Bone is a hard and dense connective tissue that supports and maintains the body structure and functions. Several factors like aging, drugs, hormonal changes, and physical activities lead to several kinds of bone injuries/fracture. To address these problems, autologous bone graft is considered an ideal material. However, limited availability and complications related to its harvesting process like donor site morbidity and pain limit the use of autologous bone graft in bone regeneration. With increasing advances in technology, several bone substitute materials such as synthetics, bioceramics, and polymers are emerging as a substitute of auto-or allogenous bone for the treatment of bone defect. These bone substitute materials should be biocompatible, bioresorbable, osteoconductive, osteoinductive, and support the ingrowth of new bone. In this chapter, we summarize the currently available bone graft and bone substitute materials including biological and bio-inorganic factors. An overview of the associated advantages, challenges, and future perspectives to clinical implication is also discussed.
Introduction: Chronic rhinosinusitis (CRS) is a global health problem affecting approximately 14% of the population of all age groups. CRS has a significant adverse impact on quality of life of the patients.Objective: The aim of this study was to compare the quality of life of patients suffering from CRS with that of normal population and to assess the association between objective nasal endoscopic score, self-rated symptom score and quality of life (QoL) score.
Methodology:This was a prospective study conducted over a period of 12 months. A total of 110 cases of CRS and 50 normal subjects taken as controls were recruited from out patients department. Patients diagnosed as a case CRS were subjected to rhinosinusitis disability index (RSDI), subjective QoL questionnaires and self-rated symptom score in their vernacular language followed by diagnostic nasal endoscopy, using 0º rigid endoscope (4 mm).Results: This study revealed that the mean ± SD total QoL score in the patients was 50.2 ± 14.9 (15-94) which was significantly affected as compared to control group where it was only 18.2 ± 9.15 (3-47). The mean ± SD of the functional, emotional and physical domains were 17.6 ± 5.46 (4-34), 16.5 ± 8.29 (5-88) and 16.5 ± 5.84 (2-35) respectively. There was no correlation between endoscopic score and the patient's self-rated symptom score or RSDI score. The correlation between the self-rated symptom score and total QoL score was significant (p = 0.02).
Conclusion:On comparing the QoL in the patients of CRS with the controls, it was observed that QoL was affected more in the patients of CRS in the physical, functional and emotional domain of their life. CRS has considerable adverse impact on QoL of patients and RSDI is a valuable tool in assessing the QoL in patients of CRS.
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