Objectives: To assess the outcome of a modified buccinator flaps’ palatal lengthening combined with radical intravelar veloplasty (Bs + Re: IVVP) for the management of postpalatoplasty velopharyngeal incompetence and report the functional and structural changes occurring in the palate. Design: Prospective cohort study of consecutive cleft patients presenting with velopharyngeal incompetence and managed by buccinator re-repair procedure. Blind assessment of randomized recordings of speech and evaluation of velar form and function with nasoendoscopy and lateral videofluoroscopy were done. Patients’ demographic data were also collected. Patients: Among 30 consecutive cases who had Bs + Re: IVVP, 24 had adequate pre- and postoperative records of speech outcome data. Setting: Multidisciplinary cleft team in a tertiary referral center. Results: There were significant improvements in hypernasality, nasal emission, facial grimace and weak consonants, and overall intelligibility of speech. Endoscopy and lateral videofluoroscopy showed significant improvement in total and functional velar length, closure ratio, velopharyngeal gap at closure, palatal thickness, palatal convexity, and mobility. Regarding the procedure complications, no flap ischemia, fistula, or obstructive sleep apnea reported, but there were one cheek hematoma and two minor oral mucosal dehiscence which healed spontaneously. Conclusions: Buccinator re-repair (Bs + Re: IVVP) has been shown to be an effective and safe procedure in treating difficult postpalatoplasty velopharyngeal incompetence. It was also shown that it is still a physiological nonobstructive procedure with low morbidity.
Background: Sleep deprivation (SD) is a growing hazard through its effects on metabolism.Orexin is involved in regulation of both sleep and metabolism. Work on orexin receptors may explainthe mechanisms of some hazardous effects of SD. Aim:To test the role of orexin-1 receptor (OX1R)blocker, SB-334867 in changes of triglycerides and cholesterol metabolisminduced by SD. Method: 72 adult albino rats arranged in 4 equal groups: control, SD, SD-OX1R blocked &SD-DMSO groups. The 3 SD groups are subjected to 8 days of paradoxical SD using the modified multiple platform method. The OX1R blocked group was injected intraperitoneallydaily with single dose (3 mg/kg/day) of SB-334867 dissolved in 2 ml DMSOand diluted 1:1000. The SD-DMSO group was injected by 2 ml of DMSO diluted 1:1000. Triglycerides and cholesterol levels weremeasured. Results: Blood triglyceride levels dropped in all groups subjected to SD after the 1 st day while the blood cholesterol level dropped in all groups subjected to SD at the 7 th or 8 th day. In SD-OX1R blocked group showed less drop in blood triglyceridesthan the other SD groups but statistically non-significant change in cholesterol level. Conclusion: SDleads to earlier and more dropin blood triglyceridesthan the drop in cholesterol levels. This can be explained by high metabolism during SD with dependence on triglyceride more than cholesterol. OX1R blocker partially reduces the drop of triglyceride not cholesterol level indicating that orexinmay be involved in control of triglyceride metabolism but not cholesterol.
The restoration of endodontically treated tooth is a subject that has been evaluated and discussed widely in the dental literature. The goal of dental treatment is to provide optimal oral health, aesthetics and functions. The successful treatment of a badly broken endodontically treated tooth depends not only on the success of the endodontic treatment but also on good prosthetic reconstruction. The prosthetic treatment on a seriously damaged, endodontically treated tooth often requires an endodontic post as an additional retention element for core build up prior to crown restoration. This case report presents a male patient of 22 years of age with prosthetic crown fracture of endodontically treated maxillary left central incisor tooth. The following clinical case represents the clinical steps involved in the utilization of a fibre-reinforced composite post-core in a maxillary left central incisor and the subsequent treatment with a full veneer crown.
Central Medical College Journal Vol 5 No 2 Jul 2021 PP 126-130
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