their pre-injury level of sports participation (p≤0.002). Conclusion: Post-operative range of motion was significantly improved in patients undergoing an OATS procedure versus a debridement for OCD lesions of the capitellum. Patients with an OATS were 5.7 times more likely to return to at least the pre-injury level of sports participation compared to patients undergoing a debridement. Further studies are necessary in order to directly compare functional outcomes in patients undergoing a debridement procedures versus and OATS procedure.

Molecular Markers in Patients with Chronic Wounds to Guide Surgical Debridement

PubMed Central

Brem, Harold; Stojadinovic, Olivera; Diegelmann, Robert F; Entero, Hyacinth; Lee, Brian; Pastar, Irena; Golinko, Michael; Rosenberg, Harvey; Tomic-Canic, Marjana

2007-01-01

Chronic wounds, such as venous ulcers, are characterized by physiological impairments manifested by delays in healing, resulting in severe morbidity. Surgical debridement is routinely performed on chronic wounds because it stimulates healing. However, procedures are repeated many times on the same patient because, in contrast to tumor excision, there are no objective biological/molecular markers to guide the extent of debridement. To develop bioassays that can potentially guide surgical debridement, we assessed the pathogenesis of the patients’ wound tissue before and after wound debridement. We obtained biopsies from three patients at two locations, the nonhealing edge (prior to debridement) and the adjacent, nonulcerated skin of the venous ulcers (post debridement), and evaluated their histology, biological response to wounding (migration) and gene expression profile. We found that biopsies from the nonhealing edges exhibit distinct pathogenic morphology (hyperproliferative/hyperkeratotic epidermis; dermal fibrosis; increased procollagen synthesis). Fibroblasts deriving from this location exhibit impaired migration in comparison to the cells from adjacent nonulcerated biopsies, which exhibit normalization of morphology and normal migration capacity. The nonhealing edges have a specific, identifiable, and reproducible gene expression profile. The adjacent nonulcerated biopsies have their own distinctive reproducible gene expression profile, signifying that particular wound areas can be identified by gene expression profiling. We conclude that chronic ulcers contain distinct subpopulations of cells with different capacity to heal and that gene expression profiling can be utilized to identify them. In the future, molecular markers will be developed to identify the nonimpaired tissue, thereby making surgical debridement more accurate and more efficacious. PMID:17515955

The estimation of tissue loss during tangential hydrosurgical debridement.

PubMed

Matsumura, Hajime; Nozaki, Motohiro; Watanabe, Katsueki; Sakurai, Hiroyuki; Kawakami, Shigehiko; Nakazawa, Hiroaki; Matsumura, Izumi; Katahira, Jiro; Inokuchi, Sadaki; Ichioka, Shigeru; Ikeda, Hiroto; Mole, Trevor; Smith, Jennifer; Martin, Robin; Aikawa, Naoki

2012-11-01

The preservation of healthy tissue during surgical debridement is desirable as this may improve clinical outcomes. This study has estimated for the first time the amount of tissue lost during debridement using the VERSAJET system of tangential hydrosurgery. A multicenter, prospective case series was carried out on 47 patients with mixed wound types: 21 (45%) burns, 13 (28%) chronic wounds, and 13 (28%) acute wounds. Overall, 44 (94%) of 47 patients achieved appropriate debridement after a single debridement procedure as verified by an independent photographic assessment. The percentage of necrotic tissue reduced from a median of 50% to 0% (P < 0.001). Median wound area and depth increased by only 0.3 cm (6.8%) and 0.5 mm (25%), respectively. Notably, 43 (91%) of 47 wounds did not progress into a deeper compartment, indicating a high degree of tissue preservation.

[Plastic Reconstruction with a Vascular Pedicle Latissimus Dorsi Flap after Sternal Osteomyelitis].

PubMed

Spindler, N; Langer, S

2017-10-01

Objective: Sternal bone and soft tissue debridement after osteomyelitis of the sternum with simultaneous defect coverage using a vascular pedicle latissimus dorsi flap. Indication: Profound sternal wound healing disorders may be covered with various flap grafts. The latissimus dorsi flap provides a fast, sufficient and reliable option to cover sternal defects. If the bone and soft tissue debridement has been very radical, coverage may be performed in a one-stage procedure. Method: The individual surgical steps for sternal debridement with simultaneous defect coverage using a vascular pedicle latissimus dorsi flap are shown. Conclusion: The radicality of debridement is crucial to treatment success and allows debridement and flap graft coverage to be performed at the same time. If two surgeons work simultaneously, the duration of surgery may be significantly reduced. Georg Thieme Verlag KG Stuttgart · New York.

Ultrasound-assisted debridement of neuroischaemic diabetic foot ulcers, clinical and microbiological effects: a case series.

PubMed

Lázaro-Martínez, José Luis; Álvaro-Afonso, Francisco Javier; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan; García-Morales, Esther; Sevillano-Fernández, David

2018-05-02

To evaluate the clinical and microbiological effects of sequential wound debridement in a case series of neuroischaemic diabetic foot ulcers (DFUs) using an ultrasound-assisted wound debridement (UAW) device. A prospective, single-centre study, involving a case series of 24 neuroischaemic DFUs, was conducted to evaluate sequential wound debridement with UAW during a six-week treatment period. Soft tissue punch biopsies were taken every second week of treatment, both before and after wound debridement sessions. Qualitative and quantitative microbiological analysis was performed and wounds were assessed at patient admission, and before and after each debridement procedure. Wound tissue quality scores improved significantly from a mean score of 2.1±1.3 points at patient inclusion, to 5.3±1.7 points (p=0.001). Mean wound sizes were 4.45cm 2 (range: 2-12.25cm 2 ) at week zero, and 2.75cm 2 (range: 1.67-10.70cm 2 ) at week six (p=0.04). The mean number of bacterial species per culture determined at week zero and at week six was 2.53±1.55 and 1.90±1.16, respectively (p=0.023). Wound debridement resulted in significant decreases in bacterial counts (1.17, 1.31 and 0.77 log units in colony forming units (CFU) for week zero, three and six, respectively). The average bacterial load in tissue samples before and after wound debridement after the six-week treatment was Log 5.55±0.91CFU/g and Log 4.59±0.89CFU/g, respectively (p<0.001). The study results showed a significant bacterial load reduction in DFU tissue samples as a result of UAW debridement, independent of bacterial species, some of which exhibited antibiotic-resistance. Significant bacterial load reduction was correlated with improved wound conditions and significant reductions of wound size.

Effects of burn location and investigator on burn depth in a porcine model.

PubMed

Singer, Adam J; Toussaint, Jimmy; Chung, Won Taek; Thode, Henry C; McClain, Steve; Raut, Vivek

2016-02-01

In order to be useful, animal models should be reproducible and consistent regardless of sampling bias, investigator creating burn, and burn location. We determined the variability in burn depth based on biopsy location, burn location and investigator in a porcine model of partial thickness burns. 24 partial thickness burns (2.5 cm by 2.5 cm each) were created on the backs of 2 anesthetized pigs by 2 investigators (one experienced, one inexperienced) using a previously validated model. In one of the pigs, the necrotic epidermis covering each burn was removed. Five full thickness 4mm punch biopsies were obtained 1h after injury from the four corners and center of the burns and stained with Hematoxylin and Eosin and Masson's trichrome for determination of burn depth by a board certified dermatopathologist blinded to burn location and investigator. Comparisons of burn depth by biopsy location, burn location and investigator were performed with t-tests and ANOVA as appropriate. The mean (SD) depth of injury to blood vessels (the main determinant of burn progression) in debrided and non-debrided pigs pooled together was 1.8 (0.3)mm, which included 75% of the dermal depth. Non-debrided burns were 0.24 mm deeper than debrided burns (P<0.001). Burn depth increased marginally from cephalic to caudal in non-debrided burns, but showed no statistical differences for these locations, in debrided burns. Additionally, there were also no statistical differences in burn depths from midline to lateral in either of these burn types. Burn depth was similar for both investigators and among biopsy locations. Burn depth was greater for caudal locations in non-debrided burns and overall non-debrided burns were deeper than debrided burns. However, burn depth did not differ based on investigator, biopsy site, and medial-lateral location. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems.

PubMed

Thomas, Anchu Rachel; Velmurugan, Natanasabapathy; Smita, Surendran; Jothilatha, Sundaramurthy

2014-10-01

The purpose of this study was to evaluate the canal isthmus debridement efficacy of a new modified EndoVac (Discus Dental, Culver City, CA) irrigation protocol in comparison with EndoVac, passive ultrasonic irrigation (PUI), and conventional needle irrigation in mesial roots of mandibular molars. The mesial roots of 64 extracted mandibular molars mounted in resin using Kuttler's endodontic cube, sectioned at 2 and 4 mm from the working length, were randomly divided into 4 groups (n = 16): group 1: Max-I-Probe (Dentsply Tulsa Dental, York, PA), group 2: EndoVac (EVI), group 3: modified EndoVac, and group 4: PUI. The specimens were reassembled and instrumented. A standard irrigation protocol was used during cleaning and shaping and final irrigation with the 4 irrigation/agitation techniques. Images of the isthmus region were taken before and after cleaning and shaping and after final irrigation. The percentage reduction of debris in the isthmus region was calculated by using the software program Image J (v1.43; National Institutes of Health, Bethesda, MD). Intergroup analysis was performed using the Kruskal Wallis and Mann-Whitney U tests. Intragroup analysis was performed using Friedman and Wilcoxon signed rank tests. The level of significance was set at P < .05. Intragroup analysis revealed a statistically significant difference in the percentage reduction of debris after cleaning and shaping and after final irrigation protocol in all the groups (P < .001). The final irrigation protocol produced significantly cleaner canal isthmuses in all the groups (P < .001). On intergroup analysis, the modified EVI group performed significantly better than the other groups. The EVI and PUI groups performed better than the Max-I-Probe group. There was no statistical significance between the EVI and PUI groups. Canal isthmuses were significantly cleaner with the modified EndoVac irrigation technique when compared with the cleanliness seen with the other irrigation systems. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Healing of human intrabony defects following regenerative periodontal therapy with a bovine-derived xenograft and guided tissue regeneration.

PubMed

Sculean, A; Stavropoulos, A; Windisch, P; Keglevich, T; Karring, T; Gera, I

2004-06-01

The purpose of the present study was to histologically evaluate the healing of human intrabony defects following treatment with either a bovine-derived xenograft (BDX) and guided tissue regeneration (GTR) [BDX + GTR] or a bovine-derived xenograft mixed with collagen (BDX Coll) and GTR [BDX Coll + GTR]. Eight patients with chronic periodontitis and each with one very deep intrabony defect around a tooth scheduled for extraction were treated with either a combination of BDX + GTR (five patients) or with BDX Coll + GTR (three patients). The postoperative healing was uneventful in all eight cases. After a healing period of 6 months, the teeth or roots were extracted together with some of their surrounding soft and hard tissues and subsequently fixed in 10% buffered formalin. Following decalcification in EDTA, the specimens were embedded in paraffin and 8-microm histological sections were cut in the mesio-distal direction, parallel to the long axes of the teeth. The sections were alternatively stained with hematoxylin and eosin, van Giesson's connective tissue stain or with the Ladevig's connective tissue staining method and examined under the light microscope. Generally, formation of new cementum with inserting collagen fibers was found in seven out of the eight treated cases, whereas in the remaining case (treated with BDX + GTR) the healing was characterized by formation of a long junctional epithelium along the debrided root surface and no formation of cementum or bone. In the specimens demonstrating periodontal regeneration the new cementum was always of a cellular type. In most cases, the graft particles were surrounded by bone. In some areas, the bone tissue around the graft particles was connected by perpendicularly inserting collagen fibers to the newly formed cementum on the root surface. The epithelium downgrowth stopped always at the most coronal part of the newly formed cementum. No remnants of the membrane material were observed in any of the biopsies. Connective tissue encapsulation of the graft particles was rarely observed and was limited to the most coronal part of the defects. The findings of the present study provide evidence that treatment of intrabony defects with both BDX + GTR and BDX Coll + GTR may enhance periodontal regeneration in humans.

Facial gunshot wound debridement: debridement of facial soft tissue gunshot wounds.

PubMed

Shvyrkov, Michael B

2013-01-01

Over the period 1981-1985 the author treated 1486 patients with facial gunshot wounds sustained in combat in Afghanistan. In the last quarter of 20th century, more powerful and destructive weapons such as M-16 rifles, AK-47 and Kalashnikov submachine guns, became available and a new approach to gunshot wound debridement is required. Modern surgeons have little experience in treatment of such wounds because of rare contact with similar pathology. This article is intended to explore modern wound debridement. The management of 502 isolated soft tissue injuries is presented. Existing principles recommend the sparing of damaged tissues. The author's experience was that tissue sparing lead to a high rate of complications (47.6%). Radical primary surgical debridement (RPSD) of wounds was then adopted with radical excision of necrotic non-viable wound margins containing infection to the point of active capillary bleeding and immediate primary wound closure. After radical debridement wound infection and breakdown decreased by a factor of 10. Plastic operations with local and remote soft tissue were made on 14, 7% of the wounded. Only 0.7% patients required discharge from the army due to facial muscle paralysis and/or facial skin impregnation with particles of gunpowder from mine explosions. Gunshot face wound; modern debridement. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Frequency of debridements and time to heal: a retrospective cohort study of 312 744 wounds.

PubMed

Wilcox, James R; Carter, Marissa J; Covington, Scott

2013-09-01

Chronic wounds usually get trapped in the inflammatory stage of wound healing; however, aggressive debridement transforms chronic wounds to acute wounds and therefore complete healing. To investigate healing outcomes and debridement frequency in a large wound data set. Retrospective cohort study. Data collected from 525 wound care centers from June 1, 2008, through June 31, 2012, using a web-based clinical management system. Referred sample of 154 644 patients with 312 744 wounds of all causes (of an initial data set of 364 534 wounds) participated. A total of 47.1% were male. Median age was 69 years (age range, 19-112 years), with 59.2% having one wound. Eligibility criteria included age older than 18 years, receiving at least 1 debridement, and having been discharged from the system. Advanced therapeutic treatment was ineligible. Because of incomplete, questionable, or ineligible data, 57 190 wounds were not included. Most wounds were diabetic foot ulcers (19.0%), venous leg ulcers (26.1%), and pressure ulcers (16.2%). Debridement (removal of necrotic tissue and foreign bodies from the wound) at different frequencies. Wound healing (completely epithelialized with dimensions at 0 × 0 × 0 cm). A total of 70.8% of wounds healed. The median number of debridements was 2 (range, 1-138). Frequent debridement healed more wounds in a shorter time (P <  .001). In regression analysis, significant variables included male sex, physician category, wound type, increased patient age, and increased wound age, area, and depth. The odds ratio varied considerably for each variable. The more frequent the debridements, the better the healing outcome. Although limited by retrospective data, this study's strength was the analysis of the largest wound data set to date.

Effect of enzymatic debridement with two different collagenases versus mechanical debridement on chronic hard-to-heal wounds.

PubMed

Onesti, Maria Giuseppina; Fioramonti, Paolo; Fino, Pasquale; Sorvillo, Valentina; Carella, Sara; Scuderi, Nicolò

2016-12-01

A chronic ulcer is usually defined as an injury that does not spontaneously evolve towards healing and does not progress through normal healing stages such as inflammation, proliferation and remodelling. This study was designed in order to compare two types of collagenases with mechanical debridement alone. It was thus possible to evaluate their differences in terms of pain and debridement efficacy. Patients were divided into three groups: 30 patients were daily dressed using an ointment based on collagenase produced by Vibrio alginolyticus (B group), 30 patients were daily dressed using an ointment based on a collagenase preparation derived from Clostridium histolyticum (N group) and 30 patients underwent classical mechanical debridement (M group). Complete wound healing over a period of 8 weeks occurred in 24 patients (27%) out of 90;10 patients belonging to the B group, 8 patients to the N group and 6 patients to the M group. This study was performed in order to highlight the differences between two commercially available collagenase-based ointments in comparison with mechanical debridement alone. At the final time point of week, the difference in the percentage of debridement was not statistically significant in all groups, but at 4 weeks, the debrided area in the B group was larger with respect to the N and M groups, suggesting a more rapid wound bed cleansing process. On the basis of our experience, collagenase derived from V. alginolyticus with hyaluronic acid showed chemical and physical properties that make it a product of great manageability and ensure the protection of peri-wound skin. Moreover, less pain was experienced by the patients. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

The Immediate and Delayed Post-Debridement Effects on Tissue Bacterial Wound Counts of Hypochlorous Acid Versus Saline Irrigation in Chronic Wounds.

PubMed

Hiebert, John M; Robson, Martin C

2016-01-01

Introduction: Wound debridement is considered essential in chronic wound management. Hypochlorous acid has been shown to be an effective agent in reducing wound bacterial counts in open wounds. Ultrasound-enabled wound debridement is an effective and efficient method of debridement. This study compared ultrasound irrigation with hypochlorous acid versus saline irrigation for wound debridement on pre- and postoperative wounds and determined regrowth of bacteria over 1 week period of time. Finally, the outcome of definitive wound closure of the clinically clean-appearing wounds was recorded. Methods: Seventeen consenting adult patients with chronic open wounds were randomly selected for study. The patients were randomly divided into the hypochlorous acid irrigation or saline irrigation group. All patients provided pre- and postoperative tissue samples for qualitative and quantitative bacteriology. For the time (7 days) between the debridement procedure and the definitive closure procedure, the wounds were dressed with a silver-impregnated dressing and a hydroconductive dressing. Results : Both types of irrigation in the ultrasonic system initially lowered the bacterial counts by 4 to 6 logs. However, by the time of definitive closure, the saline-irrigated wounds had bacterial counts back up to 10 5 whereas the hypochlorous acid-irrigated wounds remained at 10 2 or fewer. More than 80% of patients in the saline group had postoperative closure failure compared with 25% of patients in the hypochlorous acid group. Conclusions: Hypochlorous acid irrigation with ultrasound debridement reduced bacterial growth in chronic open wounds more efficiently than saline alone. Postoperative wound closure outcomes suggest a remarkable reduction in wound complications after wound debridement using hypochlorous acid irrigation with ultrasound versus saline alone.

Master apical file size - smaller or larger: a systematic review of microbial reduction.

PubMed

Aminoshariae, A; Kulild, J

2015-11-01

The purpose of this systematic review was to determine, in patients undergoing root canal treatment, whether apical enlargement of canals affected microbial reduction. A PICO (population, intervention, comparison and outcome) strategy was developed to identify previously published studies dealing with apical size of canal and microbial reduction. The MEDLINE, Embase, Cochrane and PubMed databases were searched. Additionally, the bibliographies of all relevant articles and textbooks were manually searched. Based on inclusion and exclusion criteria, two reviewers independently selected the relevant articles. Due to the variety of methodologies and different techniques used to measure outcome for master apical file enlargement, it was not possible to standardize the research data and to apply a meta-analysis. Seven articles were identified that met the inclusion criteria. Five of the seven articles generally concluded that canal enlargement reduced bioburden in the root canal system. Two articles reported no difference in canals enlarged to size 25 or 40. The results of the systematic review confirmed that more evidence-based research in this area is needed. With the limited information currently available, the best current available clinical evidence suggests that contemporary chemomechanical debridement techniques with canal enlargement techniques do not eliminate bacteria during root canal treatment at any size. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Sulcular debridement with pulsed Nd:YAG

NASA Astrophysics Data System (ADS)

Harris, David M.; Gregg, Robert H., II; McCarthy, Delwin K.; Colby, Leigh E.; Tilt, Lloyd V.

2002-06-01

We present data supporting the efficacy of the procedure, laser sulcular debridement (laser curettage), as an important component in the treatment of inflammatory periodontal disease. Laser Assisted New Attachment Procedure (LANAP) is a detailed protocol for the private practice treatment of gum disease that incorporates use of the PerioLase pulsed Nd:YAG Dental Laser for laser curettage. Laser curettage is the removal of diseased or inflamed soft tissue from the periodontal pocket with a surgical dental laser. The clinical trial conducted at The University of Texas HSC at San Antonio, Texas, evaluated laser curettage as an adjunct to scaling and root planing. They measured traditional periodontal clinical indices and used a questionnaire to evaluate patient comfort and acceptance. The Texas data (N=10 patients) are compared with pocket depth changes following LANAP. LANAP data were obtained from a retrospective review of patient records at three private practices (N=65). No significant differences in post treatment probe depth changes were found among the four centers indicating that the procedure produced consistent, favorable outcomes, and that results from controlled scientific clinical trials can be replicated in private practices. Reduction in pocket depths following laser treatment compare well with results obtained with scalpel surgery. The use of the laser offers additional benefits. We also present quantitative evidence from digitized radiographs of increased bone density in affected areas following LANAP.

Can the KTP laser change the cementum surface of healthy and diseased teeth providing an acceptable root surface for fibroblast attachment?

NASA Astrophysics Data System (ADS)

Mailhot, Jason M.; Garnick, Jerry J.

1996-04-01

The purpose of our research is to determine the effects of KTP laser on root cementum and fibroblast attachment. Initial work has been completed in testing the effect of different energy levels on root surfaces. From these studies optimal energy levels were determined. In subsequent studies the working distance and exposure time required to obtain significant fibroblast attachment to healthy cementum surfaces were investigated. Results showed that lased cemental surfaces exhibited changes in surface topography which ranged from a melted surface to an apparent slight fusion of the surface of the covering smear layer. When the optimal energy level was used, fibroblasts demonstrate attachment on the specimens, resulting in the presence of a monolayer of cells on the control surfaces as well as on the surfaces lased with this energy level. The present study investigates the treatment of pathological root surfaces and calculus with a KTP laser utilizing these optimal parameters determine previously. Thirty single rooted teeth with advanced periodontal disease and ten healthy teeth were obtained, crowns were sectioned and roots split longitudinally. Forty test specimens were assigned into 1 of 4 groups; pathologic root--not lased, pathologic root--lased, root planed root and health root planed root. Human gingival fibroblasts were seeded on specimens and cultured for 24 hours. Specimens were processed for SEM. The findings suggest that with the KTP laser using a predetermined energy level applied to pathological root surfaces, the lased surfaces provided an unacceptable surface for fibroblast attachment. However, the procedural control using healthy root planed surfaces did demonstrate fibroblast attachment.

Laser technology to manage periodontal disease: a valid concept?

PubMed

Low, Samuel B; Mott, Angie

2014-06-01

Present day dental lasers can create oral environments conducive for periodontal repair. With the bacterial etiology of periodontitis and the resulting host inflammatory reaction, clinicians continue to search for therapeutic modalities to assist in the non-surgical management of periodontal disease. Traditional chairside therapies consist of mechanical debridement with manual and/or ultrasonic instrumentation with the objective of removing calculus, biofilm, and endotoxin from tooth root surfaces. Decreasing the microbial stimuli and associated end products decreases the inflammatory reaction and allows the host an opportunity to regenerate tissue through wound healing. The purpose of this article is to examine whether dental lasers, which have been in use for the past 3 decades, may augment traditional non-surgical periodontal therapy. Review of research publications related to lasers and non-surgical periodontics with attention focused on systematic studies. Studies utilizing laser technology may demonstrate positive effects on 1) selectively decreasing the biofilm environment, 2) removing calculus deposits and neutralizing endotoxin, 3) removing sulcular epithelium to assist in reattachment and decreased pocket depth, and 4) biostimulation for enhanced wound healing. Comparisons of studies to determine the difference between lasers and their respective effects on the periodontium are difficult to assess due to a wide variation of laser protocols. Copyright © 2014 Elsevier Inc. All rights reserved.

Three-dimensional analyses of ultrasonic scaler oscillations.

PubMed

Lea, Simon C; Felver, Bernhard; Landini, Gabriel; Walmsley, A Damien

2009-01-01

It is stated that the oscillation patterns of dental ultrasonic scalers are dependent upon whether the instrument is of a magnetostrictive or piezoelectric design. These patterns are then linked to differences in root surface debridement in vitro. Piezoelectric (A, P) and magnetostrictive (Slimline, TFI-3) ultrasonic scalers (three of each) were evaluated, loaded (100 g/200 g) and unloaded with a 3D laser vibrometer. Loads were applied to the probe tips via teeth mounted in a load-measuring device. Elliptical motion was demonstrated for all probes under loaded and unloaded conditions. Loading flattened the elliptical motion along the length of the probe. Unloaded, Slimline tip 1 was significantly different to tips 2 and 3 (p<0.0001). There were no differences between the A-tips (p>0.207). All TFI-3 tips were different to each other (p<0.0001). P-tips 1 and 2 were different to each other (p=0.046). Loaded, Slimline tips were different to each other (p<0.001). There were no differences between the P probes (p>0.867). Generator power increased all Slimline and P tip vibrations (p<0.0001). Probe oscillation patterns are independent of ultrasound production mechanism and are dependent upon probe shape and generator power. Loaded probes oscillated with an elliptical pattern.

Effect of surgical periodontal treatment associated to antimicrobial photodynamic therapy on chronic periodontitis: A randomized controlled clinical trial.

PubMed

Martins, Sérgio H L; Novaes, Arthur B; Taba, Mario; Palioto, Daniela B; Messora, Michel R; Reino, Danilo M; Souza, Sérgio L S

2017-07-01

This randomized controlled clinical trial evaluated the effects of an adjunctive single application of antimicrobial photodynamic therapy (aPDT) in Surgical Periodontal Treatment (ST) in patients with severe chronic periodontitis (SCP). In a split-mouth design, 20 patients with SCP were treated with aPDT+ST (Test Group, TG) or ST only (Control Group, CG). aPDT was applied in a single episode, using a diode laser and a phenothiazine photosensitizer. All patients were monitored until 90 days after surgical therapy. Levels of 40 subgingival species were measured by checkerboard DNA-DNA hybridization at baseline, 60 and 150 days. Clinical and microbiological parameters were evaluated. In deep periodontal pockets depth (PPD ≥5 mm), Test Group presented a significantly higher decrease in PPD than Control Group at 90 days after surgical therapy (p < .05). Test Group also demonstrated significantly less periodontal pathogens of red complex (Treponema denticola) (p < .05). A single episode of aPDT used in adjunct to open flap debridement of the root surface in the surgical treatment of SCP: i) significantly improved clinical periodontal parameters; ii) eliminates periodontal pathogens of the red complex more effectively (NCT02734784). © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Timing of Debridement and Infection Rates in Open Fractures of the Hand

PubMed Central

Ketonis, Constantinos; Dwyer, Joseph; Ilyas, Asif M.

2016-01-01

Background: Literature on open fracture infections has focused primarily on long bones, with limited guidelines available for open hand fractures. In this study, we systematically review the available hand surgery literature to determine infection rates and the effect of debridement timing and antibiotic administration. Methods: Searches of the MEDLINE, EMBASE, and Cochrane computerized literature databases and manual bibliography searches were performed. Descriptive/quantitative data were extracted, and a meta-analysis of different patient cohorts and treatment modalities was performed to compare infection rates. Results: The initial search yielded 61 references. Twelve articles (4 prospective, 8 retrospective) on open hand fractures were included (1669 open fractures). There were 77 total infections (4.6%): 61 (4.4%) of 1391 patients received preoperative antibiotics and 16 (9.4%) of 171 patients did not receive antibiotics. In 7 studies (1106 open fractures), superficial infections (requiring oral antibiotics only) accounted for 86%, whereas deep infections (requiring operative debridement) accounted for 14%. Debridement within 6 hours of injury (2 studies, 188 fractures) resulted in a 4.2% infection rate, whereas debridement within 12 hours of injury (1 study, 193 fractures) resulted in a 3.6% infection rate. Two studies found no correlation of infection and timing to debridement. Conclusions: Overall, the infection rate after open hand fracture remains relatively low. Correlation does exist between the administration of antibiotics and infection, but the majority of infections can be treated with antibiotics alone. Timing of debridement, has not been shown to alter infection rates. PMID:28344521

Effectiveness of a monofilament wound debridement pad at removing biofilm and slough: ex vivo and clinical performance.

PubMed

Schultz, Gregory S; Woo, Kevin; Weir, Dot; Yang, Qingping

2018-02-02

Removal of slough and other devitalised tissue is an important step in biofilm-based wound care (BBWC) and wound bed preparation. Debridement is key to management of both slough and biofilm, and a number of methods are available to achieve this, including surgical/sharp and mechanical debridement. Developments have led to products indicated for debridement of wounds, including a sterile pad consisting of monofilament fibres. Our aim is to examine the effectiveness of a monofilament wound debridement pad (WDP), Debrisoft. We assessed the WDP, in laboratory tests, for the removal of mature biofilm from porcine dermal tissue in an ex vivo model, and the clinical management of sloughy wounds that would benefit from debridement. We used the UPPER score to determine the superficial infection status. The WDP was effective in removing biofilm from porcine dermal tissue. A case series of 10 patients with chronic wounds suggested that the WDP was beneficial in the removal of slough. All chronic wounds had slough and were cleaned weekly, for four weeks, using the MDP to achieve improved healing and a clean wound bed. The average wound size decreased from 8.09cm 2 at baseline to 2.3cm 2 at week four, with three wounds healed completely. Exudate was reduced, and the UPPER score improved in every patient. These results indicate that the WDP effectively debrides biofilm and slough, and contributes to care that follows the principles of wound bed preparation and BBWC.

[BASIC PRINCIPLES OF SURGICAL TREATMENT OF CHRONIC WOUNDS – SHARP DEBRIDEMENT].

PubMed

Marinović, M; Fumić, N; Laginja, S; Smokrović, E; Bakota, B; Bekić, M; Čoklo, M

2016-01-01

The ever improving health standards in terms of quality and more efficient health care result in an increase in life expectancy, thus increasing the number of elderly people in the population. A higher level of activity in elderly population leads to greater incidence of injuries, and on the other hand, there is an increasing number of comorbidities. Circulatory disorders, diabetes mellitus, metabolic imbalances, etc. and a reduced biological potential of tissue regeneration result in an increased number of chronic wounds that pose a significant health, social and economic burden on the society. These conditions require significant involvement of medical and non-medical staff in pre-hospital institutions. Significant material and other health care resources are allocated for the treatment of chronic wounds. These conditions result in a lower quality of life of patients and their families and caregivers. Debridement is a crucial medical procedure for the treatment of acute and chronic wounds. The result of debridement is removal of all barriers within and around the wound that obstruct physiological processes of wound healing. Debridement is a repeating process when indicated. There are several types of debridement, each with its advantages and disadvantages. The method of debridement should be determined by the physician or other professional trained person on the basis of wound characteristics and in accordance with their expertise and capabilities. In the same wound, we can combine different types of debridement, all with the goal of faster and better wound healing.

In vitro cleaning potential of three different implant debridement methods.

PubMed

Sahrmann, Philipp; Ronay, Valerie; Hofer, Deborah; Attin, Thomas; Jung, Ronald E; Schmidlin, Patrick R

2015-03-01

To assess the cleaning potential of three different instrumentation methods commonly used for implant surface decontamination in vitro, using a bone defect-simulating model. Dental implants were stained with indelible ink and mounted in resin models, which represented standardized peri-implantitis defects with different bone defect angulations (30, 60 and 90°). Cleaning procedures were performed by either an experienced dental hygienist or a 2nd-year postgraduate student. The treatment was repeated 20 times for each instrumentation, that is, with a Gracey curette, an ultrasonic device and an air powder abrasive device (PAD) with glycine powder. After each run, implants were removed and images were taken to detect color remnants in order to measure planimetrically the cumulative uncleaned surface area. SEM images were taken to assess micromorphologic surface changes (magnification 10,000 ×). Results were tested for statistical differences using two-way ANOVA and Bonferroni correction. The areas of uncleaned surfaces (%, mean ± standard deviations) for curettes, ultrasonic tips, and airflow accounted for 24.1 ± 4.8%, 18.5 ± 3.8%, and 11.3 ± 5.4%, respectively. These results were statistically significantly different (P < 0.0001). The cleaning potential of the airflow device increased with wider defects. SEM evaluation displayed distinct surface alterations after instrumentation with steel tips, whereas glycine powder instrumentation had only a minute effect on the surface topography. Within the limitations of the present in vitro model, airflow devices using glycine powders seem to constitute an efficient therapeutic option for the debridement of implants in peri-implantitis defects. Still, some uncleaned areas remained. In wide defects, differences between instruments are more accentuated. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Eschar removal by bromelain based enzymatic debridement (Nexobrid®) in burns: An European consensus.

PubMed

Hirche, Christoph; Citterio, Antonella; Hoeksema, Henk; Koller, Ján; Lehner, Martina; Martinez, José Ramón; Monstrey, Stan; Murray, Alexandra; Plock, Jan A; Sander, Frank; Schulz, Alexandra; Ziegler, Benjamin; Kneser, Ulrich

2017-12-01

Early debridement and/or eschar removal is regarded as a significant step in the treatment of deep partial and full thickness burns. It aims to control wound bioburden and allows early wound closure by conservative treatment or skin grafting. Preservation of viable dermis accompanied by early wound closure, is regarded as a necessary step to reduce scar related complication, e.g. functional limitations and/or unaesthetic scar formation. Aside from the classical techniques of surgical excision as tangential excision for eschar removal, hydro-surgery, maggot therapy, laser, enzymatic debridement have been described as additional techniques in the burn surgeon's armamentarium. It is widely accepted that early eschar removal within 72h improves the outcome of burn wound treatment by reducing bacterial wound colonization, infection and length of hospital stay. In contrast, the right technique for eschar removal is still a matter of debate. There is increasing evidence that enzymatic debridement is a powerful tool to remove eschar in burn wounds, reducing blood loss, the need for autologous skin grafting and the number of wounds requiring surgical excision. In order to assess the role and clinical advantages of enzymatic debridement by a mixture of proteolytic enzymes enriched in Bromelain (Nexobrid ® ) beyond the scope of the literature and in view of users' experience, a European Consensus Meeting was scheduled. The aim was to provide statements for application, based on the mutual experience of applying enzymatic debridement in more than 500 adult and pediatric patients by the consensus panelists. Issues to be addressed were: indications, pain management and anesthesia, timing of application, technique of application, after-intervention care, skin grafting after enzymatic debridement, blood loss, training strategies and learning curve and areas of future research needs. Sixty-eight (68) consensus statements were provided for the use of enzymatic debridement. The degree of consensus was remarkably high, with a unanimous consensus in 88.2% of statements, and lowest degree of consensus of 70% in only 3 statements. This consensus document may serve as preliminary guideline for the use of enzymatic debridement with user-oriented recommendations until further evidence and systematic guidelines are available. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Chemical Debridement of Burns

PubMed Central

Levenson, Stanley M.; Kan, Dorinne; Gruber, Charles; Crowley, Leo V.; Lent, Richard; Watford, Alvin; Seifter, Eli

1974-01-01

The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. The removal of the devitalized tissue, without damage to unburned skin or skin only partially injured by burning, and in ways which would permit immediate (or very prompt) skin grafting, would lessen substantially the problems of sepsis, speed convalescence and the return of these individuals to society as effective human beings, and would decrease deaths. The usefulness and limitations of surgical excision for patients with extensive third degree burns are discussed. Chemical debridement lends itself to complementary use with surgical excision and has the potential advantage over surgical excision in not requiring anesthesia or a formal surgical operation. The authors' work with the chemical debridement of burns, in particular the use of Bromelain, indicates that this approach will likely achieve clinical usefulness. The experimental studies indicate that rapid controlled debridement, with minimal local and systemic toxicity, is possible, and that effective chemotherapeutic agents may be combined with the Bromelain without either interfering with the actions of the other. The authors believe that rapid (hours) debridement accomplished by the combined use of chemical debriding and chemotherapeutic agents will obviate the possibility of any increase in infection, caused by the use of chemical agents for debridement, as reported for Paraenzyme21 and Travase.39,48 It is possible that the short term use of systemic antibiotics begun just before and continued during, and for a short time after, the rapid chemical debridement may prove useful for the prevention of infection, as appears to be the case for abdominal operations of the clean-contaminated and contaminated types. ImagesFigs. 1a-c.Fig. 1b.Fig. 1c.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6.Fig. 7.Fig. 8.Fig. 9a.Fig. 9B.Fig. 10.Fig. 11.Figs. 12a-c.Fig. 12b.Fig. 12c.Figs. 14a-c.Fig. 14b.Fig. 14c.Figs. 15a-c.Fig. 15b.Fig. 15c. PMID:4606330

[Clinical effect of different sequences of debridement-antibiotic therapy in treatment of severe chronic periodontitis].

PubMed

Li, Yi; Xu, Li; Lu, Rui-fang; An, Yue-bang; Wang, Xian-e; Song, Wen-li; Meng, Huan-xi

2015-02-18

To evaluate the feasibility of full-mouth debridement (subgingival scaling and root planning, SRP) by 2 times within 1 week and compare the clinical effects of different sequences of debridement-antibiotic usage in patients with severe chronic periodontitis (CP). A double-blinded, placebo-controlled, randomized clinical trial was conducted in 30 severe CP patients (14 males and 16 females, 40.5 ± 8.4 years old on average from 35 to 60) receiving 3 different sequences of debridement-antibiotictherapy: Group A, antibiotic usage (metronidazole, MTZ, 0.2 g, tid, 7 d; amoxicillin, AMX 0.5 g, tid, 7 d) was started together with SRP (completed by 2 times in 7 d); Group B, antibiotic usage (MTZ 0.2 g, tid, 7 d; AMX 0.5 g, tid, 7 d) was started 1 d after SRP(completed by 2 times in 7 d); Group C, SRP alone[probing depth (PD), bleeding index (BI) and tooth mobility] was examined. The average full-mouth probing depth, the average full-mouth proximal probing depth (pPD), the percentage of sites with PD>5 mm (PD>5 mm%), the percentage of sites with proximal PD>5 mm (pPD>5 mm%), the average bleeding index (BI) and the percentage of sites with bleeding on probing (BOP%) were calculated. Clinical examinations were performed at baseline and 2 months post therapy. (1) Compared with baseline conditions, all the subjects showed clinical improvements in all the parameters evaluated 2 months post therapy, P<0.05. (2) Significant difference were observed in the average PD changes between Group A [(2.15 ± 0.42) mm], Group B [(1.76 ± 0.29) mm] and Group C [(1.57 ± 0.33) mm], P<0.05. No significant difference was observed in the average PD changes between Group B and Group C, P=0.354. Significant differences were observed in the average pPD changes between Group A [(2.45 ± 0.43)mm] and Group C[(1.90 ± 0.48) mm], P<0.05. No significant difference was observed in BI and BOP% changes between Group A,Group B and Group C. For patients with severe chronic periodontitis, it is safe and feasible to receive full-mouth SRP by 2 times within 1 week. The short-term (2 months) advantages in PD changes are observed in patients receiving SRP and antibiotic usage at the same time comparing with patients using antibiotics after SRP or SRP alone.

Bacillus cereus strain MCN as a debriding agent

NASA Technical Reports Server (NTRS)

Dalton, H. P.; Haynes, B. W.; Stone, L. L.

1978-01-01

Biologically active means are effective for rapidly removing scar tissue caused by burns or corrosive agents. Specially selected strain of bacteria applied to injury site releases enzymes which are active against eschar. These bacteria tend to locate between eschar and unburned tissue, thus providing optimal cell surface area arrangement for enzyme dispersal. Procedure may prove especially useful in treatment of disaster casualties under relatively primitive conditions.

Maggots in the Brain: Sequelae of Ignored Scalp Wound.

PubMed

Aggarwal, Ashish; Maskara, Prasant

2018-01-01

A 26-year-old male had suffered a burn injury to his scalp in childhood and ignored it. He presented with a complaint of something crawling on his head. Inspection of his scalp revealed multiple maggots on the brain surface with erosion of overlying bone and scalp. He was successfully managed by surgical debridement and regular dressing. Copyright © 2017 Elsevier Inc. All rights reserved.

Changes in serum interleukin-6, C-reactive protein and thrombomodulin levels under periodontal ultrasonic debridement.

PubMed

Ushida, Yuka; Koshy, Geena; Kawashima, Yoko; Kiji, Makoto; Umeda, Makoto; Nitta, Hiroshi; Nagasawa, Toshiyuki; Ishikawa, Isao; Izumi, Yuichi

2008-11-01

This study aimed to compare the effect of single-visit full-mouth mechanical debridement (FMD) and quadrant-wise mechanical debridement (QMD) on the levels of serum interleukin (IL)-6, C-reactive protein (CRP) and soluble thrombomodulin. Thirty-six subjects with chronic periodontitis were randomly allocated to three groups: undergoing QMD, single-visit FMD with povidone iodine or with water. Serum IL-6 and soluble thrombomodulin were measured by enzyme-linked immunosorbent assay, and serum CRP was measured by the latex-enhanced nephelometric method. Serum IL-6 level increased significantly immediately after debridement in all the three groups, with this increase being greatest in the full-mouth groups. However, the increase in the full-mouth groups was not significantly higher than that of quadrant-wise group. In the quadrant-wise group, serum IL-6 level decreased significantly 1 month after debridement compared with baseline. Serum-soluble thrombomodulin decreased significantly in the full-mouth groups but not in the quadrant-wise group. Changes in CRP level were not significant at baseline or after debridement in all the three groups. FMD increased serum IL-6 and reduced serum-soluble thrombomodulin to a greater extent than QMD, suggesting that the former technique has stronger transient effects on systemic vascular endothelial functions than the latter.

Fournier's gangrene: an analysis of repeated surgical debridement.

PubMed

Chawla, Sam N; Gallop, Christina; Mydlo, Jack H

2003-05-01

We wanted to determine if there was a difference in outcome for those patients with Fournier's disease who underwent numerous debridements as opposed to only one initial debridement. The records of 19 patients with the diagnosis of Fournier's gangrene were reviewed retrospectively at our institution. Special attention was placed on demographic data, primary managing service, as well as wound cultures, and the number and timing of surgical debridements. Patients were also classified by a collection of variables at presentation and given a score named the Fournier's Severity Index. We utilised the Fournier's Severity Index (FSI) as developed by Laor et al. which included a number of vital sign data as well as laboratory values collected at admission in the emergency room. The average FSI was 9.1 ranging from 0 to 15. The mean FSI of survivors was 8.6 versus 12.4 of non-survivors. The surgical management of this disease process was also critically examined. The average number of repeated debridements was 3.5 ranging from 1 to 8. Both the FSI and the number of debridements were attempted to be used to predict outcome. Outcome was measured in the variables length of stay (days) and survival. A regression analysis revealed the number of debridements to be positively related to the length of stay (LOS). This was the opposite as expected at the beginning of the study. Also FSI was not predictive of LOS. Fournier's gangrene is a disease process with a wide variability in presentation. The FSI does give some indication about the likelihood of survival based on variables which can be recorded upon presentation. It also provides an efficient way to characterize the acuity of presentation and compare patients. While the repeated nature of debridements may be considered the accepted standard of care in these patients, this was not found to be predictive of outcome.

Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty.

PubMed

Yamamoto, Michiro; Murakami, Yukimi; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Hirata, Hitoshi

2016-04-02

Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A "two rings" method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. We showed that four-dimensional, preoperative simulation can be generated by adding the rotation axis to the one-position, three-dimensional computed tomography image of the affected arm. This method is feasible for elbow debridement arthroplasty.

Endoscopic debridement and fibrin glue injection of a chronic Morel-Lavallée lesion of the knee in a professional soccer player: A case report and literature review.

PubMed

Koc, Baris B; Somorjai, Nicolaas; P M Kiesouw, Egid; Vanderdood, Kurt; Meesters-Caberg, Marleen; Draijer, Frits W; Jansen, Edwin J P

2017-01-01

A Morel-Lavallée lesion is a post-traumatic closed degloving injury of soft tissue. The lesion is due to a shearing trauma with separation of subcutaneous tissue from underlying fascia. When conservative treatment fails, surgical treatment is imperative. Commonly, open drainage and debridement is performed. This case report describes a Morel-Lavallée lesion of the knee in a professional soccer player who was successfully treated with endoscopic debridement and fibrin glue injection after failure of conservative management. This method achieves the goal of an open surgical debridement without exposing patients to an increased morbidity. Copyright © 2016. Published by Elsevier B.V.

Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds

PubMed Central

Herrington, Mark T; Swenor, Karen M; Eron, Lawrence J

2011-01-01

The growth and aging of the population of Hawai‘i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds. PMID:22162609

Management of Teeth with Persistent Apical Periodontitis after Root Canal Treatment Using Regenerative Endodontic Therapy.

PubMed

Saoud, Tarek Mohamed A; Huang, George T-J; Gibbs, Jennifer L; Sigurdsson, Asgeir; Lin, Louis M

2015-10-01

Regenerative endodontic therapy (RET) is currently used to treat immature teeth with necrotic pulp and/or apical periodontitis. However, recently RET has been used to treat mature teeth with necrotic pulp and/or apical periodontitis and resulted in regression of clinical signs and/or symptoms and resolution of apical periodontitis. The purpose of this case report was to describe the potential of using RET to treat 2 mature teeth with persistent apical periodontitis after root canal therapy using RET. Two male patients, one 26-year old and another 12-year old, presented for retreatment of persistent apical periodontitis after root canal treatment of 2 mature teeth (#9 and #19). The gutta-percha fillings in the canals of teeth #9 and #19 were removed with Carvene gutta-percha solvent (Prevest DenPro, Jammu, India) and ProTaper Universal rotary retreatment files (Dentsply Maillefer, Ballaigues, Switzerland). The canals of both teeth were further chemomechanically debrided with rotary retreatment files and copious amounts of sodium hypochlorite irrigation and dressed with Metapaste (Meta Biomed, Chungbuk, Korea). RET was performed on teeth #9 and #19. Periapical bleeding was provoked into the disinfected root canals. The blood clots were covered with mineral trioxide aggregate plugs, and the access cavities were restored with intermediate restorative material. Teeth #9 and #19 showed regression of clinical signs and/or symptoms and healing of apical periodontitis after 13-month and 14-month follow-ups, respectively. Tooth #9 revealed narrowing of the canal space and apical closure by deposition of hard tissue. RET has the potential to be used to retreat teeth with persistent apical periodontitis after root canal therapy. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial.

PubMed

de Waal, Y C M; Raghoebar, G M; Meijer, H J A; Winkel, E G; van Winkelhoff, A J

2015-09-01

The objective of this randomized, double-blind, controlled trial was to evaluate the clinical, radiographic, and microbiological effects of implant surface decontamination with a 2% chlorhexidine (CHX) solution in comparison with a 0.12% chlorhexidine + 0.05% cetylpyridinium chloride (CPC) solution during resective surgical peri-implantitis treatment. Forty-four patients (108 implants) with peri-implantitis were treated with resective surgical treatment consisting of bone re-contouring, surface debridement and chemical decontamination, and apically repositioned flap. Patients were randomly allocated to decontamination with a 2% CHX solution (test group) or 0.12% CHX + 0.05% CPC (control group). Clinical and radiographic parameters were recorded before treatment (baseline), and at 3, 6, and 12 months after treatment. Microbiological parameters were recorded during surgery. Multilevel analysis showed no significant differences in bleeding, suppuration, probing pocket depth, and radiographic bone loss between control and test group over three follow-up measurements (3, 6, and 12 months) from baseline. Both decontamination procedures resulted in significant reductions in anaerobic bacterial counts on the implant surface, but no significant difference was noted between control and test group (mean log 3.37 ± 2.34 vs. 3.65 ± 2.87, P = 0.99). The use of a 2% CHX solution for implant surface decontamination during resective peri-implantitis therapy does not lead to improved clinical, radiographic, or microbiological results compared with a 0.12% CHX + 0.05% CPC solution. Overall, the additional use of CHX reduces anaerobic bacterial load on the implant surface better than mechanical debridement alone, but does not seem to enhance clinical treatment outcomes (ClinicalTrials.gov number NCT01852253). © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Functionality after arthroscopic debridement of central triangular fibrocartilage tears with central perforations.

PubMed

Möldner, Meike; Unglaub, Frank; Hahn, Peter; Müller, Lars P; Bruckner, Thomas; Spies, Christian K

2015-02-01

To investigate functional and subjective outcome parameters after arthroscopic debridement of central articular disc lesions (Palmer type 2C) and to correlate these findings with ulna length. Fifty patients (15 men; 35 women; mean age, 47 y) with Palmer type 2C lesions underwent arthroscopic debridement. Nine of these patients (3 men; 6 women; mean static ulnar variance, 2.4 mm; SD, 0.5 mm) later underwent ulnar shortening osteotomy because of persistent pain and had a mean follow-up of 36 months. Mean follow-up was 38 months for patients with debridement only (mean static ulnar variance, 0.5 mm; SD, 1.2 mm). Examination parameters included range of motion, grip and pinch strengths, pain (visual analog scale), and functional outcome scores (Modified Mayo Wrist score [MMWS] and Disabilities of the Arm, Shoulder, and Hand [DASH] questionnaire). Patients who had debridement only reached a DASH questionnaire score of 18 and an MMWS of 89 with significant pain reduction from 7.6 to 2.0 on the visual analog scale. Patients with additional ulnar shortening reached a DASH questionnaire score of 18 and an MMWS of 88, with significant pain reduction from 7.4 to 2.5. Neither surgical treatment compromised grip and pinch strength in comparison with the contralateral side. We identified 1.8 mm or more of positive ulnar variance as an indication for early ulnar shortening in the case of persistent ulnar-sided wrist pain after arthroscopic debridement. Arthroscopic debridement was a sufficient and reliable treatment option for the majority of patients with Palmer type 2C lesions. Because reliable predictors of the necessity for ulnar shortening are lacking, we recommend arthroscopic debridement as a first-line treatment for all triangular fibrocartilage 2C lesions, and, in the presence of persistent ulnar-sided wrist pain, ulnar shortening osteotomy after an interval of 6 months. Ulnar shortening proved to be sufficient and safe for these patients. Patients with persistent ulnar-sided wrist pain after debridement who had preoperative static positive ulnar variance of 1.8 mm or more may be treated by ulnar shortening earlier in order to spare them prolonged symptoms. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Timing of gangrene tissue debridement after autologous bone marrow cell implantation in patients with superficial femoral arterial occlusion: preliminary experiences.

PubMed

Wang, C H; Lan, Y J; Yeh, C H; Ng, Y T; Chung, P V H; Hsu, C M; Kuo, L T; Huang, R E; Liu, M H; Cherng, W J

2012-08-01

Although implantation of bone marrow mononuclear cells (BMI) was shown to improve outcomes in patients with severe peripheral arterial occlusive disease (PAOD), little experience has been reported in patients with an arterial occlusion level above the knee, ischemic gangrene, and high cardiovascular risk. This study sought to investigate the timing of gangrene tissue debridement and the safety of BMI in these patients. Six "no-option" PAOD patients were enrolled with an arterial occlusion level above the knee, ischemic gangrene, and 3 systemic diseases related to a high cardiovascular risk. The ischemic status was evaluated by measuring the ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), and wound healing after BMI. All patients safely underwent the procedures with intravenous general anesthesia by titrating propofol. Major lower extremity amputation, minor debridement amputation, and debridement surgery were performed in 2 (33.3%), 1 (16.7%), and 2 (33.3%) patients, respectively, 3.1 2.8 months after BMI. Compared to the amputation group (N=3), the salvage group (N=3) had a significantly higher baseline ABI (P=0.02) and a shorter distance between the gangrene site and arterial occlusion site (P=0.01). In the 3 patients who underwent debridement, ABI and TcPO2 significantly improved 1 month after BMI, and gangrenous tissues were debrided 3.8 ± 3.6 (range, 1~8) months after BMI with complete healing within 1 month. Autologous BMI therapy is safe in patients at high cardiovascular risk with an arterial occlusion level above the knee and ischemic gangrene. Effective predictors of BMI include the baseline ABI and distance to the ischemia. Gangrene tissue should be debrided at least 1 month after BMI.

In vivo laser confocal microscopic analysis of corneal K-structures after keratorefractive surgery (LASIK and epi-LASIK).

PubMed

Yokogawa, Hideaki; Kobayashi, Akira; Tagawa, Kosaku; Sugiyama, Kazuhisa

2010-01-01

To demonstrate alterations of corneal K-structures (sub-Bowman's fibrous structures) after keratorefractive surgery by in vivo laser confocal microscopy and to look for association of K-structures with fluorescein-stained anterior corneal mosaic (ACM). Five patients (nine eyes) participated in this study. For four patients, one eye was evaluated after laser in situ keratomileusis (LASIK) and the other after epipolis-laser in situ keratomileusis (epi-LASIK). For one patient, the left eye was evaluated after epithelial debridement. A photograph of the ACM was obtained. Central corneal regions were scanned by Heidelberg Retina Tomograph 2 Rostock Cornea Module (Heidelberg Engineering GmbH, Heidelberg, Germany). The ACM and K-structures disappeared in all corneas after epi-LASIK, but not after LASIK and epithelial debridement cornea. The presence of K-structures and ACM may be an index to identify eyes that had a previous refractive surgical procedure (surface ablation or LASIK) and be a health index of Bowman layer and adjacent anterior stroma. Copyright 2010, SLACK Incorporated.

Operative management of acute pavement burns: a case series.

PubMed

Silver, A G; Zamboni, W A; Baynosa, R C

2014-11-01

Acute burns suffered from contact with environmentally heated roadways and walkways are a rare entity. The aim of this report is to assess the information gained from the treatment of a series of patients. A retrospective review of a consecutive series of cases, where operative treatment was necessary, that occurred during July 2010 in southern Arizona. Seven patients were included, with an average total body surface area burn of 10.2%. Direct fascial excision and tangential excision were carried out on three and four patients, respectively. Although tangential excision was carried out to normal endpoints, there was commonly a need for repetitive debridement. The total hospital costs were over $4,400,000 (£2,730,000). Burns suffered from contact with roadways/walkways are often deeper than suggested by their appearance. Direct fascial excision minimises the number of debridement sessions. We hypothesise that the failure to offload pressure on these wounds may be a causative factor in their observed deepening.

Development of a Vascularized Skin Construct Using Adipose-Derived Stem Cells from Debrided Burned Skin

DTIC Science & Technology

2012-01-01

additional morbidity from subcutaneous liposuction . Because tangential debridement of skin often leads to debridement of some viable tissue, we have shown...32, 33]; however, in cases of extensive burn injury, liposuction may increase infectious complications of an already traumatized and immunologically...J. Foster et al., “Yield of human adipose-derived adult stem cells from liposuction aspirates,” Cytotherapy, vol. 6, no. 1, pp. 7–14, 2004. [33] B

Repeated Use of Immersive Virtual Reality Therapy to Control Pain during Wound Dressing Changes in Pediatric and Adult Burn Patients

PubMed Central

Faber, Albertus W.; Patterson, David R.; Bremer, Marco

2012-01-01

Objective The current study explored whether immersive virtual reality continues to reduce pain (via distraction) during more than one wound care session per patient. Patients: Thirty six patients aged 8 to 57 years (mean age of 27.7 years), with an average of 8.4% total body surface area burned (range .25 to 25.5 TBSA) received bandage changes, and wound cleaning. Methods Each patient received one baseline wound cleaning/debridement session with no-VR (control condition) followed by one or more (up to seven) subsequent wound care sessions during VR. After each wound care session (one session per day), worst pain intensity was measured using a Visual Analogue Thermometer (VAT), the dependent variable. Using a within subjects design, worst pain intensity VAT during wound care with no-VR (baseline, Day 0) was compared to pain during wound care while using immersive virtual reality (up to seven days of wound care during VR). Results Compared to pain during no-VR Baseline (Day 0), pain ratings during wound debridement were statistically lower when patients were in virtual reality on Days 1, 2 and 3, and although not significant beyond day 3, the pattern of results from Days 4, 5, and 6 are consistent with the notion that VR continues to reduce pain when used repeatedly. Conclusions Results from the present study suggest that VR continues to be effective when used for three (or possibly more) treatments during severe burn wound debridement. PMID:23970314

Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement.

PubMed

Xu, Ye-Sheng; Xie, Wen-Jia; Yao, Yu-Feng

2017-06-01

To report surgical management and favorable outcome in a case with delayed repair of traumatic laser in situ keratomileusis (LASIK) flap dislocation with shrinkage and folds. A 30-year-old man with a five-year history of bilateral LASIK experienced blunt trauma to his right eye followed by decreased vision for 5 weeks. The surgical management included initially softening the flap by irrigation with balanced salt solution (BSS). The shrinkage folds were carefully and gently stretched by scraping with a 26-gauge cannula accompanied by BSS irrigation. All of the epithelial ingrowth on the flap inner surface and on the bed was thoroughly debrided by scraping and irrigation. After the flap was repositioned to match its original margin, a soft bandage contact lens was placed. At his initial visit, slit-lamp microscopy and optical coherence tomography (OCT) showed shrinkage of the LASIK flap with an elevated margin approximately 3 mm above the original position. The flap covered half of the pupil and had multiple horizontal folds. Two months after surgery, the flap remained well positioned with only faint streaks in the anterior stroma. The uncorrected visual acuity of the right eye was 20/20 with a manifest refraction of Plano. For delayed repair of traumatically dislocated LASIK flaps, sufficient softening by BSS, stretching the shrinkage folds, and thorough debridement of ingrowth epithelium enable resetting the flap and provide satisfactory results.

Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement*

PubMed Central

Xu, Ye-sheng; Xie, Wen-jia; Yao, Yu-feng

2017-01-01

Objective: To report surgical management and favorable outcome in a case with delayed repair of traumatic laser in situ keratomileusis (LASIK) flap dislocation with shrinkage and folds. Methods: A 30-year-old man with a five-year history of bilateral LASIK experienced blunt trauma to his right eye followed by decreased vision for 5 weeks. The surgical management included initially softening the flap by irrigation with balanced salt solution (BSS). The shrinkage folds were carefully and gently stretched by scraping with a 26-gauge cannula accompanied by BSS irrigation. All of the epithelial ingrowth on the flap inner surface and on the bed was thoroughly debrided by scraping and irrigation. After the flap was repositioned to match its original margin, a soft bandage contact lens was placed. Results: At his initial visit, slit-lamp microscopy and optical coherence tomography (OCT) showed shrinkage of the LASIK flap with an elevated margin approximately 3 mm above the original position. The flap covered half of the pupil and had multiple horizontal folds. Two months after surgery, the flap remained well positioned with only faint streaks in the anterior stroma. The uncorrected visual acuity of the right eye was 20/20 with a manifest refraction of Plano. Conclusions: For delayed repair of traumatically dislocated LASIK flaps, sufficient softening by BSS, stretching the shrinkage folds, and thorough debridement of ingrowth epithelium enable resetting the flap and provide satisfactory results. PMID:28585430

Molar crown and root size relationship in anthropoid primates.

PubMed

Kupczik, Kornelius; Olejniczak, Anthony J; Skinner, Matthew M; Hublin, Jean-Jacques

2009-01-01

Mandibular corpus form is thought to reflect masticatory function and the size of the dentition, but there is no universal association between crown dimensions and corpus size across anthropoids. Previous research was based on the assumption that crown size is an appropriate proxy for overall tooth size, but this hypothesis remains largely untested. This study assesses the relationship between the volume and surface area of molar crowns and roots by examining two main hypotheses: (1) crown size correlates significantly with root size, and (2) the proportion of root-to-crown surface area is related to dietary proclivity. Permanent M2s (n=58) representing 19 anthropoid species were CT scanned and the volume and surface area of the crown and root were measured. Interspecific correlation and regression analyses reveal significant isometric relationships between crown and root volume and a positive allometric relationship between root and crown surface area (i.e. as crown surface area increases, root surface area becomes disproportionately greater). Intraspecifically, crown and root surface area correlate significantly in some species where such analyses were possible. In general, hard object feeders exhibit relatively larger root surface area per unit crown surface area compared to soft and tough object feeders. The results also show that despite differences in food specialization closely related species have similar root-to-crown surface area proportions, thus indicating a strong phylogenetic influence. Since it is possible that, at least in some species, crown and root size vary independently, future studies should elucidate the relationship between tooth root size and mandible form. Copyright (c) 2009 S. Karger AG, Basel.

It's not what you put on, but what you take off: techniques for debriding and off-loading the diabetic foot wound.

PubMed

Armstrong, David G; Lavery, Lawrence A; Nixon, Brent P; Boulton, Andrew J M

2004-08-01

The basic etiology of neuropathic diabetic foot wounds involves pressure in conjunction with cycles of repetitive stress, leading to failure of skin and soft tissue. The central tenet of any treatment plan addressing neuropathic diabetic foot wounds is the appropriate debridement of nonviable tissue coupled with adequate pressure relief (off-loading). Although numerous advances have been made in the treatment of diabetic foot wounds, including bioengineered tissues, autologous and exogenous cytokine delivery systems, and potentially effective topical antimicrobial modalities, none will succeed without addressing effective debridement and off-loading. Specific debridement and off-loading techniques are discussed, along with available supporting evidence. This includes the use of the "instant" total contact cast, among other modalities.

Maggot therapy in treatment of a complex hand injury complicated by mycotic infection.

PubMed

Bohac, M; Cambal, M; Zamborsky, R; Takac, P; Fedeles, J

2015-01-01

Complex injuries of the hand remain a therapeutic challenge for surgeons. We present the case of a male who suffered a devastating injury of the hand caused by a conveyor belt. The patient developed a progressive Absidia corymbifera infection of the affected soft tissues. Initial treatments with serial surgical debridement and topical and intravenous itraconazole were unsuccessful in eliminating the infection. We decided to use maggot debridement therapy in a new special design to debride all necrotic, devitalized tissue and preserve only healthy tissue and functioning structures. This maneuverer followed by negative pressure therapy allowed progressive healing. In such complex hand injuries, maggot debridement combined with negative pressure therapy could be considered to achieve effective and considerable results, although future functional morbidity may occur (Fig. 4, Ref. 18).

A Comparison of More and Less Aggressive Bone Debridement Protocols for the Treatment of Open Supracondylar Femur Fractures

PubMed Central

Ricci, William M.; Collinge, Cory; Streubel, Philipp N.; McAndrew, Christopher M.; Gardner, Michael J.

2014-01-01

Objectives This study compared results of aggressive and nonaggressive debridement protocols for the treatment of high energy open supracondylar femur fractures after the primary procedure, with respect to the requirement for secondary bone grafting procedures, and deep infection. Design Retrospective review Setting Level I and Level II Trauma Centers Patients/Participants Twenty-nine consecutive patients with high grade open (Gustilo Types II and III) supracondylar femur fractures (OTA/AO 33A and C) treated with debridement and locked plating. Intervention Surgeons at two different Level I trauma centers had different debridement protocols for open supracondylar femur fractures. One center used a More Aggressive (MA)protocol in their patients (n=17) that included removal of all devitalized bone and placement of antibiotic cement spacers to fill large segmental defects. The other center used a Less Aggressive (LA) protocol in their patients (n=12) that included debridement of grossly contaminated bone with retention of other bone fragments and no use of antibiotic cement spacers. All other aspects of the treatment protocol at the two centers were similar: definitive fixation with locked plates in all cases; IV antibiotics were used until definitive wound closure; and weight bearing was advanced upon clinical and radiographic evidence of fracture healing. Main Outcome Measurements Healing after the primary procedure, requirement for secondary bone grafting procedures, and the presence of deep infection. Results Demographics were similar between included patients at each center with regard to: age; gender; rate of open fractures; open fracture classification; mechanism; and smoking (p>.05). Patients at the MA center were more often diabetic (p<.05).Cement spacers to fill segmental defects were used more often after MA debridement (35% vs 0%, p<0.006) and more patients had a plan for staged bone grafting after MA debridement (71% vs 8%, p<0.006). Healing after the index fixation procedure occurred more often after LA debridement (92% vs 35%, p<0.003). There was no difference in infection rate between the two protocols: 25% with the LA protocol; and 18% with the MA protocol, (p=0.63). All patients in both groups eventually healed and were without evidence of infection at an average of 1.8 years of follow-up. Conclusion The degree to which bone should be debrided after a high energy, high grade, open supracondylar femur fracture is a matter of surgeon judgment and falls along a continuous spectrum. Based on the results of the current study, the theoretic tradeoff between infection risk and osseous healing potential, seems to favor a less aggressive approach towards bone debridement in the initial treatment. PMID:23760177

A comparison of more and less aggressive bone debridement protocols for the treatment of open supracondylar femur fractures.

PubMed

Ricci, William M; Collinge, Cory; Streubel, Philipp N; McAndrew, Christopher M; Gardner, Michael J

2013-12-01

This study compared results of aggressive and nonaggressive debridement protocols for the treatment of high-energy, open supracondylar femur fractures after the primary procedure, with respect to the requirement for secondary bone grafting procedures, and deep infection. Retrospective review. Level I and level II trauma centers. Twenty-nine consecutive patients with high-grade, open (Gustilo types II and III) supracondylar femur fractures (OTA/AO 33A and C) treated with debridement and locked plating. Surgeons at 2 different level I trauma centers had different debridement protocols for open supracondylar femur fractures. One center used a more aggressive (MA) protocol in their patients (n = 17) that included removal of all devitalized bone and placement of antibiotic cement spacers to fill large segmental defects. The other center used a less aggressive (LA) protocol in their patients (n = 12) that included debridement of grossly contaminated bone with retention of other bone fragments and no use of antibiotic cement spacers. All other aspects of the treatment protocol at the 2 centers were similar: definitive fixation with locked plates in all cases, IV antibiotics were used until definitive wound closure, and weight bearing was advanced upon clinical and radiographic evidence of fracture healing. Healing after the primary procedure, requirement for secondary bone grafting procedures, and the presence of deep infection. Demographics were similar between included patients at each center with regard to age, gender, rate of open fractures, open fracture classification, mechanism, and smoking (P > 0.05). Patients at the MA center were more often diabetic (P < 0.05). Cement spacers to fill segmental defects were used more often after MA debridement (35% vs. 0%, P < 0.006), and more patients had a plan for staged bone grafting after MA debridement (71% vs. 8%, P < 0.006). Healing after the index fixation procedure occurred more often after LA debridement (92% vs. 35%, P < 0.003). There was no difference in infection rate between the 2 protocols: 25% with the LA protocol and 18% with the MA protocol (P = 0.63). All patients in both groups eventually healed and were without evidence of infection at an average of 1.8 years of follow-up. The degree to which bone should be debrided after a high-energy, high-grade, open supracondylar femur fracture is a matter of surgeon judgment and falls along a continuous spectrum. Based on the results of the current study, the theoretic trade-off between infection risk and osseous healing potential seems to favor an LA approach toward bone debridement in the initial treatment. Therapeutic level III.

Using Gene Transcription Patterns (Bar Coding Scans) to Guide Wound Debridement and Healing

PubMed Central

Tomic-Canic, Marjana; Ayello, Elizabeth A.; Stojadinovic, Olivera; Golinko, Michael S.; Brem, Harold

2010-01-01

PURPOSE To acquaint wound care practitioners with new information related to debridement of chronic wounds. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in wound care. OBJECTIVES After reading this article and taking this test, the reader should be able to: Explain the role of keratinocytes in wound healing. Discuss new research findings on the physiological differences between healing and nonhealing wounds. Identify implications of the new research for debridement of chronic wounds. PMID:18836328

In vitro particle image velocity measurements in a model root canal: flow around a polymer rotary finishing file.

PubMed

Koch, Jon D; Smith, Nicholas A; Garces, Daniel; Gao, Luyang; Olsen, F Kris

2014-03-01

Root canal irrigation is vital to thorough debridement and disinfection, but the mechanisms that contribute to its effectiveness are complex and uncertain. Traditionally, studies in this area have relied on before-and-after static comparisons to assess effectiveness, but new in situ tools are being developed to provide real-time assessments of irrigation. The aim in this work was to measure a cross section of the velocity field in the fluid flow around a polymer rotary finishing file in a model root canal. Fluorescent microparticles were seeded into an optically accessible acrylic root canal model. A polymer rotary finishing file was activated in a static position. After laser excitation, fluorescence from the microparticles was imaged onto a frame-transfer camera. Two consecutive images were cross-correlated to provide a measurement of a projected, 2-dimensional velocity field. The method reveals that fluid velocities can be much higher than the velocity of the file because of the shape of the file. Furthermore, these high velocities are in the axial direction of the canal rather than only in the direct of motion of the file. Particle image velocimetry indicates that fluid velocities induced by the rotating file can be much larger than the speed of the file. Particle image velocimetry can provide qualitative insight and quantitative measurements that may be useful for validating computational fluid dynamic models and connecting clinical observations to physical explanations in dental research. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Clinical and economic benefit of enzymatic debridement of pressure ulcers compared to autolytic debridement with a hydrogel dressing.

PubMed

Waycaster, Curtis; Milne, Catherine T

2013-07-01

The purpose of this study was to determine the cost-effectiveness of enzymatic debridement using collagenase relative to autolytic debridement with a hydrogel dressing for the treatment of pressure ulcers. A 3-stage Markov model was used to determine the expected costs and outcomes of wound care for collagenase and hydrogel dressings. Outcome data used in the analysis were taken from a randomized clinical trial that directly compared collagenase and hydrogel dressings. The primary outcome in the clinical trial was the proportion of patients achieving a closed epithelialized wound. Transition probabilities for the Markov states were estimated from the clinical trial. A 1-year time horizon was used to determine the expected number of closed wound days and the expected costs for the two alternative debridement therapies. Resource utilization was based on the wound care treatment regimen used in the clinical trial. Resource costs were derived from standard cost references and medical supply wholesalers. The economic perspective taken was that of the long-term care facility. No cost discounting was performed due to the short time horizon of the analysis. A deterministic sensitivity analysis was conducted to analyze economic uncertainty. The number of expected wound days for the collagenase and hydrogel cohorts are estimated at 48 and 147, respectively. The expected direct cost per patient for pressure ulcer care was $2003 for collagenase and $5480 for hydrogel debridement. The number of closed wound days was 1.5-times higher for collagenase (317 vs 218 days) than with the hydrogel. The estimated cost/closed wound day was 4-times higher for the hydrogel ($25) vs collagenase ($6). In this Markov model based on a randomized trial of pressure ulcer care in a long-term care setting collagenase debridement was economically dominant over autolytic debridement, yielding better outcomes at a lower total cost. Since it was a single institution study with a small sample size, the results should be interpreted with caution. Specifically, the findings may not necessarily be generalized to other hydrogel dressings, healthcare settings, age groups, or to wounds of other etiologies.

Barley root hair growth and morphology in soil, sand, and water solution media and relationship with nickel toxicity.

PubMed

Lin, Yanqing; Allen, Herbert E; Di Toro, Dominic M

2016-08-01

Barley, Hordeum vulgare (Doyce), was grown in the 3 media of soil, hydroponic sand solution (sand), and hydroponic water solution (water) culture at the same environmental conditions for 4 d. Barley roots were scanned, and root morphology was analyzed. Plants grown in the 3 media had different root morphology and nickel (Ni) toxicity response. Root elongations and total root lengths followed the sequence soil > sand > water. Plants grown in water culture were more sensitive to Ni toxicity and had greater root hair length than those from soil and sand cultures, which increased root surface area. The unit root surface area as root surface area per centimeter of length of root followed the sequence water > sand > soil and was found to be related with root elongation. Including the unit root surface area, the difference in root elongation and 50% effective concentration were diminished, and percentage of root elongations can be improved with a root mean square error approximately 10% for plants grown in different media. Because the unit root surface area of plants in sand culture is closer to that in soil culture, the sand culture method, not water culture, is recommended for toxicity parameter estimation. Environ Toxicol Chem 2016;35:2125-2133. © 2016 SETAC. © 2016 SETAC.

Negative Pressure Wound Therapy With Instillation (NPWTi) Better Reduces Post-debridement Bioburden in Chronically Infected Lower Extremity Wounds Than NPWT Alone.

PubMed

Goss, S G; Schwartz, J A; Facchin, F; Avdagic, E; Gendics, C; Lantis, J C

2012-12-01

An overabundance of bacteria in the chronic wound plays a significant role in the decreased ability for primary closure. One means of decreasing the bioburden in a wound is to operatively debride the wound for wound bed optimization prior to application of other therapy, such as Negative Pressure Wound Therapy (NPWT). We undertook a prospective pilot study to assess the efficacy of wound bed preparation for a standard algorithm (sharp surgical debridement followed by NPWT) versus one employing sharp surgical debridement followed by Negative Pressure Wound Therapy with Instillation (NPWTi). Thirteen patients, corresponding to 16 chronic lower leg and foot wounds were taken to the operating room for debridement. The patients were sequentially enrolled in 2 treatment groups: the first receiving treatment with operative debridement followed by 1 week of NPWT with the instillation of quarter strength bleach solution; the other receiving a standard algorithm consisting of operative debridement and 1 week of NPWT. Quantitative cultures were taken pre-operatively after sterile preparation and draping of the wound site (POD # 0, pre-op), post-operatively once debridement was completed (POD # 0, post-op), and on post-operative day 7 after operative debridement (POD # 7, post-op). After operative debridement (post-operative day 0) there was a mean of 3 (±1) types of bacteria per wound. The mean CFU/gram tissue culture was statistically greater - 3.7 × 10(6) (±4 × 10(6)) in the NPWTi group, while in the standard group (NPWT) the mean was 1.8 × 10(6) (±2.36 × 10(6)) CFU/gram tissue culture (p = 0.016); at the end of therapy there was no statistical difference between the two groups (p = 0.44). Wounds treated with NPWTi had a mean of 2.6 × 10(5) (±3 × 10(5)) CFU/gram of tissue culture while wounds treated with NPWT had a mean of 2.79 × 10(6) (±3.18 × 10(6)) CFU/gram of tissue culture (p = 0.43). The mean absolute reduction in bacteria for the NPWTi group was 10.6 × 10(6) bacteria per gram of tissue while there was a mean absolute increase in bacteria for the NPWT group of 28.7 × 10(6) bacteria per gram of tissue, therefore there was a statistically significant reduction in the absolute bioburden in those wounds treated with NPWTi (p = 0.016). It has long been realized that NPWT does not make its greatest impact by bioburden reduction. Other work has demonstrated that debridement alone does not reduce wound bioburden by more than 1 Log. Wounds treated with NPWTi (in this case with quarter strength bleach instillation solution) had a statistically significant reduction in bioburden, while wounds treated with NPWT had an increase in bioburden over the 7 days.

Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics

PubMed Central

Karaduman, Mert

2007-01-01

Cierny-Mader (C-M) Type III osteomyelitis is defined as a localised lesion with both medullary and cortical involvement that is stable mechanically after debridement. The treatment of C-M Type III osteomyelitisis is difficult and requires a precise protocol to achieve a disease-free long-term follow-up. We report here the results of our study on 26 patients (19 men and 7 women; average age: 34.7 years) with C-M Type III osteomylelitis who were treated with radical debridement, irrigation, vancomycin-impregnated custom-made beads and culture-specific systemic antibiotics. Those patients with metaphyseal involvement were treated with deroofing of the cortex and debridement by means of a “trough” (16 patients); those with diaphyseal involvement were treated with both intramedullary reaming and debridement from a trough (ten patients). Antibiotic cement rods were used as an additional therapy in five patients with diaphyseal involvement. Recurrence developed in three patients and was attributed to inadequate debridement; all three patients were treated again in the same manner with success. The mean follow-up is currently 3.6 years (range: 2–6 years). All of the patients have normal clinical, radiographic and laboratory parameters, and all are ambulatory and have returned to their pretreatment level of activity or better. We conclude that C-M Type III chronic osteomyelitis can be safely treated with this protocol. PMID:17375299

Debriding effect of bromelain on firearm wounds in pigs.

PubMed

Hu, Wei; Wang, Ai-Min; Wu, Si-Yu; Zhang, Bo; Liu, Shuai; Gou, Yuan-Bin; Wang, Jian-Min

2011-10-01

Wound excision is the standard treatment for firearm wounds. However, achieving a satisfactory curative effect is difficult because of the traumatic mechanism of high-velocity projectiles. We propose a new therapy by using topical bromelain as a supplement to wound incision for the debridement of firearm wounds. We clarified the debriding effect of bromelain on firearm wounds in pigs. In vitro, muscle tissues around the wound track and normal muscle were incubated in bromelain solutions of different concentrations. Tissue hydrolization was estimated by measuring tissue weight and the release of total amino acids. In vivo, the hind limbs of 15 pigs were wounded with high-velocity projectiles. Five groups were classified as follows: wound excision (E), wound incision (I), bromelain (B), incision + bromelain (IB), and control (C). Debriding effectiveness was estimated using bacterial content, histopathologic examination, and wound healing time. In vitro, hydrolization of wound tissue was significantly more intensive than that of normal tissue. Bromelain solution (10 mg/mL) hydrolyzed wound tissue rapidly with minimal proteolysis of normal tissue. In vivo, the wound-track bacterial content of group IB was similar to that of group E and was significantly lower than that of groups I, B, and C. The wound healing time of group IB was also shorter. Bromelain is effective in the debridement of uncomplicated firearm wounds if used as a supplement to simple wound incision. This new therapy shows notable advantages over conventional surgical debridement as it greatly simplifies the procedures.

Identification of qSOR1, a major rice QTL involved in soil-surface rooting in paddy fields.

PubMed

Uga, Yusaku; Hanzawa, Eiko; Nagai, Shinsei; Sasaki, Kazuhiro; Yano, Masahiro; Sato, Tadashi

2012-01-01

Specific Indonesian lowland rice (Oryza sativa L.) cultivars elongate thick primary roots on the soil surface of paddy fields. To clarify the genetic factors controlling soil-surface rooting, we performed quantitative trait locus (QTL) analyses using 124 recombinant inbred lines (RILs) derived from a cross between Gemdjah Beton, an Indonesian lowland rice cultivar with soil-surface roots, and Sasanishiki, a Japanese lowland rice cultivar without soil-surface roots. These cultivars and the RILs were tested for soil-surface rooting in a paddy field. We identified four regions of chromosomes 3, 4, 6, and 7 that were associated with soil-surface rooting in the field. Among them, one major QTL was located on the long arm of chromosome 7. This QTL explained 32.5-53.6% of the total phenotypic variance across three field evaluations. To perform fine mapping of this QTL, we measured the basal root growth angle of crown roots at the seedling stage in seven BC(2)F(3) recombinant lines grown in small cups in a greenhouse. The QTL was mapped between markers RM21941 and RM21976, which delimit an 812-kb interval in the reference cultivar Nipponbare. We have designated this QTL qSOR1 (quantitative trait locus for SOIL SURFACE ROOTING 1).

Synergistic Effects of a Calcium Phosphate/Fibronectin Coating on the Adhesion of Periodontal Ligament Stem Cells Onto Decellularized Dental Root Surfaces.

PubMed

Lee, Jung-Seok; Kim, Hyun-Suk; Park, So-Yon; Kim, Tae-Wan; Jung, Jae-Suk; Lee, Jong-Bin; Kim, Chang-Sung

2015-01-01

This study aimed to enhance the attachment of periodontal ligament stem cells (PDLSCs) onto the decellularized dental root surface using surface coating with fibronectin and/or calcium phosphate (CaP) and to evaluate the activity of PDLSCs attached to a coated dental root surface following tooth replantation. PDLSCs were isolated from five dogs, and the other dental roots were used as a scaffold for carrying PDLSCs and then assigned to one of four groups according to whether their surface was coated with CaP, fibronectin, CaP/fibronectin, or left uncoated (control). Fibronectin increased the adhesion of PDLSCs onto dental root surfaces compared to both the control and CaP-coated groups, and simultaneous surface coating with CaP and fibronectin significantly accelerated and increased PDLSC adhesion compared to the fibronectin-only group. On in vivo tooth replantation, functionally oriented periodontal new attachment was observed on the CaP/fibronectin-coated dental roots to which autologous PDLSCs had adhered, while in the control condition, dental root replantation was associated only with root resorption and ankylosis along the entire root length. CaP and fibronectin synergistically enhanced the attachment of PDLSCs onto dental root surfaces, and autologous PDLSCs could produce de novo periodontal new attachment in an experimental in vivo model.

Bioremediation of phenolic compounds from water with plant root surface peroxidases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adler, P.R.; Arora, R.; El Ghaouth, A.

1994-09-01

Peroxidases have been shown to polymerize phenolic compounds, thereby removing them from solution by precipitation. Others have studied the role of root surface associated peroxidases as a defense against fungal root pathogens; however, their use in detoxification of organic pollutants in vivo at the root surface has not been studied. Two plant species, waterhyacinth [Eichhornia crassipes (C. Mart) Solms-Laub.] and tomato (Lycopersicon esculentum L.), were tested for both in vitro and in vivo peroxidase activity on the root surface. In vitro studies indicated that root surface peroxidase activities were 181 and 78 nmol tetraguaiacol formed min{sup -1} g{sup -1} rootmore » fresh wt., for tomato and waterhyacinth, respectively. Light microscope studies revealed that guaiacol was polymerized in vivo at the root surface. Although peroxidase was evenly distributed on tomato roots, it was distributed patchily on waterhyacinth roots. In vitro studies using gas chromatography-mass spectrometry (GC-MS) showed that the efficiency of peroxidase to polymerize phenols vary with phenolic compound. We suggest that plants may be utilized as a source of peroxidases for removal of phenolic compounds that are on the EPA priority pollutant list and that root surface peroxidases may minimize the absorption of phenolic compounds into plants by precipitating them at the root surface. In this study we have identified a new use for root-associated proteins in ecologically engineering plant systems for bioremediation of phenolic compounds in the soil and water environment. 25 refs., 2 figs., 2 tabs.« less

In vitro performance of DIAGNOdent laser fluorescence device for dental calculus detection on human tooth root surfaces.

PubMed

Rams, Thomas E; Alwaqyan, Abdulaziz Y

2017-10-01

This study assessed the reproducibility of a red diode laser device, and its capability to detect dental calculus in vitro on human tooth root surfaces. On each of 50 extracted teeth, a calculus-positive and calculus-free root surface was evaluated by two independent examiners with a low-power indium gallium arsenide phosphide diode laser (DIAGNOdent) fitted with a periodontal probe-like sapphire tip and emitting visible red light at 655 nm wavelength. Laser autofluorescence intensity readings of examined root surfaces were scored on a 0-99 scale, with duplicate assessments performed using the laser probe tip directed both perpendicular and parallel to evaluated tooth root surfaces. Pearson correlation coefficients of untransformed measurements, and kappa analysis of data dichotomized with a >40 autofluorescence intensity threshold, were calculated to assess intra- and inter-examiner reproducibility of the laser device. Mean autofluorescence intensity scores of calculus-positive and calculus-free root surfaces were evaluated with the Student's t -test. Excellent intra- and inter-examiner reproducibility was found for DIAGNOdent laser autofluorescence intensity measurements, with Pearson correlation coefficients above 94%, and kappa values ranging between 0.96 and 1.0, for duplicate readings taken with both laser probe tip orientations. Significantly higher autofluorescence intensity values were measured when the laser probe tip was directed perpendicular, rather than parallel, to tooth root surfaces. However, calculus-positive roots, particularly with calculus in markedly-raised ledges, yielded significantly greater mean DIAGNOdent laser autofluorescence intensity scores than calculus-free surfaces, regardless of probe tip orientation. DIAGNOdent autofluorescence intensity values >40 exhibited a stronger association with calculus (36.6 odds ratio) then measurements of ≥5 (20.1 odds ratio) when the laser probe tip was advanced parallel to root surfaces. Excellent intra- and inter-examiner reproducibility of autofluorescence intensity measurements was obtained with the DIAGNOdent laser fluorescence device on human tooth roots. Calculus-positive root surfaces exhibited significantly greater DIAGNOdent laser autofluorescence than calculus-free tooth roots, even with the laser probe tip directed parallel to root surfaces. These findings provide further in vitro validation of the potential utility of a DIAGNOdent laser fluorescence device for identifying dental calculus on human tooth root surfaces.

Effects of nicergoline on corneal epithelial wound healing in rat eyes.

PubMed

Kim, Su-Young; Choi, Jun-Sub; Joo, Choun-Ki

2009-02-01

To investigate the effect of nicergoline on corneal epithelial wound healing in rats. One hundred Sprague-Dawley male rats were divided into two groups, the control group and the nicergoline-treated group, for 2 weeks. Corneal wound healing was evaluated by fluorescein staining after epithelial debridement. Nerve growth factor (NGF) protein and NGF mRNA were measured in rat corneas by ELISA and RT-PCR. NGF concentration of lacrimal gland was also evaluated by means of ELISA. Immunofluorescent staining was performed in rat corneas. The corneal wound healing rate was increased in nicergoline-treated rats compared with control rats after debridement. Twenty-four hours after epithelial debridement, corneal NGF protein and NGF mRNA levels were higher in the nicergoline-treated group than in the control group. Immunofluorescent staining showed that NGF staining was stronger in nicergoline-treated corneas than in control corneas 24 hours after epithelial debridement. In addition, NGF concentrations in lacrimal glands of the nicergoline-treated group were significantly higher than in the control group 24 hours after epithelial debridement. Nicergoline accelerated wound healing in rat corneas. The promoting effect of nicergoline in corneal wound healing is likely to be related to increased NGF in corneas and lacrimal glands.

Root Surface Bio-modification with Erbium Lasers- A Myth or a Reality??

PubMed Central

Lavu, Vamsi; Sundaram, Subramoniam; Sabarish, Ram; Rao, Suresh Ranga

2015-01-01

The objective of this literature review was to critically review the evidence available in the literature regarding the expediency of erbium family of lasers for root bio modification as a part of periodontal therapy. The literature search was performed on the Pubmed using MeSH words such as "lasers/therapeutic use, scaling, dental calculus, tooth root/anatomy and histology, ultrasonic therapy". The studies were screened and were grouped as follows: those evaluating a) efficacy for calculus removal with the Erbium family of laser b) root surface changes following Er YAG and Er Cr YSGG application c) comparative studies of the Er YAG, Er Cr YSGG lasers versus conventional methods of root surface modification d) Bio compatibility of root surface following Erbium laser treatment e) Studies on the combined efficacy of laser root modification with conventional methods towards root surface bio-modification f) Studies on effectiveness of root surface bio-modification prior to root coverage procedures. In conclusion, the erbium family has a proven anti-bacterial action, predictable calculus removal, minimal root substance removal, and appears to favor cell attachment. The Erbium family of lasers appears to be a useful adjunct for the management of periodontal disease. PMID:25713635

The meniscal ossicle revisited: etiology and an arthroscopic technique for treatment.

PubMed

Raustol, Ole A; Poelstra, Kornelis A; Chhabra, Annikar; Diduch, David R

2006-06-01

We describe a new arthroscopic technique for repair of meniscal ossicles in support of the theory that meniscal ossicles are traumatic in nature. Using a standard inferolateral portal, the arthroscope is passed under the posterior cruciate ligament to permit visualization of the "root" of the medial meniscus with a matching donor lesion on the tibia. A limited debridement should be performed of the donor site as well as the posterior horn of the meniscus if it has healed over with fibrocartilage to allow bone-to-bone healing. A posteromedial working portal is made at an angle amenable to the repair and a 6-mm cannula is placed. A Beath passing pin commonly used for anterior cruciate ligament reconstruction is used to pass suture for the outside-inside-out repair. The pin is passed through the cannula in the posterior medial portal. The root of the medial meniscus and the avulsed ossicle are pierced with the Beath pin and tensioned, after which the pin is drilled into the matching donor site and out through the tibia. Two passes are used to create a mattress suture through the ossicle, and the suture is tied over a bone bridge on the anterolateral tibia.

Factors associated with infection following open distal radius fractures.

PubMed

Glueck, Dane A; Charoglu, Constantine P; Lawton, Jeffrey N

2009-09-01

Open fractures are often classified according to a system described by Gustilo and Anderson. However, this system was applied to open long bone fractures, which may not predict the incidence of infection in open metaphyseal fractures of the upper extremity. Other studies have found that wound contamination and systemic illness were the best predictors of infections in open hand fractures. Our study assessed infection in open distal radius fractures and identifies factors that are associated with these infections. We hypothesize that contamination, rather than absolute wound size, is the best predictor of infection associated with open distal radius fractures. A review by CPT code yielded 42 patients with open distal radius fractures between 1997 and 2002 treated at a level one trauma center. Medical records and radiographic follow-up were reviewed to assess the time to irrigation and debridement, the number of debridements in initial treatment period, the method of operative stabilization, the Gustilo and Anderson type of fracture, the Swanson type of fracture, and description of wound contamination. Forty-two patients were followed up for an average of 15 months (range 4 to 68 months). Twenty-four fractures were classified as Gustilo and Anderson type I, ten were type II, and eight were type III, 30 were Swanson type I, and 12 were Swanson type II. Five of the 42 fractures were considered contaminated. Two were exposed to fecal contamination. The others were contaminated with tar, dirt/grass, and gravel, respectively. Three of 42 (7%) fractures developed infections. All three infected cases received a single irrigation and debridement. Two of five contaminated fractures (40%) developed a polymicrobial infection. Both were exposed to fecal contamination and, therefore, considered Swanson type II fractures. They were classified as Gustilo and Anderson type II and IIIB based solely upon the size of the wound. Both required multiple debridements and eventually wrist fusions. The third infection occurred in a Gustilo and Anderson type II and Swanson type I open fracture treated with one debridement and plate fixation. Hardware removal, debridement, and antibiotics resolved the infection. Three contaminated fractures that healed uneventfully received two debridements. Statistical analysis revealed a correlation with infection and contamination (p = 0.0331). The number of initial debridements played a role in infection, but was not statistically significant. No relationship between infection and time to initial irrigation and debridement, method of fixation, Gustilo and Anderson type, or Swanson type was found. We propose that open distal radius fractures behave differently than open long bone fractures. Infection developed in 7% of the distal radius fractures in our study and was significantly associated with wound contamination. We recommend that contamination be included as factor for prognosis in open distal radius fractures. Contaminated fractures should be treated with multiple debridements as part of the initial plan not based upon subsequent development of an infection.

Efficacy of combination therapy using anorganic bovine bone graft with resorbable GTR membrane vs. open flap debridement alone in the management of grade II furcation defects in mandibular molars – A comparative study

PubMed Central

Kannan, Anitha Logaranjani; Bose, Buvaneshwari Birla; Muthu, Jananni; Perumalsamy, Rajapriya; Pushparajan, Saravanan; Namasivayam, Ambalavanan

2014-01-01

Context: Invasion of the bifurcation and trifurcation of the multi-rooted teeth resulting in furcation involvement is one of the serious complications of periodontitis. Aim: The purpose of the study was to evaluate the efficacy of combination therapy using anorganic bovine bone graft and resorbable guided tissue regeneration (GTR) membrane versus open flap debridement alone in the management of Grade II furcation defects in mandibular molars. Materials and Methods: The study included a total number of 20 sites in 10 patients with bilateral mandibular furcation defects, out of which 10 sites were treated as test group and 10 as control group. The test group was treated with combination therapy and the control group with open flap debridement alone. The parameters were recorded on 0 day (baseline), 90th day, and 180th day, which included vertical probing depth and horizontal probing depth of the furcation defect, clinical attachment level, and defect fill. Statistical Analysis Used: Mean and standard deviation were calculated for different variables in each study group at different time points. Mean values were compared by using Wilcoxon signed ranks test, after adjusting the P values for multiple comparison by using Bonferroni correction method. Results: Both the test and control groups showed a definitive improvement in clinical parameters, which was statistically significant. On comparison, the vertical probing depth showed significant reduction in the test group with a mean reduction of 3.1 ± 0.7 mm, when compared to the control group which showed a mean reduction of 1.5 ± 0.5 mm. The horizontal probing depth of furcation defects was also significantly reduced in the test group with a mean reduction of 2.2 ± 0.6 mm, when compared to the control group in which the mean reduction was 0.9 ± 0.3 mm. There was also significant gain in attachment level in the test group which showed a mean gain of 3.2 ± 0.6 mm, when compared to the control group which showed a gain of 1.2 ± 0.6 mm. Radiographic defect fill was found to be more in the test group with a mean gain of 2.0 ± 0.1 mm, when compared to the control group which showed a defect fill of 0.2 ± 0.1 mm. Conclusions: The results of this study demonstrated that the combined use of anorganic bovine bone graft and resorbable GTR membrane is effective than open flap debridement alone in the treatment of mandibular grade II furcation defects. PMID:25452926

Outcome of 28 open pilon fractures with injury severity-based fixation.

PubMed

Danoff, Jonathan R; Saifi, Comron; Goodspeed, David C; Reid, J Spence

2015-04-01

Open pilon fracture management and treatment poses a significant challenge to orthopedic surgeons. The purpose of this study was to determine patient outcomes for open pilon fractures based on wound complication and infection rates, as well as subjective outcome instruments. This was a retrospective consecutive case series of 28 fractures with Orthopaedic Trauma Association (OTA)-type 43-B and 43-C open pilon fractures. Mean length of follow-up was 36 months and minimum of 1 year. Ten fractures were Gustilo and Anderson grade IIIB, and the remaining fractures were grades I-IIIA. Patients were initially treated with spanning external fixation and staged wound debridement followed by osteosynthesis of the articular surface. Metaphyseal fixation was by either plate fixation or Ilizarov frame. The primary outcome was the incidence of deep tissue infection requiring surgery. Secondary outcomes included the incidence of other complications (nonunion, malunion, amputation) and functional outcomes (Short Musculoskeletal Functional Assessment Questionnaire and AAOS Foot and Ankle Questionnaire). Four patients developed deep tissue infections, three in the internal fixation group and one in the Ilizarov group, and all were treated successfully with staged debridement. There were two delayed unions required bone grafting, and infection-free union was ultimately achieved in all fractures. Two patients underwent arthrodesis secondary to post-traumatic arthritis, while no patients experienced malunions or amputations. The use of staged wound debridement in conjunction with either plate fixation or Ilizarov frame achieves low rates of wound infection and stable fixation after anatomic joint reconstruction for OTA-type 43-B and 43-C open pilon fractures.

Phytoremediation in the tropics--influence of heavy crude oil on root morphological characteristics of graminoids.

PubMed

Merkl, Nicole; Schultze-Kraft, Rainer; Infante, Carmen

2005-11-01

When studying species for phytoremediation of petroleum-contaminated soils, one of the main traits is the root zone where enhanced petroleum degradation takes place. Root morphological characteristics of three tropical graminoids were studied. Specific root length (SRL), surface area, volume and average root diameter (ARD) of plants grown in crude oil-contaminated and uncontaminated soil were compared. Brachiaria brizantha and Cyperus aggregatus showed coarser roots in polluted soil compared to the control as expressed in an increased ARD. B. brizantha had a significantly larger specific root surface area in contaminated soil. Additionally, a shift of SRL and surface area per diameter class towards higher diameters was found. Oil contamination also caused a significantly smaller SRL and surface area in the finest diameter class of C. aggregatus. The root structure of Eleusine indica was not significantly affected by crude oil. Higher specific root surface area was related to higher degradation of petroleum hydrocarbons found in previous studies.

Collateral damage-free debridement using 193nm ArF laser

NASA Astrophysics Data System (ADS)

Wynne, James J.; Felsenstein, Jerome M.; Trzcinski, Robert; Zupanski-Nielsen, Donna; Connors, Daniel P.

2011-03-01

Burn eschar and other necrotic areas of the skin and soft tissue are anhydrous compared to the underlying viable tissue. A 193 nm ArF excimer laser, emitting electromagnetic radiation at 6.4 eV at fluence exceeding the ablation threshold, will debride such necrotic areas. Because such radiation is strongly absorbed by aqueous chloride ions through the nonthermal process of electron photodetachment, debridement will cease when hydrated (with chloride ions) viable tissue is exposed, avoiding collateral damage to this tissue. Such tissue will be sterile and ready for further treatment, such as a wound dressing and/or a skin graft.

Economic Spillovers From Public Investments in Medical Countermeasures: A Case Study of a Burn Debridement Product.

PubMed

Farahati, Farah; Nystrom, Scott; Howell, David R; Jaffe, Richard

2017-12-01

The US federal government invests in the development of medical countermeasures for addressing adverse health effects to the civilian population from chemical, biological, and radiological or nuclear threats. We model the potential economic spillover effects in day-to-day burn care for a federal investment in a burn debridement product for responding to an improvised nuclear device. We identify and assess 4 primary components for projecting the potential economic spillover benefits of a burn debridement product: (1) market size, (2) clinical effectiveness and cost-effectiveness, (3) product cost, and (4) market adoption rates. Primary data sources were the American Burn Association's 2015 National Burn Repository Annual Report of Data and published clinical studies used to gain European approval for the burn debridement product. The study results showed that if approved for use in the United States, the burn debridement product has potential economic spillover benefits exceeding the federal government's initial investment of $24 million a few years after introduction into the burn care market. Economic spillover analyses can help to inform the prioritizing of scarce resources for research and development of medical countermeasures by the federal government. Future federal medical countermeasure research and development investments could incorporate economic spillover analysis to assess investment options. (Disaster Med Public Health Preparedness. 2017;11:711-719).

Growth and Survival of Bagged Lucilia sericata Maggots in Wounds of Patients Undergoing Maggot Debridement Therapy.

PubMed

Cičková, Helena; Cambal, Marek; Kozánek, Milan; Takáč, Peter

2013-01-01

Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n = 52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9-19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09-9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy.

A comparative evaluation of two rotary Ni-Ti instruments in the removal of gutta-percha during retreatment.

PubMed

Preetam, C S; Chandrashekhar, M; Gunaranjan, T; Kumar, S Kishore; Miskeen Sahib, S A; Kumar, M Senthil

2016-08-01

The purpose of this study is to achieve an effective method to remove root canal filling material from the root canal system. The study, thus, aims to evaluate the efficacy of the cleaning ability of two different rotary Ni-Ti systems; ProTaper Retreatment files and RaCe System compared to hand instrumentation with Hedstrom files for the removal of gutta-percha during retreatment. Thirty mandibular premolars with one single straight canal were decoronated and instrumented with ProTaper files and filled with thermoplastic gutta-percha. After 30 days, the samples were divided into three groups and gutta-percha was removed with the test instruments. The postoperative radiographs were evaluated with known criteria by dividing the root into cervical third, middle third, and apical third. The results were tabulated and Statistical Package for Social Sciences Software (IBM Corporation) was used for analysis. The mean deviation of the results were first calculated and then t-test and analysis of variance test (two-tailed P value) were evaluated for establishing significant differences. The rotary instruments were effective in removing the gutta-percha from the canals. Therefore, significant difference was observed between the efficacies of the two rotary systems used. The rotary instruments showed effective gutta-percha removal in the cervical and middle one third. (P > 0.05). However, apical debridement was effective with Hedstrom files. The study concluded the use of both rotary and hand instrumentation for effective removal of gutta-percha for retreatment.

Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: an in vitro study.

PubMed

de Gregorio, Cesar; Estevez, Roberto; Cisneros, Rafael; Paranjpe, Avina; Cohenca, Nestor

2010-07-01

The removal of vital and necrotic pulp tissue, microorganisms, and their toxins is essential for endodontic success. However, the complex anatomy of the root canal system has limited our ability to debride it completely. Hence the purpose of this study was to evaluate the effect of currently used irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and to working length in a closed system. One hundred single-rooted teeth were used in this study. A total of 600 simulated lateral canals were created, 6 in each tooth, with 2 lateral canals at 2, 4.5, and 6 mm of working length. To resemble the clinical situation, a closed system was created by coating each root with soft modeling wax. Roots were then randomly assigned to 4 experimental groups: group 1 (n = 20), Endoactivator (sonic activation); group 2 (n = 20), passive ultrasonic (PUI) activation; group 3 (n = 20), F file; group 4 (n = 20), apical negative pressure (ANP) irrigation; and control group 5 (n = 20), positive pressure irrigation. The samples were evaluated by direct observation of the images recorded under the dental operating microscope. The results demonstrated that the ANP irrigation group was superior at reaching working length, and PUI was the most effective at lateral canal penetration. The ANP irrigation system demonstrated limited activation of the irrigant into lateral canals but reached the working length significantly more than the other groups tested. In contrast, PUI group demonstrated significantly more penetration of irrigant into lateral canals but not up to the working length. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Establishing Apical Patency: To be or not to be?

PubMed

Mohammadi, Zahed; Jafarzadeh, Hamid; Shalavi, Sousan; Kinoshita, Jun-Ichiro

2017-04-01

The apical portion of the root canal is very complex and challenging during endodontic treatment. Root canal preparation and obturation to the apical constriction may provide the best prognosis. Incomplete debridement, foramen transportation, and inadequate seal in the apical portion are considered to be responsible for treatment failure. The technique "apical patency" is considered as a way for maintaining the apical part the free of the debris by recapitulation, using a small K-file through the area of the apical foramen. This term was firstly proposed by Buchanan. In this technique, the smallest diameter file is set 1 mm longer than working length and recapitulated after each instrument to prevent packing of debris in the apical part. Apical patency has been found to be effective in achieving an apical seal with gutta-percha. Teeth prepared with a step back method and with maintained apical patency may show less leakage when obturated with cold lateral condensation technique. Data regarding the effect of apical patency on the healing of periapical tissue are very scarce, and it has been shown that the patency file has detrimental effect on the healing of periapical tissues in animal studies. However, using patency file in endodontic treatment is controversial and further studies are needed. The purpose of this article is to review the effect of using a patency file on the extrusion of root canal contents, the apical seal, postoperative pain, and healing of periapical tissues. Furthermore, the effect of establishing patency on reaching irrigation solutions to the apical portion of the canal and prognosis of root canal treatment are discussed. Keywords: Apical patency, Apical seal, Apical transportation, Postoperative pain, Prognosis.

Root surface removal and resultant surface texture with diamond-coated ultrasonic inserts: an in vitro and SEM study.

PubMed

Vastardis, Sotirios; Yukna, Raymond A; Rice, David A; Mercante, Don

2005-05-01

A new diamond-coated ultrasonic insert has been developed for scaling and root planing, and it was evaluated in vitro for the amount of root surface removed and the roughness of the residual root surface as a result of instrumentation. 48 extracted single-rooted human teeth were ground flat on one root surface and mounted (flat side up) in PVC rings of standard height and diameter with improved dental stone. Each tooth surface was treated with either a plain ultrasonic insert (PI), an ultrasonic insert with a fine grit diamond coating (DI) or sharp Gracey curettes (HI). The mounted teeth were attached to a stepper motor which drove the teeth in a horizontal, reciprocal motion at a constant rate. The thickness from the flattened bottom of the ring to the flattened tooth surface was measured before and after 10, 20, and 30 instrumentation strokes for each root surface with each of the experimental instruments. A number of treated teeth were randomly selected for examination with SEM and a profilometer. Statistical analysis (analysis of co-variance) was performed to compare the amounts of tooth structure removed among the 3 instruments and t-test was used to compare the roughness of the treated root surfaces. The mean depth of root structure removed was PI 10.7 microm, HI 15.0 microm, and DI 46.2 microm after 10 strokes; and PI 21.6 microm, HI 33.2 and DI 142.0 microm after 30 strokes, respectively. On average, 0.9 microm, 1.3 microm, and 4.7 microm of root surface was removed with each stroke of PI, HI and DI, respectively. PI and HI were not different from each other for all the stroke cycles, while DI was significantly different from PI and HI for all the stroke cycles (p<0.0001). Analysis with the profilometer showed that the smoothest surface was produced by the PI followed by the HI. The DI produced a surface that was significantly rougher than the surface produced by the PI or HI. These results suggest that diamond-coated ultrasonic instruments will effectively plane roots, and that caution should be used during periodontal root planing procedures. Additionally, the diamond-coated instruments will produce a rougher surface than the plain inserts or the hand curettes.

Optimal partitioning theory revisited: nonstructural carbohydrates dominate root mass responses to nitrogen.

PubMed

Kobe, Richard K; Iyer, Meera; Walters, Michael B

2010-01-01

Under optimal partitioning theory (OPT), plants preferentially allocate biomass to acquire the resource that most limits growth. Within this framework, higher root mass under low nutrients is often assumed to reflect an allocation response to build more absorptive surface. However, higher root mass also could result from increased storage of total nonstructural carbohydrates (TNC) without an increase in non-storage mass or root surface area. To test the relative contributions of TNC and non-storage mass as components of root mass responses to resources, we grew seedlings of seven northern hardwood tree species (black, red, and white oak, sugar and red maple, American beech, and black cherry) in a factorial light x nitrogen (N) greenhouse experiment. Because root mass is a coarse metric of absorptive surface, we also examined treatment effects on fine-root surface area (FRSA). Consistent with OPT, total root mass as a proportion of whole-plant mass generally was greater in low vs. high N. However, changes in root mass were influenced by TNC mass in all seven species and were especially strong in the three oak species. In contrast, non-storage mass contributed to increased total root mass under low N in three of the seven species. Root morphology also responded, with higher fine-root surface area (normalized to root mass) under low vs. high N in four species. Although biomass partitioning responses to resources were consistent with OPT, our results challenge the implicit assumption that increases in root mass under low nutrient levels primarily reflect allocation shifts to build more root surface area. Rather, root responses to low N included increases in: TNC, non-storage mass and fine-root surface area, with increases in TNC being the largest and most consistent of these responses. The greatest TNC accumulation occurred when C was abundant relative to N. Total nonstructural carbohydrates storage could provide seedlings a carbon buffer when respiratory or growth demands are not synchronized with photosynthesis, flexibility in responding to uncertain and fluctuating abiotic and biotic conditions, and increased access to soil resources by providing an energy source for mycorrhizae, decomposers in the rhizosphere, or root uptake of nutrients.

Relationship of cariogenic bacteria levels with periodontal status and root surface caries in elderly Japanese.

PubMed

Saotome, Yasuhiko; Tada, Akio; Hanada, Nobuhiro; Yoshihara, Akihiro; Uematsu, Hiroshi; Miyazaki, Hideo; Senpuku, Hidenobu

2006-12-01

The relationship of the levels of cariogenic bacterial species with periodontal status and decayed root surfaces was investigated in elderly Japanese subjects. Three hundred and sixty-eight individuals (each 75 years old) were examined for periodontal status (pocket depth, attachment loss), root surface caries and salivary levels of mutans streptococci (MS) and lactobacilli (LB). Values >4 mm of attachment loss (rAL4) and for average attachment loss (aAL) of sites measured were significantly higher in subjects with LB than those without. Multiple regression analysis also showed a correlation between aAL and rAL4 values with the presence of LB (aAL p = 0.003; rAL4 p = 0.002). Further, multiple regression analysis of interacting factors regarding decayed root surfaces showed that LB carriers had a greater incidence of decayed root surface caries (p = 0.003), while MS and LB levels were correlated to the number of decayed root surfaces (LB p = 0.010; MS p = 0.026). Our results indicate that considerable attachment loss elevates the possibility of having LB, thus increasing the risk of root surface caries. It was also found that LB and MS measurements may be useful indicators of decayed root surfaces in elderly individuals with attachment loss.

Methylene Blue-Guided Debridement as an Intraoperative Adjunct for the Surgical Treatment of Periprosthetic Joint Infection.

PubMed

Shaw, Jeremy D; Miller, Steve; Plourde, Anna; Shaw, Daniel L; Wustrack, Rosanna; Hansen, Erik N

2017-12-01

Current methods to identify infected tissue in periprosthetic joint infection (PJI) are inadequate. The purpose of this study was (1) to assess methylene blue-guided surgical debridement as a novel technique in PJI using quantitative microbiology and (2) to evaluate clinical success based on eradication of infection and infection-free survival. Sixteen total knee arthroplasty patients meeting Musculoskeletal Infection Society criteria for PJI undergoing the first stage of 2-stage exchange arthroplasty were included in this prospective study. Dilute methylene blue (0.1%) was instilled in the knee before debridement, residual dye was removed, and stained tissue was debrided. Paired tissue samples, stained and unstained, were collected from the femur, tibia, and capsule during debridement. Samples were analyzed by neutrophil count, semiquantitative culture, and quantitative polymerase chain reaction (PCR). Clinical success was a secondary outcome. The mean age was 64.0 ± 6.0 years, and follow-up was 24.4 ± 3.5 months. More bacteria were found in methylene blue-stained vs unstained tissue-based on semiquantitative culture (P = .001). PCR for staphylococcal species showed 9-fold greater bioburden in methylene blue-stained vs unstained tissue (P = .02). Tissue pathology found 53 ± 46 polymorphonuclear leukocytes per high-power field in methylene blue-stained vs 4 ± 13 in unstained tissue (P = .0001). All subjects cleared their primary infection and underwent reimplantation. At mean 2-year follow-up, 25% of patients failed secondary to new infection with a different organism. These results suggest a role for methylene blue in providing a visual index of surgical debridement in the treatment of PJI. Copyright © 2017 Elsevier Inc. All rights reserved.

Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention.

PubMed

Aboltins, Craig; Dowsey, Michelle; Peel, Trish; Lim, Wen K; Choong, Peter

2016-05-01

Patients treated for early prosthetic joint infection (PJI) with surgical debridement and prosthesis retention have a rate of successful infection eradication that is similar to patients treated with the traditional approach of prosthesis exchange. It is therefore important to consider other outcomes after prosthetic joint infection treatment that may influence management decisions, such as quality of life (QOL). Our aim was to describe infection cure rates and quality of life for patients with prosthetic joint infection treated with debridement and prosthesis retention and to determine if treatment with this approach was a risk factor for poor quality of life outcomes. Prospectively collected pre and post-arthroplasty data were available for 2,134 patients, of which PJI occurred in 41. For patients treated for prosthetic joint infection, the 2-year survival free of treatment failure was 87% (95%CI 84-89). Prosthetic joint infection cases treated with debridement and retention had a similar improvement from pre-arthroplasty to 12-months post-arthroplasty as patients without PJI in QOL according to the SF-12 survey. Prosthetic joint infection treated with debridement and retention was not a risk factor for poor quality of life on univariate or multivariate analysis. Prosthetic joint infection treated with debridement and prosthesis retention results in good cure rates and quality of life. Further studies are required that directly compare quality of life for different surgical approaches for prosthetic joint infection to better inform management decisions. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:898-902, 2016. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

The effect of ultrasonic post instrumentation on root surface temperature.

PubMed

Huttula, Andrew S; Tordik, Patricia A; Imamura, Glen; Eichmiller, Frederick C; McClanahan, Scott B

2006-11-01

This study measured root surface temperature changes when ultrasonic vibration, with and without irrigation, was applied to cemented endodontic posts. Twenty-six, extracted, single-rooted premolars were randomly divided into two groups. Root lengths were standardized, canals instrumented, obturated, and posts cemented into prepared spaces. Thermocouples were positioned at two locations on the proximal root surfaces. Samples were embedded in plaster and brought to 37 degrees C in a water bath. Posts were ultrasonically vibrated for 4 minutes while continuously measuring temperature. Two-way ANOVA compared effects of water coolant and thermocouple location on temperature change. Root surface temperatures were significantly higher (p < 0.001) when posts were instrumented dry. A trend for higher temperatures was observed at coronal thermocouples of nonirrigated teeth and at apical thermocouples of irrigated teeth (p = 0.057). Irrigation during post removal with ultrasonics had a significant impact on the temperature measured at the external root surface.

Using multimodal imaging techniques to monitor limb ischemia: a rapid noninvasive method for assessing extremity wounds

NASA Astrophysics Data System (ADS)

Luthra, Rajiv; Caruso, Joseph D.; Radowsky, Jason S.; Rodriguez, Maricela; Forsberg, Jonathan; Elster, Eric A.; Crane, Nicole J.

2013-03-01

Over 70% of military casualties resulting from the current conflicts sustain major extremity injuries. Of these the majority are caused by blasts from improvised explosive devices. The resulting injuries include traumatic amputations, open fractures, crush injuries, and acute vascular disruption. Critical tissue ischemia—the point at which ischemic tissues lose the capacity to recover—is therefore a major concern, as lack of blood flow to tissues rapidly leads to tissue deoxygenation and necrosis. If left undetected or unaddressed, a potentially salvageable limb may require more extensive debridement or, more commonly, amputation. Predicting wound outcome during the initial management of blast wounds remains a significant challenge, as wounds continue to "evolve" during the debridement process and our ability to assess wound viability remains subjectively based. Better means of identifying critical ischemia are needed. We developed a swine limb ischemia model in which two imaging modalities were combined to produce an objective and quantitative assessment of wound perfusion and tissue viability. By using 3 Charge-Coupled Device (3CCD) and Infrared (IR) cameras, both surface tissue oxygenation as well as overall limb perfusion could be depicted. We observed a change in mean 3CCD and IR values at peak ischemia and during reperfusion correlate well with clinically observed indicators for limb function and vitality. After correcting for baseline mean R-B values, the 3CCD values correlate with surface tissue oxygenation and the IR values with changes in perfusion. This study aims to not only increase fundamental understanding of the processes involved with limb ischemia and reperfusion, but also to develop tools to monitor overall limb perfusion and tissue oxygenation in a clinical setting. A rapid and objective diagnostic for extent of ischemic damage and overall limb viability could provide surgeons with a more accurate indication of tissue viability. This may help reducing the number of surgical interventions required, by aiding surgeons in identifying and demarcating areas of critical tissue ischemia, so that a more adequate debridement may be performed. This would have obvious benefits of reducing patient distress and decreasing both the overall recovery time and cost of rehabilitation.

38 CFR 4.56 - Evaluation of muscle disabilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or... findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through... missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts...

38 CFR 4.56 - Evaluation of muscle disabilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or... findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through... missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts...

38 CFR 4.56 - Evaluation of muscle disabilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or... findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through... missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts...

Immediate titanium mesh cranioplasty for treatment of post-craniotomy infections

PubMed Central

Wind, Joshua J.; Ohaegbulam, Chima; Iwamoto, Fabio M.; Black, Peter McL.; Park, John K.

2011-01-01

OBJECTIVE Post craniotomy infections have generally been treated by debridement of infected tissues, disposal of the bone flap, and delayed cranioplasty several months later to repair the resulting skull defect. Debridement followed by retention of the bone flap has also been advocated. Here we propose an alternative operative strategy for the treatment of post craniotomy infections. METHODS Two patients presenting with clinical and radiographic signs and symptoms of post craniotomy infections were treated by debridement, bone flap disposal, and immediate titanium mesh cranioplasty. The patients were subsequently administered antibiotics and their clinical courses were followed. RESULTS The patients treated in this fashion did not have recurrence of their infections during three-year follow-up periods. CONCLUSIONS Surgical debridement, bone flap disposal and immediate titanium mesh cranioplasty may be a suitable option for the treatment of post craniotomy infections. This treatment strategy facilitates the eradication of infectious sources and obviates the risks and costs associated with a second surgical procedure. PMID:22120410

Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT.

PubMed

Hentenaar, Diederik F M; De Waal, Yvonne C M; Strooker, Hans; Meijer, Henny J A; Van Winkelhoff, Arie-Jan; Raghoebar, Gerry M

2017-12-01

Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of the implant surface during surgical peri-implantitis treatment. Peri-implantitis lesions were treated with resective surgical treatment aimed at peri-implant granulation tissue removal, bone recontouring, and pocket elimination. Fifty-three implant surfaces in 28 patients were mechanically cleaned and treated with either 35% phosphoric etching gel (test group) or sterile saline (control group). Microbiological samples were obtained during surgery; clinical parameters were recorded at baseline and at 3 months after treatment. Data were analyzed using multi-variable linear regression analysis and multilevel statistics. Significant immediate reductions in total anaerobic bacterial counts on the implant surface were found in both groups. Immediate reduction was greater when phosphoric acid was used. The difference in log-transformed mean anaerobic counts between both procedures was not statistical significant (p = 0.108), but there were significantly less culture-positive implants after the decontamination procedure in the phosphoric acid group (p = 0.042). At 3 months post-surgery, 75% of the implants in the control group and 63.3% of the implants in the test group showed disease resolution. However, no significant differences in clinical and microbiological outcomes between both groups were found. The application of 35% phosphoric acid after mechanical debridement is superior to mechanical debridement combined with sterile saline rinsing for decontamination of the implant surface during surgical peri-implantitis treatment. However, phosphoric acid as implant surface decontaminant does not seem to enhance clinical outcomes on a 3-month follow-up. Netherlands National Trial Register, NTR5185 (www.trialregister.nl).

Simulating root-induced rhizosphere deformation and its effect on water flow

NASA Astrophysics Data System (ADS)

Aravena, J. E.; Ruiz, S.; Mandava, A.; Regentova, E. E.; Ghezzehei, T.; Berli, M.; Tyler, S. W.

2011-12-01

Soil structure in the rhizosphere is influenced by root activities, such as mucilage production, microbial activity and root growth. Root growth alters soil structure by moving and deforming soil aggregates, affecting water and nutrient flow from the bulk soil to the root surface. In this study, we utilized synchrotron X-ray micro-tomography (XMT) and finite element analysis to quantify the effect of root-induced compaction on water flow through the rhizosphere to the root surface. In a first step, finite element meshes of structured soil around the root were created by processing rhizosphere XMT images. Then, soil deformation by root expansion was simulated using COMSOL Multiphysics° (Version 4.2) considering the soil an elasto-plastic porous material. Finally, fluid flow simulations were carried out on the deformed mesh to quantify the effect of root-induced compaction on water flow to the root surface. We found a 31% increase in water flow from the bulk soil to the root due to a 56% increase in root diameter. Simulations also show that the increase of root-soil contact area was the dominating factor with respect to the calculated increase in water flow. Increase of inter-aggregate contacts in size and number were observed within a couple of root diameters away from the root surface. But their influence on water flow was, in this case, rather limited compared to the immediate soil-root contact.

Identification and Characterization of Novel Matrix-Derived Bioactive Peptides: A Role for Collagenase from Santyl® Ointment in Post-Debridement Wound Healing?

PubMed

Sheets, Anthony R; Demidova-Rice, Tatiana N; Shi, Lei; Ronfard, Vincent; Grover, Komel V; Herman, Ira M

2016-01-01

Debridement, the removal of diseased, nonviable tissue, is critical for clinicians to readily assess wound status and prepare the wound bed for advanced therapeutics or downstream active healing. Removing necrotic slough and eschar through surgical or mechanical methods is less specific and may be painful for patients. Enzymatic debridement agents, such as Clostridial collagenase, selectively and painlessly degrade devitalized tissue. In addition to its debriding activities, highly-purified Clostridial collagenase actively promotes healing, and our past studies reveal that extracellular matrices digested with this enzyme yield peptides that activate cellular migratory, proliferative and angiogenic responses to injury in vitro, and promote wound closure in vivo. Intriguingly, while collagenase Santyl® ointment, a sterile preparation containing Clostridial collagenases and other non-specific proteases, is a well-accepted enzymatic debridement agent, its role as an active healing entity has never been established. Based on our previous studies of pure Clostridial collagenase, we now ask whether the mixture of enzymes contained within Santyl® produces matrix-derived peptides that promote cellular injury responses in vitro and stimulate wound closure in vivo. Here, we identify novel collagen fragments, along with collagen-associated peptides derived from thrombospondin-1, multimerin-1, fibronectin, TGFβ-induced protein ig-h3 and tenascin-C, generated from Santyl® collagenase-digested human dermal capillary endothelial and fibroblastic matrices, which increase cell proliferation and angiogenic remodeling in vitro by 50-100% over controls. Using an established model of impaired healing, we further demonstrate a specific dose of collagenase from Santyl® ointment, as well as the newly-identified and chemically-synthesized ECM-derived peptides significantly increase wound re-epithelialization by 60-100% over saline-treated controls. These results not only confirm and extend our earlier studies using purified collagenase- and matrix-derived peptides to stimulate healing in vitro and in vivo, but these Santyl®-generated, matrix-derived peptides may also represent exciting new opportunities for creating advanced wound healing therapies that are enabled by enzymatic debridement and potentially go beyond debridement.

Identification and Characterization of Novel Matrix-Derived Bioactive Peptides: A Role for Collagenase from Santyl® Ointment in Post-Debridement Wound Healing?

PubMed Central

Shi, Lei; Ronfard, Vincent; Grover, Komel V.; Herman, Ira M.

2016-01-01

Debridement, the removal of diseased, nonviable tissue, is critical for clinicians to readily assess wound status and prepare the wound bed for advanced therapeutics or downstream active healing. Removing necrotic slough and eschar through surgical or mechanical methods is less specific and may be painful for patients. Enzymatic debridement agents, such as Clostridial collagenase, selectively and painlessly degrade devitalized tissue. In addition to its debriding activities, highly-purified Clostridial collagenase actively promotes healing, and our past studies reveal that extracellular matrices digested with this enzyme yield peptides that activate cellular migratory, proliferative and angiogenic responses to injury in vitro, and promote wound closure in vivo. Intriguingly, while collagenase Santyl® ointment, a sterile preparation containing Clostridial collagenases and other non-specific proteases, is a well-accepted enzymatic debridement agent, its role as an active healing entity has never been established. Based on our previous studies of pure Clostridial collagenase, we now ask whether the mixture of enzymes contained within Santyl® produces matrix-derived peptides that promote cellular injury responses in vitro and stimulate wound closure in vivo. Here, we identify novel collagen fragments, along with collagen-associated peptides derived from thrombospondin-1, multimerin-1, fibronectin, TGFβ-induced protein ig-h3 and tenascin-C, generated from Santyl® collagenase-digested human dermal capillary endothelial and fibroblastic matrices, which increase cell proliferation and angiogenic remodeling in vitro by 50–100% over controls. Using an established model of impaired healing, we further demonstrate a specific dose of collagenase from Santyl® ointment, as well as the newly-identified and chemically-synthesized ECM-derived peptides significantly increase wound re-epithelialization by 60–100% over saline-treated controls. These results not only confirm and extend our earlier studies using purified collagenase- and matrix-derived peptides to stimulate healing in vitro and in vivo, but these Santyl®-generated, matrix-derived peptides may also represent exciting new opportunities for creating advanced wound healing therapies that are enabled by enzymatic debridement and potentially go beyond debridement. PMID:27459729

[Effects of tillage practices on root spatial distribution and yield of spring wheat and pea in the dry land farming areas of central Gansu, China].

PubMed

Zhang, Ming Jun; Li, Ling Ling; Xie, Jun Hong; Peng, Zheng Kai; Ren, Jin Hu

2017-12-01

A field experiment was conducted to explore the mechanism of cultivation measures in affecting crop yield by investigating root distribution in spring wheat-pea rotation based on a long-term conservation tillage practices in a farming region of Gansu. The results showed that with the develo-pment of growth period, the total root length, root surface area of spring wheat and pea showed a consistent trend of increase after initial decrease and reached the maximum at flowering stage. Higher root distribution was found in the 0-10 cm soil layer at seedling and 10-30 cm soil layer at flowering and maturity stages in spring wheat, while in the field pea, higher root distribution was found in the 0-10 cm soil layer at seedling and maturity, and in the 10-30 cm soil layer at flowering stages. No tillage with straw mulching and plastic mulching increased the root length and root surface area. Compared with conventional tillage in spring wheat and field pea, root length increased by 35.9% to 92.6%, and root surface area increased by 43.2% to 162.4%, respectively. No tillage with straw mulching and plastic mulching optimized spring wheat and pea root system distribution, compared with conventional tillage, increased spring wheat and field pea root length and root surface area ratio at 0-10 cm depths at the seedling stage, the root distribution at deeper depths increased significantly at flowering and maturity stages, and no tillage with straw mulching increased root length and root surface area ratio by 3.3% and 9.7% respectively, in 30-80 cm soil layer at the flowering stage. The total root length, root surface area and yield had significantly positive correlation for spring wheat in each growth period, and the total root length and pea yield also had significant positive correlation. No tillage with straw mulching and plastic mulching boosted yield of spring wheat and pea by 23.4%-38.7% compared with the conventional tillage, and the water use efficiency was increased by 13.7%-28.5%. It was concluded that no-till farming and straw mulching (plastic) could increase crop root length and root surface area, optimize the spatial distribution of roots in the soil, enhance crop root layer absorption ability, so as to improve crop yield and water utilization.

Utilization Management of Orthopedic Services by Fitzsimons Army Medical Center and Evans Army Community Hospital

DTIC Science & Technology

1993-08-01

LOS Mean LOS: Total LOS: positions g FAMC-HCFA FAMC-HCFA 214 Back & Neck Proc with CC 5 4.02 51.6 42.6 213 2_11 Wound Debrid & Skin Graft ex Hand, for...Administration (HCFA) DRG Dis- CMI FAMC LO5 Mean LOS: Total LOS: posit’i Mean FAMC-HCFA FAMC-HCFA 263 Skin Graft &/ox Debrid for Skin Ulcer or Cellulitis w CC...32.0 21.4 43 468 Extensive O.R. Proc Un- Related to Principal DX 16 3.42 7.6 -5.5 -89 217 Wound Debrid & Skin Graft ex Hand, for Muscskelet & Conn

[The genotypic diversity of oral Actinomyces naeslundii of root caries in aged people].

PubMed

Guo, Bin; Yang, Fan; Jia, Yue; Xia, Qian; Zhou, Xue-Dong

2010-12-01

To investigate the genotypic diversity of Actinomyces naeslundii in aged people and the relationship between the genotypes of Actinomyces naeslundii and root caries. According to the inclusion criteria, 20 aged people with root caries and 20 without root caries were chosen into two groups for this study. Two sites were chosen in subjects with root caries: One site was the exposed sound root surface, and the other site was the root caries. In subjects without root caries the sampling site of root surface was exposed. Bacteria were cultured and then identified. Repetitive extragenic palindromic sequence-based polymerase chain reaction (REP-PCR) was used to analyze the genotypic diversity of the Actinomyces naeslundii clinic isolates. 299 strains were isolated from the groups, 156 strains were chosen to analyze, belonged to 61 different genotypes. At the site of sound root surface in the subjects with root caries, there were 57 strains with 25 different patterns. At the site of root caries and of sound root surface in subjects without caries, there were 34 strains with 25 different patterns and 65 strains with 26 different patterns respectively. There was the genotypic diversity within Actinomyces naeslundii. There was significant difference in the genotypes in every individual site. Many different genotypes of Actinomyces naeslundii concerned with occurrence of root caries.

Estimation of runoff mitigation by morphologically different cover crop root systems

NASA Astrophysics Data System (ADS)

Yu, Yang; Loiskandl, Willibald; Kaul, Hans-Peter; Himmelbauer, Margarita; Wei, Wei; Chen, Liding; Bodner, Gernot

2016-07-01

Hydrology is a major driver of biogeochemical processes underlying the distinct productivity of different biomes, including agricultural plantations. Understanding factors governing water fluxes in soil is therefore a key target for hydrological management. Our aim was to investigate changes in soil hydraulic conductivity driven by morphologically different root systems of cover crops and their impact on surface runoff. Root systems of twelve cover crop species were characterized and the corresponding hydraulic conductivity was measured by tension infiltrometry. Relations of root traits to Gardner's hydraulic conductivity function were determined and the impact on surface runoff was estimated using HYDRUS 2D. The species differed in both rooting density and root axes thickness, with legumes distinguished by coarser axes. Soil hydraulic conductivity was changed particularly in the plant row where roots are concentrated. Specific root length and median root radius were the best predictors for hydraulic conductivity changes. For an intensive rainfall simulation scenario up to 17% less rainfall was lost by surface runoff in case of the coarsely rooted legumes Melilotus officinalis and Lathyrus sativus, and the densely rooted Linum usitatissimum. Cover crops with coarse root axes and high rooting density enhance soil hydraulic conductivity and effectively reduce surface runoff. An appropriate functional root description can contribute to targeted cover crop selection for efficient runoff mitigation.

Enterostomy can decrease the mortality of patients with Fournier gangrene

PubMed Central

Li, Yan-Dong; Zhu, Wei-Fang; Qiao, Jian-Jun; Lin, Jian-Jiang

2014-01-01

AIM: To determine the significance of enterostomy in the emergency management of Fournier gangrene. METHODS: The clinical data of 51 patients (49 men and 2 women) with Fournier gangrene who were treated at our hospital over the past 12 years were retrospectively analyzed. The patients were divided into two groups according the surgical technique performed: enterostomy combined with debridement (the enterostomy group, n = 28) or debridement alone (the control group, n = 23). Patients in the enterostomy group received thorough debridement during surgery and adequate local drainage after surgery, as well as administration of broad-spectrum antibiotics. The clinical data and outcomes in both groups were analyzed. RESULTS: The surgical procedures were successful in both patient groups. In the enterostomy group, 10 (35.8%) patients required skin grafting with a total of six debridement procedures. While in the control group, six (26.1%) patients required four debridement procedures. However, this difference was not statistically significant. Following surgery, the time to normal body temperature (6 d vs 8 d, P < 0.05) and average length of hospital stay (14.3 ± 7.8 d vs 20.1 ± 8.9 d, P < 0.05) were shorter in the enterostomy group. The case fatality rate was lower in the enterostomy group than that in the control group (3.6% vs 21.7%, P < 0.05). CONCLUSION: Enterostomy can decrease the case fatality rate of patients with Fournier gangrene. PMID:24976731

Treatment Approach for Infection of Healed Fractures After Internal Fixation.

PubMed

Lawrenz, Joshua M; Frangiamore, Salvatore J; Rane, Ajinkya A; Cantrell, William Alex; Vallier, Heather A

2017-11-01

To review the efficacy of a treatment approach for patients with infection and colonized implants after open reduction and internal fixation of fractures. Retrospective case series. Level one trauma center. Twenty patients were treated for wound infection with colonized implants after open reduction and internal fixation. Surgical debridement, removal of implants, and a short postoperative oral antibiotic course. The course of patients after surgical debridement and removal of implants, including culture results, antibiotic administration, and presence of recurrent clinical infection and radiographic union. Twenty patients had clinical presentations, including skin breakdown, serous drainage, purulent drainage and/or exposed implants, most commonly of the tibia (15 of 20). Mean time from index procedure to debridement with implant removal was 19.7 months. At the time of debridement and implant removal, 18 of 20 (90%) patients had a positive intraoperative culture (16 routine cultures and 2 broth cultures). The most common bacteria were Enterobacter cloacae (5/17) and methicillin-sensitive Staphylococcus aureus (4/17). All patients had soft tissue healing without signs of recurrent infection after mean follow up of 40 months after implant removal. Surgical debridement with implant removal plus a short oral antibiotic course is effective to resolve wound infection with a colonized implant in the setting of healed fracture after internal fixation. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Debridement Techniques in Pediatric Trauma and Burn-Related Wounds

PubMed Central

Block, Lisa; King, Timothy W.; Gosain, Ankush

2015-01-01

Significance: Traumatic injuries are the leading cause of morbidity and mortality in children. The purpose of this review is to provide an overview of the initial assessment and management of traumatic and burn wounds in children. Special attention is given to wound cleansing, debridement techniques, and considerations for pain management and psychosocial support for children and families. Recent Advances: Basic and translational research over the last 5–7 years has advanced our knowledge related to the optimal care of acute pediatric traumatic and burn wounds. Data concerning methods, volume, solution and timing for irrigation of acute traumatic wounds, timing and methods of wound debridement, including hydrosurgery and plasma knife coblation, and wound dressings are presented. Additionally, data concerning the long-term psychosocial outcomes following acute injury are presented. Critical Issues: The care of pediatric trauma and burn-related wounds requires prompt assessment, pain control, cleansing, debridement, application of appropriate dressings, and close follow-up. Ideally, a knowledgeable multidisciplinary team cares for these patients. A limitation in the care of these patients is the relative paucity of data specific to the care of acute traumatic wounds in the pediatric population. Future Directions: Research is ongoing in the arenas of new debridement techniques and instruments, and in wound dressing technology. Dedicated research on these topics in the pediatric population will serve to strengthen and advance the care of pediatric patients with acute traumatic and burn wounds. PMID:26487978

Propeller flap for treatment of a poststernotomy sternal fistula: a case report.

PubMed

Corradino, Bartolo; Di Lorenzo, Sara; Hubova, Martina; Cordova, Adriana

2014-11-01

The treatment of post-operative deep sternal wound infections is a real challenge for surgeons. Conservative treatment with debridement and vacuum-assisted closure (VAC) therapy is not always successful. In the most severe and chronic cases, a surgical debridement and reconstruction of the defect is mandatory. In this report, the authors present a case of a 61-year-old female patient with a chronic cutaneous fistula in the sternal region following a median sternotomy after coronary artery bypass. The patient had already undergone treatment with antibiotics, drainage of an abscess and local debridement, but the infection continued to relapse periodically. The authors decided to treat the fistula with debridement and reconstruction with a local freestyle propeller flap mobilised from the right parasternal region. The fistula healed without any complications. There has been no relapse, and the aesthetic result is satisfactory. The scar at the donor site is acceptable with a minimum alteration to the mammary region. Sternal fistulas after medial sternotomy are difficult to treat. The treatment method of debridement followed, in certain cases, by VAC therapy is quite controversial. A surgical procedure is sometimes necessary to speed healing. Mobilisation of a freestyle propeller flap represents a less invasive surgical approach to the treatment of sternal fistulas in cases of conservative treatment failure. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A clinical evaluation of resorbable hydroxylapatite for the repair of human intra-osseous defects.

PubMed

Corsair, A

1990-01-01

One of the goals of periodontal therapy is actual hard- and soft-tissue regeneration or at least the functional repair of periodontal defects. Alloplastic materials used in the past included dense hydroxylapatite grafts which were non-resorbable and often exfoliated. A new resorbable hydroxylapatite biomaterial [OsteoGen (HA RESORB)] was used during flap surgery. After the usual initial therapy, full-thickness flaps were elevated. A through debridement of the roots and osseous defects was accomplished. The defects were measured and then filled with OsteoGen. The mean initial bone defect depth was 4.47 mm. These defects were re-evaluated by the probing of bone levels after a 4-6-month healing period. A mean of 2.26 mm of new bone fill was obtained. This represents an average fill of 51%. Seventeen of the 22 defects had 42% or more actual new bone fill. No foreign body reaction or exfoliation occurred.

Endoscopically assisted tunnel approach for minimally invasive corticotomies: a preliminary report.

PubMed

Hernández-Alfaro, Federico; Guijarro-Martínez, Raquel

2012-05-01

The dental community has expressed low acceptance of traditional corticotomy techniques for corticotomy-facilitated orthodontics. These procedures are time consuming, entail substantial postoperative morbidity and periodontal risks, and are often perceived as highly invasive. A total of 114 interdental sites were treated in nine consecutive patients. Under local anesthesia, a tunnel approach requiring one to three vertical incisions per arch (depending on the targeted teeth) was used. Piezosurgical corticotomies and elective bone augmentation procedures were performed under endoscopic assistance. Postoperative cone-beam computerized tomography evaluation was used to confirm adequate corticotomy depth. Procedures were completed in a mean time of 26 minutes. Follow-up evaluations revealed no loss of tooth vitality, no changes in periodontal probing depth, good preservation of the papillae, and no gingival recession. No evidence of crestal bone height reduction or apical root resorption was detected. The tunnel approach minimizes soft-tissue debridement and permits effective cortical cuts. The combination of piezosurgery technique with endoscopic assistance provides a quick, reliable means to design and perform these corticotomies while maximizing root integrity preservation. Moreover, the sites needing bone augmentation are selected under direct vision. Compared to traditional corticotomies, this procedure has manifest advantages in surgical time, technical complexity, patient morbidity, and periodontium preservation.

Antibiotic loaded calcium sulfate bead and pulse lavage eradicates biofilms on metal implant materials in vitro.

PubMed

Knecht, Cory S; Moley, James P; McGrath, Mary S; Granger, Jeffrey F; Stoodley, Paul; Dusane, Devendra H

2018-03-30

Pulse lavage (PL) debridement and antibiotic loaded calcium sulfate beads (CS-B) are both used for the treatment of biofilm related periprosthetic joint infection (PJI). However, the efficacy of these alone and in combination for eradicating biofilm from orthopaedic metal implant surfaces is unclear. The purpose of the study was to understand the efficacy of PL and antibiotic loaded CS-B in eradicating bacterial biofilms on 316L stainless steel (SS) alone and in combination in vitro. Biofilms of bioluminescent strains of Pseudomonas aeruginosa Xen41 and a USA300 MRSA Staphylococcus aureus SAP231 were grown on SS coupons for 3 days. The coupons were either, (i) debrided for 3 s with PL, (ii) exposed to tobramycin (TOB) and vancomycin (VAN) loaded CS-B for 24 h, or (iii) exposed to both. An untreated biofilm served as a control. The amount of biofilm was measured by bioluminescence, viable plate count and confocal microscopy using live/dead staining. PL alone reduced the CFU count of both strains of biofilms by approximately 2 orders of magnitude, from an initial cell count on metal surface of approximately 10 9 CFU/cm 2 . The antibiotic loaded CS-B caused an approximate six log reduction and the combination completely eradicated viable biofilm bacteria. Bioluminescence and confocal imaging corroborated the CFU data. While PL and antibiotic loaded CS-B both significantly reduced biofilm, the combination of two was more effective than alone in removing biofilms from SS implant surfaces. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-6, 2018. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

The effect of EDTA in attachment gain and root coverage.

PubMed

Kassab, Moawia M; Cohen, Robert E; Andreana, Sebastiano; Dentino, Andrew R

2006-06-01

Root surface biomodification using low pH agents such as citric acid and tetracycline has been proposed to enhance root coverage following connective tissue grafting. The authors hypothesized that root conditioning with neutral pH edetic acid would improve vertical recession depth, root surface coverage, pocket depth, and clinical attachment levels. Twenty teeth in 10 patients with Miller class I and II recession were treated with connective tissue grafting. The experimental sites received 24% edetic acid in sterile distilled water applied to the root surface for 2 minutes before grafting. Controls were pretreated with only sterile distilled water. Measurements were evaluated before surgery and 6 months after surgery. Analysis of variance was used to determine differences between experimental and control groups. We found significant postoperative improvements in vertical recession depth, root surface coverage, and clinical attachment levels in test and control groups, compared to postoperative data. Pocket depth differences were not significant (P<.01).

Quantitative evaluation of root canal surface roughness after filing with adaptive reciprocating and continuous rotary instruments.

PubMed

Sakhaei Manesh, Vahid; Giacomin, Paul; Stoll, Richard

2017-06-01

Obtaining clean and smooth root canal walls is the ideal clinical outcome of the cleaning and shaping stage in root canal treatment. This study compares the surface roughness of root canal surfaces instrumented with a NiTi filing system with either adaptive reciprocating (AR) or continuous rotation (CR). Root canal cleaning and shaping was carried out on the mesial canals of 24 extracted first molars roots with either AR or CR. Roots were split in half and the surface roughness of their canals was evaluated in 12 three dimensional roughness reconstructions using a scanning electron microscope. Rz (nm) values were calculated in three areas of each reconstruction and analyzed (α = 0.05). Mann-Whitney tests showed that surface roughness was significantly higher overall in the AR group (Rz = 967 ± 250 nm) compared with the CR group (Rz = 739 ± 239 nm; p = 0.044). The roughness values generally increased from apical towards the coronal third in both groups. A less aggressive finishing file or a continuous rotary system to end the cleaning and shaping stage may be beneficial to reduce roughness of the root canal surface. © 2017 Wiley Periodicals, Inc.

Transfer of radiocesium from rhizosphere soil to four cruciferous vegetables in association with a Bacillus pumilus strain and root exudation.

PubMed

Aung, Han Phyo; Mensah, Akwasi Dwira; Aye, Yi Swe; Djedidi, Salem; Oikawa, Yosei; Yokoyama, Tadashi; Suzuki, Sohzoh; Dorothea Bellingrath-Kimura, Sonoko

2016-11-01

This study was carried out to assess the effect of Bacillus pumilus on the roots of four cruciferous vegetables with different root structures in regard to enhancement of 137 Cs bioavailability in contaminated rhizosphere soil. Results revealed that B. pumilus inoculation did not enhance the plant biomass of vegetables, although it increased root volume and root surface areas of all vegetables except turnip. The pH changes due to rhizosphere acidification by B. pumilus inoculation and root exudation did not affect the bioavailability of 137 Cs. However, concentrations of 137 Cs in plant tissues and soil-to-plant transfer values increased as a result of the larger root volume and root surface area of vegetables due to inoculation. Moreover, leafy vegetables, which possessed larger root volume and root surface areas, had a higher 137 Cs transfer value than root vegetables. Copyright © 2016 Elsevier Ltd. All rights reserved.

Post space debridement in oval-shaped canals: the use of a new ultrasonic tip with oval section.

PubMed

Coniglio, Ivanovic; Carvalho, Carlos Augusto; Magni, Elisa; Cantoro, Amerigo; Ferrari, Marco

2008-06-01

This study evaluates the effect on post space debridement in oval-shaped canals of an experimental ultrasonic tip with oval section (Satelec) compared with a circular ultrasonic tip (KaVo). Thirty teeth with an oval-shaped canal were endodontically treated and obturated and then randomly divided into 3 groups (n = 10) according to the procedure used for post space debridement: Satelec tip, Largo #2 drill + KaVo file, and Largo #2 drill + water. Debris and dentin tubules were evaluated by assigning scores to scanning electron microscope post spaces images; lower scores corresponded to fewer debris and higher number of open tubules. The Satelec group showed significantly lower debris and open tubules scores than KaVo group (p < .05) and control group (p < .05), which differed significantly between each other (p < .05). Also the debris and open tubules scores in different post space regions differed significantly among the experimental groups (p < .001). The oval ultrasonic tip resulted in a better post space debridement than a circular ultrasonic tip in oval-shaped canals.

Management of civilian ballistic fractures.

PubMed

Seng, V S; Masquelet, A C

2013-12-01

The management of ballistic fractures, which are open fractures, has often been studied in wartime and has benefited from the principles of military surgery with debridement and lavage, and the use of external fixation for bone stabilization. In civilian practice, bone stabilization of these fractures is different and is not performed by external fixation. Fifteen civilian ballistic fractures, Gustilo II or IIIa, two associated with nerve damage and none with vascular damage, were reviewed. After debridement and lavage, ten internal fixations and five conservative treatments were used. No superficial or deep surgical site infection was noted. Fourteen of the 15 fractures (93%) healed without reoperation. Eleven of the 15 patients (73%) regained normal function. Ballistic fractures have a bad reputation due to their many complications, including infections. In civilian practice, the use of internal fixation is not responsible for excessive morbidity, provided debridement and lavage are performed. Civilian ballistic fractures, when they are caused by low-velocity firearms, differ from military ballistic fractures. Although the principle of surgical debridement and lavage remains the same, bone stabilization is different and is similar to conventional open fractures. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Necrotizing fasciitis after scrotum skin injury in an infant: A case report.

PubMed

Ren, Z X; Liu, C L; Zhang, Q; Xu, F; Zheng, Y N; Li, X J; Yang, J

2018-03-01

Necrotizing fasciitis (NF) is a life-threatening situation that is rare in children, especially infants, and early diagnosis is challenging. Timely identification and broad-spectrum antibiotic and supportive treatment before surgical debridement are very important for survival and may reduce scar formation. A previously healthy 4-month-old infant was admitted to our pediatric intensive care unit (PICU) with a history of fever and cough for 5 days and extreme swelling of the scrotum for one day. Necrotic-like tissue without margins appeared on his scrotum and perineum in 24 hours. NF was suspected, and the patient soon developed shock. The patient underwent surgical debridement after his condition stabilized. Pathological analysis confirmed the diagnosis of NF. Broad-spectrum antibiotic, immediate fluid resuscitation, assistant ventilation, and vasoactive drugs were administered. Surgical debridement and autologous split-thickness skin grafting were performed. The wound recovered well after 2 months. Ultrasound revealed normal testicles, and no anorectal injury was found. Close clinical monitoring and timely treatment of skin injuries in sick children are very important. Sufficient antibiotic administration and supportive treatment before surgical debridement are crucial for survival from NF.

Rigid Posterior Lumbopelvic Fixation without Formal Debridement for Pyogenic Vertebral Diskitis and Osteomyelitis Involving the Lumbosacral Junction: Technical Report.

PubMed

Mazur, Marcus D; Ravindra, Vijay M; Dailey, Andrew T; McEvoy, Sara; Schmidt, Meic H

2015-01-01

Pelvic fixation with S2-alar-iliac (S2AI) screws can increase the rigidity of a lumbosacral construct, which may promote bone healing, improve antibiotic delivery to infected tissues, and avoid L5-S1 pseudarthrosis. To describe the use of single-stage posterior fixation without debridement for the treatment of pyogenic vertebral diskitis and osteomyelitis (PVDO) at the lumbosacral junction. Technical report. We describe the management of PVDO at the lumbosacral junction in which the infection invaded the endplates, disk space, vertebrae, prevertebral soft tissues, and epidural space. Pedicle involvement precluded screw fixation at L5. Surgical management consisted of a single-stage posterior operation with rigid lumbopelvic fixation augmented with S2-alar-iliac screws and without formal debridement of the infected area, followed by long-term antibiotic treatment. At 2-year follow-up, successful fusion and eradication of the infection were achieved. PVDO at the lumbosacral junction may be treated successfully using rigid posterior-only fixation without formal debridement combined with antibiotic therapy.

Effective conservative treatment of umbilical pilonidal sinus disease: Silver nitrate? Salt?

PubMed

Sözen, Selim; Kanat, Burhan Hakan; Kanat, Zekiye; Bali, Ilhan; Polat, Yilmaz

2015-01-01

The aim of this study was to compare the three different treatment methods and investigate The effectiveness of the therapeutic effect of common salt. This retrospective study involved patients who were treated in our clinic for umbilical pilonidal sinus disease between January 2010 and December 2011. The patients were divided to three subgroups according to treatment methods. Group I: Cases treated with only local debridement and systemic antibiotic, group II: cases treated with local debridement, systemic antibiotic and silver nitrate, group 3: cases treated with debridement, systemic antibiotic and salt. In this study, 63 patients with the diagnosis of UPS were treated in our clinic. The patients were classified into three groups; group I included 20 patients, group II included 18 patients and group III included 18 patients. During 16-24 months of follow-up, 4 (20%) recurrences in group1 and 2 (11.1%) recurrences in group 2 were detected. Recurrence rate of group 3 was significantly different (5.55%) when compared to group 2. The mean period for returning to daily activities and work was 1 day for the patients. In conclusion, we suggest that pilonidal sinus cases which are not complicated by abcess and cellulitis can be treated by local removal of umbilical hairs, debridement and dressing without surgery. We conclude that application of common salt (table/ cooking salt) to umbilical pilonidal sinus with granuloma is a simple and highly effective way of treatment without any relapse and complications. Conservative treatment, Local debridement, Umblical pilonidal sinus.

Cost effectiveness of adding clostridial collagenase ointment to selective debridement in individuals with stage IV pressure ulcers.

PubMed

Carter, Marissa J; Gilligan, Adrienne M; Waycaster, Curtis R; Schaum, Kathleen; Fife, Caroline E

2017-03-01

The purpose of this study was to determine the cost effectiveness (from a payer's perspective) of adding clostridial collagenase ointment (CCO) to selective debridement compared with selective debridement alone (non-CCO) in the treatment of stage IV pressure ulcers among patients identified from the US Wound Registry. A 3-state Markov model was developed to determine costs and outcomes between the CCO and non-CCO groups over a 2-year time horizon. Outcome data were derived from a retrospective clinical study and included the proportion of pressure ulcers that were closed (epithelialized) over 2 years and the time to wound closure. Transition probabilities for the Markov states were estimated from the clinical study. In the Markov model, the clinical outcome is presented as ulcer-free weeks, which represents the time the wound is in the epithelialized state. Costs for each 4-week cycle were based on frequencies of clinic visits, debridement, and CCO application rates from the clinical study. The final model outputs were cumulative costs (in US dollars), clinical outcome (ulcer-free weeks), and incremental cost-effectiveness ratio (ICER) at 2 years. Compared with the non-CCO group, the CCO group incurred lower costs ($11,151 vs $17,596) and greater benefits (33.9 vs 16.8 ulcer-free weeks), resulting in an economically dominant ICER of -$375 per ulcer. Thus, for each additional ulcer-free week that can be gained, there is a concurrent cost savings of $375 if CCO treatment is selected. Over a 2-year period, an additional 17.2 ulcer-free weeks can be gained with concurrent cost savings of $6,445 for each patient. In this Markov model based on real-world data from the US Wound Registry, the addition of CCO to selective debridement in the treatment of pressure ulcers was economically dominant over selective debridement alone, resulting in greater benefit to the patient at lower cost.

A comparative evaluation of two rotary Ni-Ti instruments in the removal of gutta-percha during retreatment

PubMed Central

Preetam, C. S.; Chandrashekhar, M.; Gunaranjan, T.; Kumar, S. Kishore; Miskeen Sahib, S. A.; Kumar, M. Senthil

2016-01-01

Aim: The purpose of this study is to achieve an effective method to remove root canal filling material from the root canal system. The study, thus, aims to evaluate the efficacy of the cleaning ability of two different rotary Ni-Ti systems; ProTaper Retreatment files and RaCe System compared to hand instrumentation with Hedstrom files for the removal of gutta-percha during retreatment. Materials and Methods: Thirty mandibular premolars with one single straight canal were decoronated and instrumented with ProTaper files and filled with thermoplastic gutta-percha. After 30 days, the samples were divided into three groups and gutta-percha was removed with the test instruments. The postoperative radiographs were evaluated with known criteria by dividing the root into cervical third, middle third, and apical third. The results were tabulated and Statistical Package for Social Sciences Software (IBM Corporation) was used for analysis. Results: The mean deviation of the results were first calculated and then t-test and analysis of variance test (two-tailed P value) were evaluated for establishing significant differences. The rotary instruments were effective in removing the gutta-percha from the canals. Therefore, significant difference was observed between the efficacies of the two rotary systems used. The rotary instruments showed effective gutta-percha removal in the cervical and middle one third. (P > 0.05). However, apical debridement was effective with Hedstrom files. Conclusion: The study concluded the use of both rotary and hand instrumentation for effective removal of gutta-percha for retreatment. PMID:27652245

Effect of EDTA, sodium hypochlorite, and chlorhexidine gluconate with or without surface modifiers on dentin microhardness.

PubMed

Aslantas, Eda E; Buzoglu, Hatice Dogan; Altundasar, Emre; Serper, Ahmet

2014-06-01

This study aimed to evaluate the effects of root canal irrigants on the microhardness of root canal dentin in the presence and absence of surface-modifying agents. Forty-eight root halves were prepared by longitudinal splitting of the distal roots of 24 freshly extracted mandibular human third molars and embedded in autopolymerizing acrylic resin, leaving the dentin surface exposed. After polishing, the microhardness values of the untreated dentin surfaces were recorded by using Vickers tester at the mid-root level. The root halves were randomly assigned to 6 groups composed of 8 samples each and treated for 5 minutes with one of the following irrigants: 17% EDTA, REDTA, 2% chlorhexidine gluconate (CHX), 2% CHX with surface modifiers (CHX-Plus), 6% NaOCl, or 6% NaOCl with surface modifiers (Chlor-XTRA). After surface treatment, dentin microhardness values were recorded at close proximity to the initial indentation areas. Experimental data were statistically analyzed by using the t test and one-way analysis of variance, followed by Tukey honestly significant difference test at α = 0.05. EDTA, REDTA, NaOCl, and Chlor-XTRA significantly decreased the microhardness of root dentin compared with intact controls (P < .05). The addition of surface modifiers to the irrigants did not affect the microhardness of the samples. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Phenotypic variation of Pseudomonas brassicacearum as a plant root-colonization strategy.

PubMed

Achouak, Wafa; Conrod, Sandrine; Cohen, Valérie; Heulin, Thierry

2004-08-01

Pseudomonas brassicacearum was isolated as a major root-colonizing population from Arabidopsis thaliana. The strain NFM421 of P. brassicacearum undergoes phenotypic variation during A. thaliana and Brassica napus root colonization in vitro as well as in soil, resulting in different colony appearance on agar surfaces. Bacteria forming translucent colonies (phase II cells) essentially were localized at the surface of young roots and root tips, whereas wild-type cells (phase I cells) were localized at the basal part of roots. The ability of phase II cells to spread and colonize new sites on root surface correlates with over-production of flagellin as evidenced by sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of surface proteins and microsequencing. Moreover, phase II cells showed a higher ability to swim and to swarm on semisolid agar medium. Phase I and phase II cells of P. brassicacearum NFM421 were tagged genetically with green fluorescent protein and red fluorescent protein. Confocal scanning laser microscopy was used to localize phase II cells on secondary roots and root tips of A. thaliana, whereas phase I cells essentially were localized at the basal part of roots. These experiments were conducted in vitro and in soil. Phenotypic variation on plant roots is likely to be a colonization strategy that may explain the high colonization power of P. brassicacearum.

Digital photography and transparency-based methods for measuring wound surface area.

PubMed

Bhedi, Amul; Saxena, Atul K; Gadani, Ravi; Patel, Ritesh

2013-04-01

To compare and determine a credible method of measurement of wound surface area by linear, transparency, and photographic methods for monitoring progress of wound healing accurately and ascertaining whether these methods are significantly different. From April 2005 to December 2006, 40 patients (30 men, 5 women, 5 children) admitted to the surgical ward of Shree Sayaji General Hospital, Baroda, had clean as well as infected wound following trauma, debridement, pressure sore, venous ulcer, and incision and drainage. Wound surface areas were measured by these three methods (linear, transparency, and photographic methods) simultaneously on alternate days. The linear method is statistically and significantly different from transparency and photographic methods (P value <0.05), but there is no significant difference between transparency and photographic methods (P value >0.05). Photographic and transparency methods provided measurements of wound surface area with equivalent result and there was no statistically significant difference between these two methods.

Characterization of Bacterial Communities in Venous Insufficiency Wounds by Use of Conventional Culture and Molecular Diagnostic Methods▿

PubMed Central

Tuttle, Marie S.; Mostow, Eliot; Mukherjee, Pranab; Hu, Fen Z.; Melton-Kreft, Rachael; Ehrlich, Garth D.; Dowd, Scot E.; Ghannoum, Mahmoud A.

2011-01-01

Microbial infections delay wound healing, but the effect of the composition of the wound microbiome on healing parameters is unknown. To better understand bacterial communities in chronic wounds, we analyzed debridement samples from lower-extremity venous insufficiency ulcers using the following: conventional anaerobic and aerobic bacterial cultures; the Ibis T5000 universal biosensor (Abbott Molecular); and 16S 454 FLX titanium series pyrosequencing (Roche). Wound debridement samples were obtained from 10 patients monitored clinically for at least 6 months, at which point 5 of the 10 sampled wounds had healed. Pyrosequencing data revealed significantly higher bacterial abundance and diversity in wounds that had not healed at 6 months. Additionally, Actinomycetales was increased in wounds that had not healed, and Pseudomonadaceae was increased in wounds that had healed by the 6-month follow-up. Baseline wound surface area, duration, or analysis by Ibis or conventional culture did not reveal significant differences between wounds that healed after 6 months and those that did not. Thus, pyrosequencing identified distinctive baseline characteristics of wounds that did not heal by the 6-month follow-up, furthering our understanding of potentially unique microbiome characteristics of chronic wounds. PMID:21880958

The effect of root surface conditioning on smear layer removal in periodontal regeneration (a scanning electron microscopic study)

NASA Astrophysics Data System (ADS)

Fidyawati, D.; Soeroso, Y.; Masulili, S. L. C.

2017-08-01

The role of root surface conditioning treatment on smear layer removal of human teeth is affected by periodontitis in periodontal regeneration. The objective of this study is to analyze the smear layer on root surface conditioned with 2.1% minocycline HCl ointment (Periocline), and 24% EDTA gel (Prefgel). A total of 10 human teeth indicated for extraction due to chronic periodontitis were collected and root planed. The teeth were sectioned in thirds of the cervical area, providing 30 samples that were divided into three groups - minocycline ointment treatment, 24% EDTA gel treatment, and saline as a control. The samples were examined by scanning electron microscope. No significant differences in levels of smear layer were observed between the minocycline group and the EDTA group (p=0.759). However, there were significant differences in the level of smear layer after root surface treatment in the minocycline and EDTA groups, compared with the control group (p=0.00). There was a relationship between root surface conditioning treatment and smear layer levels following root planing.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miraglia, Roberto, E-mail: rmiraglia@ismett.edu; Vitulo, Patrizio, E-mail: pvitulo@ismett.edu; Maruzzelli, Luigi, E-mail: lmaruzzelli@ismett.edu

Airway stenosis is a major complication after lung transplantation that is usually managed with a combination of interventional endoscopic techniques, including endobronchial debridement, balloon dilation, and stent placement. Herein, we report a successful case of recanalization of a complete stenosis of the right middle lobe bronchus in a lung transplant patient, by using a combined percutaneous–bronchoscopic approach after the failure of endobronchial debridement.

Conservative sharp debridement: the professional and legal issues.

PubMed

Ashworth, Jenny; Chivers, Marc

2002-06-01

In recent years there has been much debate over the use of conservative sharp debridement in the treatment of certain wound types. Here it is discussed in relation to increasing the speed of wound healing in slow-to-heal wounds. The authors examine education and skill competence in relation to the professional's duty of care to patients with wounds.

Deposition of corrosion products from dowels on human dental root surfaces measured with proton microprobe technique

NASA Astrophysics Data System (ADS)

Brune, D.; Brunell, G.; Lindh, U.

1982-06-01

Distribution of copper, mercury and zinc on human teeth root surfaces adjacent to dowels of gold alloy or brass as well as dowels of brass in conjunction with an amalgam crown has been measured with a proton microprobe using PIXE techniques. Upper limits of the contents of gold and silver on the root surfaces were established. Pronounced concentration profiles of copper and zinc were observed on the root surfaces of teeth prepared with dowels of brass. The dowel of gold alloy revealed only zinc deposition. The major part of copper on the root surfaces is assumed to arise from corrosion of the dowels, and has been transported to the surface by diffusion through the dential tubuli. Zinc in the volume analysed is a constituent of dentin tissue as well as a corrosion product of the brass dowel. Part of the zinc level could also be ascribed to erosion of the zinc phosphate cement matrix. The volumes analysed were (25×25×25)μm 3. The levels of copper, mercury and zinc on the tooth root surfaces attained values up to about 200, 20 and 600 ppm, respectively.

Surface-based GPR underestimates below-stump root biomass

Treesearch

John R. Butnor; Lisa J. Samuelson; Thomas A. Stokes; Kurt H. Johnsen; Peter H. Anderson; Carlos A. Gonzalez-Benecke

2016-01-01

Aims While lateral root mass is readily detectable with ground penetrating radar (GPR), the roots beneath a tree (below-stump) and overlapping lateral roots near large trees are problematic for surface-based antennas operated in reflection mode. We sought to determine if tree size (DBH) effects GPR root detection proximal to longleaf pine (Pinus palustris Mill) and if...

SMERGE: A multi-decadal root-zone soil moisture product for CONUS

NASA Astrophysics Data System (ADS)

Crow, W. T.; Dong, J.; Tobin, K. J.; Torres, R.

2017-12-01

Multi-decadal root-zone soil moisture products are of value for a range of water resource and climate applications. The NASA-funded root-zone soil moisture merging project (SMERGE) seeks to develop such products through the optimal merging of land surface model predictions with surface soil moisture retrievals acquired from multi-sensor remote sensing products. This presentation will describe the creation and validation of a daily, multi-decadal (1979-2015), vertically-integrated (both surface to 40 cm and surface to 100 cm), 0.125-degree root-zone product over the contiguous United States (CONUS). The modeling backbone of the system is based on hourly root-zone soil moisture simulations generated by the Noah model (v3.2) operating within the North American Land Data Assimilation System (NLDAS-2). Remotely-sensed surface soil moisture retrievals are taken from the multi-sensor European Space Agency Climate Change Initiative soil moisture data set (ESA CCI SM). In particular, the talk will detail: 1) the exponential smoothing approach used to convert surface ESA CCI SM retrievals into root-zone soil moisture estimates, 2) the averaging technique applied to merge (temporally-sporadic) remotely-sensed with (continuous) NLDAS-2 land surface model estimates of root-zone soil moisture into the unified SMERGE product, and 3) the validation of the SMERGE product using long-term, ground-based soil moisture datasets available within CONUS.

Surface modification of tooth root canal after application of an X-ray opaque waveguide

NASA Astrophysics Data System (ADS)

Dostálová, T.; Jelínková, H.; Šulc, J.; Němec, M.; Koranda, P.; Bartoňová, M.; Radina, P.; Miyagi, M.; Shi, Y.-W.; Matsuura, Y.

The interest in endodontic use of dental laser systems has been increasing. With the development of thin and flexible delivery systems for various wavelengths, laser applications in endodontics may become even more desirable. The aim of this study is to check the X-ray opacity of a hollow waveguide and to observe the results after laser root canal treatment. The root canal systems of 10 molars were treated endodontically by laser. For the laser radiation source, an Er:YAG laser system generating a wavelength of 2940 nm and an Alexandrite laser system generating a wavelength of 375 nm were used. The hollow waveguide used was checked under X-ray . A root canal surface treated by laser radiation was analyzed by a scanning electron microscope (SEM). The special hollow glass waveguide used was visible in the root canal system under X-ray imaging. Surface modification of the root canal after laser treatment was not found. After conventional treatment the root canal was enlarged. The surface was covered with a smear layer. After application of both laser systems, the smear layer was removed. The resulting canal surface was found to be clean and smooth. Under SEM observation open dentinal tubules were visible. No cracks were present, nor were surface modifications observed.

Calculus removal on a root cement surface by ultrashort laser pulses

NASA Astrophysics Data System (ADS)

Kraft, Johan F.; Vestentoft, Kasper; Christensen, Bjarke H.; Løvschall, Henrik; Balling, Peter

2008-01-01

Ultrashort-pulse-laser ablation of dental calculus (tartar) and cement is performed on root surfaces. The investigation shows that the threshold fluence for ablation of calculus is a factor of two to three times smaller than that of a healthy root cement surface. This indicates that ultrashort laser pulses may provide an appropriate tool for selective removal of calculus with minimal damage to the underlying root cement. Future application of an in situ profiling technique allows convenient on-line monitoring of the ablation process.

An Overview of the use of Bromelain-Based Enzymatic Debridement (Nexobrid®) in Deep Partial & Full Thickness Burns: Appraising the Evidence.

PubMed

Loo, Yew L; Goh, Benjamin K L; Jeffery, S

2018-03-22

Recent introduction of rapid bromelain-based enzymatic debridement has been increasingly popular in its use in non-surgical debridement in deep partial and full thickness burns. We designed this study to evaluate the evidence suggested by current studies on the perceived benefits of using Nexobrid® as compared to traditional surgical standard of care (SOC) in burns wound debridement. A comprehensive search on electronic databases Pubmed, Embase and Web of Science was done to identify studies published between 1986 to 2017 involving the use of Nexobrid in deep partial and full thickness burns. Studies were evaluated for proposed benefits and categorised under supporting evidence, contradicting evidence and anecdotal opinions. 7 well designed prospective studies met the inclusion comprising of 4 randomised controlled trials. 6 proposed benefits associated with the use of Nexobrid were extracted including reduced time to complete debridement, need for surgery, area of burns excised, need for autograft, time to wound closure and improved scar quality. Most proposed benefits have strong supporting evidences with minimal anecdotal opinions from controlled trials except the proposed improvement in scar quality and reduced time to wound healing that had at least 3 refuting evidence and 1 anecdotal evidence. Incidence of pain was also evaluated and were mainly anecdotal lacking formal objective assessment or cohort study. Despite the lack of literatures available, the benefits of Nexobrid is evident in published randomised and single arm studies. Large number of studies are needed to aid further evaluating the proposed benefits of Nexobrid.

Optimizing fluence and debridement effects on cutaneous resurfacing carbon dioxide laser surgery.

PubMed

Weisberg, N K; Kuo, T; Torkian, B; Reinisch, L; Ellis, D L

1998-10-01

To develop methods to compare carbon dioxide (CO2) resurfacing lasers, fluence, and debridement effects on tissue shrinkage and histological thermal denaturation. In vitro human or in vivo porcine skin samples received up to 5 passes with scanner or short-pulsed CO2 resurfacing lasers. Fluences ranging from 2.19 to 17.58 J/cm2 (scanner) and 1.11 to 5.56 J/cm2 (short pulsed) were used to determine each laser's threshold energy for clinical effect. Variable amounts of debridement were also studied. Tissue shrinkage was evaluated by using digital photography to measure linear distance change of the treated tissue. Tissue histological studies were evaluated using quantitative computer image analysis. Fluence-independent in vitro tissue shrinkage was seen with the scanned and short-pulsed lasers above threshold fluence levels of 5.9 and 2.5 J/cm2, respectively. Histologically, fluence-independent thermal depths of damage of 77 microns (scanner) and 25 microns (pulsed) were observed. Aggressive debridement of the tissue increased the shrinkage per pass of the laser, and decreased the fluence required for the threshold effect. In vivo experiments confirmed the in vitro results, although the in vivo threshold fluence level was slightly higher and the shrinkage obtained was slightly lower per pass. Our methods allow comparison of different resurfacing lasers' acute effects. We found equivalent laser tissue effects using lower fluences than those currently accepted clinically. This suggests that the morbidity associated with CO2 laser resurfacing may be minimized by lowering levels of tissue input energy and controlling for tissue debridement.

The use of systemic antibiotics in the treatment of refractory periodontitis: A systematic review.

PubMed

Santos, Rayane S; Macedo, Rodrigo F; Souza, Emmanuel A; Soares, Renata S C; Feitosa, Daniela S; Sarmento, Carlos F M

2016-07-01

The goal in treating refractory periodontitis (RP) is to arrest or slow disease progression, which usually has included the use of systemic antibiotics adjunct to conventional mechanical debridement. The aim of this systematic review was to evaluate the evidence that the association of systemic antibiotics with conventional mechanical debridement increases the efficacy of periodontal therapy in the treatment of RP. The authors searched for studies in PubMed MEDLINE, Cochrane Central Register of Controlled Trials, Thomson Reuters Web of Science, Scopus, Latin American and Caribbean Center on Health Sciences Information, and Scientific Electronic Library Online electronic databases by using selected key words from the earliest records up through October 31, 2014. Only clinical intervention studies in which investigators compared the treatment of participants with RP with either mechanical debridement alone or associated with systemic antibiotics were eligible for selection. Two authors independently assessed the risk of bias of each selected study. The authors identified 13 articles and included 6 of them. Investigators in all studies reported greater reductions in probing depth or in loss of clinical attachment level after adjunct systemic antibiotic therapy when compared with mechanical debridement alone. Antibiotics tested included metronidazole, clindamycin, tetracycline hydrochloride, amoxicillin, and amoxicillin and potassium clavulanate. Five studies presented a high risk of bias, and 1 study presented an unclear risk. The overall quality of the evidence does not allow the conclusion that adjunct systemic antibiotics are of additional benefit to conventional mechanical debridement alone. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Safety and efficacy of active Leptospermum honey in neonatal and paediatric wound debridement.

PubMed

Amaya, R

2015-03-01

Safety is a critically important factor in the selection of products used in neonatal and paediatric wound care. Given the lack of standardisation of neonatal and paediatric wound care protocols, the goal of this study was to present data on the safety and efficacy of active Leptospermum honey (ALH) in this patient population. A multicentre, retrospective chart review was conducted at eight inpatient facilities and one outpatient clinic between October 2011 and March 2014. The number of applications of ALH, adverse events, and the success of debridement and wound healing were recorded. Data were collected on 115 neonatal and paediatric patients, with 121 wounds requiring debridement, treated with ALH. Patients were treated for an average of 18.7 days. ALH was well tolerated, with two (1.7%) patients reporting adverse events involving a transient stinging sensation on application, which did not prohibit additional applications of ALH. Successful debridement was achieved in 86.0% (104 wounds), and 77.7% (94 wounds) were successfully closed using nonsurgical intervention. Outcomes in neonates were similar to the overall paediatric population, with 86.1% (31/36) wounds successfully debrided with no adverse events. In a subset of six patients with available pre- and post-treatment data, no clinically meaningful changes in white blood cell counts or glucose levels were associated with the initiation of treatment with ALH. The results of this study support ALH as a safe and effective treatment option in this group of patients. This study was supported by a grant from Derma Sciences (Princeton, NJ USA). Dr Amaya is a paid speaker for Derma Sciences.

Role of Subsurface Physics in the Assimilation of Surface Soil Moisture Observations

NASA Technical Reports Server (NTRS)

Reichle, R. H.

2010-01-01

Root zone soil moisture controls the land-atmosphere exchange of water and energy and exhibits memory that may be useful for climate prediction at monthly scales. Assimilation of satellite-based surface soil moisture observations into a land surface model is an effective way to estimate large-scale root zone soil moisture. The propagation of surface information into deeper soil layers depends on the model-specific representation of subsurface physics that is used in the assimilation system. In a suite of experiments we assimilate synthetic surface soil moisture observations into four different models (Catchment, Mosaic, Noah and CLM) using the Ensemble Kalman Filter. We demonstrate that identical twin experiments significantly overestimate the information that can be obtained from the assimilation of surface soil moisture observations. The second key result indicates that the potential of surface soil moisture assimilation to improve root zone information is higher when the surface to root zone coupling is stronger. Our experiments also suggest that (faced with unknown true subsurface physics) overestimating surface to root zone coupling in the assimilation system provides more robust skill improvements in the root zone compared with underestimating the coupling. When CLM is excluded from the analysis, the skill improvements from using models with different vertical coupling strengths are comparable for different subsurface truths. Finally, the skill improvements through assimilation were found to be sensitive to the regional climate and soil types.

Ultramorphology of the root surface subsequent to hand-ultrasonic simultaneous instrumentation during non-surgical periodontal treatments. An in vitro study

PubMed Central

D. ASPRIELLO, Simone; PIEMONTESE, Matteo; LEVRINI, Luca; SAURO, Salvatore

2011-01-01

Objective The purpose of this study was to investigate the ultramorphology of the root surfaces induced by mechanical instrumentation performed using conventional curettes or piezoelectric scalers when used single-handedly or with a combined technique. Material and Methods Thirty single-rooted teeth were selected and divided into 3 groups: Group A, instrumentation with curettes; Group B instrumentation with titanium nitride coated periodontal tip mounted in a piezoelectric handpiece; Group C, combined technique with curette/ultrasonic piezoelectric instrumentation. The specimens were processed and analyzed using confocal and scanning electron microscopy. Differences between the different groups of instrumentation were determined using Pearson’s χ 2 with significance predetermined at α=0.001. Results Periodontal scaling and root planing performed with curettes, ultrasonic or combined instrumentation induced several morphological changes on the root surface. The curettes produced a compact and thick multilayered smear layer, while the morphology of the root surfaces after ultrasonic scaler treatment appeared irregular with few grooves and a thin smear layer. The combination of curette/ultrasonic instrumentation showed exposed root dentin tubules with a surface morphology characterized by the presence of very few grooves and slender remnants of smear layer which only partially covered the root dentin. In some cases, it was also possible to observe areas with exposed collagen fibrils. Conclusion The curette-ultrasonic simultaneous instrumentation may combine the beneficial effects of each instrument in a single technique creating a root surface relatively free from the physical barrier of smear layer and dentin tubules orifices partial occlusion. PMID:21437474

Effect of citric acid, tetracycline, and doxycycline on instrumented periodontally involved root surfaces: A SEM study

PubMed Central

Chahal, Gurparkash Singh; Chhina, Kamalpreet; Chhabra, Vipin; Bhatnagar, Rakhi; Chahal, Amna

2014-01-01

Background: A surface smear layer consisting of organic and inorganic material is formed on the root surface following mechanical instrumentation and may inhibit the formation of new connective tissue attachment to the root surface. Modification of the tooth surface by root conditioning has resulted in improved connective tissue attachment and has advanced the goal of reconstructive periodontal treatment. Aim: The aim of this study was to compare the effects of citric acid, tetracycline, and doxycycline on the instrumented periodontally involved root surfaces in vitro using a scanning electron microscope. Settings and Design: A total of 45 dentin samples obtained from 15 extracted, scaled, and root planed teeth were divided into three groups. Materials and Methods: The root conditioning agents were applied with cotton pellets using the Passive burnishing technique for 5 minutes. The samples were then examined by the scanning electron microscope. Statistical Analysis Used: The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 15.0 for Windows). For all quantitative variables means and standard deviations were calculated and compared. For more than two groups ANOVA was applied. For multiple comparisons post hoc tests with Bonferroni correction was used. Results: Upon statistical analysis the root conditioning agents used in this study were found to be effective in removing the smear layer, uncovering and widening the dentin tubules and unmasking the dentin collagen matrix. Conclusion: Tetracycline HCl was found to be the best root conditioner among the three agents used. PMID:24744541

Clinical evaluation of demineralization and remineralization of intact root surface lesions in the clinic by a quantitative light-induced fluorescence system.

PubMed

Durmusoglu, Oykü; Tağtekin, Dilek Arslantunali; Yanikoğlu, Funda

2012-03-01

Detection of demineralization of root surface caries is an important issue since preventive approaches prolong tooth life. Quantitative light-induced fluorescence (QLF) has been shown to be useful for the laboratory assessment of demineralization of root surfaces. The aim of this study was to determine the demineralization and remineralization of root surface intact and cavitated caries lesions using a QLF system as a nondestructive in vivo method. Noncavitated and demineralized root surface lesions were detected and scored using the QLF system. Oral hygiene education was given and periodontal cleaning was completed before the remineralization treatment. After obtaining baseline QLF data, the patients were informed about the remineralization treatment. Fluoride varnish was applied to the carious lesions at the baseline visit, and the patients were then reviewed after 1, 2, 3 and 4 weeks, with QLF assessment and fluoride varnish application repeated at each review. Repeated-measures ANOVA (α = 0.05) showed significant differences between ΔQ values at each visit (p < 0.001); ΔQ showed marked decreases at all the cut-off values (15, 20, 25, 30). The changes in ΔQ were not affected by the cut-off value. The ΔQ values of QLF showed differences at all visits. The QLF system was able to detect early root surface caries lesions in vivo. Bifluoride 12 varnish improved mineral levels as shown by the QLF system. The treatment response to chemicals of intact noncavitated root surface carious lesions could be followed nondestructively in the clinic using QLF to quantify remineralization at recall visits. Teeth with root surface caries can be kept by controlling their remineralization.

In Vitro Evaluation and Mechanism Analysis of the Fiber Shedding Property of Textile Pile Debridement Materials

PubMed Central

Fu, Yijun; Xie, Qixue; Lao, Jihong; Wang, Lu

2016-01-01

Fiber shedding is a critical problem in biomedical textile debridement materials, which leads to infection and impairs wound healing. In this work, single fiber pull-out test was proposed as an in vitro evaluation for the fiber shedding property of a textile pile debridement material. Samples with different structural design (pile densities, numbers of ground yarns and coating times) were prepared and estimated under this testing method. Results show that single fiber pull-out test offers an appropriate in vitro evaluation for the fiber shedding property of textile pile debridement materials. Pull-out force for samples without back-coating exhibited a slight escalating trend with the supplement in pile density and number of ground yarn plies, while back-coating process significantly raised the single fiber pull-out force. For fiber shedding mechanism analysis, typical pull-out behavior and failure modes of the single fiber pull-out test were analyzed in detail. Three failure modes were found in this study, i.e., fiber slippage, coating point rupture and fiber breakage. In summary, to obtain samples with desirable fiber shedding property, fabric structural design, preparation process and raw materials selection should be taken into full consideration. PMID:28773428

Apical root resorption during orthodontic treatment. A prospective study using cone beam CT.

PubMed

Lund, Henrik; Gröndahl, Kerstin; Hansen, Ken; Gröndahl, Hans-Göran

2012-05-01

To investigate the incidence and severity of root resorption during orthodontic treatment by means of cone beam computed tomography (CBCT) and to explore factors affecting orthodontically induced inflammatory root resorption (OIIRR). CBCT examinations were performed on 152 patients with Class I malocclusion. All roots from incisors to first molars were assessed on two or three occasions. At treatment end, 94% of patients had ≥1 root with shortening >1 mm, and 6.6% had ≥1 tooth where it exceeded 4 mm. Among teeth, 56.3% of upper lateral incisors had root shortening >1 mm. Of upper incisors and the palatal root of upper premolars, 2.6% showed root shortenings >4 mm. Slanted surface resorptions of buccal and palatal surfaces were found in 15.1% of upper central and 11.5% of lateral incisors. Monthly root shortening was greater after 6-month control than before. Upper jaw teeth and anterior teeth were significantly associated with the degree of root shortening. Gender, root length at baseline, and treatment duration were not. Practically all patients and up to 91% of all teeth showed some degree of root shortening, but few patients and teeth had root shortenings >4 mm. Slanted root resorption was found on root surfaces that could be evaluated only by a tomographic technique. A CBCT technique can provide more valid and accurate information about root resorption.

Do root hydraulic properties change during the early vegetative stage of plant development in barley (Hordeum vulgare)?

PubMed Central

Suku, Shimi; Knipfer, Thorsten; Fricke, Wieland

2014-01-01

Background and Aims As annual crops develop, transpirational water loss increases substantially. This increase has to be matched by an increase in water uptake through the root system. The aim of this study was to assess the contributions of changes in intrinsic root hydraulic conductivity (Lp, water uptake per unit root surface area, driving force and time), driving force and root surface area to developmental increases in root water uptake. Methods Hydroponically grown barley plants were analysed during four windows of their vegetative stage of development, when they were 9–13, 14–18, 19–23 and 24–28 d old. Hydraulic conductivity was determined for individual roots (Lp) and for entire root systems (Lpr). Osmotic Lp of individual seminal and adventitious roots and osmotic Lpr of the root system were determined in exudation experiments. Hydrostatic Lp of individual roots was determined by root pressure probe analyses, and hydrostatic Lpr of the root system was derived from analyses of transpiring plants. Key Results Although osmotic and hydrostatic Lp and Lpr values increased initially during development and were correlated positively with plant transpiration rate, their overall developmental increases (about 2-fold) were small compared with increases in transpirational water loss and root surface area (about 10- to 40-fold). The water potential gradient driving water uptake in transpiring plants more than doubled during development, and potentially contributed to the increases in plant water flow. Osmotic Lpr of entire root systems and hydrostatic Lpr of transpiring plants were similar, suggesting that the main radial transport path in roots was the cell-to-cell path at all developmental stages. Conclusions Increase in the surface area of root system, and not changes in intrinsic root hydraulic properties, is the main means through which barley plants grown hydroponically sustain an increase in transpirational water loss during their vegetative development. PMID:24287810

Do root hydraulic properties change during the early vegetative stage of plant development in barley (Hordeum vulgare)?

PubMed

Suku, Shimi; Knipfer, Thorsten; Fricke, Wieland

2014-02-01

As annual crops develop, transpirational water loss increases substantially. This increase has to be matched by an increase in water uptake through the root system. The aim of this study was to assess the contributions of changes in intrinsic root hydraulic conductivity (Lp, water uptake per unit root surface area, driving force and time), driving force and root surface area to developmental increases in root water uptake. Hydroponically grown barley plants were analysed during four windows of their vegetative stage of development, when they were 9-13, 14-18, 19-23 and 24-28 d old. Hydraulic conductivity was determined for individual roots (Lp) and for entire root systems (Lp(r)). Osmotic Lp of individual seminal and adventitious roots and osmotic Lp(r) of the root system were determined in exudation experiments. Hydrostatic Lp of individual roots was determined by root pressure probe analyses, and hydrostatic Lp(r) of the root system was derived from analyses of transpiring plants. Although osmotic and hydrostatic Lp and Lp(r) values increased initially during development and were correlated positively with plant transpiration rate, their overall developmental increases (about 2-fold) were small compared with increases in transpirational water loss and root surface area (about 10- to 40-fold). The water potential gradient driving water uptake in transpiring plants more than doubled during development, and potentially contributed to the increases in plant water flow. Osmotic Lp(r) of entire root systems and hydrostatic Lp(r) of transpiring plants were similar, suggesting that the main radial transport path in roots was the cell-to-cell path at all developmental stages. Increase in the surface area of root system, and not changes in intrinsic root hydraulic properties, is the main means through which barley plants grown hydroponically sustain an increase in transpirational water loss during their vegetative development.

Effect of surface treatment of fiberglass posts on bond strength to root dentin.

PubMed

Valdivia, Andréa Dolores Correia Miranda; Novais, Veridiana Resende; Menezes, Murilo de Sousa; Roscoe, Marina Guimarães; Estrela, Carlos; Soares, Carlos José

2014-01-01

This study evaluated the influence of the surface treatments of fiberglass posts on bond strength to root dentin using push-out test. Forty bovine incisor roots were endodontically treated. The surface of the fiberglass posts (Exacto #2, Angelus) were treated using 4 different protocols (n=10): Control - 70% ethanol for 1 min; 37% phosphoric acid for 1 min; 10% hydrofluoric acid for 1 min; and 24% hydrogen peroxide for 1 min. After a silane coupling agent was applied for 1 min and all posts were cemented using self-adhesive resin cement (RelyX Unicem, 3M-ESPE). The roots were sectioned and two 1-mm-thick slices were obtained from each third: cervical, middle and apical. The specimens were subjected to the push-out test with a crosshead speed of 0.5 mm/min. Data were analyzed by repeated measures ANOVA followed by Tukey's HSD tests (=0.05). The surface treatment (p<0.001) and root third region (p=0.007) factors were significant. The retention to root canal was affected by surface treatment type. The post surface treatment with 24% hydrogen peroxide for 1 min yielded significantly higher bond strength when the fiberglass posts were cemented with RelyX Unicem.

Effect of lipid/polysaccharide ratio on surface activity of model root mucilage in its solid and liquid states

NASA Astrophysics Data System (ADS)

Chen, Fengxian; Arye, Gilboa

2016-04-01

The rhizosphere can be defined as the volume of soil around living roots, which is influenced by root activity. The biological, chemical and physical conditions that prevail in the rhizosphere are significantly different from those of the bulk soil. Plant roots can release diverse organic materials in the rhizosphere which may have different effects on its bio-chemo-physical activity. Among these exudates is the root mucilage which can play a role on the maintenance of root-soil contact, lubrication of the root tip, protection of roots from desiccation and disease, stabilization of soil micro-aggregates and the selective absorption and storage of ions. The surface activity of the root mucilage at the liquid-air interface deduced from its surface tension depression relative to water, implying on its amphiphilic nature. Consequently as the rhizosphere dry out, hydrophobic functional groups may exhibit orientation at the solid-air interface and thus, the wettability of the rhizosphere may temporarily decrease. The major fraction of the root mucilage comprise of polysaccharides and to a much lesser extent, amino acids, organic acids, and phospholipids. The most frequent polysaccharide and phospholipids detected in root mucilage are polygalacturonic acid (PGA) and Phosphatidylcholine (PC), respectively. The latter, is thought to be main cause for the surface active nature of root mucilage. Nevertheless, the role and function of root mucilage in the rhizosphere is commonly studied based on model root mucilage that comprise of only one component, where the most frequent ones are PGA or PC (or lecithin). The main objective of this study was to quantify the effect of concentration and PGA/PC ratios on the wettability of a model rhizosphere soil and the surface tension of the model root mucilage at the liquid-air interface. The PGA/PC mixtures were measured for their equilibrium and dynamic surface tension using the Wilhelmy-Plate method. Quartz sand or glass slides were coated with PGA and/or PC using the above solutions and measured for their initial advancing contact angle and dynamic one, using the capillary rise and sessile drop methods, respectively. The results of this study will be presented and their implications for the wettability of the rhizosphere will be discussed.

Morphological changes in diseased cementum layers: a scanning electron microscopy study.

PubMed

Bilgin, E; Gürgan, C A; Arpak, M Nejat; Bostanci, H S; Güven, K

2004-05-01

The aim of this study was to compare the morphological changes that occurred in root cementum layers due to periodontal disease by using scanning electron microscopy (SEM). Ninety-two periodontally hopeless teeth extracted from 29 patients were studied. Measurements of probing depth (PD) and clinical attachment loss (CAL) were taken prior to extractions. After the longitudinal fracturing process of root specimens, healthy and diseased cementum layers of roots were evaluated by SEM for the thickness of the cementum and the morphological changes in collagen fibers. The result of SEM evaluation revealed a significant ( P < 0.001) decrease in the thickness of cementum layer on the diseased root surfaces compared to the healthy surfaces. There were denser and conspicuous collagen fibers with their interfibrillar matrix in cementum layers on the healthy root surfaces compared to the diseased surfaces. Within the limits of this study, the thickness of cementum layers in diseased areas was found to be significantly less than that in the healthy areas of root surfaces. However, there exist variations in the density and visibility of cemental fibers between individuals and within the individual.

Use of Ovine-based Collagen Extracellular Matrix and Gentian Violet/Methylene Blue Antibacterial Foam Dressings to Help Improve Clinical Outcomes in Lower Extremity Wounds: A Retrospective Cohort Study.

PubMed

Lullove, Eric J

2017-04-01

Dressings that provide broad spectrum metalloprotease reduction along with inherent aspects of an extracellular matrix may contribute to improved wound healing outcomes and shorter treatment times. The author performed a retrospective case series analysis to determine the clinical outcomes of regular debridement with the use of ovine-based collagen extracellular matrix dressings and gentian violet/methylene blue polyurethane antibacterial foam dressings in treating 53 patients with 53 chronic lower extremity wounds (diabetic foot ulcers [DFUs], venous leg ulcers, and heel pressure ulcers). Patients were treated twice weekly in an outpatient clinic for the first 4 weeks and weekly thereafter until closure. Average body mass index (BMI) for the study population was 28.3, and the average patient age was 75.9 years. Mean percent wound surface area reduction at 4, 8, and 12 weeks was 38.5%, 73.3%, and 91.3%, respectively. Average time to closure for all wounds was 10.6 weeks (range, 5-24 weeks). All wounds were 100% reepithelialized by week 20 except 1 DFU that reepithelialized at week 24. The average cost of care for a single wound episode (from presentation to closure) was $2749.49. Results of this analysis showed that the healing of chronic wounds in this series could be achieved at a reasonable cost with regular debridement and a collagen matrix dressing regimen, even in patients of advanced age and above average BMI as well as in wounds that did not achieve > 40% wound surface area reduction at 4 weeks.

Limb salvage surgery.

PubMed

Kadam, Dinesh

2013-05-01

The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

The Use of a Novel Approach for the Instrumentation of a Cone-beam Computed Tomography-discernible Lateral Canal in an Unusual Maxillary Incisor: Case Report.

PubMed

Chaniotis, Antonis; Filippatos, Christos G

2017-06-01

Lateral and apical ramifications of the main root canal create potential pathways through which bacteria can spread and remain unaffected by treatment procedures. It is a challenge for the specialty to find techniques that can predictably reach, disinfect, and obturate these ramifications. Here, we report the use of a novel instrumentation approach to aid in the negotiation and management of a lateral canal discernible on cone-beam computed tomography (CBCT) in an unusual maxillary central incisor. A 23-year-old female patient was referred for evaluation and possible treatment of tooth 9. The periapical radiographic examination revealed pulp chamber obliteration, existence of a lateral lesion, and a possible complex internal root canal anatomy. The CBCT evaluation revealed the existence of a lateral lesion, a periapical lesion, an additional distopalatal canal, and a lateral canal exiting at the lateral lesion. The diagnosis of asymptomatic apical and lateral periodontitis of tooth 9 was reached. CBCT-aided access cavity preparation and scouting resulted in the successful negotiation of all canals, main and lateral. A novel instrumentation technique with precurved controlled memory files was used for the mechanical preparation of the lateral canal to a 25/04 enlargement. Obturaton of the lateral canal was achieved with a single gutta-percha cone and AH Plus Root Canal Sealer. At the 2-year follow-up, the patient was asymptomatic, and the 2-dimensional radiographic examinations revealed resolution of both the periapical and the lateral lesions. This case report describes the application of a novel instrumentation technique for the mechanical debridement of an infected lateral canal discernible on CBCT and reinforces the importance of treating the root canals as systems that possesses anatomic intricacies that need to be addressed. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic photodynamic therapy ex vivo

PubMed Central

Ng, Raymond; Singh, Fiza; Papamanou, Despoina A.; Song, Xiaoqing; Patel, Chitrang; Holewa, Colleen; Patel, Niraj; Klepac-Ceraj, Vanja; Fontana, Carla R.; Kent, Ralph; Pagonis, Tom C.; Stashenko, Philip P.; Soukos, Nikolaos S.

2010-01-01

Objective To evaluate the anti-microbial effects of photodynamic therapy (PDT) on infected human teeth ex vivo. Materials and Methods Fifty-two freshly extracted teeth with pulpal necrosis and associated periradicular radiolucencies were obtained from 34 subjects. Twenty-six teeth with 49 canals received chemomechanical debridement (CMD) with 6% NaOCl and twenty-six teeth with 52 canals received CMD plus PDT. For PDT, root canal systems were incubated with methylene blue (MB) at concentration of 50 µg/ml for 5 minutes followed by exposure to red light at 665 nm with an energy fluence of 30 J/cm2. The contents of root canals were sampled by flushing the canals at baseline and following CMD alone or CMD+PDT and were serially diluted and cultured on blood agar. Survival fractions were calculated by counting colony-forming units (CFU). Partial characterization of root canal species at baseline and following CMD alone or CMD+PDT was performed using DNA probes to a panel of 39 endodontic species in the checkerboard assay. Results The Mantel-Haenszel chi-square test for treatment effects demonstrated the better performance of CMD+PDT over CMD (P=0.026). CMD+PDT significantly reduced the frequency of positive canals relative to CMD alone (P=0.0003). Following CMD+PDT, 45 of 52 canals (86.5%) had no CFU as compared to 24 of 49 canals (49%) treated with CMD (canal flush samples). The CFU reductions were similar when teeth or canals were treated as independent entities. Post-treatment detection levels for all species were markedly lower for canals treated by CMD+PDT than were for those treated by CMD alone. Bacterial species within dentinal tubules were detected in 17/22 (77.3%) and 15/29 (51.7%) of canals in the CMD and CMD+PDT group, respectively (P= 0.034). Conclusion Data indicate that PDT significantly reduces residual bacteria within the root canal system, and that PDT, if further enhanced by technical improvements, holds substantial promise as an adjunct to CMD. PMID:21238805

In Vitro Adhesion of Streptococcus sanguinis to Dentine Root Surface After Treatment with Er:Yag Laser, Ultrasonic System, or Manual Curette

PubMed Central

Martins, Fernanda L.; Giorgetti, Ana Paula O.; de Freitas, Patrícia M.; Duarte, Poliana M.

2009-01-01

Abstract Objective: The purpose of this in vitro study was to evaluate the dentine root surface roughness and the adherence of Streptococcus sanguinis (ATCC 10556) after treatment with an ultrasonic system, Er:YAG laser, or manual curette. Background Data: Bacterial adhesion and formation of dental biofilm after scaling and root planing may be a challenge to the long-term stability of periodontal therapy. Materials and Methods: Forty flattened bovine roots were randomly assigned to one of the following groups: ultrasonic system (n = 10); Er:YAG laser (n = 10); manual curette (n = 10); or control untreated roots (n = 10). The mean surface roughness (Ra, μm) of the specimens before and after exposure to each treatment was determined using a surface profilometer. In addition, S. sanguinis was grown on the treated and untreated specimens and the amounts of retained bacteria on the surfaces were measured by culture method. Results: All treatments increased the Ra; however, the roughest surface was produced by the curettes. In addition, the specimens treated with curettes showed the highest S. sanguinis adhesion. There was a significant positive correlation between roughness values and bacterial cells counts. Conclusion: S. sanguinis adhesion was the highest on the curette-treated dentine root surfaces, which also presented the greatest surface roughness. PMID:19712018

Endoscopic Plantar Fascia Debridement for Chronic Plantar Fasciitis.

PubMed

Cottom, James M; Baker, Joseph S

2016-10-01

When conservative therapy fails for chronic plantar fasciitis, surgical intervention may be an option. Surgical techniques that maintain the integrity of the plantar fascia will have less risk of destabilizing the foot and will retain foot function. Endoscopic debridement of the plantar fascia can be performed reproducibly to reduce pain and maintain function of the foot. Copyright © 2016 Elsevier Inc. All rights reserved.

Open-to-Air Is a Viable Option for Initial Wound Care in Necrotizing Soft Tissue Infection that Allows Early Detection of Recurrence without Need for Painful Dressing Changes or Return to Operating Room.

PubMed

Yang, Derek; Davies, April; Burge, Bailey; Watkins, Phillip; Dissanaike, Sharmila

2018-01-01

The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint. An audit of wound care modalities used on adult patients with NSTI admitted to a regional burn center between January 2009 and May 2014 was performed. Patients with at least one operation were included. Those opting for palliative care were excluded. Wound care was divided into four categories: open-to-air (OTA), negative-pressure wound therapy (NPWT), packing, and ointment. Wound care, pain score, pain medication use, and number of operations were collected for the first seven days after initial debridement. Pain management was assessed by pain scores. Analgesic use was measured and compared using conversion to morphine milligram equivalents (MME). Ninety-six patients were included; 67% were men with average age of 50 years, resulting in a total of 672 days of wound care evaluated: 69 days of OTA, 127 days of NPWT, 200 days of packing, and 126 days of ointment (150 days were undocumented). Average daily pain score from all wound care modalities was 2.00. Negative pressure wound therapy had the highest reported daily pain score (2.18, p = 0.034), whereas OTA had the lowest pain score (1.63, p < 0.05). Mortality was lower in the OTA cohort but was not statistically significant; there were no other differences in long-term outcome. Leaving wounds OTA is a safe and viable option in the immediate post-debridement period of NSTI to reduce pain, while permitting frequent re-evaluation for quick recognition of disease progression and repeat operative debridement if necessary.

Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni- Ti files - An In-Vitro SEM study.

PubMed

Reddy, J M V Raghavendra; Latha, Prasanna; Gowda, Basavana; Manvikar, Varadendra; Vijayalaxmi, D Benal; Ponangi, Kalyana Chakravarthi

2014-02-01

Predictable successful endodontic therapy depends on correct diagnosis, effective cleaning, shaping and disinfection of the root canals and adequate obturation. Irrigation serves as a flush to remove debris, tissue solvent and lubricant from the canal irregularities; however these irregularities can restrict the complete debridement of root canal by mechanical instrumentation.Various types of hand and rotary instruments are used for the preparation of the root canal system to obtain debris free canals. The purpose of this study was to evaluate the amount of smear layer and debris removal on canal walls following the using of manual Nickel-Titanium (NiTi) files compared with rotary ProTaperNiTi files using a Scanning Electron Microscope in two individual groups. A comparative study consisting of 50 subjects randomized into two groups - 25 subjects in Group A (manual) and 25 subjects in Group B (rotary) was undertaken to investigate and compare the effects of smear layer and debris between manual and rotary NiTi instruments. Chi square test was used to find the significance of smear layer and debris removal in the coronal, middle and apical between Group A and Group B. Both systems of Rotary ProTaperNiTi and manual NiTi files used in the present study, did not create completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary ProTaperNiTi instruments. Rotary instruments were less time consuming when compared to manual instruments. Instrument separation was not found to be significant with both the groups. Both systems of Rotary ProTaperNiTi and manual NiTi files used did not produce completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary protaper instruments. How to cite the article: Reddy JM, Latha P, Gowda B, Manvikar V, Vijayalaxmi DB, Ponangi KC. Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni-Ti files - An In-Vitro SEM study. J Int Oral Health 2014;6(1):89-94.

To evaluate the influence of smear layer with different instruments and obturation methods on microleakage of root canal filled teeth: In vitro study.

PubMed

Likhitkar, Manoj S; Kulkarni, Shantaram V; Burande, Aravind; Solanke, Vishal; Kumar, C Sushil; Kamble, Babasaheb

2016-01-01

The success of root canal treatment depends on proper debridement, instrumentation, proper accessibility, and proper restoration. The presence of a smear layer is considered to be a significant factor. This in vitro study was conducted to assess the effect of the presence/absence of a smear layer on the microleakage of root canal filled teeth using different instruments and obturation methods. One hundred extracted mandibular premolars with closed apices and single roots were chosen and then divided into six groups, A to F, consisting of 15 teeth each. The control group included 10 teeth; 5 positive and 5 negative. The teeth were decoronated at the cementoenamel junction. Groups A, B, C, and D were instrumented with engine-driven rotary Protaper NiTi files. Groups E and F were instrumented with conventional stainless steel hand files. Groups A, C, and E were flushed with 3 ml of 17% EDTA to remove the smear layer prior to obturation. All teeth were flushed with 5.25% sodium hypochlorite solution and obturated with AH-Plus sealer with lateral condensation technique for Groups C, D, E, F and with thermoplasticized gutta-percha technique for Groups A and B. Using an electrochemical technique, leakages in the obturated canals were assessed for 45 days. The results were tabulated using Student's t-test (paired and unpaired t-test) with the Statistical Package for the Social Sciences Software Version 21 (IBM Company, New York, USA). Group A showed the lowest mean value at intervals of 10, 20, 30, and 45 days. There was no current flow in the negative controls during the test period. There was leakage in the positive controls within a few minutes of immersion. The results showed that rotary instrumentation contributed toward an exceptional preparation of root canals compared to hand instrumentation. Elimination of the smear layer enhanced the resistance to microleakage; thermoplasticized gutta-percha obturation technique produced a better seal compared to the lateral condensation technique.

Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni- Ti files - An In-Vitro SEM study

PubMed Central

Reddy, J M V Raghavendra; Latha, Prasanna; Gowda, Basavana; Manvikar, Varadendra; Vijayalaxmi, D Benal; Ponangi, Kalyana Chakravarthi

2014-01-01

Background: Predictable successful endodontic therapy depends on correct diagnosis, effective cleaning, shaping and disinfection of the root canals and adequate obturation. Irrigation serves as a flush to remove debris, tissue solvent and lubricant from the canal irregularities; however these irregularities can restrict the complete debridement of root canal by mechanical instrumentation.Various types of hand and rotary instruments are used for the preparation of the root canal system to obtain debris free canals. The purpose of this study was to evaluate the amount of smear layer and debris removal on canal walls following the using of manual Nickel-Titanium (NiTi) files compared with rotary ProTaperNiTi files using a Scanning Electron Microscope in two individual groups. Materials & Methods: A comparative study consisting of 50 subjects randomized into two groups – 25 subjects in Group A (manual) and 25 subjects in Group B (rotary) was undertaken to investigate and compare the effects of smear layer and debris between manual and rotary NiTi instruments. Chi square test was used to find the significance of smear layer and debris removal in the coronal, middle and apical between Group A and Group B. Results: Both systems of Rotary ProTaperNiTi and manual NiTi files used in the present study, did not create completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary ProTaperNiTi instruments. Rotary instruments were less time consuming when compared to manual instruments. Instrument separation was not found to be significant with both the groups. Conclusions: Both systems of Rotary ProTaperNiTi and manual NiTi files used did not produce completely clean root canals. Manual NiTi files produced significantly less smear layer and debris compared to Rotary protaper instruments. How to cite the article: Reddy JM, Latha P, Gowda B, Manvikar V, Vijayalaxmi DB, Ponangi KC. Smear layer and debris removal using manual Ni-Ti files compared with rotary Protaper Ni-Ti files - An In-Vitro SEM study. J Int Oral Health 2014;6(1):89-94. PMID:24653610

Implementing Dynamic Root Optimization in Noah-MP for Simulating Phreatophytic Root Water Uptake

NASA Astrophysics Data System (ADS)

Wang, Ping; Niu, Guo-Yue; Fang, Yuan-Hao; Wu, Run-Jian; Yu, Jing-Jie; Yuan, Guo-Fu; Pozdniakov, Sergey P.; Scott, Russell L.

2018-03-01

Widely distributed in arid and semiarid regions, phreatophytic roots extend into the saturated zone and extract water directly from groundwater. In this paper, we implemented a vegetation optimality model of root dynamics (VOM-ROOT) in the Noah land surface model with multiparameterization options (Noah-MP LSM) to model the extraction of groundwater through phreatophytic roots at a riparian site with a hyperarid climate (with precipitation of 35 mm/yr) in northwestern China. VOM-ROOT numerically describes the natural optimization of the root profile in response to changes in subsurface water conditions. The coupled Noah-MP/VOM-ROOT model substantially improves the simulation of surface energy and water fluxes, particularly during the growing season, compared to the prescribed static root profile in the default Noah-MP. In the coupled model, more roots are required to grow into the saturated zone to meet transpiration demand when the groundwater level declines over the growing season. The modeling results indicate that at the study site, the modeled annual transpiration is 472 mm, accounting for 92.3% of the total evapotranspiration. Direct root water uptake from the capillary fringe and groundwater, which is supplied by lateral groundwater flow, accounts for approximately 84% of the total transpiration. This study demonstrates the importance of implementing a dynamic root scheme in a land surface model for adequately simulating phreatophytic root water uptake and the associated latent heat flux.

Changes in root hydraulic conductivity facilitate the overall hydraulic response of rice (Oryza sativa L.) cultivars to salt and osmotic stress.

PubMed

Meng, Delong; Fricke, Wieland

2017-04-01

The aim of the present work was to assess the significance of changes in root AQP gene expression and hydraulic conductivity (Lp) in the regulation of water balance in two hydroponically-grown rice cultivars (Azucena, Bala) which differ in root morphology, stomatal regulation and aquaporin (AQP) isoform expression. Plants were exposed to NaCl (25 mM, 50 mM) and osmotic stress (5%, 10% PEG6000). Root Lp was determined for exuding root systems (osmotic forces driving water uptake; 'exudation Lp') and transpiring plants (hydrostatic forces dominating; 'transpiration-Lp'). Gene expression was analysed by qPCR. Stress treatments caused a consistent and significant decrease in plant growth, transpirational water loss, stomatal conductance, shoot-to-root surface area ratio and root Lp. Comparison of exudation-with transpiration-Lp supported a significant contribution of AQP-facilitated water flow to root water uptake. Changes in root Lp in response to treatments were correlated much stronger with root morphological characteristics, such as the number of main and lateral roots, surface area ratio of root to shoot and plant transpiration rate than with AQP gene expression. Changes in root Lp, involving AQP function, form an integral part of the plant hydraulic response to stress and facilitate changes in the root-to-shoot surface area ratio, transpiration and stomatal conductance. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Clinical Approach of High Technology Techniques for Control and Elimination of Endodontic Microbiota

PubMed Central

Chiniforush, Nasim; Pourhajibagher, Maryam; Shahabi, Sima; Bahador, Abbas

2015-01-01

The main goal in endodontic treatment is to eradicate or at least reduce intraradicular microbial population to levels that are more compatible with periapical lesions healing process. Since endodontic infections are polymicrobial in nature, intraradicular survival of endodontic microbiota and their pathogenic properties are influenced by a combination of their virulence factors. The purpose of this article is to review the endodontic microbiota and their respective virulence attributes, as well as perform a literature review of the effects of disinfection procedures in the treatment of endodontic infections to gain best practices. Conventional technique for root canal preparation includes mechanical debridement and application of antimicrobial irrigants. Recently, laser irradiation has been used to enhance the results of root canal treatment through its thermal effect. To reduce thermal side effects, laser activated irrigation (LAI) and photon induced photoacoustic streaming (PIPS) were introduced. Antimicrobial photodynamic therapy (aPDT) by photochemical reaction uses light at a specific wavelength to activate a nontoxic photosensitizer (PS) in the presence of oxygen to produce cytotoxic products. Different PSs are used in dentistry including methylene blue (MB), toluidine blue O (TBO), indocyanine green (ICG) and curcumin. Among different options, ICG could be the best choice due to its peak absorption at wavelength of 808 nm, which coincides with the commercial diode laser devices. Also, this wavelength has more penetration depth compared to other wavelengths used in aPDT. PMID:26705458

The Regulation of Growth in the Distal Elongation Zone of Maize Roots

NASA Technical Reports Server (NTRS)

Evans, Michael L.

1998-01-01

The major goals of the proposed research were 1. To develop specialized software for automated whole surface root expansion analysis and to develop technology for controlled placement of surface electrodes for analysis of relationships between root growth and root pH and electrophysiological properties. 2. To measure surface pH patterns and determine the possible role of proton flux in gravitropic sensing or response, and 3. To determine the role of auxin transport in establishment of patterns of proton flux and electrical gradients during the gravitropic response of roots with special emphasis on the role of the distal elongation zone in the early phases of the gravitropic response.

Variability of Root Traits in Spring Wheat Germplasm

PubMed Central

Narayanan, Sruthi; Mohan, Amita; Gill, Kulvinder S.; Prasad, P. V. Vara

2014-01-01

Root traits influence the amount of water and nutrient absorption, and are important for maintaining crop yield under drought conditions. The objectives of this research were to characterize variability of root traits among spring wheat genotypes and determine whether root traits are related to shoot traits (plant height, tiller number per plant, shoot dry weight, and coleoptile length), regions of origin, and market classes. Plants were grown in 150-cm columns for 61 days in a greenhouse under optimal growth conditions. Rooting depth, root dry weight, root: shoot ratio, and shoot traits were determined for 297 genotypes of the germplasm, Cultivated Wheat Collection (CWC). The remaining root traits such as total root length and surface area were measured for a subset of 30 genotypes selected based on rooting depth. Significant genetic variability was observed for root traits among spring wheat genotypes in CWC germplasm or its subset. Genotypes Sonora and Currawa were ranked high, and genotype Vandal was ranked low for most root traits. A positive relationship (R2≥0.35) was found between root and shoot dry weights within the CWC germplasm and between total root surface area and tiller number; total root surface area and shoot dry weight; and total root length and coleoptile length within the subset. No correlations were found between plant height and most root traits within the CWC germplasm or its subset. Region of origin had significant impact on rooting depth in the CWC germplasm. Wheat genotypes collected from Australia, Mediterranean, and west Asia had greater rooting depth than those from south Asia, Latin America, Mexico, and Canada. Soft wheat had greater rooting depth than hard wheat in the CWC germplasm. The genetic variability identified in this research for root traits can be exploited to improve drought tolerance and/or resource capture in wheat. PMID:24945438

Usefulness of direct W-plasty application to wound debridement for minimizing scar formation in the ED.

PubMed

Min, Jin Hong; Park, Kyung Hye; Choi, Hong Lak; Park, Jung Soo; Lee, Ji Han; Kim, Hoon; Lee, Byung Kook; Lee, Dong Hun; Lee, Taek Gu

2017-12-01

A suture line placed with the same direction as the relaxed skin tension line leads to good healing, but a suture line with over 30 degrees of angle from the relaxed skin tension line leads to longer healing time and more prominent scarring. W-plasty is widely used to change the direction of the scar or to divide it into several split scars. In this study, we applied W-plasty to patients with facial lacerations in the emergency department. From June 2012 to December 2014, 35 patients underwent simple repair or W-plasty for facial lacerations. Patients in the simple repair group underwent resection following a thermal margin, and the W-plasty group was resected within a pre-designed margin of W-shaped laceration. We assessed prognosis using the Stony Brook Scar Evaluation Scale (SBSES) after 10 days (short-term) and six months (long-term), respectively, following suture removal. Among 35 patients, 15 (42.9%) underwent simple debridement and 20 (57.1%) underwent W-plasty. In the W-plasty group, there was no difference between short-term and long-term follow-up showing high SBSES, but in the simple debridement group, long-term follow-up SBSES significantly decreased. W-plasty SBSES was higher than simple debridement at short-term as well as long-term follow-up. We experienced good results of direct W-plasty application at six-month long-term follow-up. Therefore, W-plasty application is more effective in reducing scar appearance than a simple debridement method for facial laceration patients with an angle of 30 degrees or more to the relaxed skin tension line. Copyright © 2017 Elsevier Inc. All rights reserved.

Early prosthetic hip joint infection treated with debridement, prosthesis retention and biofilm-active antibiotics: functional outcomes, quality of life and complications.

PubMed

Aboltins, C; Dowsey, M M; Peel, T; Lim, W K; Parikh, S; Stanley, P; Choong, P F

2013-07-01

Patients treated for early prosthetic joint infection (PJI) with surgical debridement, prosthesis retention and biofilm-active antibiotics, such as rifampicin or fluoroquinolones have a rate of successful infection eradication that is similar to patients treated with the traditional approach of prosthesis exchange. It is therefore important to consider other outcomes after PJI treatment that may influence management decisions, such as function, quality of life (QOL) and treatment-associated complications. To describe rates of successful treatment for patients with PJI undergoing surgical debridement, prosthesis retention and biofilm-active antibiotics and compare their functional outcomes, QOL and complication rates to patients without PJI. Nineteen patients treated for PJI after hip arthroplasty with debridement, prosthesis retention and biofilm-active antibiotics were matched to 76 controls who underwent hip arthroplasty with no infection. Cumulative survival free from treatment failure at 2 years was 88% (95% confidence interval, 59-97%). PJI cases had significant improvement from pre-arthroplasty to 12-months post-arthroplasty in function according to Harris Hip Score and QOL according to the 12-item Short Form Health Survey Physical Component Summary. There was no significant difference in the improvement between controls and cases. PJI was not a risk factor for poor function or QOL. Medical complications occurred more frequently in cases (6/19 (32%)) than controls (9/76 (12%); P = 0.04), with this difference being accounted for by drug reactions. Surgical complications were the same in the two groups. Treatment of PJI with debridement, prosthesis retention and biofilm-active antibiotics is successful, well tolerated and results in significant improvements in function and QOL, which are similar to patients without PJI. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Features and treatment of gas-forming synergistic necrotizing cellulitis: a nine-year retrospective study.

PubMed

Ling, Xiangwei; Ye, Yuanyuan; Guo, Hailei; Liu, Zhengjun; Xia, Weidong; Lin, Cai

2018-03-01

As many doctors know little about gas-forming synergistic necrotizing cellulitis, we retrospectively explored it in our study. Totally, 30 patients diagnosed with gas-forming synergistic necrotizing cellulitis between November 2006 and September 2015 were included. They were divided into two groups: open drainage group (19 patients) and aggressive debridement group (11 patients). Retrospectively analyzed data comprised demographic characteristics, APACHE II scores, pathogen culture results, bleeding amount during the operation, white blood cell count, length of hospital stay and recovery. The mortality rate was 26% in the open drainage group and 73% in the aggressive debridement group (p=0.023). There was no statistical difference in the APACHE II score before treatment between the open drainageand aggressive debridement groups (16.6±4.5 vs 18.1±7.5, p=0.511). The APACHE II score was significantly higher after treatment in the aggressive debridement group (14.2±5.8 score vs 20.1±9.1, p=0.038). There were no statistical differences in the white blood count cell before and after treatment (13.49 × 109±5.05×109 cells/L vs 17.46×109±6.94×109 cells/L, p=0.082; 10.37×109±3.54×109 cells/L vs 15.47×109 ±7.51×109 cells/L, p=0.055; respectively). The bleeding amount during the operation was significantly more in the aggressive debridement group (315±112 ml vs 105±45 ml, p<0.001. For treating gas-forming synergistic necrotizing cellulitis, performing open drainage as early as possible isthe most important procedure after admission.

Analysis of mortality in a cohort of 650 cases of bacteremic osteoarticular infections.

PubMed

Gomez-Junyent, Joan; Murillo, Oscar; Grau, Imma; Benavent, Eva; Ribera, Alba; Cabo, Xavier; Tubau, Fe; Ariza, Javier; Pallares, Roman

2018-01-31

The mortality of patients with bacteremic osteoarticular infections (B-OAIs) is poorly understood. Whether certain types of OAIs carry higher mortality or interventions like surgical debridement can improve prognosis, are unclarified questions. Retrospective analysis of a prospective cohort of patients with B-OAIs treated at a teaching hospital in Barcelona (1985-2014), analyzing mortality (30-day case-fatality rate). B-OAIs were categorized as peripheral septic arthritis or other OAIs. Factors influencing mortality were analyzed using logistic regression models. The association of surgical debridement with mortality in patients with peripheral septic arthritis was evaluated with a multivariate logistic regression model and a propensity score matching analysis. Among 650 cases of B-OAIs, mortality was 12.2% (41.8% of deaths within 7 days). Compared with other B-OAI, cases of peripheral septic arthritis were associated with higher mortality (18.6% vs 8.3%, p < 0.001). In a multiple logistic regression model, peripheral septic arthritis was an independent predictor of mortality (adjusted odds ratio [OR] 2.12; 95% CI: 1.22-3.69; p = 0.008). Cases with peripheral septic arthritis managed with surgical debridement had lower mortality than those managed without surgery (14.7% vs 33.3%; p = 0.003). Surgical debridement was associated with reduced mortality after adjusting for covariates (adjusted OR 0.23; 95% CI: 0.09-0.57; p = 0.002) and in the propensity score matching analysis (OR 0.81; 95% CI: 0.68-0.96; p = 0.014). Among patients with B-OAIs, mortality was greater in those with peripheral septic arthritis. Surgical debridement was associated with decreased mortality in cases of peripheral septic arthritis. Copyright © 2018 Elsevier Inc. All rights reserved.

Surgical pathology to describe the clinical margin of debridement of chronic wounds using a wound electronic medical record.

PubMed

Golinko, Michael S; Joffe, Renata; de Vinck, David; Chandrasekaran, Eashwar; Stojadinovic, Olivera; Barrientos, Stephan; Vukelic, Sasa; Tomic-Canic, Marjana; Brem, Harold

2009-08-01

Chronic wounds, including diabetic foot ulcers (DFU), pressure ulcers (PU), and venous ulcers (VU) result from multiple physiologic impairments. Operative debridement is a mainstay of treatment to remove nonviable tissue and to stimulate wound healing. Unlike tumor resection, however, operative wound specimens are not routinely sent for pathology. The objective of this study was to describe the pathology present in chronic wounds. Pathology reports of the skin edge and wound base from 397 initial debridements in 336 consecutive patients with chronic wounds were retrospectively reviewed. All data were entered and stored in a Wound Electronic Medical Record. Pathology data were extracted from the Wound Electronic Medical Record, coded, and quantified. Up to 15 distinct histopathologic findings across 7 tissue types were observed after review of pathology reports from chronic wounds. Specifically, the pathology of epidermis revealed hyperkeratosis: 66% in DFUs, 31% in PUs, and 29% in VUs. Dermal pathology revealed fibrosis in 49% of DFUs, 30% of PUs, and 15% of VUs. Wound bed pathology revealed necrosis in the subcutaneous tissue in 67% of DFUs, 55% of PUs, and 19% of VUs. Fibrosis was reported in between 19% and 52% of all wound types. Acute osteomyelitis was present in 39% of DFUs, 33% of PUs, and 29% of VUs. This observational study of the histopathology of initial surgical debridement of chronic wounds revealed a wide range of findings across multiple tissue levels. Although certain findings such as osteomyelitis and gangrene have been shown to directly relate to impaired wound healing and amputation, other findings require additional investigation. To rigorously define a margin of debridement, a prospective study relating histopathology and clinical outcomes such as healing rates and amputation is needed.

A Comparison of Ulnar Shortening Osteotomy Alone Versus Combined Arthroscopic Triangular Fibrocartilage Complex Debridement and Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome

PubMed Central

Song, Hyun Seok

2011-01-01

Background This study compared the results of patients treated for ulnar impaction syndrome using an ulnar shortening osteotomy (USO) alone with those treated with combined arthroscopic debridement and USO. Methods The results of 27 wrists were reviewed retrospectively. They were divided into three groups: group A (USO alone, 10 cases), group B (combined arthroscopic debridement and USO, 9 cases), and group C (arthroscopic triangular fibrocartilage complex [TFCC] debridement alone, 8 cases). The wrist function was evaluated using the modified Mayo wrist score, disabilities of the arm, shoulder and hand (DASH) score and Chun and Palmer grading system. Results The modified Mayo wrist score in groups A, B, and C was 74.5 ± 8.9, 73.9 ± 11.6, and 61.3 ± 10.2, respectively (p < 0.05). The DASH score in groups A, B, and C was 15.6 ± 11.8, 19.3 ± 11.9, and 33.2 ± 8.5, respectively (p < 0.05). The average Chun and Palmer grading score in groups A and B was 85.7 ± 8.9 and 84.7 ± 6.7, respectively. The difference in the Mayo wrist score, DASH score and Chun and Palmer grading score between group A and B was not significant (p > 0.05). Conclusions Both USO alone and combined arthroscopic TFCC debridement with USO improved the wrist function and reduced the level of pain in the patients treated for ulnar impaction syndrome. USO alone may be the preferred method of treatment in patients if the torn flap of TFCC is not unstable. PMID:21909465

Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion.

PubMed

Zhu, Guo; Jiang, Li-Yuan; Yi, Zhang; Ping, Li; Duan, Chun-Yue; Yong, Cao; Liu, Jin-Yang; Hu, Jian-Zhong

2017-11-29

Sacroiliac joint tuberculosis(SJT) is relatively uncommon, but it may cause severe sacroiliac joint destruction and functional disorder. Few studies in the literature have been presented on SJT, reports of surgical treatment for SJT are even fewer. In this study, we retrospectively reviewed surgical management of patients with severe SJT of 3 different types and proposed to reveal the clinical manifestations and features and aim to determine the efficiency and security of such surgical treatment. We reviewed 17 patients with severe SJT of 3 different types who underwent posterior open-window focal debridement and bone graft for joint fusion. Among them,five patients with anterior sacral abscess had anterior abscess curettage before debridement. Two patients with lumbar vertebral tuberculosis received one-stage posterior tuberculous debridement, interbody fusion and instrumentation. Follow-up was performed 36 months (26 to 45 months) using the following parameters: erythrocyte sedimentation rate(ESR), status of joint bony fusion on CT scan, visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Buttock pain and low back pain were progressively relieved with time. 6 months later, pain was not obvious, and ESR resumed to normal levels within 3 months. Solid fusion of the sacroiliac joint occurred within 12 months in all cases. No complications or recurrence occurred. At final follow-up, all patients had no pain or only minimal discomfort over the affected joint and almost complete functional recovery. Posterior open-window focal debridement and joint fusion is an efficient and secure surgical method to treat severe SJT. If there is an abscess in the front of the sacroiliac joint, anterior abscess curettage should be performed as a supplement.

[Algorithm of nursing procedure in debridement protocol].

PubMed

Fumić, Nera; Marinović, Marin; Brajan, Dolores

2014-10-01

Debridement is an essential act in the treatment of various wounds, which removes devitalized and colonized necrotic tissue, also poorly healing tissue and all foreign bodies from the wound, in order to enhance the formation of healthy granulation tissue and accelerate the process of wound healing. Nowadays, debridement is the basic procedure in the management of acute and chronic wounds, where the question remains which way to do it, how extensively, how often and who should perform it. Many parameters affect the decision on what method to use on debridement. It is important to consider the patient's age, environment, choice, presence of pain, quality of life, skills and resources for wound and patient care providers, and also a variety of regulations and guidelines. Irrespective of the level and setting where the care is provided (hospital patients, ambulatory or stationary, home care), care for patients suffering from some form of acute or chronic wound and requiring different interventions and a large number of frequent bandaging and wound care is most frequently provided by nurses/technicians. With timely and systematic interventions in these patients, the current and potential problems in health functioning could be minimized or eliminated in accordance with the resources. Along with daily wound toilette and bandaging, it is important to timely recognize changes in the wound status and the need of tissue debridement. Nurse/technician interventions are focused on preparation of the patient (physical, psychological, education), preparation of materials, personnel and space, assisting or performing procedures of wound care, and documenting the procedures performed. The assumption that having an experienced and competent person for wound care and a variety of methods and approaches in wound treatment is in the patient's best interest poses the need of defining common terms and developing comprehensive guidelines that will lead to universal algorithms in the field.

Temperature changes accompanying near infrared diode laser endodontic treatment of wet canals.

PubMed

Hmud, Raghad; Kahler, William A; Walsh, Laurence J

2010-05-01

Diode laser endodontic treatments such as disinfection or the generation of cavitations should not cause deleterious thermal changes in radicular dentin. This study assessed thermal changes in the root canal and on the root surface when using 940 and 980 nm lasers at settings of 4 W/10 Hz and 2.5 W/25 Hz, respectively, delivered into 2000-mum fibers to generate cavitations in water. The root surface temperature in the apical third was recorded, as was the water temperature in coronal, middle, and apical third regions, by using thermocouples placed inside the canal. Lasing was undertaken with either rest periods or rinsing between 5-second laser exposures. Both diode lasers induced only modest temperature changes on the external root surface at the settings used. Even though the temperature of the water within the canal increased during lasing by as much as 30 degrees C, the external root surface temperature increased by only a maximum of 4 degrees C. Irrigation between laser exposures was highly effective in minimizing thermal changes within the root canal and on the root surface. Diode laser parameters that induce cavitation do not result in adverse thermal changes in radicular dentin. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Extracting Metrics for Three-dimensional Root Systems: Volume and Surface Analysis from In-soil X-ray Computed Tomography Data.

PubMed

Suresh, Niraj; Stephens, Sean A; Adams, Lexor; Beck, Anthon N; McKinney, Adriana L; Varga, Tamas

2016-04-26

Plant roots play a critical role in plant-soil-microbe interactions that occur in the rhizosphere, as well as processes with important implications to climate change and crop management. Quantitative size information on roots in their native environment is invaluable for studying root growth and environmental processes involving plants. X-ray computed tomography (XCT) has been demonstrated to be an effective tool for in situ root scanning and analysis. We aimed to develop a costless and efficient tool that approximates the surface and volume of the root regardless of its shape from three-dimensional (3D) tomography data. The root structure of a Prairie dropseed (Sporobolus heterolepis) specimen was imaged using XCT. The root was reconstructed, and the primary root structure was extracted from the data using a combination of licensed and open-source software. An isosurface polygonal mesh was then created for ease of analysis. We have developed the standalone application imeshJ, generated in MATLAB(1), to calculate root volume and surface area from the mesh. The outputs of imeshJ are surface area (in mm(2)) and the volume (in mm(3)). The process, utilizing a unique combination of tools from imaging to quantitative root analysis, is described. A combination of XCT and open-source software proved to be a powerful combination to noninvasively image plant root samples, segment root data, and extract quantitative information from the 3D data. This methodology of processing 3D data should be applicable to other material/sample systems where there is connectivity between components of similar X-ray attenuation and difficulties arise with segmentation.

Adjunctive clinical effect of a water-cooled Nd:YAG laser in a periodontal maintenance care programme: a randomized controlled trial.

PubMed

Slot, Dagmar E; Timmerman, Mark F; Versteeg, Paula A; van der Velden, Ubele; van der Weijden, Fridus A

2012-12-01

Various laser systems are currently available for intra-oral use. Neodymium:Yttrium-Aluminium Garnet lasers(Nd:YAG) have been approved by the US Food and Drug Administration for soft tissue treatment in the oral cavity. The aim of this study was to test whether the use of a water-cooled Nd:YAG laser during a maintenance care programme as an adjunct to supragingival and subgingival debridement (scaling and root planing, SRP) with hand and ultrasonic instruments results in clinical improvement compared with SRP alone. This study was an examiner-blind, randomized and controlled clinical trial using a split-mouth design. Thirty subjects were selected, originally diagnosed with moderate to severe generalized periodontitis, following a periodontal maintenance care programme (PMC). Immediately after SRP in two randomly assigned contra-lateral quadrants, all pockets ≥5 mm were additionally treated with a Nd:YAG laser (1064 nm, 4W, 250-μsec pulse). Clinical assessments [probing pocket depth PPD, bleeding on pocket probing (BOPP)] were performed pre-treatment and at 6 months. Based on these assessments, the periodontal inflamed surface area (PISA) was calculated. At 6 months, the clinical parameters had significantly improved for both regimens. No statistically significant differences between treatment modalities were observed for PPD and BOPP scores at any time. PISA scores supported these findings. In residual pockets ≥5 mm, treated in a PMC, the adjunctive use of an Nd:YAG laser does not provide a clinically significant additional advantage. © 2012 John Wiley & Sons A/S.

Neural Network-Based Retrieval of Surface and Root Zone Soil Moisture using Multi-Frequency Remotely-Sensed Observations

NASA Astrophysics Data System (ADS)

Hamed Alemohammad, Seyed; Kolassa, Jana; Prigent, Catherine; Aires, Filipe; Gentine, Pierre

2017-04-01

Knowledge of root zone soil moisture is essential in studying plant's response to different stress conditions since plant photosynthetic activity and transpiration rate are constrained by the water available through their roots. Current global root zone soil moisture estimates are based on either outputs from physical models constrained by observations, or assimilation of remotely-sensed microwave-based surface soil moisture estimates with physical model outputs. However, quality of these estimates are limited by the accuracy of the model representations of physical processes (such as radiative transfer, infiltration, percolation, and evapotranspiration) as well as errors in the estimates of the surface parameters. Additionally, statistical approaches provide an alternative efficient platform to develop root zone soil moisture retrieval algorithms from remotely-sensed observations. In this study, we present a new neural network based retrieval algorithm to estimate surface and root zone soil moisture from passive microwave observations of SMAP satellite (L-band) and AMSR2 instrument (X-band). SMAP early morning observations are ideal for surface soil moisture retrieval. AMSR2 mid-night observations are used here as an indicator of plant hydraulic properties that are related to root zone soil moisture. The combined observations from SMAP and AMSR2 together with other ancillary observations including the Solar-Induced Fluorescence (SIF) estimates from GOME-2 instrument provide necessary information to estimate surface and root zone soil moisture. The algorithm is applied to observations from the first 18 months of SMAP mission and retrievals are validated against in-situ observations and other global datasets.

Effectiveness of chamomile (Matricaria recutita L.), MTAD and sodium hypochlorite irrigants on smear layer.

PubMed

Venkataram, V; Gokhale, S T; Kenchappa, M; Nagarajappa, R

2013-08-01

Endodontic success depends heavily on effective chemo-mechanical debridement of root canals through the use of instruments and irrigating solutions. To compare the effectiveness of chamomile hydroalcoholic extract, Biopure™ mixture of tetracycline isomer, acid and detergent (MTAD) and 2.5 % sodium hypochlorite (NaOCl) on removal of the smear layer. Randomised controlled trial. Thirty extracted single-rooted, primary human teeth were allocated at random into three experimental groups of 10 teeth each. For each tooth, the canal was prepared using the step-back technique. During instrumentation, 2 ml of the irrigant was used for at least 10 s after each file and 10 ml as a final flush for 2 min for chamomile and NaOCL irrigants. Whereas for MTAD, an initial rinse with 1.3 % NaOCl for a cumulated period of 20 min, and use of MTAD as the final rinse for a period of 5 min was followed. Longitudinal grooves were made on root segments, then split into two halves with a chisel, stored in 2.5 % glutaraldehyde solution and fixed in ethanol series. Specimens were examined for the smear layer according to Hulsmann et al. (Int Endod J 35:668-679, 2002) criteria using a scanning electron microscope. Kruskal-Wallis and Mann-Whitney U tests were used. The most effective result in removal of smear layer occurred with the use of MTAD, followed by chamomile extract. The chamomile extract was found to be significantly more effective than 2.5 % NaOCl solution which had only minor effects. The efficacy of chamomile to remove the smear layer was superior to 2.5 % NaOCl alone, but less effective than MTAD mixture.

SMAP Level 4 Surface and Root Zone Soil Moisture

NASA Technical Reports Server (NTRS)

Reichle, R.; De Lannoy, G.; Liu, Q.; Ardizzone, J.; Kimball, J.; Koster, R.

2017-01-01

The SMAP Level 4 soil moisture (L4_SM) product provides global estimates of surface and root zone soil moisture, along with other land surface variables and their error estimates. These estimates are obtained through assimilation of SMAP brightness temperature observations into the Goddard Earth Observing System (GEOS-5) land surface model. The L4_SM product is provided at 9 km spatial and 3-hourly temporal resolution and with about 2.5 day latency. The soil moisture and temperature estimates in the L4_SM product are validated against in situ observations. The L4_SM product meets the required target uncertainty of 0.04 m(exp. 3)m(exp. -3), measured in terms of unbiased root-mean-square-error, for both surface and root zone soil moisture.

Low-Frequency Ultrasound Debridement in Chronic Wound Healing: A Systematic Review of Current Evidence

PubMed Central

Chang, Ying-Ju Ruby; Perry, Julie

2017-01-01

Chronic wounds are painful and debilitating to patients, pose a clinical challenge to physicians, and impose financial burden on the health-care system. New treatment options are therefore highly sought after. Ultrasound debridement is a promising technology that functions to disperse bacterial biofilms and stimulate wound healing. In this review, we focus on low-frequency ultrasound (20-60 kHz) and summarize the findings of 25 recent studies examining ultrasound efficacy. Ultrasound debridement appears to be most effective when used 3 times a week and has the potential to decrease exudate and slough, decrease patient pain, disperse biofilms, and increase healing in wounds of various etiology. Although current studies are generally of smaller size, the results are promising and we recommend the testing of low-frequency ultrasound therapy in clinical practice on a larger scale. PMID:29026808

Osteochondral Autograft from the Ipsilateral Femoral Head by Surgical Dislocation for Treatment of Femoral Head Fracture Dislocation: A Case Report.

PubMed

Won, Yougun; Lee, Gi Soo; Kim, Sang Bum; Kim, Sun Joong; Yang, Kyu Hyun

2016-11-01

As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation. The osteochondral graft was harvested from the inferior non-weight-bearing articular surface and grafted to the osteochondral defect. One year later, the clinical and radiological results were good, without the collapse of the femoral head or arthritic change. This procedure introduced in our case is considered convenient and able to lessen surgical time without morbidity of the donor site associated with the harvest.

Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste.

PubMed

Horváth, Attila; Stavropoulos, Andreas; Windisch, Péter; Lukács, László; Gera, István; Sculean, Anton

2013-03-01

The aim of the study was to clinically and histologically evaluate the healing of human intrabony defects treated with open flap surgery (OFD) and application of a new, resorbable, fully synthetic, unsintered, nanocrystalline, phase-pure hydroxyapatite (nano-HA). Six patients, each of them displaying very advanced intrabony defects around teeth scheduled for extraction due to advanced chronic periodontitis and further prosthodontic considerations, were included in the study. Following local anaesthesia, mucoperiosteal flaps were reflected; the granulation tissue was removed, and the roots were meticulously debrided by hand and ultrasonic instruments. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) in order to serve as a reference for the histological evaluation. Following defect fill with nano-HA, the flaps were sutured by means of mattress sutures to allow primary intention healing. At 7 months after regenerative surgery, the teeth were extracted together with some of their surrounding soft and hard tissues and processed for histological analysis. The postoperative healing was uneventful in all cases. At 7 months following surgery, mean PPD reduction and mean CAL gain measured 4.0 ± 0.8 and 2.5 ± 0.8 mm, respectively. The histological analysis revealed a healing predominantly characterized by epithelial downgrowth. Limited formation of new cementum with inserting connective tissue fibers and bone regeneration occurred in three out of the six biopsies (i.e. 0-0.86 and 0-1.33 mm, respectively). Complete resorption of the nano-HA was found in four out of the six biopsies. A few remnants of the graft particles (either surrounded by newly formed mineralized tissue or encapsulated in connective tissue) were found in two out of the six biopsies. Within their limits, the present results indicate that nano-HA has limited potential to promote periodontal regeneration in human intrabony defects. The clinical outcomes obtained following surgery with OFD + nano-HA may not reflect true periodontal regeneration.

A comparison of root surface temperatures using different obturation heat sources.

PubMed

Lee, F S; Van Cura, J E; BeGole, E

1998-09-01

This study compared root surface temperatures produced during warm vertical obturation using the System B Heat Source (SB), the Touch 'n Heat device (TH), and a flame-heated carrier (FH). The root canals of 30 maxillary incisor, premolar, and mandibular incisor teeth were prepared; divided into three groups; and obturated using each heat source. A thermocouple placed 2 mm below the cementoenamel junction transferred the temperature rise on the external root surface to a digital thermometer. SB surface temperature rise was < 10 degrees C for all experimental teeth. TH temperature rise in maxillary incisors and premolars was < 10 degrees C; however, > 10 degrees C was observed for mandibular incisors. FH produced a > 10 degrees C surface temperature rise in all experimental teeth. The critical level of root surface heat required to produce irreversible bone damage is believed to be > 10 degrees C. The findings of this study suggest that warm vertical condensation with the SB should not damage supporting periradicular tissues. However, caution should be used with TH and FH on mandibular incisors.

Quantifying root water extraction after drought recovery using sub-mm in situ empirical data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dhiman, Indu; Bilheux, Hassina Z.; DeCarlo, Keito F.

Root-specific responses to stress are not well-known, and have been largely based on indirect measurements of bulk soil water extraction, which limits mechanistic modeling of root function. Here, we used neutron radiography to examine in situ root-soil water dynamics of a previously droughted black cottonwood ( Populus trichocarpa) seedling, contrasting water uptake by younger, thinner or older, thicker parts of the fine root system. The smaller diameter roots had greater water uptake capacity per unit surface area than the larger diameter roots, but they had less total surface area leading to less total water extraction; rates ranged from 0.0027 –more » 0.0116 g cm -2 hr -1. The finest most-active roots were not visible in the radiographs, indicating the need to include destructive sampling. Analysis based on bulk soil hydraulic properties indicated substantial redistribution of water via saturated/unsaturated flow, capillary wicking, and root hydraulic redistribution across the layers - suggesting water uptake dynamics following an infiltration event may be more complex than approximated by common soil hydraulic or root surface area modeling approaches. Lastly, our results highlight the need for continued exploration of root-trait specific water uptake rates in situ, and impacts of roots on soil hydraulic properties – both critical components for mechanistic modeling of root function.« less

Quantifying root water extraction after drought recovery using sub-mm in situ empirical data

DOE PAGES

Dhiman, Indu; Bilheux, Hassina Z.; DeCarlo, Keito F.; ...

2017-09-09

Root-specific responses to stress are not well-known, and have been largely based on indirect measurements of bulk soil water extraction, which limits mechanistic modeling of root function. Here, we used neutron radiography to examine in situ root-soil water dynamics of a previously droughted black cottonwood ( Populus trichocarpa) seedling, contrasting water uptake by younger, thinner or older, thicker parts of the fine root system. The smaller diameter roots had greater water uptake capacity per unit surface area than the larger diameter roots, but they had less total surface area leading to less total water extraction; rates ranged from 0.0027 –more » 0.0116 g cm -2 hr -1. The finest most-active roots were not visible in the radiographs, indicating the need to include destructive sampling. Analysis based on bulk soil hydraulic properties indicated substantial redistribution of water via saturated/unsaturated flow, capillary wicking, and root hydraulic redistribution across the layers - suggesting water uptake dynamics following an infiltration event may be more complex than approximated by common soil hydraulic or root surface area modeling approaches. Lastly, our results highlight the need for continued exploration of root-trait specific water uptake rates in situ, and impacts of roots on soil hydraulic properties – both critical components for mechanistic modeling of root function.« less

Use of biodegradable polylactic acid barrier materials in the treatment of grade II periodontal furcation defects in humans--Part I: A multicenter investigative clinical study.

PubMed

Vernino, A R; Ringeisen, T A; Wang, H L; Derhalli, M; Rapley, J; Nechamkin, S J; Brekke, J

1998-12-01

This study evaluated two bioresorbable polylactic acid barriers (Epi-Guide and Guidor) to determine if design differences were of therapeutic significance in the treatment of Grade II furcation defects in humans. Forty patients with bilaterally matched, Grade II furcation defects in maxillary or mandibular first or second molars were treated in a multicenter study. Comprehensive initial periodontal therapy, followed by defect debridement and root preparation, preceded randomized membrane placement. Data collected from all three investigative centers were pooled and analyzed using an analysis of variance appropriate for a counterbalancing design. Both barrier types produced measurable improvements of clinical probing values. Barrier exposure scores taken through the eighth week postoperative revealed that Epi-Guide was less likely to become exposed than Guidor. The findings of this study, which was conducted over a 12-month period, demonstrated that Epi-Guide and Guidor were comparable as measured by clinical probing determinations.

Local drug delivery agents as adjuncts to endodontic and periodontal therapy

PubMed Central

Puri, K; Puri, N

2013-01-01

Abstract In the treatment of intracanal and periodontal infections, the local application of antibiotics and other therapeutic agents in the root canal or in periodontal pockets may be a promising approach to achieve sustained/controlled drug release, high antimicrobial activity and low systemic side effects. The conventional method for the elimination of subgingival microbial infection includes mechanical debridement, irrigation with antimicrobial agents or surgical access. But, the effectiveness of conventional nonsurgical treatment is limited by lack of accessibility to bacteria in deeper periodontal pockets, and/or does not completely eliminate intracanal microorganisms. Surgical intervention may be beneficial but cannot be done in all cases, medically compromised cases and also in patients not willing to be subjected to surgical therapy. Development of local drug delivery systems provides an answer to all such difficulties. This comprehensive review tries to cover the detailed information about the latest advances in the various local drug delivery systems, their indications, contraindications and their advantages over systemic drug therapy. PMID:24868252

Debridement versus re-attachment of acetabular labral tears: A review of the literature and quantitative analysis.

PubMed

Haddad, B; Konan, S; Haddad, F S

2014-01-01

We have reviewed the current literature to compare the results of surgery aimed to repair or debride a damaged acetabular labrum. We identified 28 studies to be included in the review containing a total of 1631 hips in 1609 patients. Of these studies 12 reported a mean rate of good results of 82% (from 67% to 100%) for labral debridement. Of the 16 studies that reported a combination of debridement and re-attachment, five reported a comparative outcome for the two methods, four reported better results with re-attachment and one study did not find any significant difference in outcomes. Due to the heterogeneity of the studies it was not possible to perform a meta-analysis or draw accurate conclusions. Confounding factors in the studies include selection bias, use of historical controls and high rates of loss of follow-up. It seems logical to repair an unstable tear in a good quality labrum with good potential to heal in order potentially to preserve its physiological function. A degenerative labrum on the other hand may be the source of discomfort and its preservation may result in persistent pain and the added risk of failure of re-attachment. The results of the present study do not support routine refixation for all labral tears.

Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair

PubMed Central

Gao, Liang; Orth, Patrick; Müller-Brandt, Kathrin; Goebel, Lars K. H.; Cucchiarini, Magali; Madry, Henning

2017-01-01

Microfracture of cartilage defects may induce alterations of the subchondral bone in the mid- and long-term, yet very little is known about their onset. Possibly, these changes may be avoided by an enhanced microfracture technique with additional application of bone marrow aspirate. In this study, full-thickness chondral defects in the knee joints of minipigs were either treated with (1) debridement down to the subchondral bone plate alone, (2) debridement with microfracture, or (3) microfracture with additional application of bone marrow aspirate. At 4 weeks after microfracture, the loss of subchondral bone below the defects largely exceeded the original microfracture holes. Of note, a significant increase of osteoclast density was identified in defects treated with microfracture alone compared with debridement only. Both changes were significantly counteracted by the adjunct treatment with bone marrow. Debridement and microfracture without or with bone marrow were equivalent regarding the early cartilage repair. These data suggest that microfracture induced a substantial early resorption of the subchondral bone and also highlight the potential value of bone marrow aspirate as an adjunct to counteract these alterations. Clinical studies are warranted to further elucidate early events of osteochondral repair and the effect of enhanced microfracture techniques. PMID:28345610

Quantitative Assessment of Ultrastructure and Light Scatter in Mouse Corneal Debridement Wounds

PubMed Central

Boote, Craig; Du, Yiqin; Morgan, Sian; Harris, Jonathan; Kamma-Lorger, Christina S.; Hayes, Sally; Lathrop, Kira L.; Roh, Danny S.; Burrow, Michael K.; Hiller, Jennifer; Terrill, Nicholas J.; Funderburgh, James L.; Meek, Keith M.

2012-01-01

Purpose. The mouse has become an important wound healing model with which to study corneal fibrosis, a frequent complication of refractive surgery. The aim of the current study was to quantify changes in stromal ultrastructure and light scatter that characterize fibrosis in mouse corneal debridement wounds. Methods. Epithelial debridement wounds, with and without removal of basement membrane, were produced in C57BL/6 mice. Corneal opacity was measured using optical coherence tomography, and collagen diameter and matrix order were quantified by x-ray scattering. Electron microscopy was used to visualize proteoglycans. Quantitative PCR (Q-PCR) measured mRNA transcript levels for several quiescent and fibrotic markers. Results. Epithelial debridement without basement membrane disruption produced a significant increase in matrix disorder at 8 weeks, but minimal corneal opacity. In contrast, basement membrane penetration led to increases in light scatter, matrix disorder, and collagen diameter, accompanied by the appearance of abnormally large proteoglycans in the subepithelial stroma. This group also demonstrated upregulation of several quiescent and fibrotic markers 2 to 4 weeks after wounding. Conclusions. Fibrotic corneal wound healing in mice involves extensive changes to collagen and proteoglycan ultrastructure, consistent with deposition of opaque scar tissue. Epithelial basement membrane penetration is a deciding factor determining the degree of ultrastructural changes and resulting opacity. PMID:22467580

Landmarks for Sacral Debridement in Sacral Pressure Sores.

PubMed

Choo, Joshua H; Wilhelmi, Bradon J

2016-03-01

Most cases of sacral osteomyelitis arising in the setting of sacral pressure ulcers require minimal cortical debridement. When faced with advanced bony involvement, the surgeon is often unclear about how much can safely be resected. Unfamiliarity with sacral anatomy can lead to concerns of inadvertent entry into the dural space and compromise of future flap options. A cadaveric study (n = 6), in which a wide posterior dissection of the sacrum, was performed. Relationships of the dural sac to bony landmarks of the posterior pelvis were noted. The termination of the dural sac was found in our study to occur at the junction of S2/S3 vertebral bodies, which was located at a mean distance of 0.38 ± 0.16 cm distal to the inferior-most extent of the posterior superior iliac spine (PSIS). The mean thickness of the posterior table of sacrum at this level was 1.7 cm at the midline and 0.5 cm at the sacral foramina. The PSIS is a reliable landmark for localizing the S2/S3 junction and the termination of the dural sac. Sacral debridement medial to the sacral foramina above the level of PSIS must be conservative whenever possible. If aggressive debridement is necessary above this level, the surgeon must be alert to the possibility of dural involvement.

Advances in the local and targeted delivery of anti-infective agents for management of osteomyelitis.

PubMed

Ford, Caleb A; Cassat, James E

2017-09-01

Osteomyelitis, a common and debilitating invasive infection of bone, is a frequent complication following orthopedic surgery and causes pathologic destruction of skeletal tissues. Bone destruction during osteomyelitis results in necrotic tissue, which is poorly penetrated by antibiotics and can serve as a nidus for relapsing infection. Osteomyelitis therefore frequently necessitates surgical debridement procedures, which provide a unique opportunity for targeted delivery of antimicrobial and adjunctive therapies. Areas covered: Following surgical debridement, tissue voids require implanted materials to facilitate the healing process. Antibiotic-loaded, non-biodegradable implants have been the standard of care. However, a new generation of biodegradable, osteoconductive materials are being developed. Additionally, in the face of widespread antimicrobial resistance, alternative therapies to traditional antibiotic regimens are being investigated, including bone targeting compounds, antimicrobial surface modifications of orthopedic implants, and anti-virulence strategies. Expert commentary: Recent advances in biodegradable drug delivery scaffolds make this technology an attractive alternative to traditional techniques for orthopedic infection that require secondary operations for removal. Advances in novel treatment methods are expanding the arsenal of viable antimicrobial treatment strategies in the face of widespread drug resistance. Despite a need for large scale clinical investigations, these strategies offer hope for future treatment of this difficult invasive disease.

Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy

PubMed Central

Yamakado, Kotaro

2013-01-01

We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging. PMID:23875139

Advances in the Local and Targeted Delivery of Anti-infective Agents for Management of Osteomyelitis

PubMed Central

Ford, Caleb A.; Cassat, James E.

2018-01-01

Structured Abstract Introduction Osteomyelitis, a common and debilitating invasive infection of bone, is a frequent complication following orthopedic surgery and causes pathologic destruction of skeletal tissues. Bone destruction during osteomyelitis results in necrotic tissue, which is poorly penetrated by antibiotics and can serve as a nidus for relapsing infection. Osteomyelitis therefore frequently necessitates surgical debridement procedures, which provide a unique opportunity for targeted delivery of antimicrobial and adjunctive therapies. Areas Covered Following surgical debridement, tissue voids require implanted materials to facilitate the healing process. Antibiotic-loaded, non-biodegradable implants have been the standard of care. However, a new generation of biodegradable, osteoconductive materials are being developed. Additionally, in the face of widespread antimicrobial resistance, alternative therapies to traditional antibiotic regimens are being investigated, including bone targeting compounds, antimicrobial surface modifications of orthopedic implants, and anti-virulence strategies. Expert Commentary Recent advances in biodegradable drug delivery scaffolds make this technology an attractive alternative to traditional techniques for orthopedic infection that require secondary operations for removal. Advances in novel treatment methods are expanding the arsenal of viable antimicrobial treatment strategies in the face of widespread drug resistance. Despite a need for large scale clinical investigations, these strategies offer hope for future treatment of this difficult invasive disease. PMID:28837368

Management of lawn mower injuries to the foot and ankle.

PubMed

Corcoran, J; Zamboni, W A; Zook, E G

1993-09-01

Seventy consecutive patients treated for lawn mower injuries to the foot and ankle were reviewed to determine optimal treatment, functional results, and complications. Injuries were classified into 1 or more functional-anatomical zones (I, digits; II, dorsum; III, plantar nonweight-bearing surface; IV, heel; and V, ankle) for a total of 96 injuries. Thirty-one patients were available for follow-up. Mean age was 36.7 years and 84% were males. Most injuries (67%) involved patients > 16 years old using a push mower; however, 18% involved children < 5 years old, usually caused by riding mowers (70%). Primary closure after adequate irrigation and debridement was the preferred method of treatment except in patients with Zone IV injuries. Antibiotic prophylaxis was used in almost all injuries (93%). A 100% ambulation rate was achieved with 10% of patients requiring a prosthesis. Zone IV (heel) injuries had a 50% complication rate from chronic soft tissue breakdown. The wound infection rate per injury was 12.5% and did not vary significantly between closed (11.4%) and open (17.6%) treatment. Lawn mower injuries to the foot and ankle can be closed primarily after adequate irrigation and debridement without compromise of infection rate or function. Antibiotic prophylaxis is recommended. One-sixth of these injuries involve children < 5 years of age and can be prevented.

Root architecture and wind-firmness of mature Pinus pinaster.

PubMed

Danjon, Frédéric; Fourcaud, Thierry; Bert, Didier

2005-11-01

This study aims to link three-dimensional coarse root architecture to tree stability in mature timber trees with an average of 1-m rooting depth. Undamaged and uprooted trees were sampled in a stand damaged by a storm. Root architecture was measured by three-dimensional (3-D) digitizing. The distribution of root volume by root type and in wind-oriented sectors was analysed. Mature Pinus pinaster root systems were organized in a rigid 'cage' composed of a taproot, the zone of rapid taper of horizontal surface roots and numerous sinkers and deep roots, imprisoning a large mass of soil and guyed by long horizontal surface roots. Key compartments for stability exhibited strong selective leeward or windward reinforcement. Uprooted trees showed a lower cage volume, a larger proportion of oblique and intermediate depth horizontal roots and less wind-oriented root reinforcement. Pinus pinaster stability on moderately deep soils is optimized through a typical rooting pattern and a considerable structural adaptation to the prevailing wind and soil profile.

Potential for temperature change during application of ultrasonic vibration to intra-radicular posts.

PubMed

Satterthwaite, Julian D; Stokes, Alastair N; Frankel, Nicholas T N

2003-06-01

The aim of this study was to assess the potential for heat production when intra-radicular posts were subjected to ultrasonic vibration. Thirty zirconium ceramic posts and thirty stainless steel posts were luted into canine roots. Ultrasonic vibration was applied to the top of each post for thirty minutes and temperature change on the root surface was measured. The mean peak temperature rise from baseline was 18.7 degrees C. Post type had no influence on peak temperature. Temperature increase on the external root surfaces increased as the thickness of dentine between post and root surface reduced.

Free toe pulp transfer for digital reconstruction after high-pressure injection injury.

PubMed

Chan, B K; Tham, S K; Leung, M

1999-10-01

We report two cases of high-pressure injection injuries to the fingertip in which free toe pulp flaps were used to resurface the palmar surface of the finger following extensive wound debridement. There was good return of sensibility and, because of the high durability of the donor skin, both patients regained good functional use of the injured digits and returned to heavy manual work. There was minimal associated morbidity of the donor sites. The free toe pulp flap represents an excellent alternative for resurfacing the digit with a large residual skin defect after high-pressure injection injury.

Effect of the association between citric acid and EDTA on root surface etching.

PubMed

Manzolli Leite, Fabio Renato; Nascimento, Gustavo Giacomelli; Manzolli Leite, Elza Regina; Leite, Amauri Antiquera; Cezar Sampaio, Josá Eduardo

2013-09-01

This study aims to compare the clot stabilization on root surfaces conditioned with citric acid and ethylenediamine-tetraacetic acid (EDTA). Scaled root samples (n = 100) were set in fve groups: group I-control group (saline solution); group II (24% EDTA); group III (25% citric acid); group IV (EDTA + citric acid); group V (citric acid + EDTA). Fifty samples were assessed using the root surface modifcation index (RSMI). The other 50 received a blood drop after conditioning. Clot formation was assessed using blood elements adhesion index (BEAI). A blind examiner evaluated photomicrographs. Statistical analysis considered p < 0.05. Groups-III and G-V attained the best results for RSMI and BEAI in comparison to control. The worst results for clot stabilization were seen in group-II. EDTA employment before citric acid (group-IV) reduced clot formation in comparison to citric acid use alone (group-III). Root conditioning with citric acid alone and before EDTA had the best results for smear layer removal and clot stabilization. EDTA inhibited clot stabilization on root surface and must have a residual activity once it has diminished clot adhesion to root even after citric acid conditioning. Thus, EDTA can be used to neutralize citric acid effects on periodontal cells without affecting clot stabilization. Clinical signifcance: To demonstrate that citric acid use on root surfaces previously affected by periodontal disease may favor clot stabilization and may have a benefcial effect on surgical outcomes. Also, EDTA can be used to neutralize citric acid effects on periodontal cells.

[Effects of tree species diversity on fine-root biomass and morphological characteristics in subtropical Castanopsis carlesii forests].

PubMed

Wang, Wei-Wei; Huang, Jin-Xue; Chen, Feng; Xiong, De-Cheng; Lu, Zheng-Li; Huang, Chao-Chao; Yang, Zhi-Jie; Chen, Guang-Shui

2014-02-01

Fine roots in the Castanopsis carlesii plantation forest (MZ), the secondary forest of C. carlesii through natural regeneration with anthropogenic promotion (AR), and the secondary forest of C. carlesii through natural regeneration (NR) in Sanming City, Fujian Province, were estimated by soil core method to determine the influence of tree species diversity on biomass, vertical distribution and morphological characteristics of fine roots. The results showed that fine root biomass for the 0-80 cm soil layer in the MZ, AR and NR were (182.46 +/- 10.81), (242.73 +/- 17.85) and (353.11 +/- 16.46) g x m(-2), respectively, showing an increased tendency with increasing tree species diversity. In the three forests, fine root biomass was significantly influenced by soil depth, and fine roots at the 0-10 cm soil layer accounted for more than 35% of the total fine root biomass. However, the interaction of stand type and soil depth on fine-root distribution was not significant, indicating no influence of tree species diversity on spatial niche segregation in fine roots. Root surface area density and root length density were the highest in NR and lowest in the MZ. Specific root length was in the order of AR > MZ > NR, while specific root surface area was in the order of NR > MZ > AR. There was no significant interaction of stand type and soil depth on specific root length and specific root surface area. Fine root morphological plasticity at the stand level had no significant response to tree species diversity.

Pulse granuloma as a complication following dental trauma in children.

PubMed

Padmanabhan, Makkada Yuvaraj; Aparna, Radhakrishnan; Karthikeyani, Shanmugasundaram; Dinakar, Jayakumar; Manickaraj, Menaka

2013-01-01

Contamination and subsequent retention of foreign bodies within wound surfaces may negatively influence healing following maxillofacial injuries. Larger foreign bodies that produce embedded or impalement injuries of soft tissues are easily detected. However, smaller contaminants, such as sand, gravel, food particles, wood splinters, and glass fibers, may not be easily identified in the initial examination, and their remnants may remain within the injury site even after debridement. Tissue reactions depend on the host response, type of foreign body, and nature of the wound surface. The purposes of this report are to: (1) detail the diagnosis and management of a peripheral pulse granuloma following retention of food particles within gingival sulci during a dental injury; and (2) provide a brief review of the diagnosis of foreign body-induced granulomas following maxillofacial injuries in children.

Waving and skewing: how gravity and the surface of growth media affect root development in Arabidopsis.

PubMed

Oliva, Michele; Dunand, Christophe

2007-01-01

Arabidopsis seedlings growing on inclined agar surfaces exhibit characteristic root behaviours called 'waving' and 'skewing': the former consists of a series of undulations, whereas the latter is a deviation from the direction of gravity. Even though the precise basis of these growth patterns is not well understood, both gravity and the contact between the medium and the root are considered to be the major players that result in these processes. The influence of these forces on root surface-dependent behaviours can be verified by growing seedlings at different gel pitches: plants growing on vertical plates present roots with slight waving and skewing when compared with seedlings grown on plates held at minor angles of < 90 degrees . However, other factors are thought to modulate root growth on agar; for instance, it has been demonstrated that the presence and concentration of certain compounds in the medium (such as sucrose) and of drugs able to modify the plant cell cytoskeleton also affect skewing and waving. The recent discovery of an active role of ethylene on surface-dependent root behaviour, and the finding of new mutants showing anomalous growth, pave the way for a more detailed description of these phenomena.

Adsorption of Eu(III) onto roots of water hyacinth

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kelley, C.; Mielke, R.E.; Dimaquibo, D.

1999-05-01

The water hyacinth (Eichhornia crassipes) has drawn attention as a plant capable of removing pollutants, including toxic metals, from water. The authors are interested in the capacity of the water hyacinth to remediate aquatic environments that have been contaminated with the lanthanide metal, europium Eu(III). Using scanning electron microscopy (SEM) they have been able to determine that Eu(III) is adsorbed onto the surface of the roots from water and that the highest concentration of Eu(III) is on the root hairs. X-ray absorption spectroscopy (XAS) techniques were used to speciate the Eu(III) adsorbed onto the surface of the roots. The XASmore » data for Eu-contaminated water hyacinth roots provides evidence of a Eu-oxygen environment and establishes that Eu(III) is coordinated to 10--11 oxygen atoms at a distance of 2.44 {angstrom}. This likely involves binding of Eu(III) to the root via carboxylate groups and hydration of Eu(III) at the root surface.« less

The attachment of V79 and human periodontal ligament fibroblasts on periodontally involved root surfaces following treatment with EDTA, citric acid, or tetracycline HCL: an SEM in vitro study.

PubMed

Chandra, R Viswa; Jagetia, Ganesh Chandra; Bhat, K Mahalinga

2006-02-15

The present in vitro study has been designed to establish and compare the effects of citric acid, EDTA, and tetracycline HCl on human periodontally diseased roots on the structure, attachment, and orientation of V79 (primary Chinese hamster lung fibroblasts) cells and human periodontal ligament fibroblasts (HPDL). Commercially available V79 cells and HPDL derived from healthy human third molars were used in this study. These fibroblasts were left in solution for seven days in order to attain confluence. Forty single-rooted teeth were obtained from patients diagnosed with periodontitis. The crown part was removed under constant irrigation and the root was split vertically into two equal halves, thus, yielding 80 specimens. Following scaling and root planing, the specimens were washed with phosphate buffered saline (PBS) and kept in 50 microg/ml gentamycin sulphate solution for 24 hours. The root pieces were then treated as follows: citric acid at pH 1, 24% EDTA, or with a 10% solution of tetracycline HCl and were then placed in V79 fibroblast cultures and HPDL cultures. The specimens were harvested after four weeks and were fixed in 2.5% glutaraldehyde in PBS before preparation for scanning electron microscopy (SEM). The behavior of V79 cells was similar to that of human periodontal ligament cells on root conditioned surfaces. V79 and HPDL showed a healthy morphology on root surfaces treated with citric acid and EDTA and a relatively unhealthy appearance on root surfaces treated with tetracycline HCl and distilled water (control group). The results suggest the use of citric acid and EDTA as root conditioning agents favorably affects the migration, attachment, and morphology of fibroblasts on human root surfaces, which may play a significant role in periodontal healing and regeneration.

Hyper-hydration: a new perspective on wound cleansing, debridement and healing.

PubMed

2016-06-01

In a recent symposium organised by Hartmann, the involvement of moisture and hydration in healing was re-evaluated and the use of hyper-hydration in promoting healing was examined. The distinction between hyperhydration and maceration was also discussed. Clinical studies were presented to give an overview of the clinical evidence to how Hydro-Responsive Wound Dressings can aid in healing via cleansing, debridement and desloughing of several wound types.

Treatment of Early Post-op Wound Infection after Internal Fixation

DTIC Science & Technology

2015-10-01

Obremskey, M.D. CONTRACTING ORGANIZATION: Vanderbilt University Medical Center Nashville TN 37203 REPORT DATE: October 2015 TYPE OF REPORT: Annual...PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) October 2015 2. REPORT TYPE Annual 3. DATES COVERED (From - To...either: (Group 1) operative debridement and PO antibiotic treatment for 6 weeks; or (Group 2) operative debridement and IV antibiotics for 6 weeks and

Wound bed preparation: A novel approach using HydroTherapy.

PubMed

Atkin, Leanne; Ousey, Karen

2016-12-01

Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid. Irrigation and cleansing provided by Ringer's solution from the dressing further removes any necrotic tissue or eschar. Once effective wound bed preparation has been achieved a second dressing, HydroTac™, provides an ongoing hydrated wound environment that enables re-epithelialisation to occur in an unrestricted fashion. This paper presents 3 case studies of slow healing wounds treated with HydroClean plus™ which demonstrates effective wound debridement.

Water flow and solute transport in floating fen root mats

NASA Astrophysics Data System (ADS)

Stofberg, Sija F.; EATM van der Zee, Sjoerd

2015-04-01

Floating fens are valuable wetlands, found in North-Western Europe, that are formed by floating root mats when old turf ponds are colonized by plants. These terrestrialization ecosystems are known for their biodiversity and the presence of rare plant species, and the root mats reveal different vegetation zones at a small scale. The vegetation zones are a result of strong gradients in abiotic conditions, including groundwater dynamics, nutrients and pH. To prevent irreversible drought effects such as land subsidence and mineralization of peat, water management involves import of water from elsewhere to maintain constant surface water levels. Imported water may have elevated levels of salinity during dry summers, and salt exposure may threaten the vegetation. To assess the risk of exposure of the rare plant species to salinity, the hydrology of such root mats must be understood. Physical properties of root mats have scarcely been investigated. We have measured soil characteristics, hydraulic conductivity, vertical root mat movement and groundwater dynamics in a floating root mat in the nature reserve Nieuwkoopse Plassen, in the Netherlands. The root mat mostly consists of roots and organic material, in which the soil has a high saturated water content, and strongly varies in its stage of decomposition. We have found a distinct negative correlation between degree of decomposition and hydraulic conductivity, similar to observations for bogs in the literature. Our results show that the relatively young, thin edge of the root mat that colonizes the surface water has a high hydraulic conductivity and floats in the surface water, resulting in very small groundwater fluctuations within the root mat. The older part of the root mat, that is connected to the deeper peat layers is hydrologically more isolated and the material has a lower conductivity. Here, the groundwater fluctuates strongly with atmospheric forcing. The zones of hydraulic properties and vegetation, appear to be very similar and likely functionally related. Our experimental field data were used for modelling water flow and solute transport in floating fens, using HYDRUS 2D. Fluctuations of surface water and root mat, as well as geometry and unsaturated zone parameters can have a major influence on groundwater fluctuations and the exchange between rain and surface water and the water in the root mats. In combination with the duration of salt pulses in surface water, and sensitivity of fen plants to salinity (Stofberg et al. 2014, submitted), risks for rare plants can be anticipated.

Isolation of a novel mutant gene for soil-surface rooting in rice (Oryza sativa L.)

PubMed Central

2013-01-01

Background Root system architecture is an important trait affecting the uptake of nutrients and water by crops. Shallower root systems preferentially take up nutrients from the topsoil and help avoid unfavorable environments in deeper soil layers. We have found a soil-surface rooting mutant from an M2 population that was regenerated from seed calli of a japonica rice cultivar, Nipponbare. In this study, we examined the genetic and physiological characteristics of this mutant. Results The primary roots of the mutant showed no gravitropic response from the seedling stage on, whereas the gravitropic response of the shoots was normal. Segregation analyses by using an F2 population derived from a cross between the soil-surface rooting mutant and wild-type Nipponbare indicated that the trait was controlled by a single recessive gene, designated as sor1. Fine mapping by using an F2 population derived from a cross between the mutant and an indica rice cultivar, Kasalath, revealed that sor1 was located within a 136-kb region between the simple sequence repeat markers RM16254 and 2935-6 on the terminal region of the short arm of chromosome 4, where 13 putative open reading frames (ORFs) were found. We sequenced these ORFs and detected a 33-bp deletion in one of them, Os04g0101800. Transgenic plants of the mutant transformed with the genomic fragment carrying the Os04g0101800 sequence from Nipponbare showed normal gravitropic responses and no soil-surface rooting. Conclusion These results suggest that sor1, a rice mutant causing soil-surface rooting and altered root gravitropic response, is allelic to Os04g0101800, and that a 33-bp deletion in the coding region of this gene causes the mutant phenotypes. PMID:24280269

Isolation of a novel mutant gene for soil-surface rooting in rice (Oryza sativa L.).

PubMed

Hanzawa, Eiko; Sasaki, Kazuhiro; Nagai, Shinsei; Obara, Mitsuhiro; Fukuta, Yoshimichi; Uga, Yusaku; Miyao, Akio; Hirochika, Hirohiko; Higashitani, Atsushi; Maekawa, Masahiko; Sato, Tadashi

2013-11-20

Root system architecture is an important trait affecting the uptake of nutrients and water by crops. Shallower root systems preferentially take up nutrients from the topsoil and help avoid unfavorable environments in deeper soil layers. We have found a soil-surface rooting mutant from an M2 population that was regenerated from seed calli of a japonica rice cultivar, Nipponbare. In this study, we examined the genetic and physiological characteristics of this mutant. The primary roots of the mutant showed no gravitropic response from the seedling stage on, whereas the gravitropic response of the shoots was normal. Segregation analyses by using an F2 population derived from a cross between the soil-surface rooting mutant and wild-type Nipponbare indicated that the trait was controlled by a single recessive gene, designated as sor1. Fine mapping by using an F2 population derived from a cross between the mutant and an indica rice cultivar, Kasalath, revealed that sor1 was located within a 136-kb region between the simple sequence repeat markers RM16254 and 2935-6 on the terminal region of the short arm of chromosome 4, where 13 putative open reading frames (ORFs) were found. We sequenced these ORFs and detected a 33-bp deletion in one of them, Os04g0101800. Transgenic plants of the mutant transformed with the genomic fragment carrying the Os04g0101800 sequence from Nipponbare showed normal gravitropic responses and no soil-surface rooting. These results suggest that sor1, a rice mutant causing soil-surface rooting and altered root gravitropic response, is allelic to Os04g0101800, and that a 33-bp deletion in the coding region of this gene causes the mutant phenotypes.

Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography

PubMed Central

Stavileci, Miranda; Hoxha, Veton; Görduysus, Ömer; Tatar, Ilkan; Laperre, Kjell; Hostens, Jeroen; Küçükkaya, Selen; Muhaxheri, Edmond

2015-01-01

Background Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Material/Methods Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. Results ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (p<0.001). Similarly, there was a statistically significant difference in root canal straightening after preparation between the techniques (p<0.001). Conclusions Neither manual nor rotary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal. PMID:26092929

Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography.

PubMed

Stavileci, Miranda; Hoxha, Veton; Görduysus, Ömer; Tatar, Ilkan; Laperre, Kjell; Hostens, Jeroen; Küçükkaya, Selen; Muhaxheri, Edmond

2015-06-20

Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (p<0.001). Similarly, there was a statistically significant difference in root canal straightening after preparation between the techniques (p<0.001). Neither manual nor rotary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal.

Effect of root planing on surface topography: an in-vivo randomized experimental trial.

PubMed

Rosales-Leal, J I; Flores, A B; Contreras, T; Bravo, M; Cabrerizo-Vílchez, M A; Mesa, F

2015-04-01

The root surface topography exerts a major influence on clinical attachment and bacterial recolonization after root planing. In-vitro topographic studies have yielded variable results, and clinical studies are necessary to compare root surface topography after planing with current ultrasonic devices and with traditional manual instrumentation. The aim of this study was to compare the topography of untreated single-rooted teeth planed in vivo with a curette, a piezoelectric ultrasonic (PU) scraper or a vertically oscillating ultrasonic (VOU) scraper. In a randomized experimental trial of 19 patients, 44 single-rooted teeth were randomly assigned to one of four groups for: no treatment; manual root planing with a curette; root planing with a PU scraper; or root planing with a VOU scraper. Post-treatment, the teeth were extracted and their topography was analyzed in 124 observations with white-light confocal microscopy, measuring the roughness parameters arithmetic average height, root-mean-square roughness, maximum height of peaks, maximum depth of valleys, absolute height, skewness and kurtosis. The roughness values arithmetic average height and root-mean-square roughness were similar after each treatment and lower than after no treatment ( p < 0.05). Absolute height was lower in the VOU group than in the untreated ( p = 0.0026) and PU (p = 0.045) groups. Surface morphology was similar after the three treatments and was less irregular than in the untreated group. Values for the remaining roughness parameters were similar among all treatment groups ( p > 0.05). Both ultrasonic devices reduce the roughness, producing a similar topography to that observed after manual instrumentation with a curette, to which they appear to represent a valid alternative. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

In vitro radicular temperatures produced by injectable thermoplasticized gutta-percha.

PubMed

Weller, R N; Koch, K A

1995-03-01

In vitro temperatures produced in the root canal and on the root surface were measured simultaneously as heated gutta-percha was injected into the prepared canal. The canals were obturated with the Obtura II heated gutta-percha system with temperature settings of 160, 185, and 200 degrees C. The mean intracanal temperatures ranged from 40.21 to 57.24 degrees C, whereas the mean root surface temperatures were recorded from 37.22 to 41.90 degrees C for all three temperatures tested. The rise in temperature on the root surface was below the critical level of 10 degrees C and should not cause damage to the periodontal ligament.

Thermal and microstructural effects of nanosecond pulsed Nd:YAG laser irradiation on tooth root surface

NASA Astrophysics Data System (ADS)

Wilder-Smith, Petra B. B.; Arrastia-Jitosho, Anna-Marie A.; Grill, G.; Liaw, Lih-Huei L.; Berns, Michael W.

1995-05-01

Plaque, calculus and altered cementum removal by scaling and root planing is a fundamental procedure in periodontal treatment. However, the residual smear layer contains cytotoxic and inflammatory mediators which adversely affect healing. Chemical smear layer removal is also problematic. In previous investigations effective smear layer removal was achieved using long pulsed irradiation at 1.06 (mu) . However, laser irradiation was not adequate as an alternative to scaling and root planing procedures and concurrent temperature rises exceeded thermal thresholds for pulpal and periodontal safety. It was the aim of this study to determine whether nanosecond pulsed irradiation at 1.06 (mu) could be used as an alternative or an adjunct to scaling and root planing. Sixty freshly extracted teeth were divided as follows: 5 control, 5 root planed only, 25 irradiated only, 25 root planed and irradiated. Irradiation was performed at fluences of 0.5 - 2.7 J/cm2, total energy densities of 12 - 300 J/cm2, frequencies of 2 - 10 Hz using the Medlite (Continuum) laser. Irradiation-induced thermal events were recorded using a thermocouple within the root canal and a thermal camera to monitor surface temperatures. SEM demonstrated effective smear layer removal with minimal microstructural effects. Surface temperatures increased minimally (< 3 C) at all parameters, intrapulpal temperature rises remained below 4 C at 2 and 5 Hz, F < 0.5 J/cm2. Without prior scaling and root planing, laser effects did not provide an adequately clean root surface.

Root gravitropism in maize and Arabidopsis

NASA Technical Reports Server (NTRS)

Evans, Michael L.

1993-01-01

Research during the period 1 March 1992 to 30 November 1993 focused on improvements in a video digitizer system designed to automate the recording of surface extension in plants responding to gravistimulation. The improvements included modification of software to allow detailed analysis of localized extension patterns in roots of Arabidopsis. We used the system to analyze the role of the postmitotic isodiametric growth zone (a region between the meristem and the elongation zone) in the response of maize roots to auxin, calcium, touch and gravity. We also used the system to analyze short-term auxin and gravitropic responses in mutants of Arabidopsis with reduced auxin sensitivity. In a related project, we studied the relationship between growth rate and surface electrical currents in roots by examining the effects of gravity and thigmostimulation on surface potentials in maize roots.

Effects of erbium, chromium:YSGG laser irradiation on root surface: morphological and atomic analytical studies.

PubMed

Kimura, Y; Yu, D G; Kinoshita, J; Hossain, M; Yokoyama, K; Murakami, Y; Nomura, K; Takamura, R; Matsumoto, K

2001-04-01

The purpose of this study was to investigate the morphological and atomic changes on the root surface by stereoscopy, field emission-scanning electron microscopy (FE-SEM), and energy dispersive X-ray spectroscopy (SEM-EDX) after erbium, chromium:yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation in vitro. There have been few reports on morphological and atomic analytical study on root surface by Er,Cr:YSGG laser irradiation. Eighteen extracted human premolar and molar teeth were irradiated on root surfaces at a vertical position with water-air spray by an Er,Cr:YSGG laser at the parameter of 5.0 W and 20 Hz for 5 sec while moving. The samples were then morphologically observed by stereoscopy and FE-SEM and examined atomic-analytically by SEM-EDX. Craters having rough but clean surfaces and no melting or carbonization were observed in the samples. An atomic analytical examination showed that the calcium ratio to phosphorus showed no significant changes between the control and irradiated areas (p > 0.01). These results showed that the Er,Cr:YSGG laser has a good cutting effect on root surface and causes no burning or melting after laser irradiation.

Listeria monocytogenes - Danger for health safety vegetable production.

PubMed

Kljujev, Igor; Raicevic, Vera; Jovicic-Petrovic, Jelena; Vujovic, Bojana; Mirkovic, Milica; Rothballer, Michael

2018-04-22

The microbiologically contaminated vegetables represent a risk for consumers, especially vegetables without thermal processing. It is known that human pathogen bacteria, such as Listeria monocytogenes, could exist on fresh vegetables. The fresh vegetables could become Listeria-contaminated if they come in touch with contaminated soil, manure, irrigation water. The aim of this work was to investigate the presence of Listeria spp. and L. monocytogenes in different kind of vegetables grown in field and greenhouse condition as well as surface and endophytic colonization plant roots of different vegetables species by L. monocytogenes in laboratory conditions. The detection of Listeria spp. and L. monocytogenes in vegetable samples was done using ISO and PCR methods. The investigation of colonization vegetable roots and detection Listeria-cells inside plant root tissue was done using Fluorescence in situ hybridization (FISH) method in combination with confocal laser scanning microscopy (CLSM). The results showed that 25.58% vegetable samples were positive for Listeria spp. and only one sample (carrot) was positive for L. monocytogenes out of 43 samples in total collected from field and greenhouse. The strain L. monocytogenes EGD-E surface and endophytic colonized carrot root in highest degree while strain L. monocytogenes SV4B was the most represented at leafy vegetable plants, such at lettuce (1.68 × 10 6  cells/mm 3 absolutely dry root) and spinach (1.39 × 10 6  cells/mm 3 absolutely dry root) root surface. The cells of L. monocytogenes SV4B were visible as single cells in interior tissue of plant roots (celery and sweet corn roots) as well as in the interior of the plant root cell at sweet corn root. The cells of L. monocytogenes EGD-E bind to the surface of the plant root and they were less commonly found out on root hair. In the inner layers of the root, those bacterial cells were inhabited intercellular spaces mainly as single cells very close to the larval vessels of root. Our results suggest that L. monocytogenes is very good endophytic colonizer of vegetable plant roots. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modulatory effects by neodymium-doped yttrium aluminum garnet laser on fibroblast attachment to single rooted tooth surfaces following ultrasonic scaling and root planning: An in vitro study

PubMed Central

Negi, Shanta; Krishnamurthy, Malathi; Ganji, Kiran Kumar; Pendor, Sunil

2015-01-01

Context: One of the most important goals of periodontal therapy is connective tissue reattachment to previously diseased root surfaces. In the recent years, laser therapy has been considered as an important tool in improving the treatment of periodontal disease. Aims: To evaluate the neodymium-doped yttrium aluminum garnet (Nd: YAG) lasers effects on root surfaces affected by periodontal disease and compare this treatment with scaling and root planning (SRP) in terms of fibroblast attachment. Materials and Methods: A sample of 30 single-rooted human teeth extracted because of advanced periodontal disease was used in this study. Sixty specimens obtained by longitudinal sectioning were randomly divided in three groups. Group A control (untreated); Group B SRP; Group C laser (Nd: YAG) and ultrasonic scaling. All specimens were incubated with fibroblast suspension and then fixed and observed under scanning electron microscope. Results: With a median of 8, the control group (Group A) exhibited the least number of total fibroblasts among all the three groups. The laser and scaling - treated group (Group C) showed the highest number of fibroblasts (median = 49, mean ± standard deviation [SD] = 48.28 ± 17.18), followed by SRP only (Group B, median = 22, mean ± SD = 22.24 ± 8.67). Conclusions: Nd: YAG laser irradiation at specific energy densities can be used as a useful tool to condition the root surfaces, enhancing fibroblast attachment. Hence aiding in re-establishment of the connective tissue attachment to the root surfaces of previously diseased teeth. PMID:25810589

Root Surface Biomodification with Nd:YAG Laser for the Treatment of Gingival Recession with Subepithelial Connective Tissue Grafts

PubMed Central

Aydin, Tugba; Canakci, Varol; Cicek, Yasin

2010-01-01

Abstract Background/Aim: Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such procedures, however. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Nd:YAG laser application for root surface biomodification. Materials and Methods: Thirty-four teeth in 17 patients with Miller Class 1 and 2 recession were treated with SCTG with (test group) or without (control group) the application of Nd:YAG laser (1 W, 10 Hz, 100 mj, 60 s, 1064 nm). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and six months postsurgery. Results: Both treatments yielded significant improvements in terms of RD and RW decrease and CAL gain compared to baseline values. For test and control groups, the average root coverage was 33% and 77%, respectively (p < 0.05), and the complete root coverage was 18% and 65%, respectively (p < 0.05). The control group showed a greater reduction in RD and RW compared with the test group (p < 0.05). Conclusions: The use of Nd:YAG laser as a root surface biomodifier negatively affected the outcome of root coverage with the SCTG. PMID:19860567

Interaction of Escherichia coli with growing salad spinach plants.

PubMed

Warriner, Keith; Ibrahim, Faozia; Dickinson, Matthew; Wright, Charles; Waites, William M

2003-10-01

In this study, the interaction of a bioluminescence-labeled Escherichia coli strain with growing spinach plants was assessed. Through bioluminescence profiles, the direct visualization of E. coli growing around the roots of developing seedlings was accomplished. Subsequent in situ glucuronidase (GUS) staining of seedlings confirmed that E. coli had become internalized within root tissue and, to a limited extent, within hypocotyls. When inoculated seeds were sown in soil microcosms and cultivated for 42 days, E. coli was recovered from the external surfaces of spinach roots and leaves as well as from surface-sterilized roots. When 20-day-old spinach seedlings (from uninoculated seeds) were transferred to soil inoculated with E. coli, the bacterium became established on the plant surface, but internalization into the inner root tissue was restricted. However, for seedlings transferred to a hydroponic system containing 10(2) or 10(3) CFU of E. coli per ml of the circulating nutrient solution, the bacterium was recovered from surface-sterilized roots, indicating that it had been internalized. Differences between E. coli interactions in the soil and those in the hydroponic system may be attributed to greater accessibility of the roots in the latter model. Alternatively, the presence of a competitive microflora in soil may have restricted root colonization by E. coli. The implications of this study's findings with regard to the microbiological safety of minimally processed vegetables are discussed.

Waterlogging-induced changes in root architecture of germplasm accessions of the tropical forage grass Brachiaria humidicola.

PubMed

Cardoso, Juan Andrés; Jiménez, Juan de la Cruz; Rao, Idupulapati M

2014-04-08

Waterlogging is one of the major factors limiting the productivity of pastures in the humid tropics. Brachiaria humidicola is a forage grass commonly used in zones prone to temporary waterlogging. Brachiaria humidicola accessions adapt to waterlogging by increasing aerenchyma in nodal roots above constitutive levels to improve oxygenation of root tissues. In some accessions, waterlogging reduces the number of lateral roots developed from main root axes. Waterlogging-induced reduction of lateral roots could be of adaptive value as lateral roots consume oxygen supplied from above ground via their parent root. However, a reduction in lateral root development could also be detrimental by decreasing the surface area for nutrient and water absorption. To examine the impact of waterlogging on lateral root development, an outdoor study was conducted to test differences in vertical root distribution (in terms of dry mass and length) and the proportion of lateral roots to the total root system (sum of nodal and lateral roots) down the soil profile under drained or waterlogged soil conditions. Plant material consisted of 12 B. humidicola accessions from the gene bank of the International Center for Tropical Agriculture, Colombia. Rooting depth was restricted by 21 days of waterlogging and confined to the first 30 cm below the soil surface. Although waterlogging reduced the overall proportion of lateral roots, its proportion significantly increased in the top 10 cm of the soil. This suggests that soil flooding increases lateral root proliferation of B. humidicola in the upper soil layers. This may compensate for the reduction of root surface area brought about by the restriction of root growth at depths below 30 cm. Further work is needed to test the relative efficiency of nodal and lateral roots for nutrient and water uptake under waterlogged soil conditions. Published by Oxford University Press on behalf of the Annals of Botany Company.

Management of Mastectomy Skin Necrosis in Implant Based Breast Reconstruction.

PubMed

Sue, Gloria R; Long, Chao; Lee, Gordon K

2017-05-01

Mastectomy skin necrosis is a significant problem after breast reconstruction. This complication may lead to poor wound healing and need for implant removal, which may delay subsequent oncologic treatment. We sought to characterize factors associated with mastectomy skin necrosis and propose a management algorithm. A retrospective review was performed on consecutive patients undergoing implant-based breast reconstruction by the senior author from 2006 through 2015. Patient-level factors including age, race, body mass index, history of hypertension, history of diabetes, history of smoking, and history of radiation were collected. Surgical factors including type of mastectomy, location of implant placement, and immediate versus delayed reconstruction were collected. The incidence and treatment of mastectomy skin necrosis were analyzed. A total of 293 patients underwent either unilateral or bilateral implant-based breast reconstructions after mastectomy with a total of 471 reconstructed breasts. Mastectomy skin necrosis was observed in 8.1% of reconstructed breasts. Skin necrosis was not associated with age, hypertension, diabetes, prior radiation, or type of mastectomy. The incidence of skin necrosis was higher among smokers (17.9% vs 5.0%, P < 0.001), among patients with higher body mass index (11.4% vs 6.1%, P = 0.05), patients who underwent immediate reconstruction compared to delayed (9.6% vs 0%, P = 0.004), placement of expander under acellular dermal matrix compared with submuscular placement (12.0% vs 5.2%, P = 0.02), and use of higher initial expander fill volume compared with lower fill volume (11.4% vs 5.4%, P = 0.02).The median necrosis size was 8 cm. The median time to treatment was 15 days postoperatively. In 55% of patients minor necrosis was treated with clinic debridement, whereas 43% had larger areas of necrosis requiring operative debridement. The median size treated with clinic debridement was 5.5 cm, compared to 15 cm for operative debridement. All necrosis was treated in a timely fashion and did not delay adjuvant therapy. Mastectomy skin necrosis occurred in 8.1% of breasts after implant-based reconstruction. Necrosis less than 10 cm can be treated successfully with local debridement in the clinic setting. Timely and appropriate treatment of skin necrosis with debridement and primary closure expedites wound healing and facilitates tissue expander breast reconstruction.

Effect on Patient-Reported Outcomes of Debridement or Microfracture of Concomitant Full-Thickness Cartilage Lesions in Anterior Cruciate Ligament-Reconstructed Knees: A Nationwide Cohort Study From Norway and Sweden of 357 Patients With 2-Year Follow-up.

PubMed

Røtterud, Jan Harald; Sivertsen, Einar Andreas; Forssblad, Magnus; Engebretsen, Lars; Årøen, Asbjørn

2016-02-01

The treatment of concomitant cartilage lesions in anterior cruciate ligament (ACL)-injured knees is debatable. To evaluate the effect of debridement or microfracture (MF) compared with no treatment of concomitant full-thickness (International Cartilage Repair Society [ICRS] grades 3-4) cartilage lesions on patient-reported outcomes after ACL reconstruction. Cohort study; Level of evidence, 2. Six hundred forty-four patients who underwent primary unilateral ACL reconstruction and had a concomitant full-thickness cartilage lesion treated simultaneously by debridement (n = 129) or MF (n = 164), or underwent no treatment (n = 351) of the cartilage lesion, registered in the Norwegian and Swedish National Knee Ligament Registries from 2005 to 2008 were included. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to measure patient-reported outcomes. At a mean follow-up of 2.1 ± 0.2 years after surgery, 357 (55%) patients completed the KOOS. Linear regression analyses were used to evaluate the effect of debridement or MF on the KOOS. No significant effects of debridement were detected in the unadjusted or adjusted regression analyses on any of the KOOS subscales at 2-year follow-up. The MF treatment of the cartilage lesions had significant negative effects at 2-year follow-up on the KOOS Sport and Recreation (Sport/Rec) (regression coefficient [β] = -8.9; 95% confidence interval [CI], -15.1 to -1.5) and Knee-Related Quality of Life (QoL) (β = -8.1; 95% CI, -14.1 to -2.1) subscales in the unadjusted analyses. When adjusting for confounders, MF had significant negative effects on the same KOOS subscales of Sport/Rec (β = -8.6; 95% CI, -16.4 to -0.7) and QoL (β = -7.2; 95% CI, -13.6 to -0.8). For the remaining KOOS subscales of Pain, Symptoms, and Activities of Daily Living, there were no significant unadjusted or adjusted effects of MF. MF of concomitant full-thickness cartilage lesions showed adverse effects on patient-reported outcomes at 2-year follow-up after ACL reconstruction. Debridement of concomitant full-thickness cartilage lesions showed neither positive nor negative effects on patient-reported outcomes at 2-year follow-up after ACL reconstruction. © 2015 The Author(s).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morishige, Naoyuki; Ko, Ji-Ae, E-mail: jiae0831@yamaguchi-u.ac.jp; Morita, Yukiko

The neural guidance protein semaphorin 3A (Sema3A) is expressed in corneal epithelial cells of the adult rat. We have now further investigated the localization of Sema3A in the normal rat corneal epithelium as well as changes in its expression pattern during wound healing after central corneal epithelial debridement. The expression pattern of Sema3A was compared with that of the tight-junction protein zonula occludens-1 (ZO-1), the gap-junction protein connexin43 (Cx43), or the cell proliferation marker Ki67. Immunofluorescence analysis revealed that Sema3A was present predominantly in the membrane of basal and wing cells of the intact corneal epithelium. The expression of Sema3Amore » at the basal side of basal cells was increased in the peripheral epithelium compared with that in the central region. Sema3A was detected in all layers at the leading edge of the migrating corneal epithelium at 6 h after central epithelial debridement. The expression of Sema3A was markedly up-regulated in the basal and lateral membranes of columnar basal cells apparent in the thickened, newly healed epithelium at 1 day after debridement, but it had largely returned to the normal pattern at 3 days after debridement. The expression of ZO-1 was restricted to superficial epithelial cells and remained mostly unchanged during the wound healing process. The expression of Cx43 in basal cells was down-regulated at the leading edge of the migrating epithelium but was stable in the remaining portion of the epithelium. Ki67 was not detected in basal cells of the central epithelium at 1 day after epithelial debridement, when Sema3A was prominently expressed. Immunoblot analysis showed that the abundance of Sema3A in the central cornea was increased 1 day after epithelial debridement, whereas that of ZO-1 or Cx43 remained largely unchanged. This increase in Sema3A expression was accompanied by up-regulation of the Sema3A coreceptor neuropilin-1. Our observations have thus shown that the expression of Sema3A is increased markedly in basal cells of the newly healed corneal epithelium, and that this up-regulation of Sema3A is not associated with cell proliferation. They further suggest that Sema3A might play a role in the regulation of corneal epithelial wound healing.« less

A multicentre, clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience.

PubMed

Hodgson, H; Davidson, D; Duncan, A; Guthrie, J; Henderson, E; MacDiarmid, M; McGown, K; Pollard, V; Potter, R; Rodgers, A; Wilson, A; Horner, J; Doran, M; Simm, S; Taylor, R; Rogers, A; Rippon, M G; Colgrave, M

2017-11-02

Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed. This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing. We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (£6.33) over current standard practice regimens of a four-step debridement process (£8.05), larval therapy (£306.39) and mechanical pad debridement (£11.46). HRWD was well tolerated and was demonstrated to be an efficient debridement tool providing rapid, effective and pain free debridement in a variety of wound types.

[Effects of Nd: YAG laser irradiation on the root surfaces and adhesion of Streptococcus mutans].

PubMed

Yuanhong, Li; Zhongcheng, Li; Mengqi, Luo; Daonan, Shen; Shu, Zhang; Shu, Meng

2016-12-01

This study aimed to evaluate the effects of treatment with different powers of Nd: YAG laser irradiation on root surfaces and Streptococcus mutans (S. mutans) adhesion. Extracted teeth because of severe periodontal disease were divided into the following four groups: control group, laser group 1, laser group 2, and laser group 3. After scaling and root planning, laser group 1, laser group 2, and laser group 3 were separately treated with Nd: YAG laser irradiation (4/6/8 W, 60 s); however, the control group did not receive the treatment. Scanning electron microscopy (SEM) was used to determine the morphology. S. mutans were cultured with root slices from each group. Colony forming unit per mL (CFU·mL⁻¹) was used to count and compare the amounts of bacteria adhesion among groups. SEM was used to observe the difference of bacteria adhesion to root surfaces between control group (scaling) and laser group 2 (6 W, 60 s), thereby indicating the different bacteria adhesions because of different treatments. Morphology alterations indicated that root surfaces in control group contain obvious smear layer, debris, and biofilm; whereas the root surfaces in laser group contain more cracks with less smear layer and debris. The bacteria counting indicated that S. mutans adhesion to laser group was weaker than that of control group (P<0.05). No statistical significance among the laser groups (P>0.05) was observed. Morphology alterations also verified that S. mutans adhesion to laser group 2 (6 W, 60 s) was weaker than that of control group (scaling). This study demonstrated that Nd: YAG laser irradiation treatment after scaling can reduce smear layer, debris, and biofilm on the root surfaces as compared with conventional scaling. The laser treatment reduces the adhesion of S. mutans as well. However, Nd: YAG laser irradiation can cause cracks on the root surfaces. In this experiment, the optimum laser power of 6 W can thoroughly remove the smear layer and debris, as well as relatively improve the control of thermal damagee.

GENETIC ANALYSIS OF THE AGGA LOCUS INVOLVED IN AGGLUTINATION ND ADHERENCE OF PSEUDOMONAS PUTIDA, A BENEFICIAL FLUORESCENT PSEUDOMONAD

EPA Science Inventory

An isolate of Pseudomonas putida, which rapidly adheres to plant roots is agglutinated by a glycoprotein from root surfaces. gglutination is presented and adherence to the root surface is diminished by Tn5 insertion in mutant 5123. wo cosmid clones from wild type P putida and 2.7...

Quantitative Classification of Rice (Oryza sativa L.) Root Length and Diameter Using Image Analysis.

PubMed

Gu, Dongxiang; Zhen, Fengxian; Hannaway, David B; Zhu, Yan; Liu, Leilei; Cao, Weixing; Tang, Liang

2017-01-01

Quantitative study of root morphological characteristics of plants is helpful for understanding the relationships between their morphology and function. However, few studies and little detailed and accurate information of root characteristics were reported in fine-rooted plants like rice (Oryza sativa L.). The aims of this study were to quantitatively classify fine lateral roots (FLRs), thick lateral roots (TLRs), and nodal roots (NRs) and analyze their dynamics of mean diameter (MD), lengths and surface area percentage with growth stages in rice plant. Pot experiments were carried out during three years with three rice cultivars, three nitrogen (N) rates and three water regimes. In cultivar experiment, among the three cultivars, root length of 'Yangdao 6' was longest, while the MD of its FLR was the smallest, and the mean diameters for TLR and NR were the largest, the surface area percentage (SAP) of TLRs (SAPT) was the highest, indicating that Yangdao 6 has better nitrogen and water uptake ability. High N rate increased the length of different types of roots and increased the MD of lateral roots, decreased the SAP of FLRs (SAPF) and TLRs, but increased the SAP of NRs (SAPN). Moderate decrease of water supply increased root length and diameter, water stress increased the SAPF and SAPT, but decreased SAPN. The quantitative results indicate that rice plant tends to increase lateral roots to get more surface area for nitrogen and water uptake when available assimilates are limiting under nitrogen and water stress environments.

Quantitative Classification of Rice (Oryza sativa L.) Root Length and Diameter Using Image Analysis

PubMed Central

Gu, Dongxiang; Zhen, Fengxian; Hannaway, David B.; Zhu, Yan; Liu, Leilei; Cao, Weixing; Tang, Liang

2017-01-01

Quantitative study of root morphological characteristics of plants is helpful for understanding the relationships between their morphology and function. However, few studies and little detailed and accurate information of root characteristics were reported in fine-rooted plants like rice (Oryza sativa L.). The aims of this study were to quantitatively classify fine lateral roots (FLRs), thick lateral roots (TLRs), and nodal roots (NRs) and analyze their dynamics of mean diameter (MD), lengths and surface area percentage with growth stages in rice plant. Pot experiments were carried out during three years with three rice cultivars, three nitrogen (N) rates and three water regimes. In cultivar experiment, among the three cultivars, root length of ‘Yangdao 6’ was longest, while the MD of its FLR was the smallest, and the mean diameters for TLR and NR were the largest, the surface area percentage (SAP) of TLRs (SAPT) was the highest, indicating that Yangdao 6 has better nitrogen and water uptake ability. High N rate increased the length of different types of roots and increased the MD of lateral roots, decreased the SAP of FLRs (SAPF) and TLRs, but increased the SAP of NRs (SAPN). Moderate decrease of water supply increased root length and diameter, water stress increased the SAPF and SAPT, but decreased SAPN. The quantitative results indicate that rice plant tends to increase lateral roots to get more surface area for nitrogen and water uptake when available assimilates are limiting under nitrogen and water stress environments. PMID:28103264

Care of Pediatric Neurosurgical Patients in Iraq in 2007: Clinical and Ethical Experience of a Field Hospital

DTIC Science & Technology

2010-09-01

epidural abscess from a prior craniotomy for trauma at our facility. Patient Care Of the 42 pediatric patients seen in consultation, 28 required surgical...bifrontal craniotomy for the repair of an anterior skull base inju- ry (3 cases), decompressive craniectomy (5 cases), local debridement and wound closure...for PHI (10 cases), ICP monitoring only (4 cases), spinal instrumentation (1 case), spinal exploration/debridement with lumbar drainage for

Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.

PubMed

Hopp, Sascha; Tumin, Masjudin; Wilhelm, Peter; Pohlemann, Tim; Kelm, Jens

2014-11-01

We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting.

Arthroscopic rotator cuff debridement without decompression for the treatment of tendinosis.

PubMed

Budoff, Jeffrey E; Rodin, Dennis; Ochiai, Derek; Nirschl, Robert P

2005-09-01

The treatment of rotator cuff injury in the absence of a full-thickness tear has traditionally consisted of acromioplasty. However, this disorder may also be treated by arthroscopic rotator cuff debridement without acromioplasty. Our previous study of 79 shoulders so treated reported 87% good or excellent results at an average 53-month follow-up. The purpose of this article is to report the long-term, average 9.5-year follow-up of this cohort. Long-term follow-up of case series. We retrospectively reviewed the records of 62 shoulders in 60 patients who had undergone arthroscopic rotator cuff debridement for partial-thickness rotator cuff tears. Demographic criteria, residual pain, and the ability to return to recreational athletics were noted. The UCLA Shoulder Score and the Simple Shoulder Test scores were determined and statistical analysis performed. Using the UCLA Shoulder Score, there were 79% excellent or good results at an average 114 months of follow-up. Patients with Workers' Compensation claims had significantly worse results, with only 40% rated good or excellent. Of the 60 patients, 77% had no or only minimal pain, 57% were still able to perform recreational athletics without difficulty, and 20% could participate at a lower level of intensity. Arthroscopic debridement of rotator cuff injury in the absence of a full-thickness tear has good long-term results and minimizes additional surgical trauma. Level IV, case series.

Arthroscopic synovectomy, irrigation, and debridement for treatment of septic ankle arthrosis: a systematic review and case series.

PubMed

Mankovecky, Michael R; Roukis, Thomas S

2014-01-01

Septic arthrosis of the ankle is a rare, often devastating, infection, with a high potential for morbidity and mortality. Delay in treatment can lead to cartilage erosion, painful synovitis, and osteomyelitis. Septic ankle arthrosis deserves prompt recognition and intervention. However, quality, sound, protocol-directed arthroscopic treatment of septic ankle arthrosis of the ankle has not yet been reported. We performed a systematic review of the electronic databases and other relevant peer-reviewed sources to determine the outcomes and treatment protocols associated with septic ankle arthrosis treated with arthroscopic synovectomy, irrigation, and debridement. Nine studies, involving a total of 15 ankles, met our inclusion criteria. In addition, we present the short-term outcomes of a protocol-driven arthroscopic synovial biopsy, deep culture procurement, synovectomy, irrigation, and debridement approach for 8 ankles (8 patients). To our knowledge, this would be the largest individual case series specific to arthroscopic treatment of septic ankle arthrosis. The most common infectious organism reported in the systematic review and in our case series was methicillin-sensitive Staphylococcus aureus. Arthroscopic synovectomy, irrigation, and debridement represents an acceptable treatment method for septic ankle arthrosis and demonstrated outcomes similar to the more traditional open approach, with fewer complications. Additional, appropriately weighted, randomized controlled studies with long-term follow-up are warranted. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

CO2 laser debridement of sulphur mustard (bis-2-chloroethyl sulphide) induced cutaneous lesions accelerates production of a normal epidermis with elimination of cytological atypia.

PubMed

Smith, K J; Skelton, H G; Martin, J L; Hurst, C G; Hackley, B E

1997-10-01

Sulphur mustard (bis-2-chloroethyl sulphide; HD) exposure acutely produces lesions that vary from mild erythema, to blister formation, to necrosis. When blisters occur, with or without necrosis, healing of the lesions is delayed. Weanling pigs exposed to a mild erythema-producing dose of HD and to a moderate erythema-producing dose that consistently gave microblister formation were treated with CO2 laser (Tru-Pulse) debridement at 6, 24 or 48 h after exposure. The histopathological features observed at 14 days after exposure in control skin and skin exposed to both HD doses were compared with the features observed in CO2 laser-debrided skin in non-exposed and HD-exposed skin sites. The overlying epidermis in the non-laser treated lesions was thin, with cytological atypia and squamoid changes within the basal cell layer, as well as scattered apoptotic/necrotic keratinocytes. An increased inflammatory infiltrate and necrobiotic changes in the dermis were seen at the higher HD dose. All laser-treated lesions appeared identical, with a thick, differentiated epidermis and a well-formed basal cell layer. There was minimal inflammatory infiltrate. In the papillary dermis there were increased stromal cells. Laser debridement of mild clinical lesions induced by HD produced a more functional epidermis by 14 days as well as clearing the epidermis of damaged keratinocytes.

A comparison of thermocouple and infrared thermographic analysis of temperature rise on the root surface during the continuous wave of condensation technique.

PubMed

Mc Cullagh, J J; Setchell, D J; Gulabivala, K; Hussey, D L; Biagioni, P; Lamey, P J; Bailey, G

2000-07-01

This study was designed to use two methods of temperature measurement to analyse and quantify the in vitro root surface temperature changes during the initial stage of the continuous wave technique of obturation of 17 single-rooted premolar teeth with standard canal preparations. A model was designed to allow simultaneous temperature measurement with both thermocouples and an infrared thermal imaging system. Two thermocouples were placed on the root surface, one coronally and the other near the root apex. A series of thermal images were recorded by an infrared thermal imaging camera during the downpack procedure. The mean temperature rises on the root surface, as measured by the two thermocouples, averaged 13.9 degrees C over the period of study, whilst the infrared thermal imaging system measured an average rise of 28.4 degrees C at the same sites. Temperatures at the more apical point were higher than those measured coronally. After the first wave of condensation, the second activation of the plugger in the canal prior to its removal always resulted in a secondary rise in temperature. The thermal imaging system detected areas of greater temperature change distant from the two selected thermocouple sites. The continuous wave technique of obturation may result in high temperatures on the external root surface. Infrared thermography is a useful device for mapping patterns of temperature change over a large area.

Surface roughness and bacterial adhesion on root dentin treated with diode laser and conventional desensitizing agents.

PubMed

Cury, Maiza S; Silva, Camilla B; Nogueira, Ruchele D; Campos, Michelle G D; Palma-Dibb, Regina G; Geraldo-Martins, Vinicius R

2018-02-01

The treatments for dentin hypersensitivity (DH) may change the surface roughness of the root dentin, which can lead to biofilm accumulation, increasing the risk of root caries. The aim was to compare the surface roughness of root dentin after different treatments of DH and the biofilm formation on those surfaces. After initial surface roughness (Sa) assessment, 50 bovine root fragments received the following treatments (n = 10): G 1-no treatment; G2-5% sodium fluoride varnish; G3-professional application of a desensitizing dentifrice; G4-toothbrushing with a desensitizing dentifrice; and G5-diode laser application (908 nm; 1.5 W, 20 s). The Sa was reevaluated after treatments. Afterward, all samples were incubated in a suspension of Streptococcus mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted using a stereoscope, and the results were expressed in CFU/mL. The one-way ANOVA and the Tukey's tests compared the roughness data and the results obtained on the bacterial adhesion test (α = 5%). G2 (2.3 ± 1.67%) showed similar Sa variation than G1 (0.25 ± 0.41%) and G5 (5.69 ± 0.99%), but different from group G3 (9.05 ± 2.39%). Group 4 showed the highest Sa variation (30.02 ± 3.83%; p < 0.05). Bacterial adhesion was higher in G4 (2208 ± 211.9), suggesting that bacterial growth is greater on rougher surfaces. The diode laser and the conventional treatments for DH may change the surface roughness of the root dentin, but only brushing with desensitizing dentifrice induced a higher bacteria accumulation on root dentin surface.

Fully covered self-expanding metal stents versus lumen-apposing fully covered self-expanding metal stent versus plastic stents for endoscopic drainage of pancreatic walled-off necrosis: clinical outcomes and success.

PubMed

Siddiqui, Ali A; Kowalski, Thomas E; Loren, David E; Khalid, Ammara; Soomro, Ayesha; Mazhar, Syed M; Isby, Laura; Kahaleh, Michel; Karia, Kunal; Yoo, Joseph; Ofosu, Andrew; Ng, Beverly; Sharaiha, Reem Z

2017-04-01

Endoscopic transmural drainage/debridement of pancreatic walled-off necrosis (WON) has been performed using double-pigtail plastic (DP), fully covered self-expanding metal stents (FCSEMSs), or the novel lumen-apposing fully covered self-expanding metal stent (LAMS). Our aim was to perform a retrospective cohort study to compare the clinical outcomes and adverse events of EUS-guided drainage/debridement of WON with DP stents, FCSEMSs, and LAMSs. Consecutive patients in 2 centers with WON managed by EUS-guided debridement were divided into 3 groups: (1) those who underwent debridement using DP stents, (2) debridement using FCSEMSs, (3) debridement using LAMSs. Technical success (ability to access and drain a WON by placement of transmural stents), early adverse events, number of procedures performed per patient to achieve WON resolution, and long-term success (complete resolution of the WON without need for further reintervention at 6 months after treatment) were evaluated. From 2010 to 2015, 313 patients (23.3% female; mean age, 53 years) underwent WON debridement, including 106 who were drained using DP stents, 121 using FCSEMSs, and 86 using LAMSs. The 3 groups were matched for age, cause of the pancreatitis, WON size, and location. The cause of the patients' pancreatitis was gallstones (40.6%), alcohol (30.7%), idiopathic (13.1%), and other causes (15.6%). The mean cyst size was 102 mm (range, 20-510 mm). The mean number of endoscopy sessions was 2.5 (range, 1-13). The technical success rate of stent placement was 99%. Early adverse events were noted in 27 of 313 (8.6%) patients (perforation in 6, bleeding in 8, suprainfection in 9, other in 7). Successful endoscopic therapy was noted in 277 of 313 (89.6%) patients. When comparing the 3 groups, there was no difference in the technical success (P = .37). Early adverse events were significantly lower in the FCSEMS group compared with the DP and LAMS groups (1.6%, 7.5%, and 9.3%; P < .01). At 6-month follow-up, the rate of complete resolution of WON was lower with DP stents compared with FCSEMSs and LAMSs (81% vs 95% vs 90%; P = .001). The mean number of procedures required for WON resolution was significantly lower in the LAMS group compared with the FCSEMS and DP groups (2.2 vs 3 vs 3.6, respectively; P = .04). On multivariable analysis, DP stents remain the sole negative predictor for successful resolution of WON (odds ratio [OR], 0.18; 95% confidence interval, 0.06-0.53; P = .002) after adjusting for age, sex, and WON size. Although there was no significant difference between FCSEMSs and LAMSs for WON resolution, the LAMS was more likely to have early adverse events (OR, 6.6; P = .02). EUS-guided drainage/debridement of WON using FCSEMSs and LAMSs is superior to DP stents in terms of overall treatment efficacy. The number of procedures required for WON resolution was significantly lower with LAMSs compared with FCSEMSs and DP stents. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Effect of Er:YAG laser-activated irrigation solution on Enterococcus Faecalis biofilm in an ex-vivo root canal model.

PubMed

Sahar-Helft, Sharonit; Stabholtz, Adam; Moshonov, Joshua; Gutkin, Vitaly; Redenski, Idan; Steinberg, Doron

2013-07-01

Abstract Objective: The purpose of this study was to evaluate mineral content and surface morphology of root canals coated with Enterococcus faecalis biofilm after treatment with several endodontic irrigation solutions, with and without Er:YAG laser-activated irrigation (LAI). LAI has been introduced as a powerful method for root canal irrigation resulting in smear-layer removal from the root canal wall. Distal and palatal roots from 60 freshly extracted human molars were used in this study. The coronal of each tooth was removed. Roots were split longitudinally and placed in an ultrasonic bath to remove the smear layer, creating conditions for the formation of E. faecalis biofilm. After incubation, the two halves were reassembled in impression material to simulate clinical conditions. Specimens were divided into two main groups: roots rinsed with irrigation solutions and roots subjected to laser irradiation combined with irrigation solutions. Solutions tested were 2% chlorhexidine and 17% ethylenediaminetetraacetic acid (EDTA) and saline. Surface morphology: 17% EDTA irrigant solution combined with Er:YAG laser showed the best results for removing bacteria from the root canal walls. Chemical analysis: all samples treated with combined laser irradiation and irrigation solution had low surface levels of Ca compared with samples treated with irrigation alone. The Ca/P ratio was highest in the laser-EDTA group. Overall, mineral changes caused by laser with irrigation solutions were minimal, and statistically nonsignificant. In vitro irrigation solutions, combined with Er:YAG laser irradiation, were effective in removing E. faecalis biofilm from root canal walls. Irrigation solutions without laser irradiation were less effective, leaving a layer of biofilm on the dentin surface.

In Flanders fields: the Great War, Antoine Depage, and the resurgence of débridement.

PubMed

Helling, T S; Daon, E

1998-08-01

The care of traumatic wounds has evolved over hundreds of years, largely as a result of armed conflicts. The lessons learned during World War I in the treatment of extensive soft-tissue injuries proved invaluable in reducing infection and preventing loss of limb and life. Foremost among these was the use of debridement. This report reviews the development of debridement as standard treatment of war wounds and highlights the surgeon largely responsible for its resurgence during one of this century's saddest chapters. Before World War I, the care of wounds consisted of minimal exploration and liberal use of then-new antiseptics. For limited injuries, this approach appeared adequate. World War I saw the introduction of devastating weapons that produced injuries that caused extensive devitalization of tissue. Standard treatment of these patients proved woefully inadequate to prevent life-threatening infections. This is a historical review of the conditions that occurred during World War I that prompted a change in wound management. One of those responsible for this change was the Belgian surgeon Antoine Depage. His life and contributions to the care of war wounds are profiled. Depage reintroduced the discarded French practice of wound incision and exploration (debridement) and combined it with excision of devitalized tissue. Through the use of debridement, excision, and delayed wound closure based on bacteriologic survey, Depage was able to reduce the incidence of infectious complications of soft-tissue injuries, particularly those involving fractures. Through his experiences in the Great War, Antoine Depage was able to formulate a treatment plan for wounds of war. All such injuries were assumed to be contaminated and, as such, they required early and careful debridement. Depage thought that wound closure should often be delayed and based his decision to close on the bacteriologic status of the wound. To him, we owe our current management of traumatic wounds.

Arthroscopic Debridement for Primary Degenerative Osteoarthritis of the Elbow Leads to Significant Improvement in Range of Motion and Clinical Outcomes: A Systematic Review.

PubMed

Sochacki, Kyle R; Jack, Robert A; Hirase, Takashi; McCulloch, Patrick C; Lintner, David M; Liberman, Shari R; Harris, Joshua D

2017-12-01

The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates. A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value < .05. Nine articles (209 subjects, 213 elbows, 187 males, 22 females, mean age 45.7 ± 7.1 years, mean follow-up 41.7 ± 16.3. months; 75% right, 25% left; 79% dominant elbow, 21% nondominant) were analyzed. Elbow extension (23.4°-10.7°, Δ 12.7°), flexion (115.9°-128.7°, Δ 12.8°), and global arc of motion (94.5°-117.6°, Δ 23.1°) had statistically significant and clinically relevant improvement following arthroscopic debridement (P < .0001 for all). There was also a statistically significant (P < .0001) and clinically relevant improvement in the Mayo Elbow Performance Score (60.7-84.6, Δ 23.9) postoperatively. Six patients (2.8%) had postoperative complications. Nine (4.2%) underwent reoperation. Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. Systematic review of level IV studies. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

In Flanders fields: the Great War, Antoine Depage, and the resurgence of débridement.

PubMed Central

Helling, T S; Daon, E

1998-01-01

OBJECTIVE: The care of traumatic wounds has evolved over hundreds of years, largely as a result of armed conflicts. The lessons learned during World War I in the treatment of extensive soft-tissue injuries proved invaluable in reducing infection and preventing loss of limb and life. Foremost among these was the use of debridement. This report reviews the development of debridement as standard treatment of war wounds and highlights the surgeon largely responsible for its resurgence during one of this century's saddest chapters. SUMMARY BACKGROUND DATA: Before World War I, the care of wounds consisted of minimal exploration and liberal use of then-new antiseptics. For limited injuries, this approach appeared adequate. World War I saw the introduction of devastating weapons that produced injuries that caused extensive devitalization of tissue. Standard treatment of these patients proved woefully inadequate to prevent life-threatening infections. METHODS: This is a historical review of the conditions that occurred during World War I that prompted a change in wound management. One of those responsible for this change was the Belgian surgeon Antoine Depage. His life and contributions to the care of war wounds are profiled. Depage reintroduced the discarded French practice of wound incision and exploration (debridement) and combined it with excision of devitalized tissue. RESULTS: Through the use of debridement, excision, and delayed wound closure based on bacteriologic survey, Depage was able to reduce the incidence of infectious complications of soft-tissue injuries, particularly those involving fractures. CONCLUSIONS: Through his experiences in the Great War, Antoine Depage was able to formulate a treatment plan for wounds of war. All such injuries were assumed to be contaminated and, as such, they required early and careful debridement. Depage thought that wound closure should often be delayed and based his decision to close on the bacteriologic status of the wound. To him, we owe our current management of traumatic wounds. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. PMID:9712561

One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series.

PubMed

Zhang, Hong-qi; Lin, Min-zhong; Li, Jin-song; Tang, Ming-xing; Guo, Chao-feng; Wu, Jian-huang; Liu, Jin-yang

2013-03-01

The purpose of this study is to compare the clinical outcomes of surgical management by one-stage posterior debridement, transforaminal lumbar interbody fusion (TLIF) and instrumentation and combined posterior and anterior approaches for lumbar spinal tuberculosis, and determine the clinical effectiveness of the posterior only surgical treatment for lumbar spinal TB at the same time. Thirty-seven patients who suffered lumbar tuberculosis were treated by two different surgical procedures in our center from May 2004 to June 2012. All the cases were divided into two groups: 19 cases in Group A underwent one-stage posterior debridement, TLIF and instrumentation, and 18 cases in Group B underwent posterior instrumentation, anterior debridement and bone graft in a single-stage procedure. The operation time, blood loss, lumbar kyphotic angle, recovery of neurological function and fusion time were, respectively, compared between Group A and Group B. The average follow-up period for Group A was 46.6 ± 16.7 months, and for Group B, 47.5 ± 15.0 months. It was obvious that the average operative duration and blood loss of Group A was less than those of Group B. Lumbar tuberculosis was completely cured and the grafted bones were fused in 10 months in all patients. There was no persistence or recurrence of infection and no differences in the radiological results in both groups. The kyphosis was significantly corrected after surgical management. The average pretreatment ESR was 60.7 ± 22.5 mm/h, which became normal (9.0 ± 2.8 mm/h) within 3 months in all patients. Surgical management by one-stage posterior debridement, TLIF and instrumentation for lumbar tuberculosis is feasible and effective. This approach obtained better clinical outcomes than combined posterior and anterior surgeries.

Canal Transportation, Unprepared Areas, and Dentin Removal after Preparation with BT-RaCe and ProTaper Next Systems.

PubMed

Brasil, Sabrina C; Marceliano-Alves, Marília F; Marques, Márcia L; Grillo, João P; Lacerda, Mariane F L S; Alves, Flávio R F; Siqueira, José F; Provenzano, José C

2017-10-01

This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) instrument systems in the mesial canals of mandibular molars using micro-computed tomographic (micro-CT) imaging. A total of 17 type IV mesial roots of extracted first mandibular molars were scanned using micro-CT imaging before and after root canal preparation with the 2 instrument systems. Both systems were used in the same root but alternating the mesial canals from root to root. The following parameters were analyzed: root canal volume, surface area, unprepared surface areas, transportation, canal/root width ratio, and preparation time. There were no statistically significant differences between the 2 systems for all evaluated parameters (P > .05). The unprepared surface areas for the full canal length and the apical 5-mm segment were 33% and 14% for BT-RaCe and 31% and 14% for ProTaper Next, respectively. After preparation, all root canals had a diameter that was not larger than 35% of the root diameter at the coronal and middle segments. The 2 systems showed no differences in any of the evaluated shaping parameters. None of the tested systems put the roots at risk of fracture because of excessive dentin removal. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Scanning electron microscopic study of the effects of Er:YAG laser on root cementum.

PubMed

Fujii, T; Baehni, P C; Kawai, O; Kawakami, T; Matsuda, K; Kowashi, Y

1998-11-01

Use of Er:YAG laser has been proposed for the removal of microbial deposits and calculus present on teeth affected by periodontal disease. However, the influence of Er:YAG laser irradiation on root surfaces has not yet been fully investigated. The aim of the present study was to evaluate the effects of Er:YAG laser irradiation on root cementum by scanning electron microscopy (SEM). Specimens were obtained from extracted human periodontally-diseased teeth using a water-cooled high-speed bur. An Er:YAG laser beam was then applied at various powers ranging from 25 to 100 mJ/ pulse/sec. The laser irradiation was performed under water irrigation, with the tip held perpendicular to the root surface in the contact mode. Following laser exposure, specimens were fixed, dehydrated, and dried at critical-point in liquid CO2. After mounting on SEM plates and sputter-coating with gold, the cementum surface was examined by SEM. Observations of the root surface showed a relatively flat surface in control specimens. In Er:YAG exposed specimens, the laser beam created a circular, notched-edge, crater-like defect on the root. The bottom of the lesion showed an irregular and sharp-pointed surface. Subsequently, the specimens were fractured with a sharp scalpel perpendicularly to the surface. SEM observations of these specimens showed a 15 microm layer of damaged tissue within the laser-irradiated cementum. The tissue presented an amorphous appearance and the Sharpey's and matrix fiber bundles were not clearly distinguishable. These observations indicate that cementum tissue could be damaged by Er:YAG laser irradiation.

The use of guided tissue regeneration principles in endodontic surgery for induced chronic periodontic-endodontic lesions: a clinical, radiographic, and histologic evaluation.

PubMed

Britain, Steven K; Arx, Thomas von; Schenk, Robert K; Buser, Daniel; Nummikoski, Pirkka; Cochran, David L

2005-03-01

Chronic periodontic-endodontic lesions are not uncommon in clinical practice and their regenerative capacity has long been questioned. However, there are no published studies investigating the application of guided tissue regeneration techniques in combination with endodontic surgery using an induced perio-endo defect model. This study evaluated the clinical, radiographic, and histologic outcomes of three surgical procedures used to treat induced perio-endo lesions. Pulpal necrosis was induced in foxhounds along with surgical removal of radicular buccal bone. After 4 weeks, chronic lesions were clinically and radiographically assessed. Treatment surgery consisted of apicoectomy, root canal instrumentation, and retrofilling with mineral trioxide aggregate. Teeth were then assigned to one of the following treatment groups: open flap debridement only (OFD), OFD with bioabsorbable porcine-derived collagen membrane (BG), or OFD with BG and anorganic bovine bone matrix (BO/BG). Clinical parameters and standardized radiographs were assessed at defect creation; treatment surgery; and at 1, 2, 4, and 6 months. Animals were sacrificed at 6 months and specimens prepared for histometric analysis. Clinical and radiographic conditions improved during the study period. Mean epithelial attachment was similar between all groups. Mean connective tissue attachment for groups OFD, BG, and BO/BG was 3.79 mm, 2.63 mm, and 1.75 mm, respectively, and mean radicular bone height was 2.16 mm, 3.24 mm, and 3.45 mm, respectively. Statistically significant increases in the amount of new cementum were observed in groups BG and BO/BG when compared with OFD (P <0.05). Treatment of combined induced perio-endo lesions using bioabsorbable collagen membranes alone or in combination with anorganic bovine bone matrix resulted in increased amounts of bone, periodontal ligament, and significant increases in the amount of new cementum when compared to open flap debridement in a canine model.

Effect of zoledronic acid used in the root surface treatment of late replanted teeth: a study in rats.

PubMed

Mori, Graziela Garrido; Janjacomo, Daniela Maria de Mendonça; Nunes, Daniele Clapes; Castilho, Lithiene Ribeiro

2010-01-01

This study evaluated the use of zoledronic acid, a resorption inhibitor, as a medication for root resorption treatment of late replanted teeth. Twenty-four maxillary right central incisors of rats were avulsed and kept dry for 30 min. Then, the teeth were divided into 2 groups. In group I, root surface was treated with 2% sodium fluoride for 20 min; in group II, 10-6M zoledronic acid solution was used for 20 min. All root canals were filled with calcium hydroxide. Next, teeth were replanted in their respective sockets. After 15 and 60 days post-replantation, the animals were killed and the anatomic pieces were obtained and prepared for microscopic and morphometric analyses. The results showed that zoledronic acid was capable of limiting the occurrence of root resorption and preserving cementum resorption. Further research must be performed to confirm the use of zoledronic acid in root surface treatment of late replanted teeth.

Cross-reactive antigens and lectin as determinants of symbiotic specificity in the Rhizobium-clover association.

PubMed Central

Dazzo, F B; Hubbell, D H

1975-01-01

Cross-reactive antigens of clover roots and Rhizobium trifolii were detected on their cell surfaces by tube agglutination, immunofluorescent, and radioimmunoassay techniques. Anti-clover root antiserum had a higher agglutinating titer with infective strains of R. trifolii than with noninfective strains. The root antiserum previously adsorbed with noninfective R. trifolii cells remained reactive only with infective cells, including infective revertants. When adsorbed with infective cells, the root antiserum was reactive with neither infective nor noninfective cells. Other Rhizobium species incapable of infecting clover did not demonstrate surface antigens cross-reactive with clover. Radioimmunoassay indicated twice as much antigenic cross-reactivity of clover roots and R. trifolii 403 (infective) than R. trifolii Bart A (noninfective). Immunofluorescence with anti-R. trifolii (infective) antiserum was detected on the exposed surface of the root epidermal cells and diminished at the root meristem. The immunofluorescent crossreaction on clover roots was totally removed by adsorption of anti-R. trifolii (infective) antiserum with encapsulated infective cells but not with noninfective cells. The cross-reactive capsular antigens from R. trifolii strains were extracted and purified. The ability of these antigens to induce clover root hair deformation was much greater when they were obtained from the infective than noninfective strains. The cross-reactive capsular antigen of R. trifolii 403 was characterized as a high-molecular-weight (greater than 4.6 times 10(6) daltons), beta-linked, acidic heteropolysaccharide containing 2-deoxyglucose, galactose, glucose, and glucuronic acid. A soluble, nondialyzable, substance (clover lectin) capable of binding to the cross-reactive antigen and agglutinating only infective cells of R. trifolii was extracted from white clover seeds. This lectin was sensitive to heat, Pronase, and trypsin. inhibition studies indicated that 2-deoxyglucose was the most probable haptenic determinant of the cross-reactive capsular antigen capable of binding to the root antiserum and the clover lectin. A model is proposed suggesting the preferential adsorption of infective versus noninfective cells of R. trifolii on the surface of clover roots by a cross-bridging of their common surface antigens with a multivalent clover lectin. Images PMID:55100

Evaluation of Temperature Elevation During Root Canal Treatment with Dual Wavelength Laser: 2780 nm Er,Cr:YSGG and 940 nm Diode.

PubMed

Al-Karadaghi, Tamara Sardar; Gutknecht, Norbert; Jawad, Hussein A; Vanweersch, Leon; Franzen, Rene

2015-09-01

The purpose of this study was to evaluate the effects of dual wavelength (2780 nm Er,Cr:YSGG and 940 nm diode) laser with radial firing tip (RFT) on the external root surface and sub-surfaces, in terms of temperature changes during laser-assisted root canal treatment. A significant factor that may limit the use of lasers in endodontics is the possible thermal injury to tooth supporting structures. A total of 50 sound single-rooted extracted teeth were divided randomly into two groups (n = 25). Group A, irradiated with Er,Cr:YSGG laser at 1.06 W, 50 Hz, and 50 μs was a control group, and group B was irradiated with dual wavelength of Er,Cr:YSGG laser with the same settings as group A and a diode laser of 0.51 W at 4 ms and 10 ms pulse duration. K-type thermocouples were used to record temperature changes at the cervical, middle, and apical root thirds, on root surfaces and sub-surfaces, arising from delivery of laser energy through RFT. Temperature elevation in group B was significantly higher in the middle and apical thirds of the prepared samples than in group A (p < 0.0001). Group B presented a mean temperature elevation of 5.07°C on the apical surface region corresponding to a 1.48 mm dentin thickness, whereas a mean temperature increase of 7.72°C was recorded corresponding to dentin thickness of 0.95 mm. Within the studied parameters, the dual wavelength laser did not result in adverse thermal changes on the external root surface in vitro.

Root surface temperature variation during mechanical removal of root canal filling material. An in vitro study.

PubMed

García-Cuerva, Martín; Horvath, Lucía; Pinasco, Laura; Ciparelli, Verónica; Gualtieri, Ariel; Casadoumecq, Ana C; Rodríguez, Pablo; Gonzalez-Zanotto, Carlos

2017-04-01

The aim of this study was to analyze in vitro temperature changes on the outer surface of the dental root during mechanical filling removal procedures. Thirty recently extracted single-rooted lower premolars were cut transversally at 16 mm from the apex in order to standardize sample length. Endodontic treatment was performed on them. The filling material was subsequently removed using Gates Glidden (G1, G2, G3); Peeso (P1, P2, P3) and PostecPlus FRC (FRC) reamers while temperatures were measured on the outer surface using a digital device with thermocouple at 0, 2, 4, 6, 8, 10 and 15 seconds. Temperatures were compared using repeated measures ANOVA followed by pairwise comparison with Tukey's test. All reamers caused significant temperature variation between different times (p<0.05). Pairwise comparisons indicated that temperature increased with time for all reamers (p<0.05). Significant differences in temperature were found between different reamers after 0, 2, 4, 6, 8,10 and 15 seconds (p<0.05). Temperature at the root surface increased considerably. Values higher than 50°C were recorded, the greatest increase from baseline being 16°C. Accordingly, if the procedure were begun at 37°C (physiological temperature), the temperature in the surrounding tissues - cementum, periodontium and bone - would rise to 53°C. An increase in 10°C above body temperature at the root surface may cause lesions in surrounding tissues. While removing filling material, it is essential to cool, control action time and use instruments in perfect condition, all of which may contribute to reducing the heat generated and transmitted to the outer root surface. Sociedad Argentina de Pediatría.

Endoscopic treatment of Morel-Lavallee lesion.

PubMed

Kim, Sunghoon

2016-05-01

Morel-Lavallee lesion is a closed degloving soft tissue injury in which subcutaneous tissue is torn from the underlying muscular fascia. The tear leads to venolymphatic leak, and concomitant adipose tissue necrosis from the force of the trauma causes swelling and possible infection at the site of injury. The traditional treatment for the lesion is surgical drainage and debridement. In this report, an endoscopic method is described, which achieves the goal of an open surgical debridement but minimizes surgical morbidity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Descriptive Summary of Patients Seen at the Surgical Companies During Operation Iraqi Freedom-1

DTIC Science & Technology

2004-12-07

4 4 Tissue resection 2 1 3 Vascular shunt 2 2 Chest tube placement 1 1 Cholecystectomy 1 1 Cystostomy 1 1 Decompression craniotomy 1...debridement of his wounds and an open reduction internal fixation of his fracture. On 16 April, the patient developed purulent drainage of his wound and...went back to the operating room for another irrigation and debridement and placement of antibiotic beads. On 22 April, he had further drainage of his

Surgical treatment of hematogenous vertebral Aspergillus osteomyelitis.

PubMed

Bridwell, K H; Campbell, J W; Barenkamp, S J

1990-04-01

Three cases of Aspergillus fumigatas vertebral osteomyelitis failed courses of medical treatment. Each was subsequently treated with anterior vertebral debridement and posterior segmental spinal instrumentation. Despite poor nutritional and immune systems, resolution of the infection and subsequent anterior ankylosis occurred in each patient, with follow-up ranging from 1 to 3 years. If patients with aspergillus vertebral osteomyelitis do not respond to medical treatment, early surgical debridement and stabilization in combination with intravenous amphotericin B can lead to resolution and bony ankylosis.

Cervical necrotizing fasciitis as a complication of acute epiglottitis managed with minimally aggressive surgical intervention: Case report.

PubMed

Gollapalli, Rajesh Babu; Naiman, Ana Nusa; Merry, David

2015-07-01

Cervical necrotizing fasciitis secondary to epiglottitis is rare. The standard treatment of this severe condition has long been early and aggressive surgical debridement and adequate antimicrobial therapy. We report the case of an immunocompetent 59-year-old man who developed cervical necrotizing fasciitis as a complication of acute epiglottitis. We were able to successfully manage this patient with conservative surgical treatment (incision and drainage, in addition to antibiotic therapy) that did not involve aggressive debridement.

Evaluation of Debridement Techniques for Endodontic Instruments

DTIC Science & Technology

1976-08-20

were used to instrument canals on extracted teeth. The instrumentation was per- formed first in wet canals irrigated with 2.5% sodium hypochlorite ...Cstf3 everse OFd neeO a 1 d IIeif by locLETEa WE~~ CLJANIATO OF TH)S PAITIE OFh~ Iat NOVnteSred) EVALUATION OF DEBRIDEMENT TECHNIQUES FOR ENDODONTIC ...INSTRUMENTS *RONALD 0. SEGALL, DMD **CARLOS E. del RIO, DDS ***JOHN M. BRADY, DDS, MSPH ****WILLIAM A. AYER, DDS, PhD :f*MAJ, DC Endodontic Resident, US

Impact of adhesive surface and volume of luting resin on fracture resistance of root filled teeth.

PubMed

Krastl, G; Gugger, J; Deyhle, H; Zitzmann, N U; Weiger, R; Müller, B

2011-05-01

To investigate the correlation between geometric parameters of severely compromised root filled (RCT) pre-molar teeth with irregular root canals and their fracture resistance. The null hypothesis tested was that the fracture resistance of root filled teeth is not influenced by: (i) the adhesive surface of the post-space preparation (A(PS) ), (ii) the coronal tooth surface (A(A) ), (iii) the amount of resin cement (V(C) ) and (iv) the Young's modulus of the specimens. A total of 48 noncarious human pre-molar teeth with irregular root canals were decoronated, root filled and adhesively restored with post-retained direct composite crowns. After thermomechanical loading (1,200,000×, 5-50° C), static load was applied until failure. The geometric parameters of the tooth were evaluated by microcomputed tomography (μCT) using impressions taken after post-space preparation. Linear regression analyses were performed to correlate the geometric parameters of the specimens with their fracture resistance. The amount of resin cement (V(C) ) comprised up to 88% of the entire post-space (mean 67%) and had no impact on the maximal load (P = 0.88). The latter was significantly influenced by post-space preparation (P = 0.003). Amongst the geometric parameters tested, the surface area in the root canal had the greatest impact on fracture resistance of root filled pre-molars restored with posts and composite crowns, whilst the fit of the post was less important. © 2011 International Endodontic Journal.

Treatment of Severe Chronic Periodontitis with Surgical and Prosthetic Intervention: A 9-year Follow-up Case Report.

PubMed

Makino-Oi, Asako; Ishii, Yoshihito; Makino, Kenshi; Kondo, Asako; Uekusa, Tomomi; Ishizuka, Yoichi; Tomita, Sachiyo; Saito, Atsushi

2017-01-01

A 60-year-old woman presented with the chief complaint of mobility of tooth #16. Gingival swelling and calculus were observed. Clinical examination revealed that 49.4% of sites had a probing depth (PD) of ≥4 mm and 72% of sites bleeding on probing. Radiographic examination revealed vertical bone resorption in #35 and horizontal resorption in other regions. Periapical region radiolucency on #16 and 27 suggested a perio-endo lesion. The clinical diagnosis was severe chronic periodontitis. Initial periodontal therapy mainly comprised the following: oral hygiene instruction; quadrant scaling and root planing (SRP); extraction of #16, 27, and 31; and placement of provisional restorations. Open flap debridement was performed for teeth with a PD ≥4 mm. Bone defects exceeding the root apex were found in #17, 41, 42, and 45 intraoperatively. Teeth #41, 42, and 45 were extracted. After confirming the stability of the periodontal tissue, final prostheses were placed on #14-17, 13-22, 35-37, 33-43, 44-46, and 47. Following reevaluation, the patient was placed on supportive periodontal therapy (SPT). After 6 years, the patient experienced dull pain in and pus discharge from #17. Repeated SRP yielded no improvement, so the tooth was extracted and a removable partial denture placed on #16 and 17. Nine years have passed since the start of SPT and the level of plaque control has remained adequate and periodontal condition stable.

Prevention of neurological injuries during mandibular third molar surgery: technical notes

PubMed Central

La Monaca, Gerardo; Vozza, Iole; Giardino, Rita; Annibali, Susanna; Pranno, Nicola; Cristalli, Maria Paola

2017-01-01

Summary Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and the lingual nerve are well-recognized complications of this procedure. The aim of these technical notes is to describe operative measures for reducing neurological complications during mandibular third molar surgery. The following procedure should be used to prevent damage to the inferior alveolar nerve: a well-designed mucoperiosteal flap, to obtain appropriate access to the surgical area; a conservative ostectomy on the distal and distal-lingual side; tooth sectioning, to facilitate its removal by decreasing the retention zones; tooth dislocation in the path of withdrawal imposed by the curvature of the root apex; and careful socket debridement, when the roots of the extracted tooth are in intimate contact with the mandibular canal. To prevent injury to the lingual nerve, it is important (I) to assess the integrity of the mandibular inner cortex and exclude the presence of fenestration, which could cause the dislocation of the tooth or its fragment into the sublingual or submandibular space; (II) to avoid inappropriate or excessive dislocation proceedings, in order to prevent lingual cortex fracture; (III) to perform horizontal mesial-distal crown sectioning of the lingually inclined tooth; (IV) to protect the lingual flap with a retractor showing the cortical ridge; and (V) to pass the suture not too apically and from the inner side in a buccal-lingual direction in the retromolar area. PMID:29299188

High pressure injection injury of the foot: a role of negative pressure wound therapy.

PubMed

Marinovic, Marin; Bakota, Bore; Spanjol, Josip; Sosa, Ivan; Grzalja, Nikola; Gulan, Gordan; Ivancic, Aldo; Cicvaric, Tedi

2013-09-01

High pressure injection injuries (HPII) of the foot are not common in every-day practice. We present a 50-year-old patient with a HPII of the left foot caused by water-gun in a self-inflicted accident working as a technical diver four meters under the sea surface. Surgical treatment included extensive debridement of necrotic tissue and fibrin deposits and removal of foreign material. A negative pressure wound therapy (NPWT) device was applied resulting in a good wound base for subsequent skin grafting leading to a good functional and cosmetic outcome. Copyright © 2013 Elsevier Ltd. All rights reserved.

A comparative evaluation of the increase in root canal surface area and canal transportation in curved root canals by three rotary systems: A cone-beam computed tomographic study

PubMed Central

Prasanthi, Nalam NVD; Rambabu, Tanikonda; Sajjan, Girija S; Varma, K Madhu; Satish, R Kalyan; Padmaja, M

2016-01-01

Aim: The aim of this study was to measure the increase in root canal surface area and canal transportation after biomechanical preparation at 1, 3, and 5 mm short of the apex with three different rotary systems in both continuous rotary and reciprocating rotary motions. Materials and Methods: Sixty freshly extracted human mandibular molars with mesial root canal curvatures between 20° and 30° were included in the study. Teeth were randomly distributed into three groups (n = 20). Biomechanical preparations were done in all the mesial canals. In Group 1, instrumentation was done with ProTaper universal rotary files, Group 2, with K3XF rotary files, and Group 3, with LSX rotary files. Each group was further subdivided into subgroups A and B (n = 10) where instrumentation was done by continuous rotary and reciprocating rotary techniques, respectively. Increase in root canal surface area and canal transportation was measured using the preoperative and postoperative cone-beam computed tomography scans. Statistical Analysis: The data were analyzed by one-way ANOVA followed by Tukey pairwise multiple comparison tests. Results: Increase in root canal surface area was significantly more (P < 0.05) in ProTaper and K3XF groups when compared to LSX group. Canal transportation was significantly more (P < 0.05) in ProTaper group when compared to K3XF and LSX groups. There was no significant difference (P > 0.05) in increase of root canal surface area and canal transportation between continuous rotary and reciprocating rotary techniques for ProTaper Universal, K3XF and LSX groups. Conclusion: LSX rotary system showed minimal increase of root canal surface area and minimal canal transportation when compared to ProTaper and K3XF rotary systems. PMID:27656062

The effect of four different irrigation systems in the removal of a root canal sealer.

PubMed

Grischke, J; Müller-Heine, A; Hülsmann, M

2014-09-01

The aim of this study was to compare the efficiency of sonic, ultrasonic, and hydrodynamic devices in the removal of a root canal sealer from the surface and from simulated irregularities of root canals. Fifty-three root canals with two standardized grooves in the apical and coronal parts of longitudinally split roots were covered with AH Plus root canal sealer. Compared were the effects of (control) syringe irrigation, (1) CanalBrush, (2) passive ultrasonic irrigation, (3) EndoActivator, and (4) RinsEndo on the removal of the sealer. The specimens were divided into four groups (N = 12) and one control group (N = 5) via randomization. The amount of remaining sealer in the root canal irregularities was evaluated under a microscope using a 4-grade scoring system, whereas the remaining sealer on the root canal surface was evaluated with a 7-grade scoring system. Passive ultrasonic irrigation is more effective than the other tested irrigation systems or syringe irrigation in removing sealer from root canal walls (p < 0.01). None of the techniques had a significant effect on cleaning the lateral grooves. Within the limitations of this study protocol ultrasonic irrigation shows a superior effect on sealer removal from the root canal surface during endodontic retreatment. Cleaning of lateral grooves seems not to be possible with one of the techniques investigated. Incomplete removal of root canal sealer during re-treatment may cause treatment failure. Passive Ultrasonic irrigation seems to be the most effective system to remove sealer from a root canal.

Cold temperature delays wound healing in postharvest sugarbeet roots

USDA-ARS?s Scientific Manuscript database

Storage temperature affects the rate and extent of wound-healing in a number of root and tuber crops. The effect of storage temperature on wound-healing in sugarbeet (Beta vulgaris L.) roots, however, is largely unknown. Wound-healing of sugarbeet roots was investigated using surface-abraded roots s...

Implementing dynamic root optimization in Noah-MP for simulating phreatophytic root water uptake

USDA-ARS?s Scientific Manuscript database

Plants are known to adjust their root systems to adapt to changing subsurface water conditions. However, most current land surface models (LSMs) use a prescribed, static root profile, which cuts off the interactions between soil moisture and root dynamics. In this paper, we implemented an optimality...

[Distortion and vertical fracture of the root: effect produced by condenser design].

PubMed

Dang, D A; Walton, R E

1990-01-01

The incidence of vertical root fractures and the amount of root distortion created during lateral condensation of gutta-percha with either D11 spreaders or B-finger pluggers were evaluated in vitro. Fifty-five extracted human, single-rooted teeth were instrumented using the step-back flare technique. Ten teeth served as positive controls (obturation to the point of fracture) and five teeth as negative controls (prepared but not obtured). Strain gauges were attached to the root surfaces. In the experimental group, 20 teeth were obturated using a D11 spreader and 20 with a B-finger plugger. Recordings were made of root distortion (expansion) created during obturation. Then, after sectioning the teeth, root surfaces of obturated samples were examined for fractures under the scanning electron microscope. Only the more tapered spreader, the D11, produces vertical root fractures, although very few in number. Also, the D11 spreader caused greater root distortion than did the B-finger plugger.

Thermal measurement of root surface temperatures during application of intracanal laser energy in vitro

NASA Astrophysics Data System (ADS)

Goodis, Harold E.; White, Joel M.; Neev, Joseph

1993-07-01

The use of laser energy to clean, shape, and sterilize a root canal system space involves the generation of heat due to the thermal effect of the laser on the organic tissue contents and dentin walls of that space. If heat generation is above physiologic levels, irreparable damage may occur to the periodontal ligament and surrounding bone. This study measured temperature rise on the outer root surfaces of extracted teeth during intracanal laser exposure. Thirty single rooted, recently extracted teeth free of caries and restorations were accessed pulps extirpated and divided into three groups. Each root canal system was treated with a 1.06 micrometers pulsed Nd:YAG laser with quartz contact probes. Temperatures were recorded for all surfaces (mesial distal, buccal, lingual, apical) with infrared thermography utilizing a detector response time of 1 (mu) sec, sensitivity range (infrared) of 8 to 12 micrometers and a scan rate of 30 frames/sec.

Tissue Source and Cell Expansion Condition Influence Phenotypic Changes of Adipose-Derived Stem Cells

PubMed Central

Mangum, Lauren H.; Stone, Randolph; Wrice, Nicole L.; Larson, David A.; Florell, Kyle F.; Christy, Barbara A.; Herzig, Maryanne C.; Cap, Andrew P.

2017-01-01

Stem cells derived from the subcutaneous adipose tissue of debrided burned skin represent an appealing source of adipose-derived stem cells (ASCs) for regenerative medicine. Traditional tissue culture uses fetal bovine serum (FBS), which complicates utilization of ASCs in human medicine. Human platelet lysate (hPL) is one potential xeno-free, alternative supplement for use in ASC culture. In this study, adipogenic and osteogenic differentiation in media supplemented with 10% FBS or 10% hPL was compared in human ASCs derived from abdominoplasty (HAP) or from adipose associated with debrided burned skin (BH). Most (95–99%) cells cultured in FBS were stained positive for CD73, CD90, CD105, and CD142. FBS supplementation was associated with increased triglyceride content and expression of adipogenic genes. Culture in hPL significantly decreased surface staining of CD105 by 31% and 48% and CD142 by 27% and 35% in HAP and BH, respectively (p < 0.05). Culture of BH-ASCs in hPL also increased expression of markers of osteogenesis and increased ALP activity. These data indicate that application of ASCs for wound healing may be influenced by ASC source as well as culture conditions used to expand them. As such, these factors must be taken into consideration before ASCs are used for regenerative purposes. PMID:29138638

Simultaneous assay for plasmin and DNase using radiolabeled human fibroblasts on microcarriers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boswell, G.S.; Dimitrijevich, S.D.; Gracy, R.W.

1989-10-01

A critical step in tissue and wound repair is the removal of eschar--accumulation of denatured cellular and extracellular macromolecules. Enzymatic debridement using a combination of plasmin (fibrinolysin) and DNase has been successfully utilized on a variety of types of wounds. Monitoring the activity of these enzymes by measuring the rate of fibrinolysis, or by viscometric changes due to DNA hydrolysis, is exceedingly cumbersome, time consuming, and, at best, only semiquantitative. Although spectrophotometric assays using synthetic substrates offer several advantages, they do not allow extrapolation of the data to the more complex natural substrates encountered in vivo. We have, therefore, developedmore » an in vitro radioisotopic assay for the simultaneous and quantitative measurement of the hydrolytic activity of both plasmin and DNase. Double labeled ((3H)thymidine, (14C)leucine) human dermal fibroblasts grown on microcarrier beads are utilized as sources of nucleic acid and protein substrates. The assay meets all the criteria of analytical validity, is sensitive and rapid, and is amenable to adaptation for analysis of other hydrolytic enzymes. The method offers a direct evaluation of the enzymatic debridement of wounds using actual human cellular substrates. Moreover, the microcarriers provide a greatly increased surface area for cell attachment and growth, are amenable to rapid separation from the cells by simple mechanical methods, and are ideally suited to analytical manipulations.« less

Nitrogen metabolism of two contrasting poplar species during acclimation to limiting nitrogen availability

PubMed Central

Luo, Zhi-Bin

2013-01-01

To investigate N metabolism of two contrasting Populus species in acclimation to low N availability, saplings of slow-growing species (Populus popularis, Pp) and a fast-growing species (Populus alba × Populus glandulosa, Pg) were exposed to 10, 100, or 1000 μM NH4NO3. Despite greater root biomass and fine root surface area in Pp, lower net influxes of NH4 + and NO3 – at the root surface were detected in Pp compared to those in Pg, corresponding well to lower NH4 + and NO3 – content and total N concentration in Pp roots. Meanwhile, higher stable N isotope composition (δ15N) in roots and stronger responsiveness of transcriptional regulation of 18 genes involved in N metabolism were found in roots and leaves of Pp compared to those of Pg. These results indicate that the N metabolism of Pp is more sensitive to decreasing N availability than that of Pg. In both species, low N treatments decreased net influxes of NH4 + and NO3 –, root NH4 + and foliar NO3 – content, root NR activities, total N concentration in roots and leaves, and transcript levels of most ammonium (AMTs) and nitrate (NRTs) transporter genes in leaves and genes involved in N assimilation in roots and leaves. Low N availability increased fine root surface area, foliar starch concentration, δ15N in roots and leaves, and transcript abundance of several AMTs (e.g. AMT1;2) and NRTs (e.g. NRT1;2 and NRT2;4B) in roots of both species. These data indicate that poplar species slow down processes of N acquisition and assimilation in acclimation to limiting N supply. PMID:23963674

Mandibular molar root morphology in Neanderthals and Late Pleistocene and recent Homo sapiens.

PubMed

Kupczik, Kornelius; Hublin, Jean-Jacques

2010-11-01

Neanderthals have a distinctive suite of dental features, including large anterior crown and root dimensions and molars with enlarged pulp cavities. Yet, there is little known about variation in molar root morphology in Neanderthals and other recent and fossil members of Homo. Here, we provide the first comprehensive metric analysis of permanent mandibular molar root morphology in Middle and Late Pleistocene Homo neanderthalensis, and Late Pleistocene (Aterian) and recent Homo sapiens. We specifically address the question of whether root form can be used to distinguish between these groups and assess whether any variation in root form can be related to differences in tooth function. We apply a microtomographic imaging approach to visualise and quantify the external and internal dental morphologies of both isolated molars and molars embedded in the mandible (n=127). Univariate and multivariate analyses reveal both similarities (root length and pulp volume) and differences (occurrence of pyramidal roots and dental tissue volume proportion) in molar root morphology among penecontemporaneous Neanderthals and Aterian H. sapiens. In contrast, the molars of recent H. sapiens are markedly smaller than both Pleistocene H. sapiens and Neanderthals, but share with the former the dentine volume reduction and a smaller root-to-crown volume compared with Neanderthals. Furthermore, we found the first molar to have the largest average root surface area in recent H. sapiens and Neanderthals, although in the latter the difference between M(1) and M(2) is small. In contrast, Aterian H. sapiens root surface areas peak at M(2). Since root surface area is linked to masticatory function, this suggests a distinct occlusal loading regime in Neanderthals compared with both recent and Pleistocene H. sapiens. Copyright © 2010 Elsevier Ltd. All rights reserved.

Debridement, antibiotics, irrigation, and retention (DAIR) of the prosthesis after hip hemiarthroplasty infections. Does it work?

PubMed

Kazimoglu, Cemal; Yalcin, Nadir; Onvural, Burak; Akcay, Serkan; Agus, Haluk

2015-08-01

Debridement, antibiotic, and implant retention (DAIR) is an attractive treatment modality after hip hemiarthroplasty (HA) infections. Data about the success of the procedure after acute onset infections is lacking. The aim of this study was to analyze the clinical outcome and associated risk factors. A multicenter, retrospective cohort study was designed, including 39 patients with acute onset prosthetic infection who had undergone debridement and irrigation with prosthesis retention. The primary outcome measure was infection eradication without prosthesis removal. We also analyzed how the success rate was influenced by the length of the interval between implantation of the prosthesis and the beginning of the treatment. The overall success rate was 41%. Sedimentation rate over 60 mm/h and the longer duration (2 weeks) after prosthesis implantation were found as factors negatively influencing the success rate. Our results indicated limited success to DAIR- treated patients with infected HA. The high failure rate of DAIR treatment after 2 weeks from the implantation should be taken into consideration.

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management.

PubMed

Pattanashetty, O B; B B, Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered.

A multi-disciplinary approach to the management of fungal osteomyelitis: current concepts in post-traumatic lower extremity reconstruction: a case report.

PubMed

Cetrulo, Curtis L; Leto Barone, Angelo A; Jordan, Kathleen; Chang, David S; Louie, Kevin; Buntic, Rudolf F; Brooks, Darrell

2012-02-01

Limb salvage in fungal osteomyelitis of the post-traumatic lower extremity represents a difficult clinical problem requiring aggressive management. We report lower extremity salvage by radical bony debridement, free tissue transfer, distraction osteogenesis with bone-docking, and a novel antifungal regimen in a clinical setting of infection with Scedosporium inflatum, historically requiring amputation in 100% of cases. We treated Scedosporium inflatum osteomyelitis of the tibia and calcaneus with radical debridement of infected bone, free partial medial rectus abdominis muscle flap coverage, transport distraction osteogenesis, and combination voriconazole/terbinafine chemotherapy, a novel antifungal regimen. We achieved successful control of the infection, limb salvage, and an excellent functional outcome through aggressive debridement of infected bone and soft tissue, elimination of dead space within the bony defect, the robust perfusion provided by the free flap, the hypervascular state induced by distraction osteogenesis, and the synergism of the novel antifungal regimen.

Epiglottitis and necrotizing fasciitis: a life-threatening complication of infectious mononucleosis.

PubMed

Caballero, Miguel; Sabater, Francisco; Traserra, Jose; Alòs, Llucia; Bernal-Sprekelsen, Manuel

2005-10-01

Life-threatening cervical complications associated with infectious mononucleosis are rare. The combination of acute epiglottitis and subsequent necrotizing fasciitis of the head and neck in a patient with infectious mononucleosis has not been reported to date.A 47-year-old female with infectious mononucleosis and epiglottitis was admitted to hospital for i.v. therapy. Owing to her poor clinical condition and the spread of the infection to the throat and superior mediastinum, as evidenced by CT, a cervical debridement was performed. After cervical debridement, histological findings were consistent with necrotizing fasciitis. The bacteria identified were Streptococcus viridans, Veilonella spp. and Capnocytophaga spp. The patient was hospitalized for 33 days.Mononucleosis, usually a benign condition, may be associated with life-threatening septic complications in the neck and chest. Serial CT or MRI scans are necessary to assess the development of the infection in the deep layers of the neck. Rapid medical treatment, extensive surgical debridement and intensive care are vital.

Etidronate from Medicine to Endodontics: effects of different irrigation regimes on root dentin roughness

PubMed Central

TARTARI, Talita; DUARTE JUNIOR, Anivaldo Pereira; SILVA JÚNIOR, José Otávio Carrera; KLAUTAU, Eliza Burlamaqui; SILVA E SOUZA JUNIOR, Mario Honorato; SILVA E SOUZA, Patrícia de Almeida Rodrigues

2013-01-01

An increase in dentin roughness, associated with surface composition, contributes to bacterial adherence in recontaminations. Surface roughness is also important for micromechanical interlocking of dental materials to dentin, and understanding the characteristics of the surface is essential to obtain the adhesion of root canal sealers that have different physico-chemical characteristics. Objectives To evaluate the effects of sodium hypochlorite (NaOCl), ethylenediaminetetraacetic (EDTA), etidronic (HEBP), and citric acid (CA) associated with different irrigation regimens on root dentin roughness. Material and Methods Forty-five root halves of anterior teeth were used. The root parts were sectioned in thirds, embedded in acrylic resin and polished to a standard surface roughness. Initially, the samples of each third were randomly assigned into 3 groups and treated as follows: G1 - saline solution (control); G2 - 5% NaOCl+18% HEBP mixed in equal parts; and G3 - 2.5% NaOCl. After initial measuments, the G3 samples were distributed into subgroups G4, G5 and G6, which were subjected to 17% EDTA, 10% CA and 9% HEBP, respectively. Following the new measuments, these groups received a final flush with 2.5% NaOCl, producing G7, G8 and G9. The dentin surface roughness (Ra) was determined before and after treatments using a profilometer. The Wilcoxon test (α<0.05) was used to compare the values before and after treatments, and the Friedman test (α<0.05) to detect any differences among root thirds. Results (i) NaOCl did not affect the surface roughness; (ii) there was a significant increase in roughness after the use of chelating agents (P<0.01); and (iii) only the G3 group showed a difference in surface roughness between apical third and other thirds of the teeth (P<0.0043). Conclusion Only the irrigation regimens that used chelating agents altered the roughness of root dentin. PMID:24212986

Etidronate from medicine to endodontics: effects of different irrigation regimes on root dentin roughness.

PubMed

Tartari, Talita; Duarte Junior, Anivaldo Pereira; Silva Júnior, José Otávio Carrera; Klautau, Eliza Burlamaqui; Silva E Souza Junior, Mario Honorato; Silva E Souza Junior, Patrícia de Almeida Rodrigues

2013-01-01

An increase in dentin roughness, associated with surface composition, contributes to bacterial adherence in recontaminations. Surface roughness is also important for micromechanical interlocking of dental materials to dentin, and understanding the characteristics of the surface is essential to obtain the adhesion of root canal sealers that have different physico-chemical characteristics. To evaluate the effects of sodium hypochlorite (NaOCl), ethylenediaminetetraacetic (EDTA), etidronic (HEBP), and citric acid (CA) associated with different irrigation regimens on root dentin roughness. Forty-five root halves of anterior teeth were used. The root parts were sectioned in thirds, embedded in acrylic resin and polished to a standard surface roughness. Initially, the samples of each third were randomly assigned into 3 groups and treated as follows: G1 - saline solution (control); G2 - 5% NaOCl+18% HEBP mixed in equal parts; and G3 - 2.5% NaOCl. After initial measuments, the G3 samples were distributed into subgroups G4, G5 and G6, which were subjected to 17% EDTA, 10% CA and 9% HEBP, respectively. Following the new measuments, these groups received a final flush with 2.5% NaOCl, producing G7, G8 and G9. The dentin surface roughness (Ra) was determined before and after treatments using a profilometer. The Wilcoxon test (α<0.05) was used to compare the values before and after treatments, and the Friedman test (α<0.05) to detect any differences among root thirds. (i) NaOCl did not affect the surface roughness; (ii) there was a significant increase in roughness after the use of chelating agents (P<0.01); and (iii) only the G3 group showed a difference in surface roughness between apical third and other thirds of the teeth (P<0.0043). Only the irrigation regimens that used chelating agents altered the roughness of root dentin.

Effect of finishing instrumentation using NiTi hand files on volume, surface area and uninstrumented surfaces in C-shaped root canal systems.

PubMed

Amoroso-Silva, P; Alcalde, M P; Hungaro Duarte, M A; De-Deus, G; Ordinola-Zapata, R; Freire, L G; Cavenago, B C; De Moraes, I G

2017-06-01

To assess the effect of 90°-oscillatory instrumentation with hand files on several morphological parameters (volume, surface area and uninstrumented surface) in C-shaped root canals after instrumentation using a single-file reciprocation system (Reciproc; VDW, Munich, Germany) and a Self-Adjusting File System (SAF; ReDent Nova, Ra'anana, Israel). Twenty mandibular second molars with C-shaped canals and C1 canal configurations were divided into two groups (n = 10) and instrumented with Reciproc and SAF instruments. A size 30 NiTi hand K-file attached to a 90°-oscillatory motion handpiece was used as final instrumentation in both groups. The specimens were scanned using micro-computed tomography after all procedures. Volume, surface area increase and uninstrumented root canal surface were analysed using CTAn software (Bruker-microCT, Kontich, Belgium). Also, the uninstrumented root canal surface was calculated for each canal third. All values were compared between groups using the Mann-Whitney test and within groups using the Wilcoxon's signed-rank test. Instrumentation with Reciproc significantly increased canal volume compared with instrumentation with SAF. Additionally, the canal volumes were significantly increased after 90°-oscillatory instrumentation (between and within group comparison; (P < 0.05)). Regarding the increase in surface area after all instrumentation protocols, statistical analysis only revealed significant differences in the within groups comparison (P < 0.05). Reciproc and SAF instrumentation yielded an uninstrumented root canal surface of 28% and 34%, respectively, which was not significantly different (P > 0.05). Final oscillatory instrumentation significantly reduced the uninstrumented root canal surface from 28% to 9% (Reciproc) and from 34% to 15% (SAF; P < 0.05). The apical and middle thirds exhibited larger uninstrumented root canal surfaces after the first instrumentation that was significantly reduced after oscillatory instrumentation (P < 0.05). The Reciproc and SAF system were associated with similar morphological parameters after instrumentation of mandibular second molars with C-shaped canals except for a higher canal volume increase in the Reciproc group compared to the SAF. Furthermore, the final use of 90°-oscillatory instrumentation using NiTi hand files significantly decreased the uninstrumented canal walls that remained after Reciproc and SAF instrumentation. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

In situ investigation of the mechanisms of the transport to tissues of polycyclic aromatic hydrocarbons adsorbed onto the root surface of Kandelia obovata seedlings.

PubMed

Li, Ruilong; Zhu, Yaxian; Zhang, Yong

2015-06-01

A novel method for in situ determination of the polycyclic aromatic hydrocarbons (PAHs) adsorbed onto the root surface of Kandelia obovata seedlings was established using laser-induced time-resolved nanosecond fluorescence spectroscopy (LITRF). The linear dynamic ranges for the established method were 1.5-1240ng/spot for phenanthrene, 1.0-1360ng/spot for pyrene and 5.0-1220ng/spot for benzo[a]pyrene. Then, the mechanisms of PAHs transport from the Ko root surface to tissues were investigated. The three-phase model including fast, slow and very slow fractions was superior to the single or dual-phase model to describe the PAHs transport processes. Moreover, the fast fraction of PAHs transport process was mainly due to passive movement, while the slow and very slow fractions were not. Passive movement was the main process of B[a]P adsorbed onto Ko root surface transport to tissues. In addition, the extent of the PAHs transport to Ko root tissues at different salinity were evaluated. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Repair of cervical postradiation ulcer following radical mastectomy with lower trapezius myocutaneous flap].

PubMed

Ning, Fanggang; Qin, Fengjun; Chen, Xin; Zhang, Guoan

2015-12-01

To explore the clinical effects of ipsilateral lower trapezius myocutaneous flap for repairing cervical ulcer as a result of radiotherapy after radical mastectomy. Six patients with cervical ulcers as a result of radiotherapy after radical mastectomy were hospitalized from March 2010 to February 2015, suffering from persistent pain in different degrees. The wound area ranged from 6 cm × 4 cm to 10 cm × 6 cm before debridement, 8 cm × 5 cm to 16 cm × 10 cm after debridement. Ipsilateral lower trapezius myocutaneous flap was used to repair the wound after thorough debridement, with the area ranging from 10 cm × 7 cm to 20 cm × 13 cm. The donor sites were sutured directly or covered with medium-thickness skin graft obtained from the back. Pain was obviously relieved in all the patients 2 days after surgery. The wounds in five patients were healed, while necrosis of superficial skin approximately 1 cm in diameter appeared at the distal end of one myocutaneous flap, and it healed after dressing change. During the follow-up period of 3 to 18 months, no recurrence of ulcer was found, the texture of the myocutaneous flaps was soft with good appearance, and the donor sites healed well. On the basis of thorough debridement, it is feasible to repair the cervical ulcer as a result of radiotherapy after radical mastectomy with the ipsilateral lower trapezius myocutaneous flap.

Comparative analysis of arthroscopic debridement in osseous versus soft tissue anterior ankle impingement.

PubMed

Devgan, Ashish; Rohilla, Rajesh; Tanwar, Milind; Jain, Aditya; Siwach, Karan; Devgan, Radika

2016-01-01

Arthroscopic debridement has been a gold standard procedure for anterior ankle impingement, both in cases of osseous and soft tissue impingement. There is sparse literature on comparative outcome with respect to functional results between the two types of impingement post-arthroscopic debridement. Our study included 14 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination. They were segregated into two groups (on the basis of cause of impingement (osseous versus soft tissue)). Both groups were treated by arthroscopic debridement. Primary outcome was patient satisfaction, which was assessed by Likert scale and clinical outcomes were measured using AOFAS ankle-hind foot scale, VAS score, range of motion and time to return to pre-injury activity level in both groups. Mean follow-up was of 15 months where eleven patients reported an excellent recovery, two patients had good recovery while one patient reported poor outcome. Mean AOFAS ankle hind foot scale improved from 50.5 preoperatively to 85.71 postoperatively (statistically significant; p value - 0.0001). Mean Likert scale value post-operative was 4.21. VAS score showed significant improvement in patients of both the groups. Range of motion was slightly better in soft tissue impingement type with a relatively shorter time to return to sports or preinjury activity level as compared to osseous impingement group. The patients in both the groups had comparable outcomes with no statistically significant difference with regard to patient satisfaction and clinical outcome.

Molecular Genetics of Root Thigmoresponsiveness in Arabidopsis thaliana

NASA Technical Reports Server (NTRS)

Masson, Patrick H.

2002-01-01

The molecular mechanisms that allow plant roots to use gravity and touch as growth guides are investigated. We are using a molecular genetic strategy in Arabidopsis thaliana to study these processes. When Arabidopsis thaliana seedlings grow on tilted hard-agar surfaces, their roots develop a wavy pattern of growth which appears to derive from a succession of left-handed and right-handed circumnutation-like processes triggered by gravity and touch stimulation (Okada and Shimura, 1990; Rutherford et al., 1998; Rutherford and Masson, 1996). Interestingly, mutations that affect root waving on tilted hard-agar surfaces can be identified and characterized. Some of these mutations affect root gravitropism, while others appear to be responsible for the production of abnormal waves (no waves, compressed or square waves, coils) without affecting gravitropism. The specific objectives of this project were to functionally characterize two genes (WVD2 and WVD6) which are required for root waving on tilted agar surfaces, but not for root gravitropism. Specific objectives included a physiological and cytological analysis of the mutants, and molecular cloning and characterization of the corresponding genes. As summarized in this paper, we have reached these objectives. We have also identified and partially characterized other mutations that affect root skewing on hard-agar surfaces (sku5-1 and ago1), and have completed our work on the root-wave phenotype associated with mutations in genes of the tryptophan biosynthesis pathway (Lynn et al., 1999; Rutherford et al., 1998; Sedbrook et al., 2000, 2002). We briefly describe our progress on the cloning and characterization of WVD6, WVD2 and SKU5, and provide a list of papers (published, or in preparation) that derived from this grant. We also discuss the biological implications of our findings, with special emphasis on the analysis of WVD2.

The effect of iron plaque on uptake and translocation of norfloxacin in rice seedlings grown in paddy soil.

PubMed

Yan, Dafang; Ma, Wei; Song, Xiaojing; Bao, Yanyu

2017-03-01

Although the role of iron plaque on rice root surface has been investigated in recent years, its effect on antibiotic uptake remains uncertain. In the study, pot experiment was conducted to investigate the effect of iron plaque on uptake and translocation of norfloxacin (adding 10 and 50 mg·kg -1 treatments) in rice seedlings grown in paddy soil. Iron plaque was induced by adding different amounts of Fe(II) in soil. The results showed that the presence of norfloxacin can decrease the amount of iron plaque induced. After rice with iron plaque induced, norfloxacin was mainly accumulated in iron plaque on root surface, followed by inside root, but its translocation from root to other rice tissues is not observed. Iron plaque played the role of a barrier for norfloxacin uptake into rice roots under high norfloxacin concentration of 50 mg·kg -1 , however not that under low concentration of 10 mg·kg -1 . And the barrier function was the most strongest with adding Fe(II) of 30 mg·kg -1 as combined action of iron plaque and rhizosphere effect. Fluorescence microscope analysis showed that norfloxacin mainly distributed in the outside of root cell, which showed its translocation as apoplastic pathway in rice. Comparing with non-rhizosphere, more norfloxacin was accumulated in rhizosphere soil. Maybe, strong root oxidization (high Eh values) induced more iron oxide formation in rhizosphere and on root surface, which led to norfloxacin's mobility towards to rhizosphere through its strong adsorption of iron oxides and then promoted its uptake by rice on root surface.

Imaging tree roots with borehole radar

Treesearch

John R. Butnor; Kurt H. Johnsen; Per Wikstrom; Tomas Lundmark; Sune Linder

2006-01-01

Ground-penetrating radar has been used to de-tect and map tree roots using surface-based antennas in reflection mode. On amenable soils these methods can accurately detect lateral tree roots. In some tree species (e.g. Pinus taeda, Pinus palustris), vertically orientated tap roots directly beneath the tree, comprise most of the root mass. It is...

Mixed nano/micro-sized calcium phosphate composite and EDTA root surface etching improve availability of graft material in intrabony defects: an in vivo scanning electron microscopy evaluation.

PubMed

Gamal, Ahmed Y; Iacono, Vincent J

2013-12-01

The use of nanoparticles of graft materials may lead to breakthrough applications for periodontal regeneration. However, due to their small particle size, nanoparticles may be eliminated from periodontal defects by phagocytosis. In an attempt to improve nanoparticle retention in periodontal defects, the present in vivo study uses scanning electron microscopy (SEM) to evaluate the potential of micrograft particles of β-tricalcium phosphate (β-TCP) to enhance the binding and retention of nanoparticles of hydroxyapatite (nHA) on EDTA-treated and non-treated root surfaces in periodontal defects after 14 days of healing. Sixty patients having at least two hopeless periodontally affected teeth designated for extraction were randomly divided into four treatment groups (15 patients per group). Patients in group 1 had selected periodontal intrabony defects grafted with nHA of particle size 10 to 100 nm. Patients in group 2 were treated in a similar manner but had the affected roots etched for 2 minutes with a neutral 24% EDTA gel before grafting of the associated vertical defects with nHA. Patients in group 3 had the selected intrabony defects grafted with a composite graft consisting of equal volumes of nHA and β-TCP (particle size 63 to 150 nm). Patients in group 4 were treated as in group 3 but the affected roots were etched with neutral 24% EDTA as in group 2. For each of the four groups, one tooth was extracted immediately, and the second tooth was extracted after 14 days of healing for SEM evaluation. Fourteen days after surgery, all group 1 samples were devoid of any nanoparticles adherent to the root surfaces. Group 2 showed root surface areas 44.7% covered by a single layer of clot-blended grafted particles 14 days following graft application. After 14 days, group 3 samples appeared to retain fibrin strands devoid of grafted particles. Immediately extracted root samples of group 4 had adherent graft particles that covered a considerable area of the root surfaces (88.6%). Grafted particles appeared to cover all samples in a multilayered pattern. After 14 days, the group 4 extracted samples showed multilayered fibrin-covered nano/micro-sized graft particles adherent to the root surfaces (78.5%). The use of a composite graft consisting of nHA and microsized β-TCP after root surface treatment with 24% EDTA may be a suitable method to improve nHA retention in periodontal defects with subsequent graft bioreactivity.

Endodontic photodynamic therapy ex vivo.

PubMed

Ng, Raymond; Singh, Fiza; Papamanou, Despina A; Song, Xiaoqing; Patel, Chitrang; Holewa, Colleen; Patel, Niraj; Klepac-Ceraj, Vanja; Fontana, Carla R; Kent, Ralph; Pagonis, Tom C; Stashenko, Philip P; Soukos, Nikolaos S

2011-02-01

The objective of this study was to evaluate the antimicrobial effects of photodynamic therapy (PDT) on infected human teeth ex vivo. Fifty-two freshly extracted teeth with pulpal necrosis and associated periradicular radiolucencies were obtained from 34 subjects. Twenty-six teeth with 49 canals received chemomechanical debridement (CMD) with 6% NaOCl, and 26 teeth with 52 canals received CMD plus PDT. For PDT, root canal systems were incubated with methylene blue (MB) at concentration of 50 μg/mL for 5 minutes, followed by exposure to red light at 665 nm with an energy fluence of 30 J/cm(2). The contents of root canals were sampled by flushing the canals at baseline and after CMD alone or CMD+PDT and were serially diluted and cultured on blood agar. Survival fractions were calculated by counting colony-forming units (CFUs). Partial characterization of root canal species at baseline and after CMD alone or CMD+PDT was performed by using DNA probes to a panel of 39 endodontic species in the checkerboard assay. The Mantel-Haenszel χ(2) test for treatment effects demonstrated the better performance of CMD+PDT over CMD (P = .026). CMD+PDT significantly reduced the frequency of positive canals relative to CMD alone (P = .0003). After CMD+PDT, 45 of 52 canals (86.5%) had no CFUs as compared with 24 of 49 canals (49%) treated with CMD (canal flush samples). The CFU reductions were similar when teeth or canals were treated as independent entities. Post-treatment detection levels for all species were markedly lower for canals treated by CMD+PDT than they were for those treated by CMD alone. Bacterial species within dentinal tubules were detected in 17 of 22 (77.3%) and 15 of 29 (51.7%) canals in the CMD and CMD+PDT groups, respectively (P = .034). Data indicate that PDT significantly reduces residual bacteria within the root canal system, and that PDT, if further enhanced by technical improvements, holds substantial promise as an adjunct to CMD. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Analysis of growth patterns during gravitropic curvature in roots of Zea mays by use of a computer-based video digitizer

NASA Technical Reports Server (NTRS)

Nelson, A. J.; Evans, M. L.

1986-01-01

A computer-based video digitizer system is described which allows automated tracking of markers placed on a plant surface. The system uses customized software to calculate relative growth rates at selected positions along the plant surface and to determine rates of gravitropic curvature based on the changing pattern of distribution of the surface markers. The system was used to study the time course of gravitropic curvature and changes in relative growth rate along the upper and lower surface of horizontally-oriented roots of maize (Zea mays L.). The growing region of the root was found to extend from about 1 mm behind the tip to approximately 6 mm behind the tip. In vertically-oriented roots the relative growth rate was maximal at about 2.5 mm behind the tip and declined smoothly on either side of the maximum. Curvature was initiated approximately 30 min after horizontal orientation with maximal (50 degrees) curvature being attained in 3 h. Analysis of surface extension patterns during the response indicated that curvature results from a reduction in growth rate along both the upper and lower surfaces with stronger reduction along the lower surface.

Influence of ethanol on dentin roughness, surface free energy, and interaction between AH Plus and root dentin.

PubMed

Pantoja, Carlos Augusto de Morais Souto; Silva, Diogo Henrique da; Soares, Adriana de Jesus; Ferraz, Caio Cezar Randi; Gomes, Brenda Paula Figueiredo de Almeida; Zaia, Alexandre Augusto; Almeida, José Flávio Affonso de

2018-01-01

This study aimed to evaluate the influence of different ethanol concentrations on dentin roughness, surface free energy, and contact angle between AH Plus and the root canal dentin. One hundred human maxillary anterior teeth were split longitudinally and 200 dentin specimens were polished to make the surface flatter and smoother. An acrylic bar was positioned between two dentin specimens and impression material was added to create a block, simulating an instrumented root canal space. Specimens were removed from the mold and cleaned in an ultrasonic bath for 10 min. Thereafter, dentin specimens were divided into four groups (n = 50) according to the drying methods used: a) wet: vacuum only, b) paper points: vacuum + absorbent paper points, c) 70% alcohol: 70% alcohol (1 min) + vacuum + absorbent paper points, and d) 100% alcohol: 100% alcohol (1 min) + vacuum + absorbent paper points. A rugosimeter and a goniometer were used to verify the roughness (Ra) and to measure the surface free energy and the contact angle between the AH Plus sealer and the root canal dentin. ANOVA and Tukey tests (α = 0.05) were used for statistical analysis. The 70% and 100% ethanol groups showed significantly decreased roughness as well as increased surface free energy in the root canal dentin when compared to the wet and paper point groups. In addition, ethanol significantly reduced the contact angle between the AH Plus sealer and the root canal dentin. Ethanol solutions (70% and 100%) provide better wettability of AH Plus sealer on dentin surfaces.

The effects of rapid enzymatic debridement of deep partial-thickness burns with Debrase on wound reepithelialization in swine.

PubMed

Singer, Adam J; Taira, Breena R; Anderson, Ryon; McClain, Steve A; Rosenberg, Lior

2010-01-01

Reepithelialization of deep burns requires spontaneous or active removal or debridement of the necrotic eschar, as recently defined by the American Burn Association. Debrase is a bromelain-derived enzymatic preparation that has been shown to result in rapid and selective debridement of human and animal burns. The authors hypothesized that rapid debridement of deep dermal burns with Debrase would result in earlier reepithelialization of the remaining dermis in a porcine model. Eighty deep dermal contact burns measuring 10 by 20 mm were created on the back and flanks of anesthetized domestic pigs (25 kg) using a brass template preheated in boiling water (100 degrees C) that was applied to the skin for a period of 30 seconds. The template was applied using a spring-loaded device designed to control the amount of pressure applied to the skin by the template. Burns were randomized to a 4-hour topical application of Debrase (lyophilized dry enzyme dissolved and activated in a hydrating vehicle) (n = 40) or its hydrating vehicle (n = 40) followed by daily application of a petrolatum-based antibiotic ointment. Wounds were visually assessed and photographed daily. Four-millimeter full-thickness punch biopsies were obtained for histological analysis using hematoxylin and eosin staining by a board-certified dermatopathologist masked to burn therapy at 7, 11, 13, and 15 days after injury. The primary outcome was the percentage of the burns that were completely reepithelialized at each time point. Secondary outcomes were time to complete reepithelialization and the mean percentage of reepithelialization on microscopic analysis. A sample of 40 burns in each group had 80% power to detect a 20% difference in the percentage of completely reepithelialized burns (two tailed, P < .05). The percentage of completely reepithelialized burns was higher for Debrase than control burns at days 11 (40.9% vs 3.1%; P = .002), 13 (87.5% vs 50%; P = .007), and 15 (97.5% vs 77.5%, P = .018). The mean (SD) percentage reepithelialization of Debrase-treated burns at 7 days was higher than of control burns (47.6% [3.2] vs 0% [0]; P < .001). A larger number of cells in the epidermis and dermis of debrided burns stained positive for the proliferation antigen Ki-67. There was no evidence of any adverse events in the normal skin adjacent to the Debrase-treated burns. Rapid enzymatic debridement of deep partial-thickness burns with Debrase results in earlier reepithelialization and cellular proliferation in swine, when compared with carrier and topical antibiotic dressings alone.

Influence of Root Exudates and Soil on Attachment of Pasteuria penetrans to Meloidogyne arenaria

PubMed Central

Liu, Chang; Ji, Pingsheng; Mekete, Tesfamariam; Joseph, Soumi

2017-01-01

The bacterium Pasteuria penetrans is a parasite of root-knot nematodes (Meloidogyne spp.). Endospores of P. penetrans attach to the cuticle of second-stage juveniles (J2) and subsequently sterilize infected females. When encumbered by large numbers of spores, juveniles are less mobile and their ability to infect roots is reduced. This study looked at different factors that influence spore attachment of P. penetrans to the root-knot nematode Meloidogyne arenaria. Pretreatment of J2 with root exudates of eggplant (Solanum melongena cv. Black beauty) reduced spore attachment compared with pretreatment with phosphate-buffered saline (PBS), suggesting that the nematode surface coat was altered or the spore recognition domains on the nematode surface were blocked. Spore attachment was equally reduced following exposure to root exudates from both host and nonhost plants for M. arenaria, indicating a common signal that affects spore attachment. Although phytohormones have been shown to influence the lipophilicity of the nematode surface coat, auxins and kinetins did not affect spore attachment compared with PBS. Root exudates reduced spore attachment more in sterilized soil than in natural soil. Sterilization may have eliminated microbes that consume root exudates, or altered the chemical components of the soil solution or root exudates. Root exudates caused a greater decrease in spore attachment in loamy sand than in a sandy loam soil. The sandy loam had higher clay content than the loamy sand, which may have resulted in more adsorption of compounds in the root exudates that affect spore attachment. The components of the root exudates could have also been modified by soil type. The results of this study demonstrate that root exudates can decrease the attachment of P. penetrans endospores to root-knot nematodes, indicating that when these nematodes enter the root zone their susceptibility to spore attachment may decrease. PMID:29062153

Influence of Root Exudates and Soil on Attachment of Pasteuria penetrans to Meloidogyne arenaria.

PubMed

Liu, Chang; Timper, Patricia; Ji, Pingsheng; Mekete, Tesfamariam; Joseph, Soumi

2017-09-01

The bacterium Pasteuria penetrans is a parasite of root-knot nematodes ( Meloidogyne spp.). Endospores of P. penetrans attach to the cuticle of second-stage juveniles (J2) and subsequently sterilize infected females. When encumbered by large numbers of spores, juveniles are less mobile and their ability to infect roots is reduced. This study looked at different factors that influence spore attachment of P. penetrans to the root-knot nematode Meloidogyne arenaria . Pretreatment of J2 with root exudates of eggplant ( Solanum melongena cv. Black beauty) reduced spore attachment compared with pretreatment with phosphate-buffered saline (PBS), suggesting that the nematode surface coat was altered or the spore recognition domains on the nematode surface were blocked. Spore attachment was equally reduced following exposure to root exudates from both host and nonhost plants for M. arenaria , indicating a common signal that affects spore attachment. Although phytohormones have been shown to influence the lipophilicity of the nematode surface coat, auxins and kinetins did not affect spore attachment compared with PBS. Root exudates reduced spore attachment more in sterilized soil than in natural soil. Sterilization may have eliminated microbes that consume root exudates, or altered the chemical components of the soil solution or root exudates. Root exudates caused a greater decrease in spore attachment in loamy sand than in a sandy loam soil. The sandy loam had higher clay content than the loamy sand, which may have resulted in more adsorption of compounds in the root exudates that affect spore attachment. The components of the root exudates could have also been modified by soil type. The results of this study demonstrate that root exudates can decrease the attachment of P. penetrans endospores to root-knot nematodes, indicating that when these nematodes enter the root zone their susceptibility to spore attachment may decrease.

Morphological, anatomical, and ultrastructural changes (visualized through scanning electron microscopy) induced in Triticum aestivum by Pb²⁺ treatment.

PubMed

Kaur, Gurpreet; Singh, Harminder Pal; Batish, Daizy Rani; Kohli, Ravinder Kumar

2014-11-01

Lead (Pb) causes severe damage to crops, ecosystems, and humans, and alters the physiology and biochemistry of various plant species. It is hypothesized that Pb-induced metabolic alterations could manifest as structural variations in the roots of plants. In light of this, the morphological, anatomical, and ultrastructural variations (through scanning electron microscopy, SEM) were studied in 4-day-old seedlings of Triticum aestivum grown under Pb stress (0, 8, 16, 40, and 80 mg Pb(2+) l(-1); mild to highly toxic). The toxic effect was more pronounced in radicle growth than on the plumule growth. The SEM of the root of T. aestivum depicted morphological alterations and surface ultrastructural changes. Compared to intact and uniform surface cells in the control roots, cells were irregular and desiccated in Pb(2+)-treated roots. In Pb(2+)-treated roots, the number of root hairs increased manifold, showing dense growth, and these were apparently longer. Apart from the deformity in surface morphology and anatomy of the roots in response to Pb(2+) toxicity, considerable anatomical alterations were also observed. Pb(2+)-treated root exhibited signs of injury in the form of cell distortion, particularly in the cortical cells. The endodermis and pericycle region showed loss of uniformity post Pb(2+) exposure (at 80 mg l(-1) Pb(2+)). The cells appeared to be squeezed with greater depositions observed all over the tissue. The study concludes that Pb(2+) treatment caused structural anomalies and induced anatomical and surface ultrastructural changes in T. aestivum.

Molecular genetics of root gravitropism and waving in Arabidopsis thaliana

NASA Technical Reports Server (NTRS)

Sedbrook, J.; Boonsirichai, K.; Chen, R.; Hilson, P.; Pearlman, R.; Rosen, E.; Rutherford, R.; Batiza, A.; Carroll, K.; Schulz, T.;

Effect of ND:YAG laser irradiation and root planing on the root surface: structural and thermal effects.

PubMed

Wilder-Smith, P; Arrastia, A M; Schell, M J; Liaw, L H; Grill, G; Berns, M W

1995-12-01

Effects of ND:YAG laser irradiation on untreated and root planed tooth roots were investigated to determine whether a cleaning effect and/or removal of smear layer could be achieved without concomitant microstructural or thermal damage. Sixty (60) healthy extracted teeth were either untreated, irradiated only, root planed only, or irradiated and root planed. Intra-pulpal and surface temperatures were monitored during irradiation, then SEM was performed. Smear layer elimination was achieved without inducing hard tissue microstructural damage at 5W, using pulse durations and intervals of 0.1 s, a fluence of 0.77 J/cm2, and a total energy density of approximately 700 J/cm2. However, these results were not consistent in all samples. At these parameters, intra-pulpal temperature increases of 9 to 22 degrees C and surface temperature increases of 18 to 36 degrees C were recorded. Thus, despite their effectiveness for smear layer removal, these parameters may not be appropriate for clinical use as an adjunct to conventional periodontal therapy.

Plant root and shoot dynamics during subsurface obstacle interaction

NASA Astrophysics Data System (ADS)

Conn, Nathaniel; Aguilar, Jeffrey; Benfey, Philip; Goldman, Daniel

As roots grow, they must navigate complex underground environments to anchor and retrieve water and nutrients. From gravity sensing at the root tip to pressure sensing along the tip and elongation zone, the complex mechanosensory feedback system of the root allows it to bend towards greater depths and avoid obstacles of high impedance by asymmetrically suppressing cell elongation. Here we investigate the mechanical and physiological responses of roots to rigid obstacles. We grow Maize, Zea mays, plants in quasi-2D glass containers (22cm x 17cm x 1.4cm) filled with photoelastic gel and observe that, regardless of obstacle interaction, smaller roots branch off the primary root when the upward growing shoot (which contains the first leaf) reaches an average length of 40 mm, coinciding with when the first leaf emerges. However, prior to branching, contacts with obstacles result in reduced root growth rates. The growth rate of the root relative to the shoot is sensitive to the angle of the obstacle surface, whereby the relative root growth is greatest for horizontally oriented surfaces. We posit that root growth is prioritized when horizontal obstacles are encountered to ensure anchoring and access to nutrients during later stages of development. NSF Physics of Living Systems.

Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report

PubMed Central

2016-01-01

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar. PMID:26877992

Urethral calculi with a urethral fistula: a case report and review of the literature.

PubMed

Zeng, Mingqiang; Zeng, Fanchang; Wang, Zhao; Xue, Ruizhi; Huang, Liang; Xiang, Xuyu; Chen, Zhi; Tang, Zhengyan

2017-09-06

To explore and summarize the reasons why urethral calculi cause a urethral fistula. We retrospectively studied 1 patient in Xiangya hospital and all relevant literature published in English between 1989 and 2015. The patients (including those reported in the literature) were characterized by age, origin, location of calculus, size of calculus, fistulous track, and etiological factors. Most of urethral calculi associated with a urethral fistula were native generated. Urethral calculi can be formed in various locations of the urethra, and the size of the calculus ranged from small (multiple) calculi to giant stones. The fistula external orifice located at the root of the penis was relatively common, and there were various etiological factors, such as urethral strictures, urethral trauma induced by long-term catheterization, lumbar fractures, and congenital anomaly factors. They were managed by the excision of the fistulous tract, retrieval of the urethral stones, and/or debridement and pus drainage operations. Some elements, such as trauma, recurrent urinary tract infections, abscess formation induced by long-term catheterization, and urethral calculus, may be the risk factors for a urethral fistula.

Identifying the optimal spatially and temporally invariant root distribution for a semiarid environment

NASA Astrophysics Data System (ADS)

Sivandran, Gajan; Bras, Rafael L.

2012-12-01

In semiarid regions, the rooting strategies employed by vegetation can be critical to its survival. Arid regions are characterized by high variability in the arrival of rainfall, and species found in these areas have adapted mechanisms to ensure the capture of this scarce resource. Vegetation roots have strong control over this partitioning, and assuming a static root profile, predetermine the manner in which this partitioning is undertaken.A coupled, dynamic vegetation and hydrologic model, tRIBS + VEGGIE, was used to explore the role of vertical root distribution on hydrologic fluxes. Point-scale simulations were carried out using two spatially and temporally invariant rooting schemes: uniform: a one-parameter model and logistic: a two-parameter model. The simulations were forced with a stochastic climate generator calibrated to weather stations and rain gauges in the semiarid Walnut Gulch Experimental Watershed (WGEW) in Arizona. A series of simulations were undertaken exploring the parameter space of both rooting schemes and the optimal root distribution for the simulation, which was defined as the root distribution with the maximum mean transpiration over a 100-yr period, and this was identified. This optimal root profile was determined for five generic soil textures and two plant-functional types (PFTs) to illustrate the role of soil texture on the partitioning of moisture at the land surface. The simulation results illustrate the strong control soil texture has on the partitioning of rainfall and consequently the depth of the optimal rooting profile. High-conductivity soils resulted in the deepest optimal rooting profile with land surface moisture fluxes dominated by transpiration. As we move toward the lower conductivity end of the soil spectrum, a shallowing of the optimal rooting profile is observed and evaporation gradually becomes the dominate flux from the land surface. This study offers a methodology through which local plant, soil, and climate can be accounted for in the parameterization of rooting profiles in semiarid regions.

Use of Synthetic Osteochondral Implants to Treat Bilateral Shoulder Osteochondritis Dissecans in a Dog.

PubMed

Danielski, Alan; Farrell, Michael

2018-06-20

 An 8-month-old American Bulldog was presented for assessment of bilateral thoracic limb lameness. Computed tomographic imaging revealed large, deep osteochondritis dissecans lesions in both humeral heads.  The osteochondritis dissecans lesions were debrided and the exposed subchondral defects were prepared to receive synthetic grafts. Circular implants consisting of a surface layer of polycarbonate urethane and a deep layer of lattice-type titanium were implanted into the osteochondral defects to reconstruct the articular surface topography. Follow-up clinical examination 1.5, 3 and 9months postoperatively revealed a lack of signs of shoulder pain and resolution of thoracic limb lameness. Nine-month follow-up radiographs showed radiographic evidence of osteointegration of both implants.  Synthetic osteochondral implantation in the caudocentral aspect of the humeral head appeared technically feasible and effective in resolving lameness caused by humeral head osteochondritis dissecans. Schattauer GmbH Stuttgart.

Effects of adhesions of amorphous Fe and Al hydroxides on surface charge and adsorption of K+ and Cd2+ on rice roots.

PubMed

Liu, Zhao-Dong; Wang, Hai-Cui; Zhou, Qin; Xu, Ren-Kou

2017-11-01

Iron (Fe) and aluminum (Al) hydroxides in variable charge soils attached to rice roots may affect surface-charge properties and subsequently the adsorption and uptake of nutrients and toxic metals by the roots. Adhesion of amorphous Fe and Al hydroxides onto rice roots and their effects on zeta potential of roots and adsorption of potassium (K + ) and cadmium (Cd 2+ ) by roots were investigated. Rice roots adsorbed more Al hydroxide than Fe hydroxide because of the greater positive charge on Al hydroxide. Adhesion of Fe and Al hydroxides decreased the negative charge on rice roots, and a greater effect of the Al hydroxide. Consequently, adhesion of Fe and Al hydroxides reduced the K + and Cd 2+ adsorption by rice roots. The results of attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) and desorption of K + and Cd 2+ from rice roots indicated that physical masking by Fe and Al hydroxides and diffuse-layer overlapping between the positively-charged hydroxides and negatively-charged roots were responsible for the reduction of negative charge on roots induced by adhesion of the hydroxides. Therefore, the interaction between Fe and Al hydroxides and rice roots reduced negative charge on roots and thus inhibited their adsorption of nutrient and toxic cations. Copyright © 2017 Elsevier Inc. All rights reserved.

Fungi in neotropical epiphyte roots.

PubMed

Bermudes, D; Benzing, D H

1989-01-01

Roots of thirty-eight Ecuadoran vascular epiphytes, representing eleven angiosperm families, were examined for the presence of symbiotic microorganisms. Most orchid roots contained fungal endophytes like those that regularly infect terrestrial counterparts. Hyphae were also common in and on nonorchid roots, but assignments of these relationships to known mycorrhizal morphologies was not possible in all cases. Evidence of vesicular-arbuscular mycorrhizae (VAM) existed in a number of subjects while in Ericaceae and Campanulaceae a fungal association similar to the demateaceous surface fungi (DSF) described for alpine and prarie plants was usually present. Some associations were characterized by multicellular propagules on root surfaces. The significance of these findings and the factors likely to influence occurrence and consequences of root-fungus mutualisms in tropical forest canopies are discussed. Facts and considerations that could aid future inquiry on these systems are provided.

Assessment of the SMAP Level-4 Surface and Root-Zone Soil Moisture Product Using In Situ Measurements

USDA-ARS?s Scientific Manuscript database

The Soil Moisture Active Passive (SMAP) mission Level-4 Surface and Root-Zone Soil Moisture (L4_SM) data product is generated by assimilating SMAP L-band brightness temperature observations into the NASA Catchment land surface model. The L4_SM product is available from 31 March 2015 to present (with...

HYDRAULIC REDISTRIBUTION OF SOIL WATER BY ROOTS IN FORESTS OF THE PACIFIC NORTHWEST

EPA Science Inventory

One aspect of structural complexity of forest canopies is the root system structure belowground, which influences patterns of soil water utilization by trees. Deeply rooted trees and other plants can hydraulically lift water via their roots from several m below the soil surface ...

Knee arthrodesis with lengthening: experience of using Ilizarov techniques to salvage large asymmetric defects following infected peri-articular fractures.

PubMed

Barwick, Thomas W; Montgomery, Richard J

2013-08-01

We present four patients with large bone defects due to infected internal fixation of knee condylar fractures. All were treated by debridement of bone and soft tissue and stabilisation with flap closure if required, followed by bone transport arthrodesis of the knee with simultaneous lengthening. Four patients (three male and one female), mean age 46.5 years (37-57 years), with posttraumatic osteomyelitis at the knee (three proximal tibia and one distal femur) were treated by debridement of infected tissue and removal of internal fixation. Substantial condylar bone defects resulted on the affected side of the knee joint (6-10 cm) with loss of the extensor mechanism in all tibial cases. Two patients required muscle flaps after debridement. All patients received intravenous antibiotics for at least 6 weeks. Bone transport with a circular frame was used to achieve an arthrodesis whilst simultaneously restoring a functional limb length. In three cases a 'peg in socket' docking technique was fashioned to assist stability and subsequent consolidation of the arthrodesis. Arthrodesis of the knee, free of recurrent infection, was successfully achieved in all cases. None has since required further surgery. Debridement to union took an average of 25 months (19-31 months). The median number of interventions undertaken was 9 (8-12). Two patients developed deep vein thrombosis (DVT), one complicated by PE, which delayed treatment. Two required surgical correction of pre-existent equinus contracture using frames. The median limb length discrepancy (LLD) at the end of treatment was 3 cm (3-4 cm). None has required subsequent amputation. Bone loss and infection both reduce the success rate of any arthrodesis. However, by optimising the host environment with eradication of infection by radical debridement, soft-tissue flaps when necessary and bone transport techniques to close the defect, one can achieve arthrodesis and salvage a useful limb. The residual LLD can result from not accounting for later impaction at peg and socket sites, which had the effect of increasing LLD beyond the desirable amount. We therefore recommend continuing the lengthening for an additional 1-2 cm to allow for this. Copyright © 2013 Elsevier Ltd. All rights reserved.

Maggot Debridement Therapy in Disaster Medicine.

PubMed

Stadler, Frank; Shaban, Ramon Z; Tatham, Peter

2016-02-01

When disaster strikes, the number of patients requiring treatment can be overwhelming. In low-income countries, resources to assist the injured in a timely fashion may be limited. As a consequence, necrosis and wound infection in disaster patients is common and frequently leads to adverse health outcomes such as amputations, chronic wounds, and loss of life. In such compromised health care environments, low-tech and cheap wound care options are required that are in ready supply, easy to use, and have multiple therapeutic benefits. Maggot debridement therapy (MDT) is one such wound care option and may prove to be an invaluable tool in the treatment of wounds post-disaster. This report provides an overview of the wound burden experienced in various types of disaster, followed by a discussion of current treatment approaches, and the role MDT may play in the treatment of complex wounds in challenging health care conditions. Maggot debridement therapy removes necrotic and devitalized tissue, controls wound infection, and stimulates wound healing. These properties suggest that medicinal maggots could assist health care professionals in the debridement of disaster wounds, to control or prevent infection, and to prepare the wound bed for reconstructive surgery. Maggot debridement therapy-assisted wound care would be led by health care workers rather than physicians, which would allow the latter to focus on reconstructive and other surgical interventions. Moreover, MDT could provide a larger window for time-critical interventions, such as fasciotomies to treat compartment syndrome and amputations in case of life-threatening wound infection. There are social, medical, and logistic hurdles to overcome before MDT can become widely available in disaster medical aid. Thus, research is needed to further demonstrate the utility of MDT in Disaster Medicine. There is also a need for reliable MDT logistics and supply chain networks. Integration with other disaster management activities will also be essential. In the aftermath of disasters, MDT could play an important role facilitating timely and efficient medical treatment and improving patient outcomes. Existing social, medical, and logistic barriers will need to be overcome for MDT to be mainstreamed in Disaster Medicine.

Effects of Pulsed Electromagnetic Fields on Return to Sports After Arthroscopic Debridement and Microfracture of Osteochondral Talar Defects: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial.

PubMed

Reilingh, Mikel L; van Bergen, Christiaan J A; Gerards, Rogier M; van Eekeren, Inge C; de Haan, Rob J; Sierevelt, Inger N; Kerkhoffs, Gino M M J; Krips, Rover; Meuffels, Duncan E; van Dijk, C N; Blankevoort, Leendert

2016-05-01

Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. Various possibilities have been suggested to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMFs), which stimulate the repair process of bone and cartilage. The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports. Randomized controlled trial; Level of evidence, 1. A total of 68 patients were randomized to receive either PEMFs (n = 36) or placebo (n = 32) after arthroscopic treatment of an OCD of the talus. The primary outcomes (ie, the number of patients who resumed sports and time to resumption of sports) were analyzed with Kaplan-Meier curves as well as Mann-Whitney U, chi-square, and log-rank tests. Secondary functional outcomes were assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1-year follow-up. To assess bone repair, computed tomography scans were obtained at 2 weeks and 1 year postoperatively. Almost all outcome measures improved significantly in both groups. The percentage of sport resumption (PEMF, 79%; placebo, 80%; P = .95) and median time to sport resumption (PEMF, 17 weeks; placebo, 16 weeks; P = .69) did not differ significantly between the treatment groups. Likewise, there were no significant between-group differences with regard to the secondary functional outcomes and the computed tomography results. PEMF does not lead to a higher percentage of patients who resume sports or to earlier resumption of sports after arthroscopic debridement and microfracture of talar OCDs. Furthermore, no differences were found in bone repair between groups. Netherlands Trial Register NTR1636. © 2016 The Author(s).

Prospective randomised controlled trial of nanocrystalline silver dressing versus plain gauze as the initial post-debridement management of military wounds on wound microbiology and healing.

PubMed

Fries, C A; Ayalew, Y; Penn-Barwell, J G; Porter, K; Jeffery, S L A; Midwinter, M J

2014-07-01

Recent conflicts have been characterised by the use of improvised explosive devices causing devastating injuries, including heavily contaminated wounds requiring meticulous surgical debridement. After being rendered surgical clean, these wounds are dressed and the patient transferred back to the UK for on-going treatment. A dressing that would prevent wounds from becoming colonised during transit would be desirable. The aim of this study was to establish whether using nanocrystalline silver dressings, as an adjunct to the initial debridement, would positively affect wound microbiology and wound healing compared to standard plain gauze dressings. Patients were prospectively randomised to receive either silver dressings, in a nanocrystalline preparation (Acticoat™), or standard of care dressings (plain gauze) following their initial debridement in the field hospital. On repatriation to the UK microbiological swabs were taken from the dressing and the wound, and an odour score recorded. Wounds were followed prospectively and time to wound healing was recorded. Additionally, patient demographic data were recorded, as well as the mechanism of injury and Injury Severity Score. 76 patients were recruited to the trial between February 2010 and February 2012. 39 received current dressings and 37 received the trial dressings. Eleven patients were not swabbed. There was no difference (p=0.1384, Fishers) in the primary outcome measure of wound colonisation between the treatment arm (14/33) and the control arm (20/32). Similarly time to wound healing was not statistically different (p=0.5009, Mann-Whitney). Wounds in the control group were scored as being significantly more malodorous (p=0.002, Mann-Whitney) than those in the treatment arm. This is the first randomised controlled trial to report results from an active theatre of war. Performing research under these conditions poses additional challenges to military clinicians. Meticulous debridement of wounds remains the critical determinant in wound healing and infection and this study did not demonstrate a benefit of nanocrystaline silver dressing in respect to preventing wound colonisation or promoting healing, these dressings do however seem to significantly reduce the unpleasant odour commonly associated with battlefield wounds. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

UV-B Induced Generation of Reactive Oxygen Species Promotes Formation of BFA-Induced Compartments in Cells of Arabidopsis Root Apices

PubMed Central

Yokawa, Ken; Kagenishi, Tomoko; Baluška, František

2016-01-01

UV-B radiation is an important part of the electromagnetic spectrum emitted by the sun. For much of the period of biological evolution organisms have been exposed to UV radiation, and have developed diverse mechanisms to cope with this potential stress factor. Roots are usually shielded from exposure to UV by the surrounding soil, but may nevertheless be exposed to high energy radiation on the soil surface. Due to their high sensitivity to UV-B radiation, plant roots need to respond rapidly in order to minimize exposure on the surface. In addition to root gravitropism, effective light perception by roots has recently been discovered to be essential for triggering negative root phototropism in Arabidopsis. However, it is not fully understood how UV-B affects root growth and phototropism. Here, we report that UV-B induces rapid generation of reactive oxygen species which in turn promotes the formation of BFA-induced compartments in the Arabidopsis root apex. During unilateral UV-B irradiation of roots changes in auxin concentration on the illuminated side have been recorded. In conclusion, UV-B-induced and ROS-mediated stimulation of vesicle recycling promotes root growth and induces negative phototropism. PMID:26793199

Durability of Aortic Valve Cusp Repair With and Without Annular Support.

PubMed

Zeeshan, Ahmad; Idrees, Jay J; Johnston, Douglas R; Rajeswaran, Jeevanantham; Roselli, Eric E; Soltesz, Edward G; Gillinov, A Marc; Griffin, Brian; Grimm, Richard; Hammer, Donald F; Pettersson, Gösta B; Blackstone, Eugene H; Sabik, Joseph F; Svensson, Lars G

2018-03-01

To determine the value of aortic valve repair rather than replacement for valve dysfunction, we assessed late outcomes of various repair techniques in the contemporary era. From January 2001 to January 2011, aortic valve repair was planned in 1,124 patients. Techniques involved commissural figure-of-8 suspension sutures (n = 63 [6.2%]), cusp repair with commissuroplasty (n = 481 [48%]), debridement (n = 174 [17%]), free-margin plication (n = 271 [27%]) or resection (n = 75) or both, or annulus repair with resuspension (n = 230 [23%]), root reimplantation (n = 252 [25%]), or remodeling (n = 35 [3.5%]). Planned repair was aborted for replacement in 115 patients (10%); risk factors included greater severity of aortic regurgitation (AR; p = 0.0002) and valve calcification (p < 0.0001). In-hospital outcomes for the remaining 1,009 patients included death (12 [1.2%]), stroke (13 [1.3%]), and reoperation for valve dysfunction (14 [1.4%]). Freedom from aortic valve reoperation at 1, 5, and 10 years was 97%, 93%, and 90%, respectively. Figure-of-8 suspension sutures, valve resuspension, and root repair and replacement were least likely to require reoperation; cusp repair with commissural sutures, plication, and commissuroplasty was most likely (p < 0.05). Survival at 1, 5, and 10 years was 96%, 92%, and 83%. Immediate postoperative AR grade was none-mild (94%), moderate (5%), and severe (1%). At 10 years after repair, AR grade was none (20%), mild (33%), moderate (26%), and severe (21%). Patients undergoing root procedures were less likely to have higher-grade postoperative AR (p < 0.0001). Valve repair is effective and durable for treating aortic valve dysfunction. Greater severity of AR preoperatively is associated with higher likelihood of repair failure. Commissural figure-of-8 suspension sutures and repair with annular support have the best long-term durability. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of Apical Vapor Lock Formation and comparative Evaluation of its Elimination using Three different Techniques: An in vitro Study.

PubMed

Agarwal, Anand; Deore, Rahul B; Rudagi, Kavitarani; Nanda, Zinnie; Baig, Mirza Osman; Fareez, Md Adil

2017-09-01

The aim of this study was (i) to evaluate the formation of air bubbles in the apical region of root canal (apical vapor lock) during syringe irrigation, using cone beam computed tomography (CBCT) and (ii) comparative evaluation of the elimination of an established vapor lock by EndoActivator, ultrasonics, and manual dynamic agitation (MDA), using CBCT. A total of 60 extracted human single-rooted teeth were equally divided into three groups of 20 teeth each. The samples were decoronated 17 mm from the apex, cleaned, and shaped to size F4 Protaper using 3% sodium hypochlorite. Samples were irrigated with 3% sodium hypochlorite + cesium chloride radiopaque dye, and preoperative CBCT images were obtained. After formation of apical vapor lock in the scanned teeth, EndoActivator (group I), passive ultrasonic irrigation (group II), and MDA with K-file (group III) were performed and the teeth were again placed in CBCT scanner and results analyzed using the chi-square test. The apical vapor lock was formed in all the samples. Out of the 20 teeth in each group, the apical vapor lock was eliminated in 18 samples of EndoActivator group (90%), 16 samples of ultrasonic group (80%), while it was eliminated in 10 samples by MDA (50%). It is concluded that (1) apical vapor lock is consistently formed during endodontic irrigation in closed canal systems and (2) sonic activation performs better than the ultrasonics and MDA in eliminating the apical vapor lock, with statistically significant difference between all the three groups (p < 0.05). The results suggest that the apical vapor lock (dead water zone) is consistently formed during routine endodontic irrigation which impedes irrigant penetration till the working length, thereby leading to inefficient debridement. Hence, to eliminate this vapor lock, techniques, such as sonics or ultrasonics should be used along with the irrigant after shaping and cleaning of the root canal.

Differences in disinfection protocols for root canal treatments between general dentists and endodontists: A Web-based survey.

PubMed

de Gregorio, Cesar; Arias, Ana; Navarrete, Natalia; Cisneros, Rafael; Cohenca, Nestor

2015-07-01

The purpose of this study was to determine whether differences exist in disinfection protocols between endodontists and general dentists. The authors sent an invitation to participate in a Web-based survey to 950 dentists affiliated with the Spanish Board of Dentistry. Participants responded to 9 questions about irrigation protocols and other factors related to disinfection during root canal therapy. A total of 238 (25.05%) study participants successfully completed and returned the surveys. Among these participants, 50% were general dentists and 50% were endodontists. The authors found no statistically significant differences in respondents' first choice of an irrigant solution (that is, sodium hypochlorite), but they noted statistically significant differences in the protocols used by general dentists and by endodontists in relation to the concentration of sodium hypochlorite (P = .0003), the use and type of irrigant used to remove the smear layer (P = 5.39 × 10(-10)), the use of adjuncts to irrigation (P = 5.98 × 10(-8)), the enlargement of the apical preparation when shaping a necrotic tooth (P = .001), and the maintenance of apical patency throughout the debridement and shaping procedure (P = .04). General dentists and endodontists embrace different disinfection protocols. The results of the survey demonstrated that endodontists keep up to date with protocols published in the literature, whereas general dentists use protocols learned during their dental training. Both groups of clinicians should be aware of the importance of disinfection techniques and their relationship to treatment outcomes. Controlling microorganisms during a root canal treatment, especially in cases with necrotic pulp, is essential to improve treatment outcomes. Clinicians should update their protocols and also consider referring patients to a specialist when their protocols are based on traditional techniques, especially in those cases with necrotic pulp. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Plant-Sediment Interactions in Salt Marshes - An Optode Imaging Study of O2, pH, and CO 2 Gradients in the Rhizosphere.

PubMed

Koop-Jakobsen, Ketil; Mueller, Peter; Meier, Robert J; Liebsch, Gregor; Jensen, Kai

2018-01-01

In many wetland plants, belowground transport of O 2 via aerenchyma tissue and subsequent O 2 loss across root surfaces generates small oxic root zones at depth in the rhizosphere with important consequences for carbon and nutrient cycling. This study demonstrates how roots of the intertidal salt-marsh plant Spartina anglica affect not only O 2 , but also pH and CO 2 dynamics, resulting in distinct gradients of O 2 , pH, and CO 2 in the rhizosphere. A novel planar optode system (VisiSens TD ® , PreSens GmbH) was used for taking high-resolution 2D-images of the O 2 , pH, and CO 2 distribution around roots during alternating light-dark cycles. Belowground sediment oxygenation was detected in the immediate vicinity of the roots, resulting in oxic root zones with a 1.7 mm radius from the root surface. CO 2 accumulated around the roots, reaching a concentration up to threefold higher than the background concentration, and generally affected a larger area within a radius of 12.6 mm from the root surface. This contributed to a lowering of pH by 0.6 units around the roots. The O 2 , pH, and CO 2 distribution was recorded on the same individual roots over diurnal light cycles in order to investigate the interlinkage between sediment oxygenation and CO 2 and pH patterns. In the rhizosphere, oxic root zones showed higher oxygen concentrations during illumination of the aboveground biomass. In darkness, intraspecific differences were observed, where some plants maintained oxic root zones in darkness, while others did not. However, the temporal variation in sediment oxygenation was not reflected in the temporal variations of pH and CO 2 around the roots, which were unaffected by changing light conditions at all times. This demonstrates that plant-mediated sediment oxygenation fueling microbial decomposition and chemical oxidation has limited impact on the dynamics of pH and CO 2 in S. anglica rhizospheres, which may in turn be controlled by other processes such as root respiration and root exudation.

Fine root biomass in relation to site and stand characteristics in Norway spruce and Scots pine stands.

PubMed

Helmisaari, Heljä-Sisko; Derome, John; Nöjd, Pekka; Kukkola, Mikko

2007-10-01

Variations in fine root biomass of trees and understory in 16 stands throughout Finland were examined and relationships to site and stand characteristics determined. Norway spruce fine root biomass varied between 184 and 370 g m(-2), and that of Scots pine ranged between 149 and 386 g m(-2). In northern Finland, understory roots and rhizomes (< 2 mm diameter) accounted for up to 50% of the stand total fine root biomass. Therefore, the fine root biomass of trees plus understory was larger in northern Finland in stands of both tree species, resulting in a negative relationship between fine root biomass and the temperature sum and a positive relationship between fine root biomass and the carbon:nitrogen ratio of the soil organic layer. The foliage:fine root ratio varied between 2.1 and 6.4 for Norway spruce and between 0.8 and 2.2 for Scots pine. The ratio decreased for both Norway spruce and Scots pine from south to north, as well as from fertile to more infertile site types. The foliage:fine root ratio of Norway spruce was related to basal area and stem surface area. The strong positive correlations of these three parameters with fine root nitrogen concentration implies that more fine roots are needed to maintain a certain amount of foliage when nutrient availability is low. No significant relationships were found between stand parameters and fine root biomass at the stand level, but the relationships considerably improved when both fine root biomass and stand parameters were calculated for the mean tree in the stand. When the northern and southern sites were analyzed separately, fine root biomass per tree of both species was significantly correlated with basal area and stem surface area per tree. Basal area, stem surface area and stand density can be estimated accurately and easily. Thus, our results may have value in predicting fine root biomass at the tree and stand level in boreal Norway spruce and Scots pine forests.

Effect of two storage solutions on surface topography of two root-end fillings.

PubMed

Asgary, Saeed; Eghbal, Mohammad Jafar; Parirokh, Masoud; Ghoddusi, Jamileh

2009-12-01

The effect of different storage solutions on surface topography of mineral trioxide aggregate (MTA) and new experimental cement (NEC) as root-end fillings was investigated. Twenty-four single-rooted teeth were cleaned, shaped and obturated in a same manner. After root-end resection, 3-mm deep root-end cavities were ultrasonically prepared. Samples were randomly divided into four test groups (A1-A2-B1-B2, n = 6). Root-end cavities in groups A and B were filled with MTA and NEC, respectively, and were then stored in 100% humidity for 24 h. The samples of groups 1 and 2 were, respectively, immersed in normal saline (NS) and phosphate buffer saline solutions for 1 week. The samples were imaged under stereomicroscope before and after immersion and were then investigated and analysed by scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDXA). Results showed significant difference among studied groups. Surface topography of all samples was altered by crystal formation and precipitation on root-end fillings except for group A1 (MTA-NS). SEM and EDXA results showed that the composition and structure of precipitated crystals were comparable with that of standard hydroxyapatite. It was concluded that biocompatibility, sealing ability, and cementogenic activity of MTA and probably NEC may be attributed to this fundamental bioactive reaction.

The effect of cellulose overproduction on binding and biofilm formation on roots by Agrobacterium tumefaciens.

PubMed

Matthysse, Ann G; Marry, Mazz; Krall, Leonard; Kaye, Mitchell; Ramey, Bronwyn E; Fuqua, Clay; White, Alan R

2005-09-01

Agrobacterium tumefaciens growing in liquid attaches to the surface of tomato and Arabidopsis thaliana roots, forming a biofilm. The bacteria also colonize roots grown in sterile quartz sand. Attachment, root colonization, and biofilm formation all were markedly reduced in celA and chvB mutants, deficient in production of cellulose and cyclic beta-(1,2)-D-glucans, respectively. We have identified two genes (celG and cell) in which mutations result in the overproduction of cellulose as judged by chemical fractionation and methylation analysis. Wild-type and chvB mutant strains carrying a cDNA clone of a cellulose synthase gene from the marine urochordate Ciona savignyi also overproduced cellulose. The overproduction in a wild-type strain resulted in increased biofilm formation on roots, as evaluated by light microscopy, and levels of root colonization intermediate between those of cellulose-minus mutants and the wild type. Overproduction of cellulose by a nonattaching chvB mutant restored biofilm formation and bacterial attachment in microscopic and viable cell count assays and partially restored root colonization. Although attachment to plant surfaces was restored, overproduction of cellulose did not restore virulence in the chvB mutant strain, suggesting that simple bacterial binding to plant surfaces is not sufficient for pathogenesis.

Effect of bisphosphonates on root resorption after tooth replantation - a systematic review.

PubMed

Najeeb, Shariq; Siddiqui, Fahad; Khurshid, Zohaib; Zohaib, Sana; Zafar, Muhammad Sohail; Ansari, Shazia Akbar

2017-04-01

Replantation of avulsed teeth may lead to root resorption. Bisphosphonates (BPs), a class of drugs of used to treat resorptive diseases of the bone such as osteoporosis and Paget's disease, have been observed to exert an antiresorptive effect on periodontal bone as well. The antiresorptive properties of BPs could prove them useful in preventing root resorption of replanted avulsed teeth. The aim of this systematic review was to analyze and summarize the currently available literature concerning the use of BPs in preventing root resorption of avulsed teeth. PubMed/MEDLINE, Google Scholar, ISI Web of Knowledge, and Embase databases were searched using keywords 'bisphosphonate', 'replantation', and 'tooth'. Quality assessment of each study was carried out. In addition, general characteristics and outcomes of each study were summarized. After exclusion of 116 irrelevant articles, 10 animal studies were included in this review. The majority of the studies suggest that surface application of zoledronate or alendronate reduces root resorption of replanted teeth in animal models. Surface treatment with etidronate had no significant effect on root resorption, and intracanal etidronate accelerated resorption. Surface application of zoledronate and alendronate reduces root resorption of replanted teeth in animal models. However, the efficacy of intracanal usage of BPs is still debatable. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Diagnostic and Treatment Strategies in Morel-Lavallee Lesions in the Spinal Column and Pelvis].

PubMed

Becker, Christopher A; Kammerlander, Christian; Greiner, Axel; Sommer, Fabian; Linhart, Christoph; Böcker, Wolfgang; Rubenbauer, Bianka; Weidert, Simon

2018-04-12

The Morel-Lavallée lesion is one of the concomitant soft tissue lesions of pelvic fractures. Its role in spine fractures and its treatment in combination with osteosynthesis of pelvic or spine fractures have not yet been determined. The aim of this study was to analyse the best diagnostic and treatment options of both spine and pelvic fractures combined with Morel-Lavallée lesions (MLL). An analysis of the literature was performed via PubMed and Medline. This revealed a total of 197 studies and case reports. After analysing the literature, 19 studies/case reports met our inclusion criteria. There are several diagnostic options for MLL, including ultrasound, computed tomography or MRI. In spinal and pelvic lesions, ultrasound is capable of detecting MLL. Some authors tend to perform open debridement of the MLL, whereas others recommend percutanous treatment. Open debridement and vacuum-assisted closure are recommended in late diagnosed MLL, where primary suture of the soft tissue is impossible. Fracture fixation should be performed simultaneously to treatment of the MLL. Broad-spectrum cephalosporins combined with an aminoglycoside or piperacilline/tazobactam should be initiated. Radical debridement and drainage are recommended, especially when MLL is diagnosed late. Repeated ultrasound examinations should be performed of the surrounding soft tissue of the fracture. When MLL is diagnosed within 2 days, percutanous fracture and MLL treatment should be performed. After more than 2 days, both fracture and MLL should be treated with open debridement, open fracture fixation and primary suture if possible. Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of Partial Transection versus Synovial Debridement of the ACL as Novel Canine Models for Management of ACL Injuries.

PubMed

Bozynski, Chantelle C; Kuroki, Keiichi; Stannard, James P; Smith, Patrick A; Stoker, Aaron M; Cook, Cristi R; Cook, James L

2015-10-01

A major hurdle in investigating important clinical questions in knee ligament treatment is a lack of valid translational animal models. This study characterizes the effects of partial transection versus synovial debridement of the anterior (cranial) cruciate ligament (ACL) in dogs. A total of 27 adult purpose-bred research hounds underwent surgery and were assessed over the following 8 weeks. Dogs were randomized into the following three ACL status groups: sham control (n = 9), intact ACL with synovial debridement (exposed ACL) (n = 9), and partial transection of the ACL (partial tear ACL) (n = 9). Dogs in the exposed ACL group and partial tear ACL group had significantly (p < 0.05) more severe lameness, pain, effusion, reduced function, and reduced comfortable range of motion compared with controls, with the partial tear ACL group being most severely affected. More severe ACL and whole-joint pathology, and radiographic scores for osteoarthritis were present in the partial tear ACL group compared with exposed and/or sham control group. On the basis of these findings, biologic components of ACL injury (exposed ACL) played a role in whole-joint inflammation, but the clinical and pathological effects were more severe when both biologic and biomechanical components were present (i.e., partial tear ACL). These novel canine models were successfully developed to evaluate partial transection versus synovial debridement of the ACL and these models will be used to evaluate treatment options for acute management of ACL injuries. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[The effect of arthroscopic debridement and conservative treatment in knee osteoarthritis: Results of a 5-year follow-up and literature review].

PubMed

Spahn, G; Klinger, H M; Hofmann, G O

2013-12-01

This study is aimed to compare the effects of arthroscopic joint debridement over a 5-year period in a clearly defined patient population (only grade III knee osteoarthritis, history < 2 years). A total of 96 patients (50 male and 46 female) underwent arthroscopic knee debridement for knee OA. The main criteria for inclusion were osteoarthritis grade III (Kellgren-Lawrence score) and a maximal history of 2 years. The subjective complaints and the knee-related quality of life were estimated by the KOOS (knee injury and osteoarthritis outcome score). The score increased significantly within the 1 to 3 rd year post operation. After this interval the mean points of the score declined. But after 5 years the KOOS was higher in comparison to the baseline dates. Patients who had undergone conservative treatment at baseline had a significantly different KOOS than patients in the arthroscopy group. Over time, patients in the arthroscopy group had fewer complaints than patients in the conservative treatment group. In both groups, the results decreased over time. A total of 17 patients (17.2 %) needed a conversion to total endoprothetic replacement. The mean time-interval between index operation and conversion was 56.6 (95 % CI 54.4 - 58.4) months. In middle stages of knee OA, arthroscopic joint debridement can effectively reduce subjective complaints. Because this treatment does not stop the process of OA, the improvements decrease over time. © Georg Thieme Verlag KG Stuttgart · New York.

Comparative Evaluation of Platelet-Rich Fibrin Biomaterial and Open Flap Debridement in the Treatment of Two and Three Wall Intrabony Defects

PubMed Central

Ajwani, Himanshu; Shetty, Sharath; Gopalakrishnan, Dharmarajan; Kathariya, Rahul; Kulloli, Anita; Dolas, R S; Pradeep, A R

2015-01-01

Background: Platelet-rich concentrates are the most widely used regenerative biomaterials. Stimulation and acceleration of soft and hard tissue healing are due to local and continuous delivery of growth factors and proteins, mimicking the needs of the physiological wound healing and reparative tissue processes. This article aims to evaluate the clinical efficacy of open flap debridement (OFD) with or without platelet-rich fibrin (PRF) in the treatment of intrabony defects. Materials and Methods: Twenty subjects with forty intrabony defects were treated with either autologous PRF with open-flap debridement (test, n = 20) or open-flap debridement alone (control, n = 20). Soft tissue parameters included: Plaque index, sulcus bleeding index, probing depth, relative attachment level and gingival marginal level (GML). The hard tissue parameters included-distances from: Cement enamel junction to the base of the defect (CEJ-BOD): Alveolar crest to the base of the defect (AC-BOD): And CEJ to AC. The parameters were recorded at baseline and at 9 months postoperatively calculated using standardized radiographs by image-analysis software. Results: Statistically significant (0.005*) intragroup improvements were seen with all the hard and soft parameters in both test and control groups, except for GML. Statistically significant improvements were seen with the mean defect fill (CEJ-BOD and AC-BOD) (P = 0.003*) when intergroup comparisons were made. Conclusions: Adjunctive use of PRF with OFD significantly improves defect fill when compared to OFD alone. PRF has consistently been showing regenerative potential; it is simple, easy and inexpensive biomaterial compared with bone grafts. PMID:25954068

Stent-Graft Placement with Early Debridement and Antibiotic Treatment for Femoral Pseudoaneurysms in Intravenous Drug Addicts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fu, Qining, E-mail: cqmufqn@163.com; Meng, Xiyun, E-mail: 383274177@qq.com; Li, Fenghe, E-mail: lfh-cqmu@gmail.com

PurposeExplore the application of endovascular covered stent-graft (SG) placement in femoral pseudoaneurysms in intravenous drug addicts.Materials and MethodsWe evaluated a consecutive series of pseudoaneurysm in intravenous drug addicts treated with SGs from August 2010 to December 2013.Results15 patients with 16 arterial pseudoaneurysms were enrolled in this study. All were males with a mean age of 36.9 years. Hemorrhage was the most common reason (93.8 %) for seeking medical care, and 3 of these patients were in hemorrhagic shock at admission. All patients received broad-spectrum antibiotics, and debridement and drainage were implemented after SG placement. 7 of the 13 cases which had microbiologicmore » results showed mixed infections, while gram-negative bacteria were the major pathogens. Except for 2 patients, who were lost to follow-up, two new pseudoaneurysms formed due to delayed debridement, and one stent thrombosis occurred, none of the remaining cases had SG infection or developed claudication.ConclusionsSG placement controls massive hemorrhage rapidly, gives enough time for subsequent treatment for pseudoaneurysms due to intravenous drug abuse, and reduces the incidence of postoperative claudication. With appropriate broad-spectrum antibiotics and early debridement, the incidence of SG infection is relatively low. It is an effective alternative especially as temporary bridge measure for critical patients. However, the high cost, uncertain long-term prospects, high demand for medical adherence, and the risk of using the conduits for re-puncture call for a cautious selection of patients. More evidence is required for the application of this treatment.« less

Chlorhexidine controlled-release profile after EDTA root surface etching: an in vivo study.

PubMed

Gamal, Ahmed Y; Kumper, Radi M; Sadek, Hesham S; El Destawy, Mahmoud T

2011-05-01

The main objective of the present study was to quantify chlorhexidine (CHX) release after the use of CHX-EDTA root surface treatment as a local-delivery antimicrobial vehicle. Twenty non-smoking patients clinically diagnosed as having moderate-to-severe chronic periodontitis were selected to participate in this study. After cause-related therapy, one site in every patient received defect overfill with CHX gel 2% (20 sites). In addition, twenty contralateral sites received defect fill of CHX gel after 3 minutes of 24% EDTA gel root surface etching (20 sites). Gingival crevicular fluid samples were collected at 1, 3, 7, and 14 days post-therapy. The CHX-EDTA group showed statistically significantly higher levels of CHX than those of the control group at 1, 3, and 7 days. At 14 days, the CHX-EDTA group showed 0.8 mg/mL values. The use of CHX-EDTA root surface treatment as a local-delivery antimicrobial improves CHX substantivity.

Lightning Strike in Golf Practice

PubMed Central

Elena-Sorando, E.; Galeano-Ricaño, N.; Agulló-Domingo, A.; Cimorra-Moreno, G.; Gil-Castillo, C.

2006-01-01

Summary The case is presented of a golfer who was struck by lightning while playing golf during a thunderstorm. The patient was found lying unconscious on wet grass with his clothes scorched and his spiked golf shoes torn. He had suffered dermal burns affecting the neck, thorax, abdomen, and upper and lower limbs (10% total body surface area), without any cardiovascular or respiratory disturbances. It may be hypothesized that the lightning current went over the outside of the patient, causing ignition of his clothes. Treatment included monitoring, adequate fluid management, debridement, and topical treatment (silver sulphadiazine). Complete healing of the wounds was achieved in two weeks. After three years' follow-up, the patient had no sequelae. PMID:21991022

Physical properties of root cementum: Part 18. The extent of root resorption after the application of light and heavy controlled rotational orthodontic forces for 4 weeks: a microcomputed tomography study.

PubMed

Wu, Andy T J; Turk, Tamer; Colak, Canan; Elekdağ-Turk, Selma; Jones, Allan S; Petocz, Peter; Darendeliler, M Ali

2011-05-01

The aim of this prospective randomized clinical trial was to quantitatively measure and compare the locations, dimensions, and volume of root resorption craters in human premolars after the application of controlled light and heavy rotational orthodontic forces over a 28-day (4-week) period. Fifteen patients requiring bilateral extraction of maxillary first premolars as part of their orthodontic treatment were recruited for this study. Each patient received a heavy (225 g) rotational force on 1 premolar and a light (25 g) rotational force on the contralateral premolar. Orthodontic rotational forces were applied over 28 days with buccal and palatal cantilever springs; 0.016-inch beta-titanium molybdenum alloys were used to apply the light force and 0.018-inch stainless steel was used for the heavy force. After the 28-day experimental period, the upper first premolars were extracted under stringent protocols to prevent root surface damage. The samples were then scanned using a microcomputed tomography (micro-CT) scan x-ray system (SkyScan 1072, Skyscan, Aartselaar, Belgium), and analyzed using convex hull algorithm (CHULL2D; University of Sydney, Sydney, Australia) software to obtain direct volumetric measurements. The mean volume of resorption craters was 0.42 in the light force group and 0.51 in the heavy force group (P = 0.013). When separated at the root level, the difference in volume of root resorption craters between the 2 groups was significantly different only at the midlevel (P = 0.001). Root resorption craters were consistently detected at the boundaries between the buccal and distal surfaces and the mesial and lingual surfaces. The result supports our hypothesis that positive areas develop significantly more root resorption craters at all 3 levels, as compared with minimal areas (paired t test <0.001). Heavy rotational forces caused more root resorption than light rotational forces and compression areas (buccal-distal and lingual-mesial surfaces in this study) showed significantly higher root resorption than other areas at all levels of the root. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Incidence and severity of root resorption in orthodontically moved premolars in dogs.

PubMed

Maltha, J C; van Leeuwen, E J; Dijkman, G E H M; Kuijpers-Jagtman, A M

2004-05-01

To study treatment-related factors for external root resorption during orthodontic tooth movement. An experimental animal study. Department of Orthodontics and Oral Biology, University Medical Centre Nijmegen, The Netherlands. Twenty-four young adult beagle dogs. Mandibular premolars were bodily moved with continuous or intermittent controlled orthodontic forces of 10, 25, 50, 100, or 200 cN according to standardized protocols. At different points in time histomorphometry was performed to determine the severity of root resorption. Prevalence of root resorptions, defined as microscopically visible resorption lacunae in the dentin. Severity of resorption was defined by the length, relative length, depth, and surface area of each resorption area. The incidence of root resorption increased with the duration of force application. After 14-17 weeks of force application root resorption was found at 94% of the root surfaces at pressure sides. The effect of force magnitude on the severity of root resorption was not statistically significant. The severity of root resorption was highly related to the force regimen. Continuous forces caused significantly more severe root resorption than intermittent forces. A strong correlation (0.60 < r < 0.68) was found between the amount of tooth movement and the severity of root resorption. Root resorption increases with the duration of force application. The more teeth are displaced, the more root resorption will occur. Intermittent forces cause less severe root resorption than continuous forces, and force magnitude is probably not decisive for root resorption.

Touch and gravitropic set-point angle interact to modulate gravitropic growth in roots

NASA Technical Reports Server (NTRS)

Massa, G. D.; Gilroy, S.

2003-01-01

Plant roots must sense and respond to a variety of environmental stimuli as they grow through the soil. Touch and gravity represent two of the mechanical signals that roots must integrate to elicit the appropriate root growth patterns and root system architecture. Obstacles such as rocks will impede the general downwardly directed gravitropic growth of the root system and so these soil features must be sensed and this information processed for an appropriate alteration in gravitropic growth to allow the root to avoid the obstruction. We show that primary and lateral roots of Arabidopsis do appear to sense and respond to mechanical barriers placed in their path of growth in a qualitatively similar fashion. Both types of roots exhibited a differential growth response upon contacting the obstacle that directed the main axis of elongation parallel to the barrier. This growth habit was maintained until the obstacle was circumvented, at which point normal gravitropic growth was resumed. Thus, the gravitational set-point angle of the primary and lateral roots prior to encountering the barrier were 95 degrees and 136 degrees respectively and after growing off the end of the obstacle identical set-point angles were reinstated. However, whilst tracking across the barrier, quantitative differences in response were observed between these two classes of roots. The root tip of the primary root maintained an angle of 136 degrees to the horizontal as it traversed the barrier whereas the lateral roots adopted an angle of 154 degrees. Thus, this root tip angle appeared dependent on the gravitropic set-point angle of the root type with the difference in tracking angle quantitatively reflecting differences in initial set-point angle. Concave and convex barriers were also used to analyze the response of the root to tracking along a continuously varying surface. The roots maintained the a fairly fixed angle to gravity on the curved surface implying a constant resetting of this tip angle/tracking response as the curve of the surface changed. We propose that the interaction of touch and gravity sensing/response systems combine to strictly control the tropic growth of the root. Such signal integration is likely a critical part of growth control in the stimulus-rich environment of the soil. c2003 COSPAR. Published by Elsevier Ltd. All rights reserved.

Immunohistochemical study of bone sialoprotein and osteopontin in healthy and diseased root surfaces.

PubMed

Lao, Martin; Marino, Victor; Bartold, P Mark

2006-10-01

Periodontal disease is marked by inflammation and damage to tooth-supporting tissues. In particular, damage occurs to factors present in cementum that are thought to have the ability to influence the regeneration of surrounding tissues. Bone sialoprotein and osteopontin are major non-collagenous proteins in mineralized connective tissues associated with precementoblast chemo-attraction, adhesion to the root surface, and cell differentiation. The purpose of this investigation was to determine whether the expression and distribution of bone sialoprotein and osteopontin on root surfaces affected by periodontitis are altered compared to healthy, non-diseased root surfaces. Thirty healthy and 30 periodontitis-affected teeth were collected. Following fixation and demineralization, specimens were embedded in paraffin, sectioned, and exposed to antibodies against bone sialoprotein and osteopontin. Stained sections were assessed using light microscopy. Bone sialoprotein was not detected in the exposed cementum (absence of overlying periodontal ligament) of diseased teeth. In most areas where the periodontal ligament was intact, bone sialoprotein was detected for healthy and diseased teeth. For teeth reactive for bone sialoprotein, the matrix of the cementum just below the periodontal ligament was moderately stained. A similar immunoreactivity pattern for osteopontin was observed. The absence of bone sialoprotein and osteopontin staining along exposed cementum surfaces may be due to structural and compositional changes in matrix components associated with periodontal disease. This may influence the ability for regeneration and new connective tissue attachment onto previously diseased root surfaces.

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management

PubMed Central

Pattanashetty, O.B.; B.B., Dayanand; Bhavi, Shushrut B; Bami, Monish

2013-01-01

Introduction: Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe. Case Report: We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery. Conclusion: Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered. PMID:27298903

Micro-computed tomography evaluation of the preparation of long oval root canals in mandibular molars with the self-adjusting file.

PubMed

Paqué, Frank; Peters, Ove A

2011-04-01

The aim of this study was to assess the shaping potential of a novel nickel-titanium instrument, the self-adjusting file (SAF), in long oval root canals in distal roots in mandibular molars. Twenty mandibular molars with long oval distal root canals were selected and scanned preoperatively and postoperatively by using micro-computed tomography at an original resolution of 20 μm. Canals were shaped with the SAF, three-dimensionally reconstructed, and evaluated for volume, surface area, canal transportation, and prepared surface. Data were statistically contrasted by using paired t tests and regression analysis. Preoperatively, canal volume was 7.73 ± 2.13 mm(3), and canal area was 42.83 ± 8.14 mm(2). Volumes and surface areas increased significantly (P < .001) by 4.84 ± 1.73 mm(3) and 3.34 ± 1.73 mm(2), respectively, and no gross preparation errors were detected. Unprepared canal surface varied between individual canals, and mean unprepared surface was 23.5% ± 8.9%. Prepared areas were significantly larger compared with rotary canal preparation done in a previous study. Canal transportation scores were higher in the coronal root canal third (106 ± 50 μm) compared with the apical third (81 ± 49 μm). In vitro, preparation of long oval-shaped root canals in mandibular molars with the SAF was effective and safe. Moreover, shapes generated with the SAF were more complete compared with rotary canal preparation. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of Blood Cell Attachment on Er:Yag Laser Applied Root Surface Using Scanning Electron Microscopy

PubMed Central

CEKICI, Ali; MADEN, Ilay; YILDIZ, Sercan; SAN, Tangul; ISIK, Gulden

2013-01-01

Background: Periodontal regeneration is dependent on the uninterrupted adhesion, maturation and absorption of fibrin clots to a periodontally compromised root surface. The modification of the root surface with different agents has been used for better fibrin clot formation and blood cell attachment. It is known that Er:YAG laser application on dentin removes the smear layer succesfully. Aim: The aim of this study is to observe blood cell attachment and fibrin network formation following ER:YAG laser irradiation on periodontally compromised root surfaces in comparison to chemical root conditioning techniques in vitro. Materials and methods: 40 dentin blocks prepared from freshly extracted periodontally compromised hopeless teeth. Specimens were divided in 5 groups; those applied with PBS, EDTA, Citric acid and Er:YAG. They were further divided into two groups: those which had received these applications, and the control group. The specimens were evaluated with scanning electron microscope and micrographs were taken. Smear layer and blood cell attachment scoring was performed. Results: In the Er:YAG laser applied group, smear layer were totally removed. In the blood applied specimens, better fibrin clot formation and blood cell attachment were observed in the Er:YAG group. In the group that had been applied with citric acid, the smear layer was also removed. The smear layer could not be fully removed in the EDTA group. Conclusion: Er:YAG laser application on the root dentin seems to form a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies to support these results are necessitated. PMID:23533017

[Microbial Community Structure on the Root Surface of Patients with Periodontitis.

PubMed

Zhang, Ju-Mei; Zhou, Jian-Ye; Bo, Lei; Hu, Xiao-Pan; Jiao, Kang-Li; Li, Zhi-Jie; Li, Yue-Hong; Li, Zhi-Qiang

2016-11-01

To study the microbial community structure on the root surface of patients with periodontitis. Bacterial plaque and tissues from the root neck (RN group),root middle (RM group) and root tine (RT group) of six teeth with mobility 3 in one patient with periodontitis were sampled.The V3V4 region of 16S rRNA was sequenced on the Illumina MiSeq platform.The microbial community structure was analyzed by Mothur,Qiime and SPSS software. The principal component analysis (PCoA) results indicated that the RM samples had a similar microbial community structure as that of the RT samples,which was significant different from that of the RN samples.Thirteen phyla were detected in the three groups of samples,which included 7 dominant phyla.29 dominant genera were detected in 184 genera.The abundance of Bacteroidetes _[G-6] and Peptostre ptococcaceae _[XI][G-4] had a positive correlation with the depth of the collection site of samples ( P <0.05),while the abundance of Prevotella,Selenomonas,Corynebacterium and Olsenella had a negative correlation with the depth of the collection site of samples ( P <0.05). There is region-specificity of microbial community structure on the root surface of patients with periodontitis.

Ontogeny of Daucus carota Infected with Meloidogyne hapla

PubMed Central

Slinger, L. A.; Bird, G. W.

1978-01-01

The ontogeny of carrots (Daucus carota cv. 'Spartan Premium') grown under greenhouse conditions in pots of organic soil infected with Meloidogyne hapla was influenced detrimentally as early as 4 days after seeding, as determined through analysis of plant surface area, dry weight, fresh weight, net assimilation rate, relative growth rate, and leaf-area ratio. Only 58% of the diseased carrots were suitable for fresh market, compared with 97% of those grown in nematode-free soil. Growth and development of the shoot system (height, surface area, dry weight, and fresh weight) were retarded by M. hapla as early as 12 days after seeding. During the first 12 days after seeding, root dry weight was greater for diseased plants than for controls. Root growth and development (surface area, dry weight, and fresh weight) associated with this nematode, however, were retarded as early as 16 days after seeding. M. hapla caused a delay in the occurrence of 2nd-, 4th-, and 5th-order roots, and an increase in the occurrence of 6th-order roots in infected plants. Parasitized plants had 44% fewer roots (primary through 6th-order) and 50% less total root length. PMID:19305837

Mutations in Arabidopsis thaliana genes involved in the tryptophan biosynthesis pathway affect root waving on tilted agar surfaces

NASA Technical Reports Server (NTRS)

Rutherford, R.; Gallois, P.; Masson, P. H.

1998-01-01

Arabidopsis thaliana roots grow in a wavy pattern upon a slanted surface. A novel mutation in the anthranilate synthase alpha 1 (ASA1) gene, named trp5-2wvc1, and mutations in the tryptophan synthase alpha and beta 1 genes (trp3-1 and trp2-1, respectively) confer a compressed root wave phenotype on tilted agar surfaces. When trp5-2wvc1 seedlings are grown on media supplemented with anthranilate metabolites, their roots wave like wild type. Genetic and pharmacological experiments argue that the compressed root wave phenotypes of trp5-2wvc1, trp2-1 and trp3-1 seedlings are not due to reduced IAA biosynthetic potential, but rather to a deficiency in L-tryptophan (L-Trp), or in a L-Trp derivative. Although the roots of 7-day-old seedlings possess higher concentrations of free L-Trp than the shoot as a whole, trp5-2wvc1 mutants show no detectable alteration in L-Trp levels in either tissue type, suggesting that a very localized shortage of L-Trp, or of a L-Trp-derived compound, is responsible for the observed phenotype.

In vitro evaluation of the temperature increment at the external root surface after Er,Cr:YSGG laser irradiation of the root canal.

PubMed

Abad-Gallegos, M; Arnabat-Domínguez, J; España-Tost, A; Berini-Aytés, L; Gay-Escoda, C

2009-12-01

A study was made to determine the temperature increment at the dental root surface following Er,Cr:YSGG laser irradiation of the root canal. Human canines and incisors previously instrumented to K file number ISO 30 were used. Irradiation was carried out with glass fiber endodontic tips measuring 200 mm in diameter and especially designed for insertion in the root canal. The teeth were irradiated at 1 and 2 W for 30 seconds, without water spraying or air, and applying a continuous circular movement (approximately 2 mm/sec.) in the apico-coronal direction. At the 1 W power setting, the mean temperature increment was 3.84 degrees C versus 5.01 degrees C at 2 W. In all cases the difference in mean value obtained after irradiation versus the mean baseline temperature proved statistically significant (p<0.05). Application of the Er,Cr:YSGG laser gives rise to a statistically significant temperature increment at the external root surface, though this increment is probably clinically irrelevant, since it would appear to damage the tissues (periodontal ligament and alveolar bone) in proximity to the treated tooth.

Desirable plant root traits for protecting unstable slopes against landslides

NASA Astrophysics Data System (ADS)

Stokes, A.; Atger, C.; Bengough, G.; Fourcaud, T.; Sidle, R. C.

2009-04-01

A trait is defined as a distinct, quantitative property of organisms, usually measured at the individual level and used comparatively across species. Plant quantitative traits are extremely important for understanding the local ecology of any site. Plant height, architecture, root depth, wood density, leaf size and leaf nitrogen concentration control ecosystem processes and define habitat for other taxa. An engineer conjecturing as to how plant traits may directly influence physical processes occurring on sloping land just needs to consider how e.g. canopy architecture and litter properties influence the partitioning of rainfall among interception loss, infiltration and runoff. Plant traits not only influence abiotic processes occurring at a site, but also the habitat for animals and invertebrates. Depending on the goal of the landslide engineer, the immediate and long-term effects of plant traits in an environment must be considered if a site is to remain viable and ecologically successful. When vegetation is considered in models of slope stability, usually the only root parameters taken into consideration are tensile strength and root area ratio. Root system spatial structure is not considered, although the length, orientation and diameter of roots are recognized as being of importance. Thick roots act like soil nails on slopes, reinforcing soil in the same way that concrete is reinforced with steel rods. The spatial position of these thick roots also has an indirect effect on soil fixation in that the location of thin and fine roots will depend on the arrangement of thick roots. Thin and fine roots act in tension during failure on slopes and if they cross the slip surface, are largely responsible for reinforcing soil on slopes. Therefore, the most important trait to consider initially is rooting depth. To stabilize a slope against a shallow landslide, roots must cross the shear surface. The number and thickness of roots in this zone will therefore largely determine slope stability. Rooting depth is species dependent when soil conditions are not limiting and the number of horizontal lateral roots borne on the vertical roots usually changes with depth. Therefore, the number and orientation of roots that the shear surface intersects will change significantly with rooting depth for the same plant, even for magnitudes of only several cm. Similarly, depending on the geometry of the root system, the angle at which a root crosses the shear surface can also have an influence on its resistance to pullout and breakage. The angle at which a root emerges from the parent root is dependent on root type, depth and species (when soil conditions are not limiting). Due to the physiology of roots, a root branch can be initiated at any point along a parent root, but not necessarily emerge fully from the parent root. These traits, along with others including size, relative growth rate, regeneration strategies, wood structure and strength will be discussed with regard to their influence on slope stability. How each of these traits is influenced by soil conditions and plantation techniques is also of extreme importance to the landslide engineer. The presence of obstacles in the soil, as well as compaction, affects root length and branching pattern. Roots of many species of woody plants on shallow soils also tend to grow along fractures deep into the underlying bedrock which allows roots to locate supplies of nutrient and water rich pockets. Rooting depths of herbaceous species in water-limited environments are highly correlated with infiltration depth, but waterlogged soils can asphyxiate tree roots, resulting in shallow root systems. The need to understand and integrate each of these traits for a species is not easy. Therefore, we suggest a hierarchy whereby traits are considered in order of importance, along with how external factors influence their expression over time.

Prediction of Root Zone Soil Moisture using Remote Sensing Products and In-Situ Observation under Climate Change Scenario

NASA Astrophysics Data System (ADS)

Singh, G.; Panda, R. K.; Mohanty, B.

2015-12-01

Prediction of root zone soil moisture status at field level is vital for developing efficient agricultural water management schemes. In this study, root zone soil moisture was estimated across the Rana watershed in Eastern India, by assimilation of near-surface soil moisture estimate from SMOS satellite into a physically-based Soil-Water-Atmosphere-Plant (SWAP) model. An ensemble Kalman filter (EnKF) technique coupled with SWAP model was used for assimilating the satellite soil moisture observation at different spatial scales. The universal triangle concept and artificial intelligence techniques were applied to disaggregate the SMOS satellite monitored near-surface soil moisture at a 40 km resolution to finer scale (1 km resolution), using higher spatial resolution of MODIS derived vegetation indices (NDVI) and land surface temperature (Ts). The disaggregated surface soil moisture were compared to ground-based measurements in diverse landscape using portable impedance probe and gravimetric samples. Simulated root zone soil moisture were compared with continuous soil moisture profile measurements at three monitoring stations. In addition, the impact of projected climate change on root zone soil moisture were also evaluated. The climate change projections of rainfall were analyzed for the Rana watershed from statistically downscaled Global Circulation Models (GCMs). The long-term root zone soil moisture dynamics were estimated by including a rainfall generator of likely scenarios. The predicted long term root zone soil moisture status at finer scale can help in developing efficient agricultural water management schemes to increase crop production, which lead to enhance the water use efficiency.

Binding of isolated plant lectin by rhizobia during episodes of reduced gravity obtained by parabolic flight

NASA Technical Reports Server (NTRS)

Henry, R. L.; Green, P. D.; Wong, P. P.; Guikema, J. A.; Spooner, B. S. (Principal Investigator)

1990-01-01

Development of a legume root nodule is a complex process culminating in a plant/bacterial symbiosis possessing the capacity for biological dinitrogen fixation. Formation of root nodules is initiated by the binding and stabilization of rhizobia to plant root hairs, mediated in part by a receptor/ligand recognition system composed of lectins on the plant root surface and lectin-binding sites on the rhizobial cell surface. The dinitrogen fixation activity of these root nodules may be an important feature of enclosed, space-based life support systems, and may provide an ecological method to recycle nitrogen for amino acid production. However, the effects on nodule development of varied gravitational fields, or of root nutrient delivery hardware, remain unknown. We have investigated the effects of microgravity on root nodule formation, with preliminary experiments focused upon the receptor/ligand component. Microgravity, obtained during parabolic flight aboard NASA 930, has no apparent effect on the binding of purified lectin to rhizobia, a result that will facilitate forthcoming experiments using intact root tissues.

Anatomical analysis of the resected roots of mandibular first molars after failed non-surgical retreatment

PubMed Central

2018-01-01

Objectives Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment. PMID:29765897

Ammonium and Nitrate Uptake by the Floating Plant Landoltia punctata

PubMed Central

Fang, Yun Ying; Babourina, Olga; Rengel, Zed; Yang, Xiao E.; Pu, Pei Min

2007-01-01

Background and Aims Plants from the family Lemnaceae are widely used in ecological engineering projects to purify wastewater and eutrophic water bodies. However, the biology of nutrient uptake mechanisms in plants of this family is still poorly understood. There is controversy over whether Lemnaceae roots are involved in nutrient uptake. No information is available on nitrogen (N) preferences and capacity of Landoltia punctata (dotted duckweed), one of the best prospective species in Lemnaceae for phytomelioration and biomass production. The aim of this study was to assess L. punctata plants for their ability to take up NH4+ and NO3− by both roots and fronds. Methods NO3− and NH4+ fluxes were estimated by a non-invasive ion-selective microelectrode technique. This technique allows direct measurements of ion fluxes across the root or frond surface of an intact plant. Key Results Landoltia punctata plants took up NH4+ and NO3− by both fronds and roots. Spatial distribution of NH4+ and NO3− fluxes demonstrated that, although ion fluxes at the most distal parts of the root were uneven, the mature part of the root was involved in N uptake. Despite the absolute flux values for NH4+ and NO3− being lower in roots than at the frond surface, the overall capacity of roots to take up ions was similar to that of fronds because the surface area of roots was larger. L. punctata plants preferred to take up NH4+ over NO3− when both N sources were available. Conclusions Landoltia punctata plants take up nitrogen by both roots and fronds. When both sources of N are available, plants prefer to take up NH4+, but will take up NO3− when it is the only N source. PMID:17204539

Subgingival delivery of oral debriding agents: a proof of concept.

PubMed

Dunlap, Tanya; Keller, Duane C; Marshall, Milton V; Costerton, J William; Schaudinn, Christoph; Sindelar, Betty; Cotton, John R

2011-01-01

This study is a proof of concept to determine the efficacy of a custom-fabricated tray in placing antimicrobial and debriding agents in the periodontal pockets of persons with active gingival infections. Localized subgingival delivery of antimicrobial and antibiotic agents is routinely employed as adjunctive therapy for the treatment and management ofperiopathogens associated with periodontal disease. Because these delivery techniques often face time constraints and impose temporary restrictions on patient brushing and flossing, a custom-formed prescription dental tray can be used to deliver and maintain medications in periodontal pockets between office visits and without brushing or flossing restrictions. The ability of this tray to maintain sufficient concentrations of medication in the periodontal pockets to have a therapeutic effect is evaluated here with theoretical modeling and practical application. Hydrogen peroxide is an oral debriding agent and oral wound cleanser with antimicrobial properties. The debriding effect of 1.7% hydrogen peroxide gel was tested in vitro on Streptococcus mutans biofilm using glass carriers for collection. Diffusion modeling tested the potential of the customized tray to place hydrogen peroxide gel into the sulcus in the presence of crevicular fluid flow. Changes in periodontal microflora with scanning electron microscopy analysis of in vivo paper point site sampling were analyzed before and after a thin ribbon of 1.7% hydrogen peroxide gel (approximately 0.7 gm) and a subtherapeutic dose (three drops) of Vibramycin (50 mg/5 ml) were placed via Perio Trays into periodontal pockets, ranging from 4-8 mm at daily prescribed intervals for two to five weeks. In vitro results indicate that 1.7% hydrogen peroxide gel breaks down the exopolysaccharide slime and cell walls ofS. mutans, and begins to debride the cells from glass carriers within 10 minutes. Diffusion modeling indicates that hydrogen peroxide can penetrate into the deeper pockets (9 mm), but also its concentration in these deep pockets will increase over wearing time in the absence of degradation by peroxidases and catalase. Site sampling data confirm diffusion modeling results, with evidence that medication delivered with the prescription tray reduced subgingival bacterial loads and enhanced healing of corresponding oral tissues. The prescription Perio Tray effectively placed medication in the gingival sulcus. Mathematical modeling indicated Perio Tray placement of hydrogen peroxide gel in periodontal pockets with depths up to 9 mm over 15 minutes treatment time was theoretically possible. Pathology reports reveal reductions in subgingival bacterial loads and improvements in pretreatment pocket depths of up to 8 mm after 1.7% hydrogen peroxide and Vibramycin Syrup were prescribed for use with the Perio Tray. The in vitro analysis indicating that hydrogen peroxide is the active and effective oral debriding agent needs to be confirmed with additional studies.

An In-Situ Root-Imaging System in the Context of Surface Detection of CO2

NASA Astrophysics Data System (ADS)

Apple, M. E.; Prince, J. B.; Bradley, A. R.; Zhou, X.; Lakkaraju, V. R.; Male, E. J.; Pickles, W.; Thordsen, J. J.; Dobeck, L.; Cunningham, A.; Spangler, L.

2009-12-01

Carbon sequestration is a valuable method of spatially confining CO2 belowground. The Zero Emissions Research Technology, (ZERT), site is an experimental facility in a former agricultural field on the Montana State University campus in Bozeman, Montana, where CO2 was experimentally released at a rate of 200kg/day in 2009 into a 100 meter underground injection well running parallel to the ground surface. This injection well, or pipe, has deliberate leaks at intervals, and CO2 travels from these leaks upward to the surface of the ground. The ZERT site is a model system designed with the purpose of testing methods of surface detection of CO2. One important aspect of surface detection is the determination of the effects of CO2 on the above and belowground portions of plants growing above sequestration fields. At ZERT, these plants consist of a pre-existing mixture of herbaceous species present at the agricultural field. Species growing at the ZERT site include several grasses, Dactylis glomerata (Orchard Grass), Poa pratensis (Kentucky Bluegrass), and Bromus japonicus (Japanese Brome); the nitrogen-fixing legumes Medicago sativa, (Alfalfa), and Lotus corniculatus, (Birdsfoot trefoil); and an abundance of Taraxacum officinale, (Dandelion). Although the aboveground parts of the plants at high CO2 are stressed, as indicated by changes in hyperspectral plant signatures, leaf fluorescence and leaf chlorophyll content, we are interested in determining whether the roots are also stressed. To do so, we are combining measurements of soil conductivity and soil moisture with root imaging. We are using an in-situ root-imaging system manufactured by CID, Inc. (Camas, WA), along with image analysis software (Image-J) to analyze morphometric parameters in the images and to determine what effects, if any, the presence of leaking and subsequently upwelling CO2 has on the phenology of root growth, growth and turnover of individual fine and coarse roots, branching patterns, and root density and depth in the soil. We drilled three holes for the plexiglass root-imaging tubes in December 2008 and installed the tubes post-thaw in May 2009, with the initial set of images taken in July 2009 on the day preceding the 4-week long CO2 injection. We collected images weekly thereafter until late August 2009 by inserted a rotating camera into the tube and photographing at 10 cm intervals from the surface to a depth of 75-80 cm. By August 2009, roots were visible at 80 cm below ground. The root-imaging tubes will remain in place so that we can track the roots through the upcoming years at the ZERT site. Each year, we anticipate gathering images in the fall, winter, before the beginning of root growth in the spring, as well as during the summer injections of CO2. The information gained from these images will be useful in linking above and belowground responses of plants to CO2.

Effect of cold plasma treatment on seedling growth and nutrient absorption of tomato

NASA Astrophysics Data System (ADS)

Jiafeng, JIANG; Jiangang, LI; Yuanhua, DONG

2018-04-01

The effects of cold plasma (CP) treatment on seed germination, seedling growth, root morphology, and nutrient uptake of a tomato were investigated. The results showed that 80 W of CP treatment significantly increased tomato nitrogen (N) and phosphorus (P) absorption by 12.7% and 19.1%, respectively. CP treatment significantly improved the germination potential of tomato seed by 11.1% and the germination rate by 13.8%. Seedling growth characteristics, including total dry weight, root dry weight, root shoot rate, and leaf area, significantly increased after 80 W of CP treatment. Root activity was increased by 15.7% with 80 W of CP treatment, and 12.6% with 100 W of CP treatment. CP treatment (80 W) markedly ameliorated tomato root morphology, and root length, surface area, and volume, which increased 21.3%, 23.6%, and 29.0%, respectively. Our results suggested that CP treatment improved tomato N and P absorption by promoting the accumulation of shoot and root biomass, increasing the leaf area and root activity, and improving the length, surface area, and volume of root growth. Thus, CP treatment could be used in an ameliorative way to improve tomato nutrient absorption.

Effects of 24-epibrassinolide on enzymatic browning and antioxidant activity of fresh-cut lotus root slices.

PubMed

Gao, Hui; Chai, HongKang; Cheng, Ni; Cao, Wei

2017-02-15

Fresh-cut lotus root slices were treated with 80nM 24-epibrassinolide (EBR) and then stored at 4°C for 8days to investigate the effects on cut surface browning. The results showed that EBR treatment reduced cut surface browning in lotus root slices and alleviated membrane lipid peroxidation as reflected by low malondialdehyde content and lipoxygenase activity. EBR treatment inhibited the activity of phenylalanine ammonia lyase and polyphenol oxidase, and subsequently decreased phenolics accumulation and soluble quniones formation. The treatment also stimulated the activity of peroxidase, catalase and ascorbate peroxidase and delayed the loss of ascorbic acid, which would help prevent membrane lipid peroxidation, as a consequence, reducing decompartmentation of enzymes and substrates causing enzymatic browning. These results indicate that EBR treatment is a promising attempt to control browning at cut surface of fresh-cut lotus root slices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Rice Genotype Differences in Tolerance of Zinc-Deficient Soils: Evidence for the Importance of Root-Induced Changes in the Rhizosphere

PubMed Central

Mori, Asako; Kirk, Guy J. D.; Lee, Jae-Sung; Morete, Mark J.; Nanda, Amrit K.; Johnson-Beebout, Sarah E.; Wissuwa, Matthias

2016-01-01

Zinc (Zn) deficiency is a major constraint to rice production and Zn is also often deficient in humans with rice-based diets. Efforts to breed more Zn-efficient rice are constrained by poor understanding of the mechanisms of tolerance to deficiency. Here we assess the contributions of root growth and root Zn uptake efficiency, and we seek to explain the results in terms of specific mechanisms. We made a field experiment in a highly Zn-deficient rice soil in the Philippines with deficiency-tolerant and -sensitive genotypes, and measured growth, Zn uptake and root development. We also measured the effect of planting density. Tolerant genotypes produced more crown roots per plant and had greater uptake rates per unit root surface area; the latter was at least as important as root number to overall tolerance. Tolerant and sensitive genotypes took up more Zn per plant at greater planting densities. The greater uptake per unit root surface area, and the planting density effect can only be explained by root-induced changes in the rhizosphere, either solubilizing Zn, or neutralizing a toxin that impedes Zn uptake (possibly HCO3− or Fe2+), or both. Traits for these and crown root number are potential breeding targets. PMID:26793198

Rice Genotype Differences in Tolerance of Zinc-Deficient Soils: Evidence for the Importance of Root-Induced Changes in the Rhizosphere.

PubMed

Mori, Asako; Kirk, Guy J D; Lee, Jae-Sung; Morete, Mark J; Nanda, Amrit K; Johnson-Beebout, Sarah E; Wissuwa, Matthias

2015-01-01

Zinc (Zn) deficiency is a major constraint to rice production and Zn is also often deficient in humans with rice-based diets. Efforts to breed more Zn-efficient rice are constrained by poor understanding of the mechanisms of tolerance to deficiency. Here we assess the contributions of root growth and root Zn uptake efficiency, and we seek to explain the results in terms of specific mechanisms. We made a field experiment in a highly Zn-deficient rice soil in the Philippines with deficiency-tolerant and -sensitive genotypes, and measured growth, Zn uptake and root development. We also measured the effect of planting density. Tolerant genotypes produced more crown roots per plant and had greater uptake rates per unit root surface area; the latter was at least as important as root number to overall tolerance. Tolerant and sensitive genotypes took up more Zn per plant at greater planting densities. The greater uptake per unit root surface area, and the planting density effect can only be explained by root-induced changes in the rhizosphere, either solubilizing Zn, or neutralizing a toxin that impedes Zn uptake (possibly [Formula: see text] or Fe(2+)), or both. Traits for these and crown root number are potential breeding targets.

Plant roots use a patterning mechanism to position lateral root branches toward available water.

PubMed

Bao, Yun; Aggarwal, Pooja; Robbins, Neil E; Sturrock, Craig J; Thompson, Mark C; Tan, Han Qi; Tham, Cliff; Duan, Lina; Rodriguez, Pedro L; Vernoux, Teva; Mooney, Sacha J; Bennett, Malcolm J; Dinneny, José R

2014-06-24

The architecture of the branched root system of plants is a major determinant of vigor. Water availability is known to impact root physiology and growth; however, the spatial scale at which this stimulus influences root architecture is poorly understood. Here we reveal that differences in the availability of water across the circumferential axis of the root create spatial cues that determine the position of lateral root branches. We show that roots of several plant species can distinguish between a wet surface and air environments and that this also impacts the patterning of root hairs, anthocyanins, and aerenchyma in a phenomenon we describe as hydropatterning. This environmental response is distinct from a touch response and requires available water to induce lateral roots along a contacted surface. X-ray microscale computed tomography and 3D reconstruction of soil-grown root systems demonstrate that such responses also occur under physiologically relevant conditions. Using early-stage lateral root markers, we show that hydropatterning acts before the initiation stage and likely determines the circumferential position at which lateral root founder cells are specified. Hydropatterning is independent of endogenous abscisic acid signaling, distinguishing it from a classic water-stress response. Higher water availability induces the biosynthesis and transport of the lateral root-inductive signal auxin through local regulation of tryptophan aminotransferase of Arabidopsis 1 and PIN-formed 3, both of which are necessary for normal hydropatterning. Our work suggests that water availability is sensed and interpreted at the suborgan level and locally patterns a wide variety of developmental processes in the root.

Clinical evaluation of a dressing with poly absorbent fibres and a silver matrix for managing chronic wounds at risk of infection: a non comparative trial.

PubMed

Dalac, S; Sigal, L; Addala, A; Chahim, M; Faivre-Carrere, C; Lemdjadi, Z; Bohbot, S

2016-09-01

To assess the efficacy, safety and acceptability of a new silver poly absorbent dressing (UrgoCleanAg) in the local management of exudative chronic wounds at risk of infection, with inflammatory signs suggesting heavy bacterial load. This prospective, multicentre, non-comparative clinical trial was conducted in French hospital wards (dermatology and vascular medicine) or specialised private-practice physicians. Patients were considered at high-risk of infection when presenting with at least three of five selected inflammatory clinical signs, suggesting a heavy bacterial load (pain between two dressing changes, erythema, oedema, malodorous wound and presence of a heavy exudate). They were treated for a maximum period of four weeks, and followed by the physician on a weekly basis, including a clinical examination, area tracings and photographs. The primary efficacy criterion of the trial was the relative wound surface area reduction at the end of the four weeks of treatment. Acceptability was documented by the nursing staff at each dressing change between the weekly evaluations. We recruited 37 patients with chronic wounds. Wound surface area, mostly covered by sloughy tissue, was reduced by 32.5% at the end of the treatment (median value), while the clinical score (maximum value of 5, based on inflammatory clinical signs) decreased from 4.0 to 2.0. Effective debridement properties were documented (62.5% relative reduction of sloughy tissue at week 4; 58.8% of debrided wounds at week 4) and improvement of the periwound skin status was noted (healthy for 28.6% of the patients at week 4 versus 2.7% at baseline). In addition, the tested wound dressing presented a good safety profile associated to a high level of acceptability, noted by both patients and nursing staff. These clinical data support that the tested dressing is a credible therapeutic alternative for the management of chronic wounds at risk of infection with inflammatory signs suggesting heavy bacterial load.

Reducing Strength Prevailing at Root Surface of Plants Promotes Reduction of Ag+ and Generation of Ag0/Ag2O Nanoparticles Exogenously in Aqueous Phase

PubMed Central

Pardha-Saradhi, Peddisetty; Yamal, Gupta; Peddisetty, Tanuj; Sharmila, Peddisetty; Nagar, Shilpi; Singh, Jyoti; Nagarajan, Rajamani; Rao, Kottapalli S.

2014-01-01

Potential of root system of plants from wide range of families to effectively reduce membrane impermeable ferricyanide to ferrocyanide and blue coloured 2,6-dichlorophenol indophenol (DCPIP) to colourless DCPIPH2 both under non-sterile and sterile conditions, revealed prevalence of immense reducing strength at root surface. As generation of silver nanoparticles (NPs) from Ag+ involves reduction, present investigations were carried to evaluate if reducing strength prevailing at surface of root system can be exploited for reduction of Ag+ and exogenous generation of silver-NPs. Root system of intact plants of 16 species from 11 diverse families of angiosperms turned clear colorless AgNO3 solutions, turbid brown. Absorption spectra of these turbid brown solutions showed silver-NPs specific surface plasmon resonance peak. Transmission electron microscope coupled with energy dispersive X-ray confirmed the presence of distinct NPs in the range of 5–50 nm containing Ag. Selected area electron diffraction and powder X-ray diffraction patterns of the silver NPs showed Bragg reflections, characteristic of crystalline face-centered cubic structure of Ag0 and cubic structure of Ag2O. Root system of intact plants raised under sterile conditions also generated Ag0/Ag2O-NPs under strict sterile conditions in a manner similar to that recorded under non-sterile conditions. This revealed the inbuilt potential of root system to generate Ag0/Ag2O-NPs independent of any microorganism. Roots of intact plants reduced triphenyltetrazolium to triphenylformazon and impermeable ferricyanide to ferrocyanide, suggesting involvement of plasma membrane bound dehydrogenases in reduction of Ag+ and formation of Ag0/Ag2O-NPs. Root enzyme extract reduced triphenyltetrazolium to triphenylformazon and Ag+ to Ag0 in presence of NADH, clearly establishing potential of dehydrogenases to reduce Ag+ to Ag0, which generate Ag0/Ag2O-NPs. Findings presented in this manuscript put forth a novel, simple, economically viable and green protocol for synthesis of silver-NPs under ambient conditions in aqueous phase, using root system of intact plants. PMID:25184239

Hounsfield unit change in root and alveolar bone during canine retraction.

PubMed

Jiang, Feifei; Liu, Sean S-Y; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S; Eckert, George

2015-04-01

The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surfaces during controlled canine retractions. Eighteen maxillary canine retraction patients were selected for this split-mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment. Pretreatment and posttreatment cone-beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HUs in each division were measured. Mixed-model analysis of variance was applied to test the HU change distribution at the P <0.05 significance level. The HU changes varied with the directions relative to the canine movement. The HU reductions occurred at the root surfaces. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HUs decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. HU reduction occurs on the root surface in the direction perpendicular to tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Hounsfield Unit Change in Root and Alveolar Bone during Canine Retraction

PubMed Central

Jiang, Feifei; Liu, Sean Y.; Xia, Zeyang; Li, Shuning; Chen, Jie; Kula, Katherine S.; Eckert, George

2014-01-01

Objectives The objective of this study was to determine the Hounsfield unit (HU) changes in the alveolar bone and root surface during controlled canine retractions. Methods Eighteen maxillary canine retraction patients were selected for this split mouth design clinical trial. The canines in each patient were randomly assigned to receive either translation or controlled tipping treatment strategy. Pre- and post-treatment cone beam computed tomography scans of each patient were used to determine tooth movement direction and HU changes. The alveolar bone and root surface were divided into 108 divisions, respectively. The HU in each division was measured. The Mixed-model ANOVA was applied to test the HU change distribution at the p<0.05 significant level. Results The HU changes varied with the directions relative to the canine movement. The HU reduction occurred at the root surface. Larger reductions occurred in the divisions that were perpendicular to the moving direction. However, HU decreased in the alveolar bone in the moving direction. The highest HU reduction was at the coronal level. Conclusions HU reduction occurs on the root surface in the direction perpendicular to the tooth movement and in the alveolar bone in the direction of tooth movement when a canine is retracted. PMID:25836004

[Cell surface peroxidase--generator of superoxide anion in wheat root cells under wound stress].

PubMed

Chasov, A V; Gordon, L Kh; Kolesnikov, O P; Minibaeva, F V

2002-01-01

Development of wound stress in excised wheat roots is known to be accompanied with an increase in reactive oxygen species (ROS) production, fall of membrane potential, release of K+ from cells, alkalization of extracellular solution, changes in respiration and metabolism of structural lipids. Dynamics of superoxide release correlates with changes in other physiological parameters, indicating the cross-reaction of these processes. Activity of peroxidase in extracellular solution after a 1 h incubation and removal of roots was shown to be stimulated by the range of organic acids, detergents, metals, and to be inhibited by cyanide. Superoxide production was sensitive to the addition of Mn2+ and H2O2. Increase in superoxide production correlates with the enhancement of peroxidase activity at the application of organic acids and detergents. The results obtained indicate that cell surface peroxidase is one of the main generators of superoxide in wounded wheat root cells. Different ways of stimulation of the ROS producing activity in root cells is supposed. By controlling superoxide and hydrogen peroxide formation, the cell surface peroxidase can control the adaptation processes in stressed plant cells.

Effect of endodontic irrigating solutions on the microhardness and roughness of root canal dentin: an in vitro study.

PubMed

Patil, Chetan R; Uppin, Veerendra

2011-01-01

To evaluate the effect of widely used endodontic irrigating solutions on root dentin microhardness and surface roughness. One hundred twenty, non-carious extracted human permanent incisor teeth were selected. The crowns of the teeth were sectioned and the roots were separated longitudinally to get 240 specimens. These specimens were then divided into six groups according to the irrigating solutions used. The solutions used were 5% and 2.5% NaOCl solutions, 3% H2 O2 , 17% EDTA solution, 0.2% chlorhexidine gluconate, and distilled water. Then, the specimens were subjected to microhardness and roughness testing. The data were analyzed using ANOVA and Tukey's multiple comparison tests. The results of this study indicated that all irrigation solutions, except 0.2% chlorhexidine gluconate, decreased the microhardness of root dentin, and 3% H2 O2 and 0.2% chlorhexidine gluconate had no effect on surface roughness. Within the limitation of this study, it is concluded that 0.2% chlorhexidine gluconate seems to be an appropriate irrigation solution, because of its harmless effect on the microhardness and surface roughness of root canal dentin.

Sulphate reduction and nitrogen fixation rates associated with roots, rhizomes and sediments from Zostera noltii and Spartina maritima meadows.

PubMed

Nielsen, L B; Finster, K; Welsh, D T; Donelly, A; Herbert, R A; de Wit, R; Lomstein, B A

2001-01-01

Sulphate reduction rates (SRR) and nitrogen fixation rates (NFR) associated with isolated roots, rhizomes and sediment from the rhizosphere of the marine macrophytes Zostera noltii and Spartina maritima, and the presence and distribution of Bacteria on the roots and rhizomes, were investigated. Between 1% and 3% of the surface area of the roots and rhizomes of both macrophytes were colonized by Bacteria. Bacteria on the surfaces of S. maritima roots and rhizomes were evenly distributed, while the distribution of Bacteria on Z. noltii roots and rhizomes was patchy. Root- and rhizome-associated SRR and NFR were always higher than rates in the bulk sediment. In particular, nitrogen fixation associated with the roots and rhizomes was 41-650-fold higher than in the bulk sediment. Despite the fact that sulphate reduction was elevated on roots and rhizomes compared with bulk sediment, the contribution of plant-associated sulphate reduction to overall sulphate reduction was small (< or =11%). In contrast, nitrogen fixation associated with the roots and rhizomes accounted for 31% and 91% of the nitrogen fixed in the rhizosphere of Z. noltii and S. maritima respectively. In addition, plant-associated nitrogen fixation could supply 37-1,613% of the nitrogen needed by the sulphate-reducing community. Sucrose stimulated nitrogen fixation and sulphate reduction significantly in the root and rhizome compartments of both macrophytes, but not in the bulk sediment.

Young donor-graft assisted endothelial keratoplasty (PDEK/DMEK) with epithelial debridement for chronic pseudophakic bullous keratopathy.

PubMed

Agarwal, Amar; Narang, Priya; Kumar, Dhivya A; Agarwal, Ashvin

2017-10-01

The aim of this study was to describe the applicability and report visual outcomes for the treatment of subepithelial fibrosis and anterior stromal scarring in cases of chronic pseudophakic bullous keratopathy (PBK) with epithelial debridement and endothelial keratoplasty (EK) (pre-Descemet endothelial keratoplasty [PDEK]; Descemet membrane endothelial keratoplasty [(DMEK]) using young donor tissue. Prospective, single-centre, interventional study. 6 cases with chronic PBK (> 1 year duration). Case 1 underwent PDEK with glued intraocular lens (IOL) as a single-stage procedure, whereas cases 2 and 3 underwent glued IOL followed by DMEK and PDEK, respectively, as a second-stage procedure. Cases 4 and 6 underwent PDEK, whereas case 5 underwent DMEK. Epithelial debridement was performed in all cases at the time of EK, and young donor grafts were used. The main outcome measures were best spectacle-corrected visual acuity, clearance of corneal scar and haze, central corneal thickness (CCT), specular microscopy, and endothelial cell count (ECC). Postoperatively, all cases demonstrated significant improvement in visual acuity. The mean value of depth of subepithelial haze was 121±71.7 µm and 25.3 ± 19.8 µm in the preoperative and postoperative periods, respectively (p = 0.028). At the 1-month follow-up, the mean preoperative CCT of 676 ± 92.7 µm was reduced to 534.6 ± 21.1µm. At the 6-month follow-up, the mean ECC loss resulting from the procedure was 36.5 ± 10.4%. EK with epithelial debridement performed for the treatment of chronic PBK resulted in significantly improved visual acuity to a functional level, with the clearance of subepithelial fibrosis and anterior stromal scar, in most patients. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

One-stage posterior focus debridement, fusion, and instrumentation in the surgical treatment of lumbar spinal tuberculosis with kyphosis in children.

PubMed

Hu, Xiongke; Zhang, Hongqi; Yin, Xinhua; Chen, Yong; Yu, Honggui; Zhou, Zhenhai

2016-03-01

The purpose of this study is to investigate the clinical efficacy and feasibility of one-stage posterior focus debridement, fusion, and instrumentation in the surgical treatment of lumbar spinal tuberculosis with kyphosis in children. From December 2007 to May 2012, 13 patients (six males and seven females) suffering from lumbar spinal tuberculosis with kyphosis were admitted. All patients were treated with one-stage posterior focus debridement, fusion, and instrumentation. Then, the clinical efficacy was estimated by statistical analysis based on the data about Frankel grade, the Cobb angle of kyphosis, and erythrocyte sedimentation rate (ESR), which were collected at certain time. The age of all patients ranged from 5 to 13 years (average, 8.8 years). Operation time ranged from 120 to 190 min (average, 165 min). Intraoperative blood loss ranged from 200 to 800 ml (average, 460 ml). All patients were followed up for 24 to 57 months postoperatively (average, 33.5 months). The Cobb angle was changed significantly between preoperation and postoperation (P < 0.05), and there was no significant loss at the last follow-up. The preoperation ESR (62.5 ± 15.7) returned to normal (16.6 ± 8.1) within 3 months postoperatively in all patients (P < 0.05). Bone fusion was achieved within 3-5 months (average, 3.5 months). In the 13 cases, no postoperative severe complications occurred and neurologic function improved in various degrees. The outcomes of follow-up showed that one-stage posterior focus debridement, fusion, and instrumentation can be an effective treatment method for the lumbar spinal tuberculosis with kyphosis in children.

Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis.

PubMed

Abulizi, Yakefu; Liang, Wei-Dong; Muheremu, Aikeremujiang; Maimaiti, Maierdan; Sheng, Wei-Bin

2017-07-14

Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53.7 ± 8.7) with lumbosacral brucellosis treated by transforaminal decompression, debridement, interbody fusion, and posterior instrumentation were enrolled. Medical records, imaging studies, laboratory data were collected and summarized. Surgical outcomes were evaluated based on visual analogue scale (VAS), Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) scale. The changes in C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), clinical symptoms and complications were investigated. Graft fusion was evaluated using Bridwell grading criteria. The mean follow-up period was 24.9 ± 8.2 months. Back pain and radiating leg pain was relieved significantly in all patients after operation. No implant failures were observed in any patients. Wound infection was observed in two patients and sinus formation was observed in one patient. Solid bony fusion was achieved in 30 patients and the fusion rate was 93.8%. The levels of ESR and CRP were returned to normal by the end of three months' follow-up. VAS and ODI scores were significantly improved (P < 0.05). According to JOA score, surgical improvement was excellent in 22 cases (68.8%), good in 9 cases (28.1%), moderate in 1 case (3.1%) at the last follow-up. Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation is an effective and safe approach for lumbosacral brucellosis.

Impact of Intravenous Immunoglobulin on Survival in Necrotizing Fasciitis With Vasopressor-Dependent Shock: A Propensity Score–Matched Analysis From 130 US Hospitals

PubMed Central

Swihart, Bruce J.; Bonne, Stephanie L.; Hohmann, Samuel F.; Hennessy, Laura V.; Louras, Peter; Evans, Heather L.; Rhee, Chanu; Suffredini, Anthony F.; Hooper, David C.; Follmann, Dean A.; Bulger, Eileen M.; Danner, Robert L.

2017-01-01

Abstract Background. Shock frequently complicates necrotizing fasciitis (NF) caused by group A Streptococcus (GAS) or Staphylococcus aureus. Intravenous immunoglobulin (IVIG) is sometimes administered for presumptive toxic shock syndrome (TSS), but its frequency of use and efficacy are unclear. Methods. Adult patients with NF and vasopressor-dependent shock undergoing surgical debridement from 2010 to 2014 were identified at 130 US hospitals. IVIG cases were propensity-matched and risk-adjusted. The primary outcome was in-hospital mortality and the secondary outcome was median length of stay (LOS). Results. Of 4127 cases of debrided NF with shock at 121 centers, only 164 patients (4%) at 61 centers received IVIG. IVIG subjects were younger with lower comorbidity indices, but higher illness severity. Clindamycin and vasopressor intensity were higher among IVIG cases, as was coding for TSS and GAS. In-hospital mortality did not differ between matched IVIG and non-IVIG groups (crude mortality, 27.3% vs 23.6%; adjusted odds ratio, 1.00 [95% confidence interval, .55–1.83]; P = .99). Early IVIG (≤2 days) did not alter this effect (P = .99). Among patients coded for TSS, GAS, and/or S. aureus, IVIG use was still unusual (59/868 [6.8%]) and lacked benefit (P = .63). Median LOS was similar between IVIG and non-IVIG groups (26 [13–49] vs 26 [11–43]; P = .84). Positive predictive values for identifying true NF and debridement among IVIG cases using our algorithms were 97% and 89%, respectively, based on records review at 4 hospitals. Conclusions. Adjunctive IVIG was administered infrequently in NF with shock and had no apparent impact on mortality or hospital LOS beyond that achieved with debridement and antibiotics. PMID:28034881

[Efficacies of arthroscopic debridement and olecranon fossa plasty in the treatment of osteoarthritis and posterior elbow impingement].

PubMed

Liu, Yu-jie; Wang, Jun-liang; Li, Hai-feng; Qi, Wei; Wang, Ning

2012-07-17

To evaluate the efficacies of arthroscopic debridement and removal of osteophyma for olecroanon and olecranon fossa plasty for posterior impingement of elbow joint. Between 1999 and 2008, a total of 21 cases were diagnosed with osteoarthritis and posterior elbow impingement. There were 15 males and 6 females. And there were 16 right and 15 left cases. They included volleyball players (n = 7), tennis players (n = 7), golf enthusiasts (n = 4) and fencers (n = 3). The average duration of onset-operation was 3.5 years (range: 2.5 - 8). Arthroscopic exploration revealed synovial hyperplasia hypertrophy, cartilage degeneration and olecranon fossa hyperplasia with deformed olecranon fossa. Debridement and plasty were performed. Loose bodies were removed from elbow joint in 6 patients. Partial resection of posterior olecranon tip was performed and osteophytes or fibrous tissue removed in this area. Dynamic observation showed no posterior elbow impingement. Postoperative follow-up was conducted in 19 cases and 2 cases became lost to follow-up. The average follow-up period was 25.3 months (range: 18 - 42). All patients were evaluated preoperatively and postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. The outcomes were excellent (n = 12), good (n = 7) and fair (n = 2). Postoperative patients elbow swelling and pain relieve, sports and life function returns to normal, elbow flexion and rotating mobility obviously improved. With the elbow radiological films to measure the range of motion, the average range of motion was 90.5° preoperatively and improved to 130° postoperatively. There was significant improvement in all cases. Posterior elbow impingement is caused by hyperextension trauma and elbow overuse during specific sporting activities. Arthroscopic debridement and olecroanon or olecranon fossa plasty demonstrates excellent results for posterior impingement of elbow joint.

Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene.

PubMed

Hu, Ning; Wu, Xing-Huo; Liu, Rong; Yang, Shu-Hua; Huang, Wei; Jiang, Dian-Ming; Wu, Qiang; Xia, Tian; Shao, Zeng-Wu; Ye, Zhe-Wei

2015-08-01

Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.

Er:YAG laser in the treatment of periodontal sites with recurring chronic inflammation: a 12-month randomized, controlled clinical trial.

PubMed

Krohn-Dale, Ivar; Bøe, Olav E; Enersen, Morten; Leknes, Knut N

2012-08-01

The objective of this randomized, controlled clinical trial was to compare the clinical and microbiological effects of pocket debridement using erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser with conventional debridement in maintenance patients. Fifteen patients, all smokers, having at least four teeth with residual probing depth (PD) ≥ 5 mm were recruited. Two pockets in two jaw quadrants were randomly assigned to subgingival debridement using an Er:YAG laser (test) or ultrasonic scaler/curette (control) at 3-month intervals. Relative attachment level (RAL), PD, bleeding on probing and dental plaque were recorded at baseline and at 6 and 12 months. Microbiological subgingival samples were taken at the same time points and analysed using a checkerboard DNA-DNA hybridization technique. A significant decrease in PD took place in both treatments from baseline to 12 months (p < 0.01). In the control, the mean initial PD decreased from 5.4 to 4.0 mm at 12 months. For the test, a similar decrease occurred. No significant between-treatment differences were shown at any time point. The mean RAL showed no overall significant inter- or intra-treatment differences (p > 0.05). No significant between-treatment differences were observed in subgingival microbiological composition or total pathogens. The results failed to support that an Er:YAG laser may be superior to conventional debridement in the treatment of smokers with recurring chronic inflammation. This appears to be the first time that repeated Er-YAG laser instrumentation has been compared with mechanical instrumentation of periodontal sites with recurring chronic inflammation over a clinically relevant time period. © 2012 John Wiley & Sons A/S.

Maintenance of arytenoid abduction following carbon dioxide laser debridement of the articular cartilage and joint capsule of the cricoarytenoid joint combined with prosthetic laryngoplasty in horses: an in vivo and in vitro study.

PubMed

Hawkins, J F; Couetil, L; Miller, M A

2014-02-01

The objective was to evaluate CO2 laser debridement of the cricoarytenoid joint (CAJ) combined with prosthetic laryngoplasty to prevent post-operative loss of arytenoid abduction in seven horses. Horses were assigned to either laser debridement of the left CAJ and laryngoplasty (laser treated, n=5) or control laryngoplasty (sham, n=2), and were evaluated with endoscopic examinations and measurement of right to left angle quotients (RLQ) to assess maintenance of arytenoid abduction. The animals were euthanased at intervals after surgery and larynges were harvested for post-mortem testing, including determination of translaryngeal flow, pressure, impedance and RLQ. Measurements were obtained under increasing vacuum-generated negative pressure with laryngoplasty sutures intact and with the knot/crimp of the laryngoplasty sutures removed. Following post-mortem testing the cricoarytenoid joints were examined histologically. Post-operative endoscopic examinations revealed no significant differences between RLQ measurements calculated for day 1 following surgery to the termination date of the study for the seven horses. Post-mortem RLQ at airflows of 10 and 60 L/s was significantly higher in sham than in laser treated horses both before and after knot/crimp removal. Translaryngeal impedance at 10 and 60 L/s was not statistically different between groups. Histopathology revealed necrosis and loss of articular cartilage in the laser treated horses. The lymphoid cell infiltration subsided but joint capsule and periarticular fibrosis increased over the course of the study. Post-operative loss of arytenoid abduction after laryngoplasty can be minimized with CO2 laser debridement of the CAJ joint. Copyright © 2013 Elsevier Ltd. All rights reserved.

Percutaneous debridement and washout of walled-off abdominal abscess and necrosis using flexible endoscopy: a large single-center experience.

PubMed

Mathers, Bradley; Moyer, Matthew; Mathew, Abraham; Dye, Charles; Levenick, John; Gusani, Niraj; Dougherty-Hamod, Brandy; McGarrity, Thomas

2016-01-01

Direct percutaneous endoscopic necrosectomy has been described as a minimally invasive intervention for the debridement of walled-off pancreatic necrosis (WOPN). In this retrospective cohort study, we aimed to confirm these findings in a US referral center and evaluate the clinical value of this modality in the treatment of pancreatic necrosis as well as other types of intra-abdominal fluid collections and necrosis. Twelve consecutive patients with WOPN or other abdominal abscess requiring debridement and washout underwent computed tomography (CT)-guided drainage catheter placement. Each patient then underwent direct percutaneous endoscopic necrosectomy and washout with repeat debridement performed until complete. Drains were then removed once output fell below 30 mL/day and imaging confirmed resolution. The primary endpoints were time to clinical resolution and sustained resolution at 1-year follow up.  Ten patients were treated for WOPN, one for necrotic hepatic abscesses, and one for omental necrosis. The median time to intervention was 85 days with an average of 2.3 necrosectomies performed. Complete removal of drains was accomplished in 11 patients (92 %). The median time to resolution was 57 days. No serious adverse events occurred; however, one patient developed pancreaticocutaneous fistulas. Ten patients completed 1-year surveillance of which none required drain replacement. No patients required surgery or repeat endoscopy. This series supports the premise that direct percutaneous endoscopic necrosectomy is a safe and effective intervention for intra-abdominal fluid collections and necrosis in appropriately selected patients. Our study demonstrates a high clinical success rate with minimal adverse events. This modality offers several potential advantages over surgical and transgastric approaches including use of improved accessibility, an excellent safety profile, and requirement for only deep or moderate sedation.

Anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis: autologous iliac bone strut versus cage.

PubMed

Pee, Yong Hun; Park, Jong Dae; Choi, Young-Geun; Lee, Sang-Ho

2008-05-01

An anterior approach for debridement and fusion with autologous bone graft has been recommended as the gold standard for surgical treatment of pyogenic spondylodiscitis. The use of anterior foreign body implants at the site of active infection is still a challenging procedure for spine surgeons. Several authors have recently introduced anterior grafting with titanium mesh cages instead of autologous bone strut in the treatment of spondylodiscitis. The authors present their experience of anterior fusion with 3 types of cages followed by posterior pedicle screw fixation. They also compare their results with the use of autologous iliac bone strut. The authors retrospectively reviewed the cases of 60 patients with pyogenic spondylodiscitis treated by anterior debridement between January 2003 and April 2005. Fusion using either cages or iliac bone struts was performed during the same course of anesthesia followed by posterior fixation. Twenty-three patients underwent fusion with autologous iliac bone strut, and 37 patients underwent fusion with 1 of the 3 types of cages. The infections resolved in all patients, as noted by normalization of their erythrocyte sedimentation rates and C-reactive protein levels. Patients in both groups were evaluated in terms of their preoperative and postoperative clinical and imaging findings. Single-stage anterior debridement and cage fusion followed by posterior pedicle screw fixation can be effective in the treatment of pyogenic spondylodiscitis. There was no difference in clinical and imaging outcomes between the strut group and cage group except for the subsidence rate. The subsidence rate was higher in the strut group than in the cage group. The duration until subsidence was also shorter in the strut group than in the cage group.

Economic and clinical benefit of collagenase ointment compared to a hydrogel dressing for pressure ulcer debridement in a long-term care setting.

PubMed

Waycaster, Curtis; Milne, Catherine

2013-06-01

The purpose of this study is to determine the cost-effectiveness of collagenase ointment relative to autolysis with a hydrogel dressing when debriding necrotic pressure ulcers in a long-term care setting. A Markov decision process model with 2 states (necrotic nonviable wound bed transitioning to a granulated viable wound bed) was developed using data derived from a prospective, randomized, 6-week, single-center trial of 27 institutionalized subjects with pressure ulcers that were ≥ 85% necrotic nonviable tissue. Direct medical costs from the payer perspective included study treatments, wound treatment supplies, and nursing time. Clinical benefit was measured as "granulation days" and was derived from the time-dependent debridement rates of the alternative products. The average cost per patient for 42 days of pressure ulcer care was $1,817 in 2012 for the collagenase group and $1,611 for the hydrogel group. Days spent with a granulated wound were 3.6 times higher for collagenase (23.4 vs 6.5) than with the hydrogel. The estimated cost per granulation day was > 3.2 times higher for hydrogel ($249) vs collagenase ($78). In this economic analysis based on a randomized, controlled clinical trial, collagenase ointment resulted in a faster time to complete debridement and was more cost-effective than hydrogel autolysis for pressure ulcers in a long-term care setting. Even though collagenase ointment has a higher acquisition cost than hydrogel, the clinical benefit offsets the initial cost difference, resulting in lower cost per granulation day to the nursing home over the course of the 42-day analysis.

One-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis.

PubMed

Pang, Xiaoyang; Wu, Ping; Shen, Xiongjie; Li, Dongzhe; Luo, Chenke; Wang, Xiyang

2013-08-01

Retrospective analysis of the clinical study efficacy and feasibility of one-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis. A total of 21 patients with lumbosacral tuberculosis (TB) collected from January 2004 to January 2010, underwent one-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation. In addition, the clinical efficacy was evaluated based on the data on the lumbo-sacral angle, neuro-logical status that was recorded by American Spinal Injury Association (ASIA) Impairment Scale, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), which were collected at specific time points. All cases were followed up for 16-36 months (average 24.9 ± 6.44 months). 18 patients suffered from evident neurological deficits preoperatively, of which 16 patients returned to normal at the final follow-up. Two patients with neurological dysfunction aggravated postoperative, experienced significant partial neurological recovery. With an effective and standard anti-TB chemotherapy treated, the values of ESR and CRP returned to normal levels 3-month later postoperative and maintained till the final follow-up. Preoperative lumbosacral angle was 20.89 ± 2.32° and returned 29.62 ± 1.41° postoperative. During long-term follow-up, there was only 1-3° lumbosacral angle loss. There was a significant difference between preoperative and postoperative lumbosacral angles. With effective and standard anti-TB chemotherapy, one-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation for lumbosacral tuberculosis can effectively relieve pain symptoms, improve neurological function, and reconstruct the spinal stability.

Evaluation of the Effects of Er,Cr:YSGG Laser, Ultrasonic Scaler and Curette on Root Surface Profile Using Surface Analyser and Scanning Electron Microscope: An In Vitro Study.

PubMed

Arora, Shipra; Lamba, Arundeep Kaur; Faraz, Farrukh; Tandon, Shruti; Ahad, Abdul

2016-01-01

Introduction: The periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects. Methods: Thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A (n = 30) was taken as control and no instrumentation was performed. Part B (n = 30) was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser. Part C (n = 30) was treated by piezoelectric ultrasonic scaler. Part D (n = 30) was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average (Ra) value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope (SEM). The means across the groups were statistically compared with control using Dunnett test. Results: Among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness (mean Ra value of 4.14 μm) as compared to ultrasonic scaler (1.727 μm) and curette group (1.22 μm). However, surface with smear layer were found to be maximum (50%) in curette treated samples and minimum (20%) in laser treated ones. Maximum cracks (83.34%) were produced by ultrasonic scaler, and minimum (43.33%) by curettes. Crater formation was maximum (50%) in laser treated samples and minimum (3.33%) in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes. Conclusion: Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects.

Medical management of cutaneous sulfur mustard injuries.

PubMed

Graham, John S; Stevenson, Robert S; Mitcheltree, Larry W; Hamilton, Tracey A; Deckert, Robin R; Lee, Robyn B; Schiavetta, Ann M

2009-09-01

Sulfur mustard (2,2'-dichlorodiethyl sulfide; HD) is a potent vesicating chemical warfare agent that poses a continuing threat to both military and civilian populations. Significant cutaneous HD injuries can take several months to heal, necessitate lengthy hospitalizations, and result in long-term complications. There are currently no standardized or optimized methods of casualty management. New strategies are needed to provide for optimal and rapid wound healing. The primary aim of this research was to develop improved clinical strategies (treatment guidelines) for optimal treatment of superficial dermal (second degree) cutaneous HD injuries, with the goal of returning damaged skin to optimal appearance and normal function in the shortest period of time. Superficial dermal HD injuries were created on the ventral abdominal surface of weanling pigs. At 48h post-exposure, lesions were laser debrided and a treatment adjunct applied. Cultured epithelial allografts and 11 commercial off-the-shelf (COTS) products were examined for their efficacy in improving wound healing of these injuries. Clinical evaluations and a variety of non-invasive bioengineering methods were used at 7 and 14 days post-surgery to follow the progress of wound healing and evaluate various cosmetic and functional properties of the wounds. Measurements included reflectance colorimetry to measure erythema; evaporimetry to examine transepidermal water loss as a method of evaluating barrier function; torsional ballistometry to evaluate the mechanical properties of skin firmness and elasticity; and two-dimensional high frequency ultrasonography (HFU) to monitor skin thickness (e.g., edema, scar tissue). Histopathology and immunohistochemistry were performed 14 days following surgery to examine structural integrity and quality of healing. Logical Decisions((R)) for Windows was used to rank the 12 treatment adjuncts that were studied. The most efficacious treatment adjuncts included (1) Vacuum Assisted Closure, V.A.C., involving application of topical negative pressure, (2) Amino-Plex Spray (biO(2) Cosmeceuticals International, Inc., Beverly Hills, CA), a nutritive cosmeceutical product that is designed to increase oxygen in cells, stimulate ATP synthesis, improve glucose transportation, stimulate collagen formation, and promote angiogenesis, and (3) ReCell Autologous Cell Harvesting Device (Clinical Cell Culture Americas LLC, Coral Springs, Florida), an innovative medical device that was developed to allow rapid harvesting of autologous cells from a thin split-thickness biopsy followed by spray application of a population of skin cells onto wounds within 30 min of collecting the biopsy, without the need of culturing the keratinocytes in a clinical laboratory. Complete re-epithelialization of debrided HD injuries in 7 days is possible. In general, shallow laser debridement through the basement membrane zone (100 microm) appears to provide better results than deeper debridement (400 microm) with respect to early re-epithelialization, cosmetic appearance, functional restoration, and structural integrity. Of the 12 treatment adjuncts examined, the most promising included Vacuum Assisted Closure, Amino-Plex Spray, and ReCell Autologous Cell Harvesting Device.

Effect of indomethacin on surface treatment and intracanal dressing of replanted teeth in dogs.

PubMed

Zanetta-Barbosa, Darceny; Moura, Camilla Christian Gomes; Machado, Juliana Reis; Crema, Virginia Oliveira; Lima, Cirilo Antônio de Paula; de Carvalho, Antônio Cesar Perry

2014-01-01

This study evaluated the healing process of teeth replanted after root treatment and intracanal dressing with indomethacin alone or indomethacin with calcium hydroxide (Ca[OH]2). Through a case-control study, 24 teeth of 6 adult dogs were extracted, dried, and divided into 4 groups according to the root surface treatment protocols performed before replantation and the intracanal medication used after replantation. In group 1 (negative control), root surfaces were treated by immersion in a 0.9% saline solution and then replanted. In the other groups, the roots were immersed for 10 minutes in Ca(OH)2 (group 2), indomethacin (group 3), or a solution of indomethacin and Ca(OH)2 (group 4). After 2 weeks, group 1 teeth were subjected to single-visit root canal treatment and obturation with gutta-percha and sealer consisting of zinc oxide and eugenol. The teeth in the other groups were subjected to intracanal dressing with the same material used for immersion. After an additional period of 28 weeks, the animals were euthanized and the jaws containing the replanted teeth were processed for histologic analysis. Histometric values were statistically analyzed, with significance set at a P value less than or equal to .05. Group 1 exhibited significantly more normal periodontium than group 4 (P = .02). Total resorption was greater in group 4 than in group 1 (P = .02). No statistically significant difference in the percentage of surface resorption or in total inactive resorption was observed between the groups. The findings of this study suggest that intracanal dressing and topical root treatment with Ca(OH)2 with or without indomethacin is not recommended for teeth dried for 50 minutes, but the use of indomethacin alone as root surface treatment for delayed tooth replantation deserves further study using longer drying periods. In addition, the present results suggest that a single-visit root canal, performed up to 2 weeks after replantation, might be indicated for teeth dried for up to 50 minutes. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effects of EDTA gel preconditioning of periodontally affected human root surfaces on chlorhexidine substantivity - an SEM study.

PubMed

Gamal, Ahmed Y; Mailhot, Jason M

2007-09-01

Infection control is an important requirement during the early stages of periodontal healing. This study was performed to assess the preconditioning effect of EDTA gel on chlorhexidine (CHX) substantivity to periodontally involved root surfaces. Eighty patients with severe chronic periodontitis were enrolled in this study. Following cause-related therapy, patients were divided randomly into four groups. Each group consisted of 20 subjects with one tooth that was diagnosed as hopeless and designated for extraction. In group 1 (G1), selected periodontal pockets were filled with a placebo gel in a silica base for 2 minutes. Exposed roots in group 2 (G2) were etched for 2 minutes with a neutral EDTA conditioning agent, followed by pocket fill with the placebo gel. Pockets in group 3 (G3) were filled with 0.12% CHX digluconate gel in a silica base. Exposed roots in group 4 (G4) were etched for 2 minutes with a neutral EDTA conditioning agent, followed by pocket fill with the CHX gel. Four teeth from each group were extracted immediately and at 3, 12, 24, and 48 hours for SEM evaluation. G1 and G2 specimens showed no evidence of silica adherent to any of the examined root surfaces. At 3 hours following CHX gel application, G3 specimens showed marked reduction in CHX-coated silica. At 24 and 48 hours following EDTA and CHX gel application, G4 specimens demonstrated adherent CHX-coated silica particles despite the reclogging of the tubule orifices. EDTA and CHX gel root conditioning is a valuable regimen that improves CHX substantivity to periodontally involved root surfaces.

Challenges to estimating whole forest root biomass with ground penetrating radar

NASA Astrophysics Data System (ADS)

Butnor, J. R.

2016-12-01

Over the past two decades, substantial technical advances have been made in detecting tree roots with ground penetrating radar (GPR). Under favorable soil dielectric conditions, root location, depth, diameter and mass estimates are possible in the field. With careful notation of survey lines, three dimensional reconstructions of root architecture may also be achieved. The technique has been very useful for quantifying lateral root biomass in silvicultural studies, but is not yet a standalone technique for estimating root biomass in forests. The purpose of this presentation is to highlight the limitations of GPR in the field to stimulate discussion on how to overcome these challenges. Under field conditions, surface-based antennas with frequencies of 400 to 1500 MHz cannot detect fine roots (<2 mm diameter), vertical taproots, below-stump mass, decayed roots or separate roots by species. Higher frequency antennas designed for concrete inspection are available, but penetration through forest soils would be marginal. Over half of the root mass in many Pinus species is in the taproot which is undetectable in part or whole by GPR. This presents challenges to stand-level quantification as whole classes of biomass and structures are not reliably detected. Lack of automation of data processing and interpretation steps currently makes data analysis arduous and in some cases subject to interpretation by an expert user. Forests have a high degree of heterogeneity in surface conditions (e.g., holes, soil moisture, stems, woody and herbaceous plants) that may prevent antennas from coupling with the surface to propagate EM waves and receive reflections. What is the potential for open source data analysis programs to be developed and shared? How will new digital, multi-frequency antennas improve resolution? Can air launched antennas be developed that have both the depth penetration and resolution to detect roots? Are purpose-designed bore hole antenna needed for imaging taproots?

Morphological Changes Of The Root Surface And Fracture Resistance After Treatment Of Root Fracture By CO2 Laser And Glass Ionomer Or Mineral Trioxide Aggregates

NASA Astrophysics Data System (ADS)

Badr, Y. A.; Abd El-Gawad, L. M.; Ghaith, M. E.

2009-09-01

This in vitro study evaluates the morphological changes of the root surface and fracture resistance after treatment of root cracks by CO2 laser and glass Ionomer or mineral trioxide aggregates (MTA). Fifty freshly extracted human maxillary central incisor teeth with similar dimension were selected. Crowns were sectioned at the cemento-enamel junction, and the lengths of the roots were adjusted to 13 mm. A longitudinal groove with a dimension of 1×5 mm2 and a depth of 1.5 mm was prepared by a high speed fissure bur on the labial surface of the root. The roots were divided into 5 groups: the 10 root grooves in group 1 were remained unfilled and were used as a control group. The 10 root grooves in group 2 were filled with glass Ionomer, 10 root grooves in group 3 were filled with MTA, the 10 root grooves in group 4 were filled with glass Ionomer and irradiated by CO2 laser and the 10 root grooves in group 5 were filled with MTA and irradiated with CO2 laser. Scanning electron microscopy was performed for two samples in each group. Tests for fracture strength were performed using a universal testing machine and a round tip of a diameter of 4 mm. The force was applied vertically with a constant speed of 1 mm min 1. For each root, the force at the time of fracture was recorded in Newtons. Results were evaluated statistically with ANOVA and Turkey's Honestly Significant Difference (HSD) tests. SEM micrographs revealed that the melted masses and the plate-like crystals formed a tight Chemical bond between the cementum and glass Ionomer and melted masses and globular like structure between cementum and MTA. The mean fracture resistance was the maximum fracture resistance in group 5 (810.8 N). Glass Ionomer and MTA with the help of CO2 laser can be an alternative to the treatment of tooth crack or fracture. CO2 laser increase the resistance of the teeth to fracture.

Using Flux Site Observations to Calibrate Root System Architecture Stencils for Water Uptake of Plant Functional Types in Land Surface Models.

NASA Astrophysics Data System (ADS)

Bouda, M.

2017-12-01

Root system architecture (RSA) can significantly affect plant access to water, total transpiration, as well as its partitioning by soil depth, with implications for surface heat, water, and carbon budgets. Despite recent advances in land surface model (LSM) descriptions of plant hydraulics, RSA has not been included because of its three-dimensional complexity, which makes RSA modelling generally too computationally costly. This work builds upon the recently introduced "RSA stencil," a process-based 1D layered model that captures the dynamic shifts in water potential gradients of 3D RSA in response to heterogeneous soil moisture profiles. In validations using root systems calibrated to the rooting profiles of four plant functional types (PFT) of the Community Land Model, the RSA stencil predicts plant water potentials within 2% of the outputs of full 3D models, despite its trivial computational cost. In transient simulations, the RSA stencil yields improved predictions of water uptake and soil moisture profiles compared to a 1D model based on root fraction alone. Here I show how the RSA stencil can be calibrated to time-series observations of soil moisture and transpiration to yield a water uptake PFT definition for use in terrestrial models. This model-data integration exercise aims to improve LSM predictions of soil moisture dynamics and, under water-limiting conditions, surface fluxes. These improvements can be expected to significantly impact predictions of downstream variables, including surface fluxes, climate-vegetation feedbacks and soil nutrient cycling.

In vitro and clinical evaluation of optical coherence tomography for the detection of subgingival calculus and root cementum.

PubMed

Tsubokawa, Masaki; Aoki, Akira; Kakizaki, Sho; Taniguchi, Yoichi; Ejiri, Kenichiro; Mizutani, Koji; Koshy, Geena; Akizuki, Tatsuya; Oda, Shigeru; Sumi, Yasunori; Izumi, Yuichi

2018-05-24

This study evaluated the effectiveness of swept-source optical coherence tomography (ss-OCT) for detecting calculus and root cementum during periodontal therapy. Optical coherence tomography (OCT) images were taken before and after removal of subgingival calculus from extracted teeth and compared with non-decalcified histological sections. Porcine gingival sheets of various thicknesses were applied to the root surfaces of extracted teeth with calculus and OCT images were taken. OCT images were also taken before and after scaling and root planing (SRP) in human patients. In vitro, calculus was clearly detected as a white-gray amorphous structure on the root surface, which disappeared after removal. Cementum was identified as a thin, dark-gray layer. The calculus could not be clearly observed when soft tissues were present on the root surface. Clinically, supragingival calculus and cementum could be detected clearly with OCT, and subgingival calculus in the buccal cervical area of the anterior and premolar teeth was identified, which disappeared after SRP. Digital processing of the original OCT images was useful for clarifying the calculus. In conclusion, ss-OCT showed potential as a periodontal diagnostic tool for detecting cementum and subgingival calculus, although the practical applications of subgingival imaging remain limited.

Graviresponsiveness of surgically altered primary roots of Zea mays

NASA Technical Reports Server (NTRS)

Maimon, E.; Moore, R.

1991-01-01

We examined the gravitropic responses of surgically altered primary roots of Zea mays to determine the route by which gravitropic inhibitors move from the root tip to the elongating zone. Horizontally oriented roots, from which a 1-mm-wide girdle of epidermis plus 2-10 layers of cortex were removed from the apex of the elongating zone, curve downward. However, curvature occurred only apical to the girdle. Filling the girdle with mucilage-like material transmits curvature beyond the girdle. Vertically oriented roots with a half-girdle' (i.e. the epidermis and 2-10 layers of the cortex removed from half of the circumference of the apex of the elongating zone) curve away from the girdle. Inserting the half-girdle at the base of the elongating zone induces curvature towards the girdle. Filling the half-circumference girdles with mucilage-like material reduced curvature significantly. Stripping the epidermis and outer 2-5 layers of cortex from the terminal 1.5 cm of one side of a primary root induces curvature towards the cut, irrespective of the root's orientation to gravity. This effect is not due to desiccation since treated roots submerged in water also curved towards their cut surface. Coating a root's cut surface with a mucilage-like substance minimizes curvature. These results suggest that the outer cell-layers of the root, especially the epidermis, play an important role in root gravicurvature, and the gravitropic signals emanating from the root tip can move apoplastically through mucilage.

Compensatory Root Water Uptake of Overlapping Root Systems

NASA Astrophysics Data System (ADS)

Agee, E.; Ivanov, V. Y.; He, L.; Bisht, G.; Shahbaz, P.; Fatichi, S.; Gough, C. M.; Couvreur, V.; Matheny, A. M.; Bohrer, G.

2015-12-01

Land-surface models use simplified representations of root water uptake based on biomass distributions and empirical functions that constrain water uptake during unfavorable soil moisture conditions. These models fail to capture the observed hydraulic plasticity that allows plants to regulate root hydraulic conductivity and zones of active uptake based on local gradients. Recent developments in root water uptake modeling have sought to increase its mechanistic representation by bridging the gap between physically based microscopic models and computationally feasible macroscopic approaches. It remains to be demonstrated whether bulk parameterization of microscale characteristics (e.g., root system morphology and root conductivity) can improve process representation at the ecosystem scale. We employ the Couvreur method of microscopic uptake to yield macroscopic representation in a coupled soil-root model. Using a modified version of the PFLOTRAN model, which represents the 3-D physics of variably saturated soil, we model a one-hectare temperate forest stand under natural and synthetic climatic forcing. Our results show that as shallow soil layers dry, uptake at the tree and stand level shift to deeper soil layers, allowing the transpiration stream demanded by the atmosphere. We assess the potential capacity of the model to capture compensatory root water uptake. Further, the hydraulic plasticity of the root system is demonstrated by the quick response of uptake to rainfall pulses. These initial results indicate a promising direction for land surface models in which significant three-dimensional information from large root systems can be feasibly integrated into the forest scale simulations of root water uptake.

Analysis of the relationship between rusty root incidences and soil properties in Panax ginseng

NASA Astrophysics Data System (ADS)

Wang, Q. X.; Xu, C. L.; Sun, H.; Ma, L.; Li, L.; Zhang, D. D.; Zhang, Y. Y.

2016-08-01

Rusty root is a serious problem in ginseng cultivation that limits the production and quality of ginseng worldwide. The Changbai Mountains are the most famous area for ginseng cultivation in China. To clarify the relationship between rusty root and soil characteristics, physico-chemical properties and enzymatic activities of soil collected from five different fields in the Changbai Mountains were analyzed and a controlled experiment carried out by increasing the concentration of Fe (II). Soil bulk density, moisture, total iron (Fe) and total manganese (Mn) concentrations and polyphenol oxidase (PPO) activity were significantly higher in rusty root than healthy root groups (two-sample test, P<0.05 or P<0.01), respectively. Pearson test showed that there was a significant positive correlation between rusty root index and pH, N, Fe, Mn, Al, Zn and Ca of soil samples collected from fields (P<0.05 or P<0.01), and a significant positive correlation also occurred between rusty root index and Fe (II) added to soil in Fe (II) inducing rusty root (P<0.01). Physiological factors may be very important roles giving rise to ginseng rusty root. Fe (III) reduction and Fe (II) oxidation could be important in increasing the incidence of rusty root. Soil moisture and bulk density of non-rhizosphere soil not attached to the root surface, and pH, N and PPO content of rhizosphere soils attached to the root surface were heavily involved in the reduction, oxidation and sequestration of metal ions.

On the use of antibiotics to reduce rhizoplane microbial populations in root physiology and ecology investigations

NASA Technical Reports Server (NTRS)

Smart, D. R.; Ferro, A.; Ritchie, K.; Bugbee, B. G.

1995-01-01

No straightforward method exists for separating the proportion of ion exchange and respiration due to rhizoplane microbial organisms from that of root ion exchange and respiration. We examined several antibiotics that might be used for the temporary elimination of rhizoplane bacteria from hydroponically grown wheat roots (Triticum aestivum cv. Veery 10). Each antibiotic was tested for herbicidal activity and plate counts were used to enumerate bacteria and evaluate antibiotic kinetics. Only lactam antibiotics (penicillins and cephalosporins) did not reduce wheat growth rates. Aminoglycosides, the pyrimidine trimethoprim, colistin and rifampicin reduced growth rates substantially. Antibiotics acted slowly, with maximum reductions in rhizoplane bacteria occurring after more than 48 h of exposure. Combinations of nonphytotoxic antibiotics reduced platable rhizoplane bacteria by as much as 98%; however, this was generally a reduction from about 10(9) to 10(6) colony forming units per gram of dry root mass, so that many viable bacteria remained on root surfaces. We present evidence which suggests that insufficient bacterial biomass exists on root surfaces of nonstressed plants grown under well-aerated conditions to quantitatively interfere with root nitrogen absorption measurements.

Surface soil root response to season of repeated fire in a young longleaf pine plantation

Treesearch

Mary Anne Sword Sayer; James D. Haywood

2012-01-01

The potential exists for interaction between naturally high soil bulk density and low soil water content to create root-growth limiting soil strengths. This problem is commonly remedied by soil structural attributes, old root channels and other perturbations, and periods of wetness during which soil strength is favorable for root elongation. Because the application and...

The inflow of Cs-137 in soil with root litter and root exudates of Scots pine

NASA Astrophysics Data System (ADS)

Shcheglov, Alexey; Tsvetnova, Olga; Popova, Evgenia

2017-04-01

In the model experiment on evaluation of Cs-137 inflow in the soil with litter of roots and woody plants root exudates on the example of soil and water cultures of Scots pine (Pinus sylvestris L.) was shown, that through 45 days after the deposit Cs-137 solution on pine needles (specific activity of solution was 3.718*106 Bk) of the radionuclide in all components of model systems has increased significantly: needles, small branches and trunk by Cs-137 surface contamination during the experiment; roots as a result of the internal distribution of the radionuclide in the plant; soil and soil solution due to the of receipt Cs-137 in the composition of root exudates and root litter. Over 99% of the total reserve of Cs-137 accumulated in the components of the soil and water systems, accounted for bodies subjected to external pollution (needles and small branches) and <0.5% - on the soil / soil solution, haven't been subjected to surface contamination. At the same contamination of soil and soil solution by Cs-137 in the model experiment more than a> 99.9% was due to root exudates

[Phytoremediation of Petroleum Contaminated Soils with Iris pseudacorus L. and the Metabolic Analysis in Roots].

PubMed

Wang, Ya-nan; Cheng, Li-juan; Zhou, Qi-xing

2016-04-15

In this study, we performed a greenhouse pot-culture experiment to investigate the potential of a wild ornamental plant Iris pseudacorus L. in remediating petroleum contaminated soils from the Dagang Oilfield in Tianjin, China. The results suggested that Iris pseudacorus L. had great resistance to ≤ 40,000 mg · kg(⁻¹ of total petroleum hydrocarbons (TPHs). The removal rate of TPHs with concentrations of 10,000 mg · kg⁻¹, 20,000 mg · kg⁻¹ and 40,000 mg · kg⁻¹ in soils by Iris pseudacorus L. was 42.1%, 33.1% 31.2%, respectively, much higher than those in the corresponding controls (31.8%, 21.3% 11.9%, respectively) (P < 0.05). The root specific surface area of Iris pseudacorus L. was determined by the root scanner. The results suggested that TPHs with concentrations of 10,000 mg · kg⁻¹, 20,000 mg · kg⁻¹ and 40,000 mg · kg⁻¹ in soils increased the root specific surface area comparing with the controls. Additionally, the metabolic analysis showed that root metabolism changed to different degrees under the stress of TPHs, and the levels or species of metabolites had a significant change (P < 0.001). Furthermore, the results showed that 5 of 11 metabolites (VIP value > 1.2) with the root specific surface area from the PLS-DA model analysis, including ethanedioic acid, lactic acid, 2-butenedioic acid, phosphate and propanedioic acid, were positively correlated with the root specific surface area, but the others, gluconic acid, uridine, butanoic acid, maltose, 9,12-octadecadienoic acid, phenylalanine, were negatively correlated with it. In conclusion, using Iris pseudacorus L. to remediate petroleum contaminated soils is feasible, and the metabolic analysis in roots is useful to better understand the metabolic response of plants exposure to petroleum contaminated soils, and then reveals its remediated mechanisms.

Apices of maxillary premolars observed by swept source optical coherence tomography

NASA Astrophysics Data System (ADS)

Ebihara, Arata; Iino, Yoshiko; Yoshioka, Toshihiko; Hanada, Takahiro; Sunakawa, Mitsuhiro; Sumi, Yasunori; Suda, Hideaki

2015-02-01

Apicoectomy is performed for the management of apical periodontitis when orthograde root canal treatment is not possible or is ineffective. Prior to the surgery, cone beam computed tomography (CBCT) examination is often performed to evaluate the lesion and the adjacent tissues. During the surgical procedure, the root apex is resected and the resected surface is usually observed under dental operating microscope (DOM). However, it is difficult to evaluate the details and the subsurface structure of the root using CBCT and DOM. A new diagnostic system, swept source optical coherence tomography (SS-OCT), has been developed to observe the subsurface anatomical structure. The aim of this study was to observe resected apical root canals of human maxillary premolars using SS-OCT and compare the findings with those observed using CBCT and DOM. Six extracted human maxillary premolars were used. After microfocus computed tomography (Micro CT; for gold standard) and CBCT scanning of the root, 1 mm of the apex was cut perpendicular to the long axis of the tooth. Each resected surface was treated with EDTA, irrigated with saline solution, and stained with methylene blue dye. The resected surface was observed with DOM and SS-OCT. This sequence was repeated three times. The number of root canals was counted and statistically evaluated. There was no significant difference in the accuracy of detecting root canals among CBCT, DOM and SS-OCT (p > 0.05, Wilcoxon test). Because SS-OCT can be used in real time during surgery, it would be a useful tool for observing resected apical root canals.

Monitoring the colonization of sugarcane and rice plants by the endophytic diazotrophic bacterium Gluconacetobacter diazotrophicus marked with gfp and gusA reporter genes.

PubMed

Rouws, L F M; Meneses, C H S G; Guedes, H V; Vidal, M S; Baldani, J I; Schwab, S

2010-09-01

To evaluate the colonization process of sugarcane plantlets and hydroponically grown rice seedlings by Gluconacetobacter diazotrophicus strain PAL5 marked with the gusA and gfp reporter genes. Sugarcane plantlets inoculated in vitro with PAL5 carrying the gfp::gusA plasmid pHRGFPGUS did not present green fluorescence, but beta-glucuronidase (GUS)-stained bacteria could be observed inside sugarcane roots. To complement this existing inoculation methodology for micropropagated sugarcane with a more rapid colonization assay, we employed hydroponically grown gnotobiotic rice seedlings to study PAL5-plant interaction. PAL5 could be isolated from the root surface (10(8) CFU g(-1)) and from surface-disinfected root and stem tissues (10(4) CFU g(-1)) of inoculated plants, suggesting that PAL5 colonized the internal plant tissues. Light microscopy confirmed the presence of bacteria inside the root tissue. After inoculation of rice plantlets with PAL5 marked with the gfp plasmid pHRGFPTC, bright green fluorescent bacteria could be seen colonizing the rice root surface, mainly at the sites of lateral root emergence, at root caps and on root hairs. The plasmids pHRGFPGUS and pHRGFPTC are valid tools to mark PAL5 and monitor the colonization of micropropagated sugarcane and hydroponic rice seedlings. These tools are of use to: (i) study PAL5 mutants affected in bacteria-plant interactions, (ii) monitor plant colonization in real time and (iii) distinguish PAL5 from other bacteria during the study of mixed inoculants.

7 CFR 201.56-10 - Spurge family, Euphorbiaceae.

Code of Federal Regulations, 2011 CFR

2011-01-01

... dicot. (2) Food reserves: Cotyledons, which are thin and leaf-like; endosperm (fleshy food-storage... the cotyledons, endosperm, and epicotyl above the soil surface. (4) Root system: A primary root, with secondary roots usually developing within the test period. (b) Abnormal seedling description. (1) Cotyledons...

7 CFR 201.56-10 - Spurge family, Euphorbiaceae.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dicot. (2) Food reserves: Cotyledons, which are thin and leaf-like; endosperm (fleshy food-storage... the cotyledons, endosperm, and epicotyl above the soil surface. (4) Root system: A primary root, with secondary roots usually developing within the test period. (b) Abnormal seedling description. (1) Cotyledons...

Measurement of Net Fluxes of Ammonium and Nitrate at the Surface of Barley Roots Using Ion-Selective Microelectrodes 1

PubMed Central

Henriksen, Gordon H.; Raman, D. Raj; Walker, Larry P.; Spanswick, Roger M.

1992-01-01

Net fluxes of NH4+ and NO3− into roots of 7-day-old barley (Hordeum vulgare L. cv Prato) seedlings varied both with position along the root axis and with time. These variations were not consistent between replicate plants; different roots showed unique temporal and spatial patterns of uptake. Axial scans of NH4+ and NO3− net fluxes were conducted along the apical 7 centimeters of seminal roots of intact barley seedlings in solution culture using ion-selective microelectrodes in the unstirred layer immediately external to the root surface. Theoretically derived relationships between uptake and concentration gradients, combined with experimental observations of the conditions existing in our experimental system, permitted evaluation of the contribution of bulk water flow to ion movement in the unstirred layer, as well as a measure of the spatial resolution of the microelectrode flux estimation technique. Finally, a method was adopted to assess the accuracy of this technique. PMID:16668947

Endophytic colonization of olive roots by the biocontrol strain Pseudomonas fluorescens PICF7.

PubMed

Prieto, Pilar; Mercado-Blanco, Jesús

2008-05-01

Confocal microscopy combined with three-dimensional olive root tissue sectioning was used to provide evidence of the endophytic behaviour of Pseudomonas fluorescens PICF7, an effective biocontrol strain against Verticillium wilt of olive. Two derivatives of the green fluorescent protein (GFP), the enhanced green and the red fluorescent proteins, have been used to visualize simultaneously two differently fluorescently tagged populations of P. fluorescens PICF7 within olive root tissues at the single cell level. The time-course of colonization events of olive roots cv. Arbequina by strain PICF7 and the localization of tagged bacteria within olive root tissues are described. First, bacteria rapidly colonized root surfaces and were predominantly found in the differentiation zone. Thereafter, microscopy observations showed that PICF7-tagged populations eventually disappeared from the root surface, and increasingly colonized inner root tissues. Localized and limited endophytic colonization by the introduced bacteria was observed over time. Fluorescent-tagged bacteria were always visualized in the intercellular spaces of the cortex region, and no colonization of the root xylem vessels was detected at any time. To the best of our knowledge, this is the first time this approach has been used to demonstrate endophytism of a biocontrol Pseudomonas spp. strain in a woody host such as olive using a nongnotobiotic system.

Root hair development in grasses and cereals (Poaceae).

PubMed

Dolan, Liam

2017-08-01

Root hairs are tubular, cellular outgrowths of epidermal cells that extend from the root surface into the soil. Root hairs tether root systems to their growth substrate, take up inorganic nutrients and water, and interact with the soil microflora. At maturity, the root epidermis comprises two cell types; cells with root hairs and hairless epidermal cells. These two cell types alternate with each other along longitudinal files in grasses and cereals (Poaceae). While the mechanism by which this alternating pattern develops is unknown, the later stages of root hair differentiation are controlled by a conserved mechanism that promotes root hair development among angiosperms. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.