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\"By presenting chapter-specific roadmaps, this book offers a behind-the-scenes chronology of the response to COVID-19 and provides a rubric for future pandemic response. Targeted at lay and scientific audiences, reflections and lessons learned grant the reader an opportunity to leverage this knowledge and improve the outcomes of future pandemics\"-- Provided by publisher.

This study evaluated the clinical, radiographic, and histological outcomes of alveolar ridge preservation (ARP) using collagen sponge with xenografts (CS + Xenografts) versus collagen sponge (CS) alone, compared to spontaneous healing. 36 extraction sockets were randomly allocated into three groups: Group I (CS + Xenografts), Group II (CS alone), and Group III (control) spontaneous healing. Soft tissue assessment and CBCT imaging were conducted before tooth extraction (baseline) and 6 months post-extraction, followed by histologic and histomorphometric analysis of bone biopsies. Groups I and II exhibited minimal vertical and horizontal soft tissue changes compared to the control group (P < 0.001), with no statistically significant difference between Group I and II (P ≥ 0.05). Vertical and horizontal bone resorption was significantly lower in Groups I and II than in the control group (P < 0.001), with no statistically significant difference between Groups I and II regarding vertical bone loss (P = 0.477 and 0.108, respectively); percent of changes were 8.68 ± 2.69 and 8.61 ± 2.14 respectively. The greatest reduction in alveolar bone width was observed at 1 mm: 17.81 ± 3.97 (Group I), 19 ± 2.77 (Group II), and 41.79 ± 10.3 (Group III); overall P < 0.001. Histologically, Group I had the highest area% of lamellar bone and no residual inflammation, followed by Group II, which showed more inflammation; Group III had the lowest area% of lamellar bone. Intervention techniques were clinically and radiographically proven effective in ARP, however, CS + Xenografts histological results showed more lamellar bone and less residual inflammations.

Previous findings indicated that the laser photobiomodulation is more effective than the control or placebo in preserving the alveolar socket. This study aimed to compare two different lasers regarding their effectiveness in aiding alveolar socket preservation. Twenty extraction sockets were selected then divided into two equal groups. Group A was exposed to 650 nm Diode laser, and Group B to 810 nm Diode laser following the same protocol and parameters after a standard alveolar socket preservation procedure with collagen plug. Radiographic analysis with cone beam computed tomography was done to compare the alveolar bone surface area immediately after extraction and three months post-operatively, while bone samples collected before implant drilling were histologically examined for newly formed bone evaluation and histomorphometric analysis in terms of percentage of new bone surface area, percentage of unmineralized bone and finally, immunohistochemical analysis of Osteocalcin reaction surface area as well as optical density. Radiographically, infrared (810 nm) Diode effect on alveolar bone surface area has significantly exceeded the red laser, while histologically, red (650 nm) Diode has demonstrated statistical significance regarding all parameters; newly formed bone surface area percentage, unmineralized bone area percentage and finally Osteocalcin bone marker reaction surface area percentage and optical density. Under the specified conditions and laser parameters, photobiomodulation using the 810 nm Diode got the upper hand radiographically, yet histologically, the red 650 nm Diode managed to dominate all histological parameters when both employed as an adjunct to alveolar socket preservation procedures.

The necessity of routinely placing closed suction wound drainage in spinal surgery has been questioned. This study aims to assess if closed suction wound drainage is necessary for posterior atlantoaxial fixation via intermuscular approach. The functional outcomes of these 40 patients who underwent posterior atlantoaxial fixation via intermuscular approach without drainage tube (Group A) were compared with that of a control group, which consisted of 68 randomly enrolled cases with posterior atlantoaxial fixation via intermuscular approach with drainage tube (Group B). Outcome assessments included American Spinal Injury Association (ASIA) scoring grade and Visual Analog Scale Score for Neck Pain (VASSNP). The postoperative analgesic consumption, the incidence of subcutaneous and surrounding ecchymosis and the time of ambulation were compared between two groups. Bone fusion was evaluated through computed tomography (CT) reconstruction. Postoperative paravertebral tissue edema was evaluated by the edema coefficient. The use of drainage tube had no significant influence on the postoperative analgesic consumption, wound ecchymosis, the time of ambulation and paravertebral tissue edema ( P  > 0.05). There were no statistically significant differences in the VASSNP and bone fusion rates during the follow-up period between the two groups ( P  > 0.05). All patients achieved ASIA grade E 3 months after surgery. No complications such as wound infection occurred in either group. Posterior atlantoaxial fixation via intermuscular approach does not necessitate postoperative drainage tube placement if there is no accidental vascular injury or excessive muscle bleeding occurs intraoperatively.

Background Kirschner wire tension band (KWTB) and anatomical plate fixation are the most often used procedures for treating Mayo type II olecranon Fractures, each has its technological advantages. However, there are often some associated complications with single use, the combination of Kirschner-wire tension band reduction and locking plate fixation in treating Mayo type II olecranon fractures has been seldom recorded. This research aims to compare the efficacy of KWTB alone and KWTB combined with anatomical locking plate (ALP) in the treatment of Mayo type II olecranon fractures. Methods Clinical data from 72 individuals who had surgery for Mayo type II olecranon fractures between January 2020 and December 2022 were evaluated retrospectively. Patients were randomized to either KWTB ( n  = 37, 19 males and 18 females; range 36 to 75 years; mean age 49.12 ± 9.51 years) or KWTB + ALP ( n  = 35, 16 males and 19 females; range 37 to 75 years; mean age 50.07 ± 9.45 years). Data including operative duration, intraoperative bleeding, incision length, hospital stay, postoperative complications, and the time to return to work, fracture union time, and follow-up time were documented. Their Disabilities of the Arm, Shoulder and Hand (DASH), Mayo elbow performance score and elbow range of motion (ROM) measures were utilized for functional assessments. Results The mean follow-up time was 28.03 ± 8.14 months, there were no statistical differences in general characteristics, intraoperative blood loss and length of incision between the two groups ( P  > 0. 05).The operative duration of KWTB + ALP group was greater than that of KWTB group ( P  < 0. 05). The average stay in the hospital was 8. 80 ± 2. 62 in the KWTB group and 6. 94 ± 3. 82 in the KWTB + ALP group ( P  = 0.0181). Patients come back to work in 9.6 ± 3.4 weeks in the KWTB group and 7.8 ± 2.7 weeks in the KWTB + ALP group ( P  = 0.0156). The rate of complications was considerably greater in the KWTB group (24.3% compared with 5.8%; P  = 0.0283). The fracture union time was 15.36 ± 3.44 in the KWBT group and 12.28 ± 3.42 in the KWTB + ALP group ( P  = 0.003). The mean flexion-extension ROM values and pronation-supination ROM values showed no statistical difference between the two groups. The mean DASH score was 14.0 ± 2.8 in the KWTB group and 10.7 ± 3.2 in the KWTB + ALP group ( P  = 0.001). The average Mayo score was 84.0 ± 9.3 in the KWTB group and 88.3 ± 9.1 in the KWTB + ALP group ( P  = 0.0171). Mean Mayo score and mean DASH score were statistically different between the 02 groups. Conclusion Both operative procedures effectively treat Mayo type II olecranon fractures. Despite the fact that KWTB therapy is inexpensive and simple to administer, there is a high risk of complications associated with it. KWTB combined with ALP in the management of Mayo type II olecranon fracture, especially type IIB olecranon fracture has satisfactory medium and long-term outcome.

This randomized controlled trial evaluated the efficacy of titanium-prepared platelet-rich fibrin (T-PRF) for alveolar ridge preservation (ARP) compared with leukocyte and platelet rich fibrin (L-PRF) and spontaneous healing. Thirty single-rooted teeth requiring extraction were randomly assigned to one of three groups (ARP with T-PRF, ARP with L-PRF, and spontaneous healing) using a flapless, atraumatic extraction approach. Radiographic measurements (bone width, height, and density) were obtained pre-operatively and at four months via OnDemand3D software, and clinical parameters—including post-operative pain, analgesic consumption, soft-tissue healing, periodontal probing depth, gingival recession, and keratinized tissue width—were assessed. At four months, the T-PRF group demonstrated substantially greater preservation of ridge dimensions ( P  = 0.000), and higher bone density ( P  = 0.000), along with improved soft-tissue healing ( P  < 0.05), lower pain scores ( P  = 0.000), and reduced analgesic use ( P  < 0.05). Periodontal parameters remained stable across the groups, except for keratinized tissue width (KTW), which was substantially greater in the T-PRF group ( P  = 0.020). There were substantial differences among the groups in the need for bone regeneration when implants were placed ( P  < 0.05). These findings support the clinical advantage of T-PRF in optimizing post-extraction outcomes for implant site development. This trial was registered in the UK’s Clinical Study Registry ISRCTN (ISRCTN60191547).

Objectives To assess and compare the clinical, radiological, and histological outcomes of socket seal surgery between two protocols: deproteinized demineralized tooth matrix (dpDTM) and freeze-dried bone allograft (FDBA) each covered with a free gingival graft. Materials and methods Twenty extraction sockets in the anterior or premolar region were randomly allocated to either the dpDTM or FDBA protocol ( n  = 10 per group). Measurements of the alveolar ridge changes were obtained using an intraoral scanner and cone-beam computed tomography at 3 months post-operation. Three-month post surgery, the dental implant was installed ( n  = 5 per group), bone biopsies were obtained for histomorphometrical and micro-computed tomography analyses. Implant stability quotients (ISQs) were determined and compared at 3 months post-implant. Results Lower significant reductions in buccal alveolar ridge height and hard tissue volume were observed in dpDTM group compared to FDBA group at 3 months (0.25 ± 0.35 mm vs. 1.60 ± 0.66 mm [ p  = .000] and 9.64 ± 15.39% mm 3 vs. 31.45 ± 18.11% mm 3 [ p  = .010], respectively). At the same time, lower soft tissue volume reduction was detected in the dpDTM group compared to FDBA group (4.21 ± 5.25% mm 3 vs. 5.25 ± 5.79% mm 3 ). No statistically significant difference in the percentage of mineralized tissue formation was found between dpDTM group (53.39 ± 11.16%) and FDBA group (49.90 ± 3.27%). Even though the ISQ in the dpDTM group showed a higher value than the FDBA group at 3 months post-implant, the results were without statistical significance. Conclusions Alveolar ridge preservation using dpDTM is an efficacious procedure for providing the conditions for the development of functional and esthetic implants.

Background It is common to see patients who need orthodontic treatment but with insufficient alveolar bone volume. However, safe and effective tooth movement requires sufficient alveolar bone width and height. The aim of this study is to compare the bone augmentation efficacy of Autologous Partially Demineralized Dentin Matrix (APDDM) and Deproteinized Bovine Bone Mineral (DBBM) in orthodontic patients with insufficient bone by using a randomized controlled clinical trial approach. Materials and methods Twenty-seven orthodontic patients involving 40 posterior teeth alveolar sites ( n  = 40) with insufficient alveolar bone volume were randomly divided into a control group ( n  = 20) and an experimental group ( n  = 20). The patients in the experimental group were treated with APDDM, and those in the control group were treated with DBBM. After surgery, the adjacent teeth are moved toward the bone grafting sites according to the orthodontic treatment plan. Patients completed a postoperative response questionnaire by the Visual Analogue Scale (VAS) score to indicate pain and swelling in the bone grafted area at the time of suture removal; and CBCT scans were conducted before surgery, 6 months and 2 years after surgery to assess changes in buccal and central alveolar heights, as well as widths at the alveolar ridge apex and 3 mm, 5 mm below the apex, respectively. The CBCT image sequences were imported into Mimics 21.0 software in DICOM format. The data of the patients in both groups were collected and analyzed by SPSS 25.0. Results The VAS scores were significantly lower in the APDDM group than in the DBBM group ( p  < 0.05). Significant increases were observed in alveolar bone height and width at 6 months and 2 years postoperative ( p  < 0.05); At 2 years, the APDDM group exhibited a reduction in buccal crest height and in 3 mm, 5 mm width below alveolar ridge apex, relative to 6 months ( p  < 0.05), while the DBBM group showed a decrease only in the central height of the alveolar bone ( p  < 0.05). There was a significant bone augmentation increase found only 3 mm below the alveolar ridge apex in the APDDM group compared with the DBBM group among all 6 months group comparison ( p  < 0.05). At 2 years, the augmentation effects were similar across both groups ( p  > 0.05). Conclusion Radiomics analysis indicates that APDDM serves as a viable bone augmentation material for orthodontic patients with insufficient alveolar bone volume, achieving comparable clinical efficacy to DBBM. Additionally, APDDM is associated with a milder postoperative response than DBBM. The registration number (TRN) ChiCTR2400084607.

Objective To investigate the clinical effect of concentrated growth factors (CGF) combined with deproteinized bovine bone mineral (DBBM) on Alveolar ridge preservation during implantology. Methods A total of 38 patients were selected and randomly divided into 2 groups, with 19 cases in each group. The extraction sockets were filled with DBBM with or without CGF. Visual analogue scale (VAS) pain score was recorded within1 week and Landry wound healing index (LWHI) was recorded at 1, 2 and 3 weeks after operation. CBCT was taken preoperatively and 3 and 6 months postoperatively to measure and compare the changes of vertical height, width and gray value of alveolar bone at extraction site. The changes of alveolar bone contour were observed clinically and compared between the two groups. Results The VAS score of CGF group was lower than control group on the 1st and 3rd day after operation ( P  < 0.05). The LWHI of CGF group was higher than control group 1 week after operation ( P  < 0.05). The absorption of the labial and palatal plates height and the width in the CGF group was significantly less than the control group at 3 months ( P  < 0.05). The gray value of alveolar bone in CGF group was significantly higher than control group at 3 months ( P  < 0.05). There was no significant difference in new bone contour between the two groups ( P  > 0.05). 94.7% cases in CGF group did not undergo bone grafting, which was significantly higher than control group (78.9%). Conclusions The use of CGF combined with DBBM can help to reduce postoperative pain at the early stage of healing, form sufficient keratinized gingival tissue, effectively maintain the height and width of alveolar bone in the three-dimensional direction and provide good conditions for implant repair in the future.

Background Optimal positioning of orthodontic mini-implants is essential for a successful treatment with skeletal anchorage. This study aims to compare the accuracy of two-dimensional radiographs with a cone beam computed tomography (CBCT) for mini-implant placement. Methods An ideal site for mini-implant placement at the buccal interradicular space between the second premolar and the first molar was determined for 40 sites (in 13 patients aged 14 to 28 years) by using CBCT data. The mini-implant placement procedure was then divided into two groups. In CBCT group, mini-implants were placed at the sites determined from CBCT data. In RVG group, mini-implants were placed with the help of two-dimensional digital radiographs and a custom made guide. Postplacement CBCT scans were obtained to determine the accuracy of the mini-implant placement. The results were statistically analyzed with a Mann-Whitney test. Results A statistically significant difference ( p value = 0.02) was observed between the two groups for deviation from an ideal height of placement of the mini-implants. Deviations in mesiodistal positioning and angular deviation showed a statistically non-significant difference. Three out of twenty mini-implants in the RVG group showed root contact in the mandibular arch that may be attributed to the narrower interradicular space and reduced accessibility in the mandibular posterior region. Conclusions Although CBCT provides an accurate three-dimensional visualization of the interradicular space, the two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement. Considering the amount of radiation exposure and cost with the two techniques, it is recommended to use two-dimensional radiographs with a surgical guide for a routine mini-implant placement.