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Positional skull deformities have been on the rise for decades and can be treated with molding helmets in early childhood. Parents often fear later cosmetic stigmatization, but also a reduced quality of life (QoL) during treatment. The aim of this study was to examine therapy results in our patient collection from a new perspective. Cranial vault asymmetry (CVA), cranial vault asymmetry index (CVAI), and cranial index (CI) were compared before and after molding helmet therapy. Correction was defined by a decrease in CVA <3.5 mm and CI <90%. Subjective therapy outcome, side effects and QoL from the parents' perspective were determined using a questionnaire. There were 25 patients included. Differences between pretherapeutic and posttherapeutic CVA, CVAI, and CI were significant ( P <0.01). An objective correction according to the defined values was observed in only 12% of cases. However, 76% of parents stated that their child's skull shape was normal after therapy. There were 60 side effects reported in 23 cases. The QoL of 21 children was assessed as unimpaired during helmet therapy. Even though complete normalization was rarely observed, the parameters were significantly different after therapy, and subjective reduction in skull deformity was common., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.)

Introduction: The use of autologous block bone grafts for horizontal alveolar ridge augmentation in dental implantology is a common surgical procedure. Typically, bone grafts are individually moulded., Objective: The aim of this paper is to introduce an innovative procedure in lateral bone augmentation, where the recipient side is adjusted to the graft, not vice versa as in common procedures. Our initial clinical experience of twenty-five consecutive cases is presented., Materials and Methods: Adjusted trephine drills were used to harvest partly cylindrical grafts from the retromolar region of the mandible. After preparing the recipient site with accurately fitting grinding drills, the bone grafts were transplanted., Results: The horizontally compromised alveolar ridges were successfully augmented and treated with dental implants. No major complication occurred during transplantation, the healing period, and subsequent implant therapy in our experimental setting with 25 patients and 38 augmentation procedures. One out of twenty-five patients presented with temporary dysaesthesia of the inferior alveolar nerve., Conclusion: The new method presented is an effective treatment option for horizontal alveolar ridge augmentation prior to single implant installation. Further studies should evaluate the donor site morbidity and long-term outcome on a larger population., (Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

In patients with bony defects, autologous bone grafts are the "gold standard" for reconstruction. In children, autologous bone harvesting is limited but tissue engineering offers an alternative. Next to bone marrow, adipose tissue is a source of mesenchymal stromal cells, and adipose-derived stromal cells (ADSC) can differentiate into osteocytes. The aim of this study was to evaluate the efficacy of bioactive implants (ADSC in fibrin glue) for repair of critical-size mandibular defects in athymic rats. Human adult ADSC embedded in fibrin glue were implanted into a critical-size defect in the rat mandible and their efficacy was compared to those of protected bone healing (pbh), autologous bone graft, and an empty defect. The newly formed bone was quantified using high-resolution flat-panel volumetric CT (fpvCT) during different observation times. After eight weeks, the specimens were assessed histologically and by micro-computed tomography (μ-CT). The radiographic examination demonstrated a significantly higher level of ossified defect area in the ADSC side compared with the pbh side. The autologous bone graft side showed significantly enhanced bone formation compared to the empty defect. The histological findings in the specimens with ADSC showed bony bridging of the defect. ADSC were capable of defect reconstruction under our experimental conditions., (Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Micro-gaps and osseous overload in the implant-abutment connection are the most common causes of peri-implant bone resorption and implant failure. These undesirable events can be visualized on standardized three-dimensional finite element models and by radiographic methods. The present study investigated the influence of 7 available implant systems (Ankylos, Astra, Bego, Brånemark, Camlog, Straumann, and Xive) with different implant-abutment connections on bone overload and the appearance of micro-gaps in vitro. The individual geometries of the implants were transferred to three-dimensional finite element models. In a non-linear analysis considering the pre-loading of the occlusion screw, friction between the implant and abutment, the influence of the cone angle on bone strain, and the appearance of micro-gaps were determined. Increased bone strains were correlated with small (< 15°) cone angles. Conical implant-abutment connections efficiently avoided micro-gaps but had a negative effect on peri-implant bone strain. Bone strain was reduced in implants with greater wall thickness (Ankylos) or a smaller cone angle (Bego). The results of our in silico study provide a solid basis for the reduction of peri-implant bone strain and micro-gaps in the implant-abutment connection to improve long-term stability.

Objective: Helmet therapy is an established method to correct positional head deformity in early infancy. Side effects such as skin erythema or pressure sores are well known for helmet therapy, but not yet adequately discussed in current literature., Patients and Methods: Retrospectively, all patient-sheets of infants treated by individual orthotic therapy in the years 2007 and 2008 were sighted and complications were noted. Complications were classified and sorted by their frequency and descriptive statistics was performed. The treatment to cure complications was recorded and success in complication control was analysed., Results: Altogether, 410 patients fit the inclusion criteria for this investigation. Complications were apportioned into pressure sores, local ethanol erythema, unsatisfying fit of the helmet or loss of the helmet, skin infection, failed correction of head deformity, and subcutaneous abscess in one case. Non-compliance is to be noticed in a high number, but mainly occurred towards the end of the treatment period., Conclusion: Helmet therapy represents a safe therapeutic tool for the correction of positional cranial deformity. Complications have to be clear in number and severity for parental elucidation. Most complications can easily be avoided or eliminated by proper instruction of the parents., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: Embolia cutis medicamentosa (Nicolau syndrome) is a rare iatrogenic event of tissue necrosis after intramuscular or intraarticular application of cristalloid suspensions. Clinically, it presents as a livid discoloration of the skin, local pain, and signs of inflammation., Methods: This article presents the first case of Nicolau syndrome after the endodontic application of calcium hydroxide paste into the distal root canal of tooth 18. The patient presented to the Department for Maxillofacial Surgery and hospitalized for several days., Results: The application of calcium hydroxide paste led to a thrombosis of the inferior alveolar artery and various branches of the maxillary artery. A definite necrosis of the left-side infraorbital skin area and concomitant hypaesthesia of the infraorbital nerve and of the mental nerve were observed., Conclusions: Calcium hydroxide paste is appropriate for the medicamentous treatment of root canals, but is not suitable to stanch bleeding from periapical arteries., (Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Cranial asymmetries due to nonsynostotic deformation of the skull have been reported with increasing frequency during the last decade. Conservative approaches using helmets and physiotherapy have been shown to be effective in their treatment. Traditionally, documentation has been carried out using anthropometric caliper measurements. The present study evaluates the use of a new three-dimensional photographic system in the improved validation of changes in head deformities. This prospective analysis introduces a new technique for digital anthropometric measurement. The study series comprised 181 children with nonsynostotic head deformities. Three-dimensional photographs were obtained before and after treatment with an orthotic helmet device. The oblique head diagonals and head width and length were measured from three-dimensional photographs using 3dMD customer software. The cranial vault asymmetry index, cranial vault asymmetry, and cranial index were compared before and after treatment. The measurements obtained on three-dimensional images were able to demonstrate significant improvement in early infant cranial deformity after treatment with an orthotic helmet. The cranial vault asymmetry index in plagiocephaly was reduced by 7.16%, and cranial vault asymmetry was reduced by 0.86 cm. The cranial index in brachycephaly decreased by 7.32%. In children with combined plagiocephaly and brachycephaly, the cranial vault asymmetry index improved by 5.77%, cranial vault asymmetry improved by 0.71 cm, whereas the cranial index changed by 5.48%. Three-dimensional photogrammetry can support treatment control in patients with deformational plagiocephaly. This new technology offers several advantages such as easy acquisition of images, detection of landmarks without patient movement, repeatable measurements without patient discomfort, and the opportunity for unbiased evaluation.

Objective: Given the increasing incidence of deformational plagiocephaly due to infants' supine sleeping position to prevent sudden infant death syndrome, reliable anthropometric diagnostics are needed. Besides the traditional method of measuring landmarks with callipers, three-dimensional (3D) photography has great potential. In this investigation the accuracy of 3D photogrammetry is studied., Methods: The study included 100 randomly chosen children between the ages of 4 and 20 months with a non-synostotic cranial deformity in a retrospective analysis. Measurements of diagonals A and B on the infant's head were obtained once using callipers. 3D photographs of these children were measured 5 times by 5 clinicians separately., Results: The inter- and intra-rater agreements of the 3D measurements had low variability in the variance component analysis. The standard deviations for reproducibility and repeatability were 0.117-0.283 cm for diagonals A and B. The intra-class correlation coefficients for the inter-rater reliability resulted in excellent agreement (0.97 for plagiocephaly, 0.98 for brachycephaly, 0.96 for combined deformity). The comparison of the 3D photographic and callipers measurements showed that 3D photography resulted in a slight over-estimation., Conclusion: 3D photogrammetry is potentially a reliable tool for treatment planning and follow-up of abnormal head shapes in infancy.

In maxillofacial surgery, digital photographic documentation plays a crucial role in clinical routine. This paper gives an overview of the evolution from analog to digital in photography and highlights the integration of digital photography into daily medical routine. The digital workflow is described and we show that image quality is improved by systematic use of photographic equipment and post-processing of digital photographs. One of the advantages of digital photography is the possibility of immediate reappraisal of the photographs for alignment, brightness, positioning, and other photographic settings, which aids in avoiding errors and allows the instant repetition of photographs if necessary. Options for avoiding common mistakes in clinical photography are also described and recommendations made for post-processing of pictures, data storage, and data management systems. The new field of 3D digital photography is described in the context of cranial measurements.

Stroke represents one of the leading causes of death and disability in Western countries, but despite intense research, only few options exist for the treatment of stroke-related infarction of brain tissue. In experimental stroke, cell therapy can partly reverse some behavioural deficits. However, the underlying mechanisms have remained unknown as most studies revealed only little, if any, evidence for neuronal replacement and the observed behavioural improvements appeared to be related rather to a graft-derived induction of a positive response in the remaining host tissue than to cell replacement by the graft itself. The present study was performed to test a murine embryonic stem cell (ESC)-based approach in rats subjected to endothelin-induced middle cerebral artery occlusion. Efficacy of cell therapy regarding graft survival, neuronal yield and diversity, and electrophysiological features of the grafted cells were tested after transplanting ESC-derived neural precursors into the infarct core and periphery of adult rats. Here, we show that grafted cells can survive, albeit not entirely, most probably as a consequence of an ongoing immune response, within the infarct core for up to 12 weeks after transplantation and that they differentiate with high yield into immunohistochemically mature glial cells and neurons of diverse neurotransmitter-subtypes. Most importantly, transplanted cells demonstrate characteristics of electrophysiologically functional neurons with voltage-gated sodium currents that enable these cells to fire action potentials. Additionally, during the first 7 weeks after transplantation we observed spontaneous excitatory post-synaptic currents in graft-derived cells indicating synaptic input. Thus, our observations show that ESC-based regenerative approaches may be successful in an acutely necrotic cellular environment.

Background: Plagiocephaly, wherein infants' head exhibits a diagonal asymmetry, is currently diagnosed based on physicians' subjective judgment. Discrepancies between physician and parent perspectives may result in dissatisfaction with treatment outcomes. This problem highlights the need for an objective assessment system aligning with physician-made clinical diagnoses., Methods: Infant heads were modeled using 3-dimensional scanning techniques. We developed a craniofacial asymmetric index (CAI) based on 10 height planes of heads with varying weight. CAI and traditional craniofacial vault asymmetry index (CVAI) of 10 infants undergoing helmet therapy were compared with 11 craniofacial surgeons' judgment. The Pearson correlation coefficient and Bland-Altman plot were used to determine the correlations and agreement between physicians' judgment and the aforementioned assessment methods. The adjusted intraclass correlation coefficient was calculated to evaluate the reliability of between-physician agreement., Results: All 10 infants were divided into the following 3 severity groups: severe, moderate, and mild groups based on craniofacial surgeons' judgment. Notably in CAI, front/back halves of skull and multiangular weighting factors were evaluated. The evaluation revealed perfect alignment in severity classification between the CAI and physicians' judgment, whereas both the CVAI score and MATLAB analysis show varying degrees of difference, 6 and 4 distinct results, respectively. Coefficients of the correlations of physician-assigned scores with the MATLAB analysis, CVAI score, and CAI score were 0.500, 0.833, and 1.000, respectively. Furthermore, Bland-Altman plots revealed the best agreement between CAI and physician-assigned scores., Conclusions: CAI closely aligns with the subjective judgment of craniofacial surgeons' assessing the severity of plagiocephaly in infants., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To determine the mandibular anatomical structures by observing cone-beam computed tomography (CBCT) from multiple angles. Materials and methods: This retrospective study analyzed 1593 consecutive CBCT images. Ultimately, 95 CBCTs met the inclusion criteria. The mandibular, inferior lingual, and bony canals at the tooth apex were studied by multi-angle observation CBCT. Descriptive statistics were used for statistical analysis. Results: It is beneficial to further observe the anastomosis of the mandibular, lingual, and mandibular canals when the course of the mandibular lingual canal is observed on CBCT cross-section. The frequency of the inferior lingual canal anastomosis with the mandibular canal was 43.2% (95% confidence interval (CI) 33, 53.3) in the sample. The mental foramen was located below the long axis of the tooth in a few samples, with an occurrence rate of 29.5% (95% CI 20.1, 38.8). The occurrence rate of various types of the bony canal at the apex of the tooth in canines, first premolars, second premolars, first molars, and second molars under the root apex was recorded through the multi-angle observation of the dental volume reformat (DVR) and three-dimensional (3D) levels in CBCT. Conclusion: This study demonstrates the utility of CBCT imaging in examining mandibular anatomy from multiple angles, providing valuable insights into anatomical variations, and enhancing our understanding of mandibular structures. This research emphasizes the crucial role of meticulous CBCT examination in precisely identifying and understanding key anatomical structures, ultimately reducing the risk of surgical complications. Critical relevance statement: By examining cone-beam computed tomography scans from various perspectives, it is possible to determine the precise position of anatomical structures within the jaw. This allows for a more accurate assessment, reducing the risk of harm to these structures during treatment. Key points: • It is crucial to utilize image data effectively to enhance the comprehension of human anatomy. • We captured detailed images of the mandible from different angles and orientations utilizing cone-beam computed tomography (CBCT). • This study provides essential anatomical information for procedural planning to ensure optimal outcomes and patient safety. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to compare the results of two surgical techniques for the treatment of isolated sagittal synostosis (ISS) by means of 3D stereophotogrammetry. One technique, the Renier's "H" technique (RHT) comprised a biparietal expansion, the other, the total vault remodeling (TVR) included also a frontal remodeling. Methods: The two groups of operated children were compared with a third control group of normocephalic children. The 3D scanning was performed in all children between 12 and 245 months of age. On each 3D image six measurements and indices have been made, with the aim of evaluating not only length and width of the head, but also the height. The cranial index (CI) was measured in a plane parallel to the nasion-tragus plane, at the intersection with the opisthocranion. Results: Each of the three groups (RHT, TVR, control group) included 28 children. The measurements that were influenced by the correction of the frontal bossing, namely the CI and the sagittal length, were closer to normocephaly after TVR than after RHT. Lesser or no statistical difference was documented in the measurements evaluating the biparietal aspect and the height of the vertex, indicating that the biparietal expansion is effective in both procedures. Conclusion: Based on our results TVR results in a better esthetical outcome, particularly in relation to the direct surgical remodeling of the frontal bossing. [ABSTRACT FROM AUTHOR]

An early childhood skull deformity can have long-term health and aesthetic consequences for the growing toddler. Individual helmet therapy aims at a healthy growth of the skull shape, although not every helmet shape guarantees an optimal result. To ensure an optimal fit, a scanning procedure based on a hand-held surface scanner was evaluated. The new helmet orthosis has an inner layer adapted to the shape of the head, which can be exchanged depending on the growth stage without changing the outer layer. In collaboration with surgeons and engineers, a new helmet orthosis concept was developed that is intended to offer improvements in wearing comfort, overall weight, fit and user-friendliness compared to conventional systems. In the course of the development process and in constant exchange with parents, a multi-layer helmet system with generous perforations was created using additive manufacturing processes. The new helmet shape promises easier handling, especially through the closure system. The helmet shape developed in this study is of high quality, especially in terms of fitting accuracy. Unpleasant perspiration is significantly reduced. The integration of the closure as a direct component of the helmet represents a secure closure option. [ABSTRACT FROM AUTHOR]

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Background: Temporal filling is commonly used to correct temporal depression. However, there is a lack of quantitative criteria for pre- and post-operative evaluations. The use of three-dimensional scanning may help improving the success of temporal filling by providing quantitative assessments. The study aimed to compare the results of qualitative morphological evaluation of the temporal region with a quantitative, numerical analysis of the temporal difference value (TDV). Methods: We enrolled twenty-six male and forty-nine female volunteers aged 18 to 29 years. Facial images were acquired in OBJ format using 3dMD facial stereophotography. The morphologies of the temporal regions were separately evaluated by four researchers in the form of two-dimensional (2D) images. Results were classified as either aesthetic or unaesthetic. The quantitative evaluation of the temporal region was then conducted. First, the temporal region was trimmed out from the original 3D image into a new OBJ file. Second, interpolation was used to construct a smooth, adapted surface. Third, a mathematical model of temporal region flatness denoted as the TDV, which was defined as the sum of the Euclidean distances of all 3D points between the constructed surface and the temporal-region OBJ file. The classification of each sample was compared with its TDV to verify the mathematical model's validity. The cutoff threshold and prediction accuracy of this mathematical model were calculated. Results: The cutoff threshold between aesthetic and unaesthetic TDV was found to be 24.66 for males and 28.11 for females. The prediction accuracy rate was 0.73 for men and 0.73 for women. Conclusion: The method has high overlap and good repeatability and minimizes the influence of subjective aesthetics on morphological judgment. TDV has a certain reference value for clinical temporal region evaluation. [ABSTRACT FROM AUTHOR]

The critical requirements in developing clinical-grade human-induced pluripotent stem cells-derived neural precursors (hiPSCs-NPCs) are defined by expandability, genetic stability, predictable in vivo post-grafting differentiation, and acceptable safety profile. Here, we report on the use of manual-selection protocol for generating expandable and stable human NPCs from induced pluripotent stem cells. The hiPSCs were generated by the reprogramming of peripheral blood mononuclear cells with Sendai-virus (SeV) vector encoding Yamanaka factors. After induction of neural rosettes, morphologically defined NPC colonies were manually harvested, re-plated, and expanded for up to 20 passages. Established NPCs showed normal karyotype, expression of typical NPCs markers at the proliferative stage, and ability to generate functional, calcium oscillating GABAergic or glutamatergic neurons after in vitro differentiation. Grafted NPCs into the striatum or spinal cord of immunodeficient rats showed progressive maturation and expression of early and late human-specific neuronal and glial markers at 2 or 6 months post-grafting. No tumor formation was seen in NPCs-grafted brain or spinal cord samples. These data demonstrate the effective use of in vitro manual-selection protocol to generate safe and expandable NPCs from hiPSCs cells. This protocol has the potential to be used to generate GMP (Good Manufacturing Practice)-grade NPCs from hiPSCs for future clinical use. [ABSTRACT FROM AUTHOR]

One of the challenges in clinical translation of cell-replacement therapies is the definition of optimal cell generation and storage/recovery protocols which would permit a rapid preparation of cell-treatment products for patient administration. Besides, the availability of injection devices that are simple to use is critical for potential future dissemination of any spinally targeted cell-replacement therapy into general medical practice. Here, we compared the engraftment properties of established human-induced pluripotent stem cells (hiPSCs)-derived neural precursor cell (NPCs) line once cells were harvested fresh from the cell culture or previously frozen and then grafted into striata or spinal cord of the immunodeficient rat. A newly developed human spinal injection device equipped with a spinal cord pulsation-cancelation magnetic needle was also tested for its safety in an adult immunosuppressed pig. Previously frozen NPCs showed similar post-grafting survival and differentiation profile as was seen for freshly harvested cells. Testing of human injection device showed acceptable safety with no detectable surgical procedure or spinal NPCs injection-related side effects. [ABSTRACT FROM AUTHOR]

Bone healing deficiencies are challenging for orthopedic practice. The use of stem cells with scaffolds to treat bone tissue losses currently is popular for promoting regeneration of tissue. Programmable cells of monocytic origin (PCMO) may differentiate into three germ layers and may be a promising alternative treatment due to their stem cell-like properties. Parathyroid hormone (PTH) participates in bone metabolism. Intermittent administration of PTH promotes osteogenic activity of mesenchymal stem cdells (MSC). We investigated the osteogenic effects of continuous and intermittent administration of PTH on PCMO. Mononuclear cells were harvested from the peripheral blood of healthy donors. Isolated cells were cultured for six days in a de-differentiation medium. Indirect immunocytochemistry using anti-CD14, anti-CD45 and anti-CD90 primary antibodies, as well as electron microscopy were used to detect PCMO. PCMO then were cultured in an osteogenic differentiation medium supplemented with continuous or intermittent 50 ng/ml PTH. The PTH-free control group (CG), intermittent PTH treated group (IPG) and continuous PTH treated group (CPG) were cultured and assessed for their differentiation into osteogenic lineage cells by indirect immunocytochemistry using anti-collagen I, anti-osteonectin and anti-osteocalcin primary antibodies. Osteoblast-like cells obtained by continuous or intermittent PTH administration exhibited increased levels of collagen I, osteonectin and osteocalcin immunoreactivity. We found that continuous and intermittent PTH administration to PCMO enhanced their differentiation to osteogenic lineage cells and increased osteoblastic activity. [ABSTRACT FROM AUTHOR]

Purpose: To determine the bone regeneration potential of a ceramic biomaterial coated with fibronectin and adipose-derived stem cells covered in three-wall critical-size defects associated with dental implants. Materials and Methods: In a total of 18 dogs, four dehiscence-type and critical-size defects were created surgically in the edentulous alveolar ridge with the simultaneous placement of dental implants. Defects were randomly regenerated using biomaterials coated with particulate ß-tricalcium phosphate (ß-TCP), ß-TCP with fibronectin (Fn) (ß-TCP-Fn), and ß-TCP with a combination of Fn and autologous adipose-derived stem cells (ADSCs) (ß-TCP-Fn-ADSCs), leaving one defect as the control. The animals were divided into three groups according to the time of euthanasia (1, 2, or 3 months). Results: Statistically significant differences between the three study groups (ß-TCP, ß-TCP-Fn, ß-TCP-Fn-ADSCs) and the control group in the total area of bone regeneration and mineralized and nonmineralized tissue at 1, 2, and 3 months of healing were not observed. At 2 months, defects treated with ß-TCP-Fn-ADSCs showed a significant decrease in the percentage of bone-to-implant contact (BIC) as compared with the ß-TCP-Fn (P = .041) and control (P = .012) groups. At 3 months of healing, however, significant differences in BIC between the three study groups and controls were not found (P = .388). Conclusion: The use of ADSCs in the bone regeneration processes of dehiscencetype defects associated with simultaneous implant insertion does not seem to improve the area of bone regeneration or the percentage of BIC compared with other biomaterials or the control alveolar defect. [ABSTRACT FROM AUTHOR]

Introduction: Growth monitoring of preterm infants is essential for assessing the nutritional effects on their growth. The current growth monitoring techniques are too stressful, however, for the smallest preterm infants. We performed a systematic review to summarize studies on stress-free techniques for measuring the body size of preterm infants inside incubators other than the traditional calliper and tape measure-based instruments. Methods: We searched four online literature databases: Embase, Medline, Web of Science Core Collection, and Cochrane, using search terms related to patients (neonates, infants, children) and body size measuring techniques. By means of expert judgement we assessed the techniques' suitability for stress-free body size measurement of an infant lying in an incubator. As a criterion for suitability, we used an imaginary ideal technique. Results: Twenty-six studies were included in this review. In 24 studies, the technique for body size measurement was related to 3D technology, and the majority of these studies acknowledged clinical superiority of 3D over 2D data. Two 3D techniques were assessed as suitable for stress-free measurement of preterm infants inside incubators. The first technique used a commercially available 3D handheld scanner which needed 3D postprocessing to derive measurement data. The second technique used a self-developed stereoscopic vision system. Conclusions: 3D volumetric parameters have higher clinical value for growth monitoring than 2D. In addition, contactless 3D measurements enable stress-free growth monitoring of even the smallest preterm infants. However, the time-consuming 3D postprocessing challenges the usability of 3D techniques. Regrettably, none of the identified suitable 3D techniques met all our requirements of an ideal all-in-one body size measuring technique for extreme preterm infants. Handheld 3D scanning might have the best properties for developing this ideal technique. [ABSTRACT FROM AUTHOR]

Alginate capillary hydrogels seeded with differentiated cells can fill the lesion cavity and promote axonal regeneration after grafting into the injured spinal cord. Neural stem/progenitor cells (NSPCs) can potentially repair the spinal cord; however, effects of alginate hydrogels (AHs) on NSPCs remain unknown. In this study, we fabricated AHs cross-linked by Ca2+ and seeded hydrogels with rat embryonic day 14 NSPCs. Immunocytochemistry and electron microscopy show that NSPCs survive, proliferate and differentiate into neurons in vitro within the capillaries. After transplantation into an acute T8 complete spinal cord transection site in adult rats, approximately one-third (38.3%) of grafted cells survive and differentiate into neurons (40.7%), astrocytes (26.6%) and oligodendrocytes (28.4%) at 8 weeks post-grafting. NSPCs promote the growth of host axons within the capillaries in a time-dependent manner. Host axons make synapse-like contacts with NSPC-derived neurons within the hydrogel channels, and graft-derived axons extend into the host white and gray matter making putative synapses. This is paralleled by improved electrophysiological conductivity across the lesion and partial hindlimb locomotor recovery. [ABSTRACT FROM AUTHOR]

Introduction: We sought to compare outcomes and parental satisfaction between 2 approaches for sagittal craniosynostosis: strip craniectomy with spring-mediated skull remodeling (SMSR) and strip craniectomy with postoperative helmet (SCH). Methods: Perioperative and outcome data for SMSR or SCH patients between September 2010 and July 2019 were retrospectively reviewed. A telephone survey was administered to parents of children who underwent both procedures. Results: A total of 62 children were treated for sagittal craniosynostosis by either SMSR (n = 45) or SCH (n = 17). The SCH group had a lower estimated blood loss (27 vs. 47.06 mL, p = 0.021) and age at surgery (13.0 vs. 19.8 weeks) than the SMSR group. Three patients underwent early springs removal due to trauma or dislodgement, all of whom converted to helmeting. Of the 62 children initially identified, 59 were determined to have an adequate follow-up time to assess long-term outcomes. The mean follow-up time was 30.1 months (n = 16) in the SCH group and 32.0 months in the SMSR group (n = 43, p = 0.39). Two patients in the SCH group and one in the SMSR group converted to open cranial vault reconstruction. Thirty parents agreed to respond to the satisfaction survey (8 SCH, 22 SMSR) based on a Likert scale of responses (0 being most dissatisfied possible, 4 most satisfied possible). Average satisfaction was 3.86/4.0 in the SCH group and 3.45/4.0 in the SMSR group. No parents in the SCH group would change to SMSR, while 3 of the 22 SMSR survey responders would have changed to SCH. Conclusions: Perioperative outcomes and average parental satisfaction were similar in both groups. Importance of helmet wear compliance and risk of spring dislodgement should be discussed with parents. [ABSTRACT FROM AUTHOR]

In the late 1980s, craniofacial surgery units reported suboptimal cosmetic results, cranial volume restriction, and intracranial hypertension after anterior cranial vault remodeling in bilateral coronal synostosis associated with severe brachyturricephaly. A possible explanation was a severe associated growth restriction of the posterior calvaria with radiological synostosis at the lambda sutures. "Conventional" or "fixed" posterior cranial vault expansion techniques were developed to address these limitations, sometimes as the first surgical step in a two-staged protocol of total calvarial reconstruction, combined with suboccipital decompression in cases of symptomatic cerebellar tonsillar herniation or, more easily, to resolve the characteristic occipital flattening of lambdoid synostosis. Various surgical approaches have been described; however, the indications for and timing of surgical treatment and postoperative evaluation of results still remain controversial. Although more invasive, conventional posterior cranial vault expansion has proven to be safe and offers a remodeled and protective bony vault immediately after surgery, but the underlying cranial base malformation remained untreated, with implications in the postoperative growth of the facial skeleton. Overcorrection, rigid stabilization, and grafting are also concerns to be addressed. [ABSTRACT FROM AUTHOR]

: A decrease in the blood flow below a current level in the brain results in ischemia. Studies demonstrated that human trophoblast progenitor cells (hTPCs) contribute to the treatment of many diseases. Therefore, hTPCs might be a promising source to repair ischemia in cerebral ischemia models. For this purpose, we evaluated the expression of many neurogenesis markers by performing hTPC transplantation after focal cerebral ischemia in rats. : hTPCs, isolated from the term placentae, were characterized by immunofluorescent staining and differentiated into neuron-like cells. Differentiation was confirmed with immunostaining of GFAP and NeuN proteins. Cerebral ischemia models were generated in rats via middle cerebral artery occlusion and, after 24 hours, hTPCs were injected via the tail vein. Animals were sacrificed on day 3 or day 11. Immunohistochemical analysis was performed with proteins associated with neurogenesis and neuronal development, such as DLX2, DLX5, LHX6, NGN1, and NGN2, Olig1, Olig2, and PDGFRα. : According to our results, hTPCs may alleviate ischemic damage in the brain and contribute to the neurogenesis after ischemia. : Based on our findings, this topic should be further investigated as the hTPC-based therapies may be a reliable source that can be used in the treatment of stroke and ischemia. [ABSTRACT FROM AUTHOR]

Hypoxia conditioning could increase the survival of transplanted neuronal progenitor cells (NPCs) in rats with cerebral ischemia but could also hinder neuronal differentiation partly by suppressing mitochondrial metabolism. In this work, the mitochondrial metabolism of hypoxia-conditioned NPCs (hcNPCs) was upregulated via the additional administration of resveratrol, an herbal compound, to resolve the limitation of hypoxia conditioning on neuronal differentiation. Resveratrol was first applied during the in vitro neuronal differentiation of hcNPCs and concurrently promoted the differentiation, synaptogenesis, and functional development of neurons derived from hcNPCs and restored the mitochondrial metabolism. Furthermore, this herbal compound was used as an adjuvant during hcNPC transplantation in a photothrombotic stroke rat model. Resveratrol promoted neuronal differentiation and increased the long-term survival of transplanted hcNPCs. 18-fluorine fluorodeoxyglucose positron emission tomography and rotarod test showed that resveratrol and hcNPC transplantation synergistically improved the neurological and metabolic recovery of stroke rats. In conclusion, resveratrol promoted the neuronal differentiation and therapeutic efficiency of hcNPCs in stroke rats via restoring mitochondrial metabolism. This work suggested a novel approach to promote the clinical translation of NPC transplantation therapy. [ABSTRACT FROM AUTHOR]

Discarded tissues, like human amniotic membranes and adipose tissue, were investigated for the application of Decellularized Human Amniotic Membrane (DAM) as a viable scaffold for transplantation of Adipose-derived stromal cells (ASCs) in bone regeneration of non-healing calvarial defects in rats. Amniotic membrane was decellularized to provide a scaffold for male Wistar rats ASCs expansion and transplantation. ASCs osteoinduction in vitro promoted the deposition of a mineralized bone-like matrix by ASCs, as calcified globular accretions associated with the cells on the DAM surface and inside the collagenous matrix. Non-healing calvarial defects on male Wistar rats were randomly divided in control without treatment, treatment with four layers of DAM, or four layers of DAM associated with ASCs. After 12 weeks, tissue blocks were examined by micro-computed tomography and histology. DAM promoted osteoconduction by increasing the collagenous matrix on both DAM treatments. DAM with ASCs stimulated bone deposition, demonstrated by a higher percentage of bone volume and trabecular bone number, compared to control. Besides the osteogenic capacity in vitro, ASCs stimulated the healing of calvarial defects with significant DAM graft incorporation concomitant with higher host bone deposition. The enhanced in vivo bone regeneration by undifferentiated ASCs loaded onto DAM confirmed the potential of an easily collected autologous cell source associated with a broadly available collagenous matrix in tissue engineering. [ABSTRACT FROM AUTHOR]

Stroke disturbs both the structural and functional integrity of the brain. The understanding of stroke pathophysiology has improved greatly in the past several decades. However, effective therapy is still limited, especially for patients who are in the subacute or chronic phase. Multiple novel therapies have been developed to improve clinical outcomes by improving brain plasticity. These approaches either focus on improving brain remodeling and restoration or on constructing a neural bypass to avoid brain injury. This review describes emerging therapies, including modern rehabilitation, brain stimulation, cell therapy, brain-computer interfaces, and peripheral nervous transfer, and highlights treatment-induced plasticity. Key evidence from basic studies on the underlying mechanisms is also briefly discussed. These insights should lead to a deeper understanding of the overall neural circuit changes, the clinical relevance of these changes in stroke, and stroke treatment progress, which will assist in the development of future approaches to enhance brain function after stroke. [ABSTRACT FROM AUTHOR]

Introduction: Enterococcus faecalis can be found in failed endodontic treatment (FET) even after performing primary endodontic treatment (PET). Calcium hydroxide (Ca(OH)2) cannot fully eliminate this microorganism during PET. Brazilian green propolis (bee glue) was found to be more effective against E. faecalis when compared to Ca(OH)2. A much less studied Malaysian geopropolis (MP) as well as Aloe vera (AV) is antibacterial but is unknown against E. faecalis. Objective: The objective of this study is to determine the antimicrobial effects of MP, AV, and MP + AV in comparison with Ca(OH)2 against E. faecalis, as an intracanal medicament. Materials and Methods: Antimicrobial activity of MP, AV, MP + AV, Ca(OH)2, and dimethyl sulfoxide was tested against E. faecalis using antimicrobial sensitivity testing, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC). The results were analyzed by Kruskal–Wallis test with Mann–Whitney post hoc test and repeated measures analysis of variance with Bonferroni post hoc test (P < 0.05). Results: For agar well-diffusion method, MP + AV gave maximum inhibition zone diameter (mean: 8.11 ± 0.015 mm), MP (mean: 6.21 ± 0.046 mm, Ca(OH)2 (mean: 5.5 ± 0.006), and AV (mean: 5.05 ± 0.012) with P < 0.05. MIC for MP + AV was 2 mg/ml, MP at 8 mg/ml, Ca(OH)2 at 8 mg/ml, and AV at 16 mg/ml. The MBC for MP + AV is at 4 mg/ml, MP at 16 mg/ml, Ca(OH)2 at 16 mg/ml, and AV at 32 mg/ml. Conclusion: The combination of MP and AV consistently showed better antimicrobial activity compared to MP and AV alone against E. faecalis. The findings suggest that MP and AV used in combination may be an ideal intracanal medicament in FET and PET. [ABSTRACT FROM AUTHOR]

The microvascular endothelial network is essential for bone formation and regeneration. In this context, endothelial cells not only support vascularization but also influence bone physiology via cell contact‐dependent mechanisms. In order to improve vascularization and osteogenesis in tissue engineering applications, several strategies have been developed. One promising approach is the coapplication of endothelial and adipose derived stem cells (ADSCs). In this study, we aimed at investigating the best ratio of human umbilical vein endothelial cells (HUVECs) and osteogenic differentiated ADSCs with regard to proliferation, apoptosis, osteogenesis and angiogenesis. For this purpose, cocultures of ADSCs and HUVECs with ratios of 25%:75%, 50%:50% and 75%:25% were performed. We were able to prove that cocultivation supports proliferation whereas apoptosis was unidirectional decreased in cocultured HUVECs mediated by a p‐BAD‐dependent mechanism. Moreover, coculturing ADSCs and HUVECs stimulated matrix mineralization and the activity of alkaline phosphatase (ALP). Increased gene expression of the proangiogenic markers eNOS, Flt, Ang2 and MMP3 as well as sprouting phenomena in matrigel assays proved the angiogenic potential of the coculture. In summary, coculturing ADSCs and HUVECs stimulates proliferation, cell survival, osteogenesis and angiogenesis particularly in the 50%:50% coculture. [ABSTRACT FROM AUTHOR]