Background Protection of the palatal wound is an essential step following harvesting a palatal soft tissue graft. The aim of the current pilot randomized clinical study was to assess the efficacy of using propylene mesh as protective sheet when compared to conventional custom made acrylic stent after harvesting a palatal graft. The primary outcome of this study was bleeding postoperatively and secondary outcomes were pain, healing profile of the donor site as well as patient satisfaction. Methods Between 2018 and 2019 we conducted a prospective randomized controlled trial of 24 patients with palatal defects. Two groups of 12 patients with 24 sites were included in this study and were treated with soft tissue grafting technique using free grafts harvested from the hard palate. The palatal wounds were protected with propylene mesh (test group) or custom-made acrylic palatal stent (control group). Participants were assessed for the amount and duration of bleeding, pain duration, and the risk of infection 2, 4, 6, 8, 14 days post-operatively. The trial had been registered in clinical trials.gov (NCT04348279). Results Four sites were excluded from the study as dropouts. The polypropylene mesh was more effective at reducing bleeding by (2.4 ± 1.075) and pain by (1.600 ± 0.516), while the custom-made acrylic stent reduced the bleeding (5.8 ± 1.22) and pain (7.100 ± 0.316). The decline in amount of bleeding amount (P value = 0.021) and its duration (P value = 0.001) achieved by the propylene mesh was statistically significant. There was no statistical significant difference in patient satisfaction and the duration of healing process between the 2 groups. However, the healing profile of the test group was statistically significant when compared with the control group (P value = 0.002). Conclusions Propylene mesh is a promising material for protection of the palatal wound due to its light weight, limited bacterial wicking, tissue compatibility. Further studies are required to adequally assess the benefits of this material in periodontal plastic surgeries.

AIM:The aim of this study is to systematically evaluate and compare implant retained fixed restoration versus implant retained over denture.MATERIAL AND METHODS:Search was made in 2 databases including PubMed and PubMed Central. Title and abstract were screened to select studies comparing implant retained fixed restorations versus implant retained removable overdentures. Articles which did not follow the inclusion criteria were excluded. Included papers were then read carefully for a second stage filter, this was followed by manual searching of bibliography of selected articles.RESULTS:The search resulted in 5 included papers. One study evaluated the masticatory function, while the other 4 evaluated the patient satisfaction. Two of them used Visual Analogue Scale (VAS) as a measurement tool, while the other two used VAS and Categorical Scales (CAT). Stability, ability to chew, ability to clean, ability to speak and esthetics were the main outcomes of the 4 included papers.CONCLUSION:Conflicting results was observed between the fixed and removable restorations.

A bstract Background Tidal volume challenge pulse pressure variation (TVC-PPV) is considered one of the recent reliable dynamic indices of fluid responsiveness (FR); also, passive leg raising (PLR)-induced changes in cardiac output (CO) detected by echocardiography are considered a reliable reversible self-fluid challenge test; many patients share eligibility for both tests. Objectives The study aimed to compare the sensitivity and specificity of both tests for the prediction of FR in mechanically ventilated patients with hemodynamic instability. Methods We studied 46 patients. Hemodynamic parameters including PPV and CO (detected by velocity time integral (VTI) using echocardiography) recorded at tidal volume (VT) of 6 mL/kg/ideal body weight (IBW) in semi-recumbent position then recorded again after one-minute increase in TV from 6 to 8 mL/kg/IBW then recorded with PLR at TV of 6 mL/kg/IBW and finally with actual volume expansion in semi-recumbent position by 4 ml/kg bolus of crystalloid solution to define actual responders with increase of cardiac output of 15% or more. Results Sixteen patients were responders, and thirty patients were nonresponders; responders had significant increase in PPV with TVC 6 to 8 ml/kg/IBW with best cutoff value of 3.5 with a sensitivity of 93.8% and a specificity of 93.9%. PLR test-induced changes in CO had a sensitivity of 93.9% and a specificity of 86.7% with statistically best cutoff value of 6.5% increase in CO, but sensitivity was 75% at cutoff value of 10% increase in CO. Other parameters like PPV, PPV changes with PLR test, and PPV changes with fluid expansion were less sensitive indicators. Conclusion FR in patients with hemodynamic instability and mechanically ventilated with low tidal volume strategy can be efficiently predicted when PPV increases more than 3.5 with tidal volume challenge and when PLR induces 6.5% increase in CO monitored through VTI method by Doppler echocardiography, and both tests are equally reliable. How to cite this article Elsayed AI, Selim KAW, Zaghla HE, Mowafy HE, Fakher MA. Comparison of Changes in PPV Using a Tidal Volume Challenge with a Passive Leg Raising Test to Predict Fluid Responsiveness in Patients Ventilated Using Low Tidal Volume. Indian J Crit Care Med 2021;25(6):685–690.

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Aim:The aim of this study was to compare platelet rich fibrin "PRF socket plug technique" versus the traditionally used "socket plug technique" to improve bone quality without affecting its volumetric stability. Research question: In mandibular premolars socket preservation, will "PRF socket plug" technique improve bone quality without affecting bone quantity, when compared to 'socket plug" technique? Materials and Methods: This was a split-mouth randomized controlled trial conducted on 9 patients. For each patient, bilateral socket preservation was performed. PRF socket plug technique (intervention) was performed for one side, while the other was performed using the traditional socket plug technique (control). After 6 months, bone and soft tissue changes were measured. Horizontal and vertical alveolar ridge loss and loss percentage were measured using cone-beam CT. Bone quality was measured by histomorphometric analysis of area percentages of mineralized trabecular bone of core biopsies. Keratinized mucosa changes were measured using Williams graduated periodontal probe. Results: Intervention group showed slightly higher horizontal bone loss, loss percentage, vertical bone loss, loss percentage (1.36 mm, 16.98 %, 1.07mm, 7.99 %) with no statistically significant difference when compared to the control group (1.14mm, 13.89 %, 0.97 mm, 7.21 %). Histomorphometric analysis showed higher new bone formation (34.11 %) in intervention group compared to the control group (30.78%) with no statistically significant difference. Both groups showed keratinized mucosa gain (1.28 mm intervention, 1 mm control) with no statistically significant difference. Conclusions: Socket plug technique is an effective technique for alveolar ridge preservation; PRF clot represents an easy, successful, and economical method to cover the graft in socket plug technique; PRF socket plug technique represents a promising alternative to the routinely used socket plug technique.