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Background: Autologous fat grafting (AFG) has emerged as a useful technique in breast reconstruction. Utilizing a patient's own fat from areas like the abdomen or thighs, AFG serves various reconstruction needs. Nevertheless, the oncological safety of AFG in breast cancer patients has become a contentious issue. Concerns about its influence on cancer recurrence and detention have led to significant clinical debate and the need for thorough investigation. Methods: To determine the impact of autologous fat grafting (AFG) on loco-regional recurrence (LRR) in breast cancer survivors undergoing reconstruction, a comprehensive search of databases including PubMed, Medline, Web of Science, and Cochrane libraries was conducted from November 2023 through March 2024. This search adhered to the PRISMA guidelines and aimed to identify all the relevant studies on AFG in the context of breast reconstruction post cancer treatment. A meta-analysis was performed. Results: Out of the studies reviewed, 40 met the inclusion criteria, with a total patient cohort of 14,078. The analysis revealed that AFG had no significant association with increased rates of LRR. Conclusions: According to the available literature, AFG is a safe reconstructive option for breast cancer patients and does not increase the risk of loco-regional recurrence. Nevertheless, further well-structured long-term prospective studies are required, since heterogeneity of available studies is high and requires standardization. [ABSTRACT FROM AUTHOR]

Objective: Spondylodiscitis refers to infection of the intervertebral disk and neighboring structures. Outcomes based on instrumentation type are not well reported in the literature, but are important in establishing guidelines for surgical management of spondylodiscitis. This study aims to clarify the effect of instrumentation material selection on clinical and radiographic outcomes in patients with spondylodiscitis. Methods: Studies that evaluated the use of polyetheretherketone (PEEK), titanium, allograft, and/or autologous bone grafts for spondylodiscitis were identified in the literature. Radiographic and clinical data were analyzed using a meta-analysis of proportions, with estimated risk and confidence intervals reported for our primary study outcomes. Results: Thirty-two retrospective studies totaling 1088 patients undergoing surgical management of spondylodiscitis with PEEK, TTN, allograft, and autologous bone graft instrumentation were included. There were no differences in fusion rates (p-interaction = 0.55) with rates of fusion of 93.4% with TTN, 98.6% with allograft, 84.2% with autologous bone graft, and 93.9% with PEEK. There were no differences in screw loosening (p-interaction = 0.52) with rates of 0.33% with TTN, 0% with allograft, 1.3% with autologous bone graft, and 8.2% with PEEK. There were no differences in reoperation (p-interaction = 0.59) with rates of 2.64% with TTN, 0% with allograft, 1.69% with autologous bone graft, and 3.3% with PEEK. Conclusions: This meta-analysis demonstrates that the choice of instrumentation type in the surgical management of spondylodiscitis resulted in no significant differences in rate of radiographic fusion, screw loosening, or reoperation. Future comparative studies to optimize guidelines for the management of spondylodiscitis are needed. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion Level of Evidence To compare clinical outcomes of autologous osteoperiosteal transplantation versus bone marrow stimulation (BMS) for medium‐sized (100–150 mm2) cystic osteochondral lesions of the talus (OLTs) and assess the correlation between patient demographics and outcomes. It was hypothesised that autologous osteoperiosteal transplantation would provide better clinical outcomes than BMS for medium‐sized cystic OLTs.Patients who underwent autologous osteoperiosteal transplantation or BMS for medium‐sized cystic OLTs between 2014 and 2019 were retrospectively evaluated. According to their characteristics, a 1:1 propensity‐score matching was performed and 33 pairs of patients were matched. The visual analogue scale, American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot Ankle Outcome Score (FAOS) and Ankle Activity Score were collected preoperatively and at the last follow‐up. In addition, a general linear model analysis was performed between patient demographics and clinical outcomes in two groups separately to detect potential risk factors.Finally, 28 patients in the grafted group and 27 patients in the BMS group completed the follow‐up and were enrolled with a mean follow‐up period of 63.5 ± 13.9 months. Both groups showed significant improvement in all patient‐reported outcomes (p < 0.01). At the final follow‐up, no significant differences between groups were found in all postoperative scores except FAOS Pain (p = 0.02). Correlation analysis showed a moderate correlation between cyst depth and the postoperative AOFAS score in the BMS group (r = −0.48, p = 0.01). Based on the regression line, the patients in the BMS group with a cyst deeper than 6 mm showed a lower AOFAS score than the mean score (88.7 ± 9.5) of the grafted group.Autologous osteoperiosteal transplantation and BMS are both safe and effective for medium‐sized cystic OLTs. However, autologous osteoperiosteal transplantation is expected to provide better clinical outcomes than BMS when the cysts are deeper than 6 mm.Level III. [ABSTRACT FROM AUTHOR]

Pig skeletal muscle-derived stem cells (SK-MSCs) were transplanted onto the common peroneal nerve with a collagen tube as a preclinical large animal experiment designed to address long nerve gaps. In terms of therapeutic usefulness, a human family case was simulated by adjusting the major histocompatibility complex to 50% and 100% correspondences. Swine leukocyte antigen (SLA) class I haplotypes were analyzed and clarified, as well as cell transplantation. Skeletal muscle-derived CD34+/45− (Sk-34) cells were injected into bridged tubes in two groups (50% and 100%) and with non-cell groups. Therapeutic effects were evaluated using sedentary/general behavior-based functional recovery score, muscle atrophy ratio, and immunohistochemistry. The results indicated that a two-Sk-34-cell-transplantation group showed clearly and significantly favorable functional recovery compared to a non-cell bridging-only group. Supporting functional recovery, the morphological reconstitution of the axons, endoneurium, and perineurium was predominantly evident in the transplanted groups. Thus, Sk-34 cell transplantation is effective for the regeneration of peripheral nerve gap injury. Additionally, 50% and 100% SLA correspondences were therapeutically similar and not problematic, and no adverse reaction was found in the 50% group. Therefore, the immunological response to Sk-MSCs is considered relatively low. The possibility of the Sk-MSC transplantation therapy may extend to the family members beyond the autologous transplantation. [ABSTRACT FROM AUTHOR]

Background: Total pancreatectomy with islet autotransplantation (TPIAT) is a potentially curative treatment for patients with chronic pancreatitis (CP) refractory to medical and endoscopic therapies. Patients often receive the initial follow‐up medical care at the surgery‐performing center, but then may follow up closer to where they live. We sought to describe the characteristics and outcomes of pediatric patients who underwent TPIAT at a national surgical referral center and were subsequently followed at our regional subspecialty center, the Children's Hospital Colorado. Methods: We performed a retrospective analysis of baseline and outcomes data for the 10 pediatric patients who underwent TPIAT from 2007 to 2020 and received follow‐up care at our institution. Results: All patients had a diagnosis of CP, and nine of 10 patients had an identified underlying genetic risk factor. Insulin usage was common immediately following TPIAT, but at 1 year of follow‐up, five of nine patients (55.6%) were insulin‐independent and nine of nine had an HbA1c below 6.5%. For the four patients on insulin 1 year after TPIAT, total daily insulin dose ranged from 0.06 to 0.71 units/kg/day. All patients who underwent mixed meal tolerance testing had a robust peak C‐peptide response at 1 year. There were significant improvements in nausea, school/work absences, narcotic dependence, and pancreas‐related hospital admissions 1 year after TPIAT. Conclusions: Patients followed at our center had long‐term improvements with low‐insulin usage, detectable C‐peptide, and improved pancreatitis‐related outcomes after TPIAT. Pediatric patients who undergo TPIAT can be successfully co‐managed in conjunction with the original surgery‐performing center. [ABSTRACT FROM AUTHOR]

Vitiligo is a common acquired disease of pigment loss. In lesions recalcitrant to non-invasive treatment, transplantation of cultured autologous melanocytes is an emerging choice. Conventionally, the recipient site is often prepared by laser-mediated or mechanical dermabrasion. Such preparation procedures have disadvantages including prolonged transplantation duration, long period for reepithelialization and potential scarring. We propose a method of preparing recipient sites by psoralen and controlled ultraviolet A (PUVA)-induced blistering followed by transplanting suspended melanocytes. We introduced this method in 10 patients with segmental vitiligo on their recipient site 3 to 5 days before transplantation and blistering developed in 2 to 3 days afterwards. On the day of transplantation, the blister roof could be peeled off easily without bleeding and the recipient site preparation could be completed in 20 min. The recipient site became reepithelialized within 1 week. Progressive repigmentation was observed for up to 6 months, with an average of 65.06% repigmentation in the recipient site without scarring at the end of follow-up. Hence, preparation of the recipient site by controlled PUVA-induced sunburn-like blistering can potentially facilitate melanocyte transplantation and prevent scarring. [ABSTRACT FROM AUTHOR]

Background: Injury of peripheral nerve capable of regeneration with much poorer prognosis affects people's life quality. The recovery of nerve function after transplantation for peripheral nerve injury remain a worldwide problem. Silicon-induced biofilms as vascularized biological conduits can promote nerve regeneration by encapsulating autologous or allogeneic nerve graft. Objective: We proposed to explore the effect of silicon-induced biofilms on nerves regeneration and whether the VEGF/VEGFR2/ERK pathway was involved in the present study. Methods: Biofilms around the transplanted nerves in peripheral nerve injury rats were induced by silicon. Vascularization and proteins related to VEGF/VEGFR2/ERK were measured. Pathology and morphology of nerves were investigated after encapsulating the transplanted nerves by silicon-induced biofilms. Results: Our results indicated that the biofilms induced by silicon for 6 weeks showed the most intensive vascularization and the optimal effect on nerve regeneration. Moreover, silicon-induced biofilms for 4, 6 and 8 weeks could significantly secrete VEGF with the highest content at week 6 after induction. VEGFR2, VEGF, p-VEGFR2, ERK1, ERK2, p-ERK1 and p-ERK2 were expressed in the biofilms. p-VEGFR2, p-ERK1 and p-ERK2 expression were different at each time point and significantly increased at week 6 compared with that at week 4 or week 8 which was consistent with that 6 week of was the optimum time for biofilms induction to improve the nerve repair after peripheral nerve injury. Conclusion: Our results suggested that combination of silicon-induced autologous vascularized biofilm and autologous transplantation may promote the repair of rat sciatic nerve defect quickly through VEGF/VEGFR2/ERK pathway. [ABSTRACT FROM AUTHOR]

Background: This 20-year retrospective study aimed to evaluate the treatment methods used in patients with impacted maxillary permanent canines and to determine the occurrence of ankylotic and resorptive processes and their association with potential risk factors. Methods: The cohort consisted of 351 consecutive Caucasian patients (120 males and 231 females, mean age 18.4 and 19.9 years, respectively) with 420 impacted maxillary permanent canines. CT and CBCT findings were subsequently confirmed during surgery. Statistical analyses were performed by the generalized linear models, Pearson x2 and Fisher exact tests using the statistical programs R and Statistica v. 14. Results: A total of 273 (65.0%) impacted canines were aligned in the dental arch by orthodontic traction after surgical exposure, this treatment was predominant in patients under 20 years of age. Surgical extraction was performed in 115 (27.2%) impacted canines and was more common in older patients. Ankylotic changes were recorded in 61 (14.5%) impacted canines. The probability of ankylosis increased with age, particularly after the patient's 20th year of life (p < 0.001). Patients were 1.2% likely to develop ankylosis at age 15 years, 4.3% at age 20 years, 14.1% at age 25 years, and 96.8% at age 45 years. Invasive cervical root resorption (ICRR) was found in 8 (1.9%) canines. In 4 canines (1.0%), root ankylosis in addition to ICRR was observed. In contrast to ankylosis, whose frequency of occurrence increased with age, the occurrence of ICRR resulting from PDL damage during surgery was more typical in younger patients. Canines in a high position above the root apices of the adjacent teeth, with a horizontal inclination of the longitudinal axis, with the crown located deep in the center of the alveolar bone and with labiopalatal position, should be considered critically impacted canines with a high risk to failure of orthodontic traction. Conclusion: In conclusion, the treatment of impacted canines depends mainly on the age of the patient, and the position and inclination of the longitudinal axis of the impacted tooth. To select an adequate treatment method, we recommend CBCT examination, which allows a precise analysis of the position of impacted canines. [ABSTRACT FROM AUTHOR]

Background: Heat burns are a prevalent type of trauma. Rapid and effective treatment is crucial for deep burns to minimize complications. Autologous skin grafting is a highly effective treatment for full-thickness burns. A multidisciplinary team plays a vital role in managing burn patients undergoing skin grafting, from initial contact to outpatient follow-up. Case Summary: This case study involves a 56-year-old patient who suffered burns on 60% of his body following an alcohol explosion on an open flame. The patient underwent autologous skin grafting at a Major Burn Center. Initial symptoms included severe pain and immobility, but the patient remained alert and breathed spontaneously. The diagnosis was a loss of epidermis and dermis with burns covering 60–69% of the total body surface area (TBSA) and third-degree burns covering 10% TBSA. Post-discharge, the patient showed significant improvement, with complete healing of the grafts and partial resolution of other lesions. Six months after the intervention, the patient significantly improved his autonomy and mobility. Conclusions: This case highlights the importance of burn prevention and the critical role of multidisciplinary teams in the entire care pathway of burn patients. Appropriate diagnosis, complete treatment, and continuous multidisciplinary support are essential to prevent complications and ensure recovery. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare conventional sintering with additive manufacturing techniques for β-TCP bioceramics, focusing on mechanical properties and biocompatibility. A "critical" bone defect requires surgical intervention beyond simple stabilization. Autologous bone grafting is the gold standard treatment for such defects, but it has its limitations. Alloplastic bone grafting with synthetic materials is becoming increasingly popular. The use of bone graft substitutes has increased significantly, and current research has focused on optimizing these substitutes, whereas this study compares two existing manufacturing techniques and the resulting β-TCP implants. The 3D printed β-TCP hybrid structure implant was fabricated from two components, a column structure and a freeze foam, which were sintered together. The conventionally fabricated ceramics were fabricated by casting. Both scaffolds were characterized for porosity, mechanical properties, and biocompatibility. The hybrid structure had an overall porosity of 74.4 ± 0.5%. The microporous β-TCP implants had a porosity of 43.5 ± 2.4%, while the macroporous β-TCP implants had a porosity of 61.81%. Mechanical testing revealed that the hybrid structure had a compressive strength of 10.4 ± 6 MPa, which was significantly lower than the microporous β-TCP implants with 32.9 ± 8.7 MPa. Biocompatibility evaluations showed a steady increase in cell proliferation over time for all the β-TCP implants, with minimal cytotoxicity. This study provides a valuable insight into the potential of additive manufacturing for β-TCP bioceramics in the treatment of bone defects. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate, through qualitative and semi‐quantitative histological analysis, onlay autologous bone grafts fixed with ethyl‐cyanoacrylate adhesive and titanium screw, in order to verify whether the method of applying the adhesive would interfere with the graft incorporation. Materials and Methods: Fourteen rats underwent bone graft surgery: seven grafts were fixed with ethyl‐cyanoacrylate (SB group, n = 7) and seven grafts were fixed with titanium screws (TS group, n = 7). After 30 days, the grafts were histologically analysed for vitality, adhesive presence, tissue reaction with formation of osteoid matrix, bone resorption presence, capillaries formation, inflammatory infiltrate, fibroblastic proliferation, presence of osteoblasts, osteocytes and osteoclasts. The data were submitted to non‐parametric tests, Mann–Whitney, Fisher's Test, Wilcoxon and McNemar and to statistical analysis (p < 0.05). Results: No significant differences were found in the qualitative evaluations. While findings of more osteocytes (p = 0.035) in the TS group in greater inflammation (p = 0.030) and more osteoclasts (p = 0.048) in the SB. Despite the fact that the titanium screw has presented bone neoformation with welding points, there was no complete incorporation and the adhesive affected the bone repair in a way that not even neoformation points could be seen in 30 days. Conclusion: The method of applying the adhesive did not show an advantage according to the histological aspects studied, as there was the formation of a dead space at the interface of the SB group and the adhesive acted as a barrier. [ABSTRACT FROM AUTHOR]

The aim of this report is to demonstrate the guided tooth autotransplantation of a palatally impacted maxillary canine into the site of a failed maxillary canine dental implant. A 47‐year‐old woman visited a dental clinic complaining of loose dental implant in the left maxillary canine site, tooth #11, as well as pain and swelling of the gum around the implant. The clinical examination revealed a mobile implant along with swollen soft tissues with bleeding on probing. A periapical radiograph demonstrated peri‐implant marginal bone loss. Cone beam computed tomography sections revealed that tooth #11 was impacted palatally. The implant was removed and replaced with the impacted canine via guided autotransplantation and posterior orthodontic alignment. The patient was recalled at 1, 3, 6, 9, 12, 24 and 48 months after the procedure. During this period, the patient was symptom‐free and radiographic examination at 2 years revealed no periapical pathosis or root resorption. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, leading to various vascular complications. Accumulating evidence indicates that endothelial colony-forming cells (ECFCs) have attractive prospects for repairing and restoring blood vessels. Thus, ECFCs may be a novel therapeutic option for diabetic patients with vascular complications who require revascularization therapy. However, it has been reported that the function of ECFCs is impaired in DM, which poses challenges for the autologous transplantation of ECFCs. In this review, we summarize the molecular mechanisms that may be responsible for ECFC dysfunction and discuss potential strategies for improving the therapeutic efficacy of ECFCs derived from patients with DM. Finally, we discuss barriers to the use of ECFCs in human studies in light of the fact that there are no published reports using these cells in humans. [ABSTRACT FROM AUTHOR]

Autologous stem-cell transplantation (ASCT) is the standard of care for the management of multiple myeloma and has a well-established role in the treatment of some types of lymphoma. Over the last decades, the number of ASCT performed has increased significantly, leading to elevated pressure and cost for healthcare services. Conventional model of ASCT includes the admission of patients to a specialized Transplant Unit at any stage of the procedure. To optimize healthcare provision, ambulatory (outpatient/at-home) setting should be the focus moving forward. Thus, ambulatory ASCT model permits reducing average hospital stays and pressures on healthcare services, with significant costsaving benefits and high degree of patient and caregiver satisfaction. In addition, it facilitates the bed resource for other complex procedures such as allografts or CAR-T cell therapy. The aim of this systematic review is to document the health impact, feasibility and safety of the outpatient/at-home ASCT models, which are increasingly being applied around the world. [ABSTRACT FROM AUTHOR]

Case report Conclusions Clinical Significance This case report describes the multidisciplinary approach performed in a 9‐year‐old male patient with dental agenesia affecting teeth 21 and 22. Autotransplantation of the right upper second premolar with incomplete rhizogenesis to the missing area was combined with coronary reshaping with resin composite and orthodontic therapy. The treatment began with the extraction of the deciduous upper left central incisor, bone preparation for the recipient site of the donor tooth, atraumatic extraction of the right upper second premolar and immediate autotransplantation in the surgically prepared recipient site. Subsequently, sutures to reposition the flap and a rigid splint were performed. After 12 months, coronary reshaping of the autotransplanted tooth with resin composite was carried out. Orthodontic treatment involving the use of a fixed appliance was used to correct the interdental spaces and achieve adequate occlusion. Clinical and radiographic follow‐up 10 years after tooth autotransplantation and 9 years after reshaping revealed partial obliteration of the pulp chamber, root resorption, ankylosis and the presence of endodontic treatment.The long‐term outcomes highlighted that tooth autotransplantation represents a biologically and cost‐effective procedure for replacing missing teeth in young patients, particularly in cases of incomplete rhizogenesis of the autotransplanted tooth.This case report discusses tooth autotransplantation and resin composite reshaping as viable and long‐term clinical options for treating young patients with dental agenesis. [ABSTRACT FROM AUTHOR]

Background: Retrograde Drilling (RD) is a surgical technique employed for osteochondral lesions of the talus (OCLTs) to reach the subchondral bone lesion from behind, thus preserving cartilage integrity. The aim of the present pilot study was to set up an in vitro model of OCLTs to evaluate the regenerative potential of biological approaches that could be associated with the RD technique. Methods: For this purpose, an OCLT was created in human osteochondral specimens, to try to mimic the RD technique, and to compare the regenerative potential of two biological treatments. For this purpose, three groups of treatments were performed in vitro: (1) no treatment (empty defect); (2) autologous bone graft (ABG); (3) hyaluronic membrane enriched with autologous bone marrow cells. Tissue viability; production of Collagen I and II, Vascular Endothelial Growth Factor, and Aggrecan; and histological and microCT evaluations were performed after 30 days of culture in normal culture conditions. Results: It was observed that Group 3 showed the highest viability, and Group 2 showed the highest protein production. From a histological and microtomographic point of view, it was possible to appreciate the structure of the morcellized bone with which the defect of Group 2 was filled, while it was not yet possible to observe the deposition of mineralized tissue in Group 3. Conclusions: To conclude, this pilot study shows the feasibility of an alternative in vitro model to evaluate and compare the regenerative potential of two biological scaffolds, trying to mimic the RD technique as much as possible. The tissues remained vital for up to 4 weeks and both ABG and hyaluronic acid-based scaffolds stimulated the release of proteins linked to regenerative processes in comparison to the empty defect group. [ABSTRACT FROM AUTHOR]

Background: All orthopaedic procedures, comprising foot and ankle surgeries, seemed to show a positive trend, recently. Bone grafts are commonly employed to fix bone abnormalities resulting from trauma, disease, or other medical conditions. This study specifically focuses on reviewing the safety and efficacy of various bone substitutes used exclusively in foot and ankle surgeries, comparing them to autologous bone grafts. Methods: The systematic search involved scanning electronic databases including PubMed, Scopus, Cochrane online library, and Web of Science, employing terms like 'Bone substitute,' 'synthetic bone graft,' 'Autograft,' and 'Ankle joint.' Inclusion criteria encompassed RCTs, case-control studies, and prospective/retrospective cohorts exploring different bone substitutes in foot and ankle surgeries. Meta-analysis was performed using R software, integrating odds ratios and 95% confidence intervals (CI). Cochrane's Q test assessed heterogeneity. Results: This systematic review analyzed 8 articles involving a total of 894 patients. Out of these, 497 patients received synthetic bone grafts, while 397 patients received autologous bone grafts. Arthrodesis surgery was performed in five studies, and three studies used open reduction techniques. Among the synthetic bone grafts, three studies utilized a combination of recombinant human platelet-derived growth factor BB homodimer (rhPDGF-BB) and beta-tricalcium phosphate (β-TCP) collagen, while four studies used hydroxyapatite compounds. One study did not provide details in this regard. The meta-analysis revealed similar findings in the occurrence of complications, as well as in both radiological and clinical evaluations, when contrasting autografts with synthetic bone grafts. Conclusion: Synthetic bone grafts show promise in achieving comparable outcomes in radiological, clinical, and quality-of-life aspects with fewer complications. However, additional research is necessary to identify the best scenarios for their use and to thoroughly confirm their effectiveness. Levels of evidence: Level II. [ABSTRACT FROM AUTHOR]

Recent advancements in medical treatments, particularly gene therapy using hematopoietic stem cells (HSCs), have significantly impacted the treatment of inherited blood disorders. HSCs can self-renew and differentiate into blood cells, making them essential for treating conditions like sickle cell anemia, thalassemia, and severe combined immunodeficiency (SCID). This study conducted a literature review on autologous stem cell therapy for genetic blood disorders, analyzing studies from databases such as PubMed and Scopus. Gene therapy corrects genetic defects in HSCs, offering an alternative to allogeneic transplantation by avoiding immune rejection. The therapy involves modifying stem cells in the lab, often through viral vectors or gene-editing tools, and reinfusing them into the patient to produce healthy blood cells long-term. Lentiviral vectors, considered safer than retroviruses, have been particularly effective in treating various conditions, including immunodeficiencies and hemoglobinopathies. The ex vivo gene transfer approach, commonly used for genetic disorders, has shown promise for one-time curative treatments, especially for pediatric diseases. However, early gene therapy efforts, such as the use of gamma-retroviral vectors for SCID, faced complications like leukemia, leading to a shift towards safer lentiviral vectors. Despite its complexity, the procedure has a low failure rate and provides a less risky alternative to traditional allogeneic stem cell transplants. Ultimately, HSC gene therapy holds significant potential for curing genetic blood disorders by permanently altering the stem cells, ensuring long-term benefits and improved treatment outcomes, with ongoing advancements in safety and efficacy. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to assess and compare the efficacy of autotransplantation of molars with complete and incomplete root formation, by checking the viability of the procedure to replace non‑restorable molar teeth in the extraction sockets. Materials and Methods: Twenty patients with non‑restorable molars were included in this study. They were divided into two groups with complete and incomplete root‑formed third molars, which needed to be transplanted in place of non‑restorable molars. A routine surgical procedure was performed to remove infected molars. Atraumatic removal of the third molar was performed and reimplanted in the socket of previously extracted infected molars. Results: Results were evaluated based on clinical observation and radiographic analysis of the transplanted tooth. Out of 20 transplants, one transplant, despite good initial stability, was extracted after one month because of abnormal horizontal and axial mobility; this was the single failure case (5%). Of the rest, 19/20 (95%) transplants were followed up for 6 months and showed no failure. Conclusion: This study clearly indicated that the benefits of autotransplantation over other treatment options are numerous, and the results are not affected by whether the root of the transplanted tooth is complete or incompletely formed. [ABSTRACT FROM AUTHOR]

Background: Peyronie's disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity. Methods: This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years. Results: The mean operative time was 126.31 ± 21.45 min. Additional Nesbit's plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature <10°) was achieved in 89% (17 / 19) of patients. Increase in the penile length (>1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances. Conclusion: LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results. [ABSTRACT FROM AUTHOR]

Objective: Kienböck disease is a rare condition characterized by severe pain and restricted wrist movement. Various palliative methods have been proposed as therapeutic strategies for alleviating symptoms. Mesenchymal stromal cell transplantation has been suggested as an innovative and promising approach due to its potential for inducing regeneration and immunomodulation in the necrotic tissue. This study aims to evaluate the safety of autologous bone marrow derived mesenchymal stromal cells (BM-MSCs) transplantation after core decompression in Kienböck disease. Materials and Methods: In this phase I of an open-label clinical trial, three patients (one female and two males) with stage 2 Kienböck disease underwent autologous BM-MSCs transplantation following lunate core decompression. The patients were followed up for six months to assess safety as well as secondary clinical outcomes, including pain level, range of motion (ROM), and functional disability. Results: Safety of BM-MSCs injection following the core decompression was evaluated by recording post-treatment complications during the six-month follow-up. No adverse events (AEs) or severe AEs (SAEs) were reported, indicating that BM-MSCs injection after core decompression is a safe intervention. All patients showed a remarkable reduction in visual analog scale (VAS) scores and "Disabilities of the Arm, Shoulder, and Hand" (DASH) questionnaire scores, suggesting the therapeutic potential of this intervention. Moreover, an increase in the ROM indicated that BM-MSCs transplantation can improve wrist functionality. Additionally, radiographic assessments before and after cell infusion demonstrated a reduction in lunate sclerosis after six months of follow-up. Conclusion: The transplantation of autologous BM-MSCs following lunate core decompression seems to be a safe clinical intervention and may lead to pain relief in patients with Kienböck disease. Furthermore, this procedure may help prevent disease progression during the follow-up period (registration number: NCT02646007). [ABSTRACT FROM AUTHOR]

The aim of this study is to show the experience with autotransplanted 3D model development and its use during surgery. The development of a 3D model has undergone three phases: building the virtual model, 3D printing and finally sterilisation. A 37-year-old female patient was recommended to our department for treatment of the 2nd quadrant. After planning the extraction of 26, 27 and consequently autotransplantation of tooth 28 was decided. According to CBCT data, two 3D models of the autotransplanted tooth were built and plasma sterilisation was done. After extraction of 26 and 27, a tooth cavity was prepared for the 3D model phantom and the autotransplantation was finished; extra alveolar time of tooth 28 was only 21 seconds. Healing period had no adverse problems and the patient was very satisfied with the result. Autotransplantation is one of the possible choices when treating malformation or tooth loss. The use of a 3D phantom during surgery leads to shortening of surgery time, thus lowering the risk of periodontal tissue damage by repeated testing of the right size of the tooth position and size. [ABSTRACT FROM AUTHOR]

Background: Alveolar echinococcosis (AE) primarily affects the liver and potentially spreads to other organs. Managing recurrent AE poses significant challenges, especially when it involves critical structures and multiple major organs. Case presentation: We present a case of a 59-year-old female with recurrent AE affecting the liver, heart, and lungs following two previous hepatectomies, the hepatic lesions persisted, adhering to major veins, and imaging revealed additional diaphragmatic, cardiac, and pulmonary involvement. The ex vivo liver resection and autotransplantation (ELRA), first in human combined with right atrium (RA) reconstruction were performed utilizing cardiopulmonary bypass, and repairs of the pericardium and diaphragm. This approach aimed to offer a potentially curative solution for lesions previously considered inoperable without requiring a donor organ or immunosuppressants. The patient encountered multiple serious complications, including atrial fibrillation, deteriorated liver function, severe pulmonary infection, respiratory failure, and acute kidney injury (AKI). These complications necessitated intensive intraoperative and postoperative care, emphasizing the need for a comprehensive management strategy in such complicated high-risk surgeries. Conclusions: The multidisciplinary collaboration in this case proved effective and yielded significant therapeutic outcomes for a rare case of advanced hepatic, cardiac, and pulmonary AE. The combined approach of ELRA and RA reconstruction under extracorporeal circulation demonstrated distinct advantages of ELRA in treating complex HAE. Meanwhile, assessing diaphragm function during the perioperative period, especially in patients at high risk of developing pulmonary complications and undergoing diaphragmectomy is vital to promote optimal postoperative recovery. For multi-resistant infection, it is imperative to take all possible measures to mitigate the risk of AKI if vancomycin administration is deemed necessary. [ABSTRACT FROM AUTHOR]

Introduction: Iliac crest autograft is frequently used to fill in bone defects after osteotomies. Nonetheless, surgery for bone autograft procurement is associated with morbidity and pain at the donor site. Alternatives to it have been explored, but there is no consensus to guide their application as a routine practice in several orthopedic procedures. Thus, this study was designed to compare the efficacy and safety between iliac crest autograft and allograft in medial opening wedge high tibial osteotomy. Materials and methods: Forty-seven patients with a symptomatic unilateral genu varum and an indication for high tibial osteotomy were randomly assigned to receive either autograft or allograft to fill the osteotomy site. Operative time, bone healing, and complication rates (delayed union, nonunion, superficial and deep infection, loss of correction, and hardware failure) were recorded after a one-year follow-up. Data were expressed as Mean ± Standard Deviation and considered statistically significant when p < 0.05. Results: The time to radiologic union was similar between both groups (Allograft: 2.38 ± 0.97 months vs. Autograft: 2.45 ± 0.91 months; p = 0.79). Complication rates were also similar in both groups, with one infection in the allograft group and two in the autograft group, two delayed unions in the allograft group, and three in the autograft group. The operative time differed by 11 min between the groups, being lower in the allograft group (Allograft: 65.4 ± 15.1 min vs. Autograft: 76.3 ± 15.2 min; p = 0.02). Conclusion: Iliac crest allografts can be safely and effectively used in medial opening wedge high tibial osteotomy as it promotes the same rates of bone union as those achieved by autologous grafts, with the benefits of a shorter operative time. Trial Registration Number: U1111-1280-0637 1 December 2022, retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Incidental dural tears are common complications in lumbar spine surgery, particularly in endoscopic procedures where primary closure via suturing is challenging. The absence of a standardized approach for dural closure in endoscopic spine surgery necessitates exploring alternative techniques. Objective: This study introduces a surgical technique for dural closure utilizing fat graft and Gelfoam, offering an effective alternative to standard approaches in endoscopic spine surgery. Methods: Surgical data from patients who underwent interlaminar endoscopic discectomy or stenosis decompression at Lerdsin Hospital from October 2014 to October 2021 were analyzed. Results: Among 393 cases, dural tears occurred in 2% (8 patients). Our technique achieved successful closure in all these cases, with no incidents of cerebrospinal fluid leakage or wound complications. The majority of patients showed favorable clinical outcomes, except for one case involving concomitant nerve root injury. Conclusion: This study demonstrates that using fat graft and Gelfoam for dural closure is a simple, reliable, and safe technique, particularly effective for challenging-to-repair areas in interlaminar endoscopic lumbar spine surgery. [ABSTRACT FROM AUTHOR]

Objective: The recent literature is scarce regarding the outcomes of mid-shaft clavicular non-union treated by open reduction and internal fixation (ORIF) with autologous bone grafting, and the influence of the type of initial treatment has not yet been investigated. The study aims: (1) to present the mid-term surgical results of mid-shaft clavicular non-unions treated by plate fixation with autologous bone grafting and (2) to determine the effect the type of initial treatment has on the surgical results. Material and Method: The study reviews 14 patients (eight females) who'd undergone ORIF with autologous bone grafting due to atrophic mid-shaft clavicular nonunion where clinical and radiographical outcomes were recorded. The study divides the patients into two groups based on their initial treatment: Group A (eight with non-surgical treatment) and Group B (six with surgical treatment). Result: The mean QuickDASH score at final follow-up was 22. The Constant Score significantly improved from 40 to 87 postoperatively. The mean Preoperative Visual Analogous Scale (VAS) score went down from 7 to 2 (p<0.001). A solid union was achieved in all patients. In the preoperative between-group comparison, no significant differences were observed for any of the clinical outcome. At final follow-up, Group A exhibited significantly higher Constant Scores. Conclusion: Regardless of the type of initial treatment, plate fixation with autologous bone grafting is effective in obtaining solid fusion and improving the clinical status of patients with mid-shaft clavicular non-union. Additionally, this technique can provide shorter time to union and greater improvements in specific shoulder function in patients who've undergone non-surgical treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: Gonadal tissue transplantation as a fertility preservation technique is highly conditioned by our current knowledge of functionality following transplantation, tissue cryodamage, and ischemia–reperfusion injury. This paper presents an updated review of the literature on mitochondrial dysfunction and oxidative stress in the context of gonadal tissue cryopreservation and transplantation. Advances in tissue preservation techniques have allowed reproductive medicine and assisted reproductive technologies (ARTs) to flourish in recent years. Because radio- and chemotherapy procedures are often gonadotoxic, irreversible damage can preclude future gamete production and endocrine support. Accordingly, in recent years, the freezing and storage of gonadal tissue fragments prior to the first oncological treatment appointment and autologous transplantation post-recovery have been considered improved solutions for fertility recovery in cancer survivors. Nevertheless, the cryopreservation and transplantation of thawed tissues is still very limited, and positive outcomes are relatively low. This review aims to discuss the limitations of oncofertility protocols with a focus on the impacts of mitochondrial dysfunction, oxidative stress, and the loss of antioxidant defense in graft integrity. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the short term-outcomes of venous reconstruction using a round ligament-covered prosthetic vascular graft and assess its effectiveness in the prevention of prosthetic vascular graft migration in right‑lobe living donor liver transplantation (LDLT). Methods and results: Thirty patients underwent reconstruction of the middle hepatic vein (MHV) tributaries during right lobe LDLT between January, 2021 and October, 2022. These patients were divided into the autologous vascular graft group (A group, n = 24) and the round ligament-covered prosthetic vascular graft group (RP group, n = 6). The computed tomography (CT) density ratio of the drainage area in the posterior segment of patent grafts was significantly higher in the RP group than in the A group (0.91 vs. 1.06, p = 0.0025). However, the patency rates of reconstructed MHV tributaries in the A and RP groups were 61% and 67%, respectively, with no significant difference between the groups (p = 0.72). Prosthetic vascular graft migration did not occur in the RP group. Conclusion: Venous reconstruction using round ligament-covered prosthetic vascular grafts is a feasible and simple method to prevent prosthetic vascular graft migration in right-lobe LDLT. [ABSTRACT FROM AUTHOR]

This case report describes the treatment of a postoperative painful neuroma of the tibial nerve using an autologous nerve graft in a dog. The patient presented with sudden non–weight-bearing lameness 10 days after iatrogenic tibial nerve injury during preparation of a reverse saphenous conduit flap. The dog showed severe pain at the surgical site without nerve deficits. A magnetic resonance imaging examination revealed an enlarged tibial nerve at the injury site, consistent with a neuroma. Analgesics were administered over 11 days, but the patient remained in severe pain and non–weight-bearing. Therefore, surgical resection was recommended. The fusiform neuroma was resected microsurgically, and a saphenous nerve graft was transplanted using an epineural nerve repair technique. Histopathological examination was consistent with a neuroma. The dog showed immediate pain relief and weight-bearing the day after surgery with normal motor function. The dog made a full recovery by the last follow-up 6 mo after surgery. If patients develop pain and lameness following surgery or nerve injury, neuroma formation must be considered, even shortly after surgery. Microsurgical resection and autologous nerve transplantation using an epineural nerve repair technique is a viable method to treat painful neuromas and minimize the risk for recurrence in dogs. [ABSTRACT FROM AUTHOR]

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School 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.)

Copyright of RSBO: Revista Sul-Brasileira de Odontologia is the property of UNIVILLE 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.)

Objective: To study the efficacy of autologous fat transplantation after preservation at -2 to -18°C in a domestic refrigerator. Patients and methods: This study was conducted in a private clinic from December 2017 to December 2021. A total of 973 female patients were included. Under a full aseptic technique, fat was harvested using a 4 mm suction blunt cannula with three longitudinal slits. Three 50 mL syringes of fat were obtained before transferring it to 10 mL syringes; then, the fat was centrifuged at 3500 rpm for 1 min and injected through an 18 gauge blunt cannula. In addition, 50 mL of fat without centrifugation was stored in a domestic refrigerator for 3 weeks to be reinjected after fast thawing for 20 min, and then centrifuged to be ready for the second session. All participants had follow-up visits at 3 weeks, 6 months, and 1 year. Results: Participants ranged in age from 18 to 65 years. The abdomen was the fat donor site in 63.3% of the patients, while round-face style augmentation was performed in 48.3% of the patients. An assessment at 3 weeks revealed that 84.1% of patients required a second session. After 6 months, on an assessment using a 10-point scale, patients who received a single session and a second session scored 6.05 and 7.46, respectively. At 1 year, the assessment scores were 5.65 and 7.12 for those with a single and second session, respectively, and 60% of patients were fully satisfied. Conclusion: Autologous fat preserved in a domestic refrigerator for 3 weeks is a safe, cheap, and tolerated filler for facial augmentation. [ABSTRACT FROM AUTHOR]

This clinical report presents a technique to reconstruct extensively resected mandibles using a combination of autologous bone grafts and additive manufacturing techniques. Mandibular defects, often arising from trauma, tumors, or congenital anomalies, can severely impact both function and aesthetics. Conventional reconstruction methods have their limitations, often resulting in suboptimal outcomes. In these reports, we detail clinical cases where patients with different mandibular defects underwent reconstructive surgery. In each instance, autologous grafts were harvested to ensure the restoration of native bone tissue, while advanced virtual planning techniques were employed for precise graft design and dental implant placement. The patients experienced substantial improvements in masticatory function, speech, and facial aesthetics. Utilizing autologous grafts minimized the risk of rejection and complications associated with foreign materials. The integration of virtual planning precision allowed customized solutions, reducing surgical duration and optimizing implant positioning. These 2 cases underscores the potential of combining autologous grafts with virtual planning precision and dental implants produced by additive manufacturing for mandible reconstruction. [ABSTRACT FROM AUTHOR]

A nationally ranked Division One female collegiate tennis player presented with pain in the chest and right posterior rib region after feeling a popping sensation during a routine overhead movement. The patient was eventually diagnosed with 2 lower rib stress fractures. After unsuccessful conservative management, the player underwent an open reduction and internal fixation and autologous bone grafting of the sixth and seventh ribs with a muscle-sparing approach and was able to return to full competition. We present this case along with a systematic review of the literature regarding rib stress fractures, which included 6 separate online data sources (PubMed, EMBASE, Cochrane, CINAHL, SportDiscus, and Medline). The successful surgical intervention demonstrates a significant option for elite athletes who wish to return to competition but have been unable to with standard of care conservative management of rib stress fractures. [ABSTRACT FROM AUTHOR]

Background: Post acne and post burn facial scarring are more common in young generation leading to disfigurement and unpleasing result. These scars have major aesthetic, functional, and social effects on the affected person. Aim of the study was to establish the role of Autologous Nanofat grafting in treating post acne & post burn facial scarring in terms of pleasing aesthetic appearance of face & patient satisfaction. Methods: A total no. of 24 patients with mean age of 23 years was enrolled in the study. Thirteen patients were of post acne face scarring and 11 patients were suffering from post-burn face scarring. There were 10 male and 14 female patients. All patients were treated with Nanofat grafting with an average of 3 sessions at an interval of 4-6 weeks. The results were assessed after 6 months from the last session by comparison of pre procedure & post procedure pictures and patient satisfaction. Results: Scars started improving after first session of Nanofat grafting and significant improvement in the scars was noted after 3rd session in terms of pigmentation, scar thickness and softness. Overall appearances of the scar were aesthetically improved a lot with a higher patient satisfaction rate. Conclusion: Autologous Nanofat grafting is a potential effective treatment modality for post-acne and post burn facial scarring with a good aesthetic outcome and higher patient satisfaction rate. [ABSTRACT FROM AUTHOR]

Background: Selective bromelain‐based enzymatic debridement (BED) has emerged as a valid alternative for the treatment of extensive burns, with Total Body Surface Area (TBSA) > 20%. Autologous skin grafting represents the procedure of choice but the scarcity of donor sites remains the main reconstructive challenge. The modified Meek micro‐grafting technique may represent a valid strategy to optimize the final outcome. Methods: A single‐cohort retrospective analysis was performed, involving nine burn patients (TBSA > 20%) who underwent both BED and subsequently modified Meek technique. Demographic and clinical data (mechanism of injury, surgical treatment, complications, necessity of re‐grafting, further surgery and esthetic outcome) were collected. Results: All patients had large burns of mixed and deep dermal thickness (first, second, and third degree). All burns were enzymatically debrided postadmission and covered by the modified Meek technique. Local infection due to poor general conditions was the main complication for all patients. All but two patients survived. The selectiveness of the enzymatic debridement and dermal preservation seemed to improve the quality of scars resulting from micro‐grafting. Evaluations performed at 12 ± 2 months postburn showed superior scar quality compared to areas treated with traditional (sheet/mesh) grafts. Conclusion: Combined BED and Meek techniques may provide an effective synergic combination for the treatment of extensive burns. Key messages: Combined bromelain‐based enzymatic debridement and Meek techniques may provide an effective synergic combination for the treatment of extensive burns, implying superior scar quality.Nine burn patients were evaluated, demographic, epidemiological and clinical data were collected.The selectiveness of the enzymatic debridement and dermal preservation seemed to improve the quality of scars resulting from micro‐grafting. [ABSTRACT FROM AUTHOR]

Ex vivo surgery and autotransplantation may provide a promising option for radical resection of conventionally unresectable liver tumors. Two cirrhotic patients with hepatocellular carcinoma (HCC), which has an “awkward seat” located in the “intrahepatic vascular triangle area (IVTA)” that consists of the middle hepatic vein (MHV), the right branches of the Glisson sheath, and the inferior vena cava (IVC), underwent in vivo extended right-half hepatectomy followed by ex vivo tumor resection and partial liver autotransplantation. Innovatively, the outflow of the tumor-free liver was reconstructed ex vivo using pre-frozen allograft blood vessels from brain-dead donors; the patients recovered well postoperation. We report the surgical experience to provide a novel curable surgical procedure for locally advanced IVTA liver tumors.

The article discusses a successful allogeneic hair transplantation procedure performed on a 37-year-old woman with extensive cicatricial alopecia resulting from discoid lupus erythematosus. The patient's identical twin sister served as the donor for the procedure, which took place in August 2022. Follow-up examinations showed significant improvement in hair density and no reactivation of the underlying inflammatory scalp disease. The case introduces the potential option of allogeneic hair transplantation for patients with scarring alopecia, highlighting a unique approach to hair restoration in such conditions. [Extracted from the article]

Managing patients with severe fixation of intra-abdominal contents, known as frozen abdomen, often creates a vicious cycle of tissue injury that further prolongs open abdomen resolution. We share the management course of a 28-year-old male status post motor vehicle accident with traumatic pancreatitis and complex liver injury. Following multiple laparotomies for abdominal wash out, he developed a frozen abdomen and an entero-atmospheric fistula (EAF) through granulated bowel. The exposed granulated bowel, bilious leak and fistula limited options for abdominal closure and ostomy appliance placement. NovoSorb Biodegradable Temporizing Matrix (BTM) applied to the granulated bowel eventually allowed an ostomy appliance to be placed around the fistula on top of the non-absorbable layer of the BTM. Eventual fistula closure was achieved and appropriate granulation tissue had formed prior to autografting. This is the first report utilizing BTM to aid in the closure of open abdomen in the setting of frozen abdomen with EAF. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Background: This article contains two cases with accompanying surgical videos, illustrating the use of a Tutoplast plug to create a watertight seal in the corneoscleral fistula formed after tube shunt removal. Case description: These cases demonstrate that Tutoplast can be cut into a strategic geometric shape to both plug the fistula formed at the tube entry site and reinforce adjacent areas of scleral thinning during tube removal or repositioning surgery. Specifically, a piece of dehydrated scleral Tutoplast was shaped into a small rectangle with an attached larger rectangle. The smaller rectangle or "head" would plug the fistula, while the attached larger rectangle or "body" could be used to reinforce the adjacent area of scleral thinning. The patch graft was sutured to the sclera at the four corners and resembled a turtle with four sutures for legs, with its head in the fistula. Hence, this technique is called the scleral "Turtle-Plast." Conclusion and clinical significance: This "Turtle-Plast" technique is advantageous over direct suturing of the tube track because the head of the turtle provides an astigmatically neutral, watertight seal for the short anterior fistula, which can often be technically challenging to secure. Meanwhile, the body of the turtle can serve as a more substantive piece of patch graft to suture down to the underlying sclera that may be susceptible to thinning. [ABSTRACT FROM AUTHOR]

Objectives: Many treatment options accepted for unsalvageable traumatized teeth in adults would seem contraindicated in children and adolescents. Instead, growing patients need interim restorative measures, thus extensively preserving their local bone and soft tissue structures and, ideally, preparing the involved site for later definitive restoration while they transform to skeletal maturity. This narrative topic review addresses the interim management in case of very deep intra-extra-alveolar fractures, extensive infection-related root resorption, tooth ankylosis, and anterior tooth loss in growing patients, and seeks to empower the clinician to select the appropriate treatment approach. Data sources: The literature up to 2021 was reviewed based on several scoping searches on PubMed and the Cochrane Library using relevant terms. Due to the complexity of the topic (with various poor prognosis scenarios and the differing therapeutic options), a systematic review was deemed inappropriate. Conclusion: Suitable interim treatment options include extrusion of teeth showing deep intra-extra-alveolar fractures, and decoronation of ankylosed teeth as well as resin-bonded fixed dental prostheses, natural tooth pontics, and primary tooth autotransplantations after tooth loss. The interim management options described in this article represent compromises chosen in the absence of better alternatives after a careful risk-benefit analysis. However, if adequately performed, the presented treatment options have the potential to achieve the temporary restoration of function and esthetics in growing patients. Close clinical and (if appropriate) radiologic monitoring of these patients is considered mandatory to ensure early detection of possible complications that might jeopardize or could render impossible subsequent therapeutic measures. [ABSTRACT FROM AUTHOR]

Objective: Autologous iliac bone is commonly used as a bone graft material to achieve solid fusion in craniocervical junction (CVJ) surgery. However, the developing iliac bone of children is less than ideal as a bone graft material. The matured rib bone of children presents a potential substitute material for iliac bone. The aim of this study was to evaluate the efficacy of autologous rib grafts for craniocervical junction surgery in children. Methods: The outcomes of 10 children with abnormalities of the craniocervical junction who underwent craniocervical junction surgery between January 2020 and December 2022 were retrospectively reviewed. All patients underwent posterior fusion and internal fixation surgery with autologous rib grafts. Pre- and post-operative images were obtained and clinical follow-ups were conducted to evaluate neurological function, pain level, donor site complications, and bone fusion rates. Results: All surgeries were successful. During the 8- to 24-month follow-up period, all patients achieved satisfactory clinical results. Computed tomography at 3–6 months confirmed successful bone fusion and regeneration of the rib defect in all patients with no neurological or donor site complications. Conclusion: Autologous rib bone is a safe and effective material for bone grafting in craniocervical junction fusion surgery for children that can reduce the risks of donor site complications and increase the amount of bone graft, thereby achieving a higher bone fusion rate. [ABSTRACT FROM AUTHOR]

Intra‐abdominal desmoid tumors are a rare and complex clinical problem. These tumors are locally invasive, and surgical ablation represents the mainstay of treatment. When localized at the root of the mesentery, their resection may require extensive excision of the intestine resulting in intestinal failure and life‐long total parenteral nutrition. Intestinal transplantation, either autotransplantation or allotransplantation, has been used as a viable option to treat this group of patients. Herein, we describe a series of 4 patients with unresectable intra‐abdominal desmoid tumor who underwent cadaveric isolated intestinal and ascending colon transplantation. [ABSTRACT FROM AUTHOR]

Background: Hypertrophic scarring results from myofibroblast differentiation and persistence during wound healing. Currently no effective treatment for hypertrophic scarring exists however, autologous fat grafting has been shown to improve scar elasticity, appearance, and function. The aim of this study was to understand how paracrine factors from adipose tissues and adipose-derived stromal cells (ADSC) affect fibroblast to myofibroblast differentiation. Methods: The transforming growth factor-β1 (TGF-β1) induced model of myofibroblast differentiation was used to test the effect of conditioned media from adipose tissue, ADSC or lipid on the proportion of fibroblasts and myofibroblasts. Results: Adipose tissue conditioned media inhibited the differentiation of fibroblasts to myofibroblasts but this inhibition was not observed following treatment with ADSC or lipid conditioned media. Hepatocyte growth factor (HGF) was readily detected in the conditioned medium from adipose tissue but not ADSC. Cells treated with HGF, or fortinib to block HGF, demonstrated that HGF was not responsible for the inhibition of myofibroblast differentiation. Conditioned media from adipose tissue was shown to reduce the proportion of myofibroblasts when added to fibroblasts previously treated with TGF-β1, however, conditioned media treatment was unable to significantly reduce the proportion of myofibroblasts in cell populations isolated from scar tissue. Conclusions: Cultured ADSC or adipocytes have been the focus of most studies, however, this work highlights the importance of considering whole adipose tissue to further our understanding of fat grafting. This study supports the use of autologous fat grafts for scar treatment and highlights the need for further investigation to determine the mechanism. [ABSTRACT FROM AUTHOR]

A novel developed 4D bioprinting technique is used for the manufacturing of human‐scale, small‐diameter vascular grafts. Accordingly, a bio‐ink is synthesized from a hybrid molecule containing sodium alginate (SA) and collagen peptide (COP). Endothelial progenitor cells (EPC) isolated from human whole blood are integrated into the bioartificial vascular graft as an autologous cell source. Likewise, human umbilical vein endothelial cells (HUVEC) are used as experimental standard. The evolving vascular grafts are printed by a customized 4D bioprinter into CaCl2 support medium for rapid cross‐linking inducing the temporospatial shaping of the grafts. After culturing for 21 days, histological and ultrastructural analyses of the bioartificial vascular grafts reveal a well‐organized matrix with imbedded EPC or HUVEC. Live‐3D‐cell–imaging and cell viability assays demonstrate a multitude of vital and metabolically active cells. Biomechanics of the grafts are proven to be comparable to human saphenous veins. Coagulation analysis reveals low thrombogenicity and high functional integrity of the vascular grafts. Surgical implantation of the grafts in a perfused cadaver model can be performed effectively and without technical issues. Finally, the current study describes for the first time the 4D bioprinting and characterization of a small‐diameter, human‐scale vascular graft for putative clinical translation. [ABSTRACT FROM AUTHOR]

Background: Masquelet membrane induction technology is one of the treatment strategies for large bone defect (LBD). However, the angiogenesis ability of induced membrane decreases with time and autologous bone grafting is associated with donor site morbidity. This study investigates if the PRP-FG-nHA/PA66 scaffold can be used as a spacer instead of PMMA to improve the angiogenesis ability of induced membrane and reduce the amount of autologous bone graft. Methods: Platelet rich plasma (PRP) was prepared and PRP-FG-nHA/PA66 scaffold was synthesized and observed. The sustained release of VEGFA and porosity of the scaffold were analyzed. We established a femur LBD model in male SD rats. 55 rats were randomly divided into four groups depending on the spacer filled in the defect area. "Defect only" group (n = 10), "PMMA" group (n = 15), "PRP-nHA/PA66" group (n = 15) and "PRP-FG-nHA/PA66" group (n = 15). At 6 weeks, the spacers were removed and the defects were grafted. The induced membrane and bone were collected and stained. The bone formation was detected by micro-CT and the callus union was scored on a three point system. Results: The PRP-FG-nHA/PA66 scaffold was porosity and could maintain a high concentration of VEGFA after 30 days of preparation. The induced membrane in PRP-FG-nHA/PA66 group was thinner than PMMA, but the vessel density was higher.The weight of autogenous bone grafted in PRP-FG-nHA/PA66 group was significantly smaller than that of PMMA group. In PRP-FG-nHA/PA66 group, the bone defect was morphologically repaired. Conclusion: The study showed that PRP-FG-nHA/PA66 scaffold can significantly reduce the amount of autologous bone graft, and can achieve similar bone defect repair effect as PMMA. Our findings provide some reference and theoretical support for the treatment of large segmental bone defects in humans. [ABSTRACT FROM AUTHOR]

One of the main therapeutic problems worldwide is the restoration of cartilaginous lesions in order to prevent osteoarthritis which can lead to heavy and high‐cost joint replacement operations with metal implants. In situations where large cartilage lesions occur, the only solution is the transplantation of autologous cells such as chondrocytes or mesenchymal cells. These transplants require the use of scaffolds that are derived from various animals or even synthetic materials, acting as carriers of the above‐mentioned cells. In the context of this study, an integrated system is introduced aiming to rapidly design and fabricate customized 3D‐printed scaffolds, which are constructed from biomaterials, providing that way a valuable solution to their production as well as eliminating the need for multiple operations. The main idea is the employment of a stereoscopic endoscope during the arthroscopy operation extracting stereoscopic images of the investigated area in order to perform a 3D reconstruction of the cartilage lesion area prior and after the surgeon's operation. The fusion of the preoperative images (magnetic resonance imaging [MRI] for organic tissue and computed tomography [CT] for synthetic phantoms) with the captured stereoscopic images allows the formulation of an appropriate 3D model of the scaffold. In addition, the physical model of the scaffold is manufactured with the aid of a sterilized 3D printer utilizing biomaterials, such as polycaprolactone (PCL), chitosan, etc. Finally, the 3D printed scaffold is impregnated with autologous cells and inserted into the cartilage lesion during the arthroscopy operation saving precious time and reducing the overall rehabilitation cost. [ABSTRACT FROM AUTHOR]

Background: A critical-sized bone defect (CsBD) is considered one that will not heal spontaneously and requires reconstruction. This study aims to compare the results of using different bone reconstructive techniques and to study the potential of platelet-rich fibrin (PRF) to enhance the healing properties of a bone substitute (BS). Methods: In this experimental study on rats, the treatment of critical-sized bone defects was carried out by analysing four groups: a control group in which the bone defect was left empty; a group treated with Bio-Gen®; another group in which the defect was treated with PRF in combination with Bio-Gen®; and the last that was treated with autologous bone graft (ABG). The defects were evaluated by microcomputed tomography (µCT) and then histomorphometrically. Results: From both the histological and imagistic point of view, the best results were registered in the ABG group, followed by the group treated with Bio-Gen® with PRF, Bio-Gen® group, and control group, with statistically significant differences. Conclusions: A 5 mm defect in the rat radius can be considered critical. ABG showed the best results in treating the bone defect. PRF significantly enhanced the efficacy of Bio-Gen®. [ABSTRACT FROM AUTHOR]