Laminectomy is a commonly performed surgery to decompress the spinal canal to relieve spinal canal stenosis secondary to a variety of etiologies such as degenerative spinal changes, fractures, tumors, vascular lesions, and infections. Advances in technologies have allowed for more precise osteotomies and offer more protection to nearby structures; however, these technologies may not always be available at some facilities. To the best of the authors\' knowledge, we describe an innovative technique to perform laminectomy using a handheld osteotome, which is widely available and at low cost. Our experience with cadavers and a case study shows that the technique appears to be safe and effective and may have the potential to reduce the procedure length of a laminectomy.

The piezo surgery was reported to cause minimal trauma to the soft tissue. The aim of this study was to compare the periorbital edema and ecchymosis after transcutaneous lateral osteotomy in rhinoplasty using 2-mm osteotome versus Piezo scalpel respectively. In a randomized clinical trial and split-mouth-design, we performed primary rhinoplasty in 15 patients (7 men, 8 women; age 18-35 years, mean age 26.6 ± 5.7 years). Transcutaneous lateral osteotomy was performed using a 2-mm osteotome on the one side and a piezo scalpel on the opposite side. We took digital photographs of the face on 1, 3, 7 and 14 postoperative days. Three examiners used a standard 5-point Kara-Gokalan scale to assess the early postoperative periorbital edema and ecchymosis on each side. We found more difficult to use the piezo scalpel via only one incision and found easier to use two stab incisions for inserting the piezo scalpel. The time spend for each osteotomy was similar (P > 0.05). The inter-observer agreement was high (> 0.676). The postoperative edema showed to be significantly different on day 1, 3 and 7 (P-value < 0.05), ecchymosis was much less on piezo side but not significantly. It was more difficult to use piezo scalpel via only one incision. The piezo scalpel showed to reduce the postoperative edema significantly and improved the ecchymosis. Swelling and bleeding could have crossed the midline and blurred the comparison of two sides. However, this is the best design to achieve the highest similarity in study condition. Level of Evidence Level I, therapeutic study.

UNASSIGNED: Olecranon osteotomy is employed for the fixation of intraarticular distal humeral fractures. We conducted a prospective, randomised study comparing Chevron\'s osteotomy with olecranon osteotomy by a Gigli saw for exposure of the intraarticular distal humerus in terms of functional outcome and intra-operative ease of the surgery.
UNASSIGNED: Thirty patients with skeletally mature AO/OTA type 13- B and 13-C distal humerus fractures were randomly allocated to Chevron\'s or Gigli saw groups. Each group consisted of a total of 15 patients. Both the groups were assessed on post-operative parameters including arm, shoulder or hand pain, ability to perform certain routine activities, tingling sensations and pain while sleeping.
UNASSIGNED: In the Gigli saw group, 12 patients had no gross limitation of activity and 13 were able to perform moderate activities with ease. Similar results were observed in the Chevron\'s group. The mean difference between the two groups in Oxford Score was 0.60, within the 95% confidence interval and in line with QuickDASH-11 Score.
UNASSIGNED: Chevron\'s technique offers stability and better healing, providing a larger surface area for bone union. However, it is challenging and time-consuming. Also, literature suggests that the Gigli saw has multiple benefits, saves time and effort, and heals by switching blood supply from centrifugal to centripetal post-operatively. Our study suggests that both Chevron\'s technique and the use of the Gigli saw are effective in distal humeral intra-articular fractures as assessed by multiple parameters. Hence both techniques can be equally used depending on the surgeon\'s preference.

UNASSIGNED: Total hip arthroplasty (THA) is frequently performed in patients with end-stage hip disease. Periacetabular osteophytes are common during THA; however, these osteophytes should be removed intraoperatively to avoid potential impingement between osteophytes and femoral prostheses and decrease dislocation risk. There are no current standard procedures or surgical technique criteria to remove these osteophytes. Osteophytes around the acetabulum are usually removed with an osteotome, yet this presents certain disadvantages. Hence, this study aimed to introduce a novel and more efficient technique than the aforementioned one, the SH-9Hospital acetabular edge file.
UNASSIGNED: Fifty-four patients (54 hips) who underwent primary THA using osteotome and the SH-9Hospital acetabular edge file to remove periacetabular osteophytes intraoperatively were retrospectively studied. Clinical and radiographic data were obtained for all patients intra- and postoperatively.
UNASSIGNED: The mean osteophyte removal time was 274.6±102.7 s and 51.3±21.1 s in the osteotome and SH-9Hospital acetabular edge file groups, respectively. Intraoperative images and postoperative radiographs showed that acetabular osteophytes were removed thoroughly and precisely by the acetabular edge file and that there was no iatrogenic injury and prostheses malposition in both groups.
UNASSIGNED: The SH-9Hospital acetabular edge file was a novel, efficient, highly precise, and repeatable method for removing periacetabular osteophytes in patients undergoing total hip arthroplasty.

UNASSIGNED: Trans-crestal sinus lift procedures are well established.
UNASSIGNED: to retrospectively analyse the efficacy of a flapless trans-crestal maxillary sinus floor elevation and simultaneous dental implant placement based on the Localised Management of Sinus Floor (LMSF) technique suitable for cases with sufficient width of keratinized tissue and of crestal bone but insufficient vertical dimensions of the bone below the sinus.
UNASSIGNED: 71 sinus elevations with simultaneous implant placement were performed on 52 consecutive patients. Following an initial pilot bur transmucosal perforation, the Magnetic Mallet was used with progressively larger osteotomes. The mallet osteotomes are initially directed palatally, towards the cortex of the medial wall of the sinus, below the palato-nasal recess (PNR) and then redirected in a more vertical direction to create the final osteotomy for implant placement.
UNASSIGNED: No significant complications were reported in the post-operative phase. The cumulative success rate during the observation period was 95%. All successful implants were successfully loaded with metal-ceramic or monolithic zirconia crowns and bridges and remained in function during the observation period.
UNASSIGNED: Flapless Localised Management of Sinus Floor (LMSF) is a safe and effective surgical technique with minimal risks and with the advantage of low morbidity. Also, only native bone is used for augmentation and there is no need for additional grafting.

UNASSIGNED: To investigate the efficacy of Ultrasonic Bone Scalpel (UBS) in thoracic spinal stenosis (TSS) in comparison to traditional technique.
UNASSIGNED: A total of 55 patients who had undergone conventional surgery (Group A) are compared with 45 patients of UBS (Group B) in TSS. The primary outcome measure of Modified Japanese Orthopaedic Association score (m JOA) with neurological complications and dural injury were assessed. Secondary outcome measures of total blood loss (TBL), time duration of surgery (ORT) and length of hospital stay (LHS) were analysed.
UNASSIGNED: The pre-operative mJOA score 5.00(4.00-6.00) in the group A and 5.00(4.00-6.00) in the group B improved to 7.00(7.00-8.00) in the group A and 9.00(9.00-10.00) in the group B, respectively (P<0.001) at final average follow-up of 117.55 months for group A and 75.69 months in group B. More significant grade of myelopathy improvement and mJOA recovery rate (RR) were noted in group B. The TBL, ORT and LHS were more favourable in group B as compared to group A (p<0.0001). The group A had 9 (16.36%) neurological deficits compared to 2 (4.44%) in group B (p<0.001). Dural tears occurred in both groups (A=11, B=9). It was more frequent and not repairable in group A but without significant statistical difference.
UNASSIGNED: UBS can reduce neurological deficits and improve outcomes in TSS. Secondarily, reduced blood loss, lesser surgical time and reduced LHS are significant added advantages of this new technology.

According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.

During the rehabilitation of patients with atrophic maxilla, an oral implantologist may face a challenge in achieving accurate implant placement. We present a 54-year-old man who is completely edentulous with a history of unretentive conventional complete dentures. The patient sought help for a fixed implant prosthesis and disagreed with the proposed plan to restore his missing teeth using a removable prosthesis. Clinical and radiographic examinations showed a severely resorbed maxilla with horizontal and vertical bone deficiency. A computer-guided surgical stent was used to place implants in the atrophic maxillary ridge. A double cone beam CT (CBCT) scan procedure was performed. The first scan of the patient\'s jaw was done using a radiographic scan appliance, and the second scan was done only with the scan appliance. This was followed by virtual implant planning, after which we designed and printed the CAD-CAM surgical stent. From the pilot drill to the final one, implant site preparation was done using a guide. Furthermore, ridge expansion and implant fixture placement were performed using a planned surgical guide to ensure accurate and precise implant placement. Next, a postoperative CBCT was done to determine the accuracy of the computer-guided stent using In2guide Pro Software. By superimposing the preoperative plane onto the postoperative scan, the postoperative CBCT was aligned on the same axis as the preoperative image. This case report shows that computer-guided stents for severely atrophic maxilla can potentially be used to facilitate both implant installation and bone expansion. However, in order to reach sound conclusions, further randomised control trials with large sample sizes should be carried out.
يواجه أخصائي زراعة الأسنان تحدي كبير عند إعادة التأهيل الفموي لحالات الامتصاص العظمي للفك العلوي. هذا التقرير يسرد علاج مريض يبلغ من العمر ٥٤ عاما ويشتكي من عدم ثبات طقم الأسنان العلوي. الفحوصات السريرية والأشعة التشخيصية أظهرت امتصاص عظمي أفقي وعمودي للفك العلوي للمريضتم عمل أشعة مقطعية للفك العلوي ومن ثم عمل تخطيط لوضع الزرعات باستخدام برنامج مختص في مجال زراعة الأسنان، من ثم تم تصميم دعامة جراحية موجهة بالحاسوب كدليل جراحي للمساعدة في وضع زرعات للفك العلوي للمريض. يصف هذا التقرير طريقة الإرشاد الكامل لوضع زراعة الأسنان ابتداء من استخدام المثقاب الأول إلي إدخال الزرعة عن طريق الدليل الإرشادي، وليس هذا وحسب بل تم عمل توسعه للعظم في أماكن محددة عن طريق إدخال أداة التوسيع من خلال الدليل الإرشادي لضمان وضع الزرعات في المكان المخطط له. بعد وضع الزرعات تم عمل أشعة مقطعية أخرى ومن ثم تمت عملية مطابقة الأشعة الأولى التي تحتوي على الخطة العلاجية لأماكن الزرعات قبل العملية بتلك الأشعة التي تحتوي على الزرعات بعد العملية. تبين وجود انحراف بسيط جدا عن الخطة العلاجية مقارنة بما نشر مؤخرا مما يبين إمكانية استخدام الدعامات الموجهة بالحاسوب لتسهيل تثبيت الزرع وتوسيع العظم. بالطبع، لا يمكن استخلاص استنتاج محدد من تقرير الحالة، وسيلزم إجراء مزيد من تجارب المراقبة العشوائية باستخدام عينات كبيرة للوصول إلى استنتاجات سليمة.

Implants inserted in the posterior maxilla frequently need additional surgery for successful bone augmentation. One of the most common procedures for this is transalveolar sinus floor elevation. There are different protocols for this procedure, and there is controversy over the simultaneous application of grafting material upon elevating. In this prospective randomized clinical study in humans, a total of 49 transalveolar sinus floor elevations were performed in 49 different patients, divided into a control group (without graft, 25 patients) and a test group (with graft, 24 patients). The analyzed variables were obtained through digital orthopantomography on day 0 (day of surgery) and 18 months after surgery. These measurements showed a tendency towards greater vertical bone gain in the test group, but this was not statistically significant. Therefore, considering that sinus elevation and implant placement without the application of grafts is a successful treatment with fewer complications, a critical assessment of the need for these biomaterials is necessary.

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