1.Assessment of Clinical Outcomes and Pain Management of Single-Level Lumbar Laminectomy Between Unilateral Biportal Endoscopic, Tubular, and Open Approaches
Samuel EZEONU ; Nicholas VOLLANO ; Alyssa CAPASSO ; Juan RODRIGUEZ-RIVERA ; Constance MAGLARAS ; Tina RAMAN ; Yong H. KIM ; Charla R. FISCHER
Journal of Minimally Invasive Spine Surgery and Technique 2024;9(2):94-101
Objective:
While minimally invasive surgical procedures have been shown to reduce postoperative pain and recovery time compared to an open surgical approach, few studies have also compared pain management, particularly involving the use of unilateral biportal endoscopy (UBE).
Methods:
Patients who underwent single-level laminectomy through a UBE, open, or tubular technique were chart-reviewed for up to 90 days for perioperative outcomes, including opioid and nonopioid utilization. The chi-square test and analysis of variance were used to analyze differences in characteristics and outcomes between groups. The post hoc Tukey test and multinomial regression were conducted when significance was found in initial tests.
Results:
In total, 184 patients were included in the study (110 open, 44 tubular, 30 UBE). The UBE patients were the oldest. Post hoc analysis showed that UBE and tubular patients had significantly lower blood loss than the open group (p<0.05). Moreover, UBE surgery was associated with significantly longer operative times than both tubular and open surgery (p<0.05). No significant differences were observed in complications, 90-day readmissions, or return to the operating room. Postdischarge, patients in the open and tubular groups had higher rates of acetaminophen and cyclobenzaprine prescriptions, respectively, than the UBE group (p<0.05). Postoperative opioid use at 2 weeks significantly differed among groups. When controlling for age and preoperative opioid use, multivariate regression revealed that patients who underwent decompression by UBE had lower odds of postdischarge opioid use at 2 weeks than the open group (53.20% vs. 21.70%; odds ratio [OR], 0.267; 95% confidence interval [CI], 0.09–0.79; p=0.017) and the tubular group (50.0% vs. 21.70%; OR, 0.268; 95% CI, 0.08–0.91; p=0.038). No statistically significant between-group differences were observed for ongoing opioid use at the 6-week and 3-month time points.
Conclusions
Patients who underwent UBE had significantly lower odds of postdischarge narcotic use at 2-week follow-up than those undergoing the open and tubular approaches.
2.Wear resistance of indirect composite resins used for provisional restorations supported by implants
Akimasa TSUJIMOTO ; Carlos JURADO ; Jose VILLALOBOS-TINOCO ; Wayne BARKMEIER ; Nicholas FISCHER ; Toshiki TAKAMIZAWA ; Mark LATTA ; Masashi MIYAZAKI
The Journal of Advanced Prosthodontics 2019;11(4):232-238
PURPOSE: The aim of this study was to investigate simulated localized and generalized wear of indirect composite resins used for implant supported provisional restorations. MATERIALS AND METHODS: The study investigated ten indirect composite resins. Two kinds of wear were simulated by 400,000 cycles in a Leinfelder-Suzuki (Alabama) machine. Localized wear was simulated with a stainless-steel ball bearing antagonist and generalized with a flat-ended stainless-steel cylinder antagonist. The tests were carried out in water slurry of polymethyl methacrylate beads. Wear was measured using a Proscan 2100 noncontact profilometer in conjunction with Proscan and AnSur 3D software. RESULTS: Both localized and generalized wear were significantly different (P<.05) among the indirect composite resins. SR Nexco and Gradia Plus showed significantly less wear than the other indirect composite resins. The rank order of wear was same in both types of wear simulation. CONCLUSION: Indirect composite resins are recommended when a provisional implant-supported restoration is required to function in place over a long period. Although only some indirect composite resins showed similar wear resistance to CAD/CAM composite resins, the wear resistance of all the indirect composite resins was higher than that of bis-acryl base provisional and polymethyl methacrylate resins.
Composite Resins
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Dental Prosthesis
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Dental Restoration Wear
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Polymethyl Methacrylate
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Water

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