The use of topical corticoid (MF) in the preoperative period can improve endoscopic vision, reduce bleeding, and decrease operation time in CRS patients with and without polyps undergoing ESS, but our sample size cannot exclude small, and possibly trivial, group differences.
The aim of this study is to systemically review the available evidence on the in vivo behavior of eggshell as a guided bone regeneration substitute material. Five databases (PubMed, Cochrane, Web of Science, Scopus, EMBASE) were searched up to October 2020. In vivo animal studies with a bone defect model using eggshell as a grafting material were included. Risk of bias was assessed using SYRCLE tool and the quality assessment using the ARRIVE guidelines. Overall, a total of 581 studies were included in the study, 187 after duplicate removal. Using the inclusion and exclusion criteria 167 records were further excluded. The full text of the remaining 20 articles was assessed for eligibility and included in the qualitative and quantitative assessment synthesis. There were different methods of obtaining eggshell grafting materials. Eggshell is a biocompatible grafting material, with osteoconduction proprieties. It forms new bone similar to Bio-Oss and demineralized freeze-dried bone matrix. It can be combined with other materials to enhance its proprieties. Due to the high variability of the procedures, animals, production and assessment methods, no meta-analysis could be performed. Eggshell might be considered a promising biomaterial to be used in bone grafting procedures, though further research is needed.
The aim of this study was to evaluate the microscopic structure of soft tissue covering titanium plates and screws used in jaw surgery (mandible fracture and orthognathic surgery), after a minimum period of 12 months from insertion, and to quantify the presence of any metallic particles. Periosteum covering the osteosynthesis plates was removed from 20 patients and examined by light microscopy in order to assess the cell morphological changes and the possibility of metal particles presence in the soft tissue. Local signs of tissue toxicity or inflammation were taken into consideration when evaluating the routine removal of titanium maxillofacial miniplates. No signs of screw loosening or acute inflammation were detected on the osteosynthesis site, but de-coloration of the periosteum was seen, and metallic particles were observed to have migrated into the soft tissues. Even if the titanium is well-tolerated by the human body in time, without severe local or general complications, our findings suggest that plate removal should be considered after bone healing has occurred.
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