CASE PRESENTATION: We present here a novel technique of using intravenous (IV) cannula as an alternative to suture passer for fascial closure during laparoscopic IPOM repair for a 59-year-old patient with an incisional ventral hernia. The placement of non-absorbable sutures for fascial closure was done with the help of a 14 gauge IV cannula instead of a transfascial suture passer. The rest of the procedural steps were the same as a standard laparoscopic IPOM repair. The patient's post-operative recovery was uneventful.
DISCUSSION: Primary fascial closure during a laparoscopic IPOM hernia repair can be done either by intracorporeal or extracorporeal techniques, using interrupted or continuous sutures. We propose a novel alternative to suture passer in primary fascial closure. IV cannulas are widely available in hospital settings. The advantage of using an IV cannula instead of a suture passer is that they are widely available. Its single-use also eliminates the risk of transmissible diseases, and as it has a smaller diameter than suture passer, it requires a lower insertion force for successful placement.
CONCLUSION: An IV cannula may be used as a more economical alternative to a transfascial suture passer. This technique is easily reproducible and does not violate the principles of primary fascial defect closure in laparoscopic ventral hernia repair.
AIM: To evaluate the fracture resistance and failure pattern of three different cavity designs restored with monolithic zirconia.
MATERIALS AND METHODS: Human maxillary premolars atraumatically extracted for orthodontic reasons were chosen. A total of 40 teeth were selected and divided into four groups (n=10). Group I-Sound teeth (control with no preparation). Group II-MOD Inlay, Group III-Partial Onlay, Group IV-Complete Onlay. Restorations were fabricated with monolithic partially sintered zirconia CAD (SAGEMAX- NexxZr). All the 30 samples were cemented using Multilink Automix (Ivoclar) and subjected to fracture resistance testing using Universal Testing Machine (UTM) (Instron) with a steel ball of 3.5 mm diameter at crosshead speed of 0.5 mm/minute. Stereomicroscope was used to evaluate the modes of failure of the fractured specimen. Fracture resistance was tested using parametric one way ANOVA test, unpaired t-test and Tukey test. Fracture patterns were assessed using non-parametric Chi-square test.
RESULTS: Group IV (Complete Onlay) presented highest fracture resistance and showed statistical significant difference. Group II (MOD Inlay) and Group III (Partial Onlay) showed significantly lower values than the Group I (Sound teeth). However, Groups I, II and III presented no significant difference from each other. Coming to the modes of failure, Group II (MOD Inlay) and Group III (Partial Onlay) presented mixed type of failures; Group IV (Complete Onlay) demonstrated 70% Type I failures.
CONCLUSION: Of the three cavity designs evaluated, Complete Onlay had shown a significant increase in the fracture resistance than the Sound teeth.
Materials and Methods: This an in vitro study was done by preparing cavities on the buccocervical surface of 62 extracted premolar teeth which randomly assigned to two groups (n = 31) where Group 1 was restored with nanocomposite and Group 2 was cemented with porcelain cervical inlays. They were then subjected to thermocycling before immersion in 2% methylene blue dye for 24 h. Dye penetration depths were measured using Leica imaging system For statistical analysis, independent t-test was used to analyze the results (P < 0.05).
Results: Porcelain cervical inlay restorations demonstrated statistically lesser microleakage depth for the cervical margins (P = 0.018) when compared to CR. Deeper microleakage depth at the cervical compared to coronal margins of CR (P = 0.006) but no significant difference of both margins for porcelain cervical inlays (P = 0.600).
Conclusion: Porcelain cervical inlays show lesser microleakage than CR which could be alternative treatment option in restoring NCCL with better marginal seal and esthetics.