Search

Background. Various materials are used for splinting impression copings, the most common of which are auto-polymerizing resins. In this study, a new light-curing pattern resin (Jig-Gel) was investigated and compared with auto-polymerizing resins using two different splinting methods. Methods. After taking impressions with two different materials, a digital caliper with an accuracy of 0.01 mm was used for splinting and measuring the distances between the external parts of the analogs inside the plaster cast. The accuracy was also compared in five groups as follows; group 1: splinting of impression copings by auto-polymerizing acrylic resin, group 2: cutting the splinting of impres­sion copings with self-polymerizing acrylic resin, group 3: splinting of impression copings with a light-cured resin pattern (Jig-Gel), group 4: splinting of impression copings cut by a light-cured resin pattern, and group 5: impression with no splint. All statistical analyses were performed with SPSS 17. Statistical significance was set at P

This study aimed to address the stability of orthodontic mini-implants submitted to an immediate orthodontic functional load, in splinted or unsplinted conditions, further characterizing the histomorphometric parameters of the neighboring bone tissue, in an in vivo experimental model. Mini-implants (1.4 × 6.0 mm) were placed in the proximal tibia of New Zealand White rabbits and immediately loaded with a 150 g force. Tissue healing was characterized within 8 weeks. Microtomography was used to assess the mini-implants' tipping and bone histomorphometric indexes. Loaded implants were evaluated in splinted and unsplinted conditions, with data being compared to that of unloaded mini-implants with the Kruskal–Wallis nonparametric test, followed by Dunn's multiple comparison tests. The splinting of mini-implants submitted to immediate orthodontic loading significantly reduced the tipping to levels similar to those of unloaded mini-implants. Immediate loading further increased the histomorphometric indexes associated with bone formation at the peri-implant region, in both splinted and unsplinted conditions, with no significant differences between the tension and compression regions. Accordingly, within this experimental setting, splinting was found to lessen tipping and mini-implants' displacement, without affecting the increased bone formation at the peri-implant region, induced by a functional orthodontic load. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to gather existing data on the efficacy of tooth splinting (TS) in patients with traumatized primary teeth, evaluating their overall prognosis and reported complications. Methods: Electronic searches were performed in seven databases up to Februray/2023. Clinical studies published in the last two decades and presenting the following characteristics were included: (a) reporting on children with traumatized primary teeth; (b) describing the efficacy of splinting those teeth. Studies describing imobilization of dental avulsion were excluded. Results: A total of 163 potentially relevant studies were initially found. After title/abstract screening, and full-text evaluation, three retrospective studies with moderate to high risk of bias were included. The studies described the outcomes of TS in primary teeth with luxation (intrusion, extrusion, lateral displacement), intra-alveolar root fracture, and/or alveolar fracture. High clinical success rate was observed for teeth with root fracture. Benefits of spliting teeth with lateral luxation were not identified, although it may be a reccomended approach. No study was found evaluating TS for alveolar fracture. Conclusion: Based on a low level of evidence, the findings highlight a better clinical success rate of the use of TS in the management of deciduous teeth with root fractures. [ABSTRACT FROM AUTHOR]

Background. Carpal tunnel syndrome is the most common compression mononeuropathy. The choice of the preferred conservative treatment method is still relevant, especially for the patients with the moderate severity of the disease. Objective: to perform a comparative study of the effectiveness of local injection therapy and wrist splinting in idiopathic moderate carpal tunnel syndrome; to assess the duration of the clinical effect in the follow‑up period to 6 months. Materials and methods. The study included 105 cases of moderate idiopathic carpal tunnel syndrome. Patients were randomized to 2 groups depending on the treatment method: the main group (n = 54) received 1 or 2 ultrasound‑guided injections with glucocorticosteroid (betamethasone 5 mg + 2 mg/1.0 ml) and lidocaine 2 % 1.0 ml into the carpal canal; the control group (n = 51) was assigned wrist splinting at night for 1 month. The primary criterion for therapy effectiveness was evaluation by clinical scales (SSS, FSS, LANSS, Visual Analogue Scale) after 1 month from the treatment initiation. A secondary criterion for the therapy effectiveness was the assessment of changes in electrophysiological and neurosonographic parameters.Results. The scores for SSS, FSS, LANSS and Visual Analogue Scale were significantly lower at 1 month in the injection therapy group than in the splinting group (p

Objective: To determine the frequency, cause and type of dental injury in patients reporting to Armed Forces Institute of Dentistry. Study design: Cross-Sectional Survey. Place and Duration of Study: Department of Operative Dentistry Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from Sep 2021 to Sep 2022. Methodology: A questionnaire was filled out for 357 patients reporting dental injury, including the extent of hard and soft tissue injuries. The cause and place of injury occurred; investigations, the treatment provided by the treating dentists ranging from restoration to root canal, type and duration of splint were also recorded. Results: In the current study, 189(52.9%) out of 357 children got injury due to falls to the playground and other places. Maxillary incisors were mostly affected, and 163(45.7%) children had complicated crown fractures. Rigid splinting was done in 39(70.9%) of root fracture cases, while flexible splinting was done in 162(53.6%) patients with complicated crown fracture cases and 81(26.8%) complicated crown fracture cases. In 72(88.8%) cases of uncomplicated crown fracture, indirect pulp capping was done, and in 67(41.1%) cases of complicated crown fracture, root canal treatment were done. Apexification was done in 28(68.3%) of avulsion cases. Conclusion: Our survey showed that most injuries occurred at school and the roadside. Maxillary incisors are primarily involved with complicated crown fractures, which are effectively managed. Keywords: Avulsion, Complicated crown fracture, Dental injury, Splinting.

Aim: This study aimed to identify and validate a multimodal approach for optimising post-operative recovery of patients admitted for elective abdominal surgery. Background: Identifying the risk of post-operative complications after abdominal surgery enables modification of the risk through targeted interventions and enhanced monitoring. Evidence shows that patients suffer needlessly due to inadequate pre-operative preparation and lack of information regarding the post-operative journey. Methods and materials: The study was conducted using a quasi- experimental, post-test-only, control group design. The sample comprised 60 participants, 30 each in the experimental and control groups. Four aspects of participant recovery were measured -- pain (using a numerical pain rating scale), vital signs (temperature, pulse rate, respiratory rate and blood pressure), wound healing (using the Southampton wound grading system) and length of hospital stay (in days). Results: One third of the experimental group (33.3%) had normal wound healing compared to one tenth of the control group (10%). Mean pain scores of the experimental group were significantly lower than those of the control group on post-operative days 0, 1 and 3 (p<0.05). The physical parameters of the experimental and control groups were not found to be significantly different other than the pulse rate on post-operative day 2 and the respiratory rate on post-operative day 0. The difference in length of hospital stay between the experimental and control groups was not found to be significant. Conclusion: Overall, the study found that the multimodal approach was effective in promoting post-operative recovery in elective abdominal surgery. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate and compare the accuracy of hexed and nonhexed pickup impression copings with and without splinting using polyether (PE) and polyvinyl siloxane (PVS) impression materials in open-tray technique in recording multiple straight and angulated implant positions. Settings and Design: An accurate impression results in an accurate definitive cast, thus minimizing the incidence of prosthesis misfit. The critical aspect is to record the three-dimensional location of the implant in bone rather than reproducing fine surface details. Precise fit of a fixed implant-supported prosthesis depends on the accuracy of the implant analog location within the definitive cast. Factors which affect impression accuracy include implant angulation, impression material, impression copings, technique, and splinting. Materials and Methods: A sample size of 80 study models fabricated from the impression of different groups was included. A reference master model based on All-on-4 implant concept with two parallel (implants 1 and 2) and two angulated (implant 3 at 17° and implant 4 at 30°) was fabricated using implant angulation guide. All impressions were recorded using open-tray impression technique. The groups were divided into two main groups of 40 samples each. Group A used hexed open-tray impression copings and Group B used nonhexed open-tray impression copings. Both the groups involved impression recording using splinted (Subgroup I) and nonsplinted impression copings (Subgroup II). Further, impressions in each subgroup were made using PE (Subsubgroups a) and PVS (Subsubgroup b). A total of eight subsubgroups with ten samples each were included. Impressions were recorded for each group and poured into Type IV die stone for fabrication of study models. After 24 h, the study models and reference master model were fitted with implant abutments for measurement with coordinate measuring machine. Statistical Analysis Used: The mean differences of the interimplant distance R1 (1-2), R2 (1-3), R3 (2-4), and R4 (3-4) between the reference model and sample models in different subsubgroups were calculated and three-way analysis of variance test was applied with Tukey's post hoc tests. Results: No significant difference was found in mean coronal deviations for distance R1, R2, and R3 (P > 0.05) between different study groups. P = 0.02 for R4 (distance between 17° and 30° implants) between impression materials subsubgroups suggested that significantly less distortion was created in location of highly angulated implants (>30°) using PVS impression material. Splinting and type of coping did not have a significant influence on impression accuracy. Increasing angulation decreased the accuracy. Conclusion: PVS was found equivalent in accuracy to rigid PE for recording parallel or angulated implants. Impressions of implants with higher angulations were recorded more accurately with PVS. The study found no difference in accuracy with or without splinting. Furthermore, nonhexed impression copings facilitate easier and accurate recording of multiple angulated implant location in bone. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This case report presents long-term results following horizontal root fracture of both maxillary central incisors in a 19-year-old woman with aggressive periodontitis. Due to extensive marginal bone loss and the close proximity of the fracture lines to the bottoms of the periodontal pockets, the prognosis of both teeth was uncertain at the time of the accident. Nevertheless, a conservative treatment strategy consisting of splinting and nonsurgical periodontal therapy was initiated. Follow-up at 12 years after the start of treatment revealed a stable situation from clinical and radiologic perspectives. Permanent fixation to the adjacent teeth and regular supportive periodontal care were the basis for a favorable long-term prognosis. [ABSTRACT FROM AUTHOR]

Background/Aim: Opportunities for dental students to obtain clinical experience in the management of traumatic dental injuries are scarce, and most dentists encounter difficulties with their first trauma patients after graduation. The aim of this study was to question students on the ease of handling of four types of flexible splints, with two common methods of bonding to the tooth. Material and methods: A total of 161 fourth year dental students completed a simulated treatment of an avulsed tooth using orthodontic wire, Twistflex wire, nylon fishing line, and Powermesh as splints. The bonding materials were composite resin (Spectra ST LV) or glass ionomer cement (GC Fuji LC Ortho). The students then answered 16 questions on a 5‐point Likert scale, or with an open answer field. Results: Most students agreed (48.8%) or strongly agreed (31.3%) that the simulated trauma exercise assisted their learning. There was strong agreement (68.8%) and agreement (28.7%) that the simulation added value to their dental training compared to didactic training only. Similarly, 52.3% of participants strongly agreed and 40% agreed that they felt engaged in the learning activity. Only 53.8% of the participants agreed and 7.5% strongly agreed that the simulation felt realistic. Most students (56.2%) found a Powermesh/composite splint was the easiest to place, and nylon fishing line/GC Fuji LC Ortho splints was the least difficult to remove (35%). Conclusion: Wire‐free splints with composite bonding were judged as the easiest to place by students, while glass ionomer cement was the easiest to remove. [ABSTRACT FROM AUTHOR]

• The Definition of Hand Therapy and the Scope of Practice of Certified Hand Therapists established by HTCC, strongly and accurately reflects current hand therapy practice by CHTs. • Hand therapy is a mature and stable specialty field of occupational therapy and physical therapy. • The use of the terminology of "upper limb" (which excludes the cervical and thoracic spine) instead of "upper quadrant" in the definition of hand therapy remains the most accurate representation of practice. • The use of orthoses in hand therapy is not an isolated, standalone, technical skill, but is thoroughly integrated into the evaluation and treatment of hand therapy patients. • Hand therapists use custom and prefabricated orthoses on a daily basis as an integral part of a rehabilitation plan of care In 2019, the Hand Therapy Certification Commission (HTCC), in consultation with Scantron Corporation, performed a practice analysis study of hand therapy, the sixth in a series of similar studies performed byHTCC over a 35-year period. The primary goal of this study was to update and validate the definition and delineation of hand therapy and to ensure that the test content outline for the Hand Therapy Certification Examination (HTCE) reflects the critical tasks, knowledge, and skills required in the practice of hand therapy. Additionally, HTCC explored specific trends in hand therapy practice, compared findings with previous studies, and gathered data about the frequency, criticality, and performance expectations for the use and fabrication of orthoses by hand therapists. Quantitative Descriptive. More than 40 subject matter experts from the United States and Canada, representing a broad range of experiences and perspectives, developed an updated delineation of the domains, tasks, knowledge, and techniques and tools used in hand therapy practice. A large-scale online survey of all certified hand therapists from the United States, Canada, and other countries was completed to test the profile within the practice of hand therapy. This large-scale online survey overwhelmingly validated the profile of hand therapy. The results affirmed the test specifications for the Hand Therapy Certification Examination; affirmed the definition of hand therapy; and refined the scope of hand therapy practice. New data was gathered regarding the use of orthotics in hand therapy. This study establishes content validity for the HTCE. It highlights that the specialty of hand therapy is a mature and stable specialty field of occupational therapy and physical therapy. Certified Hand Therapists frequently issue pre-fabricated and fabricate custom orthoses in the course of rehabilitation for clients with hand and arm injuries, and overall consider this a highly critical task in hand therapy practice. N/A [ABSTRACT FROM AUTHOR]

A digital technique for planning and manufacturing a periodontal splint from composite material reinforced with glass fibers is presented. The lingual surface of the permanent mandibular anterior teeth is scanned intraorally. An accurate periodontal splint of the mandibular anterior teeth with increased mobility is fabricated. Digital planning and fabrication of an immobilizing splint minimize the human factor that affects the accuracy of the restoration.

Abstract Background Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO. Methods All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well. Results Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery. Conclusions This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.

Cervical root fractures are often more difficult to manage than fractures of the apical and middle third of the root, due to the weak chance of healing with dental hard tissue between fragments, and the likelihood of subsequent infection of the root canal system. This case report describes the management of a cervical horizontal root fracture by repositioning the coronal fragment of a maxillary central incisor, and long‐term splinting using a bonded lingual orthodontic retainer wire. Throughout the 7‐year stabilisation period with clinical and radiographic follow‐up, the tooth has remained asymptomatic with radiographic evidence of progressive pulp canal obliteration. In applicable cases, long‐term stabilisation of the fractured coronal fragment with a fixed orthodontic retainer may offer a minimally invasive solution to maintain pulp vitality, function and aesthetics until cessation of growth or until a more comprehensive, multidisciplinary approach is required. [ABSTRACT FROM AUTHOR]

Background. Various materials are used for splinting impression copings, the most common of which are auto-polymerizing resins. In this study, a new light-curing pattern resin (Jig-Gel) was investigated and compared with auto-polymerizing resins using two different splinting methods. Methods. After taking impressions with two different materials, a digital caliper with an accuracy of 0.01 mm was used for splinting and measuring the distances between the external parts of the analogs inside the plaster cast. The accuracy was also compared in five groups as follows; group 1: splinting of impression copings by auto-polymerizing acrylic resin, group 2: cutting the splinting of impression copings with self-polymerizing acrylic resin, group 3: splinting of impression copings with a light-cured resin pattern (Jig-Gel), group 4: splinting of impression copings cut by a light-cured resin pattern, and group 5: impression with no splint. All statistical analyses were performed with SPSS 17. Statistical significance was set at P<0.05. Results. The highest impression accuracy was obtained in the group without cutting the splint of the impression copings using auto-polymerizing acrylic resin. Compared with the impression methods, impression making of non-splint samples in an impression coping was the least accurate, and the results for the two used methods were similar. Conclusion. The results of this study showed that the combination of the impression coping method and auto-polymerizing acrylic resin had the highest accuracy. [ABSTRACT FROM AUTHOR]

Abstract Background Carpal tunnel syndrome (CTS) is a common upper limb entrapment neuropathy; severe cases are treated surgically and mild to moderate can be managed conservatively. The purpose of this systematic review and meta-analysis was to define the efficacy of gabapentin as an adjuvant to splinting in the treatment of mild to moderate CTS. Methods A systematic search through 13 databases, randomized clinical trials (RCTs) reporting the use of gabapentin with splinting in CTS were included and analyzed. Results Three RCTs including 170 patients were eligible. There was no significant difference between gabapentin plus splinting and splinting alone in 5 measured parameters: (1) Symptom Severity Scale (SSS) [MD (95% CI) = − 0.76 (− 2.46–0.93), p = 0.378], (2) Functional Status Scale (FSS) [MD (95% CI) = − 0.23 (− 1.40–0.94), p = 0.701], (3) visual analogue scale (VAS) to assess pain [MD (95% CI) = − 0.6 (− 1.47–0.27), p = 0.174], (4) Grip strength [MD (95% CI) = − 0.11 (− 0.70–0.48), p = 0.718], and (5) pinch strength [MD (95% CI) = 0.72 (− 0.10–1.54), p = 0.083]. Conclusion This review provides low-quality evidence that gabapentin plus nocturnal splinting is not superior to splinting alone. More high-quality trials are needed to determine the role of this drug as an adjuvant in the management of CTS.

Objectives There is no consensus on whether conservative treatment with night splints is indicated also in moderate and severe stages of carpal tunnel syndrome (CTS). The goal of this study was to compare the efficacy of night-time splinting at different stages of CTS. Material and Methods Forty-five patients with electrodiagnostic (EDX) features of CTS included in the study were divided into 2 groups based on nerve conduction studies. The patients in the first group had only median nerve sensory fiber involvement, whereas the patients in the second group had also motor fiber involvement. The custom-made volar night splint was the only treatment for all of the included patients. The patients were assessed before the fabrication of orthosis and after 12 weeks of its use. The parameters measured were hand grip strength and the Visual Analogue Scale for pain and paraesthesia. The patients further completed the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and a shorter version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH). Results In the first group, a statistically significant improvement was established in paraesthesia and hand grip strength (p = 0.019, p = 0.024, respectively), but there was no statistically significant improvement in pain, and the results of both BCTQ and QuickDASH. In the second group, a statistically significant improvement was found in paraesthesia, the BCTQ Symptom Severity Scale and QuickDASH results (p = 0.008, p < 0.001, p = 0.011, respectively), whereas no statistically significant improvement was established in pain, hand grip strength and the BCTQ Functional Status Scale . However, when comparing the change in the outcome measures between the 2 groups, no statistically significant differences were found. Conclusions This study has shown that 12-week night-time splinting is beneficial not only for patients with mild CTS but also for those with advanced CTS, and those awaiting surgical treatment. Therefore, splinting is recommended for all patients with CTS. Int J Occup Med Environ Health. 2020;33(6):771–80

This study aimed to address the stability of orthodontic mini-implants submitted to an immediate orthodontic functional load, in splinted or unsplinted conditions, further characterizing the histomorphometric parameters of the neighboring bone tissue, in an in vivo experimental model. Mini-implants (1.4 × 6.0 mm) were placed in the proximal tibia of New Zealand White rabbits and immediately loaded with a 150 g force. Tissue healing was characterized within 8 weeks. Microtomography was used to assess the mini-implants’ tipping and bone histomorphometric indexes. Loaded implants were evaluated in splinted and unsplinted conditions, with data being compared to that of unloaded mini-implants with the Kruskal–Wallis nonparametric test, followed by Dunn’s multiple comparison tests. The splinting of mini-implants submitted to immediate orthodontic loading significantly reduced the tipping to levels similar to those of unloaded mini-implants. Immediate loading further increased the histomorphometric indexes associated with bone formation at the peri-implant region, in both splinted and unsplinted conditions, with no significant differences between the tension and compression regions. Accordingly, within this experimental setting, splinting was found to lessen tipping and mini-implants’ displacement, without affecting the increased bone formation at the peri-implant region, induced by a functional orthodontic load.

Rostral mandibular injuries present unique challenges for repair. The presence of strategically important teeth which occupy a large volume of the mandible, multiple tooth roots and the mental neurovascular bundle all combine to limit treatment options that serve to preserve the form and function of the involved structures. This case series describes the approach to treatment for rostral mandibular trauma seen in four dogs with a unique etiology that has not been previously described., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A common consequence of moderate to extreme periodontitis is pathologic migration. This denotes tooth movement when the periodontal disease interjects the equilibrium among the elements that preserve physiological tooth position. The balancing factors can migrate the teeth in any direction. The etiology of pathological migration tends to be multifactorial, thus achieving early diagnosis is imperative, which will ultimately lead to the prompt removal of the etiological factors while avoiding severe bone destruction. In this case maxillary central incisors had diastema due to pathological migration with mobility grade I in maxillary left central incisor. Many cases of moderate to severe pathological migration need a suitable, interdisciplinary approach. Nevertheless, since it is possible to detect mild cases of Pathological tooth migration (PTM) at an early stage, spontaneous correction of migrated teeth can be accomplished by periodontal therapy alone. Regardless of the treatment selected, maintenance of stable results should be considered as an aim of treatment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the accuracy of open tray dental implant impressions when the implants are placed with varying implant angulations and depths. Four partially edentulous models were fabricated using photopolymer resin, each having different angulation and depth of the implant analogs. A total of 40 open tray elastomeric impressions were made, which were poured in type IV die stone (n = 10). These casts were evaluated and compared for accurate reproduction of the spatial orientation of the implant analogs in the models using digitization in 3 dimensions. The results were analyzed using the independent T test. Statistically significant differences were observed when the casts were compared with their respective master models. These casts had the implant replicas placed deeper within the replicated soft tissue. Making accurate impressions in partially edentulous situations with dental implants placed with varying depth and angulation is critical and clinically demanding. There is a need for future in vivo research to identify methods and materials, exploring digital impression techniques as well, in order to make precise impressions. [ABSTRACT FROM AUTHOR]

Background: Clavicle fractures are common. An emergency physician needs to understand the diagnostic classifications of clavicle fractures, have a plan for immobilization, identify associated injuries, understand the difference between treating pediatric and adult patients, and have an approach to multimodal pain control. It is also important to understand when expert orthopedic consultation or referral is indicated.Objective Of the Review: To provide an evidence-based review of clavicle fracture management in the emergency department.Discussion: Clavicle fractures account for up to 4% of all fractures evaluated in the emergency department. They can be separated into midshaft, distal, and proximal fractures. They are also classified in terms of their degree of displacement, comminution and shortening. Emergent referral is indicated for open fractures, posteriorly displaced proximal fractures, and those with emergent associated injuries. Urgent referral is warranted for fractures with greater than 100% displacement, fractures with >2 cm of shortening, comminuted fractures, unstable distal fractures, and floating shoulder. Nondisplaced or minimally displaced fractures with no instability or associated neurovascular injury are managed non-operatively with a sling. Pediatric fractures are generally managed conservatively, with adolescents older than 9 years-old for girls and 12 years-old for boys being treated using algorithms that are similar to adults.Conclusions: When encountering a patient with a clavicle fracture in the emergency department the fracture pattern will help determine whether emergent consultation or urgent referral is indicated. Most patients can be discharged safely with sling immobilization and appropriate outpatient follow-up. [ABSTRACT FROM AUTHOR]

Background: The treatment strategy for bony mallet fingers remains controversial. The outcomes of conservative treatment were investigated in this study. In addition, the time to bone union, and gap between the bone fragment and distal phalanx are discussed. Methods: The subjects were 26 patients (27 fingers) with bony mallet fingers (20 males and 6 females, mean age: 46.0 years old, the mean limitation of extension of the distal interphalangeal (DIP) joint: − 20.2°). In conservative treatment, splinting was applied for 6 weeks, followed by 2-week taping. The time to bone union, range of motion of the DIP joint, and the Crawford classification on the final follow-up were investigated. In addition, the bone fragment occupation rate was evaluated on plain radiography on the first examination. Furthermore, the gap on the first examination and after splinting. The relationship between the gap and bone union period was also investigated. Results: The mean time from injury to bone union was 170.2 days, the mean range of motion of the DIP joint was − 8.5° in extension and 60.9° in flexion, and the Crawford classification was Excellent for 22 fingers, Good for 2, Fair for 2, and Poor for 1. On the first examination, the mean bone fragment occupation rate was 44.0%. The mean gap on the first examination was 1.1 mm and this was significantly narrowed to 0.8 mm after splinting (p < 0.01). No significant correlation was noted between the time to bone union and gap on the first examination (p = 0.16), however, a significant positive correlation was noted between them after splinting (p < 0.01). Conclusions: This study suggested that a favorable clinical outcome can be achieved by conservative treatment. Moreover, the bone union period decreased as the gap after splinting decreased, being significantly correlated. [ABSTRACT FROM AUTHOR]

Implant treatment should be restoratively driven, however at times, ideal implant positioning may be sacrificed for surgical convenience at the expense of restorative complexity. A prosthesis incorporating a novel design was constructed to restore two converging implants placed in close proximity utilizing standard implant impression componentry and simple clinical stages. As the use of angulated screw channel technology was not possible, a customized cast “rest” abutment and overlying telescopic crown was fabricated that facilitated access for oral hygiene and retrievability as required. The complexity of the case design was transferred to the laboratory phases of construction. The case presented a satisfactory clinical outcome for an initially challenging implant presentation and reinforced the need to work closely with the laboratory technician.

Introduction: The wire composite splint as a general rule is placed on the middle third of labial surface of the tooth. This is due to ease of application, better isolation, and fewer chances of contamination. However, these assumptions are opinion-based, with no scientific evidence to support them. In addition, to best of our knowledge no research has been carried out to evaluate the effect of position of wire splints on the mobility of the affected tooth and anchor teeth. Aim: The aim of this study was to evaluate the effect of the cervico-incisal position of splinting wire on the mobility of a replanted tooth and anchor teeth in a cadaveric model. Methodology: Three cadavers (one female, 45 years old and two males, each 40 years old) were included in the study. periotest S was used to assess physiologic-tooth-mobility in three cadavers at baseline and after “extraction-replantation-wire-composite” splinting-protocol. Results: Greatest splint effect for horizontal-mobility was found to be 9.33 ± 0.57 for Cadaver-I (incisal-third), whereas it was highest (3.66 ± 2.51) for vertical-mobility in Cadaver-II (cervical third). Conclusion: Middle third position of wire composite splint have lowest splint effect on both horizontal and vertical mobility of replanted teeth, thus rendering the most favorable position for the establishment of physiologic mobility.

Back ground: Many different splinting techniques have been described in dental trauma articles. Wire-composite splint, Orthodontic splint, TTS splint, Resin splint, Kevlar/fiberglass splint (fiberglass), Self-etching and bonding material, Suture splint. We describe here a new technique for splinting traumatized teeth and alveolar bone. To evaluate the simplicity and reliability of cold-cured acrylic resin immediate splinting in the management of traumatized anterior teeth. Results: A total number of (46) patients with traumatized dental or dento-alveolar segment due to accident or operation were managed with immediate cold-cured acrylic resin splint without the need for anesthesia for fixation, the study carried out from January (2008–2014). Forty four dento-alveolar trauma patients, 2 patients following upper dento-alveolar osteotomy, 2 splints dropped down (2) days post-splinting, the splints removed (14-21) days. Conclusion: this new technique in the management of dento-alveolar trauma is a reliable, simple, easy, less technical, painless and less time consuming procedure.

Abstract Background Carpal tunnel syndrome (CTS) is a common cause of pain, weakness, sensory loss, and activity limitations. Currently, the most common initial treatment is use of a rigid splint immobilizing the wrist, usually during night-time, for several weeks. Evidence regarding the efficacy and effect durability of wrist splinting is weak. The treatment is associated with costs and may cause discomfort and limit daily and work activities. No placebo-controlled trials have been performed. Methods This is a randomized controlled trial designed to assess the efficacy of a rigid wrist splint compared with soft wrist bandage (placebo) in patients with primary idiopathic CTS. The trial will be conducted at an orthopedic department. Patients, 25 to 65 years old, who seek primary health-care with symptoms of CTS will be screened, and potentially eligible patients will be referred to the study center. Patients who fulfill the trial’s eligibility criteria will be invited to participate. A total of 112 patients who provide informed consent will be randomly assigned to treatment with either a rigid wrist splint or a soft bandage to be used initially for 6 weeks at night and, if possible, during the day. The splints and bandages will be fitted with a temperature-monitoring device to measure the total time during which they have actually been worn. The trial participants will complete a questionnaire that includes the 6-item CTS symptoms scale (CTS-6); the 11-item disabilities of the arm, shoulder, and hand (QuickDASH) scale; and the EuroQol 5-dimension (EQ-5D) health status and quality-of-life measure at baseline and at 6, 12, 24, and 52 weeks after treatment start. The participants will undergo physical examination and nerve conduction testing at baseline and at 52 weeks. The trial’s primary outcomes are the change in the CTS-6 score from baseline to 12 weeks and the rate of carpal tunnel release surgery at 52 weeks. Discussion This is the first placebo-controlled randomized trial with electronic monitoring of actual splint use and will provide evidence regarding the efficacy of wrist splinting in patients with CTS. Trial registration ISRCTN Registry, ISRCTN81836603. Registered on May 5, 2018.

Introduction: Swellings of pinna are common but various cystic lesions encountered in clinical practice are not reported too often. Management of these lesions if not done at the earliest may lead to disfigurement and change the entire appearance of the face. Aim and Objective: The aim and objective of the study was to determine the clinical presentation, relevant investigations, appropriate treatment, timing of surgical intervention, and prevention of complications. Materials and Methods: Our study comprised 38 cases; male and female patients presented with different types of pinna swellings. Results: A total number of pseudocyst patients were 30 and of which only four were females. Recurrence seen in pseudocyst was 13.33%. Complete resolution was seen after excision in all cases of dermoid and sebaceous cyst. Conclusions: Aspiration and drainage followed by splinting is a simple, safe, and effective surgical treatment of pseudocyst. Simple excision is the most effective surgical treatment of dermoid cyst and sebaceous cyst. [ABSTRACT FROM AUTHOR]

Dentoalveolar trauma occurs in relation to injuries of fall, road traffic accidents, sports injury or physical violence. There may be injury limited to the tooth, or may involve the periodontium around, or in severe cases, alveolar bone or oral mucosa may be traumatised. There can be myriad injuries of the same structure depending upon the severity of impact. The injuries of tooth most commonly being crown fractures, followed by root fractures, luxation or complete avulsion of the tooth. Every type of dentoalveolar injury requires a specific set of clinical protocols to be followed in order to successfully diagnose and manage the particular case. We hereby report a case of a 29-year-old male patient with a history of fall under the influence of alcohol, who had fallen flat on his face and had suffered intrusive luxation of permanent maxillary right central incisor and avulsion of permanent maxillary left central and lateral incisors. The exarticulated teeth still had slight soft tissue attachment to the socket. On the patients first visit to dental OPD, being a dental emergency, the avulsed teeth were immediately restored back into the socket under local anaesthesia after adequately irrigating and debriding the socket, followed by repositioning of the internally luxated tooth, so that all were in their correct anatomical position. After checking for occlusion, they were splinted in position with Erich’s arch bar and 26 gauge SS wire and after giving post-operative instructions patient was asked to follow up after 6 weeks. At 6 weeks, the affected teeth were found to be firm and so arch bar were removed. Patient was advised to follow up further. At periodic follow ups, the patient was asymptomatic and maintained adequate oral functioning of the injured teeth, thus with good patient compliance and proper diagnosis and treatment, dentoalveolar fractures can be managed successfully. The main purpose of this article is to lay emphasis on the timing of treatment of the dentoalveolar injuries. The earlier they are managed, the better is the outcome. [ABSTRACT FROM AUTHOR]