Nineteen consecutive patients undergoing anterior cruciate ligament reconstruction using the central third of the ipsilateral patellar tendon were included in the study. Serial magnetic resonance images revealed that the donor-site gap in the tendon decreased with time (mean follow-up, 26 months). The thickness was significantly increased compared with the intact contralateral patellar tendon, regardless of when the magnetic resonance imaging was performed. Ultrasonography showed the same findings at a mean follow-up of 26 months. Histologic evaluation of the repair tissue in the central part of the tendon, as well as the tissue in the peripheral part of the patellar tendon at the donor site, revealed a significant increase in cellularity and vascularity as compared with normal control tendons. Thus, 2 years after the harvesting procedure, the patellar tendon displayed significant radiographic and histologic abnormalities. On the basis of these findings, reharvest of the patellar tendon, at least up to 2 years after primary harvest, cannot be recommended.
In general, adult orthodontic patients were satisfied with the process of treatment, and good communication played a major part in this. Despite the differences in working models in the public and private sectors, many similarities arose when comparing the factors between the 2 sites.
After a minimum 10 years of follow-up, the surgical treatment of SAIS appears to render better clinical results than physical therapy alone. No significant differences were found among the groups in terms of the presence of full-thickness rotator cuff ruptures and OA.
It is previously known that the patellar tendon does not normalise histologically in the short term after harvesting its central third. The aim of the study was to obtain long-term serial biopsies from the central and peripheral parts of the patellar tendon after the harvesting procedure. Our hypothesis was that in the long term after harvesting its central third, the patellar tendon does not regain normal histological appearance. Seventeen consecutive patients, who had undergone anterior cruciate ligament reconstruction using patellar tendon autografts, were included. Percutaneous biopsies were obtained under ultrasonographic guidance 27 (24-29) months and 71 (68-73) months after the index procedure, respectively. The sections were stained with haematoxylin and eosin. The biopsies were evaluated using light microscope. Both at 27 months and 71 months, the fibre structure was deteriorated and the vascularity and cellularity were increased compared with normal tendon. This was seen in both the central and peripheral parts of the tendon. In conclusion, nearly 6 years after harvesting its central third, the patellar tendon had still not normalised histologically, neither in the central nor peripheral parts of the tendon.
The growth in adult orthodontics presents new challenges to both the general dental practitioner and the orthodontist. Although many of the main objectives of orthodontic treatment are similar for adults, young adults and children, adult patients frequently bring significant challenges in several areas not often seen in the younger patient group. In areas such as planning realistic treatment outcomes, it is paramount that the patient's expectations are identified, respected and managed where appropriate. The adult patient's dental health often dictates deviation from the ideal treatment plan and periodontal problems are a common example. Based on current evidence, this paper presents an overview of some of the difficulties in the management of these issues, as well as highlighting developments with regard to pain conditions and their relevance to orthodontic treatment and its effects on temporomandibular joint disorders (TMD) management.
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