Introduction: With surgical advancements and improved implants and instrumentation, nailing is the procedure of choice in subtrochanteric fractures. However, failure in achieving reduction of the multidirectional displacement of the fragments prior to passing the nail, contributes to delayed/non-unions at the fracture site leading to implant failures. In this study, we aim to analyse the factors affecting union of closed subtrochanteric fractures treated by nailing. Materials and methods: In this retrospective study, closed subtrochanteric fractures treated with cephalomedullary nailing between 2015 and 2019 were included. Demographic, surgical and radiological data were retrieved and analysed. A total of 60 cases were eligible to be included in the study. Results: Majority of patients were male (50), with a mean age of 46.07±16.40 years. Twenty-two fractures were multifragmentary having a separate butterfly fragment. In 27 patients mini-open technique was used to get the anatomical alignment and to hold reduction until fixation. Overall, the mean time for union was 7.63±5.85 months. We had nine delayed unions and eight non-unions. Varus alignment in the coronal plane of more than 8.5° was the only significant factor associated with delayed or non-union apart from loss of medial continuity. Conclusion: We recommend achieving fracture reduction with less than 8.5° of varus malalignment in the coronal plane. Varus malalignment is poorly tolerated in fractures at this region. To achieve this, we suggest having a very low threshold to minimally open the fracture site for reduction of these fractures, which does not have any negative effect on the fracture union.

BACKGROUND: Gingival mesenchymal stem cells (GMSCs) are distinctive homogenous subset of mesenchymal stem cells (MSCs), which has its development from neural ectomesenchyme along with contributions from the perifollicular mesenchyme and the dental follicle proper. GMSCs stand apart from other dental MSCs owing to their ease of accessibility and availability with incredible long culture sustainability without any tumorigenic capability, and stable telomerase activity. Their capacity to differentiate into various cell lineages and inherent therapeutic effect in chronic inflammatory diseases like colitis, rheumatoid arthritis, systemic lupus erythematous (SLE) and diabetes makes them immensely valuable. The immunomodulatory and anti-inflammatory properties aid its usage in auto immune diseases and graft versus host disease. However, the differentiation, immunomodulatory and anti-inflammatory effects of GMSCs in periodontal tissue regeneration are less explored. METHODS: In this review article, we have comprehensively compiled and described several reports on GMSCs till date, including their basic properties and isolation protocols, subpopulations, spheroid GMSCs, gingiva-derived IPSCsinduced pluripotent stem cells (iPSCs), their characterization, multilineage differentiation, and immunomodulatory properties along with precise applications in periodontal regeneration and peri-implantitis. RESULTS AND CONCLUSION: Though the studies on GMSCs in periodontal regeneration lack superior quality random clinical trials, this review article still strengthens the view that GMSCs can be a newer source in periodontal tissue reconstruction/regeneration.

BACKGROUND: Gingival mesenchymal stem cells (GMSCs) are distinctive homogenous subset of mesenchymal stem cells (MSCs), which has its development from neural ectomesenchyme along with contributions from the perifollicular mesenchyme and the dental follicle proper. GMSCs stand apart from other dental MSCs owing to their ease of accessibility and availability with incredible long culture sustainability without any tumorigenic capability, and stable telomerase activity. Their capacity to differentiate into various cell lineages and inherent therapeutic effect in chronic inflammatory diseases like colitis, rheumatoid arthritis, systemic lupus erythematous (SLE) and diabetes makes them immensely valuable. The immunomodulatory and anti-inflammatory properties aid its usage in auto immune diseases and graft versus host disease. However, the differentiation, immunomodulatory and anti-inflammatory effects of GMSCs in periodontal tissue regeneration are less explored. METHODS: In this review article, we have comprehensively compiled and described several reports on GMSCs till date, including their basic properties and isolation protocols, subpopulations, spheroid GMSCs, gingiva-derived IPSCsinduced pluripotent stem cells (iPSCs), their characterization, multilineage differentiation, and immunomodulatory properties along with precise applications in periodontal regeneration and peri-implantitis. RESULTS AND CONCLUSION: Though the studies on GMSCs in periodontal regeneration lack superior quality random clinical trials, this review article still strengthens the view that GMSCs can be a newer source in periodontal tissue reconstruction/regeneration.

BACKGROUND: Gingival mesenchymal stem cells (GMSCs) are distinctive homogenous subset of mesenchymal stem cells (MSCs), which has its development from neural ectomesenchyme along with contributions from the perifollicular mesenchyme and the dental follicle proper. GMSCs stand apart from other dental MSCs owing to their ease of accessibility and availability with incredible long culture sustainability without any tumorigenic capability, and stable telomerase activity. Their capacity to differentiate into various cell lineages and inherent therapeutic effect in chronic inflammatory diseases like colitis, rheumatoid arthritis, systemic lupus erythematous (SLE) and diabetes makes them immensely valuable. The immunomodulatory and anti-inflammatory properties aid its usage in auto immune diseases and graft versus host disease. However, the differentiation, immunomodulatory and anti-inflammatory effects of GMSCs in periodontal tissue regeneration are less explored. METHODS: In this review article, we have comprehensively compiled and described several reports on GMSCs till date, including their basic properties and isolation protocols, subpopulations, spheroid GMSCs, gingiva-derived IPSCsinduced pluripotent stem cells (iPSCs), their characterization, multilineage differentiation, and immunomodulatory properties along with precise applications in periodontal regeneration and peri-implantitis. RESULTS AND CONCLUSION: Though the studies on GMSCs in periodontal regeneration lack superior quality random clinical trials, this review article still strengthens the view that GMSCs can be a newer source in periodontal tissue reconstruction/regeneration.

BACKGROUND: Gingival mesenchymal stem cells (GMSCs) are distinctive homogenous subset of mesenchymal stem cells (MSCs), which has its development from neural ectomesenchyme along with contributions from the perifollicular mesenchyme and the dental follicle proper. GMSCs stand apart from other dental MSCs owing to their ease of accessibility and availability with incredible long culture sustainability without any tumorigenic capability, and stable telomerase activity. Their capacity to differentiate into various cell lineages and inherent therapeutic effect in chronic inflammatory diseases like colitis, rheumatoid arthritis, systemic lupus erythematous (SLE) and diabetes makes them immensely valuable. The immunomodulatory and anti-inflammatory properties aid its usage in auto immune diseases and graft versus host disease. However, the differentiation, immunomodulatory and anti-inflammatory effects of GMSCs in periodontal tissue regeneration are less explored. METHODS: In this review article, we have comprehensively compiled and described several reports on GMSCs till date, including their basic properties and isolation protocols, subpopulations, spheroid GMSCs, gingiva-derived IPSCsinduced pluripotent stem cells (iPSCs), their characterization, multilineage differentiation, and immunomodulatory properties along with precise applications in periodontal regeneration and peri-implantitis. RESULTS AND CONCLUSION: Though the studies on GMSCs in periodontal regeneration lack superior quality random clinical trials, this review article still strengthens the view that GMSCs can be a newer source in periodontal tissue reconstruction/regeneration.

BACKGROUND: Gingival mesenchymal stem cells (GMSCs) are distinctive homogenous subset of mesenchymal stem cells (MSCs), which has its development from neural ectomesenchyme along with contributions from the perifollicular mesenchyme and the dental follicle proper. GMSCs stand apart from other dental MSCs owing to their ease of accessibility and availability with incredible long culture sustainability without any tumorigenic capability, and stable telomerase activity. Their capacity to differentiate into various cell lineages and inherent therapeutic effect in chronic inflammatory diseases like colitis, rheumatoid arthritis, systemic lupus erythematous (SLE) and diabetes makes them immensely valuable. The immunomodulatory and anti-inflammatory properties aid its usage in auto immune diseases and graft versus host disease. However, the differentiation, immunomodulatory and anti-inflammatory effects of GMSCs in periodontal tissue regeneration are less explored. METHODS: In this review article, we have comprehensively compiled and described several reports on GMSCs till date, including their basic properties and isolation protocols, subpopulations, spheroid GMSCs, gingiva-derived IPSCsinduced pluripotent stem cells (iPSCs), their characterization, multilineage differentiation, and immunomodulatory properties along with precise applications in periodontal regeneration and peri-implantitis. RESULTS AND CONCLUSION: Though the studies on GMSCs in periodontal regeneration lack superior quality random clinical trials, this review article still strengthens the view that GMSCs can be a newer source in periodontal tissue reconstruction/regeneration.

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates.This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child’s age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3–9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall–Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

Methods: Twenty-one patients who underwent surgery for AVH between 2009 and 2018 were analyzed. Demographic and clinical details of patients were retrieved from hospital information system. Imaging information (i.e., radiography, computed tomography, magnetic resonance imaging) of all patients was accessed and analyzed in picture archiving and communication system. Tumor staging was performed using Enneking and Weinstein–Boriani–Biagini classifications and Spinal Instability Neoplastic Score. At followup, neurological and radiological evaluations were performed. Results: Twenty-one patients (13 [61.9%] females and 8 [38.1%] males) were included with a mean age of 44.29 years (range, 14–72 years). All patients in the study had neurological deficit. Back pain was present in 80.9% of patients. Mean duration of symptoms was 4.6 months (range, 1 day to 10 months). Most common lesion location was thoracic spine (n=12), followed by thoracolumbar (D11– L2; n=7) and lumbar (n=2) regions. Ten patients had multiple level lesions. All patients underwent preoperative embolization. Nine patients underwent intralesional spondylectomy with reconstruction; another nine patients underwent stabilization, decompression, and vertebroplasty; three patients underwent decompression and stabilization. Neurology improved in all patients, and only one case of recurrence was noted in a mean follow-up of 55.78±25 months (range, 24–96 months). Conclusions In AVH, good clinical and neurological outcomes with low recurrence rates can be achieved using less extensive procedures, such as posterior instrumented decompression with vertebroplasty and intralesional tumor resection.

Methods: Forty NP tissues were snap-frozen in liquid nitrogen (–196°C) immediately before being subjected to proteomic and bioinformatic analyses from five different disk phenotypes (eight each). Results: Tandem mass spectrometric analysis revealed a total of 1,050 proteins in FDs, 1,809 in ND, 1,487 in SD, 1,859 in DH, and 1,538 in the DD group. Of 28 major collagens reported in the human body, this study identified 24 different collagens with 34 subtypes in NP. Fibril-forming collagens (COL-1, 2, and 11A1) and fibril-associated collagens with interrupted triple helices (COL-9A1, 12A1, and 14A1) were abundantly expressed in FDs, representing their role in the development of NP. Multiplexin (COL-15), a hybrid proteoglycan–collagen molecule, was discovered only in FDs. Degeneration was associated with COL2A1 downregulation and COL-10A1 upregulation. Conclusions COL10 was discovered to be a new biomarker for disk degeneration. Besides COL-1 and 2, other important COLs (6, 9, 11, 12, 14, 15) with anabolic potential and abundant expression in the fetal phenotype could be investigated for tissue engineering and novel DDD therapy.

PURPOSE: Intramedullary interlocking nailing is one of the accepted methods of treating humerus diaphyseal fractures. Appropriate nail length and diameter are of paramount importance to achieve a stable fracture fixation. Estimating the nail length can be as challenging in certain cases as it is important. This study aims to provide an easy-to-use formula utilizing clinical measurements from contra lateral arm to accurately estimate humeral nail length. METHODS: This descriptive cross-sectional study was conducted at 3 tertiary care hospitals in Mangalore, India. Patients above the age of 18 years coming to the outpatient department with elbow, shoulder or arm complaints requiring radiological investigation from July 2021 to July 2022 were included. Patients with fractures or dislocations of upper limbs, malunited or non-united fractures of upper limbs, congenital or developmental deformities and patients with open growth plates were excluded. Patients' variables (like age and gender), radiological humerus length and contralateral arm clinical measurements were recorded. An independent samples t-test was used for univariate analysis, and linear regression analysis was done to estimate the desired nail length using the clinical measurement of the humerus (cm) in both genders separately. The significance level was set at p < 0.05. RESULTS: Our study included 204 participants of which 108 were male and 96 were female. The formula for predicting humeral nail length in males is (-2.029) + (0.883 × clinical measurement). The formula for females is 1.862 + (0.741 × clinical measurement). A simplified formula to determine humeral nail length is 0.9 clinical length - 2 cm (in males) and 0.7 × clinical length + 2 cm (in females). CONCLUSION To improve the stability of fixation with intramedullary nails it is imperative to select the appropriate nail length. There have been studies that devised reliable methods of determining nail lengths in the tibia and femur using preoperative clinical measurements. A similar clinical method of determining humeral nail length is lacking in the literature. Our study was able to correlate radiological lengths of the humerus medullary canal with clinical measurements performed using anatomical landmarks to arrive at a formula. This allows for a reliable and easy nail length determination preoperatively.
Humans ; Male ; Female ; Adolescent ; Cross-Sectional Studies ; Bone Nails ; Humerus/surgery* ; Fracture Fixation, Intramedullary/methods* ; Humeral Fractures/surgery* ; Treatment Outcome