This article deals with the impact of mandibular frontal crowding on the initiation and progression of gingival inflammation. For the purposes of this study, sixty patients were included, of which thirty with normal occlusion and another thirty with mandibular frontal crowding of their teeth were examined. In all patients, the accumulation, retention and elimination of the dental plaque was analyzed, whereas its impact on the integrity of the gingival tissue was followed by clinical observation of the gingival tissue and the recorded changes were shown through IGI and IGK. The respondents were observed several times, i.e. upon their first visit and then in 15, 30 and 45 days from their first check, i.e. after the elimination of the dental plaque and other overlays from their teeth as well as the elimination of the gingival inflammation. The acquired results from the examinations showed that there is a significant difference in the accumulation and retention of the dental plaque between the two examined groups, namely between the group of patients with normal occlusion and those with mandibular frontal crowding (p-0000*). On the 15th day of therapeutic treatment, upon the examination, the presence of dental plaque was still noticeable, in both groups, as a result of the inadequate maintenance of oral hygiene. The difference from the acquired values of the amount of the dental plaque from both examined groups is significant (p-005). The same was noticed even after the 30th day of the treatment; however, after the 45th day, the significance of the difference in acquired results was (p-0000*). Significant differences were noticed between the values obtained from both examined groups in terms of the index of gingival inflammation and the index of gingival bleeding(p-0002). The difference from the obtained values for IGI and IGK after the 15th day are insignificant; the difference from the obtained values for IGI and IGK after the 30th day was p-005 whereas after the 45th day p-0002. These results point to the fact that mandibular crowding of frontal teeth represents a significant factor for the accumulation, retention and elimination of the dental biofilm and has indirect impact on the initiation and progression of gingival inflammation, namely the periodontal illness.

Awake craniotomy has emerged as a critical neurosurgical technique for resecting tumors located near eloquent brain regions, such as those governing speech, motor functions, and cognition. Unlike traditional craniotomy, awake craniotomy allows surgeons to receive real-time patient feedback, enabling precise resection while preserving essential neurological functions. This paper explores the various techniques utilized in awake craniotomy, including preoperative planning, anaesthesia protocols, and intraoperative mapping. It highlights the benefits of awake craniotomy, such as enhanced precision, reduced complication rates, improved functional outcomes, and higher patient satisfaction. Additionally, it provides a comparative analysis of awake and traditional craniotomies, emphasizing superior short-term and long-term patient outcomes associated with awake procedures. The study further discusses the potential for awake craniotomy to become a standard practice in neurosurgery, particularly for complex brain lesions. Future directions include research into advanced technologies, such as augmented reality and neuro-navigation, which could enhance the efficacy of awake procedures. The findings underscore the significant role of awake craniotomy in modern neurosurgical practice, with implications for improved patient quality of life and expanded surgical applications.

The second most prevalent kind of intra-dural lesions affecting the thoracic spine are schwannomas. They are commonly observed as diverse, solid lesions. To our knowledge, there have only been few cases of totally cystic thoracic schwannomas documented in the English literature, making them a rare pathological schwannoma variation. We describe a male patient, age 45 years, who had upper back pain for three months with lower limb weakness. A cystic-solid lesion at the T5-T6 level was visible on magnetic resonance imaging (MRI) with peripheral contrast enhancement. The patient's symptoms completely disappeared once the lesion was surgically removed and he improved significantly with normal neurological functioning. Due to the absence of thorough investigation and the scarcity of symptoms, cystic schwannomas are frequently not diagnosed right away. The diagnosis may be made only by the presence of rim enhancement on contrast-enhanced MRI. Since the best surgical outcome is significantly correlated with early detection and complete resection of the lesion, cystic schwannomas should be taken into consideration when making a differential diagnosis for cystic spinal lesions.