Sternal wound dehiscence after cardiac surgery is usually accompanied by a high morbidity and mortality rate. When sternal rewiring fails, rigid fixation systems may be used for sternal reconstruction. We report a case involving a female patient with multiple risk factors for sternal dehiscence who underwent a coronary artery bypass graft procedure.Postoperatively, she experienced sternal dehiscence that necessitated primary rewiring.Despite the surgical intervention and clinical optimization, the sternal wound dehiscence recurred. The patient experienced severe chest pain and thoracic instability, presenting with complete non-union of the sternal segments and right ventricular protrusion. Given the symptoms and the risk of both direct and indirect trauma to the heart, the multidisciplinary team opted to reinforce the anterior chest wall with a pre-planned titanium prosthesis to provide protection and stability. This report highlights the advantages of a comprehensive strategy for managing repeated sternal dehiscence.

Sternal wound dehiscence after cardiac surgery is usually accompanied by a high morbidity and mortality rate. When sternal rewiring fails, rigid fixation systems may be used for sternal reconstruction. We report a case involving a female patient with multiple risk factors for sternal dehiscence who underwent a coronary artery bypass graft procedure.Postoperatively, she experienced sternal dehiscence that necessitated primary rewiring.Despite the surgical intervention and clinical optimization, the sternal wound dehiscence recurred. The patient experienced severe chest pain and thoracic instability, presenting with complete non-union of the sternal segments and right ventricular protrusion. Given the symptoms and the risk of both direct and indirect trauma to the heart, the multidisciplinary team opted to reinforce the anterior chest wall with a pre-planned titanium prosthesis to provide protection and stability. This report highlights the advantages of a comprehensive strategy for managing repeated sternal dehiscence.

Sternal wound dehiscence after cardiac surgery is usually accompanied by a high morbidity and mortality rate. When sternal rewiring fails, rigid fixation systems may be used for sternal reconstruction. We report a case involving a female patient with multiple risk factors for sternal dehiscence who underwent a coronary artery bypass graft procedure.Postoperatively, she experienced sternal dehiscence that necessitated primary rewiring.Despite the surgical intervention and clinical optimization, the sternal wound dehiscence recurred. The patient experienced severe chest pain and thoracic instability, presenting with complete non-union of the sternal segments and right ventricular protrusion. Given the symptoms and the risk of both direct and indirect trauma to the heart, the multidisciplinary team opted to reinforce the anterior chest wall with a pre-planned titanium prosthesis to provide protection and stability. This report highlights the advantages of a comprehensive strategy for managing repeated sternal dehiscence.

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2 ) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of “oximetry” AND “dental pulp test” were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%–85.04%) for the central incisors, 89.29% (95% CI, 89.22%– 89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%–89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2 ) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of “oximetry” AND “dental pulp test” were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%–85.04%) for the central incisors, 89.29% (95% CI, 89.22%– 89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%–89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.