Paraffin hard MP 43-46C solid

Alveolar ridge preservation using biomaterials is a well-established approach to counteract post-extraction bone resorption and optimize conditions for implant placement. However, most studies rely only on a single evaluation method and thereby risk overlooking essential aspects of alveolar regeneration. This preliminary analysis aimed to assess alveolar ridge preservation outcome using a multimodal approach combining histomorphometric, radiological, and image-based visualization methods. Twenty out of a planned 60 patients per group from an ongoing randomized controlled clinical trial were included. Patients were allocated to alveolar ridge preservation with a bone substitute material (BSM), a collagen-based material, a combination of both, or natural healing as control. Outcomes included CBCT-based volumetric analysis, histomorphometry, and primary implant stability via ISQ. Mineralized bone volume was significantly better preserved in bone substitute material groups compared to other groups, with BSM combined with collagen yielding the highest values. Histomorphometrically determined hard tissue fractions and implant stability were comparable across groups. Notably, CBCT-based visualization revealed non-ossified hypodense regions, so-called cavitations or covered socket residuum (CSR) within the former extraction sockets across all groups, independent of the biomaterial applied. BSM-based alveolar ridge preservation, particularly combined with a collagen membrane, most effectively maintained mineralized bone volume after extraction. Beside volumetric benefits, this preliminary in-dept analysis of the first part of the trial highlights cavitations/CSRs as a potentially underrecognized feature of post-extraction healing. Integrating quantitative with qualitative visualization-based assessments provides a more complete understanding of alveolar bone regeneration.

Abstract licence: CC BY

Background: Riedel's thyroiditis is a rare fibrosing thyroid disorder that remains one of the most difficult to diagnose, often being initially interpreted as malignant due to its clinical, radiological, and histopathological similarities with anaplastic carcinoma or other infiltrative thyroid diseases. Preoperative investigations, including fine-needle aspiration cytology (FNAC), may be misleading and contribute to an erroneous diagnosis of cancer. Methods: We report the case of a 44-year-old woman presenting with a rapidly enlarging, hard goiter associated with compressive symptoms and cytological findings suspicious for papillary thyroid carcinoma (Bethesda V). Based on these findings and the multidisciplinary team's assessment, surgical intervention was undertaken. Intraoperatively, the thyroid gland was densely fibrotic and adherent to adjacent structures, prompting frozen-section analysis that revealed a benign fibroinflammatory process consistent with Riedel's thyroiditis. This intraoperative finding guided the surgical team toward a near-total thyroidectomy, preventing unnecessary radical excision. Results: The paraffin-embedded section confirmed the diagnosis. Postoperative recovery was favorable, with complete resolution of compressive symptoms. Conclusions: This case highlights the persistent diagnostic challenges of Riedel's thyroiditis and illustrates how intraoperative frozen-section examination can contribute to differentiating it from malignancy when preoperative findings remain inconclusive. A multidisciplinary approach and surgical expertise are essential in tailoring the extent of resection, preventing complications, and achieving both diagnostic confirmation and symptom relief.

Abstract licence: CC BY