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Sample records for partially edentulous patients

  1. Implant rehabilitation of partial maxillectomy edentulous patient

    Science.gov (United States)

    Gowda, Mahesh E.; Mohan, Murali S.; Verma, Kamal; Roy, I. D.

    2013-01-01

    Edentulous patients with maxillectomy defects present a significant challenge for prosthetic rehabilitation and the adaptive capabilities of the patient as retention is highly compromised. Hence, the option of using endosseous implants to increase obturator retention has been used. A patient of mucormycosis of the left maxilla was treated with surgical excision. After satisfactory healing, definitive implant supported magnet retained prosthesis was fabricated for the patient. Implants with magnetic units offer a practical method of improving the retention of obturators provided acceptable prosthetic protocols are followed for the rehabilitation. PMID:24124314

  2. Prosthodontic rehabilitation of completely edentulous patient with partial glossectomy

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    Aditi Garg

    2016-01-01

    Full Text Available Oral cancer accounts for about 40% of all cancers inflicting the human beings. Those involving the tongue results in mild to severe deficiencies of phonation, deglutition, mastication, and taste depending upon the degree and extent tissues involved. Often rehabilitation of such patient is a challenge for the prosthodontist and involves a careful observation and evaluation of the residual oral function and ways to restore them. This article presents a case report of prosthodontic rehabilitation completely edentulous patient, who underwent partial glossectomy following surgical resection of the squamous cell carcinoma involving left lateral borders of the tongue. An attempt was made to restore the comfort and function of the patient with the help of palatal augmentation prosthesis, with additional assistance through speech therapy and simple oral exercises.

  3. Cast Partial Denture versus Acrylic Partial Denture for Replacement of Missing Teeth in Partially Edentulous Patients

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    Pramita Suwal

    2017-03-01

    Full Text Available Aim: To compare the effects of cast partial denture with conventional all acrylic denture in respect to retention, stability, masticatory efficiency, comfort and periodontal health of abutments. Methods: 50 adult partially edentulous patient seeking for replacement of missing teeth having Kennedy class I and II arches with or without modification areas were selected for the study. Group-A was treated with cast partial denture and Group-B with acrylic partial denture. Data collected during follow-up visit of 3 months, 6 months, and 1 year by evaluating retention, stability, masticatory efficiency, comfort, periodontal health of abutment. Results: Chi-square test was applied to find out differences between the groups at 95% confidence interval where p = 0.05. One year comparison shows that cast partial denture maintained retention and stability better than acrylic partial denture (p< 0.05. The masticatory efficiency was significantly compromising from 3rd month to 1 year in all acrylic partial denture groups (p< 0.05. The comfort of patient with cast partial denture was maintained better during the observation period (p< 0.05. Periodontal health of abutment was gradually deteriorated in all acrylic denture group (p

  4. Mastication and jaw motion of partially edentulous patients are affected by different implant-based prostheses.

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    Gonçalves, T M S V; Campos, C H; Rodrigues Garcia, R C M

    2014-07-01

    The main goal of prosthetic treatment is to restore masticatory function. However, insufficient evidence supports the recommendation of one specific prosthetic intervention for partially edentulous patients. Function after the use of three different prostheses by the same partially edentulous subject. Mastication was assessed in 12 subjects (mean age 62.6 ± 7.8 years) after they had used removable partial dentures (RPDs), implant-supported partial dentures (IRPDs) and implant-fixed partial dentures (IFPDs). Masticatory ability (MA) was estimated by visual analogue scale questionnaire, while the mandibular chewing motion was evaluated by kinesiographic device, representing an objective measurement of masticatory function. Data were analysed by repeated-measures anova followed by Tukey-Kramer (P < 0.05). MA improved after IRPD and IFPD use (P < 0.05). Opening, closing and total cycle time duration were reduced after both IRPD and IFPD use (P < 0.05), irrespectively the implant prosthesis type. IFPDs and IRPDs restore the masticatory function of partially edentulous patients better than RPDs. © 2014 John Wiley & Sons Ltd.

  5. Comparison of Treatment Outcomes in Partially Edentulous Patients with Implant-Supported Fixed Prostheses and Removable Partial Dentures.

    Science.gov (United States)

    Nogawa, Toshifumi; Takayama, Yoshiyuki; Ishida, Keita; Yokoyama, Atsuro

    The aim of this study was to compare masticatory performance, occlusal force, and oral health-related quality of life (OHRQoL) in patients with mandibular distal-extension edentulism between those with implant-supported fixed prostheses (ISFPs) and those with removable partial dentures (RPDs), and to evaluate relationships among them. Subjects were recruited from patients using ISFPs or RPDs for mandibular distal-extension edentulism. Masticatory performance was evaluated based on the glucose extracted from chewed gummy jelly. Occlusal force was measured with a pressure-sensitive sheet, and data were subjected to computer analysis. The Japanese version of the Oral Health Impact Profile (OHIP-J) was used to evaluate OHRQoL. The masticatory performance, occlusal force, and OHIP-J scores of the ISFP and RPD groups were compared using the Wilcoxon rank-sum test. The relationships among the variables were analyzed using the Spearman rank correlation coefficient test. Multivariate logistic regression analysis was employed with the OHIP-J score as a dependent variable. Nineteen patients with ISFPs and 25 patients with RPDs participated in this study. No significant difference was observed between the two groups with regard to masticatory performance and occlusal force. The OHIP-J score was significantly lower in the ISFP group than in the RPD group. The OHIP-J score had no significant correlation with masticatory performance, but was significantly correlated with occlusal force and the prosthetic method. Multivariate logistic regression analysis showed that younger age, RPDs, and lower occlusal force were significantly associated with a higher OHIP-J summary score. The present results suggest that the difference in masticatory performance and occlusal force between ISFPs and RPDs is small, but ISFPs are superior to RPDs with regard to OHRQoL in patients with mandibular distal-extension edentulism. In addition, there appears to be a slight correlation between the OHIP

  6. Reference-based digital concept to restore partially edentulous patients following an immediate loading protocol: a pilot study

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    Tahmaseb, A.; de Clerck, R.; Eckert, S.; Wismeijer, D.

    2011-01-01

    PURPOSE: To describe the use of a computer-aided three-dimensional planning protocol in combination with previously placed reference elements and computer-aided design/computer-assisted manufacture (CAD/CAM) technology to restore the partially edentulous patient. MATERIALS AND METHODS: Mini-implants

  7. Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

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    S. OZER

    2011-06-01

    Full Text Available Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months, the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.

  8. Psychometric properties of the WHO-5 Well-being index in partially edentulous patients

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    Miguel Simancas-Pallares

    2016-10-01

    Full Text Available Introduction: Measuring well-being in dental patients allows early detection of emotional disorders. Objective: To evaluate the psychometric properties of the Wellbeing index by the World Health Organization (WHO-5 WBI in partially edentulous patients. Materials and methods: Scale validation study and diagnostic tests without reference standard performed in 105 patients treated at an oral implantology service. The WHO-5 WBI was applied before treatment and an exploratory factor analysis was performed to determine the amount of factors in the construct that confirmed its validity and internal consistency through Cronbach’s alpha and McDonald’s omega. Results: The exploratory factor analysis showed a single factor solution that accounted for 56.17% of the variance. The confirmatory analysis showed adjustment indexes X2=1120.516; df=10, p=0.04; RMSEA=0.134 (90% CI: 0.056-0.217; CFI=0.992; TLI=0.983 and WRMR= 0.61. Conclusions: The WHO-5 WBI showed acceptable reproducibility, one-dimensional factor structure and questionable construct validity.

  9. Aesthetics and Survival of Immediately Restored Implants in Partially Edentulous Anterior Maxillary Patients

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    Roni Kolerman

    2018-03-01

    Full Text Available This retrospective study was undertaken to determine survival rates and aesthetic outcomes of immediate placement of multiple implants at anterior maxilla sites. One hundred and eighteen implants placed in 39 patients (21 women and 18 men; average age 58.3 years were immediately restored (24–72 h after placement. Aesthetic assessment, radiographic bone loss, and biological and prosthetic complications were evaluated. Data collection between 12 and 84 months (mean 32.2 ± 18 after final prosthetic installation revealed that no implants were lost, and that 106/118 (89.8% implants had no more than 1.5 mm of bone loss by the end of the first year and an additional 0.2 mm for each successive year. The marginal bone loss was higher for extractions due to periodontitis compared to extractions due to caries (mean mesial loss of 1.37 mm vs. 1.01 mm, respectively, and mean distal loss of 1.37 mm and 0.99 mm, respectively, p = 0.001. The mesial papilla was present in 83/118 implants (70.3%, while the distal papilla was present in 76/118 implants (64.4%. The cervical metallic part of the abutment was exposed in 16/118 (13.5% implants. There was a higher ratio of recessions and missing papillae in patients in whom the extractions were performed due to periodontal reasons. Within the limitations of the present study, aesthetic and radiographic parameters support immediate restoration of partially edentulous maxillae.

  10. Masseter muscle thickness in unilateral partial edentulism: An ultrasonographic study

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    S Sathasivasubramanian

    2017-01-01

    Full Text Available Introduction: Teeth and facial muscles play a very important role in occlusal equilibrium and function. Occlusal derangement, seen in unilateral partially edentulous individuals, has an effect on masseter muscle anatomy and function. The present study aims to evaluate masseter muscle thickness in unilateral partial edentulism. Patients and Methods: Institutional ethics committee approval was obtained before the commencement of the study. The study involved patients who routinely visited the Department of Oral Medicine and Radiology, Sri Ramachandra University. The study sample included 27 unilateral edentulous patients (Group E and 30 controls (Group C. The masseter muscle thickness was evaluated using high-resolution ultrasound real-time scanner (linear transducer − 7.5–10 MHz at both relaxed and contracted states. Statistical Analysis Used: The results were analyzed using paired t-test and independent t-test. Duration of edentulism and muscle thickness was assessed using Pearson's correlation coefficient. Results: The study patients' age ranged between 25 and 48 years (mean – 36 years. The comparative evaluation of masseter muscle thickness between the dentulous and edentulous sides of experimental group was statistically significant (P < 0.05. However, no statistically significant difference in masseter muscle thickness was found between the dentulous side of control and experimental groups. The correlation between the duration of partial edentulism and muscle thickness was statistically insignificant. Conclusion: The study proves masseter atrophy in the edentulous side. However, since the difference is found to be marginal with the present sample, a greater sample is necessary to establish and prove the present findings as well as to correlate with the duration of edentulism. Further studies are aimed to assess the muscle morphology after prosthetic rehabilitation.

  11. [Pain in edentulous patients

    NARCIS (Netherlands)

    Baat, C. de

    2006-01-01

    In daily social life, orofacial pain is strongly associated with teeth. However, edentulousness is no lifetime guarantee of being pain-free in the orofacial region. Common oral pains in edentulous people are caused by denture misfits or occlusal errors, by alveolar ridge atrophy, by (sharp)

  12. The effect of unilateral partial edentulism to muscle thickness

    International Nuclear Information System (INIS)

    Koca-Ceylan, Golzem; Guler, Ahmet U.; Taskay-Yelmir, Nergiz; Lutfi, Incesu; Aksoz, Tolga

    2003-01-01

    Teeth and muscle play a very important role for occlusal equilibrium and function.when tooth loss begins ,it may also effect the function of muscle tissues. The thickness of masseter and anterior temporalis muscles were measured bilaterally in 30 healthy fully dentate adults and in 30 unilateral edentulous patients by using ultrasonographic imaging. All scans were carried out by the same radiologist to eliminate the inter-observer difference, using a real time scanner (Toshiba SSA -270A,Japan). A 7.5 MHz linear transducer was used. The effect of age, sex, duration of partial edentulism, unilateral chewing habits of the individuals to the muscle thickness were also evaluated. In all subjects,facial proportion index was also determined. Main purpose of this study was to compare and establish the differences of muscle thickness between dentate and edentulous side in unilateral partial edentulous patients with ultrasonography and to test whether the variation in the thickness of the muscle is related to the variation in the facial and morphology. Ultrasonography revealed a large variation in the thickness of the masseter and temporolis muscles in experimental and controlled groups ,both relaxed and contracted conditions.The thickness of muscles in females was less in both conditions.In experimental group, a high negative correlation was found between the thickness of the masseter muscle and Facial Proportion Index ( FPI) in the females ,however, the statistical analysis showed no significant difference in the males. Also a high negative correlation was found in female control group. There was no statistically significant relationship between unilateral chewing habits and muscle thickness .In this study the duration of partial edentulism did not affect the thickness of the muscle.Further research is required to study muscular atrophy for comparison with total edentulism. (author)

  13. From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients

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    Giorgio Andrea Dolcini

    2016-01-01

    Full Text Available Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT, the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results.

  14. Oral health related quality-of-life outcomes of partially edentulous patients treated with implant-supported single crowns or fixed partial dentures.

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    AlZarea, Bader K

    2017-05-01

    Oral health-related quality of life (OHRQoL) is afflicted by different variables. Limited information is available regarding the impact of different phases of implant therapy on OHRQoL of edentulous patients. This study was carried out to assess the OHRQoL of patients treated with implant-supported single crowns or fixed partial dentures. A total of 79 healthy partially edentulous subjects needing implant therapy were incorporated in this study. Before placement of the implants, the subjects were instructed to fill the original version of OHIP questionnaire. Subsequently patients received titanium oral implants of the ITI® Dental Implant System. After 1st, 2nd and 3rd year of implant placement, patients filled the same OHIP-49 questionnaire. In this manner the impact of implant therapy on OHRQoL by putting in comparison pre- and post-treatment OHIP-49 scores was assessed. Statistical analyses were performed using Statistical Package for the Social Science software (SPSS, version 22, Chicago, IL, USA). Paired t test and Unpaired t test were performed and a statistical significance was set at 5% level of significance ( p disability, psychological disability, social disability were significantly decreased from baseline to 1st year ( p 0.05). All variables were also significantly decreased from baseline to 2nd year and 3rd year ( p 0.05). Patients aged less than 60 years and more than 60 years of age groups differed significantly with respect to OHIP scores measured at 1st year, 2nd year and at 3rd year of implant placement ( p Oral health-related quality-of-life.

  15. Implant rehabilitation of partial maxillectomy edentulous patien

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    Mahesh E Gowda

    2013-01-01

    Full Text Available Edentulous patients with maxillectomy defects present a significant challenge for prosthetic rehabilitation and the adaptive capabilities of the patient as retention is highly compromised. Hence, the option of using endosseous implants to increase obturator retention has been used. A patient of mucormycosis of the left maxilla was treated with surgical excision. After satisfactory healing, definitive implant supported magnet retained prosthesis was fabricated for the patient. Implants with magnetic units offer a practical method of improving the retention of obturators provided acceptable prosthetic protocols are followed for the rehabilitation.

  16. A simplified classification system for partially edentulous spaces

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    Bhandari Aruna J, Bhandari Akshay J

    2014-04-01

    Full Text Available Background: There is no single universally employed classification system that will specify the exact edentulous situation. Several classification systems exist to group the situation and avoid confusion. Classifications based on edentulous areas, finished restored prostheses, type of direct retainers or fulcrum lines are there. Some are based depending on the placement of the implants. Widely accepted Kennedy Applegate classification does not give any idea about length, span or number of teeth missing. Rule 6 governing the application of Kennedy method states that additional edentulous areas are referred as modification number 1,2 etc. Rule 7 states that extent of the modification is not considered; only the number of edentulous areas is considered. Hence there is a need to modify the Kennedy –Applegate System. Aims: This new classification system is an attempt to modify Kennedy –Applegate System so as to give the exact idea about missing teeth, space, span, side and areas of partially edentulous arches. Methods and Material: This system will provide the information regarding Maxillary or Mandibular partially edentulous arches, Left or Right side, length of the edentulous space, number of teeth missing and whether there will be tooth borne or tooth – tissue borne prosthesis. Conclusions: This classification is easy for application, communication and will also help to design the removable cast partial denture in a better logical and systematic way. Also, this system will give the idea of the edentulous status and the number of missing teeth in fixed, hybrid or implant prosthesis.

  17. Rehabilitation strategies for partially edentulous-prosthodontic principles and current trends.

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    D'Souza, Dsj; Dua, Parag

    2011-07-01

    The prosthetic considerations for treatment of partially edentulous patients involve evaluation of important aspects such as presence of certain functional or skeletal deficits, orientation of the occlusal plane, free-way space, size and location of edentulous areas, number, strategic location and quality of the likely abutment teeth, vertical dimension, and the type of occlusion. A comprehensive evaluation, multidisciplinary approach and a sequential treatment plan, worked out in harmony with the patient's perceptions are important factors to ensure a successful outcome. This article discusses the principles, current trends and importance of clinical decisions in designing a treatment strategy when confronted with complex situations of partial edentulism.

  18. 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients

    NARCIS (Netherlands)

    van Velzen, F.J.J.; Ofec, R.; Schulten, E.A.J.M.; ten Bruggenkate, C.M.

    2015-01-01

    Purpose This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients.

  19. Giant Calculus In The Mouth Of Partially Edentulous Woman, (Case ...

    African Journals Online (AJOL)

    Objective: This case report is to create awareness of the presence of giant calculus in the mouth, the possible causes and its prevention. Report: This describes the oral condition of a partially edentulous woman with a giant calculus in the mouth. It highlights the effect of such an enormous calculus in the oral cavity.

  20. Immediate versus early non-occlusal loading of dental implants placed flapless in partially edentulous patients. One-year results from a randomised controlled trial.

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    Merli, Mauro; Merli, Aldo; Bernardelli, Francesco; Lombardini, Francesco; Esposito, Marco

    2008-01-01

    To compare immediate versus early (6 weeks) non-occlusal loading of dental implants placed flapless in partially edentulous patients 1 year after loading. Sixty patients were randomised: 30 to the immediately loaded group and 30 to the early loaded group. In order to be immediately loaded, implants were inserted with a minimum torque of > or = 40Ncm. Implants were fully occlusally loaded after 6 months. Outcome measures were prosthesis and implant failures, and biological and biomechanical complications. Five implants in five patients randomised to the immediately loaded group did not reach the required primary implant stability. Three of these implants (two prostheses) were not immediately loaded. Two patients who were randomised to the early loaded group were immediately loaded erroneously. Implants in five patients of the early loaded group were conventionally loaded. No patient dropped out and there were no failures. Two complications occurred in the early and one in the immediately loaded group (no statistically significant difference), but were solved. The use of a flapless technique for placing dental implants in conjunction with non-occlusal immediate or early loading in selected patients can provide excellent clinical results. No differences were observed when comparing implants that were loaded immediately or early. Therefore, when a high primary implant stability is obtained, it might be preferable to load the implants immediately rather than waiting for a few weeks.

  1. Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy’s Classes– A Literature Review

    OpenAIRE

    Jeyapalan, Vidhya; Krishnan, Chitra Shankar

    2015-01-01

    Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality.

  2. Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy's Classes- A Literature Review.

    Science.gov (United States)

    Jeyapalan, Vidhya; Krishnan, Chitra Shankar

    2015-06-01

    Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality. The objective of the study is to review the prevalence of partial edentulousness and its correlation to age,gender, arch predominance, socio economic factors and incidence of various Kennedy's Classes. Key observations drawn from the review are as below. There is no gender correlation for partial edentulism.Prevalence of partial edentulism is more common in mandibular arch than maxillary arch.Younger adults have more Class III and IV RPDs. Elders have more distal extension RPDs Class I and II.

  3. Immediate versus early non-occlusal loading of dental implants placed flapless in partially edentulous patients: a 3-year randomized clinical trial.

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    Merli, Mauro; Moscatelli, Marco; Mariotti, Giorgia; Piemontese, Matteo; Nieri, Michele

    2012-02-01

    To compare immediate versus early non-occlusal loading of dental implants placed flapless in a 3-year, parallel group, randomized clinical trial. The study was conducted in a private dental clinic between July 2005 and July 2010. Patients 18 years or older were randomized to receive implants for fixed partial dentures in cases of partial edentulism. The test group was represented by immediate non-occlusal implant loading, whereas the control group was represented by early non-occlusal implant loading. The outcome variables were implant failure, complications and radiographic bone level at implant sites 3 years after loading, measured from the implant-abutment junction to the most coronal point of bone-to-implant contact. Randomization was computer-generated with allocation concealment by opaque sequentially numbered sealed envelopes, and the measurer was blinded to group assignment. Sixty patients were randomized: 30 to the immediately loaded group and 30 to the early loaded group. Four patients dropped out; however, the data of all patients were included in the analysis. No implant failure occurred. Two complications occurred in the control group and one in the test group. The mean bone level at 3 years was 1.91 mm for test group and 1.59 mm for control group. The adjusted difference in bone level was 0.26 mm (CI 95% -0.08 to 0.59, p = 0.1232). The null hypothesis of no difference in failure rates, complications and bone level between implants that were loaded immediately or early at 3 years cannot be rejected in this randomized clinical trial. © 2011 John Wiley & Sons A/S.

  4. Actinobacillus actinamycetemcomitans-associated peri-implantitis in an edentulous patient - A case report

    NARCIS (Netherlands)

    van Winkelhoff, AJ; Wolf, JWA

    Background: Peri-implantitis is a risk factor for implant loss. Late bacterial infection of the peri-implant tissues and loss of alveolar bone in edentulous patients is caused by commensal oral anaerobic bacteria. In partially edentulous patients, Porphyromonas gingivalis and occasionally

  5. [New protocol combining orthodontics and implant therapy for partially edentulous adult patients. Part I: Description of the Decker protocol].

    Science.gov (United States)

    Davarpanah, K; Decker, A; Sache, M P; Deffrennes, D; Demurashvili, G; Szmukler-Moncler, S

    2014-12-01

    The treatment of adult malocclusion is usually complex and pluridisciplinary. Its prognosis is not reliable. We present a new clinical protocol to improve the management and final result. We use a specific software (Simplant®, OMS®, Materialise Dental) and its accessory modules. It allows visualization of the expected final clinical result of the orthodontic treatment. Combined with guided-surgery, it allows placing implants at the beginning of treatment in a position that is compatible with the final position. The implants serve as absolute anchorage for dental motions during the orthodontic step; it is also used to support the final prosthesis. The treatment is thus optimized and its prognosis is improved. Finally, the reversed surgical sequences shorten the treatment thus promoting the compliance of patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Mouth floor enlargements related to the sublingual glands in edentulous or partially edentulous patients: a microscopic study Tumefações do soalho bucal relacionadas às glândulas sublinguais em pacientes edêntulos ou parcialmente edêntulos: estudo microscópico

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    Liogi Iwaki Filho

    2006-08-01

    Full Text Available Mouth floor enlargements (MFE are observed in edentulous and partially edentulous patients, impairing denture fitting, and have recently been described in the literature as hyperplasias of the sublingual glands. OBJECTIVE: This study aims at describing the microscopic aspects of MFE that contribute to their final diagnosis. METHODS: Twenty-four specimens were surgically removed from the enlarged mouth floor of 19 patients (15 females and 4 males. Patient age ranged from 48 to 74 years, with a mean of 57 years. The main surgical indication was to permit or improve the fitting of dentures. Six patients were completely edentulous and 13 were partially edentulous. The material was processed for microscopic examination and stained with hematoxylin-eosin, Mallory's trichrome and periodic-acid Schiff (PAS. RESULTS AND CONCLUSIONS: The epithelium of the mouth floor was normal in 17 cases, hyperplastic in 4 and atrophic in 3. Six of the 24 sublingual glands removed were microscopically normal, while the other specimens presented acinar atrophy with hyperplasia of duct-like structures. Interstitial fibrosis was observed in 18 cases and was accompanied by adipose tissue infiltration in 15. Decreased lymphoid tissue was observed in 16 samples and oncocytosis was present in 5 cases. We suggest that MFE in edentulous or partially edentulous patients should be considered as an entity for the text books.Tumefações do soalho bucal (TSB são observadas em pacientes edêntulos ou parcialmente edêntulos, prejudicando a adaptação de próteses, e têm sido descritas recentemente na literatura como hiperplasias das glândulas sublinguais. OBJETIVO: O objetivo desse estudo é descrever os aspectos microscópicos das TSB a fim de contribuir para o seu diagnóstico final. MATERIAL E MÉTODOS: Foram removidos cirurgicamente 24 espécimes de 19 pacientes (15 mulheres e 4 homens que possuíam TSB. A idade variou de 48 a 74 anos, com média de 57 anos. A principal

  7. 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients.

    Science.gov (United States)

    van Velzen, Frank J J; Ofec, Ronen; Schulten, Engelbert A J M; Ten Bruggenkate, Christiaan M

    2015-10-01

    This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients. Patients who had dental implant surgery in the period between November 1997 and June 2001, with a follow-up of at least 10 years, were investigated for clinical and radiological examination. Among the 506 inserted dental implants in 250 patients, 10-year data regarding the outcome of implants were available for 374 dental implants in 177 patients. In the current study, peri-implantitis was defined as advanced bone loss (≧1.5 mm. postloading) in combination with bleeding on probing. At 10-year follow-up, only one implant was lost (0.3%) 2 months after implant surgery due to insufficient osseointegration. The average bone loss at 10 year postloading was 0.52 mm. Advanced bone loss at 10-year follow-up was present in 35 dental implants (9.8%). Seven percent of the observed dental implants showed bleeding on probing in combination with advanced bone loss and 4.2% when setting the threshold for advanced bone loss at 2.0 mm. Advanced bone loss without bleeding on probing was present in 2.8% of all implants. In this prospective study, the 10-year survival rate at implant and patient level was 99.7% and 99.4%, respectively. Peri-implantitis was present in 7% of the observed dental implants according to the above-mentioned definition of peri-implantitis. This study shows that SLA implants offer predictable long-term results as support in the treatment of fully and partially edentulous patients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Retrospective comparative ten-year study of cumulative survival rates of remaining teeth in large edentulism treated with implant-supported fixed partial dentures or removable partial dentures.

    Science.gov (United States)

    Yamazaki, Seiya; Arakawa, Hikaru; Maekawa, Kenji; Hara, Emilio Satoshi; Noda, Kinji; Minakuchi, Hajime; Sonoyama, Wataru; Matsuka, Yoshizo; Kuboki, Takuo

    2013-07-01

    This study aimed to compare the survival rates of remaining teeth between implant-supported fixed dentures (IFDs) and removable partial dentures (RPDs) in patients with large edentulous cases. The second goal was to assess the risk factors for remaining tooth loss. The study subjects were selected among those who received prosthodontic treatment at Okayama University Dental Hospital for their edentulous space exceeding at least four continuous missing teeth. Twenty-one patients were included in the IFD group and 82 patients were included in the RPD group. Survival rates of remaining teeth were calculated in three subcategories: (1) whole remaining teeth, (2) adjacent teeth to intended edentulous space, and (3) opposing teeth to intended edentulous space. The ten-year cumulative survival rate of the whole remaining teeth was significantly higher in the IFD group (40.0%) than in the RPD group (24.4%). On the other hand, there was no significant difference between two groups in the survival rate of teeth adjacent or opposing to intended edentulous space. A Cox proportional hazard analysis revealed that RPD restoration and gender (male) were the significant risk factors for remaining tooth loss (whole remaining teeth). These results suggest that IFD treatment can reduce the incidence of remaining tooth loss in large edentulous cases. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  9. Reconstruction-based Digital Dental Occlusion of the Partially Edentulous Dentition

    Science.gov (United States)

    Zhang, Jian; Xia, James J.; Li, Jianfu; Zhou, Xiaobo

    2016-01-01

    Partially edentulous dentition presents a challenging problem for the surgical planning of digital dental occlusion in the field of craniomaxillofacial surgery because of the incorrect maxillomandibular distance caused by missing teeth. We propose an innovative approach called Dental Reconstruction with Symmetrical Teeth (DRST) to achieve accurate dental occlusion for the partially edentulous cases. In this DRST approach, the rigid transformation between two symmetrical teeth existing on the left and right dental model is estimated through probabilistic point registration by matching the two shapes. With the estimated transformation, the partially edentulous space can be virtually filled with the teeth in its symmetrical position. Dental alignment is performed by digital dental occlusion reestablishment algorithm with the reconstructed complete dental model. Satisfactory reconstruction and occlusion results are demonstrated with the synthetic and real partially edentulous models. PMID:26584502

  10. Comparative clinical evaluation of removable partial dentures made of two different materials in Kennedy Applegate class II partially edentulous situation.

    Science.gov (United States)

    Hundal, Maninder; Madan, Rajesh

    2015-12-01

    Cast Chromium Cobalt alloy has been the material of choice for fabricating Removable Partial Dentures (RPDs) but has certain drawbacks. Newer materials like the flexible Nylon based Super Polyamide have been introduced to overcome these drawbacks. The present study has compared the above two materials for nine clinical parameters. The study was carried out on 30 patients presenting with a Kennedy Applegate class II partially edentulous situation who were divided into two equal groups and clinically assessed. Statistically significant results were obtained in favor of flexible RPDs, in the parameters of 'aesthetics' and 'overall patient satisfaction'. Both groups showed more or less similar values for 'frequency of fracture of the prosthesis during usage' with the incidence being slightly higher for patients wearing the cast RPDs. The clinical parameters of 'oral soft tissue tolerance', 'gingival health', 'periodontal health' and 'adaptability in areas with undercut' were statistically at par for all the 30 patients thus suggesting the comparable biocompatibility of the two materials. The highlight of this study was the relative ease in fabrication of the flexible RPDs as compared to the cast RPDs. Based on the favorable clinical results of this study, it can be summarized that the flexible RPDs is a viable alternative to cast RPDs in Kennedy Applegate class II partially edentulous situation in the short term.

  11. Restoration-Guided Implant Rehabilitation of the Complex Partial Edentulism: a Clinical Report

    Directory of Open Access Journals (Sweden)

    Nikitas Sykaras

    2010-01-01

    Full Text Available Background: The hard and soft tissue deficiency is a limiting factor for the prosthetic restoration and any surgical attempt to correct the anatomic foundation needs to be precisely executed for optimal results. The purpose of this paper is to describe the clinical steps that are needed to confirm the treatment plan and allow its proper execution.Methods: Team work and basic principles are emphasized in a step-by-step description of clinical methods and techniques. This clinical report describes the interdisciplinary approach in the rehabilitation of a partially edentulous patient. The importance of the transitional restoration which sets the guidelines for the proper execution of the treatment plan is especially emphasized along with all the steps that have to be followed.Results: The clinical report describes the diagnostic arrangement of teeth, the ridge augmentation based on the diagnostic evaluation of the removable prosthesis, the implant placement with a surgical guide in the form of the removable partial denture duplicate and finally the special 2-piece design of the final fixed prosthesis.Conclusions: Clinical approach and prosthesis design described above offers a predictable way to restore partial edentulism with a fixed yet retrievable prosthesis, restoring soft tissue and teeth and avoiding an implant supported overdenture.

  12. Multidisciplinary approach to restoring anterior maxillary partial edentulous area using an IPS Empress 2 fixed partial denture: a clinical report.

    Science.gov (United States)

    Dundar, Mine; Gungor, M Ali; Cal, Ebru

    2003-04-01

    Esthetics is a major concern during restoration of anterior partial edentulous areas. All-ceramic fixed partial dentures may provide better esthetics and biocompatibility in the restoration of anterior teeth. This clinic report describes a multidisciplinary approach and treatment procedures with an IPS Empress 2 fixed partial denture to restore missing anterior teeth.

  13. Management of long span partially edentulous maxilla with fixed removable denture prosthesis

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    Mahilan I Jeyavalan

    2012-01-01

    Full Text Available Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  14. Management of long span partially edentulous maxilla with fixed removable denture prosthesis.

    Science.gov (United States)

    Jeyavalan, Mahilan I; Narasimman, M; Venkatakrishnan, C J; Philip, Jacob M

    2012-07-01

    Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  15. Temporary Shell Proof-of-Concept Technique: Digital-Assisted Workflow to Enable Customized Immediate Function in Two Visits in Partially Edentulous Patients

    Science.gov (United States)

    Pozzi, Alessandro; Arcuri, Lorenzo; Moy, Peter K

    2018-03-01

    The growing interest in minimally invasive implant placement and delivery of a prefabricated provisional prosthesis immediately, thus minimizing "time to teeth," has led to the development of numerous 3-dimensional (3D) planning software programs. Given the enhancements associated with fully digital workflows, such as better 3D soft-tissue visualization and virtual tooth rendering, computer-guided implant surgery and immediate function has become an effective and reliable procedure. This article describes how modern implant planning software programs provide a comprehensive digital platform that enables efficient interplay between the surgical and restorative aspects of implant treatment. These new technologies that streamline the overall digital workflow allow transformation of the digital wax-up into a personalized, CAD/CAM-milled provisional restoration. Thus, collaborative digital workflows provide a novel approach for time-efficient delivery of a customized, screw-retained provisional restoration on the day of implant surgery, resulting in improved predictability for immediate function in the partially edentate patient.

  16. Correlation of pontic design and partial edentulous areas: A one year cross sectional study

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    Nikzad S.

    2008-12-01

    Full Text Available "nBackground and Aim: By definition, pontic is an artificial replacement of missing tooth (teeth which is essentially used to establish function and esthetics. In order to this fact that, pontic(s is not completely the same as tooth (teeth to be replaced, it may not be concern as a simple type of restoration to achieve the best result, it must be design from the esthetically and hygienically point of view as well as comfort, demand and tissue health of patient. The main purpose of this study is to investigate the pontic designs and their relationship to edentulous partial aras. "nMaterials and Methods: 73 pontics in 57 patients have been included in this cross-sectional study. These patients were under treatment in the department of prosthodontics. A primary cast was achieved from each patient and then the cross-sectional contour of edentulous ridge was depicted. For each patient the type of pontic design was derived from textbook standards and then compared with the design of actual verified Prosthesis at delivery. The shape of tissue surface of each denture was determined by a low viscous impression material. The result of each comparison was recorded in a chart data set. "nResults: The most common pontic design was Modified ridge lap with frequency of 93.2%. The type of ridge was %45.2 normal, %19.2 class I, %8.2 class II and %27.4 class III, respectively. %72.6 of pontics tested have inappropriate design in tissue surface. "nConclusion: It seems that in a high percentage of cases the tissue surface contour of prescribed pontics in department of prosthodontics was incorrect and more attention must be paid to the education of students and technicians.

  17. Removable partial overdentures for the irradiated patient

    International Nuclear Information System (INIS)

    Rosenberg, S.W.

    1990-01-01

    Patients who have received radiotherapy to the head and neck area must avoid dental extractions and seek simplicity in treatment and home care follow-up. For partially edentulous patients, removable partial overdenture therapy can fulfill these goals while maintaining the high level of function and aesthetics desired by patients.11 references

  18. Technical Considerations in Rehabilitation of an Edentulous Total Glossectomy Patient

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    Pravin Bhirangi

    2012-01-01

    Full Text Available The technician by virtue of his profession plays an important role in fabricating silicone tongue prosthesis for a total glossectomy patient. The technician, with his skills and specialized knowledge in handling material, plays a valuable role as a member of the oncology team. A patient with total glossectomy can be rehabilitated by silicone tongue prosthesis as an aid to improve his speech and swallowing. This paper describes the technical steps involved in fabricating a silicone tongue prosthesis for an edentulous total glossectomy patient.

  19. Bone Height Changes of the Mandibular Edentulous Ridge in Screw Retained Versus Telescopic Restorations for Completely Edentulous Patients

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    Eman Helal

    2017-01-01

    CONCLUSION: Up to the limitations of this study both treatment options the screw retained and telescopic overdenture can be used for rehabilitation of completely edentulous patients. These cases must be followed for a longer period to have a definite answer regarding their efficiency in the long run.

  20. Nasal mask ventilation is better than face mask ventilation in edentulous patients

    OpenAIRE

    Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

    2016-01-01

    Background and Aims: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Material and Methods: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively ev...

  1. Clinical experiences of implant-supported prostheses with laser-welded titanium frameworks in the partially edentulous jaw: a 5-year follow-up study.

    Science.gov (United States)

    Ortorp, A; Jemt, T

    1999-01-01

    Titanium frameworks have been used in the endentulous implant patient for the last 10 years. However, knowledge of titanium frameworks for the partially dentate patient is limited. To report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks in the partially edentulous jaw. A consecutive group of 383 partially edentulous patients were, on a routine basis, provided with fixed partial prostheses supported by Brånemark implants in the mandible or maxilla. Besides conventional frameworks in cast gold alloy, 58 patients were provided with titanium frameworks with three different veneering techniques, and clinical and radiographic 5-year data were collected for this group. The overall cumulative survival rate was 95.6% for titanium-framework prostheses and 93.6% for implants. Average bone loss during the follow-up period was 0.4 mm. The most common complications were minor veneering fractures. Loose and fractured implant screw components were fewer than 2%. An observation was that patients on medications for cardiovascular problems may lose more implants than others (p laser-welded titanium frameworks was similar to that reported for conventional cast frames in partially edentulous jaws. Low-fusing porcelain veneers also showed clinical performance comparable to that reported for conventional porcelain-fused-to-metal techniques.

  2. A Survey of Removable Partial Denture (RPD) Retentive Elements in Relation to the Type of Edentulism and Abutment Teeth Found in Commercial Laboratories, Athens, Greece

    Science.gov (United States)

    Sotiriou, Michael; Zissis, Alcibiades

    2014-01-01

    Objective The aim of this survey was to record removable partial denture (RPD) retentive elements and abutment teeth in partially edentulous patients, identified in commercial laboratories in Athens, Greece. Material and Methods 628 master casts with the corresponding cast metal frameworks used in the construction of RPDs were evaluated. Casts were photographed to identify the number and position of existing teeth, the partial edentulism class and the retentive elements. Prevalence tables and the x2 test were used for the statistical analysis of the collected data (α=.05). Results There were 276 maxillary (43.9%) and 352 (56.1%) mandibular casts. Maxillary edentulism entailed almost a total absence of right third molars in 96.7% and left third molars 96.0% of casts, with lower rates for the first and second molars. Edentulism in the posterior mandible presented a similar pattern. The most profound findings concerning retentive elements were: 91.9% of the retainers used were clasps and the remaining 8.1% were attachments. Of the clasps used, 48.9% were of the Roach Τ type, a finding more common in Kennedy Class I as compared to other Kennedy Classes (p<0.01). The circumferential clasps accounted for 19.3% of the total clasps used, and it was less frequently presented (8.8%) in Kennedy I Classes (p<0.01). Conclusions Roach clasps were used in the majority of cases whereas RPI clasps and attachments were rarely used. PMID:27688367

  3. A Survey of Removable Partial Denture (RPD Retentive Elements in Relation to Type of Edentulism and Abutment Teeth in Commercial Laboratories in Athens

    Directory of Open Access Journals (Sweden)

    Michael Sotiriou

    2014-01-01

    Full Text Available Objective. The aim of this survey was to record removable partial denture (RPD retentive elements and abutment teeth in partially edentulous patients, identified in commercial laboratories in Athens, Greece. Material and Methods. 628 master casts with the corresponding cast metal frameworks used in the construction of RPDs were evaluated. Casts were photographed to identify the number and position of existing teeth, the partial edentulism class and the retentive elements. Prevalence tables and the x2 test were used for the statistical analysis of the collected data (α=.05. Results. There were 276 maxillary (43.9% and 352 (56.1% mandibular casts. Maxillary edentulism entailed almost a total absence of right third molars in 96.7% and left third molars 96.0% of casts, with lower rates for the first and second molars. Edentulism in the posterior mandible presented a similar pattern. The most profound findings concerning retentive elements were: 91.9% of the retainers used were clasps and the remaining 8.1% were attachments. Of the clasps used, 48.9% were of the Roach Τ type, a finding more common in Kennedy Class I as compared to other Kennedy Classes (p<0.01. The circumferential clasps accounted for 19.3% of the total clasps used, and it was less frequently presented (8.8% in Kennedy I Classes (p<0.01. Conclusions. Roach clasps were used in the majority of cases whereas RPI clasps and attachments were rarely used.

  4. Effects of a denture adhesive in edentulous patients after maxillectomy.

    Science.gov (United States)

    Sumita, Yuka I; Otomaru, Takafumi; Taniguchi, Hisashi

    2012-06-01

    The objective of this study is to evaluate the usefulness of a denture adhesive in edentulous patients after maxillectomy. Maxillectomy patients suffer from functional impairments. Denture adhesives (DAs) are the solution in such patients. However, little is known about DAs in maxillectomy patients. Eight edentulous patients who had undergone maxillectomy were included and divided into three groups. Group 1 (half ≤ remaining residual maxilla), Group 2 (quarter < remaining residual maxilla < half) and Group 3 (remaining residual maxilla ≤ quarter). They were evaluated by a speech intelligibility test and a mixing ability test, respectively. A cream-type DA called New Poligrip(®) (GlaxoSmithKline, Tokyo, Japan) was used. Applying the DA, speech intelligibility showed a higher score than the data without DA. The effects of using a DA depend on the amount of the remaining residual maxilla. Our study showed that if the remaining residual maxilla is less than a quarter (Group 3), it is difficult to have confidence in the effectiveness of the DA to improve masticatory function. On the other hand, the use a DA showed improved speech intelligibility test values in all groups. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  5. Digital versus conventional implant impressions for edentulous patients: accuracy outcomes.

    Science.gov (United States)

    Papaspyridakos, Panos; Gallucci, German O; Chen, Chun-Jung; Hanssen, Stijn; Naert, Ignace; Vandenberghe, Bart

    2016-04-01

    To compare the accuracy of digital and conventional impression techniques for completely edentulous patients and to determine the effect of different variables on the accuracy outcomes. A stone cast of an edentulous mandible with five implants was fabricated to serve as master cast (control) for both implant- and abutment-level impressions. Digital impressions (n = 10) were taken with an intraoral optical scanner (TRIOS, 3shape, Denmark) after connecting polymer scan bodies. For the conventional polyether impressions of the master cast, a splinted and a non-splinted technique were used for implant-level and abutment-level impressions (4 cast groups, n = 10 each). Master casts and conventional impression casts were digitized with an extraoral high-resolution scanner (IScan D103i, Imetric, Courgenay, Switzerland) to obtain digital volumes. Standard tessellation language (STL) datasets from the five groups of digital and conventional impressions were superimposed with the STL dataset from the master cast to assess the 3D (global) deviations. To compare the master cast with digital and conventional impressions at the implant level, analysis of variance (ANOVA) and Scheffe's post hoc test was used, while Wilcoxon's rank-sum test was used for testing the difference between abutment-level conventional impressions. Significant 3D deviations (P impressions (P > 0.001). Digital implant impressions are as accurate as conventional implant impressions. The splinted, implant-level impression technique is more accurate than the non-splinted one for completely edentulous patients, whereas there was no difference in the accuracy at the abutment level. The implant angulation up to 15° did not affect the accuracy of implant impressions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Radiographic screening of edentulous patients: sense or nonsense? A risk-benefit analysis

    International Nuclear Information System (INIS)

    Keur, J.J.

    1986-01-01

    The benefits of radiographic examination of symptomless edentulous patients are presented. Based on data from the literature, an estimate of the risk of fatal malignancy from such a procedure is provided. Because the benefits are considerable and the risks low, a recommendation for selective screening of edentulous patients is made

  7. Digital versus conventional implant impressions for partially edentulous arches: An evaluation of accuracy.

    Science.gov (United States)

    Marghalani, Amin; Weber, Hans-Peter; Finkelman, Matthew; Kudara, Yukio; El Rafie, Khaled; Papaspyridakos, Panos

    2018-04-01

    To the authors' knowledge, while accuracy outcomes of the TRIOS scanner have been compared with conventional impressions, no available data are available regarding the accuracy of digital scans with the Omnicam and True Definition scanners versus conventional impressions for partially edentulous arches. The purpose of this in vitro study was to compare the accuracy of digital implant scans using 2 different intraoral scanners (IOSs) with that of conventional impressions for partially edentulous arches. Two partially edentulous mandibular casts with 2 implant analogs with a 30-degree angulation from 2 different implant systems (Replace Select RP; Nobel Biocare and Tissue level RN; Straumann) were used as controls. Sixty digital models were made from these 2 definitive casts in 6 different groups (n=10). Splinted implant-level impression procedures followed by digitization were used to produce the first 2 groups. The next 2 groups were produced by digital scanning with Omnicam. The last 2 groups were produced by digital scanning with the True Definition scanner. Accuracy was evaluated by superimposing the digital files of each test group onto the digital file of the controls with inspection software. The difference in 3-dimensional (3D) deviations (median ±interquartile range) among the 3 impression groups for Nobel Biocare was statistically significant among all groups (P3D deviations among the 3 impression groups for Straumann was statistically significant among all groups (P=.003), except for the conventional impression (22 ±5 μm) and True Definition (17 ±5 μm) groups; the median ±interquartile range for the Omnicam group was 26 ±15 μm. The difference in 3D deviations between the 2 implant systems was significant for the Omnicam (P=.011) and conventional (Pimpression techniques but not for the True Definition technique (P=.247). Within the limitations of this study, both the impression technique and the implant system affected accuracy. The True

  8. Alveolar ridge atrophy related to facial morphology in edentulous patients

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    Kuć J

    2017-09-01

    Full Text Available Joanna Kuć,1 Teresa Sierpińska,2 Maria Gołębiewska1 1Department of Prosthodontics, 2Department of Dental Technology, Medical University of Bialystok, Bialystok, Poland Objectives: The morphology of the alveolar process determines the retention and stability of prosthetic restorations, thereby determining the result of the therapy. Considering that the edentulous jaws may be affected by the atrophy process, it was hypothesized that the morphology of the alveolar process of the maxilla may be dependent on the anterior facial height and anatomy of the mandible. Subjects and methods: Twenty-five healthy edentulous Caucasian individuals were randomly chosen. Each subject underwent a lateral cephalogram before and after prosthetic rehabilitation. During exposition, newly made prostheses were placed in the patient’s mouth. Teeth remained in maximal intercuspidation. Morphological parameters were evaluated according to the Ricketts, McNamara, and Tallgren’s method. Results: An inversely proportional association was observed between patient age and the distal part of the maxilla. A statistically significant connection was noted between the vertical dimension of alveolar ridge and anterior total and lower facial height conditioned by prosthetic rehabilitation. Conclusion: The height of the lateral part of the alveolar ridge of the maxilla remains in connection with the anterior total and lower facial height obtained in the course of prosthetic rehabilitation. The vertical dimension of the alveolar ridge of the maxilla seems to be in close relationship with the morphology of the lower jaw. Keywords: anterior facial height, cephalometric analysis, complete dentures, vertical occlusal dimension

  9. Edentulous patients' knowledge of dental hygiene and care of prostheses.

    Science.gov (United States)

    de Castellucci Barbosa, Luciano; Ferreira, Manoela Rejane Maia; de Carvalho Calabrich, Carolina Freire; Viana, Aline Cavalcanti; de Lemos, Maria Catarina Lavigne; Lauria, Roberta Andrade

    2008-06-01

    The aim of this study was to analyse denture users' oral care habits with regard to the use of their prostheses. Rehabilitative treatment is only successful when patients are motivated and aware of correct prosthesis use and hygiene. Questionnaires were distributed to 150 complete denture users at the Federal University of Bahia School of Dentistry, the Esmeralda Natividade Health Center, the Bahian Science Development Foundation and a Salvador nursing home. The questionnaire included information on gender, age, length of prosthesis use, cleaning methods and materials, etc. The data were analysed using EpiInfo version 6 software. The chi-squared test was used for statistical analysis, with a significance level of 5%. Questionnaire results showed that 78% of the subjects, with an average age of 67.3 years, had used the same complete denture for over 5 years. 64% slept with their prostheses and 44% removed them from the mouth only for cleaning. None of the patients interviewed knew anything about brushes designed specifically for complete dentures. 37.3% had a restricted diet and 44% believed that a complete denture would last for more than 10 years. Within the limitations of this study, it was concluded that the edentulous patients surveyed had limited awareness of prosthetic hygiene and long-term oral care despite extended periods of denture use.

  10. Prosthetic rehabilitation of edentulous patient with limited oral access: A clinical report

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2012-01-01

    Full Text Available Microstomia may result from surgical treatment of orofacial neoplasms, cleft lips, maxillofacial trauma, burns, radiotherapy or scleroderma. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical report presents the prosthodontic management of a total edentulous patient with microstomia. Sectional mandibular and maxillary trays and foldable mandibular and maxillary denture were fabricated for the total edentulous patient.

  11. Morphology and morphometry of the human sublingual glands in mouth floor enlargements of edentulous patients

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    Josiane Costa Rodrigues de SA

    2013-12-01

    Full Text Available Asymptomatic mouth floor enlargements may be observed in edentulous patients. These masses, which protrude from the mouth floor, may complicate the fitting of dentures and require surgery. Whether this "entity" may be considered an anatomical variation of the mouth floor or represent specific alterations in the sublingual gland is not known. Objective: The aim of this work is to investigate the morphological and morphometric aspects of the sublingual glands of edentulous patients with mouth floor enlargements and compare the glands of these patients with the sublingual glands of human cadavers. Material and Methods: Microscopic evaluation was performed on human sublingual glands from edentulous patients with mouth floor enlargements (n=20 and edentulous cadavers (n=20. The patients and cadavers were of similar ages. The data were compared using Mann-Whitney U, Fisher's exact and Student's t tests (p0.05. Only the variables "autolysis" and "congested blood vessels" presented statistical difference between groups (p=0.014; p=0.043. The morphometric study revealed that the volume densities of acini, ducts, stroma and adipose tissue were similar between the groups (p>0.05. CONCLUSION: The microscopic characteristics of the sublingual glands in mouth floor enlargements in edentulous patients correspond to characteristics associated with the normal aging process. The glands are not pathological and represent an age-related alteration that occurs with or without the presence of the mouth floor enlargements.

  12. A new bite block for panoramic radiographs of anterior edentulous patients: A technical report.

    Science.gov (United States)

    Park, Jong-Woong; Symkhampha, Khanthaly; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul

    2015-06-01

    Panoramic radiographs taken using conventional chin-support devices have often presented problems with positioning accuracy and reproducibility. The aim of this report was to propose a new bite block for panoramic radiographs of anterior edentulous patients that better addresses these two issues. A new panoramic radiography bite block similar to the bite block for dentulous patients was developed to enable proper positioning stability for edentulous patients. The new bite block was designed and implemented in light of previous studies. The height of the new bite block was 18 mm and to compensate for the horizontal edentulous space, its horizontal width was 7 mm. The panoramic radiographs using the new bite block were compared with those using the conventional chin-support device. Panoramic radiographs taken with the new bite block showed better stability and bilateral symmetry than those taken with the conventional chin-support device. Patients also showed less movement and more stable positioning during panoramic radiography with the new bite block. Conventional errors in panoramic radiographs of edentulous patients could be caused by unreliability of the chin-support device. The newly proposed bite block for panoramic radiographs of edentulous patients showed better reliability. Further study is required to evaluate the image quality and reproducibility of images with the new bite block.

  13. OK-432 (Picibanil) sclerotherapy for recurrent dislocation of the temporomandibular joint in elderly edentulous patients: Case reports.

    Science.gov (United States)

    Matsushita, Kazuhiro; Abe, Takae; Fujiwara, Toshikatsu

    2007-09-01

    Dislocation of the temporomandibular joint (TMJ) is a thorny problem not only for a patient but also a doctor. Especially for the elderly edentulous patients, it is very hard to treat the condition although there are many surgical and non-surgical procedures. We successfully treated it in two elderly edentulous patients by injection of OK-432 as a sclerosing agent.

  14. Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients.

    Science.gov (United States)

    Turkyilmaz, Ilser; Company, Andrea M; McGlumphy, Edwin A

    2010-03-01

    Nowadays, there is some speculation among dental educators that the need for complete dentures will significantly decrease in the future and that training in their provision should be removed from the dental curriculum. To sensitise the reader to the functional shortcomings of complete denture therapy in the edentulous patient and present restorative options including implants to improve edentulous quality of life in these patients. Information retrieval followed a systematic approach using PubMed. English articles published from 1964 to 2008, in which the masticatory performance of patients with implant-supported dentures was assessed by objective methods and compared with performance with conventional dentures, were included. National epidemiological survey data suggested that the adult population in need of one or two complete dentures will increase from 35.4 million adults in 2000 to 37.9 million adults in 2020. Clinical studies have showed that the ratings of general satisfaction were significantly better in the patients treated with implant overdentures post-delivery compared with the complete denture users. In addition, the implant group gave significantly higher ratings on comfort, stability and ability to chew. Furthermore, patients who received mandibular implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. Implant-supported dentures including either complete overdentures or a hybrid prosthesis significantly improve the quality of life for edentulous patients compared with conventional removable complete dentures. Therefore, the contemporary dental practitioner should consider other options as well as conventional removable complete dentures to restore edentulous patients.

  15. A cephalometric study to determine the plane of occlusion in completely edentulous patients.

    Science.gov (United States)

    Hindocha, Amit D; Vartak, Vikas N; Bhandari, Aruna J; Dudani, Mohit T

    2013-01-01

    Determination of the plane of occlusion in completely edentulous patients with the help of the ala-tragus line (Camper's plane) may be questioned. An attempt to devise an alternative method to determine the orientation of the plane of occlusion was made. Cephalometric analysis was used to identify whether a correlation exists between the plane of occlusion of dentulous Indian individuals and other stable cranial landmarks. A negative correlation was found to exist between the occlusal Plane-FH plane angle and the porion-nasion-anterior nasal spine (PoNANS) angle. From the derived mathematical correlation, it was concluded that the angulation of the occlusal plane in completely edentulous subjects may be determined by taking a cephalogram at the diagnostic stage. Further, the clinical applicability of the derived mathematical formula (while determining the plane of occlusion) was tested on completely edentulous patients.

  16. Nueva indicación de implantes cigomáticos para la rehabilitación fija de desdentados parciales: reporte de un caso A new indication for Zygomatic implants for the fixed rehabilitation of the partially edentulous patient: Case report

    Directory of Open Access Journals (Sweden)

    M.F. Pintor Willcock

    2007-08-01

    Full Text Available Los implantes cigomáticos están indicados en casos de reabsorciones maxilares severas. Esto permitiría eliminar la necesidad de injertos óseos o levantamientos de seno de manera de recuperar el volumen óseo necesario para rehabilitar en base a implantes convencionales, disminuyendo así la morbilidad y el tiempo de tratamiento. A continuación presentamos caso de paciente desdentado parcial superior, clase I de Kennedy, en el cual se utilizaron dos implantes cigomáticos a cada lado, emergiendo sobre el reborde, a través de una modificación de la técnica.Zygomatic Implants are used in the rehabilitation of severely resorbed maxillas. This eliminates the necessity of bone grafting or sinus augmentation to restore the osseous volume necessary for conventional implant rehabilitation. This also minimizes morbidity and treatment times. We present the case of a patient with a partially edentulous upper ridge, Kennedy class I, in whom two zygomatic implants were placed in each side, that emerged over the alveolar ridge crest as a result of a technique modification.

  17. Nasal mask ventilation is better than face mask ventilation in edentulous patients.

    Science.gov (United States)

    Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

    2016-01-01

    Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed. A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant. Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients.

  18. Occlusal plane location in edentulous patients: a review.

    Science.gov (United States)

    Shetty, Sanath; Zargar, Nazia Majeed; Shenoy, Kamalakanth; Rekha, V

    2013-09-01

    Occlusal plane orientation is an important factor in the construction of a complete denture. Occlusal plane could be oriented using landmarks in the mandibular arch as well as in the maxillary arch. In the mandibular arch there are few landmarks which could be used to orient the occlusal plane like the retromolar pad, corner of the lips (lower lip length) whereas the maxillary arch has a number of landmarks, of which the ala-tragal line is the most commonly used and the same being the most controversial. In the following article different landmarks and its accuracy for orientating the occlusal plane in an edentulous subject as studied by various authors has been discussed.

  19. Effects of Impression Material, Impression Tray Type, and Type of Partial Edentulism on the Fit of Cobalt-Chromium Partial Denture Frameworks on Initial Clinical Insertion: A Retrospective Clinical Evaluation.

    Science.gov (United States)

    Baig, Mirza Rustum; Akbar, Jaber Hussain; Qudeimat, Muawia; Omar, Ridwaan

    2018-02-15

    To evaluate the effects of impression material, impression tray type, and type of partial edentulism (ie, Kennedy class) on the accuracy of fit of cobalt-chromium (Co-Cr) partial removable dental prostheses (PRDP) in terms of the number of fabricated frameworks required until the attainment of adequate fit. Electronic case documentations of 120 partially edentulous patients provided with Co-Cr PRDP treatment for one or both arches were examined. Statistical analyses of data were performed using analysis of variance and Tukey honest significant difference test to compare the relationships between the different factors and the number of frameworks that needed to be fabricated for each patient (α = .05). Statistical analysis of data derived from 143 records (69 maxillary and 74 mandibular) revealed no significant correlation between impression material, tray type, or Kennedy class and the number of construction attempts for the pooled or individual arch data (P ≥ .05). In PRDP treatment, alginate can be chosen as a first-choice material, and metal stock trays can be a preferred option for making final impressions to fabricate Co-Cr frameworks.

  20. Trueness and precision of digital impressions obtained using an intraoral scanner with different head size in the partially edentulous mandible.

    Science.gov (United States)

    Hayama, Hironari; Fueki, Kenji; Wadachi, Juro; Wakabayashi, Noriyuki

    2018-03-01

    It remains unclear whether digital impressions obtained using an intraoral scanner are sufficiently accurate for use in fabrication of removable partial dentures. We therefore compared the trueness and precision between conventional and digital impressions in the partially edentulous mandible. Mandibular Kennedy Class I and III models with soft silicone simulated-mucosa placed on the residual edentulous ridge were used. The reference models were converted to standard triangulated language (STL) file format using an extraoral scanner. Digital impressions were obtained using an intraoral scanner with a large or small scanning head, and converted to STL files. For conventional impressions, pressure impressions of the reference models were made and working casts fabricated using modified dental stone; these were converted to STL file format using an extraoral scanner. Conversion to STL file format was performed 5 times for each method. Trueness and precision were evaluated by deviation analysis using three-dimensional image processing software. Digital impressions had superior trueness (54-108μm), but inferior precision (100-121μm) compared to conventional impressions (trueness 122-157μm, precision 52-119μm). The larger intraoral scanning head showed better trueness and precision than the smaller head, and on average required fewer scanned images of digital impressions than the smaller head (pdigital impressions. Digital impressions are partially comparable to conventional impressions in terms of accuracy; the use of a larger scanning head may improve the accuracy for removable partial denture fabrication. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  1. Rehabilitation with implant-supported overdentures in total edentulous patients: A review

    OpenAIRE

    Martínez–Lage-Azorín, Juan F.; Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

    2013-01-01

    Objectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on ...

  2. Digital Workflow for Computer-Guided Implant Surgery in Edentulous Patients: A Case Report.

    Science.gov (United States)

    Oh, Ji-Hyeon; An, Xueyin; Jeong, Seung-Mi; Choi, Byung-Ho

    2017-12-01

    The purpose of this article was to describe a fully digital workflow used to perform computer-guided flapless implant placement in an edentulous patient without the use of conventional impressions, models, or a radiographic guide. Digital data for the workflow were acquired using an intraoral scanner and cone-beam computed tomography (CBCT). The image fusion of the intraoral scan data and CBCT data was performed by matching resin markers placed in the patient's mouth. The definitive digital data were used to design a prosthetically driven implant position, surgical template, and computer-aided design and computer-aided manufacturing fabricated fixed dental prosthesis. The authors believe this is the first published case describing such a technique in computer-guided flapless implant surgery for edentulous patients. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Effect of resilient liner on masticatory efficiency and general patient satisfaction in completely edentulous patients

    DEFF Research Database (Denmark)

    Mangtani, Nidhi; Pillai, Rajath; Babu, Dinesh

    2015-01-01

    Objectives: To assess the effect of resilient lined denture on patient masticatory efficiency, general patient satisfaction and denture quality as compare to conventional complete denture over a period of one year. Material and methodology: A total of 28 completely edentulous patients (14 males...... denture liner – group 2). All patients were clinically evaluated to assess the denture quality, and administered questionnaires for masticatory efficiency and patients general satisfaction level at three intervals i.e. one month (T0), 6 months (T1) and 1 year post-insertion (T2). Results: Statistical...... masticatory efficiency improved significantly over time in controls, while in experimental group masticatory efficiency remained the same (p>.05) for almost all the questions. Patient general satisfaction score at different time intervals for each question showed no significant difference (P>.05) on inter...

  4. A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

    Science.gov (United States)

    Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

    2000-01-01

    The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

  5. Restoration of Oral Function for Adult Edentulous Patients with Ectodermal Dysplasia: A Prospective Preliminary Clinical Study.

    Science.gov (United States)

    Wu, Yiqun; Wang, Xu Dong; Wang, Feng; Huang, Wei; Zhang, Zhiyong; Zhang, Zhiyuan; Kaigler, Darnell; Zou, Duohong

    2015-10-01

    Therapy with zygomatic implants (ZIs) or conventional implants (CIs) has proven to be an effective method to restore oral function for systemically healthy patients. However, it is still a major challenge to fully restore oral function to edentulous adult patients with ectodermal dysplasia (ED). The aim of this study was to determine an effective treatment protocol for restoring oral function using ZIs and CIs to edentulous adult ED patients. Ten edentulous adult ED patients were treated in this study. The treatment protocol involved the following: (1) bone augmentation in the region of the anterior teeth; (2) placement of two ZIs and four CIs in the maxilla, and four CIs in the mandible; (3) fabrication of dental prosthesis; and (4) psychological and oral education. Following treatment of these patients, implant success rates, biological complications, patient satisfaction, and psychological changes were recorded. Although there was evidence of bone graft resorption in the maxilla, bone augmentation of the mandible was successful in all patients. Nine CIs in the maxilla failed and were removed. All ZIs were successful, and the CIs success rates were 77.50% in the maxilla and 100% in the mandible, with a mean of 88.75%. The mean peri-implant bone resorption for the CIs ranged from 1.3 ± 0.4 mm to 1.8 ± 0.6 mm, and four cases exhibited gingival hyperplasia in the maxilla and mandible. One hundred percent of the patients were satisfied with the restoration of their oral function, and >50% of the patients exhibited enhanced self-confidence and self-esteem. This study demonstrates that oral function can be restored in edentulous adult ED patients using a comprehensive and systematic treatment protocol involving psychological and oral education, bone augmentation, implant placement, and denture fabrication. Despite these positive outcomes, bone augmentation remains challenging in the anterior region of the maxilla for edentulous adult ED patients. © 2015

  6. Implant-assisted removable partial dentures as an alternative treatment for partial edentulism: a review of the literature.

    Science.gov (United States)

    Chatzivasileiou, Konstantinos; Kotsiomiti, Eleni; Emmanouil, Ioannis

    2015-01-01

    This study reviewed the current literature concerning implant-assisted removable partial dentures (RPDs) in order to present the existing knowledge about performance issues. An electronic search was conducted on the PubMed database for published English-language articles that contained information about implant-assisted RPDs. A review of these articles indicated that the combination of dental implants with RPDs constitutes a cost-efficient prosthetic protocol that can offer solutions to problematic aspects of treatment with removable partial dentures. Well-designed studies are still needed to provide robust evidence on critical issues, such as design guidelines, long-term survival of implants associated with RPDs, and their effect on patients' quality of life.

  7. Imaging technique for the complete edentulous patient treated conventionally or with mini implant overdenture

    Science.gov (United States)

    Meleşcanu Imre, M; Preoteasa, E; Țâncu, AM; Preoteasa, CT

    2013-01-01

    Rationale. The imaging methods are more and more used in the clinical process of modern dentistry. Once the implant based treatment alternatives are nowadays seen as being the standard of care in edentulous patients, these techniques must be integrated in the complete denture treatment. Aim. The study presents some evaluation techniques for the edentulous patient treated by conventional dentures or mini dental implants (mini SKY Bredent) overdentures, using the profile teleradiography. These offer data useful for an optimal positioning of the artificial teeth and the mini dental implants, favoring to obtain an esthetic and functional treatment outcome. We proposed also a method to conceive a simple surgical guide that allows the prosthetically driven implants placement. Material and method. Clinical case reports were made, highlighting the importance of cephalometric evaluation on lateral teleradiographs in complete edentulous patients. A clinical case that gradually reports the surgical guide preparation (Bredent silicon radio opaque), in order to place the mini dental implants in the best prosthetic and anatomic conditions, was presented. Conclusions. The profile teleradiograph is a useful tool for the practitioner. It allows establishing the optimal site for implant placement, in a good relation with the overdenture. The conventional denture can be easily and relatively costless transformed in a surgical guide used during implant placement. PMID:23599828

  8. Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review.

    Science.gov (United States)

    Zhang, Qi; Jin, Xin; Yu, Mengliu; Ou, Guoming; Matsui, Hiroyuki; Liang, Xing; Sasaki, Keiichi

    Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients. The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature. Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective. Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures.

  9. Small-diameter dental implants: An adjunct for retention, stability, and comfort for the edentulous patient

    Directory of Open Access Journals (Sweden)

    Antonio Scarano

    2012-10-01

    Full Text Available Aim: Studies have shown that mandibular implant overdentures significantly increase satisfaction and quality of life of edentulous elders. Improved chewing ability appears to have a positive impact on nutritional state. Materials and methods: Forty edentulous subjects received four permucosal mini-implants for overdentures in the interforamina region of the mandible. Almost all participants were still satisfied with their overdentures. Participant satisfaction concerning retention and stability of the mandibular overdenture was assessed. A micro invasive technique was adopted, without open flap and performed in one chirurgical step; this technique can be used also in the so-called “highrisk” patients (anticoagulant terapy, diabetes, etc. Results and conclusion: Results and conclusion The results suggest that a mandibular overdenture retained by 4 mini-implants may be the best treatment strategy for edentulous people with atrophic ridges. The use of mini-implants is in many cases a good clinical alternative to the use of larger diameter implants, in that they enable to reduce surgical time, bleeding, postoperative discomfort and healing time.

  10. A Simple Method for Prosthodontic Rehabilitation of Edentulous Patient with Epidermolysis Bullosa: A Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Farhang Mahboub

    2011-06-01

    Full Text Available An abnormally small oral orifice is defined as microstomia. Microstomia may result from epidermolysis bullosa (EB, which consists of a group of disorders characterized by the presence of mechanical fragility of the skin with recurrent development of blisters and vesicles, resulting from minor mechanical friction or trauma. Since such patients have a small oral aperture, it may be impossible to take impression and fabricate dentures using conventional methods. In this article, a simple method for taking preliminary impressions from upper and lower edentulous ridges in one patient with limited mouth opening and then preparing the complete denture with custom denture teeth in a single unit was described.

  11. Oral health-related quality of life of edentulous patients after complete dentures relining

    Directory of Open Access Journals (Sweden)

    Krunić Nebojša

    2015-01-01

    Full Text Available Background/Aim. Tooth loss affects oral health-related life quality. More than a third of edentulous patients are not fully satisfied with their complete dentures and mainly complain of insufficient stability, retention, and pain during mastication. Solving the problem may include relining by materials that are based on silicone or acrylic. The aim of this study was to determine the level of patients’ satisfaction before and after relining upper dentures with soft and rigid liners. Methods. The patients (n = 24 were divided into two study groups. Maxillary denture relining of the first group of patients was performed with hard acrylic based resins while in the second group of patients complete denture was relined with a silicone-based soft liner. They were asked the questions from the specifically adapted the Oral Health Impact Profile Questionnaire for edentulous patients before and three months after relining dentures. Results. After relining the patients showed a higher degree of satisfaction with their dentures in all the tested domains (masticatory function, psychological discomfort, social disability and retention and hygiene. The patients with soft denture relines were more satisfied. Conclusion. Relining of maxillary complete dentures significantly positively impacts the quality of life of patients in all the tested domains (masticatory function, psychological discomfort, social disability, pain and oral hygiene. Better results were achieved using a silicone-based soft liner, which recommends it as the material of choice for relining dentures.

  12. Interdisciplinary treatment for a compensated Class II partially edentulous malocclusion: Orthodontic creation of a posterior implant site.

    Science.gov (United States)

    Chiu, Grace; Chang, Chris; Roberts, W Eugene

    2018-03-01

    A 36-year-old woman with good periodontal health sought treatment for a compensated Class II partially edentulous malocclusion associated with a steep mandibular plane (SN-MP, 45°), 9 missing teeth, a 3-mm midline discrepancy, and compromised posterior occlusal function. She had multiple carious lesions, a failing fixed prostheses in the mandibular right quadrant replacing the right first molar, and a severely atrophic edentulous ridge in the area around the mandibular left first and second molars. After restoration of the caries, the mandibular left third molar served as anchorage to correct the mandibular arch crowding. The mandibular left second premolar was retracted with a light force of 2 oz (about 28.3 cN) on the buccal and lingual surfaces to create an implant site between the premolars. Modest lateral root resorption was noted on the distal surface of the mandibular left second premolar after about 7 mm of distal translation in 7 months. Six months later, implants were placed in the mandibular left and right quadrants; the spaces were retained with the fixed appliance for 5 months and a removable retainer for 1 month. Poor cooperation resulted in relapse of the mandibular left second premolar back into the implant site, and it was necessary to reopen the space. When the mandibular left fixture was uncovered, a 3-mm deep osseous defect on the distobuccal surface was found; it was an area of relatively immature bundle bone, because the distal aspect of the space was reopened after the relapse. Subsequent bone grafting resulted in good osseous support of the implant-supported prosthesis. The relatively thin band of attached gingiva on the implant at the mandibular right first molar healed with a recessed contour that was susceptible to food impaction. A free gingival graft restored soft tissue form and function. This severe malocclusion with a discrepancy index value of 28 was treated to an excellent outcome in 38 months of interdisciplinary treatment

  13. Variations in rest vertical dimension: effects of standing posture in edentulous patients.

    Science.gov (United States)

    Makzoume, Joseph E

    2007-01-01

    The orientation of a patient's head changes, depending on whether he or she is sitting or standing in a relaxed upright position. An edentulous patient's vertical dimension at rest may show variations that can result in an inaccurate determination of his or her occlusal vertical dimension. This study recorded the rest vertical dimension (RVD) established among 60 totally edentulous subjects who were standing in the position of greatest comfort (self-balance position) and compared it with the patients' RVD when they were seated in a relaxed upright position, with the Frankfort Plane parallel to the horizontal. The RVD was measured (in mm) between two dots located on the midline of the face. Two measurements were made: one when the patient was seated upright and relaxed (with the Frankfort Plane parallel to the horizontal) with no head support, and the other when the patient was standing relaxed on both feet in a self-balance position. Five alternated measurements were made for each subject in each position. A mean RVD was calculated for each subject in each body posture and the mean values from both positions were compared. Statistical analysis was performed using Student's t-test (alpha = 0.05). No significant differences were noted between the RVD of the seated and standing positions (P = 0.67).

  14. Effects of Salivary Oxidative Markers on Edentulous Patients' Satisfaction with Prosthetic Denture Treatments: A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Chia-Huang Chang

    Full Text Available The purpose of this study was to assess relationships among periodontal conditions, salivary antioxidant levels, and patients' satisfaction with their prostheses.This study was conducted at the Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital. The periodontal condition of patients was based on an assessment of the plaque index (PI and gingival index (GI. The pH value, flow rate, and buffer capacity of the saliva were estimated. The salivary total antioxidant status (TAS and superoxide dismutase (SOD level were also determined. Patients' satisfaction with prosthetic treatments was evaluated using the Chinese version of the short-form Oral Health Impact Profile (OHIP-14C. A multivariate regression model was used to determine whether patients' satisfaction with prosthetic treatment was affected by their oral health status.In total, 35 edentulous patients were recruited. In the Spearman correlation analysis, salivary pH (r = -0.36, p = 0.03 and the buffer ability (r = -0.48, p<0.01 were associated with OHIP-14C scores. In the multivariate analysis, patients who had a higher GI also had a higher score of physical disabilities (β = 1.38, p = 0.04. Levels of SOD increased with the scores of psychological discomfort (β = 0.33 U/g protein, p = 0.04.This study suggested that both the GI and SOD levels were associated with patients' satisfaction with prosthetic treatments. To the best of our knowledge, this is the first study to elucidate the relationship between OHIP scores and salivary oxidative markers in edentulous patients.

  15. Implant loading protocols for edentulous patients with fixed prostheses: a systematic review and meta-analysis.

    Science.gov (United States)

    Papaspyridakos, Panos; Chen, Chun-Jung; Chuang, Sung-Kiang; Weber, Hans-Peter

    2014-01-01

    To report on the effect of immediate implant loading with fixed prostheses compared to early and conventional loading on implant and prosthesis survival, failure, and complications. An electronic and manual search was conducted to identify randomized controlled clinical trials (RCTs) as well as prospective and retrospective studies involving rough surface implants and implant fixed complete dental prostheses for edentulous patients. The 62 studies that fulfilled the inclusion criteria featured 4 RCTs, 2 prospective case-control studies, 34 prospective cohort studies, and 22 retrospective cohort studies. These studies yielded data from 2,695 patients (2,757 edentulous arches) with 13,653 implants. Studies were grouped according to the loading protocol applied; 45 studies reported on immediate loading, 8 on early loading, and 11 on conventional loading. For the immediate loading protocol with flap surgery, the implant and prosthesis survival rates ranged from 90.1% to 100% and 93.75% to 100%, respectively (range of follow-up, 1 to 10 years). When immediate loading was combined with guided flapless implant placement, the implant survival rates ranged from 90% to 99.4%. For the early loading protocol, the implant and prosthesis survival rates ranged from 94.74% to 100% and 93.75% to 100%, respectively (range of follow-up, 1 to 10 years). For the conventional loading protocol, the implant and prosthesis survival rates ranged from 94.95% to 100% and 87.5% to 100%, respectively (range of follow-up, 2 to 15 years). No difference was identified between maxilla and mandible. When selecting cases carefully and using dental implants with a rough surface, immediate loading with fixed prostheses in edentulous patients results in similar implant and prosthesis survival and failure rates as early and conventional loading. For immediate loading, most of the studies recommended a minimal insertion torque of 30 Ncm. The estimated 1-year implant survival was above 99% with all three

  16. Socio-demographic factors and edentulism: the Nigerian experience

    Directory of Open Access Journals (Sweden)

    Akeredolu Patricia

    2004-11-01

    Full Text Available Abstract Background The rate of total edentulism is said to be increasing in developing countries and this had been attributed mainly to the high prevalence of periodontal diseases and caries. Several reports have shown that non-disease factors such as attitude, behavior, dental attendance, characteristics of health care systems and socio-demographic factors play important roles in the aetiopathogenesis of edentulism. The aim of this study was to assess the relationship between socio-demographic factors and edentulism. Methods A total of 152 patients made up of 80 (52.6% males and 72 (47.4% females who presented in two prosthetic clinics located in an urban and a rural area were included in the study. The relationship between gender, age, socio-economic status and edentulism in this study population was established. Results No significant relationship between gender and denture demand was noted in the study. The demand for complete dentures increased with age while the demand for removable partial dentures also increased with age until the 3rd decade and then started to decline. A significant relationship was found between denture demand and the level of education with a higher demand in lower educational groups (p Conclusions The findings in this study revealed a significant relationship between socio-demographic variables and edentulism with age, educational level and socio-economic status playing vital roles in edentulism and denture demand.

  17. Customized Cheek Plumper with Friction Lock Attachment for a Completely Edentulous Patient to Enhance Esthetics: A Clinical Report.

    Science.gov (United States)

    Bhushan, Prem; Aras, Meena A; Coutinho, Ivy; Rajagopal, Praveen; Mysore, Ashwin R; Kumar, Swati

    2017-01-25

    Prosthetic rehabilitation of a completely edentulous patient should never be restricted to the replacement of missing teeth. The ultimate aim of complete denture treatment should be restoration of the full range of oral functions and esthetics. Slumped cheeks are always a concern for esthetically demanding complete denture patients. This article describes a simple, scientific, cost-effective technique to improve facial esthetics in a completely edentulous patient with the help of a cheek plumper. The technique used here implements the concept of neutral zone to precisely determine the amount of space available for the cheek plumper. The simple friction lock attachments that retained the cheek plumpers on the prosthesis were also fabricated after determining the space available in the appropriate areas. Thus an effort was made to keep the cheek plumpers unobtrusive yet effective to ensure complete integration of the prosthesis into the stomatognathic system. © 2017 by the American College of Prosthodontists.

  18. Evaluation of 4 mm implants in mandibular edentulous patients with reduced bone height. Surgical preliminary results

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    J.L. Calvo-Guirado

    2014-06-01

    Full Text Available Aim: Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this short comunication was to evaluate the clinical use of implants < 10 mm in length and to determine short implant-supported prosthesis success in the atrophic jaw. Materials and methods: Six women and three men were recruited for the treatment of edentulous mandibles. A total of 6 implants were inserted in each patient: two anterior implants of conventional lenght and four posterior 4 mm Titanium Zirconium (TiZr implants. The insertion torque and bone denisty were evaluated. Results: The mean insertion torque for the 4 mm implants was lower than for conventional ones, without any statistical difference. Moreover, most of the patients (88% showed a D2 bone type. Conclusion: The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

  19. The Prevalence of Edentulism among Patients Over 35 Years of Age Referring to the Selected Dental Clinics in Qom City, Iran, 2014

    Directory of Open Access Journals (Sweden)

    mina hamian

    2016-12-01

    Full Text Available Backgroung and Objectives: Edentulism is a common phenomenon among the elderly, which its prevalence is one of the community health indicators. Edentulism leads to gastrointestinal diseases, esthetic defects, and reduction of social and psychological abilities. The aim of this study was to investigate the prevalence of edentulism among patients aged 35 years and over who referred to the selected dental clinics of Qom city. Methods: In this cross-sectional study, 394 patients (aged 35 years and over referring to the selected dental clinics of Qom city, 2014, were randomly selected. Before performing oral examination for each person, demographic characteristics, including age, sex, job, marital status, and economic status, as well as history of smoking, xerostomia, systemic diseases, oral hygiene, and causes for edentulism, were recorded in a questionnaire. Data were analyzed using descriptive statistics and chi-square test. The level of significance was set at p<0.05. Results: The prevalence of edentulism was 23.9%, which had a significant relationship with gender, and was higher in male gender. The results of independent t-test showed that the mean age was higher in edentulous subjects and was higher (56.6. The most cause of tooth loss (75% was tooth decay. Among edentulous individuals, 84% were under diploma and 52.6% had moderate economic status. Also, 71.9% of them were brushing rarely. Conclusion: According to the results, the prevalence of edentulism in Qom was high. Also, there was a significant relationship between edentulism and education level, smoking, caries, periodontal disease, economic status, occupation, xerostomia, oral hygiene, and systemic diseases.

  20. Improved Prefrontal Activity and Chewing Performance as Function of Wearing Denture in Partially Edentulous Elderly Individuals: Functional Near-Infrared Spectroscopy Study

    Science.gov (United States)

    Kamiya, Kazunobu; Narita, Noriyuki; Iwaki, Sunao

    2016-01-01

    The purpose of this study was to elucidate the effects of wearing a denture on prefrontal activity during chewing performance. We specifically examined that activity in 12 elderly edentulous subjects [63.1±6.1 years old (mean ± SD)] and 12 young healthy controls (22.1±2.3 years old) using functional near-infrared spectroscopy (fNIRS) in order to evaluate the quality of prefrontal functionality during chewing performance under the conditions of wearing a denture and tooth loss, and then compared the findings with those of young healthy controls. fNIRS and electromyography were used simultaneously to detect prefrontal and masticatory muscle activities during chewing, while occlusal force and masticatory score were also examined by use of a food intake questionnaire. A significant increase in prefrontal activity was observed during chewing while wearing a denture, which was accompanied by increased masticatory muscle activity, occlusal force, and masticatory score, as compared with the tooth loss condition. Prefrontal activation during chewing while wearing a denture in the elderly subjects was not much different from that in the young controls. In contrast, tooth loss in the elderly group resulted in marked prefrontal deactivation, accompanied by decreased masticatory muscle activity, occlusal force, and masticatory score, as compared with the young controls. We concluded that intrinsic prefrontal activation during chewing with a denture may prevent prefrontal depression induced by tooth loss in elderly edentulous patients. PMID:27362255

  1. Impact of implant-supported prostheses on nutritional status and oral health perception in edentulous patients.

    Science.gov (United States)

    El Osta, Nada; El Osta, Lana; Moukaddem, Farah; Papazian, Tatiana; Saad, Robert; Hennequin, Martine; Rabbaa Khabbaz, Lydia

    2017-04-01

    Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses. This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index (GOHAI) respectively at Baseline (first visit before treatment), 2-3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment. Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2-3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result. Copyright © 2017

  2. Mandibular Flexure in Anterior-Posterior and Transverse Plane on Edentulous Patients in Mashhad Faculty of Dentistry

    Directory of Open Access Journals (Sweden)

    Azam Sadat Madani

    2013-01-01

    Full Text Available Introduction: Angle and internal position of lateral pterygoid muscle leads to contraction over two half of the mandible in maximum opening and protrusion position so it can affects impression prosthetic procedures. The aim of this study was to evaluate the mandibular flexure in two transverse and antro-posterior dimensions. Methods: Seventy edentulous patients at Mashhad Faculty of Dentistry as the main group and 50 dentulous patients as the control group were selected. In these patients, transverse dimensions between second molar areas and also canine eminence from one side to another side, and longitudinal dimensions based on the distance between canine to second molar area at centric occlusion and maximum mouth opening were measured. Dimensional differences as the mandibular flexure were measured. Results: The mandibular dimensions in maximum opening and closed mouth were different. Average reduction in transverse dimension on second molar region at maximum mouth opening and closing position were almost equal to -0.0787 mm for target group and 0.7512 mm for control group. On anterior side, averages of these changes were equal to 0.3069 mm for target group and were 0.2254 mm for control group. Conclusion: Transverse dimensions in anterior region at maximum opening position are smaller than the same dimension at closed mouth in edentulous and dentulous patients.

  3. Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation.

    Science.gov (United States)

    Nitecka-Buchta, Aleksandra; Proba, Thomas; Proba, Paulina; Stefański, Kamil; Baron, Stefan

    2018-01-01

    The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics). The influence of the method used to obtain the centric relation on patients' stomatognathic system (condyle centralization, pain) was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

  4. Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation

    Directory of Open Access Journals (Sweden)

    Aleksandra Nitecka-Buchta

    2018-01-01

    Full Text Available The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics. The influence of the method used to obtain the centric relation on patients’ stomatognathic system (condyle centralization, pain was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

  5. CAD/CAM technologies in the surgical and prosthetic treatment of the edentulous patient with biomymetic individualized approach.

    Science.gov (United States)

    Pozzi, A; Gargari, M; Barlattani, A

    2008-04-01

    The advent of modern endosseous implant design and improved surface technology has allowed the development of new restorative techniques that decrease patient's total treatment time. Utilizing the latest scanning, CAD/CAM and manufacturing technolgies we are able to manufacture individualized dental restoration with high accuracy and a perfect precision of fit. This report describes the rehabilitation of a completely edentulous patient utilizing a CT-based implant planning with computer-assisted surgical design, simultaneous CAD/CAM fabrication of a surgical template, a flapless surgical placement of the implants, and a prefabricated fixed complete denture for an immediately loaded restoration according to Nobel Biocare's Teeth-in-an-Hour™ (Nobel Biocare Goteborg, Sweden) protocol. This systematic approach to full mouth rehabilitation reduces the time necessary for an edentulous patient to go from severely atrophic alveolar support to implant retained prosthetic restoration. These aspects of minimally invasive and simplified surgery, along with reducing the treatment time and postsurgical discomfort, are beneficial to the patient, and allowing for rehabilitation with the same level of success as in flap surgery. The Teeth-in-an-Hour protocol is a unique solution made possible by the Procera System. With the aid of the CT scans and a virtual planning software, a custom fabricated precision drill guide and a pre-manufactured prosthesis can be made before surgery. The execution of implant placement is performed with a flapless procedure that results in minimal surgical intervention. This results in a short and non-traumatic surgery with a minimum of postoperative complications, allowing the patient to leave the chair with a fixed prosthesis. Utilizing the latest scanning, CAD/CAM and manufacturing technologies the dental team is able to develop individualized zirconia full arch framework with high accuracy and precision of fit.

  6. Attitudes towards Prosthodontic Clinical Decision-Making for Edentulous Patients among South West Deanery Dental Foundation Year One Dentists

    Directory of Open Access Journals (Sweden)

    Andrew Barber

    2016-05-01

    Full Text Available The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the study between May and June 2011 and a previously piloted questionnaire was administered to the trainees by their training programme directors. The questionnaire posed questions based upon a clinical scenario of discussing treatment options with patients. Seventy-two questionnaires were used in the analysis (91% overall response rate. Trainees perceived their own values to be less important than the patient’s values (p < 0.001 in decision making, but similar to the patient’s friend’s/relative’s values (p = 0.1. In addition, the trainees perceived the patient’s values to be less important than their friend’s/relatives (p < 0.001. Sixty-six per cent of trainees acknowledged an influence from their own personal values on their presentation of material to patients who are in the process of choosing among different treatment options, and 87% thought their edentulous patients were satisfied with the decision making process when choosing among different treatment options. Fifty-eight per cent of trainees supported a strategy of negotiation between patients and clinicians (shared decision making. There was no strong evidence to suggest gender had an influence on the attitudes towards decision making. The finding of a consensus towards shared decision making in the attitudes of trainees, and no gender differences is encouraging and is supportive of UK dental schools’ ability to foster ethical and professional values among dentists.

  7. Incidence of peri-implant mucositis and peri-implantitis in edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period

    NARCIS (Netherlands)

    Meijer, Henny J. A.; Raghoebar, Gerry M.; de Waal, Yvonne C. M.; Vissink, Arjan

    2014-01-01

    Objectives: The aim of this sub-analysis of two prospective studies was to assess the incidence of peri-implant mucositis and peri-implantitis in fully edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period. Material and Methods: One hundred and fifty

  8. Shape model of the maxillary dental arch using Fourier descriptors with an application in the rehabilitation for edentulous patient.

    Science.gov (United States)

    Rijal, Omar M; Abdullah, Norli A; Isa, Zakiah M; Noor, Norliza M; Tawfiq, Omar F

    2013-01-01

    The knowledge of teeth positions on the maxillary arch is useful in the rehabilitation of the edentulous patient. A combination of angular (θ), and linear (l) variables representing position of four teeth were initially proposed as the shape descriptor of the maxillary dental arch. Three categories of shape were established, each having a multivariate normal distribution. It may be argued that 4 selected teeth on the standardized digital images of the dental casts could be considered as insufficient with respect to representing shape. However, increasing the number of points would create problems with dimensions and proof of existence of the multivariate normal distribution is extremely difficult. This study investigates the ability of Fourier descriptors (FD) using all maxillary teeth to find alternative shape models. Eight FD terms were sufficient to represent 21 points on the arch. Using these 8 FD terms as an alternative shape descriptor, three categories of shape were verified, each category having the complex normal distribution.

  9. Early Loading of Single-Piece Implant for Partially Edentulous Posterior Arch: A Prospective One-Year Case Report

    Directory of Open Access Journals (Sweden)

    Amol Beldar

    2013-01-01

    Full Text Available Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies. However, to date there are insufficient data to determine a universally acceptable opinion on early loading of implants for single-tooth replacement. This case report involves early loading, combined with construction of a restoration, inserted directly after 6 weeks of implant surgery and followup of one year.

  10. Ten-year survival rates of teeth adjacent to treated and untreated posterior bounded edentulous spaces.

    Science.gov (United States)

    Aquilino, S A; Shugars, D A; Bader, J D; White, B A

    2001-05-01

    Failure to replace a single missing posterior tooth may lead to a variety of dental problems, which may ultimately result in tooth loss. However, little is known about the fate of the adjacent teeth if a missing posterior tooth is not replaced. This retrospective study evaluated the survival of teeth adjacent to treated and untreated posterior bounded edentulous spaces. Data were obtained from electronic treatment records from the Kaiser Permanente Dental Care Program, Portland, Ore. A final sample of 317 patients who met the study inclusion criteria was identified. Each bounded edentulous space was placed in 1 of 3 treatment categories: untreated, restored with a fixed partial denture, or restored with a removable partial denture. Subsequent treatment and the status of the teeth adjacent to the bounded edentulous space were followed through December 1999. Ten-year Kaplan-Meier survival estimates were generated for each treatment group, and differences in survival were evaluated with the log-rank chi-square test (alpha=.05). There was a significant difference in survival among the 3 treatment categories (P=.005). Spaces restored with a fixed partial denture had longer 10-year survival estimates (92%) than those that remained untreated (81%). Spaces restored with a removable partial denture had the poorest 10-year survival rate (56%). Under the conditions and selection bias associated with this retrospective study, the survival of teeth adjacent to a single posterior edentulous space was negatively associated with removable partial denture placement compared with no treatment or the use of a fixed partial denture.

  11. A 5- to 8-year retrospective study comparing the clinical results of implant-supported telescopic crown versus bar overdentures in patients with edentulous maxillae.

    Science.gov (United States)

    Zou, Duohong; Wu, Yiqun; Huang, Wei; Zhang, Zhiyong; Zhang, Zhiyuan

    2013-01-01

    The objective of this study was to compare implant survival and success rates, peri-implant parameters, and prosthodontic maintenance efforts for implant-supported telescopic crown overdentures and bar overdentures to restore maxillary edentulism. This retrospective clinical study involved patients with maxillary edentulism who were fitted with implant-supported overdentures from January 2004 to June 2007. During a 5- to 8-year follow-up period, the implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance, and patient satisfaction were retrospectively analyzed. The data were evaluated statistically and P overdentures. Twenty-one patients chose telescopic crown overdentures and 23 patients chose bar overdentures. A total of 41 patients and 201 implants were available for follow-up. The implant survival and success rates, average bone resorption, and subjective patient satisfaction scores showed no difference between the telescopic crown and the bar overdenture group at follow-up. However, there were higher values for Plaque and Calculus Indexes in the bar group compared with the telescopic crown group, and these values showed a statistically significant difference annually from the 3-year follow-up (P overdentures provided a healthy peri-implant structure for implants in both groups. Implant-supported telescopic crown or bar overdentures can provide a good treatment option for patients with edentulous maxillae.

  12. [Systematic review and meta-analysis on the effect of implant supported overdentures on the oral health related quality of life of edentulous patients].

    Science.gov (United States)

    Zhang, S S; Zhang, Y; Di, P; Lin, Y

    2017-05-09

    Objective: To evaluate the effect of implant related treatment on the oral health related quality of life (OHRQoL) of edentulous patients. Methods: The CNKI, Wanfang database and Medline, EMBASE, Cochrane Library databases that include randomized clinical trials comparing implant supported overdentures with conventional complete denture for edentulous patients were retrived. Nine studies involving 769 cases were included and meta-analysis was conducted. Results: The standardized mean difference (SMD) of oral health impact profile (OHIP) score was 1.63 (95% CI: 1.25-2.02) and improved after implant related treatment, which was significantly better than the conventional complete denture (0.87, 95% CI: 0.54-1.20). Conclusions: Implant supported overdentures improved patient's OHRQoL and showed better performance compared to the overdentures complete dentures.

  13. Immediate occlusal loading of Osseotite implants in mandibular edentulous patients: a prospective observational report with 18-month data.

    Science.gov (United States)

    Drago, Carl J; Lazzara, Richard J

    2006-01-01

    To evaluate the efficacy of treatment consisting of placement and immediate occlusal loading of implants in 27 patients with edentulous mandibles. Twenty-seven patients were treated in two private practice settings. One hundred fifty-one implants were placed and immediately occlusally loaded with fixed implant prostheses (15 cement-retained, 12 screw-retained) on the day of implant placement. The implant-retained prostheses were inserted within 5 hours of implant placement. Patients were followed for at least 18 months. The required criteria for immediate occlusal loading was primary implant stability of at least 30 Ncm of insertion torque. The implant prostheses were removed at least 12 months post-placement and the implants were evaluated for primary clinical stability and radiographic bone apposition to implants. At the 12-month follow-up appointments, cumulative survival rates of 98.0% and 100% were recorded for implants and prostheses, respectively. Three implants failed within 3 months. All other implants were clinically successful. Immediate occlusal loading of multiple, splinted mandibular implants is an effective treatment when implants are stable at insertion and are rigidly splinted with implant-retained prostheses.

  14. Outcomes Assessment of Treating Completely Edentulous Patients with a Fixed Implant-Supported Profile Prosthesis Utilizing a Graftless Approach. Part 1: Clinically Related Outcomes.

    Science.gov (United States)

    Alzoubi, Fawaz; Bedrossian, Edmond; Wong, Allen; Farrell, Douglas; Park, Chan; Indresano, Thomas

    To assess outcomes of treating completely edentulous patients with a fixed implant-supported profile prosthesis utilizing a graftless approach for the maxilla and for the mandible, with emphasis on clinically related outcomes, specifically implant and prosthesis survival. This was a retrospective study with the following inclusion criteria: completely edentulous patients rehabilitated with a fixed implant-supported profile denture utilizing a graftless approach. Patients fulfilling the inclusion criteria were asked to participate in the study during their follow-up visits, and hence a consecutive sampling strategy was used. Data regarding implant and prosthesis cumulative survival rates (CSRs) were gathered and calculated. Thirty-four patients were identified with a total of 220 implants placed. An overall CSR of 98.2% was recorded with an observation of up to 10 years. For tilted, axial, and zygomatic implants, CSRs of 96.9%, 98.0%, and 100%, respectively, were observed for up to 10 years. For provisional prostheses, CSRs of 92.3% at 1 year, and 84.6% at 2 years were observed. For final prostheses, a CSR of 93.8% was observed at 10 years. The results suggest that treating completely edentulous patients with a fixed profile prosthesis utilizing a graftless approach in the maxilla and the mandible can be a reliable treatment option.

  15. Restoration of unfavorably positioned implants for a partially endentulous patient by using an overdenture retained with a milled bar and attachments: a clinical report.

    Science.gov (United States)

    Asvanund, Chanavut; Morgano, Steven M

    2004-01-01

    The restorative dentist may encounter patients with previously placed misaligned implants that are well integrated. Often, these patients have deficient alveolar ridge contour further complicating treatment options. This clinical report describes a treatment approach for a partially edentulous patient with unfavorably positioned implants that incorporated: (1) an implant-supported milled bar with a removable, metal-acrylic resin, partial overdenture, (2) implant-supported single crowns, and (3) crowns retained by natural teeth.

  16. Systematic assessment of the various controversies, difficulties, and current trends in the reestablishment of lost occlusal planes in edentulous patients.

    Science.gov (United States)

    Sahoo, S; Singh, D; Raghav, D; Singh, G; Sarin, A; Kumar, P

    2014-05-01

    Accurate occlusal plane orientation is an essential factor in the fabrication of complete denture prosthesis. Over the years, it has received a number of methodologies by several researchers utilizing various anatomical landmarks however none of them is considered as perfect that could orient ideal occlusal plane. The presented literature review is an attempt to enlighten historical perspectives, pioneer researches, different controversies, difficulties and current trends for re-establishment of lost occlusal plane in edentulous patients. An extensive literature search was performed using Medline/PubMed interface and other scholarly research bibliographic databases using Medical Subject Headings. Studies describing research studies, case series and assorted clinical reports were retrieved and evaluated from 1963 to 2013. Most of the studies have suggest and evidence to consider Camper's plane for artificial orientation of occlusal plane however there is a substantial lack of genuine long term studies and authentic data that could recommend a single reliable landmark for perfect occlusal plane reorientation in a variety of cases.

  17. Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report

    Directory of Open Access Journals (Sweden)

    José Fernando Scarelli LOPES

    2015-04-01

    Full Text Available A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework, allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

  18. Missing Teeth and Prosthetic Treatment in Patients Treated at College of Dentistry, University of Dammam

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    Shaimaa M. Fouda

    2017-01-01

    Full Text Available The percentage of completely and partially edentulous patients and their prosthetic treatment at the Department of Substitutive Dental Sciences (SDS, College of Dentistry, University of Dammam, were investigated. Panoramic radiographs and medical records of adult patients (n=479, mean age 45.9 years, and range 25–96 years treated in 2011–2014 were examined. 6% of the patients were completely edentulous, 8% had single jaw edentulousness, and 74% were partially edentulous. Edentulousness was significantly correlated with age and the number of missing teeth was significantly higher among males (p<0.026. Diabetes was significantly associated with complete edentulousness, single edentulous jaw (p value 0.015, and partial edentulousness (p value 0.023. Kennedy class III was the most frequent class of partial edentulousness in single and/or both jaws (p=0.000. Patients having class I and/or class II were treated most often with removable partial dentures (RPD (p=0.000, while patients having class III were treated with fixed partial dentures (FPD. It was found that complete edentulousness increases in older age and the number of missing teeth was significantly higher among males. Kennedy class III was most common in both upper and lower jaw and was treated more often with FPD than with RPD.

  19. An Alternative Prosthetic Approach for Rehabilitation of Two Edentulous Maxillectomy Patients: Clinical Report.

    Science.gov (United States)

    Yenisey, Murat; Külünk, Şafak; Kaleli, Necati

    2017-07-01

    Obturator prosthesis is a common treatment method for maxillectomy patients for maintaining their oronasal separation and resuming their social lives. After tumor resection, the remaining anatomical structures have a significant effect on prosthesis retention. The present study describes the rehabilitation of two maxillectomy patients after cancer surgery using a prosthesis consisting of a denture and a special retentive obturator that is positioned in the anatomical undercuts of the nasal cavity. These patients have undergone total and subtotal maxillectomy surgery after the diagnosis of squamous cell carcinoma. The systemic and local health status of the total maxillectomy patient was not suitable for zygomatic implant surgery. Only one osseointegrated dental implant was placed into the left maxillary tuberosity area in the subtotal maxillectomy patient. In addition, the quality, vertical height, and horizontal width of the remaining bone structures in the maxilla limited the use of osseointegrated dental implants. Mechanical prosthesis retention was provided using a multiunit retentive mechanism composed of an orthodontic forsus fatigue resistant device (OFFRD), two Herbst appliances, and an acrylic piece associated with healthy keratinized mucosa. The OFFRD could easily apply a consistent force and push the acrylic pieces toward the retentive undercut under the control of the two Herbst appliances. Two OFFRD units in different directions were designed for the total maxillectomy patient, while only one OFFRD unit was placed on the opposite side of the osseointegrated implant in the subtotal maxillectomy patient. A sufficient retention was obtained for both patients. The patients were satisfied, and no major complications were observed in periodic controls. © 2017 by the American College of Prosthodontists.

  20. Mandibular subluxation for distal internal carotid artery exposure in edentulous patients

    NARCIS (Netherlands)

    Jaspers, Gijs W.; Witjes, Max J.; van den Dungen, Jan J.; Reintsema, Harry; Zeebregts, Clark J.

    2009-01-01

    Four patients with high internal carotid artery (ICA) occlusive disease were indicated for surgical endarterectomy and needed additional exposure be-sides regular head rotation and extension. When indicated, in our clinic this is usually achieved by mandibular subluxation with interdental wiring.

  1. Developing Prosthodontic Residents' Communication Strategies with Edentulous Patients: A Pilot Study.

    Science.gov (United States)

    Murthy, Varsha; Sethuraman, K R; Choudhury, Sunayana; Shakila, P

    2017-11-01

    The aim of this study was to investigate whether prosthodontic residents' attitudes toward provider-client communication would be shaped by a tailor-made communications skills course. In 2016, the pre-intervention attitudes of all six second- and third-year prosthodontic residents in a three-year residency at an academic dental institution in India were assessed using the Communication Skills Attitude Scale (CSAS). The residents' performance was then video-recorded while they treated complete denture patients and was analyzed using the Kalamazoo scale, a validated scale for communication skills assessment. The residents' weaknesses were identified, and a custom-made generic module was designed along with individual guidance counseling for addressing aspects relevant to complete denture patients. The residents' attitudes were again assessed immediately after they completed the training using CSAS, as well as after two and four months using Balint sessions. Analysis of the recordings showed that few of the deficiencies during intraoral procedures were contextual, and the Kalamazoo scale did not address them: these were noted as being "beyond Kalamazoo." After the training, the residents reported awareness of their weaknesses and feeling motivated to practice their newly acquired skills. The Balint sessions showed that they had started valuing patients' agendas and the rapport-building process, and they reported transfer of skills when treating other types of prosthodontic patients. In this study, a customized communication skills module brought about a positive change in residents' attitudes, which was sustained over four months. Similar training could be implemented in other dental specialties.

  2. Male patients with partial androgen insensitivity syndrome

    DEFF Research Database (Denmark)

    Hellmann, Philip; Christiansen, Peter; Johannsen, Trine Holm

    2012-01-01

    To describe the natural history of phenotype, growth and gonadal function in patients with partial androgen insensitivity syndrome.......To describe the natural history of phenotype, growth and gonadal function in patients with partial androgen insensitivity syndrome....

  3. A clinico-radiographic study to compare and co-relate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in completely edentulous patients.

    Science.gov (United States)

    Shetty, Sanath; Kunta, Mythili; Shenoy, Kamalakanth

    2018-01-01

    The purpose of this study was to compare and correlate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in edentulous patients. Twelve completely edentulous patients were selected by the inclusion and exclusion criteria. Conventional steps in the fabrication of complete denture till jaw relation were carried out. Intraoral gothic arch tracing and protrusive interocclusal records were obtained for each patient. Protrusive interocclusal record was used to program the Hanau Wide-Vue semi-adjustable articulator, thus obtaining the sagittal condylar guidance angle. Using RadiAnt DICOM software, on the orthopantomogram obtained for each patient in the study, two reference lines were drawn. The Frankfort's horizontal plane and the mean curvature line (joining the most superior and the inferior points on the glenoid fossa curvature) were drawn. The mean curvature line was extended to intersect the Frankfort's horizontal plane, thus obtaining the radiographic sagittal condylar guidance angle. The condylar guidance angles obtained by these two methods were compared and subjected to paired t -test. There was no statistically significant difference between the sagittal condylar guidance angles obtained between right and left sides with intraoral gothic arch tracing and radiographic methods ( P = 0.107 and 0.07, respectively). Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used for programming semi-adjustable articulators.

  4. Technique to Obtain a Predictable Aesthetic Result through Appropriate Placement of the Prosthesis/Soft Tissue Junction in the Edentulous Patient with a Gingival Smile.

    Science.gov (United States)

    Demurashvili, Georgy; Davarpanah, Keyvan; Szmukler-Moncler, Serge; Davarpanah, Mithridade; Raux, Didier; Capelle-Ouadah, Nedjoua; Rajzbaum, Philippe

    2015-10-01

    Treating the edentulous patient with a gingival smile requires securing the prosthesis/soft tissue junction (PSTJ) under the upper lip. To present a simple method that helps achieve a predictable aesthetic result when alveoplasty of the anterior maxilla is needed to place implants apical to the presurgical position of the alveolar ridge. The maximum smile line of the patient is recorded and carved on a thin silicone bite impression as a soft tissue landmark. During the three-dimensional radiographic examination, the patient wears the silicone guide loaded with radiopaque markers. The NobelClinician® software is then used to bring the hard and soft tissue landmarks together in a single reading. Using the software, a line is drawn 5 mm apical to the smile line; it dictates the position of the crestal ridge to be reached following the alveoplasty. Subsequently, the simulated implant position and the simulated residual bone height following alveoplasty can be simultaneously evaluated on each transverse section. An alveoplasty of the anterior maxilla was performed as simulated on the software, and implants were placed accordingly. The PSTJ was always under the upper lip, even during maximum smile events. The aesthetic result was, therefore, fully satisfactory. This simple method permits the placement of the PSTJ under the upper lip with a predictable outcome; it ensures a reliable aesthetic result for the edentulous patient with a gingival smile. © 2013 Wiley Periodicals, Inc.

  5. Rehabilitation of an edentulous cleft lip and palate patient with a soft palate defect using a bar-retained, implant-supported speech-aid prosthesis: a clinical report.

    Science.gov (United States)

    Hakan Tuna, S; Pekkan, Gurel; Buyukgural, Bulent

    2009-01-01

    Prosthetic rehabilitation of an edentulous cleft lip and palate patient with a combined hard and soft palate defect is a great challenge, due to the lack of retention of the obturator prosthesis as a result of its weight and the inability to obtain a border seal. Dental implants improve the retention, stability, and occlusal function of prostheses when used in carefully selected cleft lip and palate cases. This clinical report presents an edentulous unilateral cleft lip and palate patient who has hard and soft palate defects and an atrophied maxilla, treated with an implant-supported speech-aid prosthesis.

  6. Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: Retrospective study of a cohort of edentulous patients.

    Science.gov (United States)

    Fernandez-Estevan, Lucia; Selva-Otaolaurruchi, Eduardo J; Montero, Javier; Sola-Ruiz, Fernanda

    2015-07-01

    This work aims to confirm if implant-supported overdentures are a good treatment option for edentulous patients and offer an improvement in quality of life compared with traditional complete prostheses (dentures). This retrospective clinical descriptive study included three evaluation groups: validation group (n=57); control group of patients with complete removeable prostheses (n=56); study group of patients with implant-supported overdentures retained with the Locator® system (n=80). The study also validated the Oral Health Impact Profile-20 questionnaire. Individual protocols were created that included socio-demographic data, the Oral Health Impact Profile-20 (OHIP-20) questionnaire and Oral Satisfaction Scale (OSS). Descriptive and bivariate statistical analysis was carried out applying χ², Pearson, Kruskal-Wallis, and Student t tests, transferring data into SPSS-Windows® software from a Microsoft® Excel spreadsheet. The OHIP-20 proved to be a valid instrument and provided reliable assessment of health-related quality of life among both the Spanish general population and edentulous patients. The control and study groups proved comparable, showing socio-demographic homogeneity. For patients with overdentures retained by means of the Locator® system, these restorations had significantly lower impact on quality of life (19 vs 33), both generally and for each individual questionnaire item, and much higher satisfaction with the state of their oral cavities (8.3 vs 5.3) than patients wearing dentures; both sets of data showed a direct linear relationship, so that as the level of impact on quality of life increased, perceived oral satisfaction worsened. Patients rehabilitated with implant supported overdentures retained by the Locator® system, presented significantly lower levels of impact on their quality of life and significantly higher oral satisfaction than patients with conventional complete prostheses.

  7. Flexible Thermoplastic Denture Base Materials for Aesthetical Removable Partial Denture Framework

    OpenAIRE

    Singh, Kunwarjeet; Aeran, Himanshu; Kumar, Narender; Gupta, Nidhi

    2013-01-01

    Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated...

  8. Functional benefits of implants placed during ablative surgery: A 5-year prospective study on the prosthodontic rehabilitation of 56 edentulous oral cancer patients.

    Science.gov (United States)

    Wetzels, Jan Willem; Koole, Ron; Meijer, Gert J; de Haan, Anton F J; Merkx, Matthias A W; Speksnijder, Caroline M

    2016-04-01

    The timing of placement as well as the functional benefit of interforaminal implants in edentulous patients treated for oral cancer is unclear. Fifty-six patients were recruited at 2 institutions. In 1 institution, interforaminal implants were placed during ablative surgery, the other institution used conventional prosthodontics with optional placement of implants postsurgery (postponed-placement). Masticatory performance, bite force, and subjective masticatory function were assessed before and 6 months, 1 year, and 5 years after surgery. Implant-retained overdentures (IODs) demonstrated the highest bite force and the least problems with solid food and food choice. Masticatory performance was equal for IODs and conventional dentures. After 5 years, IODs from patients in the during-ablative-surgery cohort tend to have higher bite force and masticatory performance than those from patients in the postponed-placement cohort. IODs produce the highest overall masticatory function. Implant placement during ablative surgery seems to be functionally beneficial. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2103-E2111, 2016. © 2016 Wiley Periodicals, Inc.

  9. Treatment of Orally Handicapped Edentulous Older Adults Using Dental Implants.

    Science.gov (United States)

    Zahedi, Charles

    2016-07-01

    The oral handicap of complete edentulism is the terminal outcome of a multifactorial process involving biological factors and patient-related factors. Fully edentulous orally handicapped older adults have been neglected because removable acrylic dentures have been the classic therapy for complete edentulism but are only rehabilitative, not therapeutic. Not replacing missing teeth with stable dentures could prevent adequate food intake. Osseointegrated endosseous implants used as a therapeutic adjunct can reduce the problem of long-term bone resorption to less than 0.1 mm per year. Implant-borne prostheses substantially increase the overall health and quality of life of orally handicapped fully edentulous older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Oral Health-Related Quality of Life in Edentulous Patients with Two- vs Four-Locator-Retained Mandibular Overdentures: A Prospective, Randomized, Crossover Study.

    Science.gov (United States)

    Karbach, Julia; Hartmann, Sinsa; Jahn-Eimermacher, Antje; Wagner, Wilfried

    2015-01-01

    To compare the oral health-related quality of life (OHRQoL) in a prospective, randomized crossover trial in patients with mandibular overdentures retained with two or four locators. In 30 patients with edentulous mandibles, four implants (ICX-plus implants [Medentis Medical]) were placed in the intraforaminal area. Eight weeks after transgingival healing, patients were randomly assigned to have two or four implants incorporated in the prosthesis. After 3 months, the retention concepts were switched. The patients with a two-implant-supported overdenture had four implants incorporated, whereas patients with a four-implant-supported overdenture had two retention locators taken out. After 3 more months, all four implants were retained in the implant-supported overdenture in every patient. To measure OHRQoL of the patients, the Oral Health Impact Profile 14, German version (OHIP-14 G), was used. A considerable increase in OHRQoL could be seen in all patients after the prosthesis was placed on the implants. Also, a statistically significant difference of OHRQoL could be seen in the OHIP-14 G scores between two-implant and four-implant overdentures. Patients had a higher OHRQoL after incorporation of four implants in the overdenture compared with only two implants. Patients with implant-retained overdentures had better OHRQoL compared with those with conventional dentures. The number of incorporated implants in the locator-retained overdenture also influenced the increase in OHRQoL, with four implants having a statistically significant advantage over two implants.

  11. Comparison of three-implant-supported fixed dentures and two-implant-retained overdentures in the edentulous mandible: a pilot study of treatment efficacy and patient satisfaction.

    Science.gov (United States)

    De Kok, Ingeborg J; Chang, Kuang-Han; Lu, Tsui-Shan; Cooper, Lyndon F

    2011-01-01

    The mandibular two-implant overdenture has been shown to be a highly successful treatment. However, overdenture patients who desire a fixed prosthesis may not be satisfied with a removable overdenture. This prospective study sought to compare prosthetic outcomes, patient satisfaction, and survival rates of implants between two-implant-supported overdentures (IODs) and three-implant-supported fixed dentures (ISFDs). Twenty completely edentulous patients were randomly and equally assigned to two groups. New conventional complete dentures were made, and the mandibular denture was used as a surgical guide during implant placement. Implants were placed in one stage, followed by a mandibular denture soft reline (provisional loading). Ball attachments were inserted at 8 weeks, and ISFDs were delivered at 16 weeks. IODs were connected to the attachments at 8 weeks, using each patients's existing denture. The definitive ISFDs were fabricated using computer-aided design/computer-assisted manufacture milled titanium frameworks and acrylic resin base and teeth. Patient satisfaction and panoramic radiographs were investigated at 6 and 12 months. Both treatments had significant and positive effects on patient satisfaction and quality of life. None of the 50 implants placed had failed at 12 months of follow-up; therefore, the implant survival rate was 100%. Prosthetic complications were generally rare and easily manageable. Both the treatment modalities-the ISFD supported by three implants and the IOD supported by two implants-significantly and similarly improved patient satisfaction and oral health-related quality of life, and prosthetic complications were relatively rare for both treatments. Three implants can be used to support a mandibular fixed prosthesis; however, a longer observation period is needed to validate this treatment modality.

  12. Clinical evaluation of failures in removable partial dentures.

    Science.gov (United States)

    Jorge, Janaina H; Quishida, Cristiane C C; Vergani, Carlos E; Machado, Ana L; Pavarina, Ana C; Giampaolo, Eunice T

    2012-01-01

    The aim of this clinical study was to evaluate the effects of removable partial dentures on the support tissues and changes occurring in lower tooth-supported and bilateral distal-extension dentures, 5 years after placement. The study involved analysis of a total of 53 patients who received prosthetic treatment for removable partial dentures. The patients were divided into two groups. In group 1, the patients had a completely edentulous maxilla and an edentulous area with natural teeth remaining in both the anterior and posterior regions. In group 2, the patients had a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth. Tooth mobility, prevalence of caries, fracture of the abutment teeth, fracture and/or deformation of the removable partial denture components and stability of the denture base were evaluated. The use of a removable partial denture increased tooth mobility, reduced the prevalence of caries, and did not cause loss or fracture of the abutments or damage to their components, when compared with the baseline. It was concluded that there was no difference between the groups as evaluated in terms of tooth mobility, prevalence of caries, loss and fracture of the abutments or damage to the components of the removable partial denture.

  13. Vertical distraction of the severely resorbed edentulous mandible : An assessment of treatment outcome

    NARCIS (Netherlands)

    Raghoebar, Gerry M.; Stellingsma, Kees; Meijer, Henny J. A.; Vissink, Arjan

    2008-01-01

    Purpose: To assess the treatment outcome (implant survival, surgical complications, patient satisfaction) of vertical distraction of the severely resorbed edentulous mandible. Materials and Methods: Forty-six patients with severe resorption of the edentulous mandible (bone height 5 to 8 mm, median 6

  14. Individual- and community-level social gradients of edentulousness.

    Science.gov (United States)

    Ito, Kanade; Aida, Jun; Yamamoto, Tatsuo; Ohtsuka, Rika; Nakade, Miyo; Suzuki, Kayo; Kondo, Katsunori; Osaka, Ken

    2015-03-11

    Community-level factors as well as individual-level factors affect individual health. To date, no studies have examined the association between community-level social gradient and edentulousness. The aim of this study was to investigate individual- and community-level social inequalities in edentulousness and to determine any explanatory factors in this association. We analyzed the data from the Japan Gerontological Evaluation Study (JAGES). In 2010-2012, 112,123 subjects aged 65 or older responded to the questionnaire survey (response rate = 66.3%). Multilevel logistic regression analysis was applied to determine the association between community-level income and edentulousness after accounting for individual-level income and demographic covariates. Then, we estimated the probability of edentulousness by individual- and community-level incomes after adjusted for covariates. Of 79,563 valid participants, the prevalence of edentulousness among 39,550 men (49.7%) and 40,013 women (50.3%) were both 13.8%. Living in communities with higher mean incomes and having higher individual-level incomes were significantly associated with a lower risk of edentulousness (odds ratios [ORs] by 10,000 USD increments were 0.37 (95% confidence interval [CI] [0.22-0.63]) for community-level and 0.85 (95% CI [0.84-0.86]) for individual-level income). Individual- and community-level social factors, including density of dental clinics, partially explained the social gradients. However, in the fully adjusted model, both community- and individual-level social gradients of edentulousness remained significant (ORs = 0.43 (95% CI [0.27-0.67]) and 0.90 (95% CI [0.88-0.91]), respectively). One standard deviation changes in community- and individual-level incomes were associated with 0.78 and 0.84 times lower odds of edentulousness, respectively. In addition, compared to men, women living in communities with higher average incomes had a significantly lower risk of edentulousness (p-value for

  15. Lack of dental insurance is correlated with edentulism.

    Science.gov (United States)

    Simon, Lisa; Nalliah, Romesh P; Seymour, Brittany

    2015-01-01

    The correlation between insurance status and edentulism has not previously been reported in a population with known access to a dentist, and little is known about patient demographics in corporate dental settings. This study investigated patient demographics of a former dental franchise in Chicopee, Massachusetts, and examined a correlation between dental insurance and edentulism in this group. The correlation of edentulism with age, gender, and dental risk factors (diabetes, temporomandibular disorder, trouble with previous dental work, or oral sores and ulcers) was also examined. This was a retrospective case study. Age, gender, and presence of dental risk factors were recorded from the patient medical history intake form. Dentate status was recorded from patient odontograms. Dental insurance status was obtained from billing records. Data was aggregated and deidentified. Descriptive and bivariate statistics and logistic regression models were used to identify associations (p-value ≤ 0.05 significance). Of 1,123 records meeting inclusion criteria, 52.54 percent of patients had dental insurance, 26.27 percent had at least one dental risk factor, and 18.17 percent were edentulous. Age and insurance status were significantly correlated with edentulism. Correcting for age, individuals without insurance were 1.56 times as likely to be edentulous. This case study provides insight into patient demographics that might seek care in a corporate setting and suggests that access to a dentist alone may not be adequate in preserving the adult dentition; dental insurance may also be important to health. As the corporate dental practice model continues to grow, these topics deserve further study.

  16. Patient satisfaction with laser-sintered removable partial dentures: A crossover pilot clinical trial.

    Science.gov (United States)

    Almufleh, Balqees; Emami, Elham; Alageel, Omar; de Melo, Fabiana; Seng, Francois; Caron, Eric; Nader, Samer Abi; Al-Hashedi, Ashwaq; Albuquerque, Rubens; Feine, Jocelyne; Tamimi, Faleh

    2018-04-01

    Clinical data regarding newly introduced laser-sintered removable partial dentures (RPDs) are needed before this technique can be recommended. Currently, only a few clinical reports have been published, with no clinical studies. This clinical trial compared short-term satisfaction in patients wearing RPDs fabricated with conventional or computer-aided design and computer-aided manufacturing (CAD-CAM) laser-sintering technology. Twelve participants with partial edentulism were enrolled in this pilot crossover double-blinded clinical trial. Participants were randomly assigned to wear cast or CAD-CAM laser-sintered RPDs for alternate periods of 30 days. The outcome of interest was patient satisfaction as measured using the McGill Denture Satisfaction Instrument. Assessments was conducted at 1, 2, and 4 weeks. The participant's preference in regard to the type of prosthesis was assessed at the final evaluation. The linear mixed effects regression models for repeated measures were used to analyze the data, using the intention-to-treat principle. To assess the robustness of potential, incomplete adherence, sensitivity analyses were conducted. Statistically significant differences were found in patients' satisfaction between the 2 methods of RPD fabrication. Participants were significantly more satisfied with laser-sintered prostheses than cast prostheses in regard to general satisfaction, ability to speak, ability to clean, comfort, ability to masticate, masticatory efficiency, and oral condition (Premovable partial dentures may lead to better outcomes in terms of patient satisfaction in the short term. The conclusion from this pilot study requires confirmation by a larger randomized controlled trial. ClinicalTrials.gov. A study about patient satisfaction with laser-sintered removable partial dentures; NCT02769715. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  17. A Technique for Digital Impression and Bite Registration for a Single Edentulous Arch.

    Science.gov (United States)

    Fang, Yiqin; Fang, Jing-Huan; Jeong, Seung-Mi; Choi, Byung-Ho

    2018-03-09

    Few studies have reported the application of digital technology for the process of impression and interocclusal recordings in edentulous patients. This article describes a digitizing system for generating digital edentulous models with a jaw relationship by taking direct digital impressions and a virtual bite registration using intraoral digital scanning. A specialized scan retractor was used to make digital impressions of edentulous jaws in patients' mouths using an intraoral scanner. Virtual bite registration was obtained with optical scanning of the buccal surfaces of both jaws at the occlusal vertical dimension. The registration was then used as a reference for aligning both jaws. Digital edentulous models that include the jaw relationship would be clinically beneficial for the fabrication of complete dentures in edentulous patients. © 2018 by the American College of Prosthodontists.

  18. Effects of edentulism in obstructive sleep apnea syndrome ...

    African Journals Online (AJOL)

    Objectives: The purpose of this study was to investigate the effects of edentulism in obstructive sleep apnea syndrome (OSAS) patients. Materials and Methods: The study patients' were selected from the Gaziantep University Sleep Clinic and Orthodontic Department archives between the years of 2009 and 2011.

  19. Removable partial dentures: clinical concepts.

    Science.gov (United States)

    Bohnenkamp, David M

    2014-01-01

    This article provides a review of the traditional clinical concepts for the design and fabrication of removable partial dentures (RPDs). Although classic theories and rules for RPD designs have been presented and should be followed, excellent clinical care for partially edentulous patients may also be achieved with computer-aided design/computer-aided manufacturing technology and unique blended designs. These nontraditional RPD designs and fabrication methods provide for improved fit, function, and esthetics by using computer-aided design software, composite resin for contours and morphology of abutment teeth, metal support structures for long edentulous spans and collapsed occlusal vertical dimensions, and flexible, nylon thermoplastic material for metal-supported clasp assemblies. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Implant Rehabilitation Planning Protocol for the Edentulous Patient According to Denture Space, Lip Support, and Smile Line.

    Science.gov (United States)

    Lago, Laura; Rilo, Benito; Fernández-Formoso, Noelia; DaSilva, Luis

    2017-08-01

    Rehabilitation with implants is a challenge. Having previous evaluation criteria is key to establishing the best treatment for the patient. In addition to clinical and radiological aspects, the prosthetic parameters must be taken into account in the initial workup, since they allow discrimination between fixed and removable rehabilitation. We present a study protocol that analyzes three basic prosthetic aspects. First, denture space defines the need to replace teeth, tissue, or both. Second, lip support focuses on whether or not to include a flange. Third, the smile line warns of potential risks in esthetic rehabilitation. Combining these parameters allows us to make a decision as to the most suitable type of prosthesis. The proposed protocol is useful for assessing the prosthetic parameters that influence decision making as to the best-suited type of restoration. From this point of view, we think it is appropriate for the initial approach to the patient. In any case, other considerations of study may amend the proposal. © 2016 by the American College of Prosthodontists.

  1. Telescopic Partial Dentures-Concealed Technology

    OpenAIRE

    Bhagat, Tushar Vitthalrao; Walke, Ashwini Nareshchandra

    2015-01-01

    The ideal goal of good dentist is to restore the missing part of oral structure, phonetics, his look and the most important is restored the normal health of the patient, which is hampered due to less or insufficient intake of food. Removable partial denture (RPD) treatment option is considered as a notion, which precludes the inevitability of ?floating plastic? in edentulous mouth, that many times fail to fulfill the above essential of the patients. In modern dentistry, though the dental impl...

  2. Influence of balanced occlusion in complete dentures on the decrease in reduction of an edentulous ridge

    Directory of Open Access Journals (Sweden)

    Poštić Srđan D.

    2012-01-01

    Full Text Available Background/Aim. Balanced occlusal arrangement of artificial teeth and balanced occlusion is a specific type of occlusion that preserves the stability of complete dentures. Balanced occlusion comprises realization of tooth contacts at the working side as well as at the balancing side, at the same time. The aim of this study was to assess the influence of balanced occlusal arrangement of artificial teeth on the decrease in reduction of edentulous alveolar ridge. Methods. A longitudinal study on 91 fully edentulous patients was conducted using their panoramic radiographs and parameters of vertical dimension of edentulous ridges. All the patients were clinically examined by the same and a qualified dental practitioner. Numerical values of parameters of vertical dimensions of edentulous ridges and lines were statistically processed and compared using the Student’s t-test. Results. Vertical dimensions and heights of edentulous ridges were different after comparison of parameters in complete denture wearers with balanced occlusion and complete denture wearers without bilaterally balanced occlusion, as well as between male and female edentulous patients. Statistically significant differences of heights were established in complete denture wearers’ with a set of artificial teeth without balanced occlusion, at the baseline and 12 months after wearing of complete dentures. Conclusion. Balanced occlusion is a favored occlusal design in setting of artificial teeth in conventional complete dentures, which preserves edentulous ridge and influence the stability of dentures.

  3. REHABILITATION OF COMPLETELY EDENTULOUS MANDIBULAR ARCH USING IMPLANT SUPPORTED FIXED PROSTHESIS - A CASE REPORT.

    OpenAIRE

    Kiran Kaushik; Pankaj Dhawan; Pankaj Madhukar; Piyush Tandan; Prateek Agarwal.

    2018-01-01

    Teeth are important structures in the oral cavity with many associated functions. Loss of teeth may be inevitable due to several reasons. Replacement of teeth should be done to restore the functions like mastication, phonetics, and esthetics. Modern dentistry aims to return patients to normal oral health and function in a predictable fashion. Satisfying a completely edentulous patient is always considered as a difficult task. Various treatment options for completely edentulous patients are av...

  4. Evaluation of palatal rugoscopy in dentulous and edentulous cases for human identification in forensic dentistry

    Directory of Open Access Journals (Sweden)

    Rogério José Scandiuzzi

    2014-03-01

    The search for identity is based on a set of characteristics, which defines the uniqueness of a person. Principles such as classificability, immutability, persistence, practicability and uniqueness must be considered when applying an identification technique. This study aimed to evaluate the use of palatal rugoscopy in dentulous and edentulous volunteers, with or without upper removable denture, for purposes of human identification. In this study 60 subjects were asked to give dental casts and photography of the upper dental arch, defined in the following groups: Group A (n = 30, edentulous patients with full upper removable dentures and Group B (n = 30, dentulous without upper removable partial denture. The rugoscopy analysis method used was Martins-dos-Santos classification, for checking the applicability and success in human identification. It was found that it is possible to use this technique and it has an application of 40% in the group A and 86.66% in the group B. In conclusion, the identification method by palatal rugoscopy is satisfactory for dentulous patients, however in cases of tooth loss and friction cases generated by prosthetic devices, the region of the palate lose its characteristics, but even then it is still possible to be applied.

  5. The Use of Implants to Improve Removable Partial Denture Function.

    Science.gov (United States)

    Pimentel, Marcele Jardim; Arréllaga, Juan Pablo; Bacchi, Ataís; Del Bel Cury, Altair A

    2014-12-01

    The oral rehabilitation with conventional removable partial dentures in Kennedy class I patients allows continuous bone resorption, dislodgment of the prosthesis during the mastication caused by the resilience of the mucosa, and rotation of the prosthesis. Thus, the associations of distal implants become an attractive modality of treatment for these patients. This case report presented an association of removable partial dentures, milled crowns and osseointegrated implants to rehabilitate a partial edentulous patient. A removable partial denture associated with implants and metal-ceramic milled crowns can offer excellent esthetics, and will improve function and biomechanics, at a reduced cost.

  6. A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures

    DEFF Research Database (Denmark)

    Karlsson, U; Gotfredsen, K; Olsson, C

    1998-01-01

    In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1...

  7. Cost-effectiveness of implant-supported mandibular removable partial dentures

    NARCIS (Netherlands)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    ObjectivesThe aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Material and methodsThirty

  8. A Comparative Rugoscopic Study of the Dentate and Edentulous Individuals in the South Indian Population

    Directory of Open Access Journals (Sweden)

    Jagdish Prasad Rajguru

    2014-01-01

    Full Text Available This study analyzes the rugae pattern in dentulous and edentulous patients and also evaluates the association of rugae pattern between males and females. Aims and Objectives. This study aims to investigate rugae patterns in dentulous and edentulous patients of both sexes in South Indian population and to find whether palatoscopy is a useful tool in human identification. Materials and Methods. Four hundred outpatients from Sree Balaji Dental College and Hospital, Chennai, were included in the study. The study group was equally divided between the sexes, which was further categorized into 100 dentulous and edentulous patients, respectively. Results. The edentulous male showed the highest mean of wavy pattern and total absence of circular pattern while the edentulous female group showed the highest mean of curved pattern and total absence of nonspecific pattern, while dentate population showed similar value as that of the overall population such as straight, wavy, and curved patterns. Conclusion. The present study concludes that there is similar rugae pattern of distribution between male and female dentate population while there is varied pattern between the sexes of edentulous population. However, the most predominant patterns were straight, wavy, and circular patterns.

  9. Edentulism in high poverty rural counties.

    Science.gov (United States)

    Mitchell, Jordan; Bennett, Kevin; Brock-Martin, Amy

    2013-01-01

    To examine the differences in oral health status among residents of high-poverty counties, as compared to residents of other rural or urban counties, specifically on the prevalence of edentulism. We used the 2005 Behavioral Risk Factor Surveillance System (BRFSS) and the 2006 Area Resource File (ARF). All analyses were conducted with SAS and SAS-callable SUDAAN, in order to account for weighting and the complex sample design. Characteristics significantly related to edentulism include: geographic location, gender, race, age, health status, employment, insurance, not having a usual source of care, education, marital status, presence of chronic disease, having an English interview, not deferring care due to cost, income, and dentist saturation within the county. Significant associations between high-poverty rural and other rural counties and edentulism were found, and other socioeconomic and health status indicators remain strong predictors of edentulism. © 2012 National Rural Health Association.

  10. Removable partial dentures: The clinical need for innovation.

    Science.gov (United States)

    Campbell, Stephen D; Cooper, Lyndon; Craddock, Helen; Hyde, T Paul; Nattress, Brian; Pavitt, Sue H; Seymour, David W

    2017-09-01

    The number of partially dentate adults is increasing, and many patients will require replacement of missing teeth. Although current treatment options also include fixed partial dentures and implants, removable partial dentures (RPDs) can have advantages and are widely used in clinical practice. However, a significant need exists to advance materials and fabrication technologies because of the unwanted health consequences associated with current RPDs. The purpose of this review was to assess the current state of and future need for prosthetics such as RPDs for patients with partial edentulism, highlight areas of weakness, and outline possible solutions to issues that affect patient satisfaction and the use of RPDs. The data on treatment for partial edentulism were reviewed and summarized with a focus on currently available and future RPD designs, materials, means of production, and impact on oral health. Data on patient satisfaction and compliance with RPD treatment were also reviewed to assess patient-centered care. Design, materials, ease of repair, patient education, and follow-up for RPD treatment all had a significant impact on treatment success. Almost 40% of patients no longer use their RPD within 5 years because of factors such as sociodemographics, pain, and esthetics. Research on RPD-based treatment for partial edentulism for both disease-oriented and patient-centered outcomes is lacking. Future trials should evaluate new RPD materials and design technologies and include both long-term follow-up and health-related and patient-reported outcomes. Advances in materials and digital design/production along with patient education promise to further the application of RPDs and improve the quality of life for patients requiring RPDs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Effect of complete and partial removable dentures on chewing movements.

    Science.gov (United States)

    Gonçalves, T M S V; Vilanova, L S R; Gonçalves, L M; Rodrigues Garcia, R C M

    2014-03-01

    Partial or complete edentulism impairs mastication. However, it is unclear how the chewing cycle is affected by prosthetics. We evaluated the chewing movements of patients fitted with complete (CD) or removable partial denture (RPD). A total of 29 subjects were kinesiographically evaluated during chewing of peanuts and Optocal portions in a random sequence. The subjects were divided into two groups according to prosthesis type. Group RPD was composed of 14 partially edentulous patients using a lower distal extension RPD (mean age 61 ± 8 years), and group CD contained 15 completely edentulous patients using CD (mean age 65·9 ± 7·9 years) in both jaws. Opening, closing, occlusal and masticatory cycle times, movement angle (opening and closing), maximum velocity (opening and closing), total area and chewing cycle amplitudes were evaluated. The results were subjected to anova and Tukey's HSD test at a significance level of 5%. The RPD group exhibited shorter opening and closing phases and masticatory cycle time (P chewing envelope was smaller in the CD group (P chewing cycles in any of the parameters evaluated (P > 0·05). RPD wearers use a faster chewing sequence with greater vertical and lateral jaw excursions compared with CD wearers. © 2013 John Wiley & Sons Ltd.

  12. Flexible thermoplastic denture base materials for aesthetical removable partial denture framework.

    Science.gov (United States)

    Singh, Kunwarjeet; Aeran, Himanshu; Kumar, Narender; Gupta, Nidhi

    2013-10-01

    Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps may affect aesthetics. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior to flipper and cast partial dentures, may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning and insertion technique of this prosthesis is very important, which have been thoroughly described in this article.

  13. Short-term retrospective case series of implant-assisted removable partial dentures with locator abutments.

    Science.gov (United States)

    Ortiz-Puigpelat, Octavi; Gargallo-Albiol, Jordi; Hernández-Alfaro, Federico; Cabratosa-Termes, Josep

    2014-01-01

    The purpose of this retrospective case series was to report on the clinical performance of implant-assisted removable partial dentures (IARPDs) with Locator abutments in different partial edentulism situations, with a mean follow-up period of 28.6 months. Twelve consecutive patients were treated with IARPDs. A total of 24 implants were placed in the edentulous area. Minimum follow-up period was 12 months. Overall patient satisfaction, health of peri-implant tissues, survival of implants and abutments, and prosthetic complications were reported. Overall implant survival was 91.6%; two implants failed. No major complications were reported-only one IARPD metal framework broke. No Locator abutment loosening was reported. Within the limitations of this retrospective study, treatment with IARPDs can improve the patient's function, phonetics, and esthetics without the need for extensive bone regeneration surgeries and prosthodontic rehabilitations. However, well-designed prospective clinical studies on IARPDs are needed to support their long-term use.

  14. Partial anomalous pulmonary venous return in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Sung, Won-kyung; Au, Virginia; Rose, Anand

    2012-01-01

    Anomalous pulmonary venous return is an uncommon congenital malformation, and may be partial or total. Partial anomalous pulmonary venous return (PAPVR) is more common than total anomalous pulmonary venous return, and is often associated with other congenital cardiac anomalies. Whilst many patients with PAPVR remain asymptomatic, some may present in later age with symptoms related to left-to-right shunt, right heart failure and pulmonary hypertension. We report two cases of PAPVR detected on Computed Tomography Pulmonary Angiogram (CTPA) for the work up of pulmonary hypertension. The cases demonstrate that, although uncommon, partial anomalous pulmonary venous return can be a contributing factor to pulmonary hypertension and pulmonary veins should be carefully examined when reading a CTPA study.

  15. Scala vestibuli cochlear implantation in patients with partially ossified cochleas.

    Science.gov (United States)

    Berrettini, Stefano; Forli, Francesca; Neri, Emanuele; Segnini, Giovanni; Franceschini, Stefano Sellari

    2002-11-01

    Partial cochlear obstruction is a relatively common finding in candidates for cochlear implants and frequently involves the inferior segment of the scala tympani in the basal turn of the cochlea. In such patients, the scala vestibuli is often patent and offers an alternative site for implantation. The current report describes two patients with such partial obstruction of the inferior segment of the basal cochlear turn, caused in one case by systemic vasculitis (Takayasu's disease) and in the other by obliterative otosclerosis. A scala vestibuli implantation allowed for complete insertion of the electrode array. No problems were encountered during the surgical procedures and the good post-operative hearing and communicative outcomes achieved were similar to those reported in patients without cochlear ossification. The importance of accurate pre-operative radiological study of the inner ear is underscored, to disclose the presence and define the features of the cochlear ossification and ultimately to properly plan the surgical approach.

  16. Three-year treatment outcomes with three brands of implants placed in the posterior maxilla and mandible of partially edentulous patients

    NARCIS (Netherlands)

    Ozkan, Yasar; Ozcan, Mutlu; Akoglu, Burcin; Ucankale, Mert; Kulak-Ozkan, Yasemin

    Statement of problem. Survival rates of implants in posterior regions vary among clinical studies. Problems occur more often in the posterior segment of the maxilla due to proximity of the maxillary sinus and reduced quality or quantity of alveolar bone. Purpose. This clinical study evaluated the

  17. Immediate versus delayed loading of strategic mini dental implants for the stabilization of partial removable dental prostheses: a patient cluster randomized, parallel-group 3-year trial.

    Science.gov (United States)

    Mundt, Torsten; Al Jaghsi, Ahmad; Schwahn, Bernd; Hilgert, Janina; Lucas, Christian; Biffar, Reiner; Schwahn, Christian; Heinemann, Friedhelm

    2016-07-30

    Acceptable short-term survival rates (>90 %) of mini-implants (diameter implants as strategic abutments for a better retention of partial removable dental prosthesis (PRDP) are not available. The purpose of this study is to test the hypothesis that immediately loaded mini-implants show more bone loss and less success than strategic mini-implants with delayed loading. In this four-center (one university hospital, three dental practices in Germany), parallel-group, controlled clinical trial, which is cluster randomized on patient level, a total of 80 partially edentulous patients with unfavourable number and distribution of remaining abutment teeth in at least one jaw will receive supplementary min-implants to stabilize their PRDP. The mini-implant are either immediately loaded after implant placement (test group) or delayed after four months (control group). Follow-up of the patients will be performed for 36 months. The primary outcome is the radiographic bone level changes at implants. The secondary outcome is the implant success as a composite variable. Tertiary outcomes include clinical, subjective (quality of life, satisfaction, chewing ability) and dental or technical complications. Strategic implants under an existing PRDP are only documented for standard-diameter implants. Mini-implants could be a minimal invasive and low cost solution for this treatment modality. The trial is registered at Deutsches Register Klinischer Studien (German register of clinical trials) under DRKS-ID: DRKS00007589 ( www.germanctr.de ) on January 13(th), 2015.

  18. [Acrylic resin removable partial dentures

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Creugers, N.H.J.

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of

  19. Partial central diabetes insipidus in patient with common variable immunodeficiency.

    Science.gov (United States)

    Megías, Marta Cano; Matei, Ana Maria; Gonzalez Albarran, Olga; Perez Lopez, Gilberto

    2012-07-03

    Approximately 20% of patients with common variable immunodeficiency (CVID) have any autoimmune disease, as concurrent as prior to diagnosis, even during follow-up. In recent years, cases of CVID associated to endocrine autoimmune diseases have been reported. To our knowledge, no cases of CVID with diabetes insipidus has been reported previously. The authors present the case of a 37-year-old male, diagnosed of CVID, who had thirst, polyuria and nocturia for several years. After a water deprivation test and a complete resolution of patient's symptoms with vasopressin (DDAVP) treatment, diagnosis of partial central diabetes insipidus was finally made. Patients diagnosed of CVID could develop water misbalance due to posterior hypophysis autoimmune disorder. A high index of clinical suspicion, an early diagnosis and treatment of these disease could avoid future complications and improve the quality of life of these patients.

  20. Partial splenic embolization in patients with idiopathic portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Maurizio E-mail: maurizio.romano@ibb.cnr.it; Giojelli, Angela; Capuano, Gaetano; Pomponi, Domenico; Salvatore, Marco

    2004-03-01

    Purpose: To evaluate the effectiveness of partial splenic embolization (PSE) in patients with idiopathic portal hypertension (IPH) in reducing variceal bleeding episodes, splenomegaly and thrombocytopenia. Materials and methods: Six patients (2M, 4F, mean age 30.3 years) with IPH presenting with splenomegaly, thrombocytopenia and recurrent variceal bleeding were treated with PSE using gelatin sponge (four patients) or Contour particles (two patients) as embolization material. Results: PSE was performed successfully in all cases; 3F coaxial microcatheters were necessary in two patients due to extreme splenic artery tortuosity. The average amount of devascularized parenchyma at CT 1 week after PSE was 71%. Splenomegaly and thrombocytopenia improved in all cases, with a mean platelet count increase of 120000/mm{sup 3} and an average 68% reduction of spleen volume at follow up. Variceal bleeding did not recur after PSE. Esophageal or gastroesophageal varices disappeared (one patient) or significantly reduced (five patients) at endoscopic controls. No significant complications were noted. The follow up was of at least 18 months in all patients; mean follow up was 28.2 months. Conclusion: In patients with IPH PSE can be effective in preventing variceal bleedings, in reducing spleen volume and in significantly increasing platelet count; therapeutic results were durable in our population.

  1. A comparative study of two methods for the orientation of the occlusal plane and the determination of the vertical dimension of occlusion in edentulous patients.

    Science.gov (United States)

    Koller, M M; Merlini, L; Spandre, G; Palla, S

    1992-07-01

    The aim of this study was to compare two methods used to orientate the occlusal plane (OP) and to determine the vertical dimension of occlusion (VDO). In method A the VDO was established by means of the rest position, the minimal speaking distance, and the patient's profile. Method B used a newly developed registration pin assembly. The VDO was registered using a silicone occlusion rim and the swallowing technique. The results were compared to the values of the new dentures. Three standardized lateral radiographs were taken at the VDO obtained with methods A, B, and at that of the final dentures. On each radiograph the orientation of the OP to the Camper plane and the VDO were measured by two investigators independently. The results indicated no statistically significant differences between the mean VDO with method A and B compared with the new dentures (P greater than 0.05). With both methods it was not possible to orientate the OP parallel to the Camper plane. None of the occlusal planes of the new dentures were parallel either. Their OP diverged on average by 7 degrees dorso-caudally. The time spent with method B to orient the OP and to determine the VDO was significantly lower than with method A (17-50 min).

  2. The Effects of Partial Turbinectomy on Patients Undergoing Rhinoplasty

    Directory of Open Access Journals (Sweden)

    Behrooz Gandomi

    2011-03-01

    Full Text Available Introduction: A reduction or cessation of the ability to breathe through the nose can affect a person's overall health. Nasal passage blockage can also result in snoring. Difficulty in breathing through the nose after rhinoplasty is a serious problem and patient dissatisfaction can be significant even when cosmetic results are excellent. Long-term impacts on the quality of life and contributions to the pathophysiology of sleep-related breathing disorders have both been documented. This study compares nasal obstruction and other prevalent respiratory side effects of rhinoplasty in the presence and absence of partial turbinectomy. Methods and Materials: This is an experimental case study conducted in 2007 on patients undergoing rhinoplastic surgery in Shahid Dastgheyb Hospital of Shiraz, Iran. Sampling was done on all admitted patients during this year in the mentioned hospital. For the first group, rhinoplasty plus partial turbinectomy was performed while taking into consideration the Helsinki criteria septorhinoplasty without partial turbinectomy was performed on the second group. P-value less than 0.05 was considered as statistically significant. Results: There was no significant difference between the case and control group in terms of their mean age and gender distribution. Respiratory mean scores before and after rhinoplasty in both groups were significantly different in some issues of Nasal Scale (i.e.: Nasal blockage or obstruction, trouble sleeping, inability to get enough air through the nose during exercise or exertion, trouble breathing through nose.  Conclusion: Achieving cosmetic goals while preserving such necessary functions is a great concern for rhinologists and this makes different complexes. To create a balance between the maximum physiologic function and the best cosmetic feature is an art.

  3. Treatment Outcomes Based on Patients' Self-Reported Measures after Receiving New Clasp or Precision Attachment-Retained Removable Partial Dentures.

    Science.gov (United States)

    Peršić, Sanja; Kranjčić, Josip; Pavičić, Daniela Kovačević; Mikić, Vlatka Lajnert; Čelebić, Asja

    2017-02-01

    To evaluate effects of a treatment taking into consideration esthetics, chewing, and oral health-related quality of life (OHRQoL) of two tooth replacement strategies for maxillary partially edentulous patients with clasp (C-RPD) and precision attachment (PA-RPD) retained removable partial dentures (RPD). The study included 150 patients (72 men, 78 women) who received maxillary RPDs; 88 patients received clasp and 62 patients received precision attachment retained RPDs. Patients completed three questionnaires before treatment and again 3 months after treatment: the Orofacial Esthetic Scale (OES), the Oral Health Impact Profile (OHIP-14), and the Chewing Function Questionnaire (CFQ). Statistical analysis comprised descriptive statistics, paired t-test, and two-factor ANOVA. Both RPD treatments yielded better after-treatment summary scores when compared with the baseline scores (p < 0.01); however, better results were obtained in the PA-RPD group. Gender, as a single factor, did not yield significant effects; mutual interaction of retention type and gender yielded significant effects. The PA-RPD female group assessed esthetics, chewing function, and OHRQoL significantly better than males, and significantly worse than males in the C-RPD group. The covariate baseline scores yielded statistically significant effects; patients with worse pretreatment condition benefited more from both therapies. Treatment outcomes were better in the PA-RPD group than the C-RPDs. Women showed greater concern for the treatment outcomes; their rates were significantly better than in male patients in the PA-RPD group; however, when their satisfaction was lower, their rates were significantly worse than in male patients (in the C-RPD group). © 2015 by the American College of Prosthodontists.

  4. Removable partial denture on osseointegrated implants and natural teeth.

    Science.gov (United States)

    Chang, Li-Ching; Wang, Jen-Chyan; Tasi, Chi-Cheng

    2007-01-01

    Implants have been designed to provide edentulous patients with fixed prostheses or overdentures. Recently, implant-supported fixed partial prostheses and single crowns have become successful treatment alternatives to removable and fixed partial dentures. However, few researchers have examined "removable partial dentures on implants and natural teeth". In this article, we report two patients fitted with "removable partial dentures on implants and natural teeth". The patients were satisfied with their dentures in terms of function and aesthetics. Regular follow-up visits revealed that the periodontal and peri-implant conditions were stable. There was no evidence of excessive intrusion or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. Since the average duration of observation was about 38 months, further follow-up examinations are necessary to determine whether these dentures remain stable long-term.

  5. Patient's Satisfaction with Removable Partial Dentures: A Retrospective Case Series.

    Science.gov (United States)

    Shala, Kujtim Sh; Dula, Linda J; Pustina-Krasniqi, Teuta; Bicaj, Teuta; Ahmedi, Enis F; Lila-Krasniqi, Zana; Tmava-Dragusha, Arlinda

    2016-01-01

    This retrospective clinical study aimed to assess patient's satisfaction with removable partial dentures (RPDs), as retention, chewing ability, aesthetics during the observation period. A total of 63 patients with RPDs, participated in this study. The following data was collected: Kennedy classification, denture design, denture support, satisfaction and success of RPD. The results showed that 73.6% of patients were wearing RPD for the first time and were finally satisfied. According to the denture support of RPDs, clasp-retained quadrangular RPDs were 100% effective, followed by triangular dental support 81% and linear dental support 47.7%. Comparison of RPDs with attachment with RPDs with claps assessed through Fisher exact test, confirmed statistically significant difference (P=0.008), despite retention; however, chewing ability and aesthetics showed no statistically significant difference with X 2 test on patient's satisfaction with RPD with or without attachment. Patients often would prefer not showing the anterior buccal clasps of RPD, therefore are generally satisfied more with RPD with attachment based on level of retention, chewing ability and aesthetics.

  6. Thinking pattern of first grade students towards edentulous replacement

    Directory of Open Access Journals (Sweden)

    Eri H. Jubhari

    2007-06-01

    Full Text Available Many people ignore their oral hygiene and do not use denture after extraction. This may caused by their thinking pattern. Thinking pattern indicates the degree of comprehension to solve a problem. This research aims to find out the thinking pattern of first year students towards edentulous replacement. The questionnaire was filled in by students. The oral cavity state of students who have edentulous was inspected. The study finds that only 3 men and 27 women had edentulous, all of them did not use denture. However, more than 96% of the edentulous and not-edentulous groups said that edentulous need denture, due to aesthetic factor. The reasons for not using denture are, for example, not enough time, not disturbed by the absence of denture, and its cost. It can be concluded that the 2005 batch students of Faculty of Dentistry (FKG UNHAS had shown a good understanding about edentulous replacement. Their views on the profits and detriments using denture are the main reasons to determine whether they will use denture.

  7. Functional MR imaging in the patients with complex partial seizures

    International Nuclear Information System (INIS)

    Chung, Jin Il; Chang, Kee Hyun; Song, In Chan; Goo, Jin Mo; Chung, Chun Kee; Lee, Sang Kun; Kim, Hong Dae; Han, Moon Hee; Kim, Sam Soo

    1999-01-01

    To evaluate the clinical usefulness of functional MR imaging (fMRI) for localization of the cerebral motor and sensory cortices and language center in patients with complex partial seizure. A total of 47 fMRIs were obtained in 14 patients (M:F = 9:5; age 15-50 years; 13 right handed and 1 ambidextrous) with complex partial seizure (6 temporal lobe epilepsy, 6 frontal lobe epilepsy, 1 occipitotemporal lobe epilepsy, 1 hemispheric epilepsy). Conventional MR imaging revealed no abnormality in four patients, localized cerebral atrophy in one, hippocampal sclerosis in four, and benign neoplasm in the remaining five. fMRI was performed on a 1.5 T MR scanner (GE Signa Horizon) using gradient-echo singleshot EPI. Nineteen fMRIs were obtained in eight patients who performed the language task, 16 fMRIs in ten who performed the motor task and 12 fMRIs in ten who performed the somatosensory task. The activation task consisted of three language tasks (silent picture naming , word generation from a character, categorical word generation), motor tasks (opposition of thumb and index finger for hand/dorsifexion or extension for foot), and sensory tasks (passive tactile stimulation of hand or foot using a toothbrush). The data were analyzed using z-score (p<0.05), clustering, and cross-correlation analysis based upon homemade software, IDL 5.1. The success rate for obtaining meaningful fMRI was evaluated and activated regions were assessed on the basis of each fMRI obtained during, language, motor, and somatosensory tasks. fMRI findings were compared with those of the Wada test (n = 7) for language lateralization and with invasive cortical mapping (n = 3) for the localization of eloquent cerebral cortex, especially around the central sulcus. The overall success rate of fMRI was 79 % (37/47); success rates of fMRI with language, sensory, and motor task were 89% (17/19), 83 % (10/12), and 63 % (10/16), respectively. Areas activated during language tasks (n=17) included the

  8. Treatment planning: implant-supported partial overdentures.

    Science.gov (United States)

    Chee, Winston W L

    2005-04-01

    When multiple anterior teeth are missing, many options of replacement are available. Traditionally, the choice was between a fixed or removable prostheses. Today, with the predictability of dental implants, the options of tooth replacement range from removable partial dentures to implant-supported fixed prostheses. The choice of which restoration that will best provide occlusion and esthetics depends on multiple factors including the number and location of missing teeth, the residual ridge form in relation to the replacement teeth, the relationship of the maxillary and mandibular anterior teeth, the condition of teeth adjacent to the edentulous span, the amount of bone available for implant placement, the patients "smile line" and display of teeth, lip support, and financial constraints. When there is minimal loss of the ridge contour, restorations that emerge from the ridge are the most functional and esthetic restorations, adhesive-type fixed partial dentures, conventional fixed partial dentures, and implant-supported restorations can be indicated with the choice of restoration dependent on a risk benefit and cost benefit analysis. When there is a loss of ridge contour due to residual ridge resorption or trauma, the decision becomes more complex as not only does the tooth structure need to be replaced, the ridge form also has to be replaced. (Figures 1 and 2). This can be assessed clinically as illustrated by Figures 1 and 2 where a dis crepancy in arch form and ridge form in relation to the adjacent teeth and/or opposing arch can be observed. Other considerations are lip support and display of the teeth when smiling. This article presents a case and rationale for implant-supported par tial overdentures. Many authors have written on the merits of com plete overdentures. The complete overdenture has proven to be an improvement over conventional complete prostheses with respect to chewing efficiency, patient comfort and satisfaction. In partial edentulism, the

  9. Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Englund, Martin; Christensen, Robin

    2017-01-01

    OBJECTIVES: To compare patient reported outcomes from before surgery to 52 weeks after surgery between individuals undergoing arthroscopic partial meniscectomy for traumatic meniscal tears and those for degenerative meniscal tears. DESIGN: Comparative prospective cohort study. SETTING: Four public......-55, and undergoing arthroscopic partial meniscectomy for a traumatic or degenerative meniscal tear (defined by a combination of age and symptom onset). INTERVENTIONS: Both participant groups underwent arthroscopic partial meniscectomy for a meniscal tear, with operating surgeons recording relevant information......% women) with a traumatic or degenerative meniscal tear (n=141, mean age 38.7 years (standard deviation 10.9); n=256, 46.6 years (6.4); respectively) were included in the main analysis. At 52 weeks after arthroscopic partial meniscectomy, 55 (14%) patients were lost to follow-up. Statistically...

  10. Oxidative Stress in Patients with Drug Resistant Partial Complex Seizure

    Directory of Open Access Journals (Sweden)

    Lourdes Lorigados Pedre

    2018-06-01

    Full Text Available Oxidative stress (OS has been implicated as a pathophysiological mechanism of drug-resistant epilepsy, but little is known about the relationship between OS markers and clinical parameters, such as the number of drugs, age onset of seizure and frequency of seizures per month. The current study’s aim was to evaluate several oxidative stress markers and antioxidants in 18 drug-resistant partial complex seizure (DRPCS patients compared to a control group (age and sex matched, and the results were related to clinical variables. We examined malondialdehyde (MDA, advanced oxidation protein products (AOPP, advanced glycation end products (AGEs, nitric oxide (NO, uric acid, superoxide dismutase (SOD, glutathione, vitamin C, 4-hydroxy-2-nonenal (4-HNE and nitrotyrosine (3-NT. All markers except 4-HNE and 3-NT were studied by spectrophotometry. The expressions of 4-HNE and 3-NT were evaluated by Western blot analysis. MDA levels in patients were significantly increased (p ≤ 0.0001 while AOPP levels were similar to the control group. AGEs, NO and uric acid concentrations were significantly decreased (p ≤ 0.004, p ≤ 0.005, p ≤ 0.0001, respectively. Expressions of 3-NT and 4-HNE were increased (p ≤ 0.005 similarly to SOD activity (p = 0.0001, whereas vitamin C was considerably diminished (p = 0.0001. Glutathione levels were similar to the control group. There was a positive correlation between NO and MDA with the number of drugs. The expression of 3-NT was positively related with the frequency of seizures per month. There was a negative relationship between MDA and age at onset of seizures, as well as vitamin C with seizure frequency/month. We detected an imbalance in the redox state in patients with DRCPS, supporting oxidative stress as a relevant mechanism in this pathology. Thus, it is apparent that some oxidant and antioxidant parameters are closely linked with clinical variables.

  11. Measurement of Mucosal Thickness in Denture-bearing Area of Edentulous Mandible

    Directory of Open Access Journals (Sweden)

    Jian Dong

    2015-01-01

    Full Text Available Background: The thickness of the alveolar mucosa influences the probability of the occurrence of denture-induced irritations. Thick denture-supporting tissues offer relief from mucosal tenderness and ulcers; however, the uniformity of the thickness across the entire mandibular alveolar mucosa cannot be accurately determined in edentulous patients. This study aimed to assess the mucosal thickness of the denture-bearing area in the edentulous mandible. Methods: Twenty-seven edentulous patients underwent cone-beam computed tomography scanning, wherein the patients wore a record base to retract soft tissues away from the alveolar mucosa. The measured regions were the central incisor (IC, lateral incisor (IL, canine (Ca, first premolar (P1, second premolar (P2, first molar (M1, and second molar (M2 regions. The thickness was measured in the alveolar ridge crest (T, buccal (B1-B4, and lingual (L1-L4 alveolar ridge mucosa. The average thickness of the mucosa at buccal sides (B and lingual sides (L were also assessed. Results: The differences in the mucosal thickness between the left and right sides were not significant. In the Ca-M2 regions, T was the thickest, and L3 was the thinnest of all the measured points in the same regions. L was significantly less than B in posterior regions (P < 0.01. On the other hand, M2 at L4 was thinnest of all the measured regions from Ca to M2 (P < 0.01, and was thicker than IC, IL, P1, and P2 at B2. Conclusions: Since the mucosal thickness of denture-bearing area in the edentulous mandible is not uniform; the tissue surface of the denture base or custom tray should be selectively relieved, which may reduce the risk of denture-induced irritations.

  12. Removable Partial Denture Supported by Implants with Prefabricated Telescopic Abutments - A Case Report

    Science.gov (United States)

    Sehgal, Komal

    2014-01-01

    Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy—biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. PMID:25121066

  13. Removable partial denture supported by implants with prefabricated telescopic abutments - a case report.

    Science.gov (United States)

    Kumar, Lalit; Sehgal, Komal

    2014-06-01

    Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy-biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs.

  14. Implications of Edentulism on Quality of Life among Elderly

    Directory of Open Access Journals (Sweden)

    Efigênia Ferreira e Ferreira

    2012-01-01

    Full Text Available This study aimed was to test the association between quality of life and edentulism among elderly individuals in a city in southeastern Brazil. This cross-sectional study was carried out with 163 individuals aged 60 years or older, functionally independent and non-institutionalized. Data were collected with a questionnaire and oral examination. The edentulism was the dependent variable. The independent variables were sex, age, household income and quality of life (WHOQOL-Old and their scores. To assess the association between the dependent variable and independent variables was used bivariate analysis (p < 0.10. Poisson regression model was performed, adjusting for age and sex. The average age of participants was 69 years (± 6.1, 68.7% were female and 52.8% were diagnosed as completely edentulous (90% CI: 0.33–1.24. When the independent variables were associated to the prevalence of edentulism, statistically significant associations were found for age (p = 0.03 and social participation dimension of the WHOQOL-Old (p = 0.08. In the Poisson regression, social participation remained statistically associated to edentulism {RP = 2.12 [90% CI (1.10–4.00]}. The social participation proved to have a significant association to edentulism, thereby attesting to the negative effect of this condition on social aspects.

  15. Implant support for removable partial overdentures: a case report.

    Science.gov (United States)

    Halterman, S M; Rivers, J A; Keith, J D; Nelson, D R

    1999-01-01

    Functional stability and the preservation of remaining alveolar bone are primary, and often elusive, goals when restoring the partially edentulous arch. The incorporation of dental implants for the partial support of removable prostheses offers a practical adjunct in the fulfillment of these objectives. Planning for complex courses of treatment that include dental implants requires close coordination between the surgeon and the restorative dentist. Decisions that deal with type, location, size, number of implant fixtures, and design of the prosthesis are critical. All of these areas must be discussed and established as acceptable to the patient and each clinician before the initiation of treatment. In this report, we present a course of patient treatment in which a removable partial denture is supported by natural remaining teeth in conjunction with osseointegrated implants.

  16. Arthroscopic partial meniscectomy in middle-aged patients with mild or no knee osteoarthritis

    DEFF Research Database (Denmark)

    Hare, Kristoffer B; Lohmander, Stefan; Christensen, Robin

    2013-01-01

    Arthroscopic partial meniscectomy has been shown to be of no benefit to patients with concomitant knee osteoarthritis, but the optimal treatment of a degenerative meniscus tear in patients with mild or no knee osteoarthritis is unknown. This article describes the rationale and methodology...... of a randomized sham-controlled trial to assess the benefit of arthroscopic partial meniscectomy of a medial meniscus tear in patients with mild or no knee osteoarthritis. The objective of the study is to test whether the benefit from arthroscopic partial meniscectomy in patients with knee pain, medial meniscus...... lesion and mild/no knee osteoarthritis, is greater after arthroscopic partial meniscectomy than following sham surgery....

  17. Angiogenesis in the reparatory mucosa of the mandibular edentulous ridge is driven by endothelial tip cells.

    Science.gov (United States)

    Stănescu, Ruxandra; Didilescu, Andreea Cristiana; Jianu, Adelina Maria; Rusu, M C

    2012-01-01

    Sprouting angiogenesis is led by specialized cell--the endothelial tip cells (ETCs) which can be targeted by pro- or anti-angiogenic therapies. We aimed to perform a qualitative study in order to assess the guidance by tip cells of the endothelial sprouts in the repairing mucosa of the edentulous mandibular crest. Mucosa of the mandibular edentulous ridge was collected from six adult patients, prior to healing abutment placement (second surgery). Slides were prepared and immunostained with antibodies for CD34 and Ki67. The abundant vasculature of the lamina propria was observed on slides and the CD34 antibodies labeled endothelial tip cells in various stages of the endothelial sprouts. Ki67 identified positive endothelial cells, confirming the proliferative status of the microvascular bed. According to the results, the in situ sprouting angiogenesis is driven by tip cells in the oral mucosa of the edentulous ridge and these cells can be targeted by various therapies, as required by the local pathologic or therapeutic conditions.

  18. Relevance of variations in the opposing dentition for the functionality of fixed and removable partial dentures: a systematic review.

    Science.gov (United States)

    Pommer, Bernhard; Krainhöfner, Martin; Watzek, Georg; Tepper, Gabor; Dintsios, Charalabos-Markos

    2012-01-01

    The aim of this systematic review was to evaluate the functionality of fixed and removable partial dentures as test interventions in relation to variations in the opposing dentition and their prosthetic restoration. The abstracts identified in the respective databases were screened independently by two investigators. RCTs and uncontrolled studies were considered, provided the patients were included consecutively and the confounding variables were adequately monitored. Seventeen papers were included. The study and publication quality was assessed using a "biometric quality" tool showing an overall poor quality. The reported outcomes, such as survival rates, were in each case obtained from a single study. Two possible trends could be deduced for the endpoint longevity: (a) the first trend in favor of removable partial dentures, compared to fixed partial dentures, with a fully edentulous opposing arch fitted with a removable prosthesis; (b) the second trend in favor of implant-supported partial dentures, compared to conventionally fixed partial dentures, with natural opposing dentition or with a removable partial denture in the opposing arch. No evidence could be generated as to whether, and if so how, variations in the opposing dentition have a bearing on the decision to fit a partially edentulous arch with a fixed or removable partial denture.

  19. Relevance of Variations in the Opposing Dentition for the Functionality of Fixed and Removable Partial Dentures: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Bernhard Pommer

    2012-01-01

    Full Text Available The aim of this systematic review was to evaluate the functionality of fixed and removable partial dentures as test interventions in relation to variations in the opposing dentition and their prosthetic restoration. The abstracts identified in the respective databases were screened independently by two investigators. RCTs and uncontrolled studies were considered, provided the patients were included consecutively and the confounding variables were adequately monitored. Seventeen papers were included. The study and publication quality was assessed using a “biometric quality” tool showing an overall poor quality. The reported outcomes, such as survival rates, were in each case obtained from a single study. Two possible trends could be deduced for the endpoint longevity: (a the first trend in favor of removable partial dentures, compared to fixed partial dentures, with a fully edentulous opposing arch fitted with a removable prosthesis; (b the second trend in favor of implant-supported partial dentures, compared to conventionally fixed partial dentures, with natural opposing dentition or with a removable partial denture in the opposing arch. No evidence could be generated as to whether, and if so how, variations in the opposing dentition have a bearing on the decision to fit a partially edentulous arch with a fixed or removable partial denture.

  20. Prefabricated light-polymerizing plastic pattern for partial denture framework

    Directory of Open Access Journals (Sweden)

    Atsushi Takaichi

    2011-01-01

    Full Text Available Our aim is to report an application of a prefabricated light-polymerizing plastic pattern to construction of removable partial denture framework without the use of a refractory cast. A plastic pattern for the lingual bar was adapted on the master cast of a mandibular Kennedy class I partially edentulous patient. The pattern was polymerized in a light chamber. Cobalt-chromium wires were employed to minimize the potential distortion of the plastic framework. The framework was carefully removed from the master cast and invested with phosphate-bonded investment for the subsequent casting procedures. A retentive clasp was constructed using 19-gauge wrought wire and was welded to the framework by means of laser welding machine. An excellent fit of the framework in the patient′s mouth was observed in the try-in and the insertion of the denture. The result suggests that this method minimizes laboratory cost and time for partial denture construction.

  1. Comparison of chewing ability, oral health related quality of life and nutritional status before and after insertion of complete denture amongst edentulous patients in a Dental College of Pune.

    Science.gov (United States)

    Madhuri, Sonawane; Hegde, Shetiya Sahana; Ravi, Shirahatti; Deepti, Agarwal; Simpy, Mahuli

    2014-07-01

    The relationship between tooth loss and nutritional intake is important. As people age, their diminished physical capacity and decreased income adversely affect their ability to maintain their teeth. The aim of the study was to assess and compare the chewing ability, oral health related quality of life and nutritional status before and after fabrication and insertion of complete denture amongst edentulous participants in a dental college. Non Randomized Intervention study. The study population consisted of 42 participants (16 females and 26 males), aged 50 years and above. Prior to commencement of the study, informed consent was obtained and validation and reliability test of the questionnaire were done. The data for chewing ability, GOHAI and nutritional status assessment was recorded at baseline, 3(rd), 6(th) and 12(th) month after denture fabrication and insertion. The statistical comparisons were performed by repeated measure ANOVA and Chi-square test. P valueNutritive value of food (protein, energy and fat) showed no significant difference over a period of 12 months (poral health related quality of life.

  2. Effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force: A preliminary cross over study.

    Science.gov (United States)

    Elsyad, Moustafa Abdou; Mostafa, Aisha Zakaria

    2018-01-01

    This cross over study aimed to evaluate the effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force MATERIALS AND METHODS: Twenty patients with complete maxillary edentulism and partially edentulous mandibles with anterior teeth only remaining were selected for this cross over study. All patients received complete maxillary dentures and mandibular partial removable dental prosthesis (PRDP, control). After 3 months of adaptation, PRDP was replaced with conventional telescopic partial dentures (TPD) or telescopic partial dentures with cantilevered extensions (TCPD) in a quasi-random method. Oral health related quality of life (OHRQoL) was measured using OHIP-14 questionnaire and Maximum bite force (MBF) was measured using a bite force transducer. Measurements were performed 3 months after using each of the following prostheses; PRDP, TPD, and TCPD. TCPD showed the OHIP-14 lowest scores (i.e., the highest patient satisfaction with their OHRQoL), followed by TPD, and PRDP showed the highest OHIP-14 scores (i.e., the lowest patient satisfaction with OHRQoL). TCPD showed the highest MBF (70.7 ± 3.71), followed by TPD (57.4 ± 3.43) and the lowest MBF (40.2 ± 2.20) was noted with PRDP. WITHIN The Limitations of This Study, Mandibular Telescopic Distal Extension Removable Partial Dentures with Cantilevered Extensions Were Associated with Improved Oral Health Related Quality of Life and Maximum Bite Force Compared to Telescopic or Conventional PRDP. Telescopic distal extension removable prostheses is an esthetic restoration in partially edentulous patients with free end saddle. This article describes the addition of cantilevered extensions of this prosthesis. The results showed that telescopic distal extension removable prostheses with cantilevered extensions were associated with improved oral health related quality of life and maximum bite force compared to telescopic or conventional RPDs

  3. Telescopic Partial Dentures-Concealed Technology.

    Science.gov (United States)

    Bhagat, Tushar Vitthalrao; Walke, Ashwini Nareshchandra

    2015-09-01

    The ideal goal of good dentist is to restore the missing part of oral structure, phonetics, his look and the most important is restored the normal health of the patient, which is hampered due to less or insufficient intake of food. Removable partial denture (RPD) treatment option is considered as a notion, which precludes the inevitability of "floating plastic" in edentulous mouth, that many times fail to fulfill the above essential of the patients. In modern dentistry, though the dental implants or fixed partial denture is the better options, but they have certain limitations. However, overdentures and particularly telescopic denture is the overlooked technology in dentistry that would be a boon for such needy patients. Telescopic denture is especially indicated in the distal edentulous area with minimum two teeth bilaterally present with a good amount of periodontal support. This treatment modality is sort of preventive prosthodontics remedy, which in a conservative manner preserve the remaining teeth and helps in conservation of alveolar bone ultimately. There are two tenets related to this option, one is constant conservation edentulous ridge around the retained tooth and the most important is the endless existence of periodontal sensory action that directs and monitor gnathodynamic task. In this option the primary coping or inner coping are cemented on the prepared tooth, and a similar removable outer or inner telescopic crown placed tightly by using a mechanism of tenso-friction, this is firmly attached to a removable RPD in place without moving or rocking of the prosthesis, which is the common compliant of almost all patients of RPD. Copings are also protecting the abutment from tooth decay and also offers stabilization and maintaining of the outer crown. The outer crown engages the inner coping and gives as an anchor for the remainder of the dentition. This work is the review of telescopic prosthesis which is well supported by the case discussion, and

  4. Bar versus ball attachments for implant-supported overdentures in complete edentulism: A systematic review.

    Science.gov (United States)

    Anas El-Wegoud, Marwah; Fayyad, Ahmed; Kaddah, Amal; Nabhan, Ashraf

    2018-04-01

    Implant-supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball attachments used to retain overdentures in terms of patient satisfaction and prosthesis retention. The purpose of this study is to compare the effectiveness of bar and ball attachments for conventionally loaded implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention. We conducted the review according to the Cochrane methods and following MECIR standards. We searched Cochrane Oral Health Group Trial register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO ICTRP (March 31, 2017). Two review authors assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals. We included 10 trials (465 participants). After 5 y, one trial reported higher patient satisfaction when bar attachment was used (MD 1.30, 95% CI 0.20-2.40), and reported no difference between both systems in prosthesis retention (MD -0.90, 95% CI -1.90 to 0.10). Two trials reported no implant failures after 1 and 5 y in both attachments. Downgrading of evidence was based on the unclear risk of bias of included studies and the wide CI crossing the line of no effect. There is insufficient evidence to support bar or ball attachment to be used with implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention (PROSPERO 2014:CRD42014014594). © 2017 Wiley Periodicals, Inc.

  5. Mastication improvement after partial implant-supported prosthesis use.

    Science.gov (United States)

    Gonçalves, T M S V; Campos, C H; Gonçalves, G M; de Moraes, M; Rodrigues Garcia, R C M

    2013-12-01

    Partially edentulous patients may be rehabilitated by the placement of removable dental prostheses, implant-supported removable dental prostheses, or partial implant fixed dental prostheses. However, it is unclear the impact of each prosthesis type over the masticatory aspects, which represents the objective of this paired clinical trial. Twelve patients sequentially received and used each of these 3 prosthesis types for 2 months, after which maximum bite force was assessed by a strain sensor and food comminution index was determined with the sieving method. Masseter and temporal muscle thicknesses during rest and maximal clenching were also evaluated by ultrasonography. Each maxillary arch received a new complete denture that was used throughout the study. Data were analyzed by analysis of variance for repeated measures, followed by the Tukey test (p mastication, and the magnitude of this effect was related to prosthesis type.

  6. Edentulism, beaks, and biomechanical innovations in the evolution of theropod dinosaurs.

    Science.gov (United States)

    Lautenschlager, Stephan; Witmer, Lawrence M; Altangerel, Perle; Rayfield, Emily J

    2013-12-17

    Maniraptoriformes, the speciose group of derived theropod dinosaurs that ultimately gave rise to modern birds, display a diverse and remarkable suite of skeletal adaptations. Apart from the evolution of flight, a large-scale change in dietary behavior appears to have been one of the main triggers for specializations in the bauplan of these derived theropods. Among the different skeletal specializations, partial or even complete edentulism and the development of keratinous beaks form a recurring and persistent trend in from the evolution of derived nonavian dinosaurs. Therizinosauria is an enigmatic maniraptoriform clade, whose members display these and other osteological characters thought to be correlated with the shift from carnivory to herbivory. This makes therizinosaurians prime candidates to assess the functional significance of these morphological characters. Based on a highly detailed biomechanical model of Erlikosaurus andrewsi, a therizinosaurid from the Upper Cretaceous of Mongolia, different morphological configurations incorporating soft-tissue structures, such as a keratinous rhamphotheca, are evaluated for their biomechanical performance. Our results indicate that the development of beaks and the presence of a keratinous rhamphotheca would have helped to dissipate stress and strain, making the rostral part of the skull less susceptible to bending and displacement, and this benefit may extend to other vertebrate clades that possess rhamphothecae. Keratinous beaks, paralleled by edentulism, thus represent an evolutionary innovation developed early in derived theropods to enhance cranial stability, distinct to postulated mass-saving benefits associated with the origin of flight.

  7. Rehabilitation of a patient with complete mandibulectomy and partial glossectomy

    International Nuclear Information System (INIS)

    Meyerson, M.D.; Johnson, B.H.; Weitzman, R.S.

    1980-01-01

    Following a number of radiologic and surgical procedures for the treatment of oral cancer, a patient with severe facial difigurement and alteration of the vocal tract acquired acceptable speech. Consultation among referring physicians and speech pathologists can aid such a patient by facilitating the rehabilitative process through improvement of communicative skills

  8. Effects of Edentulism on Mandibular Morphology: Evaluation of Panoramic Radiographs

    Directory of Open Access Journals (Sweden)

    Rıdvan Okşayan

    2014-01-01

    Full Text Available Purpose. The objective of this study was to evaluate morphological changes of the mandible in edentulous and dentate subjects using panoramic radiographs. Materials and Methods. Panoramic radiographs were divided into the following three groups: Group I (completely edentulous group, Group II (old dentate group and Group III (young dentate group. The research parameters of gonial angle, condylar height, ramus height, ramus notch depth, and antegonial notch depth were measured on panoramic radiographs. The Kruskal-Wallis statistical test was used to determine significant differences in mandibular morphological parameters among the three groups. The Mann-Whitney U test was used to compare the subgroups. Results. Significant differences were found only in ramus height between three groups. According to the Mann-Whitney U test, a significant difference was exhibited among Groups I and II in the ramus height parameter. No significant differences were found in the gonial angle, condylar height, ramus notch depth, or antegonial notch depth when comparing the young dentate, old dentate, and completely edentulous subjects. Conclusions. Significant differences were found only in ramus height between the groups. Ramus height may be an indicator that changed by years and tooth loss. It must be considered that ramus height can be decreased in edentulism.

  9. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

    NARCIS (Netherlands)

    Wismeijer, D.; Tawse-Smith, A.; Payne, A.G.T.

    2013-01-01

    Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular

  10. Prosthetic rehabilitation of a patient after partial maxillectomy: A clinical report

    Directory of Open Access Journals (Sweden)

    Shobha J Rodrigues

    2011-01-01

    Full Text Available Malignant melanoma of the oral cavity is very rare. This clinical report describes a method for prosthetic rehabilitation of a patient with malignant melanoma of the palate following partial maxillectomy with a closed hollow interim obturator.

  11. Prosthetic rehabilitation of a patient after partial maxillectomy: A clinical report

    OpenAIRE

    Rodrigues, Shobha J.; Saldanha, Sharon

    2011-01-01

    Malignant melanoma of the oral cavity is very rare. This clinical report describes a method for prosthetic rehabilitation of a patient with malignant melanoma of the palate following partial maxillectomy with a closed hollow interim obturator.

  12. Prosthetic rehabilitation of a patient after a partial mandibulectomy

    Directory of Open Access Journals (Sweden)

    Marcelo Coelho Goiato

    2015-06-01

    Conclusion: A correct occlusal adjustment and an adequate retention of the prostheses bases may improve their retention and stability. Patients without xerostomy and with a satisfactory amount of alveolar bone may have a favorable prognosis for conventional dentures.

  13. Treatment of edentulism: optimizing outcomes with tissue management and impression techniques.

    Science.gov (United States)

    Salinas, Thomas J

    2009-02-01

    Significant numbers of patients throughout the world seek treatment for edentulism. The trend toward tissue-integrated prostheses has been a monumental step in restoring edentulous patients to function; however, this treatment can be out of reach for those who fail to qualify or those who do not have sufficient resources to afford it. In these cases, conventional dentures remain an important primary course of treatment. Attention to detail when diagnosing, treatment planning, and performing treatment for these patients is still a prime consideration for the best possible outcome. In particular, many experienced denture wearers are afflicted with chronically inflamed denture-bearing mucosa. Clinicians must recognize the need for tissue conditioning, choices of impression materials, and accepted fabrication techniques that can have favorable outcomes when matched with patients who are philosophical and realistic in their expectations. The purpose of this article is to review impression philosophies, associated materials, and methods of tissue conditioning. Retention and stability of the denture bases can be augmented by the routine use of denture adhesive, and indications for use of denture adhesive will be discussed.

  14. Oral Rehabilitation of Adult Edentulous Siblings Severely Lacking Alveolar Bone Due to Ectodermal Dysplasia: A Report of 2 Clinical Cases and a Literature Review.

    Science.gov (United States)

    Wu, Yiqun; Zhang, Chenping; Squarize, Cristiane H; Zou, Duohong

    2015-09-01

    The oral conditions of adult edentulous patients with ectodermal dysplasia (ED) often lead to decreased physical and psychological health, and the negative effects can become as extreme as social and psychological isolation. However, restoring oral function of adult edentulous patients with ED using zygomatic implants (ZIs) or conventional implants (CIs) remains challenging for dentists because of the severe atrophy of these patients' alveolar ridges. This report describes 2 cases of adult edentulous siblings with ED; they exhibited severe alveolar bone atrophy and were treated with ZIs and CIs as bases to augment the bone in their anterior jaws. For these patients, bone augmentation was completed with an autogenous fibular graft. Although there was mild evidence of bone graft resorption in the maxilla, the bone augmentation procedures were successful in the 2 patients. Effective osseointegration of the implants was obtained. After placement, the functional and esthetic results of the oral rehabilitation were acceptable. More importantly, restoration of the patients' oral function enhanced their self-confidence and self-esteem. Therefore, restoring oral function in adult patients with ED and edentulous jaws using ZIs and CIs as the bases for bone augmentation is an effective approach. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  15. Tamoxifen with and without radiation after partial mastectomy in patients with involved nodes

    Energy Technology Data Exchange (ETDEWEB)

    Cooke, Andrew L; Perera, Francisco; Fisher, Barbara; Opeitum, Abiola; Yu, Norman

    1995-02-15

    Purpose: To determine the effect of tamoxifen on local control after partial mastectomy with and without adjuvant breast irradiation. Methods and Materials: A retrospective study of 97 node positive patients identified from the records of the London Regional Cancer Center included 44 patients who received tamoxifen and breast irradiation (40 or 50 Gy plus booster dose) after partial mastectomy, and 53 patients who received tamoxifen only after partial mastectomy. Base line characteristics of the two groups were similar. Results: At 39 months actuarial follow-up there was a breast tumor recurrence (BTR) in 5% vs. 21% of patients when radiation was omitted (p = 0.0388), but there was no difference in the cause-specific mortality of the two treatment groups. Cox Regression analysis (on only 10 BTR) showed age and adjuvant radiation as significant predictors of BTR. In patients not receiving radiation, no BTR was seen in 22 patients {>=}70 years of age at diagnosis vs. 8 BTR in 31 patients <70 years (p = 0.0130). All BTR occurred while patients were receiving tamoxifen. Conclusion: Tamoxifen alone with omission of radiation after partial mastectomy provides inferior breast tumor control in node positive patients. This is especially true for patients under 70 years of age. Patients aged 70 years or older at the time of diagnosis of breast cancer who receive tamoxifen have a low rate of breast tumor recurrence when radiation is omitted. These patients represent a group for whom radiation might not be necessary.

  16. Abnormal Moral Reasoning in Complete and Partial Callosotomy Patients

    Science.gov (United States)

    Miller, Michael B.; Sinnott-Armstrong, Walter; Young, Liane; King, Danielle; Paggi, Aldo; Fabri, Mara; Polonara, Gabriele; Gazzaniga, Michael S.

    2010-01-01

    Recent neuroimaging studies suggest lateralized cerebral mechanisms in the right temporal parietal junction are involved in complex social and moral reasoning, such as ascribing beliefs to others. Based on this evidence, we tested 3 anterior-resected and 3 complete callosotomy patients along with 22 normal subjects on a reasoning task that…

  17. Implant-assisted removable partial dentures: practical considerations.

    Science.gov (United States)

    Omura, Aaron J; Latthe, Vaibhav; Marin, Mark M; Cagna, David R

    2016-01-01

    At the heart of prosthodontic treatment planning must be a sound understanding of the quality and reliability of the prosthodontic foundation. Implant prosthodontics relies almost entirely on the biological and mechanical properties of an osseous foundation. Initiation of therapy in the absence of a healthy and stable prosthodontic foundation risks unintended and suboptimal treatment outcomes. For conventional removable partial denture (RPD) therapy, consideration must be given to interactions between the soft and hard tissues available to support and stabilize planned prostheses. The strategic addition of implants to the partially edentulous foundation can improve the support, comfort, and esthetics of an RPD, resulting in elevated patient satisfaction and greater therapeutic success. This article discusses aspects of diagnosis, treatment planning, clinical management, laboratory execution, and maintenance that must be considered in order to obtain optimal results with implant-assisted RPDs.

  18. Management of Sjogren's Syndrome Patient: A Case Report of Prosthetic Rehabilitation with 6-Year Follow-Up

    OpenAIRE

    de Mendonça Invernici, Marcos; Finger Stadler, Amanda; Vale Nicolau, Gastão; Naval Machado, Maria Ângela; Soares de Lima, Antônio Adilson; Compagnoni Martins, Marilia

    2014-01-01

    Completely and partially edentulous patients with Sjogren’s syndrome (SS) experience severe hyposalivation, xerostomia, and considerable difficulty in using tissue-supported prosthesis. This clinical paper describes the management, treatment, and 6-year follow-up of a patient diagnosed with SS type II, who uses corticosteroids and antihyperglycemic drugs. The patient received restorative, periodontal, and surgical treatments followed by implant-supported fixed prosthesis. Radiographic evaluat...

  19. Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

    Science.gov (United States)

    Jemt, Torsten; Kowar, Jan; Nilsson, Mats; Stenport, Victoria

    2015-01-01

    Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

  20. [Evaluation of cermet fillings in abutment teeth in removable partial prostheses].

    Science.gov (United States)

    Saulic, S; Tihacek-Sojic, Lj

    2001-01-01

    The aim of the study was to describe the clinical process of setting the purpose filling on abutment teeth, after finishing the removable partial dentures. The aim was also to investigate the use of cermet glass-ionomer cement for the purpose filling in the abutment teeth for removable partial dentures, as well as to investigate the surface of the purpose filling. For the clinical evaluation of purpose filling slightly modified criteria according to Ryg's were used in 20 patients with different type of edentulousness. Changes occurring on the surface of purpose filling have been experimentally established by the method of scanning electron microscopy on the half-grown third molars in seven patients. It could be concluded that cement glass-ionomer was not the appropriate material for the purpose fillings in abutment teeth for removable partial dentures.

  1. Effects of cognitive remediation on cognitive dysfunction in partially or fully remitted patients with bipolar disorder

    DEFF Research Database (Denmark)

    Demant, Kirsa M; Almer, Glennie Marie; Vinberg, Maj

    2013-01-01

    A large proportion of patients with bipolar disorder experience persistent cognitive dysfunction, such as memory, attention and planning difficulties, even during periods of full remission. The aim of this trial is to investigate whether cognitive remediation, a new psychological treatment......, improves cognitive function and, in turn, psychosocial function in patients with bipolar disorder in partial or full remission....

  2. Teenage patients with ingrown toenails: Treatment with partial matrix excision or segmental phenolization

    Directory of Open Access Journals (Sweden)

    Murat Korkmaz

    2013-01-01

    Full Text Available Background: Ingrown toenails (IT is a very common problem leading to significant associated morbidity. The articles related to phenolization for matrix removal in teenagers with IT are not enough in the foot surgery literature. Aims: To compare the postoperative recovery periods, complication rate, and tolerability of partial matrix excision and segmental phenolization in teenagers with IT. Materials and Methods: Thirty-nine patients (13-17 years with 48 IT were randomly divided into two groups and were treated with partial matrix excision (Group I and segmental phenolization (Group II. We assessed the recurrence rates, postoperative complications, duration of analgesic usage, and time to return to daily activities. Results: There was no significant difference between the demographic and clinical data of the two groups. Three patients in Group I and two patients in Group II experienced moderate pain postoperatively. These patients used analgesics for 3 days. The rates of postoperative complications and recurrences between the two groups showed no statistically significant difference ( P = 0.688. The time to return to normal daily activities was significantly shorter in Group II patients than in Group I patients ( P < 0.05. Conclusions: Partial matrix excision is a very safe model of therapy in the surgical treatment of teenagers with IT. It has low recurrence rate and minimal postoperative morbidity. We concluded that segmental phenolization is also as safe as partial matrix excision in the treatment of IT and patients return to their daily activities in less time with this treatment modality.

  3. Partial pleural covering for intractable pneumothorax in patients with Birt-Hogg-Dubé Syndrome.

    Science.gov (United States)

    Okada, Akira; Hirono, Tatsuhiko; Watanabe, Takehiro; Hasegawa, Go; Tanaka, Reiko; Furuya, Mitsuko

    2017-03-01

    Birt-Hogg-Dubé syndrome (BHD) is an inherited disorder associated with a germline mutation of the folliculin (FLCN) gene. Most patients with BHD have multiple pulmonary cysts, and are at high risk of repeated pneumothorax. Although an increasing number of patients are diagnosed with BHD by genetic testing, therapeutic approaches for intractable pneumothorax have not yet been described. We treated three patients who had repeated episodes of pneumothorax. All had multiple pulmonary cysts in the lower lobes, and two had a family history of pneumothorax. Video-assisted thoracic surgery was used to perform wedge resections and partial pleural covering of the cystic lesions. The partial pleural covering technique used sheets of polyglycolic acid felt or regenerative oxidized cellulose mesh. The resected tissues underwent histopathological evaluation, and peripheral blood leukocytes were tested for FLCN mutations. The operative times were less than 2 h, and there were no complications. The resected cysts had histopathological features characteristic of BHD lung. All patients were found to have FLCN germline mutations; thus their repeated pneumothoraces were a manifestation of BHD. None of the patients developed respiratory problems after undergoing the partial pleural covering procedure, and they have all been well without pneumothorax for 30 months or more. Partial pleural covering combined with resection of protruding cysts should be a safe and effective therapeutic approach for BHD patients with intractable pneumothorax. Further investigation is needed to establish a detailed protocol for treatment of pneumothorax that results in minimal functional impairment. © 2015 John Wiley & Sons Ltd.

  4. Epidemiological Data and Survival Rate of Removable Partial Dentures

    Science.gov (United States)

    Moreno, Amália; Haddad, Marcela Filié; Rocha, Eduardo Passos; Assunção, Wirley Gonçalves; Filho, Humberto Gennari; Santos, Emerson Gomes Dos; Sonego, Mariana Vilela; Santos, Daniela Micheline Dos

    2016-01-01

    Introduction The use of removable partial denture (RPD) is considered as low-cost and common treatment option to rehabilitate edentulous areas. Aim This study aimed to investigate the epidemiological data of patients rehabilitated with removable partial denture (RPD) in order to assess treatment survival rate and failures. Materials and Methods Epidemiological data and medical records of patients treated with RPD between 2007 and 2012 at the RPD discipline of a Brazilian University (Aracatuba Dental School- UNESP) were evaluated as well as dental records of patients who underwent RPD treatments (fabrication or repairs) between 2000 and 2010. Factors such as gender, age, presence of systemic disease, main complaint, edentulous arch, period and cause of denture replacement and the prosthesis characteristics were recorded. The chi-square test was used to assess the differences between the variables and the Kaplan Meyer to assess the survival of the RPDs evaluated. Results A total of 324 maxillary RPD and 432 mandibular RPD were fabricated. Most of the patients were women aging 41 to 60-year-old. The number of mandibular RPD Kennedy class I (26%) was statistically higher for the maxillary arch (p<.05). There was no association between main complaint to gender or the presence of systemic disease. The lingual plate was the most common major connector used in the mandible (32%). The main reason for altering the design of replaced RPDs were changes during treatment plan. Conclusion The number of patients who require RPD is large; most of RPDs are Kennedy Class I. A good treatment plan is very important for achieving a positive treatment outcome, and it is strictly related to the survival rate. PMID:27437367

  5. Prevalence of Upper Abdominal Complaints in Patients Who Have Undergone Partial Gastrectomy

    Directory of Open Access Journals (Sweden)

    RJLF Loffeld

    2000-01-01

    Full Text Available Little is known about the long term occurrence and prevalence of upper abdominal complaints after previous partial gastrectomy. Therefore, a retrospective, uncontrolled, cross-sectional, descriptive, clinical, endoscopic study was done. A questionnaire was mailed to patients who had undergone partial gastrectomy and been sent for upper gastrointestinal endoscopy. Eight questions were scored on a five-point Likert scale, and a symptom score was calculated. During the five-year study period, 189 patients (137 men, 52 women were identified as having had a partial gastrectomy -- 143 (76% received the Billroth II operation and 46 (24% received the Billroth I operation. The questionnaire was mailed to 124 patients, of whom 79 (64% responded. Eighty-eight per cent of patients had undergone surgery more than 15 years earlier. Fifty-nine patients (75% suffered from upper abdominal symptoms. Regurgitation of food, retrosternal heartburn and bile reflux occurred significantly more often in patients who underwent the Billroth II operation. The mean symptom score of patients who underwent Billroth I resection was significantly lower (4.5 [SD 3.6] than that of patients who underwent Billroth II resection (7.1 [SD 4.4](P=0.04. One or more symptoms indicative of dumping were found in 70% of patients who underwent Billroth II resection and in 59% of patients who underwent Billroth I resection (not significant. Many patients who had undergone a partial gastrectomy developed upper abdominal symptoms during long term follow-up that were not specifically linked to dumping.

  6. Smile designing for cleft lip and palate patient: The prosthodontic approach

    Directory of Open Access Journals (Sweden)

    Karuna Gajanan Pawashe

    2017-01-01

    Full Text Available The case report describes smile designing of a 22-year-old male patient who was surgically operated for unilateral cleft lip (left side with Andrew's Bridge system. It is composed of two components: Fixed component (retainers on abutments joined by bar and removable component. The patient exhibited maxillary anterior defect (Siebert's Class-III anterior ridge defect, teeth transposition, increased mesiodistal edentulous space, bilaterally missing lateral incisor. When there is a limitation of bone grafting/surgical augmentation, alternative treatment modalities such as removable partial dentures, fixed partial dentures with gingival porcelain and/or fixed-removable partial dentures known as Andrew's bridge are indicated.

  7. Partial lower axillary dissection for patients with clinically node-negative breast cancer.

    Science.gov (United States)

    Kodama, H; Mise, K; Kan, N

    2012-01-01

    To evaluate retrospectively the outcomes of partial lower axillary lymph node dissection caudal to the intercostobrachial nerve in patients with clinically node-negative (N(0)) breast cancer. Numbers of dissected and metastatic nodes, overall and disease-free survival rates, postoperative complication rates, and axillary recurrence were compared between patients who underwent breast cancer surgery with partial axillary node dissection (n = 1043) and historical controls who underwent conventional dissection (n = 1084). The 5-year overall and disease-free survival rates were 95.6% and 89.7%, and 94.9% and 88.4%, respectively, in the partial dissection and conventional dissection groups; the differences were not significant. Mean duration of surgery (41.6 min versus 60.9 min), intraoperative blood loss (28.0 ml versus 51.3 ml), volume of lymphatic drainage at 2 weeks postoperatively (488 ml versus 836 ml), and persistent arm lymphoedema (0.0% versus 11.8%) were significantly different between the partial and conventional dissection groups, respectively. Partial axillary lymph node dissection was associated with similar survival rates (but lower postoperative complication rates) compared with conventional axillary dissection and is recommended in patients with N(0) breast cancer.

  8. Postoperative delirium after partial laryngectomy in a middle-aged patient: A case report.

    Science.gov (United States)

    Yu, Huiqian; Shen, Xia

    2018-02-01

    Postoperative delirium is a common occurrence in older patients. However, reports of postoperative delirium in middle-aged patients are limited, and the underlying mechanism of delirium in this patient population is not clear. A 45-year-old man who developed postoperative delirium on the second day after partial laryngectomy. Interviews of the surgical team, patient, and patient's spouse revealed that the patient was psychologically stressed, but had not been diagnosed or treated. The patient also suffered impairment in physiological functioning and sleep disturbance after surgery. Postoperative delirium. The postoperative delirium was treated with an antipsychotic drug. The patient recovered well. Preoperative psychological stress, which is often undiagnosed and untreated, can increase the risk of postoperative delirium in middle-aged patients undergoing laryngectomy. Therefore, screening for psychological stress and implementing strategies to prevent delirium should be considered for patients who undergo laryngectomy, even if they are not in high-risk older age groups.

  9. A patient with de-novo partial deletion of Xp (p11.4-pter) and partial duplication of 22q (q11.2-qter).

    Science.gov (United States)

    Armour, Christine M; McGowan-Jordan, Jean; Lawrence, Sarah E; Bouchard, Amélie; Basik, Mark; Allanson, Judith E

    2008-01-01

    We report on a girl with partial deletion of Xp and partial duplication of 22q. Family studies demonstrate that both the patient's mother and her nonidentical twin sister carry the corresponding balanced translocation; 46,X,t(X;22)(p11.4;q11.2). This girl has developmental delay, microcephaly, mild dysmorphisms and hearing loss but otherwise shows few of the features described in individuals with duplications of the long arm of chromosome 22. She does manifest characteristics, such as short stature and biochemical evidence of ovarian failure, which are seen in partial or complete Xp deletions and Turner's syndrome.

  10. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors

    NARCIS (Netherlands)

    Jansen, P. L.; Chamuleau, R. A.; van Leeuwen, D. J.; Schipper, H. G.; Busemann-Sokole, E.; van der Heyde, M. N.

    1990-01-01

    Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single-photon computed tomography (SPECT), using 99mTc-colloid as tracer. The method was

  11. Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

    Directory of Open Access Journals (Sweden)

    Meyer Ulrich

    2007-01-01

    Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

  12. REHABILITATION OF A HEMI-MAXILLECTOMY PATIENT WITH A CAST PARTIAL OBTURATOR PROSTHESIS - A CLINICAL REPORT.

    OpenAIRE

    Aprajita; Atul Bhatnagar; Kumari Deepika; Shankar singh.

    2018-01-01

    Prosthodontic rehabilitation of patient who have underwent maxillectomy surgery is a challenging task. Achieving optimum stability, retention and support are the major problems. An obturator with cast partial design is used to rehabilitate maxillectomy defect. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissues and to provide comfort, function, and aesthetics to the patients. This case report describes several steps of fabrication of a definitive obtu...

  13. Serum retinol binding protein 4 in patients with familial partial lipodystrophy.

    Science.gov (United States)

    Godoy-Matos, Amélio F; Moreira, Rodrigo O; MacDowell, Renata; Bendet, Izidro; Mory, Patrícia B; Moises, Regina S

    2009-07-01

    To determine Retinol Binding Protein 4 (RBP4) levels in patients with Familial Partial Lipodystrophy (FPLD). Ten patients with FPLD and a control group (9 patients) were selected to participate in the study. RBP4-log levels were lower in patients with FPLD in comparison to control group (1.52 +/- 0.32 vs 1.84+/-0.25, p=0.029). A statistical trend was observed between Waist-to-Hip Ratio and RBP4-log (r=-0.44, p=0.054). RBP4 levels are decreased in FPLD.

  14. Partial unilateral lentiginous and colon polyp in a young male patient

    Directory of Open Access Journals (Sweden)

    Gulhan Gurel

    2018-03-01

    Full Text Available Partial unilateral lentiginosis is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin. Pigmented macules are usually localized in one half of the body. Associations with café-au-lait spots, cutis marmorata, acanthosis nigricans, nevus depigmentosus, vitiligo, blue nevus, segmental neurofibromatosis, central nervous system diseases, celiac disease, and sickle cell anemia have been reported. We describe a 17-year-old male patient with a partial unilateral lentiginous lesion on the left side of the body and left upper back and incidental polyp in the descending colon.

  15. A modified occlusal wafer for managing partially dentate orthognathic patients--a case series.

    Science.gov (United States)

    Soneji, Bhavin Kiritkumar; Esmail, Zaid; Sharma, Pratik

    2015-03-01

    A multidisciplinary approach is essential in orthognathic surgery to achieve stable and successful outcomes. The model surgery planning is an important aspect in achieving the desired aims. An occlusal wafer used at the time of surgery aids the surgeon during correct placement of the jaws. When dealing with partially dentate patients, the design of the occlusal wafer requires modification to appropriately position the jaw. Two cases with partially dentate jaws are presented in which the occlusal wafer has been modified to provide stability at the time of surgery.

  16. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction.

    Science.gov (United States)

    Wismeijer, Daniel; Tawse-Smith, Andrew; Payne, Alan G T

    2013-01-01

    To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Forty-eight participants who were dissatisfied with their existing conventional mandibular distal extension dentures opposing complete maxillary dentures were selected for a multicentre prospective study in New Zealand, Colombia and the Netherlands. A control group of 12 participants in New Zealand received conventional mandibular partial dentures. Three test groups involving 36 participants in New Zealand (12), Colombia (12) and the Netherlands (12) received bilateral distal implants in the second molar regions. After conventional loading, the test group participants initially had healing caps placed on the distal implants providing support only, followed after approximately 6 months by ball abutments (retentive anchors) for support and retention. Patient outcomes were determined with questionnaires completed at specific stages of the study for up to 3 years. Visual analogue scale, Likert and oral health impact questionnaires before and after treatment indicated improved results. There were significantly improved parameters of overall satisfaction, stability, chewing and appearance after 3 years (P removable partial dentures are a preferable treatment option for patients with complaints about their conventional distal extension partial dentures. © 2011 John Wiley & Sons A/S.

  17. Differentiation of mucosal disease from partial development of the paranasal sinuses in pediatric patients

    International Nuclear Information System (INIS)

    Duerinckx, A.J.; Whyte, A.M.; Lufkin, R.B.; Hall, T.R.; Kangarloo, H.

    1988-01-01

    On magnetic resonance (MR) images of pediatric patients, sinus mucosal disease may have an appearance similar to that of the normal partially developed sinus, leading to an increase in the number of patients labeled as having incidental sinusitis. The paranasal sinuses were retrospectively evaluated in 27 infants and children aged 0-11 years undergoing brain MR imaging for indications both unrelated and related to sinus disease. The authors developed criteria for grading paranasal sinus development and mucosal disease. Incidental mucosal disease is not uncommon, occurring in 28% of patients aged 0-7 years. In children under 3 years of age, inflammatory mucosal thickening and marrow surrounding the partially developed sinus have a high signal on many MR sequences and may be confused. Recognition of the low-intensity peripheral cortical margin of the sinus and awareness of the stages of normal sinus development allow differentiation

  18. The edentulous mandible opposing maxillary natural teeth: treatment considerations utilizing implant overdentures.

    Science.gov (United States)

    Winkler, S; Monasky, G E

    1993-01-01

    The restoration of the edentulous mandible opposing all or part of the maxillary natural dentition with implant overdentures is described. There are many situations in which the maxillary teeth opposing an edentulous mandible can and should be retained. Mandibular implant overdentures can be utilized as long as health considerations, morphologic features of the resorbed mandible, and maxillomandibular jaw relationships are satisfactory.

  19. Return to Sports and Physical Activities After Primary Partial Arthrodesis for Lisfranc Injuries in Young Patients.

    Science.gov (United States)

    MacMahon, Aoife; Kim, Paul; Levine, David S; Burket, Jayme; Roberts, Matthew M; Drakos, Mark C; Deland, Jonathan T; Elliott, Andrew J; Ellis, Scott J

    2016-04-01

    Research regarding outcomes in sports and physical activities after primary partial arthrodesis for Lisfranc injuries has been sparse. The purposes of this study were to assess various sports and physical activities in young patients following primary partial arthrodesis for Lisfranc injuries and to compare these with clinical outcomes. Patients who underwent primary partial arthrodesis for a Lisfranc injury were identified by a retrospective registry review. Thirty-eight of 46 eligible patients (83%) responded for follow-up at a mean of 5.2 (range, 1.0 to 9.3) years with a mean age at surgery of 31.8 (range, 16.8 to 50.3) years. Physical activity participation was assessed with a new sports-specific, patient-administered questionnaire. Clinical outcomes were assessed with the Foot and Ankle Outcome Score (FAOS). Patients participated in 29 different and 155 total physical activities preoperatively, and 27 different and 145 total physical activities postoperatively. Preoperatively, 47.1% were high impact, and postoperatively, 44.8% were high impact. The most common activities were walking, bicycling, running, and weightlifting. Compared to preoperatively, difficulty was the same in 66% and increased in 34% of physical activities. Participation levels were improved in 11%, the same in 64%, and impaired in 25% of physical activities. Patients spent on average 4.2 (range, 0.0 to 19.8) hours per week exercising postoperatively. In regard to return to physical activity, 97% of respondents were satisfied with their operative outcome. Mean postoperative FAOS subscores were significantly worse for patients who had increased physical activity difficulty. Most patients were able to return to their previous physical activities following primary partial arthrodesis for a Lisfranc injury, many of which were high-impact. However, the decreased participation or increase in difficulty of some activities suggests that some patients experienced postoperative limitations in exercise

  20. Connection of functional quality of partial removable dentures and the degree of patients' phonetic adaptation.

    Science.gov (United States)

    Artjomenko, Victoria; Vidzis, Aldis; Zigurs, Guntis

    2015-01-01

    Phonetic adaptation is a complex biological phenomenon with a highly individual course, depending on the patient's motivation to use prosthesis, on the functional quality of removable dentures. The aim of the study was to estimate phonetic adaptation in patients with partial dentures, connecting it to alteration in speech quality and dentures functional value. We examined some peculiarities of phonetic adaptation in 50 patients with removable dentures (50 patients with natural dentition were invited for the control group). The standardized evaluation protocols (12 speech quality determining parameters) were developed separately for Latvian and Russian native speakers. 500 speech video samples were recorded and analysed according to pre-established guidelines. The connection of speech quality and the functional quality of the dentures was assessed. Statistical analysis was performed using SPSS 20.0. P values equal to or less than 0.05 were considered to be statistically significant. In patients with appropriate functional quality of removable dentures distorted speech production was detected in 25% (pk=0.008) cases and in patients with inappropriate functional quality of the prosthesis - in 40% (pkdentures functional value were satisfied with their speech performance in 96% (pk=0.674), in the group with inappropriate dentures functional value only 59% (premovable dentures depends on the patient's individual adaptation capacity, prosthetic design and functional value. Thus statistically significant correlation between removable partial dentures functional value, duration of usage and the degree of patients' phonetic adaptation (p<0.001) may be considered to be confirmed.

  1. Implant supported prosthesis in an edentulous boy with Hypohidrotic Ectodermal Dysplasia - "A happy boy"

    DEFF Research Database (Denmark)

    Gjørup, Hans; Nyhuus, Lone; Buhl, Jytte

    2009-01-01

    region. 3. At the age of 10 years a new set of dentures were made. This time the upper denture was made as an overdenture supported and retained by 4 implants and a Dolder bar. The surgical procedure included bone grafting from the anterior ramus mandibulae. The boy's subjective judgement of his oral......Implant supported prosthesis in an edentulous boy with Hypohidrotic Ectodermal Dysplasia - "A happy boy". Authors; Gjoerup,H1; Nyhuus,L2; Buhl,J3. 1) Center for Oral Health in Rare Conditions, Aarhus University Hospital 2) Prosthodontic Department, the Dental School, Aarhus University 3) Department...... by the patient and his family. Case presentation The boy was untreated until the age of 5 years. His oral functions were compromised in relation to speech and psychosocial aspects. In the following 6 years, he underwent prosthodontic treatment in three phases. 1. At the age of 5 years a set of complete dentures...

  2. Association Between Masticatory Function and Oral Health-Related Quality of Life in Partial Maxillectomy Patients.

    Science.gov (United States)

    Said, Mohamed Moustafa; Otomaru, Takafumi; Aimaijiang, Yiliyaer; Li, Na; Taniguchi, Hisashi

    The aim of this study was to investigate associations between objectively and subjectively measured masticatory function and oral health-related quality of life (OHRQoL) in partial maxillectomy patients wearing dentomaxillary prostheses. A sample of 32 consecutively treated patients who had undergone a partial maxillectomy were enrolled. Masticatory function was assessed using two objective measures and one subjective measure. The objective measures were masticatory performance (MP), which was estimated by measuring the glucose extracted from gummy jelly, and food mixing ability (a*), which was assessed using color-changeable chewing gum. The subjective measure was perceived chewing ability, rated as masticatory score (MS) based on the patient's responses to a food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Relationships between the masticatory function measures and OHRQoL were analyzed using Spearman rank correlation coefficient. The correlation coefficients (r) obtained were 0.57 (P = .001) for MS and GOHAI, 0.247 (P = .173) for MP and GOHAI, -0.173 (P = .343) for a* and GOHAI, 0.517 (P = .002) for MP and a*, 0.199 (P = .257) for MP and MS, and 0.019 (P = .919) for a* and MS. Subjective MS showed a significant positive correlation with GOHAI score, suggesting that perceived chewing ability could be an important factor in the estimation of OHRQoL in partial maxillectomy patients.

  3. REGULATION OF IMMUNE RESPONSE OF PATIENTS WITH PARTIALLY CONTROLLED vs CONTROLLED BRONCHIAL ASTHMA

    Directory of Open Access Journals (Sweden)

    E. Yu. Barabash

    2017-01-01

    Full Text Available A control group included seventeen conditionally healthy people (Group 1. Eighty-eight patients with proven bronchial asthma (BA at the age of 22 to 48 were enrolled into the study. I.e., Group 2 included nine patients with well-controlled BA. Group 3 included persons with partially controlled BA (n=79. There were 8 people with easily treated BA in group 2, and 57 such cases in Group 3. The levels of interleukins (IL-4, IL-10, IL-17A, interferon-γ (IFNγ, and tumor-α necrosis factor (TNFα were monitored by means of flow cytometry technique. The parameters of cellular immunity were registered by flow cytofluorimetry assays. Phagocytosis indicators were studied by means of D. Mayansky method, metabolic activity of neutrophils, by the B.Park method, as modified by E.Shmelev. Evaluation of cellular immunity did not reveal statistically significant differences for distinct CD subpopulations between healthy controls and BA patients. The patients with controlled and partially controlled BA exhibited some changes in cytokine concentrations, i.e., increased IL-4, IL-17А, IL-10 and TNFα levels; changes in phagocytosis and oxygen dependent bactericidal activities of neutrophils. We have revealed higher concentrations of IL-4, IL-17А in the less controlled BA (group 3 , as compared with group 2. TNFα induction remained at significantly higher level in both groups of BA patients, exceeding mean control values by 2.3 times. The degree of IL-10 production in group 2 with controlled BA was significantly higher than in group with partial disease control (group 3, p < 0.001, thus suggesting application of IL-10 levels as an index of active inflammation control. Patients with BA (groups 2, 3 exhibited a decrease of basal IFNγ, as compared to healthy people (p < 0.001. In group 3 (partial control, this parameter was 3-fold lower than in healthy persons. Evaluation of monocyte/phagocyte functions showed statistically significant differences between BA

  4. Immediately loaded implants supporting fixed prostheses in the edentulous maxilla: a preliminary clinical and radiologic report.

    Science.gov (United States)

    Bergkvist, Göran; Sahlholm, Sten; Karlsson, Ulf; Nilner, Krister; Lindh, Christina

    2005-01-01

    To evaluate the survival rate of immediately loaded ITI sand-blasted, large-grit, acid-etched (SLA) solid-screw dental implants in the edentulous maxilla after 8 months of loading. Twenty-eight patients (mean age 63 years) with edentulous maxillae each received 6 implants and 1 implant-supported fixed provisional prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patient received a definitive, screw-retained, implant-supported fixed prosthesis. A total of 168 implants were placed. Clinical parameters were registered after 1 month of loading with the implant-supported fixed prostheses as well as 8 months after implant placement. Radiologic examinations and assessments were made at implant placement and after 8 months. The mean marginal bone level at implant placement was 1.6 mm (range 0 to 5.1; SD 1.1) apical of the reference point (the implant shoulder). The mean marginal bone level at the 8-month follow-up was 3.2 mm (range 0.4 to 5.9; SD 1.1) apical of the reference point. Three implants failed during the healing period. The improved results in the present study might be a result of the positive effect of splinting the implants immediately after placement. ITI SLA solid-screw implants immediately loaded (ie, loaded within 24 hours of placement) and supporting fixed prostheses had successful survival rates after 8 months. The present results constitute a solid baseline for future follow-up studies.

  5. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  6. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee

    2016-01-01

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change

  7. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients

    DEFF Research Database (Denmark)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy...... clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial....... Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option. Trial registration www.clinicaltrials.gov (NCT01002794)....

  8. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients

    DEFF Research Database (Denmark)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje

    2016-01-01

    OBJECTIVE: To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. DESIGN: Randomised controlled superiority trial. SETTING: Orthopaedic departments at two public hospitals and two physiotherapy...... clinics in Norway. PARTICIPANTS: 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. INTERVENTIONS: 12 week supervised exercise therapy alone or arthroscopic partial....... Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.Trial registration www.clinicaltrials.gov (NCT01002794)....

  9. Removable partial dentures: Patient satisfaction and complaints in Makkah City, KSA

    Directory of Open Access Journals (Sweden)

    Mohsen K. Aljabri, BDS

    2017-12-01

    Full Text Available Objective: To assess the satisfaction level and complaints among patients using different types of removable partial dentures (RPDs in Makkah city, KSA. Methods: In this retrospective study, 551 patients who had received RPDs between February and December 2015 were contacted by telephone. One hundred patients responded, and 60 of them agreed to participate in the study. The participants were asked two questions to determine their satisfaction level and complaints with RPD usage, eating, communication, and aesthetics. Data were analysed statistically by chi-square, analysis of variance, and Scheffe's tests. Results: Of 60 patients, 35% were very satisfied, 21.7% were satisfied and 23.3% were nearly satisfied. However, only 20% were not satisfied. There were no significant differences in mean RPD satisfaction among different age groups and between sexes (P > 0.01. There was a significant difference in satisfaction among RPD type (P < 0.01. However, no significant differences were recorded between either metal and acrylic, or acrylic and flexible RPDs (P < 0.01. As many as 26.7% of respondents complained of aesthetic problems, 16.7% complained of pain during mastication, 10% complained of gag reflex, and 8.3% complained of phonetic problems. However, the majority of respondents (38.3% had no complaints. Conclusion: The majority of patients were satisfied with the quality of removable partial dentures treatment in Makkah city hospitals. Oral rehabilitation with RPDs should be applied with care when patients have high aesthetic demands. Keywords: Aesthetics, Dental prosthesis, Oral complaints, Patient satisfaction, Removable partial denture

  10. Efficacy of low to moderate doses of oxcarbazepine in adult patients with newly diagnosed partial epilepsy.

    Science.gov (United States)

    Zou, Xue-Mei; Chen, Jia-Ni; An, Dong-Mei; Hao, Nan-Ya; Hong, Zhen; Hao, Xiao-Ting; Rao, Ping; Zhou, Dong

    2015-07-01

    The objective of this study was to explore the efficacy of low dose of oxcarbazepine (OXC) in adult patients with newly diagnosed partial epilepsy in an actual clinical setting. The associated factors influencing the poor control of seizures were also evaluated. The epilepsy database (2010-2014) from the Epilepsy Clinic of West China Hospital was retrospectively reviewed. A total of 102 adult patients with newly diagnosed, previously untreated partial epilepsy initially treated with OXC were included, and divided into good response group (64) and poor response group (38) according to whether they were seizure-free for at least 12 months. There were 27 (26.5%) patients becoming seizure-free with OXC 600 mg/day monotherapy. The remaining 75 patients had doses of either increasing OXC to 900 mg/day (n = 59) or the addition of another antiepileptic drug (AED) (n = 16), with another 20 (19.6%) and six (5.9%) patients becoming seizure-free, respectively (P = 0.788). In addition, two (2.0%) and nine (8.8%) patients became seizure-free with OXC > 900 mg/day monotherapy and OXC ≥ 900 mg/day combination therapy, respectively. Multivariate binary logistic regression analysis revealed that the time from onset of epilepsy to treatment initiation is significantly associated with seizure control (P = 0.02). Our results indicated that OXC at low to moderate doses is effective for the treatment of Chinese adult patients with newly diagnosed, previously untreated partial epilepsy, and a longer time interval from the onset of epilepsy to the start of treatment significantly predicts poor seizure control. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  11. Investigation of Accelerated Partial Breast Patient Alignment and Treatment With Helical Tomotherapy Unit

    International Nuclear Information System (INIS)

    Langen, Katja M.; Buchholz, Daniel J.; Burch, Doug R. C.; Burkavage, Rob C.; Limaye, Arti U.; Meeks, Sanford L.; Kupelian, Patrick A.; Ruchala, Kenneth J.; Haimerl, Jason; Henderson, Doug; Olivera, Gustavo H.

    2008-01-01

    Purpose: To determine the precision of megavoltage computed tomography (MVCT)-based alignment of the seroma cavity for patients undergoing partial breast irradiation; and to determine whether accelerated partial breast irradiation (APBI) plans can be generated for TomoTherapy deliveries that meet the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol guidelines for target coverage and normal tissue dose limitations. Methods and Materials: We obtained 50 MVCT images from 10 patients. An interuser study was designed to assess the alignment precision. Using a standard helical and a fixed beam prototype ('topotherapy') optimizer, two APBI plans for each patient were developed. Results: The precision of the MVCT-based seroma cavity alignment was better than 2 mm if averaged over the patient population. Both treatment techniques could be used to generate acceptable APBI plans for patients that fulfilled the recommended NSABP B-39/RTOG-0413 selection criteria. For plans of comparable treatment time, the conformation of the prescription dose to the target was greater for helical deliveries, while the ipsilateral lung dose was significantly reduced for the topotherapy plans. Conclusions: The inherent volumetric imaging capabilities of a TomoTherapy Hi-Art unit allow for alignment of patients undergoing partial breast irradiation that is determined from the visibility of the seroma cavity on the MVCT image. The precision of the MVCT-based alignment was better than 2 mm (± standard deviation) when averaged over the patient population. Using the NSABP B-39/RTOG-0413 guidelines, acceptable APBI treatment plans can be generated using helical- or topotherapy-based delivery techniques

  12. Management and Followup of Complicated Crown Fractures in Young Patients Treated with Partial Pulpotomy

    Directory of Open Access Journals (Sweden)

    Francisco Ojeda-Gutierrez

    2013-01-01

    Full Text Available Two cases of young patients with traumatized permanent teeth having complicated crown fractures are reported. Endodontic management included partial pulpotomy by the Cvek technique; restorative management included resin restoration and reattachment of the teeth fragments. Treatments were considered successful in all cases according to the following criteria: absence of clinical symptoms, absence of X-ray signs of pathology, and presence of pulpal vitality 6 to 25 months after treatment.

  13. Objective assessment of mastication predominance in healthy dentate subjects and patients with unilateral posterior missing teeth.

    Science.gov (United States)

    Yamasaki, Y; Kuwatsuru, R; Tsukiyama, Y; Oki, K; Koyano, K

    2016-08-01

    We aimed to investigate mastication predominance in healthy dentate individuals and patients with unilateral posterior missing teeth using objective and subjective methods. The sample comprised 50 healthy dentate individuals (healthy dentate group) and 30 patients with unilateral posterior missing teeth (partially edentulous group). Subjects were asked to freely chew three kinds of test foods (peanuts, beef jerky and chewing gum). Electromyographic activity of the bilateral masseter muscles was recorded. The chewing side (right side or left side) was judged by the level of root mean square electromyographic amplitude. Mastication predominance was then objectively assessed using the mastication predominant score and the mastication predominant index. Self-awareness of mastication predominance was evaluated using a modified visual analogue scale. Mastication predominance scores of the healthy dentate and partially edentulous groups for each test food were analysed. There was a significant difference in the distribution of the mastication predominant index between the two groups (P mastication predominant score was weakly correlated with self-awareness of mastication predominance in the healthy dentate group, whereas strong correlation was observed in the partially edentulous group (P mastication predominance and were more aware of mastication predominance than healthy dentate individuals. Our findings suggest that an objective evaluation of mastication predominance is more precise than a subjective method. © 2016 John Wiley & Sons Ltd.

  14. Outcomes of breast cancer patients with triple negative receptor status treated with accelerated partial breast irradiation.

    Science.gov (United States)

    Wilkinson, J Ben; Reid, Robert E; Shaitelman, Simona F; Chen, Peter Y; Mitchell, Christine K; Wallace, Michelle F; Marvin, Kimberly S; Grills, Inga S; Margolis, Jeffrey M; Vicini, Frank A

    2011-11-01

    Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Outcomes of Breast Cancer Patients With Triple Negative Receptor Status Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Wilkinson, J. Ben; Reid, Robert E.; Shaitelman, Simona F.; Chen, Peter Y.; Mitchell, Christine K.; Wallace, Michelle F.; Marvin, Kimberly S.; Grills, Inga S.; Margolis, Jeffrey M.; Vicini, Frank A.

    2011-01-01

    Purpose: Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). Methods and Materials: We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Results: Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). Conclusions: In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer.

  16. CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 10-year comparative clinical study.

    Science.gov (United States)

    Örtorp, Anders; Jemt, Torsten

    2012-03-01

    No long-term clinical studies covering more than 5 years are available on Computer Numeric Controlled (CNC) milled titanium frameworks. To evaluate and compare the clinical and radiographic performance of implant-supported prostheses provided with CNC titanium frameworks in the edentulous jaw with prostheses with cast gold-alloy frameworks during the first 10 years of function. Altogether, 126 edentulous patients were by random provided with 67 prostheses with titanium frameworks (test) in 23 maxillas and 44 mandibles, and with 62 prostheses with gold-alloy castings (control) in 31 maxillas and 31 mandibles. Clinical and radiographic 10-year data were collected for the groups and statistically compared on patient level. The 10-year prosthesis and implant cumulative survival rate was 95.6% compared with 98.3%, and 95.0% compared with 97.9% for test and control groups, respectively (p > .05). No implants were lost after 5 years of follow-up. Smokers lost more implants than nonsmokers after 5 years of follow-up (p .05), respectively. One prosthesis was lost in each group due to loss of implants, and one prosthesis failed due to framework fracture in the test group. Two metal fractures were registered in each group. More appointments of maintenance were needed for the prostheses in the maxilla compared with those in the mandible (p CNC-milled titanium frameworks are a viable alternative to gold-alloy castings for restoring patients with implant-supported prostheses in the edentulous jaw. © 2009 Wiley Periodicals, Inc.

  17. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors

    International Nuclear Information System (INIS)

    Jansen, P.L.M.; Chamuleau, R.A.F.; Leeuwen, D.J. van; Schippor, H.G.; Busemann-Sokole, E.; Heyde, M.N. van der

    1990-01-01

    Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single photon computed tomography (SPECT), using 99m Tc-colloid as tracer. The method was assessed in 11 patients by comparing the pre- and post-operative volume measurement with the volume of the resected liver mass. Liver function was determined by measuring the galactose elimination capacity and the caffeine clearance. After a postoperative follow-up period of 50 days, the liver had regenerated maximally to a volume of 75 ± 2% of the preoperative liver mass. Maximal restoration of liver function was achieved 120 days after operation and amounted to 75 ± 10% for the caffeine clearance and to 100 ± 25% for the galactose elimination capacity. This study shows that SPECT is a useful method for assessing liver regeneration in patients after partial hepatectomy. The study furthermore shows that caffeine clearance correlates well with total liver volume, whereas the galactose elimination capacity overestimates total liver volume after partial hepatectomy. 22 refs

  18. Interventions for replacing missing teeth: partially absent dentition.

    Science.gov (United States)

    Abt, Elliot; Carr, Alan B; Worthington, Helen V

    2012-02-15

    Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients. To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction. We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials. Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review. Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data. Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than

  19. Implant planning on NobelClinician software‎ : incidence of bone density on the implants orientation for completely edentulous maxillae

    OpenAIRE

    Vankelst, Maëva

    2016-01-01

    The Purpose of this study wasto compare bone density in straight and tilted implants using the software NobelClinician on fifteen maxillary edentulous. For each patient, two schedules were created on NobelClinician: a first plan of 6 implants placed axially and a second plan where the last implant of each sector was tilted of 30 ° from the occlusal plane. The laying of the first four implants being common to both plans.The study was performed on DICOM files coming from the CBCT’s of 15 patien...

  20. Recent advances in radiotherapy: Partial Breast Irradiation (PBI) in breast cancer patients after breast conserving surgery

    International Nuclear Information System (INIS)

    Niwinska, A.

    2003-01-01

    The interest in accelerated partial breast irradiation (PBI) after conservative surgery has increased over the past decade as a result of many factors, including clinical and pathological data questioning the efficacy of whole breast irradiation in highly selected patients, as well as factors related to patient's convenience. High dose rate and low dose rate brachytherapy, brachytherapy MammoSite, Electron Intraoperative Therapy - ELIOT and Targeted Intraoperative Radiotherapy - TARGIT are the subject of investigation. The tolerability and efficacy of the treatment are of special interest. In this review article, methods of accelerated PBI, eligibility criteria, techniques of radiotherapy, early results and side effects are reviewed. (author)

  1. The effect of implant-supported removable partial dentures on oral health quality of life.

    Science.gov (United States)

    Gates, W Day; Cooper, Lyndon F; Sanders, Anne E; Reside, Glenn J; De Kok, Ingeborg J

    2014-02-01

    Removable partial dentures (RPDs) represent standard treatment for partial edentulism despite major shortcomings. To alleviate these shortcomings, endosseous implants provide support and stability as well as contribute to maintenance of alveolar bone. This prospective, within subject, time series study evaluated patient-based outcomes of RPDs compared to implant-supported removable partial dentures (ISRPDs). The study hypothesis was that the ISRPD would substantially improve oral health quality of life for patients. Seventeen patients requesting new mandibular Kennedy I or II RPDs received one 6-mm dental implant in one or both of the posterior edentulous areas. After healing, conventional RPDs were fabricated and delivered. Twelve weeks later, second-stage surgery was performed, and ball abutments with Clix attachments were inserted, thereby converting the prostheses to ISRPDs. Oral health quality of life was evaluated using the 49-item Oral Health Impact Profile (OHIP-49) questionnaire. The OHIP-49 was administered prior to treatment (baseline), at 6 and 12 weeks following RPD delivery and at 6 and 12 weeks following ISRPD conversion. Radiographic evaluation was performed at 6 and 12 weeks following ISRPD conversion. In statistical analysis, a fixed-slope random intercept variance components model took account of the multiple observations per person over time. In 17 subjects, 29 of 30 implants survived. The failed implant was replaced without complications. Abutment complications were limited to one abutment loosening and one attachment replacement. Minor prosthodontic complications were recorded. The OHIP-49 score reduced by 11.8 points, on average, at 12 weeks following ISRPD conversion (P = 0.011). Patients reported improved oral health following conversion to an ISRPD from RPD. The ISRPD involving short implants is one treatment option that should be considered when treatment planning Kennedy Class I and II patients. © 2012 John Wiley & Sons A/S.

  2. Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 5-year follow-up study.

    Science.gov (United States)

    Ortorp, A; Linden, B; Jemt, T

    1999-01-01

    The purpose of this study was to report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks and to compare their performance with that of prostheses provided with conventional cast frameworks. On a routine basis, a consecutive group of 824 edentulous patients were provided with fixed prostheses supported by implants in the edentulous mandible. In addition to conventional gold-alloy castings, patients were at random provided with 2 kinds of laser-welded titanium frameworks. In all, 155 patients were included in the 2 titanium framework groups. A control group of 53 randomly selected patients with conventional gold-alloy castings was used for comparison. Clinical and radiographic 5-year data was collected for the 3 groups. All followed patients still had fixed prostheses in the mandible after 5 years. The overall cumulative success rates were 95.9% and 99.7% for titanium-framework prostheses and implants, respectively. The corresponding success rates for the control group were 100% and 99.6%, respectively. Bone loss was 0.5 mm on average during the 5-year follow-up period. The most common complications for titanium frameworks were resin or tooth fractures, gingival inflammation, and fractures of the metal frames (10%). One of the cast frameworks fractured and was resoldered. Loose and fractured implant screw components were few (laser-welded titanium frameworks seem to be a viable alternative to conventional castings in the edentulous mandible.

  3. Two consecutive partial liver transplants in a patient with Classic Maple Syrup Urine Disease

    Directory of Open Access Journals (Sweden)

    H.L. Chin

    2015-09-01

    Full Text Available Maple syrup urine disease is caused by a deficiency in the branched chain ketoacid dehydrogenase (BCKAD complex. This results in the accumulation of branched chain amino acids (BCAA and branched chain ketoacids in the body. Even when aggressively treated with dietary restriction of BCAA, patients experience long term cognitive, neurological and psychosocial problems. Liver transplantation from deceased donors has been shown to be an effective modality in introducing adequate BCKAD activity, attaining a metabolic cure for patients. Here, we report the clinical course of the first known patient with classic MSUD who received two consecutive partial liver grafts from two different living non-carrier donors and his five year outcome posttransplant. We also show that despite the failure of the first liver graft, and initial acute cellular rejection of the second liver graft in our patient, his metabolic control remained good without metabolic decompensation.

  4. Usage of removable partial dentures in Saudi male patients after 1 year telephone interview

    Science.gov (United States)

    Akeel, Riyadh

    2010-01-01

    Objective The success of removable partial dentures (RPDs) is partly dependent on patients’ acceptance and compliance in using them. The purpose of this study was to describe the usage of removable partial dentures (RPDs) by patients 1 year after insertion and to evaluate the factors that influence their denture usage. Methods Forty-seven patients who received 75 new RPDs at the undergraduate clinic of College of Dentistry, King Saud University, were contacted by telephone 1 year later for an interview. The questions covered denture usage, patient’s satisfaction and reasons for non-use. Results Results showed that 36% of patients discarded or occasionally used their RPDs. There was no significant association between denture usage and RPD experience, location or Kennedy classification. A significantly more RPD rejection was found when it was opposed by natural teeth or complete denture. The most quoted reason for RPD rejection was pain and discomfort. Conclusion Despite the short follow-up period, RPDs were poorly accepted by patients treated by undergraduate students. PMID:23960487

  5. Image/patient registration from (partial) projection data by the Fourier phase matching method

    International Nuclear Information System (INIS)

    Weiguo Lu; You, J.

    1999-01-01

    A technique for 2D or 3D image/patient registration, PFPM (projection based Fourier phase matching method), is proposed. This technique provides image/patient registration directly from sequential tomographic projection data. The method can also deal with image files by generating 2D Radon transforms slice by slice. The registration in projection space is done by calculating a Fourier invariant (FI) descriptor for each one-dimensional projection datum, and then registering the FI descriptor by the Fourier phase matching (FPM) method. The algorithm has been tested on both synthetic and experimental data. When dealing with translated, rotated and uniformly scaled 2D image registration, the performance of the PFPM method is comparable to that of the IFPM (image based Fourier phase matching) method in robustness, efficiency, insensitivity to the offset between images, and registration time. The advantages of the former are that subpixel resolution is feasible, and it is more insensitive to image noise due to the averaging effect of the projection acquisition. Furthermore, the PFPM method offers the ability to generalize to 3D image/patient registration and to register partial projection data. By applying patient registration directly from tomographic projection data, image reconstruction is not needed in the therapy set-up verification, thus reducing computational time and artefacts. In addition, real time registration is feasible. Registration from partial projection data meets the geometry and dose requirements in many application cases and makes dynamic set-up verification possible in tomotherapy. (author)

  6. Magnetic Resonance Imaging Findings in Symptomatic Patients After Arthroscopic Partial Meniscectomy for Torn Discoid Lateral Meniscus.

    Science.gov (United States)

    Lee, Chang-Rack; Bin, Seong-Il; Kim, Jong-Min; Kim, Nam-Ki

    2016-11-01

    To evaluate the change in the thickness and width of the residual meniscus using magnetic resonance imaging (MRI) in patients who underwent arthroscopic partial meniscectomy for discoid lateral meniscus (DLM), to assess whether the degeneration of the articular cartilage in the lateral compartment of the knee progressed, and to evaluate clinical results. Among the patients who underwent arthroscopic partial meniscectomy for DLM between January 1997 and December 2011, those who were aged 40 or below at surgery were followed up for at least 3 years, and received at least 2 follow-up MRIs that were retrospectively reviewed. MRIs were done in symptomatic knees. Using MRI, the relative thickness and width were measured in the anterior horn, midportion, and posterior horn. To determine whether the degeneration of the lateral compartment would progress, the articular cartilage was graded based on the Outerbridge classification in MRIs. The clinical results were evaluated using the Lysholm score. A total of 20 patients (21 knees) were included. The average follow-up period was 6.8 years. In residual meniscus, the relative thickness of the midportion decreased from 9.0% ± 2.4% to 7.3% ± 2.3% (P meniscus. A progression of degeneration in the lateral compartment was observed. However, the clinical results did not present significant changes. In symptomatic patients after arthroscopic partial meniscectomy for DLM, the thickness and width of the residual meniscus decreases over time. The arthritic change of the lateral compartment of the knee progressed. However, the change in the size of the residual meniscus was of unknown clinical significance. Level IV, therapeutic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. Individual white matter fractional anisotropy analysis on patients with MRI negative partial epilepsy.

    Science.gov (United States)

    Duning, Thomas; Kellinghaus, Christoph; Mohammadi, Siawoosh; Schiffbauer, Hagen; Keller, Simon; Ringelstein, E Bernd; Knecht, Stefan; Deppe, Michael

    2010-02-01

    Conventional structural MRI fails to identify a cerebral lesion in 25% of patients with cryptogenic partial epilepsy (CPE). Diffusion tensor imaging is an MRI technique sensitive to microstructural abnormalities of cerebral white matter (WM) by quantification of fractional anisotropy (FA). The objectives of the present study were to identify focal FA abnormalities in patients with CPE who were deemed MRI negative during routine presurgical evaluation. Diffusion tensor imaging at 3 T was performed in 12 patients with CPE and normal conventional MRI and in 67 age matched healthy volunteers. WM integrity was compared between groups on the basis of automated voxel-wise statistics of FA maps using an analysis of covariance. Volumetric measurements from high resolution T1-weighted images were also performed. Significant FA reductions in WM regions encompassing diffuse areas of the brain were observed when all patients as a group were compared with controls. On an individual basis, voxel based analyses revealed widespread symmetrical FA reduction in CPE patients. Furthermore, asymmetrical temporal lobe FA reduction was consistently ipsilateral to the electroclinical focus. No significant correlations were found between FA alterations and clinical data. There were no differences in brain volumes of CPE patients compared with controls. Despite normal conventional MRI, WM integrity abnormalities in CPE patients extend far beyond the epileptogenic zone. Given that unilateral temporal lobe FA abnormalities were consistently observed ipsilateral to the seizure focus, analysis of temporal FA may provide an informative in vivo investigation into the localisation of the epileptogenic zone in MRI negative patients.

  8. Frequency Distribution of Edentulous Posterior Mandibular Ridge Types using Cone Beam Computed Tomography in an Iranian Population

    Directory of Open Access Journals (Sweden)

    2016-07-01

    Full Text Available Introduction: The existing bone is regarded as an important criteria in dental implants. In this regard, the radiographic modality is of great significance in quantifying the remaining bone, and CBCT accurately represents height and width of the existing bone. Therefore, this study aimed to evaluate the frequency distribution of the edentulous posterior mandibular ridge types using cone beam computed tomography in an Iranian population. Methods: In this cross-sectional descriptive study, CBCT scans of 127 patients with full edentulous mandible with an average age of 61.15 were evaluated who referred to a radiology clinic in Tehran. The images were analyzed applying OnDemand3D application and bone height and width of each area were determined. To analyze the collected data, SPSS software (ver,17 was employed applying Fisher's exact test. Results: The ridges were classified in 4 different groups (A,B+,B-w,C-w. The frequency of ridge types A and B + in male and ridge types B-w and C-w in females were demonstrated to be higher. An increase in age led to a reduction in the frequency of type A and a rise in the frequency of type C-w. The mean bone height was higher in males in all areas. In addition, the mean bone width was higher in males in all areas except for the first molar area. Conclusions:  The study results indicated that as the age increases, the height of edentulous mandible reduces, while no significant relationship was detected between the bone width and aging. As a result, with aging the evolution of bone was held to be from type A to type C-W.

  9. The role of robotic partial cystectomy in a patient with metastatic primary adenocarcinoma of the bladder

    Directory of Open Access Journals (Sweden)

    Katherine James

    2015-03-01

    Full Text Available Treatment of urachal adenocarcinoma (UA of the urinary bladder has typically been with radical cystectomy (RC but more conservative approaches are gaining popularity. Here we present the case of a female patient with metastatic primary bladder UA who was treated with robotic partial cystectomy (RPC and adjuvant chemotherapy; she is alive with no evidence of disease recurrence or metastatic disease at 5 years. This case provides some of the longest follow-up after RPC to date thereby demonstrating that RPC is a safe and oncologically viable treatment for selected patients even several years after definitive treatment. Patients undergoing RPC benefit from the reduced morbidity associated with this less radical treatment whilst enjoying similarly successful oncological outcomes to RC.   

  10. Partial purification of Leucine aminopeptidase (LAP) in Acromegalic Sample of Iraqi Patients

    Science.gov (United States)

    Uloom Mohammad, Taghreed

    2018-05-01

    Acromagaly is a syndrome caused by increased growth hormone secretion from the frontal lobe of the pituitary gland. A Leucine aminopeptidase (EC 34111) activity has been assayed in (30) patients sera samples(15 female and 15 males) with acromegaly age range between (3050) years and (30) sera of healthy as control group (16 femal and 14 male) age range between (3050) years. The goal of the research was partial purified of enzyme from sera patients with acromegaly by dialysis gel filtration by using sephdex G50 and ion exchange chromatography by using DEAE cellulose A50. The results showed a single peak by using gel filtration and the activity was reached to 152 U/L. Two isoenzymes were obtained by using ion exchange chromatography and the purity degree of isoenzymse (I II) were (125) and (128) fold respectively. The current study found that the enzyme showed no significant difference between the healthy and the patients.

  11. Outcomes After Accelerated Partial Breast Irradiation in Patients With ASTRO Consensus Statement Cautionary Features

    International Nuclear Information System (INIS)

    McHaffie, Derek R.; Patel, Rakesh R.; Adkison, Jarrod B.; Das, Rupak K.; Geye, Heather M.; Cannon, George M.

    2011-01-01

    Purpose: To evaluate outcomes among women with American Society for Radiation Oncology (ASTRO) consensus statement cautionary features treated with brachytherapy-based accelerated partial breast irradiation (APBI). Methods and Materials: Between March 2001 and June 2006, 322 consecutive patients were treated with high-dose-rate (HDR) APBI at the University of Wisconsin. A total of 136 patients were identified who met the ASTRO cautionary criteria. Thirty-eight (27.9%) patients possessed multiple cautionary factors. All patients received 32 to 34 Gy in 8 to 10 twice-daily fractions using multicatheter (93.4%) or Mammosite balloon (6.6%) brachytherapy. Results: With a median follow-up of 60 months, there were 5 ipsilateral breast tumor recurrences (IBTR), three local, and two loco-regional. The 5-year actuarial rate of IBTR was 4.8% ± 4.1%. The 5-year disease-free survival was 89.6%, with a cause-specific survival and overall survival of 97.6% and 95.3%, respectively. There were no IBTRs among 32 patients with ductal carcinoma in situ (DCIS) vs. 6.1% for patients with invasive carcinoma (p = 0.24). Among 104 patients with Stage I or II invasive carcinoma, the IBTR rate for patients considered cautionary because of age alone was 0% vs. 12.7% in those deemed cautionary due to histopathologic factors (p = 0.018). Conclusions: Overall, we observed few local recurrences among patients with cautionary features. Women with DCIS and patients 50 to 59 years of age with Stage I/II disease who otherwise meet the criteria for suitability appear to be at a low risk of IBTR. Patients with tumor-related cautionary features will benefit from careful patient selection.

  12. Cerebral blood flow during paroxysmal EEG activation induced by sleep in patients with complex partial seizures

    International Nuclear Information System (INIS)

    Gozukirmizi, E.; Meyer, J.S.; Okabe, T.; Amano, T.; Mortel, K.; Karacan, I.

    1982-01-01

    Cerebral blood flow (CBF) measurements were combined with sleep polysomnography in nine patients with complex partial seizures. Two methods were used: the 133Xe method for measuring regional (rCBF) and the stable xenon CT method for local (LCBF). Compared to nonepileptic subjects, who show diffuse CBF decreases during stages I-II, non-REM sleep onset, patients with complex partial seizures show statistically significant increases in CBF which are maximal in regions where the EEG focus is localized and are predominantly seen in one temporal region but are also propagated to other cerebral areas. Both CBF methods gave comparable results, but greater statistical significance was achieved by stable xenon CT methodology. CBF increases are more diffuse than predicted by EEG paroxysmal activity recorded from scalp electrodes. An advantage of the 133Xe inhalation method was achievement of reliable data despite movement of the head. This was attributed to the use of a helmet which maintained the probes approximated to the scalp. Disadvantages were poor resolution (7 cm3) and two-dimensional information. The advantage of stable xenon CT method is excellent resolution (80 mm3) in three dimensions, but a disadvantage is that movement of the head in patients with seizure disorders may limit satisfactory measurements

  13. Partial recovery of adrenal function in a patient with autoimmune Addison's disease.

    Science.gov (United States)

    Smans, L C C J; Zelissen, P M J

    2008-07-01

    To our knowledge, no case of remission in autoimmune Addison's disease has previously been reported. We describe a patient with primary adrenal insufficiency caused by autoimmune adrenalitis in whom partial remission was observed after 7 yr. A 39-yr-old male was referred because of extreme fatigue, weight loss, anorexia, nausea, and bouts of fever. During physical examination hyperpigmentation was seen. Laboratory tests showed a plasma cortisol of 0.02 micromol/l (08:30 h). Cortisol failed to increase during the ACTH stimulation test (0.02 to 0.03 micromol/l) and ACTH was markedly elevated (920 pmol/l). Adrenal auto-antibodies were weakly positive. A CT-scan showed no evidence of calcifications or other abnormalities of the adrenal glands. The diagnosis of autoimmune Addison's disease was made and replacement therapy with hydrocortisone and fludrocortisone was started. During the following years the dose of hydrocortisone was gradually decreased. Eventually, the patient decided to stop his medication completely. A repeated ACTH-stimulation test revealed a basal cortisol of 0.25 micromol/l and a peak cortisol of 0.30 micromol/l with a basal ACTH of 178 pmol/l. The patient did not have any complaints. Recovery of adrenal insufficiency, due to causes other than autoimmune adrenalitis, has been reported in the past. If our case of partial recovery of autoimmune adrenalitis is not unique this could have profound effects on treatment and follow-up of Addison's disease.

  14. Heterozygous CAV1 frameshift mutations (MIM 601047 in patients with atypical partial lipodystrophy and hypertriglyceridemia

    Directory of Open Access Journals (Sweden)

    Alston Lindsay

    2008-01-01

    Full Text Available Abstract Background Mice with a deleted Cav1 gene encoding caveolin-1 develop adipocyte abnormalities and insulin resistance. From genomic DNA of patients with atypical lipodystrophy and hypertriglyceridemia who had no mutations in any known lipodystrophy gene, we used DNA sequence analysis to screen the coding regions of human CAV1 (MIM 601047. Results We found a heterozygous frameshift mutation in CAV1, designated I134fsdelA-X137, in a female patient who had atypical partial lipodystrophy, with subcutaneous fat loss affecting the upper part of her body and face, but sparing her legs, gluteal region and visceral fat stores. She had severe type 5 hyperlipoproteinemia, with recurrent pancreatitis. In addition, she had some atypical features, including congenital cataracts and neurological findings. Her father was also heterozygous for this mutation, and had a similar pattern of fat redistribution, hypertriglyceridemia and congenital cataracts, with milder neurological involvement. An unrelated patient had a different heterozygous frameshift mutation in the CAV1 gene, designated -88delC. He also had a partial lipodystrophy phenotype, with subcutaneous fat loss affecting the arms, legs and gluteal region, but sparing his face, neck and visceral fat stores. He also had severe type 5 hyperlipoproteinemia, with recurrent pancreatitis; however he had no clinically apparent neurological manifestations. The mutations were absent from the genomes of 1063 healthy individuals. Conclusion Thus, very rare CAV1 frameshift mutations appear to be associated with atypical lipodystrophy and hypertriglyceridemia.

  15. [A patient treated with partial duodenectomy for invasive transverse colon cancer].

    Science.gov (United States)

    Notani, Hiroyuki; Kawamura, Toru; Sato, Taku; Hoshino, Akihiro; Sato, Yasushi; Nakajima, Akira

    2013-11-01

    The patient was an 83-year-old woman who visited our hospital with a chief complaint of weight loss. Duodenal invasion by transverse colon cancer was suspected on abdominal computed tomography( CT). An extramural tumor invading the second portion of the duodenum was noted on upper gastrointestinal endoscopy, and a circumferential type 2 lesion was observed in the transverse colon on lower intestinal endoscopy. The pathological diagnosis of both lesions was well-differentiated adenocarcinoma, and right hemicolectomy and partial duodenectomy were performed. The invaded duodenal region was located on the oral side of the papilla of Vater, and the resection involved approximately one-third of the circumference of the second portion of the duodenum and was approximately 5 cm in length. The jejunum was elevated using the Roux- en-Y method, and side-to-side duodenojejunostomy was performed for reconstruction. On histopathological examination, the lesion was diagnosed as SI, N0, Stage II. Tumor markers with elevated levels before surgery showed a rapid decrease to within normal ranges. No evidence of recurrence or metastasis has been observed for 3 years after surgery. Although pancreatoduodenectomy is the standard surgical procedure for duodenal tumorous lesions, this approach is very invasive for elderly patients. Partial duodenectomy may be a favorable treatment option for cancers invading other organs, as was the case for this patient.

  16. Personality and Psychopathology of Patients with Grandmal and Complex Partial Seizures

    Directory of Open Access Journals (Sweden)

    Najafi

    2010-06-01

    Full Text Available Introduction: Epileptic patients have special mental profile and experience emotional and psychopathological problems. Some studies have reported that epilepsy and psychopathology occur together. The aim of this study was to evaluate the mental profile of Complex partial seizure (CPS and Grandmal seizure (GMS patients and compare them with the control group. Methods: This descriptive-analytical study was carried out in 2008 at the neurological clinics of Isfahan and included 40 Patients with CPS and GMS epilepsy selected conveniently and control group included relatives of the patients. Psychological and personality profile was measured with MMPI inventory. The obtained data was analyzed with SPSS software, mainly through the analysis of Chi Square and ANOVA. Results: The findings of this research showed that although the scores of clinical scales in MMPI are higher than control group, this psychopathology isn’t abnormal. Epileptic patients in hypochondria, depression and hysteria had more elevated levels in comparison with the control group, but this difference was significant only in CPS patients. Conclusion: The results showed that epileptic patients tend to have more psychological disorders than normal people. These findings emphasize the necessity for psychological treatment along with drug therapy.

  17. Ictal and interictal SPECT imaging of 8 patients with symptomatic partial epilepsy

    International Nuclear Information System (INIS)

    Motooka, Hiromichi

    1993-01-01

    Although epileptic discharges such as spike, spike and wave complex, sharp wave, and sharp and wave complex can be recorded by interictal scalp electroencephalography (EEG) in many patients with epilepsy, recent studies have demonstrated that no epileptic discharges can be recorded by interictal and ictal scalp EEGs in some patients who clinically exhibit epileptic seizures. Accordingly scalp EEG is not always helpful for diagnosing epilepsy or identifying the epileptic foci in the brain in these patients. Recently, studies using single photon emission computed tomography (SPECT) have been performed for patients with epilepsy and evidence that epileptic foci can be identified by changes in the regional cerebral blood flow (rCBF) seen on SPECT scanning have been accumulated. In the present study, therefore, 8 patients with medically intractable partial seizures were simultaneously or independently investigated by the recordings of scalp EEG and SPECT scanning during the interictal and ictal period. N-isopropyl-p[ 123 I]-iodoamphetamine ( 123 I-IMP) was used for SPECT scanning for 7 patients and 99m Tc-d,l-hexamethyl-propyleneamineoxime ( 99m Tc-HMPAO) for 1 patient. An increase in rCBF (hyperperfusion) or decrease in rCBF (hypoperfusion) were found in 4 patients by interictal SPECT imaging and in all patients by ictal SPECT imaging although epileptic discharges were observed in 3 patients by interictal scalp EEG and 5 patients by ictal scalp EEG. The findings of the present study indicate that ictal SPECT scanning is more useful for diagnosing epilepsy and identifying the epileptic foci in the brain than ictal scalp EEG. (author)

  18. The effect of prosthetic rehabilitation and simple dietary counseling on food intake and oral health related quality of life among the edentulous individuals: A randomized controlled trial.

    Science.gov (United States)

    Amagai, Noriko; Komagamine, Yuriko; Kanazawa, Manabu; Iwaki, Maiko; Jo, Ayami; Suzuki, Hiroyuki; Minakuchi, Shunsuke

    2017-10-01

    To investigate the combined effect of complete denture renewal and simple dietary advice. A randomized controlled trial was performed with edentulous patients who required new complete dentures. All participants received complete denture treatment. In addition, the intervention group received dietary advice in a pamphlet form, while the control group received advice pertaining to the care and maintenance of the dentures. The advice was given by dentists for each group. The participants' food intake was assessed at baseline and 3 months after intervention using a diet history questionnaire and an oral health related quality of life assessment measured using the Japanese version of the Oral Health Impact Profile for edentulous people (OHIP-EDENT-J). Among 70 participants who were randomized, 62 participants finished all parts of this trial. At baseline, there was no significant difference in the food intake between the two groups. At the 3-month assessment, the intervention group showed significantly greater intake of chicken (P=0.013), fish with bones (P=0.012), and carrots and pumpkins (P=0.025) compared to the control group. However, at baseline and at the 3-month assessment, there was no significant difference in the OHIP-EDENT-J scores between the groups, but the OHIP-EDENT-J scores significantly improved for both groups at the 3-month assessment. There were more significant improved dimensions of OHIP-EDENT-J in the intervention group than in the control group at the 3-month assessment. Simple dietary advice combined with complete denture treatment could improve food intake of edentulous patients. The present study suggests that brief dietary advice provided by dentists can improve food intake of edentulous elderly. This simply diet advice is much easier compared to customized forms, might enable normal dentists provide patients it. The result of this study broadens possibility of nutritional counseling in daily clinical practice. Copyright © 2017 Elsevier Ltd

  19. Partial symptom-response to proton pump inhibitors in patients with non-erosive reflux disease or reflux oesophagitis - a post hoc analysis of 5796 patients

    DEFF Research Database (Denmark)

    Bytzer, P; van Zanten, S Veldhuyzen; Mattsson, H

    2012-01-01

    Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief.......Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief....

  20. Patient-Reported Outcomes following Breast Conservation Therapy and Barriers to Referral for Partial Breast Reconstruction.

    Science.gov (United States)

    Vrouwe, Sebastian Q; Somogyi, Ron B; Snell, Laura; McMillan, Catherine; Vesprini, Danny; Lipa, Joan E

    2018-01-01

    The purpose of this study was to evaluate the self-reported aesthetic outcome of breast conservation therapy in a generalized sample of patients, and to describe potential barriers to referral for partial breast reconstruction. Consecutive breast conservation therapy patients completing radiotherapy over a 1-year period at a regional cancer center were identified. Eligible patients were contacted by means of mail/e-mail and invited to participate. Participants completed the BREAST-Q breast conservation therapy module along with a questionnaire examining feelings about breast reconstruction. Multiple regression analysis was performed using the satisfaction with breasts scale as the dependent variable. Surveys were completed by 185 of 592 eligible participants (response rate, 31.3 percent; mean age, 61 years) an average of 38 months after lumpectomy. The mean score for the BREAST-Q satisfaction with breasts scale was 59 of 100. Younger age (p = 0.038), lumpectomy reexcision (p = 0.018), and lumpectomy at a nonacademic center (p = 0.026) were significantly associated with lower satisfaction. Bra size, months from lumpectomy, and tumor quadrant/size were not significantly associated with satisfaction (p > 0.05). The most common statements regarding reconstruction were "I don't feel the need for it" (60.0 percent), "I don't like the thought of having breast implants" (22.7 percent), and "I don't want any more surgeon/doctor visits" (22.2 percent). Before lumpectomy, only 1.6 percent had a consultation for reconstruction, and only 22.7 percent were aware of this option. If offered, 33.1 percent of patients would have attended this consultation. There is an unmet demand for partial breast reconstruction, with an opportunity to advocate and increase awareness on behalf of patients undergoing breast conservation therapy.

  1. Comparison of functionally orientated tooth replacement and removable partial dentures on the nutritional status of partially dentate older patients: a randomised controlled clinical trial.

    Science.gov (United States)

    McKenna, Gerald; Allen, P Finbarr; O'Mahony, Denis; Flynn, Albert; Cronin, Michael; DaMata, Cristiane; Woods, Noel

    2014-06-01

    The aims of this study were to conduct a randomised controlled clinical trial (RCT) of partially dentate older adults comparing functionally orientated treatment based on the SDA concept with conventional treatment using RPDs to replace missing natural teeth. The two treatment strategies were evaluated according to their impact on nutritional status measured using haematological biomarkers. A randomised controlled clinical trial (RCT) was conducted of partially dentate patients aged 65 years and older (Trial Registration no. ISRCTN26302774). Each patient provided haematological samples which were screened for biochemical markers of nutritional status. Each sample was tested in Cork University Hospital for serum Albumin, serum Cholesterol, Ferritin, Folate, Vitamin B12 and 25-hydroxycholecalciferol (Vitamin D). A mixed model analysis of covariance (ANCOVA) indicated that for Vitamin B12 (p=0.9392), serum Folate (p=0.5827), Ferritin (p=0.6964), Albumin (p=0.8179), Serum Total Cholesterol (p=0.3670) and Vitamin D (p=0.7666) there were no statistically significant differences recorded between the two treatment groups. According to the mixed model analysis of covariance (ANCOVA) for Vitamin D there was a significant difference between levels recorded at post-operative time points after treatment intervention (p=0.0470). There was an increase of 7% in 25-hydroxycholecalciferol levels recorded at 6 months compared to baseline (p=0.0172). There was no further change in recorded levels at 12 months (p=0.6482) and these increases were similar within the two treatment groups (p>0.05). The only measure which illustrated consistent significant improvements in nutritional status for either group were Vitamin D levels. However no significant difference was recorded between the two treatment groups. Functionally orientated prosthodontic rehabilitation for partially dentate older patients was no worse than conventional removable partial dentures in terms of impact on nutritional

  2. Optimising the treatment of the partially platinum-sensitive relapsed ovarian cancer patient

    Directory of Open Access Journals (Sweden)

    Nicoletta Colombo

    2014-12-01

    Full Text Available The choice of second-line chemotherapy in patients with recurrent ovarian cancer (ROC is complex, with several factors to be considered, the most important of which is the length of the platinum-free treatment interval (PFI. Recently ROC patients have been further stratified into platinum sensitive (PS, partially platinum sensitive (PPS and platinum resistant (PR subgroups depending on the length of the PFI. Response to second-line therapy, progression-free survival (PFS and overall survival (OS are linked to the PFI, all of them improving as the PFI increases. Consequently, there is increasing interest in PFI extension strategies with platinum-free therapeutic options. Such strategies are currently being studied in patients with partially platinum-sensitive disease (PFI 6-12 months, as the treatment of these patients remains clinically challenging. A non-platinum option, trabectedin + pegylated liposomal doxorubicin (PLD combination, has been evaluated in ROC patients in the pivotal phase III OVA-301 study. The OVA-301 study differed from previous trials in the same setting as it included only patients who were not expected to benefit from or who were ineligible for or who were unwilling to receive re-treatment with platinum-based chemotherapy, including those with PPS and PR disease. Subset analysis of patients with PPS disease in OVA-301 showed that the trabectedin + PLD combination significantly improved PFS compared with PLD alone; median PFS 7.4 versus 5.5 months, p=0.0152. Final survival data from the same subset of patients, showed that trabectedin + PLD also achieved a significant 36% decrease in the risk of death compared with PLD alone (HR=0.64; 95% CI, 0.47–0.88; p=0.0027. Median overall survival (OS was 22.4 months in the trabectedin + PLD arm versus 16.4 months in the PLD arm. This represents a statistically significant 6-month improvement in median OS in patients treated with trabectedin + PLD compared to those treated with PLD

  3. Type III Mixed Cryoglobulinemia and Antiphospholipid Syndrome in a Patient With Partial DiGeorge Syndrome

    Directory of Open Access Journals (Sweden)

    Alice D. Chang

    2006-01-01

    Full Text Available We studied a 14 year-old boy with partial DiGeorge syndrome (DGS, status post complete repair of Tetralogy of Fallot, who developed antiphospholipid syndrome (APS and type III mixed cryoglobulinemia. He presented with recurrent fever and dyspnea upon exertion secondary to right pulmonary embolus on chest computed tomography (CT. Coagulation studies revealed homozygous methylene tetrahydrofolate reductase 677TT mutations, elevated cardiolipin IgM antibodies, and elevated β2-glycoprotein I IgM antibodies. Infectious work-up revealed only positive anti-streptolysin O (ASO and anti-DNAse B titers. Autoimmune studies showed strongly positive anti-platelet IgM, elevated rheumatoid factor (RF, and positive cryocrit. Renal biopsy for evaluation of proteinuria and hematuria showed diffuse proliferative glomerulonephritis (DPGN with membranoproliferative features consistent with cryoglobulinemia. Immunofixation showed polyclonal bands. Our patient was treated successfully with antibiotics, prednisone, and mycophenolate mofetil (MMF. This is the first report of a patient with partial DGS presenting with APS and type III mixed cryoglobulinemia possibly due to Streptococcal infection.

  4. Clinical outcome of patients with familial hypercholesterolemia and coronary artery disease undergoing partial ileal bypass surgery

    Directory of Open Access Journals (Sweden)

    Jaqueline Scholz Issa

    2000-07-01

    Full Text Available Familial hypercholesterolemia is characterized by high serum levels of total cholesterol and LDL-cholesterol. It may be homozygous or heterozygous. In homozygous patients, LDL-cholesterol levels range from 500 to 1000mg/dL and coronary artery disease is precocious, usually manifesting itself between the 2nd and 3rd decades of life. The diagnosis is often made by the presence of xanthoma tuberosum and tendinous xanthomas that appear between the 1st and 2nd decades of life. The use of high doses of statins or even unusual procedures (apheresis, partial ileal bypass surgery, liver transplantation, gene therapy, or both, is necessary for increasing survival and improving quality of life, because a reduction in cholesterol levels is essential for stabilizing the coronary artery disease and reducing xanthomas. We report our experience with 3 patients with xanthomatous familial hypercholesterolemia and coronary artery disease, who underwent partial ileal bypass surgery. Their follow-up over the years (approximately 8 years showed a mean 30% reduction in total cholesterol, with a significant reduction in the xanthomas and stabilization of the coronary artery disease.

  5. Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Nicolò Cavalli

    2012-01-01

    Full Text Available Purpose. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. Materials and Methods. Thirty-four patients (18 women and 16 men were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. Results. The overall follow-up range was 12 to 73 months (mean 38.8 months. No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients, peri-implantitis (5.9% patients, and temporomandibular joint pain (5.9% patients. The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients and definitive (17.7% patients prosthesis and the minor acrylic fractures in the temporary (14.7% patients and definitive (2.9% patients prosthesis. Hygienic complications occurred in 38.2% patients. No patients’ dissatisfactions were recorded. Conclusions. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.

  6. Telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement

    Directory of Open Access Journals (Sweden)

    Mladenović Dragan

    2013-01-01

    Full Text Available Introduction. In the management of edentulous spaces, there is a permanent need of a dentist-prosthetician in charge to consult other specialists. Modern telemedicine, based on powerful computer and telecomunication systems, offers an adequate answer to these challenges, being able to transfer and obtain clinical data and consultation information over large distances. Using smartphone or a computer, the teleconsultant acces the system, downloads and review the data and photographs and gave suggestions. The system then enables direct, real time contact with the consultant, chat, or directs them to contact each other by phone. Case report. We presented telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement in 3 cases with different teleconsultation requirements: the first case for prosthetic rehabilitation of his upper teeth, the second one for prosthetic management of his partial edentulousness and “a growth on his gums” in the vestibular region of the frontal teeth and the third one for prosthetic management of total edentulousness of her upper jaw. We used the system of telemedicine in dentistry, established at the Faculty of Medicine in Kosovska Mitrovica. The operation was based on the computer application system XPA3 Online, computer networking and mobile smartphone network. All consultations were succefull with no need for further procedures in regional center. Conclusion. The use of a mobile smartphone has brought about the mobility and availability of teleconsultant specialists in an extent never seen before. Prostheticians are thus able to offer better service to their patients and improve the quality of management of partially or totally edentulous patients, especially in rural areas.

  7. Telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement.

    Science.gov (United States)

    Mladenović, Dragan; Tosić, Goran; Zivković, Dusan; Djindjić, Natasa; Mladenović, Lidija; Mladenović, Sanja; Marković, Ivana

    2013-09-01

    In the management of edentulous spaces, there is a permanent need of a dentist-prosthetician in charge to consult other specialists. Modern telemedicine, based on powerful computer and telecomunication systems, offers an adequate answer to these challenges, being able to transfer and obtain clinical data and consultation information over large distances. Using smartphone or a computer, the teleconsultant acces the system, downloads and review the data and photographs and gave suggestions. The system then enables direct, real time contact with the consultant, chat, or directs them to contact each other by phone. We presented telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement in 3 cases with different teleconsultation requirements: the first case for prosthetic rehabilitation of his upper teeth, the second one for prosthetic management of his partial edentulousness and "a growth on his gums" in the vestibular region of the frontal teeth and the third one for prosthetic management of total edentulousness of her upper jaw. We used the system of telemedicine in dentistry, established at the Faculty of Medicine in Kosovska Mitrovica. The operation was based on the computer application system XPA3 Online, computer networking and mobile smartphone network. All consultations were succefull with no need for further procedures in regional center. The use of a mobile smartphone has brought about the mobility and availability of teleconsultant specialists in an extent never seen before. Prostheticians are thus able to offer better service to their patients and improve the quality of management of partially or totally edentulous patients, especially in rural areas.

  8. Use of personal computers for Gothic arch tracing: analysis and evaluation of horizontal mandibular positions with edentulous prosthesis.

    Science.gov (United States)

    Watanabe, Y

    1999-11-01

    Determining mandibular position for an edentulous patient raises the question of whether to emphasize centric relation or muscular position. This challenge results from the lack of a convenient procedure for quantifying the horizontal mandibular position, which can be determined by a variety of methods. This study analyzed and evaluated the horizontal mandibular positions produced by different guidance systems. Twenty-six edentulous subjects with no clinical evidence of abnormality of temporomandibular disorder were selected. Horizontal position data for the mandible obtained by gothic arch tracing was loaded into a personal computer by setting the sensor portion of a digitizer into the oral cavity to serve as a miniature lightweight tracing board. By connecting this with a digitizer control circuit set in an extraoral location, each mandibular position was displayed in a distinguishable manner on a computer display in real time, then recorded and analyzed. The gothic arch apex and tapping point varied, depending on body position. In the supine position, the gothic arch apex and the tapping point were close to the mandibular position determined by bilateral manipulation. This system provides effective data concerning mandibular positions for fabrication of dentures.

  9. Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants

    Directory of Open Access Journals (Sweden)

    Matteo Danza

    2014-01-01

    Full Text Available The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.

  10. Impact of partial participation in integrated family planning training on medical knowledge, patient communication and professionalism.

    Science.gov (United States)

    Steinauer, Jody E; Turk, Jema K; Preskill, Felisa; Devaskar, Sangita; Freedman, Lori; Landy, Uta

    2014-04-01

    Obstetrics and gynecology residency programs are required to provide access to abortion training, but residents can opt out of participating for religious or moral reasons. Quantitative data suggest that most residents who opt out of doing abortions participate and gain skills in other aspects of the family planning training. However, little is known about their experience and perspective. Between June 2010 and June 2011, we conducted semistructured interviews with current and former residents who opted out of some or all of the family planning training at ob-gyn residency programs affiliated with the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. Residents were either self-identified or were identified by their Ryan Program directors as having opted out of some training. The interviews were transcribed and coded using modified grounded theory. Twenty-six physicians were interviewed by telephone. Interviewees were from geographically diverse programs (35% Midwest, 31% West, 19% South/Southeast and 15% North/Northeast). We identified four dominant themes about their experience: (a) skills valued in the family planning training, (b) improved patient-centered care, (c) changes in attitudes about abortion and (d) miscommunication as a source of negative feelings. Respondents valued the ability to partially participate in the family planning training and identified specific aspects of their training which will impact future patient care. Many of the effects described in the interviews address core competencies in medical knowledge, patient care, communication and professionalism. We recommend that programs offer a spectrum of partial participation in family planning training to all residents, including residents who choose to opt out of doing some or all abortions. Learners who morally object to abortion but participate in training in family planning and abortion, up to their level of comfort, gain clinical and professional skills. We

  11. Kinesiographic study of complete denture movement related to mucosa displacement in edentulous patients Estudo cinesiográfico da movimentação da prótese total resultante da deformação da fibromucosa em desdentados totais

    Directory of Open Access Journals (Sweden)

    Marco Antonio Compagnoni

    2003-12-01

    Full Text Available The mucosa that covers the residual ridges of edentulous patients may present some distortion or displacement when occlusal loading is applied in complete dentures. This distortion and movement of the denture can result in acceleration of residual ridge resorption and loss of retention and stability. The aim of this study was to analyze the pattern of upper complete denture movement related to underlying mucosa displacement. A sample of 10 complete denture wearers was randomly selected, which had acceptable upper and lower dentures and normal volume and resilience of residual ridges. The kinesiographic instrument K6-I Diagnostic System® was used to measure denture movements, according to the method proposed by Maeda et al.7, 1984. Denture movements were measured under the following experimental conditions: (A 3 maximum voluntary clenching cycles and (B unilateral chewing for 20 seconds. The results showed that under physiological load, oral mucosa distortion has two distinct phases: a fast initial displacement as load is applied and a slower and incomplete recovery when load is removed. Intermittent loading such as chewing progressively reduces the magnitude of the denture displacement and the recovery of the mucosa is gradually more incomplete.Devido às características de compressibilidade da fibromucosa, a incidência de cargas sobre a prótese total resulta na movimentação da prótese em direção ao rebordo, a qual pode resultar no aumento da reabsorção do rebordo residual, na desadaptação interna e na perda de retenção da prótese. O objetivo do presente estudo é avaliar o padrão de movimentação da prótese total superior em função da deformação da fibromucosa. Foram selecionados 10 pacientes usuários de próteses totais bimaxilares, com retenção satisfatória e relações oclusais corretas e rebordos alveolares com volume e grau de resiliência normais. Para a análise da movimentação da prótese total superior foi

  12. Outcomes in patients with esotropic duane retraction syndrome and a partially accommodative component

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    Ramesh Kekunnaya

    2013-01-01

    Full Text Available Background: The management of Duane retraction syndrome (DRS is challenging and may become more difficult if an associated accommodative component due to high hyperopia is present. The purpose of this study is to review clinical features and outcomes in patients with partially accommodative esotropia and DRS. Setting and Design: Retrospective, non-comparative case series. Materials and Methods: Six cases of DRS with high hyperopia were reviewed. Results: Of the patients studied, the mean age of presentation was 1.3 years (range: 0.5-2.5 years. The mean amount of hyperopia was + 5D (range: 3.50-8.50 in both eyes. The mean follow up period was 7 years (range: 4 months-12 years. Five cases were unilateral while one was bilateral. Four cases underwent vertical rectus muscle transposition (VRT and one had medial rectus recession prior to presentation; all were given optical correction. Two (50% of the four patients who underwent vertical rectus transposition cases developed consecutive exotropia, one of whom did not have spectacles prescribed pre-operatively. All other cases (four had minimal residual esotropia and face turn at the last follow-up with spectacle correction. Conclusion: Patients with Duane syndrome can have an accommodative component to their esotropia, which is crucial to detect and correct prior to surgery to decrease the risk of long-term over-correction. Occasionally, torticollis in Duane syndrome can be satisfactorily corrected with spectacles alone.

  13. Pre- and postoperative memory of dichotically presented words in patients with complex partial seizures.

    Science.gov (United States)

    Christianson, S A; Nilsson, L G; Silfvenius, H

    1989-01-01

    Dichotic listening tests were used to determine cerebral hemisphere memory functions in patients with complex partial seizures before, 10 days after, and 1-3 yr after right (RTE) or left (LTE) temporal-lobe excisions. Control subjects were also tested on two occasions. The tests consisted of presenting a series of 12-word lists and 7-word lists alternately to the two ears while backward speech was presented to the other ear. Measures of immediate free recall, final free recall, final cued recall, and serial recall were employed. The results revealed: (a) that both groups of patients were inferior the control group in tests tapping long-term memory functions rather than short-term memory functions, (b) a right-ear advantage for RTE patients at postoperative testing, (c) that the LTE group was more affected by surgery than the RTE group, and (d) a general improvement in recall performance from early to late postoperative testing. Taken together, these results indicate that the present dichotic test can be used as a non-invasive hemisphere memory test to complement invasive techniques for diagnosis of patients considered for epilepsy surgery.

  14. Intravenous levetiracetam terminates refractory status epilepticus in two patients with migrating partial seizures in infancy.

    Science.gov (United States)

    Cilio, Maria Roberta; Bianchi, Roberto; Balestri, Martina; Onofri, Alfredo; Giovannini, Simona; Di Capua, Matteo; Vigevano, Federico

    2009-09-01

    To evaluate the efficacy and tolerability of intravenous (IV) levetiracetam in refractory status epilepticus of migrating partial seizures in infancy (MPSI). IV levetiracetam was infused in two infants, first as a loading dose of 60mg/kg in 30min, then at 30mg/kg twice a day. Both infants were continuously monitored with video-EEG before, during and after the drug trial. Blood count, liver enzymes, serum creatinine, ammonia and lactate blood levels were performed repeatedly before and after the IV levetiracetam administration. Follow-up was of 16 and 10 months. EEG monitoring allowed the diagnosis of MPSI, showing the typical seizures pattern in both patients. IV levetiracetam was effective in stopping status epilepticus in both infants. Levetiracetam also prevented the recurrence of status epilepticus during follow-up. No adverse reactions were observed during the infusion phase or during follow-up. MPSI is a newly recognized epileptic syndrome characterized by early onset of intractable partial seizures arisingly independently and sequentially from both hemispheres, migrating from one region of the brain to another and from one hemisphere to another. We report the efficacy of intravenous levetiracetam in resolving refractory status epilepticus in two infants with this new epilepsy syndrome.

  15. Dosimetric investigation depending on tumor location in patient breast in partial breast irradiation

    International Nuclear Information System (INIS)

    Kim, Min Joo; Park, So Hyun; Jung, Joo Young; Woong, Cho; Suh, Tae Suk

    2012-01-01

    The Partial Breast Irradiation (PBI) technique, which involves radiation beam delivery techniques that use a limited range of treatment volumes, has been a challenging approach that is worthy of consideration compared to whole-breast radiation therapy (WBRT). Because of a small target volumes used in the PBI technique, the radiation dose can be safely delivered to the targeted tissue without the unwanted delivery of radiation to normal breast tissues and organ at risk (OAR), such as contralateral breast, lung and heart.Through PBI technique, better cosmetic outcomes and minimizing damages to OARs could be expected and also the daily dose can be increased with smaller number of fractionation in radiation therapy. The purpose of this study was to evaluate the dosimetric effects according to tumor locations in patient's breast for Partial Breast Irradiation (PBI) technique using three Dimensional Conformal Radiation Therapy (3DCRT), Electron Beam Radiation therapy (EBRT) and Helical-tomotherapy (H-TOMO). Dosimetric comparisons of PBI technique for 3DCRT, EBRT, and H-TOMO depending on the classified tumor locations were performed. H-TOMO delivered the low dose to lager volume to surrounding normal tissue, such as the heart and lungs compared to 3DCRT and EBRT although it had the same degree of target coverage as the other methods (3DCRT, EBRT). EBRT had a curative effect for early-stage breast cancers located in the lower and inner sections (LIQ-S, LIQ-D)

  16. Influence of mastication and edentulism on mandibular bone density.

    Science.gov (United States)

    Chou, Hsuan-Yu; Satpute, Devesh; Müftü, Ali; Mukundan, Srinivasan; Müftü, Sinan

    2015-01-01

    The aim of this study was to demonstrate that external loading due to daily activities, including mastication, speech and involuntary open-close cycles of the jaw contributes to the internal architecture of the mandible. A bone remodelling algorithm that regulates the bone density as a function of stress and loading cycles is incorporated into finite element analysis. A three-dimensional computational model is constructed on the basis of computerised tomography (CT) images of a human mandible. Masticatory muscle activation involved during clenching is modelled by static analysis using linear optimisation. Other loading conditions are approximated by imposing mandibular flexure. The simulations predict that mandibular bone density distribution results in a tubular structure similar to what is observed in the CT images. Such bone architecture is known to provide the bone optimum strength to resist bending and torsion during mastication while reducing the bone mass. The remodelling algorithm is used to simulate the influence of edentulism on mandibular bone loss. It is shown that depending on the location and number of missing teeth, up to one-third of the mandibular bone mass can be lost due to lack of adequate mechanical stimulation.

  17. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw.

    Science.gov (United States)

    Adell, R; Lekholm, U; Rockler, B; Brånemark, P I

    1981-12-01

    Osseointegration implies a firm, direct and lasting connection between vital bone and screw-shaped titanium implants of defined finish and geometry-fixtures. Thus, there is no interposed tissue between fixture and bone. Osseointegration can only be achieved and maintained by a gentle surgical installation technique, a long healing time and a proper stress distribution when in function. During a 15-year period (1965-1980), 2768 fixtures were installed in 410 edentulous jaws of 371 consecutive patients. All patients were provided with facultatively removable bridges and were examined at continuous yearly controls. The surgical and prosthetic technique was developed and evaluated over a pilot period of 5 years. The results of standardized procedures applied on a consecutive clinical material with an observation time of 5-9 years were thought to properly reflect the potential of the method. In this group, 130 jaws were provided with 895 fixtures, and of these 81% of the maxillary and 91% of the mandibular fixtures remained stable, supporting bridges. In 89% of the maxillary and 100% of the mandibular cases, the bridges were continuously stable. During healing and the first year after connection of the bridge, the mean value for marginal bone loss was 1.5 mm. Thereafter only 0.1 mm was lost annually. The clinical results achieved with bridges on osseointegrated fixtures fulfill and exceed the demands set by the 1978 Harvard Conference on successful dental implantation procedures.

  18. Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Englund, Martin; Christensen, Robin

    2017-01-01

    orthopaedic departments in the Region of Southern Denmark. Participants were recruited between 1 February 2013 and 31 January 2014, and at one of the original four hospitals from 1 February 2014 to 31 January 2015. PARTICIPANTS: Individuals selected from Knee Arthroscopy Cohort Southern Denmark, aged 18...... on knee pathology. Patient reported outcomes were recorded via online questionnaires. MAIN OUTCOME MEASURES: Primary outcome was the average between-group difference in change on four of five subscales of the knee injury and osteoarthritis outcome score (KOOS). The four subscales covered pain, symptoms...

  19. Clinical Outcomes Using Accelerated Partial Breast Irradiation in Patients With Invasive Lobular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, J. Ben; Shaitelman, Simona; Grills, Inga; Wallace, Michelle; Mitchell, Christina [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, MI (United States)

    2011-11-15

    Purpose: We compared clinical outcomes of women diagnosed with either invasive lobular carcinoma (ILC) or invasive ductal carcinoma (IDC) treated with accelerated partial breast irradiation (APBI). Methods and Materials: A total of 16 patients with ILC received APBI as part of their breast-conservation therapy (BCT) and were compared with 410 patients with IDC that received APBI as part of their BCT. Clinical, pathologic, and treatment related variables were analyzed including age, tumor size, hormone receptor status, surgical margins, lymph node status, adjuvant hormonal therapy, adjuvant chemotherapy, and APBI modality. Clinical outcomes including local recurrence (LR), regional recurrence (RR), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed. Results: Median follow-up was 3.8 years for the ILC patients and 6.0 years for the IDC patients. ILC patients were more likely to have positive margins (20.0% vs. 3.9%, p = 0.006), larger tumors (14.1 mm vs. 10.9 mm, p = 0.03) and less likely to be node positive (0% vs. 9.5%, p < 0.001) when compared with patients diagnosed with IDC. The 5-year rate of LR was 0% for the ILC cohort and 2.5% for the IDC cohort (p = 0.59). No differences were seen in the rates of RR (0% vs. 0.7%, p = 0.80), distant metastases (0% vs. 3.5%, p = 0.54), DFS (100% vs. 94%, p = 0.43), CSS (100% vs. 97%, p = 0.59), or OS (92% vs. 89%, p = 0.88) between the ILC and IDC patients, respectively. Additionally, when node-positive patients were excluded from the IDC cohort, no differences in the rates of LR (0% vs. 2.2%, p = 0.62), RR (0% vs. 0%), DFS (100% vs. 95%, p = 0.46), CSS (100% vs. 98%, p = 0.63), or OS (92% vs. 89%, p = 0.91) were noted between the ILC and IDC patients. Conclusion: Women with ILC had excellent clinical outcomes after APBI. No difference in local control was seen between patients with invasive lobular versus invasive ductal histology.

  20. Clinical Outcomes Using Accelerated Partial Breast Irradiation in Patients With Invasive Lobular Carcinoma

    International Nuclear Information System (INIS)

    Shah, Chirag; Wilkinson, J. Ben; Shaitelman, Simona; Grills, Inga; Wallace, Michelle; Mitchell, Christina; Vicini, Frank

    2011-01-01

    Purpose: We compared clinical outcomes of women diagnosed with either invasive lobular carcinoma (ILC) or invasive ductal carcinoma (IDC) treated with accelerated partial breast irradiation (APBI). Methods and Materials: A total of 16 patients with ILC received APBI as part of their breast-conservation therapy (BCT) and were compared with 410 patients with IDC that received APBI as part of their BCT. Clinical, pathologic, and treatment related variables were analyzed including age, tumor size, hormone receptor status, surgical margins, lymph node status, adjuvant hormonal therapy, adjuvant chemotherapy, and APBI modality. Clinical outcomes including local recurrence (LR), regional recurrence (RR), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed. Results: Median follow-up was 3.8 years for the ILC patients and 6.0 years for the IDC patients. ILC patients were more likely to have positive margins (20.0% vs. 3.9%, p = 0.006), larger tumors (14.1 mm vs. 10.9 mm, p = 0.03) and less likely to be node positive (0% vs. 9.5%, p < 0.001) when compared with patients diagnosed with IDC. The 5-year rate of LR was 0% for the ILC cohort and 2.5% for the IDC cohort (p = 0.59). No differences were seen in the rates of RR (0% vs. 0.7%, p = 0.80), distant metastases (0% vs. 3.5%, p = 0.54), DFS (100% vs. 94%, p = 0.43), CSS (100% vs. 97%, p = 0.59), or OS (92% vs. 89%, p = 0.88) between the ILC and IDC patients, respectively. Additionally, when node-positive patients were excluded from the IDC cohort, no differences in the rates of LR (0% vs. 2.2%, p = 0.62), RR (0% vs. 0%), DFS (100% vs. 95%, p = 0.46), CSS (100% vs. 98%, p = 0.63), or OS (92% vs. 89%, p = 0.91) were noted between the ILC and IDC patients. Conclusion: Women with ILC had excellent clinical outcomes after APBI. No difference in local control was seen between patients with invasive lobular versus invasive ductal histology.

  1. [Utilization of carbamazepine and oxcarbazepine in pediatric patients with partial epilepsy in Spain. An observational study].

    Science.gov (United States)

    Rufo Campos, M; Carreño, M

    2009-01-01

    It is important to conduct studies on the utilization of new antiepileptic drugs in order to improve their use. Our objective is to describe the use patterns of carbamazepine and oxcarbazepine. Observational, cross-sectional, national study with 58 investigators that included 185 pediatric patients with partial epilepsy. We recorded prescription patterns, quality of life (QoL) using the QoL scale in childhood epilepsy (CAVE) and use of resources. 134 patients were under treatment with oxcarbazepine (72.4 %), with a mean dose of 22.3 mg/kg/day; standard deviation (SD): 8.04; 95 % confidence interval (CI): 20.9 to 23.7, and 51 (27.6%) with carbamazepine, mean dose of 14 mg/kg/day; SD: 6.2; 95 % CI: 12.3 to 15.8. A total of 19.4% and 21.6 %, respectively, followed multiple drug treatment. The mean scores on functional dimensions of CAVE were (out of 5): school attendance: 4.5; SD: 0.7; social relationships: 4.1; SD: 0.9, and autonomy: 3.9; SD: 1.9. Patients receiving multiple drug therapy had worse results in quality of life (p used in lower doses than recommended and the dosing is not adjusted for weight. Underdosing may lead to regimes of multiple drug therapy that should be reviewed individually.

  2. Prosthetic reconstruction using gingiva-colored ceramic agent in fixed partial restoration in a 24-year old patient

    Directory of Open Access Journals (Sweden)

    Sadaqah NR

    2012-11-01

    Full Text Available Nasrin R Sadaqah,1 Jawad Ali Abu Tair21Department of Prosthodontics, 2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Arab American University, Jenin, Palestinian TerritoryAbstract: Achieving an optimal esthetic result when replacing missing anterior teeth with a fixed partial denture can be a challenge. This is especially true when interdisciplinary treatment is needed and the patient refuses this for personal or financial reasons. Here we report a clinical case where a fixed partial denture was used to change the incisor relationship and to restore the normal tooth and gingival tissue shape, morphology, and relationship by including artificial gingiva within the fixed partial denture when the patient refused lengthy and costly multispecialty treatment options.Keywords: gingival porcelain, fixed partial denture, diagnostic waxup, provisional restoration

  3. [Intensity of negative symptoms, working memory and executive functions disturbances in schizophrenic patients in partial remission period].

    Science.gov (United States)

    Hintze, Beata; Borkowska, Alina

    2011-01-01

    The aim of the study was to assess the correlation between the level of working memory and executive functions impairment in schizophrenic subjects in their partial remission period and the intensity of psychopathological symptoms measured by PANSS scale. 45 patients with schizophrenia were included in the study (28 male and 17 female), aged 18-46 (mean 27 +/- 7) years during partial remission of psychopathological symptoms (PANSS partial remission period, the significant dysfunctions of working memory and executive functions show association with negative (not positive) schizophrenic symptoms.

  4. A f-MRI study on memory function in normal subjects and patients with partial epilepsies

    International Nuclear Information System (INIS)

    Kamoda, Sachiko

    2004-01-01

    To investigate cerebral regions concerning a memory function and presence of memory lateralization, activated areas and the difference between the right and left hemisphere in functional magnetic resonance imaging (f-MRI) during verbal and visual memory tasks were examined in normal subjects and, as its clinical application, in patients with partial epilepsies. Subjects were 39 normal adult subjects and 10 adult patients. Of the 39 normal subjects, 30 were right-handed and 9 were left-handed. Further, of the 10 patients, 9 were right-handed and one was left-handed, and 7, 2 and 1 had temporal lobe, frontal lobe and undetermined partial epilepsies, respectively. Following the three type of memory task were designed; verbal memory tasks consisting of covert and overt recall tests of 10 words given auditory and visual memory task of covert recall tasks of 6 figures given visually. Activated cerebral areas were imaged with f-MRI using 1.5 tesla Magnetom Vision taken repeatedly during these tasks and neutral condition. Most of the 30 right-handed normal subjects showed activated areas over the left hemisphere specifically on the anterior cingulate, superior, middle and inferior frontal gyri during the verbal memory tasks of covert recall tests. Left hemisphere dominant activated areas in the precentral gyri were added during the verbal memory tasks of overt recall tests. On the other hand, 4 of the 9 left-handed normal subjects showed the left side-dominantly activated areas in the above-mentioned regions during the verbal memory tasks of covert and overt tests, in common with the right-handed subjects. However, 3 of the 9 left-handed normal subjects had right hemisphere dominant activation during the verbal memory tasks, while none of the 30 right-handed normal subjects showed such right side-dominancy. Further, the bilateral occipital lobes were activated during visual memory tasks. The reproducibility in this activation during these verbal and visual memory tasks

  5. Recovery of lower extremity muscle strength and functional performance in middle-aged patients undergoing arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Ganderup, Tina; Jensen, Carsten; Holsgaard-Larsen, Anders

    2017-01-01

    PURPOSE: To investigate lower extremity muscle strength and functional performance before and after arthroscopic partial meniscectomy in middle-aged patients with degenerative meniscal tears. We hypothesized that patients would experience deficiencies in the affected leg at 3 months post-surgery,...

  6. Management of Sjogren’s Syndrome Patient: A Case Report of Prosthetic Rehabilitation with 6-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Marcos de Mendonça Invernici

    2014-01-01

    Full Text Available Completely and partially edentulous patients with Sjogren’s syndrome (SS experience severe hyposalivation, xerostomia, and considerable difficulty in using tissue-supported prosthesis. This clinical paper describes the management, treatment, and 6-year follow-up of a patient diagnosed with SS type II, who uses corticosteroids and antihyperglycemic drugs. The patient received restorative, periodontal, and surgical treatments followed by implant-supported fixed prosthesis. Radiographic evaluation and probing depth showed gingival health and no bone loss after 6 years. Treatment with implant-retained dental prosthesis greatly increased comfort and function, offering an alternative to patients with SS.

  7. Management of Sjogren's Syndrome Patient: A Case Report of Prosthetic Rehabilitation with 6-Year Follow-Up

    Science.gov (United States)

    de Mendonça Invernici, Marcos; Vale Nicolau, Gastão; Naval Machado, Maria Ângela; Soares de Lima, Antônio Adilson

    2014-01-01

    Completely and partially edentulous patients with Sjogren's syndrome (SS) experience severe hyposalivation, xerostomia, and considerable difficulty in using tissue-supported prosthesis. This clinical paper describes the management, treatment, and 6-year follow-up of a patient diagnosed with SS type II, who uses corticosteroids and antihyperglycemic drugs. The patient received restorative, periodontal, and surgical treatments followed by implant-supported fixed prosthesis. Radiographic evaluation and probing depth showed gingival health and no bone loss after 6 years. Treatment with implant-retained dental prosthesis greatly increased comfort and function, offering an alternative to patients with SS. PMID:25478245

  8. Clinical Evaluation of Implant-Supported Removable Partial Dentures With a Stress-Breaking Attachment.

    Science.gov (United States)

    Suzuki, Yasunori; Kono, Kentaro; Shimpo, Hidemasa; Sato, Yohei; Ohkubo, Chikahiro

    2017-08-01

    The stress-breaking ball (SBB) attachment can distribute the occlusal force equally between the alveolar ridge and the implants. The purpose of this study was to evaluate the implant-supported distal extension removable partial dentures (RPDs) with SBB attachment in 10 patients who were partially edentulous. This randomized crossover study was designed to compare the function of RPDs with and without healing abutments and SBB attachments to support the posterior aspects of the RPDs. Mandibular jaw movements during mastication and the occlusal force and contact area were measured with a commercially available tracking device and pressure-sensitive sheets. Using a visual analog scale, 4 criteria-chewing, retention, stability, and comfort-were evaluated. All of the data obtained were analyzed using a 1-way analysis of variance (α = 0.05). There were no significant differences in either the mean time or the coefficient of variation among the SBB attachments and healing abutments of implant-supported removable partial dentures (ISRPDs) and conventional removable partial dentures (CRPDs). SBB attachments and healing abutments of ISRPDs had greater forces and contact areas than those of CRPDs with significant differences. For all criteria, patients preferred SBB attachments to healing abutments and CRPDs. The implant-supported distal extension RPDs with SBB attachment improved denture stability and patients' satisfaction.

  9. Robot-assisted laparoscopic versus open partial nephrectomy in patients with chronic kidney disease: A propensity score-matched comparative analysis of surgical outcomes.

    Science.gov (United States)

    Takagi, Toshio; Kondo, Tsunenori; Tachibana, Hidekazu; Iizuka, Junpei; Omae, Kenji; Kobayashi, Hirohito; Yoshida, Kazuhiko; Tanabe, Kazunari

    2017-07-01

    To compare surgical outcomes between robot-assisted laparoscopic partial nephrectomy and open partial nephrectomy in patients with chronic kidney disease. Of 550 patients who underwent partial nephrectomy between 2012 and 2015, 163 patients with T1-2 renal tumors who had an estimated glomerular filtration rate between 30 and 60 mL/min/1.73 m 2 , and underwent robot-assisted laparoscopic partial nephrectomy or open partial nephrectomy were retrospectively analyzed. To minimize selection bias between the two surgical methods, patient variables were adjusted by 1:1 propensity score matching. The present study included 75 patients undergoing robot-assisted laparoscopic partial nephrectomy and 88 undergoing open partial nephrectomy. After propensity score matching, 40 patients were included in each operative group. The mean preoperative estimated glomerular filtration rate was 49 mL/min/1.73 m 2 . The mean ischemia time was 21 min in robot-assisted laparoscopic partial nephrectomy (warm ischemia) and 35 min in open partial nephrectomy (cold ischemia). Preservation of the estimated glomerular filtration rate 3-6 months postoperatively was not significantly different between robot-assisted laparoscopic partial nephrectomy and open partial nephrectomy (92% vs 91%, P = 0.9348). Estimated blood loss was significantly lower in the robot-assisted laparoscopic partial nephrectomy group than in the open partial nephrectomy group (104 vs 185 mL, P = 0.0025). The postoperative length of hospital stay was shorter in the robot-assisted laparoscopic partial nephrectomy group than in the open partial nephrectomy group (P negative surgical margin status were not significantly different between the two groups. In our experience, robot-assisted laparoscopic partial nephrectomy and open partial nephrectomy provide similar outcomes in terms of functional preservation and perioperative complications among patients with chronic kidney disease. However, a lower estimated blood loss and

  10. 99Tcm brain imaging for the assessment of patients with intractable partial epilepsy - our experience

    International Nuclear Information System (INIS)

    Schlicht, S.; Bruns, M.; Booth, R.; Octigan, K.; Karamoskos, P.; Cook, M.; O'Brien, T.

    2000-01-01

    Full text: 99 Tc m - Ethyl Cysteinate Diethylester (ECD) or Bicisate is a new radiopharmaceutical used for the assessment of cerebral perfusion. Unlike 99 Tc m Hexamethylpropylene Amine Oxime ( 99 Tc m - HMPAO) which is unstable and needs to be reconstituted immediately prior to injection, 99 Tc m -ECD is stable for up to eight hours following reconstitution. Therefore, 99 Tc m -ECD does not require mixing just prior to injection and is readily available on a daily inpatient basis to the epilepsy unit, facilitating earlier and faster injections, and the acquisition of true ictal studies. This is particularly important with patients who have extra temporal seizures which are typically brief in duration. 45 patients have undergone 99 Tc m -ECD studies for epilepsy in our department over a period of one year. Image acquisition routinely commences within two hours of injection, and consists of a 360 degree elliptical SPECT using an ADAC Dual Headed Gamma Camera. Patients undergo both ictal and inter ictal SPECT studies, and an MRI. Visual comparison of the ictal, inter ictal and MRI images is performed, as well as subtraction and co-registration. The SISCOM analysis technique is used which allows subtraction of the SPECTs and co registration with MRI. This has the advantage of improved specificity, sensitivity, and accurate anatomical localisation. The results of our experience with 99Tcm-ECD will be presented. In conclusion, we have found that 99 Tc m -ECD is ideally suited for peri-ictal SPECT studies as part of the pre-operative assessment of patients with intractable partial epilepsy. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. Comparative evaluation of computed tomography for dental implants on the mandibular edentulous area

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Kyung Hoon; Jeong, Ho Gul; Park, Hyok; Park, Chang Seo; Kim, Kee Deog [Department of Oral and Maxillofacial Radiology, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

    2009-03-15

    The purpose of this study was to evaluate the clinical usefulness of the recently developed multi-detector computed tomography and cone beam computed tomography in pre-operative implant evaluation, by comparing them with the single detector computed tomography, already confirmed for accuracy in this area. Five partially edentulous dry human mandibles, with 1 X 1 mm gutta percha cones, placed in 5 mm intervals posterior to the mental foramen on each side of the buccal part of the mandible, were used in this study. They were scanned as follows: 1) Single detector computed tomography: slice thickness 1 mm, 200 mA, 120 kV 2) Multi-detector computed tomography: slice thickness 0.75 mm, 250 mA, 120 kV 3) Cone beam computed tomography: 15 mAs, 120 kV Axial images acquired from three computed tomographs were transferred to personal computer, and then reformatted cross-sectional images were generated using V-Implant 2.0 (CyberMed Inc., Seoul, Korea) software. Among the cross-sectional images of the gutta percha cone, placed in the buccal body of the mandible, the most precise cross section was selected as the measuring point and the distance from the most superior border of the mandibular canal to the alveolar crest was measured and analyzed 10 times by a dentist. There were no significant intraobserver differences in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). There were no significant differences among single detector computed tomography, multi-detector computed tomography and cone beam computed tomography in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). Multi-detector computed tomography and cone beam computed tomography are clinically useful in the evaluation of pre-operative site for mandibular dental implants, with consideration for radiation exposure dose and scanning time.

  12. Comparative evaluation of computed tomography for dental implants on the mandibular edentulous area

    International Nuclear Information System (INIS)

    Sun, Kyung Hoon; Jeong, Ho Gul; Park, Hyok; Park, Chang Seo; Kim, Kee Deog

    2009-01-01

    The purpose of this study was to evaluate the clinical usefulness of the recently developed multi-detector computed tomography and cone beam computed tomography in pre-operative implant evaluation, by comparing them with the single detector computed tomography, already confirmed for accuracy in this area. Five partially edentulous dry human mandibles, with 1 X 1 mm gutta percha cones, placed in 5 mm intervals posterior to the mental foramen on each side of the buccal part of the mandible, were used in this study. They were scanned as follows: 1) Single detector computed tomography: slice thickness 1 mm, 200 mA, 120 kV 2) Multi-detector computed tomography: slice thickness 0.75 mm, 250 mA, 120 kV 3) Cone beam computed tomography: 15 mAs, 120 kV Axial images acquired from three computed tomographs were transferred to personal computer, and then reformatted cross-sectional images were generated using V-Implant 2.0 (CyberMed Inc., Seoul, Korea) software. Among the cross-sectional images of the gutta percha cone, placed in the buccal body of the mandible, the most precise cross section was selected as the measuring point and the distance from the most superior border of the mandibular canal to the alveolar crest was measured and analyzed 10 times by a dentist. There were no significant intraobserver differences in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). There were no significant differences among single detector computed tomography, multi-detector computed tomography and cone beam computed tomography in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). Multi-detector computed tomography and cone beam computed tomography are clinically useful in the evaluation of pre-operative site for mandibular dental implants, with consideration for radiation exposure dose and scanning time.

  13. A comparative study of partial vs total splenectomy in thalassemia major patients

    Directory of Open Access Journals (Sweden)

    Bahador Ali

    2007-01-01

    Full Text Available Background : In this study, we show the advantages of partial splenectomy (PS over total splenectomy (TS regarding the chances of overwhelming postsplenectomy sepsis (OPSI. Materials and Methods: From February 1991 to December 1999, 143 cases of β-thalassemia underwent PS. 1/3, 1/4 of the splenic tissue was preserved. One hundred and ten cases were followed for an average of 5 years. None of the patients received vaccination or prophylactic antibiotics. Pre- and postoperative hematological profiles, IgM levels, recurrence of hypersplenism and septic episodes were compared among the data of 60 cases TS; all these cases have been operated in the same hospital. Results: Hematological profile significantly increased and transfusion requirement approximately reduced to three-fold. After 3 years, 22.7% in PS and 13.3% in TS groups required the same amount of preoperative transfusion. After 5 years, these percentages were 27.3 and 18.3%, respectively. Two patients in PS and six in TS group developed signs of sepsis. Conclusion : Vaccination or prophylactic antibiotics are not necessary after PS. The risk of sepsis in PS without antibiotics is less than that in TS with antibiotics, and resplenectomy after PS is not associated with serious complications.

  14. Buccal mucosal cancer patient who failed to recover taste acuity after partial oral cavity irradiation

    International Nuclear Information System (INIS)

    Saito, Tsutomu; Fukushima, Shoko; Furuhashi, Satoru; Yoshinobu, Takashi; Takahashi, Motoichiro; Miyake, Masahiko; Kawamori, Jiro; Tanaka, Yoshiaki

    2002-01-01

    We report a patient who suffered from prolonged loss of taste acuity after partial oral cavity irradiation. The electric taste threshold (ETT) of each point in the oral cavity was measured with an electric gustometer to evaluate quantitative local taste acuity. A subjective total taste acuity (STTA) scale was used to evaluate subjective total taste acuity. A 61-year-old male patient with right buccal mucosal cancer underwent radiation therapy more than 11 years ago, and has suffered from loss of taste acuity since then. He received electron beam irradiation to part of the oral cavity and right upper neck, mainly the right buccal mucosa near the retromolar trigone and a metastatic right submandibular node. He did not receive irradiation to the anterior portion of the tongue or left side of the posterior portion of the tongue. His ETT scores for each point were equal to or greater than 26, and his STTA score was grade 3. The present case implies that radiation damage to part of the oral cavity can cause the loss of subjective total taste acuity. (author)

  15. Buccal mucosal cancer patient who failed to recover taste acuity after partial oral cavity irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Tsutomu; Fukushima, Shoko; Furuhashi, Satoru; Yoshinobu, Takashi; Takahashi, Motoichiro [Nihon Univ., Tokyo (Japan). Surugadai Hospital; Miyake, Masahiko [Nihon Univ., Tokyo (Japan). School of Dentistry; Kawamori, Jiro; Tanaka, Yoshiaki [Nihon Univ., Tokyo (Japan). School of Medicine

    2002-10-01

    We report a patient who suffered from prolonged loss of taste acuity after partial oral cavity irradiation. The electric taste threshold (ETT) of each point in the oral cavity was measured with an electric gustometer to evaluate quantitative local taste acuity. A subjective total taste acuity (STTA) scale was used to evaluate subjective total taste acuity. A 61-year-old male patient with right buccal mucosal cancer underwent radiation therapy more than 11 years ago, and has suffered from loss of taste acuity since then. He received electron beam irradiation to part of the oral cavity and right upper neck, mainly the right buccal mucosa near the retromolar trigone and a metastatic right submandibular node. He did not receive irradiation to the anterior portion of the tongue or left side of the posterior portion of the tongue. His ETT scores for each point were equal to or greater than 26, and his STTA score was grade 3. The present case implies that radiation damage to part of the oral cavity can cause the loss of subjective total taste acuity. (author)

  16. Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    White, Elizabeth A.; Cho, John; Vallis, Katherine A.; Sharpe, Michael B.; Lee, Grace B.Sc.; Blackburn, Helen; Nageeti, Tahani; McGibney, Carol; Jaffray, David A.

    2007-01-01

    Purpose: To evaluate the role of cone-beam CT (CBCT) guidance for setup error reduction and soft tissue visualization in accelerated partial breast irradiation (APBI). Methods and Materials: Twenty patients were recruited for the delivery of radiotherapy to the postoperative cavity (3850 cGy in 10 fractions over 5 days) using an APBI technique. Cone-beam CT data sets were acquired after an initial skin-mark setup and before treatment delivery. These were registered online using the ipsilateral lung and external contours. Corrections were executed for translations exceeding 3 mm. The random and systematic errors associated with setup using skin-marks and setup using CBCT guidance were calculated and compared. Results: A total of 315 CBCT data sets were analyzed. The systematic errors for the skin-mark setup were 2.7, 1.7, and 2.4 mm in the right-left, anterior-posterior, and superior-inferior directions, respectively. These were reduced to 0.8, 0.7, and 0.8 mm when CBCT guidance was used. The random errors were reduced from 2.4, 2.2, and 2.9 mm for skin-marks to 1.5, 1.5, and 1.6 mm for CBCT guidance in the right-left, anterior-posterior, and superior-inferior directions, respectively. Conclusion: A skin-mark setup for APBI patients is sufficient for current planning target volume margins for the population of patients studied here. Online CBCT guidance minimizes the occurrence of large random deviations, which may have a greater impact for the accelerated fractionation schedule used in APBI. It is also likely to permit a reduction in planning target volume margins and provide skin-line visualization and dosimetric evaluation of cardiac and lung volumes

  17. Biological dose estimation of partial body exposures in cervix cancer patients

    International Nuclear Information System (INIS)

    Di Giorgio, Marina; Nasazzi, Nora B.; Taja, Maria R.; Roth, B.; Sardi, M.; Menendez, P.

    2000-01-01

    fraction. Cells containing aberrations will have been in the irradiated part of the body. Normal undamaged cells will comprise two subpopulations; those from the unexposed fraction and irradiated cells representing the first term (e -γ ) of the Poisson series. From the degree of the deviation from Poisson, the fraction of irradiated lymphocytes of the body and its mean dose can be obtained. The alternative Qdr method considers the yield of dicentrics and rings only from those cells that contain unstable aberrations and assumes that these cells were irradiated in situ. The Qdr value represents the expected frequency of dicentrics and rings among first division damaged cells (containing dicentrics, rings and excess acentric fragments). It is dose dependent, but independent of dose homogeneity and of a dilution of damaged cells by undamaged cells. Qdr assumes that the excess acentric fragments follow the Poisson distribution, but this is not borne out by data from in vitro experiments. It also assumes that cells containing excess acentric fragments will have been in the irradiated fraction of the body. However, their induction is not radiation specific, showing a variable spontaneous frequency, As these limitations are thought to be important, they were avoided by considering the yield of dicentrics + rings in those damaged cells which contain just dicentrics + rings (Qdr reduced equations). This simplified equation produces a dose estimate identical to that obtained by Dolphin method. Therefore, we apply Qdr reduced equation for data analysis. After inhomogeneous exposures, information on the absorbed dose and its distribution in the body is of great importance for an early assessment of irradiation consequences in the exposed individuals. As cancer patients undergoing partial-body fractionated radiotherapy may provide a model for in vivo irradiation, the objective of this work has been to assess the possibilities and limitations of Qdr method to determine reliable dose

  18. Using a partially randomized patient preference study design to evaluate the therapeutic effect of acupuncture and cupping therapy for fibromyalgia: study protocol for a partially randomized controlled trial.

    Science.gov (United States)

    Cao, Hui-Juan; Liu, Jian-Ping; Hu, Hui; Wang, Nissi S

    2014-07-10

    Conducting randomized controlled trials on traditional Chinese non-drug therapies has been limited by factors such as patient preference to specific treatment modality. The aim of this study is to investigate the feasibility of applying a partially randomized patient preference (PRPP) trial model in evaluating the efficacy of two types of traditional Chinese medicine therapies, acupuncture and cupping, for fibromyalgia while accounting for patients' preference of either therapeutic modality. This protocol was approved by the Institutional Ethics Committee of affiliated Dongfang Hospital, Beijing University of Chinese Medicine (approval number: 2013052104-2). One hundred participants with fibromyalgia will be included in this study. Diagnosis of fibromyalgia will be based on the American College of Rheumatology criteria. Before treatment, participants will be interviewed for their preference toward acupuncture or cupping therapy. Fifty participants with no preference will be randomly assigned to one of the two groups and another 50 participants with strong preference to either acupuncture or cupping will receive what they choose. For acupuncture and cupping therapy, the main acupoints used will be tender points (Ashi). Treatment will be three times a week for 5 consecutive weeks with a follow-up period of 12 weeks. Outcome measures will be qualitative (patient expectation and satisfaction) and quantitative (pain intensity, quality of life, depression assessment). NCT01869712 (in clinicaltrials.gov, on 22nd May 2013).

  19. Clinical, laboratory and molecular signs of immunodeficiency in patients with partial oculo-cutaneous albinism.

    Science.gov (United States)

    Dotta, Laura; Parolini, Silvia; Prandini, Alberto; Tabellini, Giovanna; Antolini, Maddalena; Kingsmore, Stephen F; Badolato, Raffaele

    2013-10-17

    Hypopigmentation disorders that are associated with immunodeficiency feature both partial albinism of hair, skin and eyes together with leukocyte defects. These disorders include Chediak Higashi (CHS), Griscelli (GS), Hermansky-Pudlak (HPS) and MAPBP-interacting protein deficiency syndromes. These are heterogeneous autosomal recessive conditions in which the causal genes encode proteins with specific roles in the biogenesis, function and trafficking of secretory lysosomes. In certain specialized cells, these organelles serve as a storage compartment. Impaired secretion of specific effector proteins from that intracellular compartment affects biological activities. In particular, these intracellular granules are essential constituents of melanocytes, platelets, granulocytes, cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells. Thus, abnormalities affect pigmentation, primary hemostasis, blood cell counts and lymphocyte cytotoxic activity against microbial pathogens. Among eight genetically distinct types of HPS, only type 2 is characterized by immunodeficiency. Recently, a new subtype, HPS9, was defined in patients presenting with immunodeficiency and oculocutaneous albinism, associated with mutations in the pallidin-encoding gene, PLDN.Hypopigmentation together with recurrent childhood bacterial or viral infections suggests syndromic albinism. T and NK cell cytotoxicity are generally impaired in patients with these disorders. Specific clinical and biochemical phenotypes can allow differential diagnoses among these disorders before molecular testing. Ocular symptoms, including nystagmus, that are usually evident at birth, are common in patients with HPS2 or CHS. Albinism with short stature is unique to MAPBP-interacting protein (MAPBPIP) deficiency, while hemophagocytic lymphohistiocytosis (HLH) mainly suggests a diagnosis of CHS or GS type 2 (GS2). Neurological disease is a long-term complication of CHS, but is uncommon in other syndromic albinism. Chronic

  20. Optimizing Penile Length in Patients Undergoing Partial Penectomy for Penile Cancer: Novel Application of the Ventral Phalloplasty Oncoplastic Technique

    Directory of Open Access Journals (Sweden)

    Jared J. Wallen

    2014-10-01

    Full Text Available The ventral phalloplasty (VP has been well described in modern day penile prosthesis surgery. The main objectives of this maneuver are to increase perceived length and patient satisfaction and to counteract the natural 1-2 cm average loss in length when performing implantation of an inflatable penile prosthesis. Similarly, this video represents a new adaptation for partial penectomy patients. One can only hope that the addition of the VP for partial penectomy patients with good erectile function will increase their quality of life. The patient in this video is a 56-year-old male who presented with a 4.0x3.5x1.0 cm, pathologic stage T2 squamous cell carcinoma of the glans penis. After partial penectomy with VP and inguinal lymph node dissection, pathological specimen revealed negative margins, 3/5 right superficial nodes and 1/5 left superficial nodes positive for malignancy. The patient has been recommended post-operative systemic chemotherapy (with external beam radiotherapy based on the multiple node positivity and presence of extranodal extension. The patient’s pre-operative penile length was 9.5 cm, and after partial penectomy with VP, penile length is 7 cm.

  1. [Acrylic resin removable partial dentures].

    Science.gov (United States)

    de Baat, C; Witter, D J; Creugers, N H J

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of removable partial dentures, the acrylic resin removable partial denture has 3 favourable aspects: the economic aspect, its aesthetic quality and the ease with which it can be extended and adjusted. Disadvantages are an increased risk of caries developing, gingivitis, periodontal disease, denture stomatitis, alveolar bone reduction, tooth migration, triggering of the gag reflex and damage to the acrylic resin base. Present-day indications are ofa temporary or palliative nature or are motivated by economic factors. Special varieties of the acrylic resin removable partial denture are the spoon denture, the flexible denture fabricated of non-rigid acrylic resin, and the two-piece sectional denture. Furthermore, acrylic resin removable partial dentures can be supplied with clasps or reinforced by fibers or metal wires.

  2. Investigation of obsessive-compulsive disorder and assessment of obsessionality as a personality trait in patients with complex partial seizure

    Directory of Open Access Journals (Sweden)

    Banihashemian K

    2010-05-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Behavioral changes in patients with epilepsy could cause comorbid psychiatric disorders such as anxiety disorders. This study is concerned with investigation of obsessive-compulsive disorders and assessment of obsessionality as a personality trait in patients with complex partial seizure. "n"nMethods: Seventy six patients with complex partial seizure, 74 patients with generalized epilepsy that referred to Shiraz psychiatric professional center during three month (from July to September 2009, and 76 matched healthy controls were randomly selected and evaluated using the Yale-Brown obsessive compulsive scale (Y-BOCS, short form of Minnesota multiphasic personality inventory (MMPI and clinical interview. "n"nResults: Complex partial seizure and obsessive-compulsive disorder (%13.15 are significantly more prevalent than generalized seizure (%2.70 and than control groups (%1.31 (p<0.001, and mean of psychasthenia scale (Pt scale scores in patients with complex partial seizure is more than mean of Pt scores in generalized epilepsy and control groups (p<0.001. There is significant relationship between total score of Yale-Brown scale and Pt scale in MMPI (r=0.79, p<0.01."n"nConclusions: Patients with complex

  3. Impact of periodontal maintenance on tooth survival in patients with removable partial dentures.

    Science.gov (United States)

    Tada, Sayaka; Allen, Patrick Finbarr; Ikebe, Kazunori; Matsuda, Ken-ichi; Maeda, Yoshinobu

    2015-01-01

    Removable partial dentures (RPDs) may have a negative impact on oral health and have the potential to cause further tooth loss, especially of abutment teeth. However, no evidence indicates the effective interval of regular periodontal maintenance after RPD provision. This practice-based cohort study aimed to examine the impact of regular periodontal maintenance visits on survival of RPD abutment teeth. One hundred and ninety-two patients had been previously provided with 304 new clasp-retained RPDs at Osaka University Dental Hospital, Japan. Using the Kaplan-Meier method and log-rank test, 1094 abutments were analysed to illustrate survival curves and to compare each curve. According to the frequency of periodontal maintenance, study samples were divided into three groups; every 3-6 months (3-6M) group, 1-year (1Y) group and no-maintenance (NM) group. Seven-year cumulative survival rates were 83.7% (3-6M), 75.5% (1Y) and 71.9% (NM) respectively. Survival of abutment teeth in the 3-6M group was significantly better than both 1Y (p = 0.005) and NM (p < 0.001) groups. These longitudinal clinical data indicates that periodontal maintenance at least once in 6 months had the most favourable outcome. Frequent periodontal maintenance after RPD provision could be effective in preventing further tooth loss. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Nutritional status in edentulous people as compared to age matched dentate individuals-a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Sukhabogi Jagadeeswara Rao

    2013-01-01

    Full Text Available Objectives: To assess the nutritional status in completely edentulous subjects and to compare with age matched dentate individuals. Materials and Method: The study was carried out in 60 individuals divided into two groups. Group one consisted of 30 edentulous subjects and 30 dentate individuals formed the second group Body Mass Index (BMI, serum albumin and hemoglobin values were analyzed in both the groups. Independent sample t- test was employed to check for the difference between the groups and Pearson′s correlation was done to ascertain the association between the variables within the groups. Results: There was a significant difference in all the biomarkers evaluated in between the groups. The values were negatively correlated with the period of edentulism within the groups. Conclusion: Edentulous people had lower nutritional values than their dentate counterparts and maintaining a healthy and normal dentition may have significant bearing on the overall health of an individual. body mass index, serum albumin, malnutrition, edentulous, dental status

  5. Implant rehabilitation of the atrophic edentulous maxilla including immediate fixed provisional restoration without the use of bone grafting: a review of 1-year outcome data from a long-term prospective clinical trial.

    Science.gov (United States)

    Toljanic, Joseph A; Baer, Russell A; Ekstrand, Karl; Thor, Andreas

    2009-01-01

    The literature suggests that predictable integration can be achieved when dental implant placement is combined with immediate fixed provisional restoration in a variety of clinical situations. Fewer data are available, however, regarding outcomes for immediate provisional restoration of implants in the edentulous maxilla. This report presents 1-year data acquired from a long-term prospective clinical trial designed to assess outcomes following the immediate provisional fixed restoration of implants in the atrophic edentulous maxilla without the use of bone augmentation. Fifty-one subjects diagnosed with an atrophic edentulous maxilla received a total of 306 implants (six implants per subject) followed by fixed provisional restoration within 24 hours of implant placement. No subjects underwent grafting to enhance bone volume in preparation for implant treatment. Data acquired included bone quantity and quality, implant dimensions, implant locations, and implant placement stability. Subjects returned for 1-year follow-up examinations to assess implant integration and restoration function. Periapical radiographs were obtained and compared to baseline images to assess marginal bone height maintenance. At the 3-month follow-up examination, 294 of 306 implants placed in 51 subjects were found to be integrated. This represents a cumulative implant survival rate of 96%. At the 1-year follow-up examination, mean marginal bone loss of 0.5 mm was noted, with no further loss of implants. These results support the contention that predictable long-term outcomes may be obtained for the atrophic edentulous maxilla when treated with an implant rehabilitation protocol that includes immediate fixed provisional restoration without the use of bone grafting. This strategy offers a promising treatment alternative for the patient with an atrophic edentulous maxilla.

  6. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position

    NARCIS (Netherlands)

    Jensen, Charlotte; Raghoebar, Gerry M.; Kerdijk, Wouter; Meijer, Henny J. A.; Cune, Marco S.

    2016-01-01

    Objectives: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Methods: Thirty subjects with a bilateral

  7. Absence of association between major vault protein (MVP) gene polymorphisms and drug resistance in Chinese Han patients with partial epilepsy.

    Science.gov (United States)

    Zhou, Luo; Zhang, Mengqi; Long, Hongyu; Long, Lili; Xie, Yuanyuan; Liu, Zhaoqian; Kang, Jin; Chen, Qihua; Feng, Li; Xiao, Bo

    2015-11-15

    Drug resistance in epilepsy is common despite many antiepileptic drugs (AEDs) available for treatment. The development of drug resistant epilepsy may be a result of multiple factors. Several previous studies reported that the major vault protein (MVP) was significantly increased in epileptogenic brain tissues resected from patients with partial-onset seizures, indicating the possible involvement of MVP in drug resistance. In this article, we aimed to identify the association between single nucleotide polymorphisms (SNPs) of MVP gene and drug resistance of partial epilepsy in a Chinese Han population. A total of 510 patients with partial-onset seizures and 206 healthy controls were recruited. Among the patients, 222 were drug resistant and 288 were responsive. The selection of tagging SNPs was based on the Hapmap database and Haploview software and the genotyping was conducted on the Sequenom MassARRAY iPLEX platform. For the selected loci rs12149746, rs9938630 and rs4788186 in the MVP gene, there was no significant difference in allele or genotype distribution between the drug resistant and responsive groups, or between all of the patients and healthy controls. Linkage disequilibrium between any two loci was detected but there was no significant difference in haplotype frequency between the drug resistant and responsive groups. Our results suggest that MVP genetic polymorphisms and haplotypes may not be associated with drug resistance of partial epilepsy in the Chinese Han population. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum

    OpenAIRE

    Russo, Emilio; Mumoli,Laura; Palleria,Caterina; Gasparini,Sara; Citraro,Rita; Labate,Angelo; Ferlazzo,Edoardo; Gambardella,Antonio; De Sarro,Giovambattista

    2015-01-01

    Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum] Mumoli L, Palleria C, Gasparini S, et al. Drug Des Devel Ther. 2015;9:5719–5725.   The authors advise several errors in the paper that are corrected in Corrigendum. View the original article by Mumoli et al.

  9. A walker with a device of partial suspension for patients with gait disturbance: body weight supported walker.

    Science.gov (United States)

    Ochi, Mitsuhiro; Makino, Kenichiro; Wada, Futoshi; Saeki, Satoru; Hachisuka, Kenji

    2009-09-01

    We developed a walker, the Body Weight Supported (BWS) Walker, with a device of partial suspension for patients with gait disturbance. It consists of a light frame with casters, a harness, and a winch system. One therapist alone can perform gait training safely with the BWS Walker without any additional physical load, even if a patient has severe gait disturbance, and the therapist can concentrate on evaluating and improving the patient' s standing balance and gait pattern. Because the BWS Walker is less expensive, simpler, and easier to operate than other BWS systems, we believe the BWS Walker can be widely applicable in training for patients with severe and moderate gait disturbance.

  10. Retrospective analysis of 56 edentulous dental arches restored with 344 single-stage implants using an immediate loading fixed provisional protocol: statistical predictors of implant failure.

    Science.gov (United States)

    Kinsel, Richard P; Liss, Mindy

    2007-01-01

    The purpose of this retrospective study was to evaluate the effects of implant dimensions, surface treatment, location in the dental arch, numbers of supporting implant abutments, surgical technique, and generally recognized risk factors on the survival of a series of single-stage Straumann dental implants placed into edentulous arches using an immediate loading protocol. Each patient received between 4 and 18 implants in one or both dental arches. Periapical radiographs were obtained over a 2- to 10-year follow-up period to evaluate crestal bone loss following insertion of the definitive metal-ceramic fixed prostheses. Univariate tests for failure rates as a function of age ( or = 60 years), gender, smoking, bone grafting, dental arch, surface type, anterior versus posterior, number of implants per arch, and surgical technique were made using Fisher exact tests. The Cochran-Armitage test for trend was used to evaluate the presence of a linear trend in failure rates regarding implant length and implant diameter. Logistic regression modeling was used to determine which, if any, of the aforementioned factors would predict patient and implant failure. A significance criterion of P = .05 was utilized. Data were collected for 344 single-stage implants placed into 56 edentulous arches (39 maxillae and 17 mandibles) of 43 patients and immediately loaded with a 1-piece provisional fixed prosthesis. A total of 16 implants failed to successfully integrate, for a survival rate of 95.3%. Increased rates of failure were associated with reduced implant length, placement in the posterior region of the jaw, increased implant diameter, and surface treatment. Implant length emerged as the sole significant predictor of implant failure. In this retrospective analysis of 56 consecutively treated edentulous arches with multiple single-stage dental implants loaded immediately, reduced implant length was the sole significant predictor of failure.

  11. Dipeptidyl peptidase-4 levels are increased and partially related to body fat distribution in patients with familial partial lipodystrophy type 2.

    Science.gov (United States)

    Valerio, Cynthia Melissa; de Almeida, Juliana Severo; Moreira, Rodrigo Oliveira; Aguiar, Luiza Barreto S; Siciliano, Priscila O; Carvalho, Denise P; Godoy-Matos, Amelio F

    2017-01-01

    Dipeptidyl peptidase-4 (DDP4) is an enzyme responsible for glucagon-like peptide-1 inactivation and plays an important role in glucose metabolism. The aim of this study was to evaluate DPP4 levels in patients with familial partial lipodystrophy type 2 (FPLD2) and correlate it with body fat distribution. Fourteen patients with FPLD2 were selected to participate in this study and matched to a healthy control group (n = 8). All participants had anthropometrical data registered. Body adiposity index (BAI) was used to evaluate fat distribution in this population. Body fat content and distribution were analyzed by dual X-ray absorptiometry (DXA). Biochemical exams, including DPP4 levels, were performed in all individuals. Despite the same body mass index, lipodystrophic patients had a significant lower hip (median 92.0 vs 94.5; p = 0.028), HDL cholesterol (42.6 ± 10.4 vs 66.1 ± 16.0; p correlation was found between DPP4 levels and percentage of total body fat (r = 0.86; p = 0.0025) and android fat (r = 0.78; p = 0.014). Patients with FPLD2 exhibit an increase in DDP4 levels in comparison to a healthy control group. The increase in the levels of this enzyme does not seem to be related to the diagnosis of diabetes and might be associated with an increase in central fat (estimated using BAI and measured using DXA). These results might be used to reinforce the concept that DDP4 is an adipokine related to central fat distribution.

  12. Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

    International Nuclear Information System (INIS)

    Gupta, Nakul; Patel, Anish; Ensor, Joe; Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael; Matin, Surena; Gupta, Sanjay

    2017-01-01

    PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

  13. Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Nakul [Houston Methodist Hospital (United States); Patel, Anish [The University of Texas Southwestern Medical Center (United States); Ensor, Joe [Houston Methodist Research Institute, The Houston Methodist Cancer Center (United States); Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States); Matin, Surena [The University of Texas MD Anderson Cancer Center, Department of Urology (United States); Gupta, Sanjay, E-mail: sgupta@mdanderson.org [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)

    2017-02-15

    PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

  14. Overdentures in the edentulous mandible supported by implants and retained by a Dolder bar: a 5-year prospective study.

    Science.gov (United States)

    Heschl, Alexander; Payer, Michael; Clar, Volker; Stopper, Marlene; Wegscheider, Walther; Lorenzoni, Martin

    2013-08-01

    This prospective study was performed to evaluate the outcomes of XiVE® S plus implants (Dentsply Friadent, Mannheim, Germany) following conventional restoration with bar structures and overdentures in the edentulous mandible. A total of 39 patients were treated with four interforaminal implants (n = 156) splinted by a Dolder bar. Overdentures were attached to the bars after 3 months of healing. As primary outcome measures, clinical and radiological parameters were evaluated at the time of implant placement (baseline) and once a year (1, 2, 3, 4, 5 years) after functional loading. Secondary outcome measures included (i) primary stability and surgical complications, as well as (ii) Periotest® (Medizintechnik Gulden, Modautal, Germany) values, implant survival, and prosthetic complications at baseline and follow-up. A total of 156 implants were placed. The vast majority (n = 149) were tightened to >30 Ncm, while torques in the range of 20-30 Ncm were obtained in the remaining cases (n = 7). Mean crestal bone levels around the implants were 0.41 mm at baseline and 1.04/1.20/1.34/1.45/1.44 mm after 1/2/3/4/5 years respectively. The mean values of the plaque, calculus, bleeding, and mucosal indices remained low throughout this period. The reported follow-up periods involved one implant loss after 3 months (survival rate: 99.4%) and one implant failure after 4 years (success rate: 98.4%). Prosthetic complications included factures of bars (n = 3) and denture teeth (n = 7). Prosthetic survival was 100%. Dolder bars to restore oral implants in the edentulous mandible appear to offer a high rate of implant survival, good stability of the peri-implant tissue, and a low rate of prosthetic complications. © 2011 Wiley Periodicals, Inc.

  15. External Validation of Contact Surface Area as a Predictor of Postoperative Renal Function in Patients Undergoing Partial Nephrectomy.

    Science.gov (United States)

    Haifler, Miki; Ristau, Benjamin T; Higgins, Andrew M; Smaldone, Marc C; Kutikov, Alexander; Zisman, Amnon; Uzzo, Robert G

    2017-09-20

    We sought to externally validate a mathematical formula for tumor contact surface area as a predictor of postoperative renal function in patients undergoing partial nephrectomy for renal cell carcinoma. We queried a prospectively maintained kidney cancer database for patients who underwent partial nephrectomy between 2014 and 2016. Contact surface area was calculated using data obtained from preoperative cross-sectional imaging. The correlation between contact surface area and perioperative variables was examined. The correlation between postoperative renal functional outcomes, contact surface area and the R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to polar lines and tumor touches main renal artery or vein) nephrometry score was also assessed. A total of 257 patients who underwent partial nephrectomy had sufficient data to enter the study. Median contact surface area was 14.5 cm 2 (IQR 6.2-36) and the median nephrometry score was 9 (IQR 7-10). Spearman correlation analysis showed that contact surface area correlated with estimated blood loss (r s = 0.42, p contact surface area and nephrometry score were independent predictors of the absolute change in the estimated glomerular filtration rate (each p contact surface area was a better predictor of a greater than 20% postoperative decline in the estimated glomerular filtration rate compared with the nephrometry score (AUC 0.94 vs 0.80). Contact surface area correlated with the change in postoperative renal function after partial nephrectomy. It can be used in conjunction with the nephrometry score to counsel patients about the risk of renal functional decline after partial nephrectomy. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures

    NARCIS (Netherlands)

    Narhi, TO; Geertman, ME; Hevinga, M; Abdo, H; Kalk, W

    Statement of problem. It has been suggested that risk for severe resorption in the anterior maxilla is increased in persons wearing mandibular implant-retained overdentures. However, little information is available about the changes in the edentulous maxilla after mandibular implant treatment.

  17. ITI implants with overdentures: a prevention of bone loss in edentulous mandibles?

    DEFF Research Database (Denmark)

    von Wowern, N; Harder, F; Hjørting-Hansen, E

    1990-01-01

    Changes in the bone mineral content (BMC) of edentulous mandibles with osseointegrated ITI implants supporting overdentures were measured in vivo by dual-photon absorptiometry. The BMC measurements were performed 3 weeks postoperatively and at the 2-year follow-up visit. Measurements were made...

  18. Dual jaw treatment of edentulism using implant-supported monolithic zirconia fixed prostheses.

    Science.gov (United States)

    Altarawneh, Sandra; Limmer, Bryan; Reside, Glenn J; Cooper, Lyndon

    2015-01-01

    This case report describes restoration of the edentulous maxilla and mandible with implant supported fixed prostheses using monolithic zirconia, where the incisal edges and occluding surfaces were made of monolithic zirconia. Edentulism is a debilitating condition that can be treated with either a removable or fixed dental prosthesis. The most common type of implant-supported fixed prosthesis is the metal acrylic (hybrid), with ceramo-metal prostheses being used less commonly in complete edentulism. However, both of these prostheses designs are associated with reported complications of screw loosening or fracture and chipping of acrylic resin and porcelain. Monolithic zirconia implant-supported fixed prostheses have the potential for reduction of such complications. In this case, the CAD/CAM concept was utilized in fabrication of maxillary and mandibular screw-retained implant-supported fixed prostheses using monolithic zirconia. Proper treatment planning and execution coupled with utilizing advanced technologies contributes to highly esthetic results. However, long-term studies are required to guarantee a satisfactory long-term outcome of this modality of treatment. This case report describes the clinical and technical procedures involved in fabrication of maxillary and mandibular implant-supported fixed prostheses using monolithic zirconia as a treatment of edentulism, and proposes the possible advantages associated with using monolithic zirconia in eliminating dissimilar interfaces in such prostheses that are accountable for the most commonly occurring technical complication for these prostheses being chipping and fracture of the veneering material. © 2015 Wiley Periodicals, Inc.

  19. Bone augmentation followed by implant surgery in the edentulous mandible: a systematic review

    NARCIS (Netherlands)

    de Groot, R. J.; Oomens, M. A. E. M.; Forouzanfar, T.; Schulten, E. A. J. M.

    2018-01-01

    Long-standing loss of natural teeth in the mandible can lead to severe jaw atrophy and even mandibular fracture. There is no consensus on the best preprosthetic surgical treatment to reconstruct the atrophic edentulous mandible. The purpose of this review is to provide an overview of the existing

  20. Biofeedback in Partial Weight Bearing: Usability of Two Different Devices from a Patient's and Physical Therapist's Perspective.

    Science.gov (United States)

    van Lieshout, Remko; Pisters, Martijn F; Vanwanseele, Benedicte; de Bie, Rob A; Wouters, Eveline J; Stukstette, Mirelle J

    2016-01-01

    Partial weight bearing is frequently instructed by physical therapists in patients after lower-limb trauma or surgery. The use of biofeedback devices seems promising to improve the patient's compliance with weight-bearing instructions. SmartStep and OpenGo-Science are biofeedback devices that provide real-time feedback. For a successful implementation, usability of the devices is a critical aspect and should be tested from a user's perspective. To describe the usability from the physical therapists' and a patients' perspective of Smartstep and OpenGo-Science to provide feedback on partial weight bearing during supervised rehabilitation of patients after lower-limb trauma or surgery. In a convergent mixed-methods design, qualitative and quantitative data were collected. Usability was subdivided into user performance, satisfaction and acceptability. Patients prescribed with partial weight bearing and their physical therapists were asked to use SmartStep and OpenGo-Science during supervised rehabilitation. Usability was qualitatively tested by a think-aloud method and a semi-structured interview and quantitatively tested by the System-Usability-Scale (SUS) and closed questions. For the qualitative data thematic content analyses were used. Nine pairs of physical therapists and their patients participated. The mean SUS scores for patients and physical therapists were for SmartStep 70 and 53, and for OpenGo-Science 79 and 81, respectively. Scores were interpreted with the Curved Grading Scale. The qualitative data showed that there were mixed views and perceptions from patients and physical therapists on satisfaction and acceptability. This study gives insight in the usability of two biofeedback devices from the patient's and physical therapist's perspective. The overall usability from both perspectives seemed to be acceptable for OpenGo-Science. For SmartStep, overall usability seemed only acceptable from the patient's perspective. The study findings could help

  1. Reduced GABAA receptor density contralateral to a potentially epileptogenic MRI abnormality in a patient with complex partial seizures

    International Nuclear Information System (INIS)

    Kuwert, T.; Stodieck, S.R.G.; Puskas, C.; Diehl, B.; Puskas, Z.; Schuierer, G.; Vollet, B.; Schober, O.

    1996-01-01

    Imaging cerebral GABA A receptor density (GRD) with single-photon emission tomography (SPET) and iodine-123 iomazenil is highly accurate in lateralizing epileptogenic foci in patients with complex partial seizures of temporal origin. Limited knowledge exists on how iomazenil SPET compares with magnetic resonance imaging (MRI) in this regard. We present a patient with complex partial seizures in whom MRI had identified an arachnoid cyst anterior to the tip of the left temporal lobe. Contralaterally to this structural abnormality, interictal electroencephalography (EEG) performed after sleep deprivation disclosed an intermittent frontotemporal dysrhythmic focus with slow and sharp waves. On iomazenil SPET images GRD was significantly reduced in the right temporal lobe and thus contralaterally to the MRI abnormality, but ipsilaterally to the pathological EEG findings. These data suggest that iomazenil SPET may significantly contribute to the presurgical evaluation of epileptic patients even when MRI identifies potentialy epileptogenic structural lesions. (orig.)

  2. Edentulism and associated factors among community-dwelling middle-aged and elderly adults in China.

    Science.gov (United States)

    Ren, Chong; McGrath, Colman; Yang, Yanqi

    2017-06-01

    To investigate the prevalence of self-reported edentulism and its associated risk factors among community-dwelling adults aged 45 years and older in China. Data from the national baseline survey (2011-2012) of the China Health and Retirement Longitudinal Study (CHARLS) were used for this study (N = 17 167). Bivariate and multivariate logistic regressions were conducted to assess the predictors of edentulism. Models 1 and 2 were based on the whole sample. Models 3 and 4 were based on the subsample (N = 9933) from whom anthropometric and blood biomarker data were available. The prevalence of edentulism was 8.64% among Chinese adults aged 45 and above. As shown by Model 1, older age was a robust predictor for edentulism (odds ratio [OR] = 3.81 for people aged 55-64; OR = 11.22 for people aged 65-74; OR = 24.05 for people aged 75 and above). Other factors positively associated with edentulism included being female (OR = 1.25), rural residence (OR = 1.30), asthma (OR = 1.48), depression (OR = 1.20), reduced physical function (OR = 1.37) and current smoking status (OR = 1.36). People with higher educational levels (OR = 0.75 for people who can read and write; OR = 0.64 for people who obtained a junior high school education or above) and better-off economic status (OR = 0.80) were less likely to be edentate. The association between edentulism and age, educational level, economic status and physical function remained significant in Model 3, and in addition, being underweight appeared as another strong predictor (OR = 1.93). The estimated prevalence of edentulism and the identified associated factors will provide epidemiologic evidence for future research and interventions in the target population in China. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  3. Edentulation alters material properties of cortical bone in the human craniofacial skeleton: functional implications for craniofacial structure in primate evolution

    Science.gov (United States)

    Dechow, Paul C.; Wang, Qian; Peterson, Jill

    2011-01-01

    Skeletal adaptations to reduced function are an important source of skeletal variation and may be indicative of environmental pressures that lead to evolutionary changes. Humans serve as a model animal to investigate the effects of loss of craniofacial function through edentulation. In the human maxilla, it is known that edentulation leads to significant changes in skeletal structure such as residual ridge resorption and loss of cortical thickness. However, little is known about changes in bone tissue structure and material properties, which are also important for understanding skeletal mechanics but are often ignored. The aims of this study were to determine cortical material properties in edentulous crania and to evaluate differences with dentate crania and thus examine the effects of loss of function on craniofacial structure. Cortical bone samples from fifteen edentulous human skulls were measured for thickness and density. Elastic properties and directions of maximum stiffness were determined by using ultrasonic techniques. These data were compared to those from dentate crania reported in a previous investigation. Cortical bone from all regions of the facial skeleton of edentulous individuals is thinner than in dentate skulls. Elastic and shear moduli, and density are similar or greater in the zygoma and cranial vault of edentulous individuals, while these properties are less in the maxilla. Most cortical bone, especially in edentulous maxillae, has reduced directional orientation. The loss of significant occlusal loads following edentulation may contribute to the change in material properties and the loss of orientation over time during the normal process of bone remodeling. These results suggest that area-specific cortical microstructural changes accompany bone resorption following edentulation. They also suggest that functional forces are important for maintaining bone mass throughout the craniofacial skeleton, even in areas such as the browridges, which

  4. Immediate occlusal loading of implants in the partially edentate mandible: a prospective 1-year radiographic and 4-year clinical study.

    Science.gov (United States)

    Ostman, Pär-Olov; Hellman, Mats; Sennerby, Lars

    2008-01-01

    The purpose of the present prospective clinical study was to evaluate the radiographic and clinical outcome of immediately loaded implants in the partial edentulous mandible over a 4-year follow-up period using a modified surgical protocol, primary implant stability criteria, and splinting for inclusion. Patients in need of implant treatment in the partial edentate mandible were consecutively included in the study. The implant sites were underprepared to obtain maximal stability. Inclusion criteria for the study were torque of a least 30 Ncm before final seating of the implant and an ISQ greater than 60. A provisional fixed partial denture was delivered within 24 hours and a definitive fixed partial denture within 3 months. The patients were monitored with clinical and radiographic follow-up examinations for up to 4 years. Stability of the implants was measured with resonance frequency analysis at placement and after 6 months. Ninety-six patients were evaluated, and 77 patients who met the inclusion criteria were included. A total of 111 fixed partial dentures supported by 257 Brånemark System implants (77 turned and 180 TiUnite implants) were delivered. Four (1.6%) of the 257 implants did not osseointegrate, giving an overall survival rate of 98.4% after 4 years. Three turned (3.9%) implants and 1 oxidized implant (0.6%) failed after 4 to 13 months. The average marginal bone resorption was 0.7 mm (SD 0.78) during the first year in function. Turned implants showed an average bone loss of 0.5 mm (SD 0.8) and oxidized implants an average of 0.7 mm (SD 0.8). Resonance frequency analysis showed a mean implant stability quotient of 72.2 (SD 7.5) at placement and 72.5 (SD 5.7) after 6 months of loading. It is concluded that immediate loading of implants with firm primary stability in partially edentulous areas of the mandible appears to be a viable procedure with predictable outcome.

  5. Preserve the lower limb in a patient with calcaneal osteomyelitis and severe occlusive peripheral vascular disease by partial calcanectomy

    Directory of Open Access Journals (Sweden)

    Chin-Ta Lin

    2015-01-01

    Full Text Available Heel ulcers in patients with severe peripheral artery occlusive disease represent a challenge to the treating physician. They become more difficult to treat with underlying medical comorbidities. We report a case of 76-year-old man with hypertension, diabetes mellitus, and end-stage renal disease in uremia status presented to our hospital with a 3-month history of a diabetic foot ulcer on his right heel. He was diagnosed with near total artery occlusion below the knee at the local hospital, and vascular reconstruction failed. After admission, surgical debridement was performed with subsequent partial calcanectomy facilitating wound closure without tension. After surgery, the foot was immobilized with a short-leg splint for 2 weeks. Thereafter, ankle immobilization was accomplished using a thermal protective plastic splint and cast shoes with a posterior window for wound care. The wound healed well with no recurrence during the 12-month follow-up period, and the patient may return to an ambulatory status, including a normal gait pattern. In this case, we demonstrate that the partial calcanectomy is practical for the treatment of plantar heel ulcers in a patient with severe comorbidities. With proper surgical planning and postoperative care, partial calcanectomy is a viable alternative to below-the-knee amputation and may better serve the patient who would otherwise be restricted to a sedentary lifestyle.

  6. Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum

    Directory of Open Access Journals (Sweden)

    Mumoli L

    2015-12-01

    Full Text Available Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum] Mumoli L, Palleria C, Gasparini S, et al. Drug Des Devel Ther. 2015;9:5719–5725.   The authors advise several errors in the paper that are corrected in Corrigendum. View the original article by Mumoli et al.

  7. Physiotherapy after arthroscopic partial meniscectomy surgery: an assessment of costs to the National Health Service, patients, and society.

    Science.gov (United States)

    Goodwin, Peter Charles; Ratcliffe, Julie; Morrissey, Matthew Charles

    2005-01-01

    The purpose of this study was to determine and inform clinicians, managers, and budget allocators of the costs incurred to the British National Health Service (NHS), patient, and society when attending clinic-based physiotherapy compared with not attending clinic-based physiotherapy after arthroscopic partial meniscectomy surgery. The valuation principle used in this study was the economic concept of opportunity cost. Costs were referred to as direct medical (NHS), direct nonmedical (patient), and indirect (societal) costs. Due to the difficulties of their measurement and valuation, intangible costs, in the form of pain and anxiety related to the effect of receiving or not receiving treatment, have not been considered in this analysis. Providing clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is more costly to the NHS and patient, but no more costly to society than when not providing it and does not result in reduced contact with the NHS. Clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is costly and evidence is needed that its effectiveness is high enough to support its use.

  8. Awareness, attitudes, need and demand on replacement of missing teeth among a group of partially dentate patients attending a University Dental Hospital.

    Science.gov (United States)

    Jayasinghe, Rasika Manori; Perera, Janana; Jayasinghe, Vajira; Thilakumara, Indika P; Rasnayaka, Sumudu; Shiraz, Muhammad Hanafi Muhammad; Ranabahu, Indra; Kularatna, Sanjeewa

    2017-07-27

    Our objective was to assess awareness, attitudes, need and demand on replacement of missing teeth according to edentulous space, age, gender, ethnicity, educational level and socio-economical status of the patient. 76.2% of the study group was opined that the missing teeth should be replaced by prosthetic means. Majority were keen in getting them replaced mainly for the comfort in mastication. Although 77.9 and 32.9% were aware of the removable prostheses and implants respectively, only 25.2% knew about tooth supported bridges as an option of replacement of missing teeth. Participants' awareness on tooth and implant supported prostheses is at a higher level. Participants' opinion on need of regular dental visit was statistically significant when gender, ethnicity and education level were considered. The highest demand for replacement of missing teeth was observed in Kennedy class I and II situations in both upper and lower arches. Demand for fixed prostheses was significantly highest in Kennedy class II in upper and lower arches. In conclusion, although removable prosthodontic options are known to most of the patients, their awareness on tooth and implant supported prostheses is also at a higher level. The highest demand for replacement of missing teeth is by patients with Kennedy class I and II situations whereas Kennedy class II being the category with highest demand for fixed prostheses. We recommend that the location of missing teeth to be considered as a priority when educating patients on the most appropriate prosthetic treatment options. Dentists' involvement in educating patients on prosthetic options needs to be improved.

  9. Can Repeat Injection Provide Clinical Benefit in Patients with Lumbosacral Diseases When First Epidural Injection Results Only in Partial Response?

    Science.gov (United States)

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-02-01

    Epidural steroid injection (ESI) is known to be an effective treatment for lower back or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after a single ESI, there has been little evidence supporting the usefulness of repeat injections in cumulative clinical pain reduction. The purpose of this study was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than that provided by intermittent injection performed only when pain was aggravated. An Institutional Review Board (IRB)-approved retrospective chart review. Spine hospital. Two hundred and four patients who had underwent transforaminal ESI (TFESI) for treatment of lower back and radicular pain due to HIVD or SS and could be followed-up for one year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (NRS = 3 after first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 96) comprised partial responders who did not receive a repeat injection at the prescribed interval, but received repeat injections only for aggravation of pain. Various clinical data including total number of injections during one year, duration of NRS group A, or after first injection in group B (time to reinjection), were assessed. These data were compared between groups A and B in terms of total population, HIVD, and SS. In the whole population, the mean time to reinjection was 6.09 ± 3.02 months in group A and 3.69 ± 2.07 months in group B. The NRS groups A and B, respectively. In HIVD patients, the mean time to reinjection was 5.82 ± 3.23 months in group A and 3.84 ± 2.34 months in group B, and NRS groups A and B, respectively. In SS patients, the mean time to

  10. Prosthetic status and prosthetic need among the patients attending various dental institutes of ahmedabad and gandhinagar district, gujarat.

    Science.gov (United States)

    Shah, Vrinda R; Shah, Darshana N; Parmar, Chaitanya H

    2012-09-01

    The oral health being an integral part for the healthy living, necessity of disability limitation and rehabilitation in oral health has taken a paramount role. To assess the prosthetic status and to evaluate the prosthetic needs of the patients attending various institutes of Ahmedabad and Gandhinagar district. A total of 510 (264 males and 246 females) subjects at various dental institutes were examined in the study. A survey proforma was prepared with the help of WHO oral health assessment form (1997). Prosthetic status and prosthetic treatment need was recorded. Out of 510, any type of Edentulousness was 322 (63 %). Among them, 254 (49.8 %) were partially edentulous while 68 (13.3 %) were completely edentulous. Only 69 (13 %) were having any prosthesis in upper arch while only 80 (16 %) were having any prosthesis in lower arch. Need for any type of prosthesis in upper and lower arch was 55 and 60 % in males and females, respectively. In lower social class group need of prosthesis in upper and lower arch was 62 and 63 %, respectively. It was found that prosthetic status and prosthetic treatment need increased with increase in age. Steps should be taken to overcome this disparity and more emphasis should be given to meet the felt need of the people through government and non government organizations to improve the oral health. The unmet prosthetic treatment need should be met to rehabilitate needy people so that their disability may be limited.

  11. Case presentation of two maxillectomy patients restored with two-piece hollow bulb obturator retained using two different types of magnets

    Directory of Open Access Journals (Sweden)

    B Devi Parameswari

    2017-01-01

    Full Text Available Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two partially edentulous patients, both with surgically induced palatal defect and explains how to achieve the goal for esthetics and phonetics. This also describes the fabrication of a hollow obturator by two piece method, which is simple and may be used as definitive obturator for maximum comfort of the patient. In both the above cases, since the mouth opening is restricted due to surgery, obturator prosthesis is given as two pieces retained with opposite poles of magnet, which facilitates the removal and insertion of the prosthesis.

  12. Case Presentation of Two Maxillectomy Patients Restored with Two-piece Hollow Bulb Obturator Retained using Two Different Types of Magnets.

    Science.gov (United States)

    Parameswari, B Devi; Rajakumar, M; Jagadesaan, N; Annapoorni, H

    2017-11-01

    Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two partially edentulous patients, both with surgically induced palatal defect and explains how to achieve the goal for esthetics and phonetics. This also describes the fabrication of a hollow obturator by two piece method, which is simple and may be used as definitive obturator for maximum comfort of the patient. In both the above cases, since the mouth opening is restricted due to surgery, obturator prosthesis is given as two pieces retained with opposite poles of magnet, which facilitates the removal and insertion of the prosthesis.

  13. Prosthetic implant treatment of the edentulous maxilla with overdenture.

    Science.gov (United States)

    Inversini, M

    2006-10-01

    The literature concerning the success of prosthetic implant treatment with maxillary overdenture is reviewed, and variables affecting treatment from the implant and prosthetic standpoint are analysed. Guidelines for the fabrication of maxillary overimplants comparable to those for mandibular overimplants are still lacking, as are evidence-based prosthetic design concepts. Individual methods and techniques have been described, but evaluation standards for the outcome of maxillary prosthetic-implant treatment are lacking or individually interpreted. The biomechanics involved in the proposed system are described, together with the advantages of telescopic crowns for the retention of removable partial prosthesis supported by maxillary implants. The positive influence, in terms of long-term prognosis, of the perio-protective design of removable partial prostheses supported by maxillary overimplants is also discussed. The proposed system not only provides stability, support and retention for removable partial prostheses supported by maxillary implants, but also enables implant survival rates to be improved, both for biomechanical reasons and due to improved oral hygiene. The simplification of fabrication procedures, repair, rebasing and re-operating also reduce the cost of follow-up and improve the cost/benefit ratio. However, additional studies are needed to clarify the number and most appropriate distribution of implants, as well as the most favourable prosthetic designs for maxillary overimplants.

  14. Implant and prosthodontic survival rates with implant fixed complete dental prostheses in the edentulous mandible after at least 5 years: a systematic review.

    Science.gov (United States)

    Papaspyridakos, Panos; Mokti, Muizzaddin; Chen, Chun-Jung; Benic, Goran I; Gallucci, German O; Chronopoulos, Vasilios

    2014-10-01

    The treatment of mandibular edentulism with implant fixed complete dental prostheses (IFCDPs) is a routinely used treatment option. The study aims to report the implant and prosthodontic survival rates associated with IFCDPs for the edentulous mandible after an observation period of a minimum 5 years. An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and prospective studies with IFCDPs for the edentulous mandible. Clinical studies with at least 5-year follow-up were selected. Pooled data were statistically analyzed and cumulative implant- and prosthesis survival rates were calculated by meta-analysis, regression, and chi-square statistics. Implant-related and prosthesis-related factors were identified and their impact on survival rates was assessed. Seventeen prospective studies, including 501 patients and 2,827 implants, were selected for meta-analysis. The majority of the implants (88.5% of all placed implants) had been placed in the interforaminal area. Cumulative implant survival rates for rough surface ranged from 98.42% (95% confidence interval [CI]: 97.98-98.86) (5 years) to 96.86% (95% CI: 96.00-97.73) (10 years); smooth surface implant survival rates ranged from 98.93% (95% CI: 98.38-99.49) (5 years) to 97.88% (95% CI: 96.78-98.98) (10 years). The prosthodontic survival rates for 1-piece IFCDPs ranged from 98.61% (95% CI: 97.80-99.43) (5 years) to 97.25% (95% CI: 95.66-98.86) (10 years). Treatment with mandibular IFCDPs yields high implant and prosthodontic survival rates (more than 96% after 10 years). Rough surface implants exhibited cumulative survival rates similar to the smooth surface ones (p > .05) in the edentulous mandible. The number of supporting implants and the antero-posterior implant distribution had no influence (p > .05) on the implant survival rate. The prosthetic design and veneering material, the retention type, and the loading protocol (delayed, early, and immediate) had no

  15. Avoidant coping partially mediates the relationship between patient problem behaviors and depressive symptoms in spousal Alzheimer caregivers.

    Science.gov (United States)

    Mausbach, Brent T; Aschbacher, Kirstin; Patterson, Thomas L; Ancoli-Israel, Sonia; von Känel, Roland; Mills, Paul J; Dimsdale, Joel E; Grant, Igor

    2006-04-01

    Caring for a loved one with Alzheimer disease is a highly stressful experience that is associated with significant depressive symptoms. Previous studies indicate a positive association between problem behaviors in patients with Alzheimer disease (e.g., repeating questions, restlessness, and agitation) and depressive symptoms in their caregivers. Moreover, the extant literature indicates a robust negative relationship between escape-avoidance coping (i.e., avoiding people, wishing the situation would go away) and psychiatric well-being. The purpose of this study was to test a mediational model of the associations between patient problem behaviors, escape-avoidance coping, and depressive symptoms in Alzheimer caregivers. Ninety-five spousal caregivers (mean age: 72 years) completed measures assessing their loved ones' frequency of problem behaviors, escape-avoidance coping, and depressive symptoms. A mediational model was tested to determine if escape-avoidant coping partially mediated the relationship between patient problem behaviors and caregiver depressive symptoms. Patient problem behaviors were positively associated with escape-avoidance coping (beta = 0.38, p avoidance coping was positively associated with depressive symptoms (beta = 0.33, p avoidance coping. Sobel's test confirmed that escape-avoidance coping significantly mediated the relationship between problem behaviors and depressive symptoms (z = 2.07, p avoidance coping partially mediates the association between patient problem behaviors and depressive symptoms among elderly caregivers of spouses with dementia. This finding provides a specific target for psychosocial interventions for caregivers.

  16. Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

    Directory of Open Access Journals (Sweden)

    Silvio Mario Meloni

    2013-01-01

    Full Text Available Purpose. The aim of this study was to analyze the clinical and radiographic outcomes of 23 edentulous jaws treated with 3D software planning, guided surgery, and immediate loading and restored with CAD-CAM full arch frameworks. Materials and Methods. This work was designed as a prospective case series clinical study. Twenty patients have been consecutively rehabilitated with an immediately loaded implant supported fixed full prosthesis. A total of 120 fixtures supporting 23 bridges were placed. 117 out of 120 implants were immediately loaded. Outcome measures were implants survival, radiographic marginal bone levels and remodeling, soft tissue parameters, and complications. Results. 114 of 117 implants reached a 30 months follow-up, and no patients dropped out from the study. The cumulative survival rate was 97.7%; after 30 months, mean marginal bone level was  mm, mean marginal bone remodeling value was , mean PPD value was  mm, and mean BOP value was 4% ± 2.8%. Only minor prosthetic complications were recorded. Conclusion. Within the limitations of this study, it can be concluded that computer-guided surgery and immediate loading seem to represent a viable option for the immediate rehabilitations of completely edentulous jaws with fixed implant supported restorations. This trial is registered with Clinicaltrials.gov NCT01866696.

  17. Changes in the edentulous maxilla with ball and telescopic attachments of implant-retained mandibular overdentures: a 4-year retrospective study.

    Science.gov (United States)

    Elsyad, Moustafa Abdou; Khairallah, Ahmed Samir; Shawky, Ahmad Fathalla

    2013-07-01

    This retrospective study investigated the clinical and radiographic changes in the edentulous maxilla in patients with either ball or telescopic attachments of implantretained mandibular overdentures. Thirty-two completely edentulous patients (21 males and 11 females) received two implants in the canine region of the mandible. New maxillary complete dentures and mandibular overdentures were fabricated. Overdentures were connected to the implants either with ball (group 1, n = 16) or telescopic (group 2, n = 16) attachments. Retention and stability of the maxillary denture as well as mucosal changes of the maxillary ridge were recorded after 4 years of denturewearing. Traced rotational tomograms were used for measurements of maxillary alveolar bone loss. The proportional value between bone areas and areas of reference not subject to resorption was expressed as a ratio (R). Change in R immediately before (T0) and after 4 years (T4) of overdenture insertion was calculated for the anterior and posterior regions of the maxilla. After 4 years of denture-wearing, maxillary denture retention was significantly higher in group 1 than in group 2, while occurrence of flabby ridges was significantly higher in group 2 than in group 1. The change in R of the anterior region of the maxilla was significantly higher than the change in the posterior region in both groups. Group 2 showed significant anterior residual ridge resorption compared to group 1. Telescopic attachments for implant-retained mandibular overdentures are associated with increased maxillary ridge resorption and flabbiness, and decreased maxillary denture retention when compared to ball attachments.

  18. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

    Science.gov (United States)

    Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical

  19. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blinded...... set-up, first visually and subsequently quantitatively by an automatic regional analysis. By visual analysis 95% of the patients were considered abnormal in one part of the brain, of whom 27% were abnormal on CT, 45% on MRI and 98% on scalp EEG. Using a quantitative regional analysis subdividing each...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  20. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blinded...... set-up, first visually and subsequently quantitatively by an automatic regional analysis. By visual analysis 95% of the patients were considered abnormal in one part of the brain, of whom 27% were abnormal on CT, 45% on MRI and 98% on scalp EEG. Using a quantitative regional analysis subdividing each...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

  1. Whether partial colectomy is oncologically safe for patients with transverse colon cancer: a large population-based study.

    Science.gov (United States)

    Guan, Xu; Zhao, Zhixun; Yang, Ming; Chen, Haipeng; Chen, Wei; Liu, Zheng; Jiang, Zheng; Chen, Yinggang; Wang, Guiyu; Wang, Xishan

    2017-11-03

    Due to special tumor location and technical difficulty of transverse colon cancer (TCC), partial colectomy (PC) is being widely applied in selected TCC patients, instead of extended hemicolectomy (HC). However, the oncological safety of this less aggressive surgical approach is not well studied. Here, we identified 10344 TCC patients from Surveillance, Epidemiology, and End-Results (SEER) database. The surgical treatment for those patients included PC and HC. Firstly, we compared lymph nodes evaluations between patients treated with HC and PC, including median number of nodes, the rate of nodes ≥ 12 and the rate of node positivity. Then, 5-year cancer specific survival (CSS) was obtained. Kaplan-Meier methods and Cox regression models were performed to assess the correlations between prognostic factors and long-term survival. Despite of less node examined by PC, the rate of node positivity was equal between PC and HC, suggesting node retrieval under PC was adequate to tumor stage. In addition, the 5-year CSS for patients who underwent PC were 67.5%, which was similar to patients who received HC (66.5%). The result after propensity score matching also confirmed the equivalent survival outcome between HC and PC. However, subgroup analyses showed that patients with tumor size ≥ 5 cm could not obtain survival benefit from PC. Furthermore, surgical approach was not considered as independent prognostic factor for TCC patients. Therefore, although PC is a less aggressive surgical approach, it should be a safe and feasible option for selected TCC patients.

  2. Feasibility and Accuracy of Digitizing Edentulous Maxillectomy Defects: A Comparative Study.

    Science.gov (United States)

    Elbashti, Mahmoud E; Hattori, Mariko; Patzelt, Sebastian Bm; Schulze, Dirk; Sumita, Yuka I; Taniguchi, Hisashi

    The aim of this study was to evaluate the feasibility and accuracy of using an intraoral scanner to digitize edentulous maxillectomy defects. A total of 20 maxillectomy models with two defect types were digitized using cone beam computed tomography. Conventional and digital impressions were made using silicone impression material and a laboratory optical scanner as well as a chairside intraoral scanner. The 3D datasets were analyzed using 3D evaluation software. Two-way analysis of variance revealed no interaction between defect types and impression methods, and the accuracy of the impression methods was significantly different (P = .0374). Digitizing edentulous maxillectomy defect models using a chairside intraoral scanner appears to be feasible and accurate.

  3. [Effect of removable partial dentures restoration on oral health-related quality of life of patients with shortened dental arch].

    Science.gov (United States)

    Fu, Zhen-nan; Lin, Xue-feng

    2013-11-01

    To assess the effect of removable partial dentures (PRD) restoration on oral health-related quality of life (OHRQOL) of subjects with shortened dental arches (SDA) using the Chinese version of the Oral Health Impact Profile (OHIP-14). Consecutive patients with shortened dental arches were recruited from the Department of Prosthodontics, Foshan Chancheng Hospital of Stomatology. The Chinese version of OHIP-14 was administered to each subject before treatment and after treatment. The subjective outcomes of removable partial dentures therapy on SDA were collected and the pre- and post-treatment scores of the Chinese version of OHIP-14 were compared. After treatment, significant decrease in patients' total score of OHRQOL [before: 9 (6, 12) ; after: 4 (2.25, 6)] was detected, as well as physical pain subscale, physical disability subscale and handicap subscale; and the score of OHRQOL in function limitation subscale increased [before: 0(0,0); after: 2(1, 2)]. The main impacts of shortened dental arch with intact anterior region affecting patients' OHRQOL are physical disability.From a quality-of-life perspective, patients with SDA can perceive benefits from RPD.

  4. Age, period, and cohort analysis of regular dental care behavior and edentulism: A marginal approach

    Science.gov (United States)

    2011-01-01

    Background To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts. Methods Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software. Results The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (P dental health policy was demonstrated by a continued increase of regular dental visiting habits and tooth retention in adults because school dental care was provided to Danes in their childhood. PMID:21410991

  5. Reliability and Validity of a Nepalese Version of the Oral Health Impact Profile for Edentulous Subjects.

    Science.gov (United States)

    Shrestha, Bidhan; Niraula, Surya Raj; Parajuli, Prakash K; Suwal, Pramita; Singh, Raj Kumar

    2018-06-01

    To assess the reliability and to validate the translated Nepalese version of the Oral Health Impact Profile (OHIP-EDENT-N) in Nepalese edentulous subjects. The international guidelines for translation and cross-cultural adaption of OHIP-EDENT were followed, and a Nepalese version of the questionnaire was adapted for this study. Eighty-eight completely edentulous subjects were then selected for the study and completed their responses for the questionnaire. The reliability of the OHIP-EDENT-N was evaluated using internal consistency. Validity was assessed as construct and convergent validity. Construct validity was determined using exploratory factor analysis (EFA). The correlation between OHIP-EDENT-N subscale scores and the global question was investigated to test the convergent validity. Cronbach's alpha for the total score of OHIP-EDENT-N was 0.78. Construct validity was assessed by factor analysis: 70.196% of the variance was accountable to five factors extracted from the factor analysis. Factor loadings above 0.40 were noted for all items. In terms of convergent validity, significant correlations could be established between OHIP-EDENT-N and global questions. This study has been able to establish the reliability and validity of the OHIP-EDENT-N, and OHIP-EDENT-N can be a considered a reliable tool to assess the oral health related quality of life in the Nepalese edentulous population. © 2016 by the American College of Prosthodontists.

  6. Phase II trial of 3D-conformal accelerated partial breast irradiation: Lessons learned from patients and physicians’ evaluation

    International Nuclear Information System (INIS)

    Azoury, Fares; Heymann, Steve; Acevedo, Catalina; Spielmann, Marc; Vielh, Philippe; Garbay, Jean-Rémi; Taghian, Alphonse G.; Marsiglia, Hugo; Bourgier, Céline

    2012-01-01

    Introduction: The present study prospectively reported both physicians’ and patients’ assessment for toxicities, cosmetic assessment and patients’ satisfaction after 3D-conformal accelerated partial breast irradiation (APBI). Materials and Methods: From October 2007 to September 2009, 30 early breast cancer patients were enrolled in a 3D-conformal APBI Phase II trial (40 Gy/10 fractions/5 days). Treatment related toxicities and cosmetic results were assessed by both patients and physicians at each visit (at 1, 2, 6 months, and then every 6 months). Patient satisfaction was also scored. Results: After a median follow-up of 27.7 months, all patients were satisfied with APBI treatment, regardless of cosmetic results or late adverse events. Good/excellent cosmetic results were noticed by 80% of patients versus 92% of cases by radiation oncologists. Breast pain was systematically underestimated by physicians (8–20% vs. 16.6–26.2%; Kappa coefficient KC = 0.16–0.44). Grade 1 and 2 fibrosis and/or breast retraction occurred in 7–12% of patients and were overestimated by patients (KC = 0.14–0.27). Conclusions: Present results have shown discrepancies between patient and physician assessments. In addition to the assessment of efficacy and toxicity after 3D-conformal APBI, patients’ cosmetic results consideration and satisfaction should be also evaluated.

  7. Evaluation of mandibular bone mineral density using the dual-energy X-ray absorptiometry technique in edentulous subjects living in an endemic fluorosis region.

    Science.gov (United States)

    Buyukkaplan, U S; Guldag, M U

    2012-07-01

    Fluoride is one of the biological trace elements with a strong affinity for osseous, cartilaginous and dental tissue. The dental and skeletal effects of high fluoride intake have already been studied in the literature, but little is known about the effects of high fluoride intake on edentulous mandibles. The purpose of this study was to evaluate the effects of high fluoride intake on mandibular bone mineral density (BMD) measured by the dual-energy X-ray absorptiometry (DXA) technique in edentulous individuals with systemic fluorosis. 32 people who were living in an endemic fluorosis area since birth and 31 people who were living in a non-endemic fluorosis area since birth (control group) participated in this study. Systemic fluorosis was diagnosed in the patients using the sialic acid (NANA)/glycosaminoglycan (GAG) ratio. The BMDs of the mandibles were determined by the DXA technique. The serum NANA/GAG ratios in the fluorosis group were significantly lower than those in the control group (p structures of the stomatognathic system.

  8. Magnetic resonance imaging in 120 patients with intractable partial seizures: a preoperative assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lefkopoulos, A.; Haritanti, A.; Papadopoulou, E.; Karanikolas, D.; Fotiadis, N.; Dimitriadis, A.S. [AHEPA University Hospital, Department of Radiology, Thessaloniki (Greece)

    2005-05-01

    The aim of this study was to describe magnetic resonance imaging (MRI) findings in patients with medically intractable epilepsy and to compare different magnetic resonance (MR) sequences in order to establish a dedicated and shorter scan time imaging protocol of choice. One hundred and twenty patients with seizures that were refractory to medical treatment were assessed by MRI with spin-echo (SE) T1, fast spin-echo (FSE) T2, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR) and contrast-enhanced T1 SE sequences. Pathological scans were acquired in 78 patients. Hippocampal sclerosis was detected in 30 patients (25%), cerebral, tumoral, mass lesions in 12 patients (10%), vascular malformations in nine patients (7.5%), cortical infarcts in eight patients (6.7%), cerebral infections in four patients (4.2%) and developmental disorders in 15 patients (12.5%). The most common location of the lesions was the temporal lobe (60%). Coronal, thin (slice thickness 4-5 mm) images have proven to be the most useful in the assessment of the hippocampus. FLAIR and IR are particularly useful in the detection of lesions abutting cerebrospinal fluid (CSF) spaces and developmental disorders, respectively, while T1 SE sequences before and after the intravenous administration of gadolinium offer great facility in identifying space-occupying lesions and infections. MRI is the most important diagnostic tool for the assessment of epileptogenic foci, thus playing the primary role in indicating the type of treatment to be applied. (orig.)

  9. Magnetic resonance imaging in 120 patients with intractable partial seizures: a preoperative assessment

    International Nuclear Information System (INIS)

    Lefkopoulos, A.; Haritanti, A.; Papadopoulou, E.; Karanikolas, D.; Fotiadis, N.; Dimitriadis, A.S.

    2005-01-01

    The aim of this study was to describe magnetic resonance imaging (MRI) findings in patients with medically intractable epilepsy and to compare different magnetic resonance (MR) sequences in order to establish a dedicated and shorter scan time imaging protocol of choice. One hundred and twenty patients with seizures that were refractory to medical treatment were assessed by MRI with spin-echo (SE) T1, fast spin-echo (FSE) T2, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR) and contrast-enhanced T1 SE sequences. Pathological scans were acquired in 78 patients. Hippocampal sclerosis was detected in 30 patients (25%), cerebral, tumoral, mass lesions in 12 patients (10%), vascular malformations in nine patients (7.5%), cortical infarcts in eight patients (6.7%), cerebral infections in four patients (4.2%) and developmental disorders in 15 patients (12.5%). The most common location of the lesions was the temporal lobe (60%). Coronal, thin (slice thickness 4-5 mm) images have proven to be the most useful in the assessment of the hippocampus. FLAIR and IR are particularly useful in the detection of lesions abutting cerebrospinal fluid (CSF) spaces and developmental disorders, respectively, while T1 SE sequences before and after the intravenous administration of gadolinium offer great facility in identifying space-occupying lesions and infections. MRI is the most important diagnostic tool for the assessment of epileptogenic foci, thus playing the primary role in indicating the type of treatment to be applied. (orig.)

  10. A Novel Partially Covered Self-Expandable Metallic Stent with Proximal Flare in Patients with Malignant Gastric Outlet Obstruction.

    Science.gov (United States)

    Takahara, Naminatsu; Isayama, Hiroyuki; Nakai, Yousuke; Yoshida, Shuntaro; Saito, Tomotaka; Mizuno, Suguru; Yagioka, Hiroshi; Kogure, Hirofumi; Togawa, Osamu; Matsubara, Saburo; Ito, Yukiko; Yamamoto, Natsuyo; Tada, Minoru; Koike, Kazuhiko

    2017-07-15

    Endoscopic placement of self-expandable metal stents (SEMSs) has emerged as a palliative treatment for malignant gastric outlet obstruction (GOO). Although covered SEMSs can prevent tumor ingrowth, frequent migration of covered SEMSs may offset their advantages in preventing tumor ingrowth. We conducted this multicenter, single-arm, retrospective study at six tertiary referral centers to evaluate the safety and efficacy of a partially covered SEMS with an uncovered large-bore flare at the proximal end as an antimigration system in 41 patients with symptomatic malignant GOO. The primary outcome was clinical success, and the secondary outcomes were technical success, stent dysfunction, adverse events, and survival after stent placement. The technical and clinical success rates were 100% and 95%, respectively. Stent dysfunctions occurred in 17 patients (41%), including stent migration in nine (23%), tumor ingrowth in one (2%), and tumor overgrowth in four (10%). Two patients (5%) developed adverse events: one pancreatitis and one perforation. No procedure-related death was observed. A novel partially covered SEMS with a large-bore flare proximal end was safe and effective for malignant GOO but failed to prevent stent migration. Further research is warranted to develop a covered SEMS with an optimal antimigration system.

  11. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2014-01-01

    BACKGROUND: Functional limitations exist postmeniscectomy, but preoperative data are scarce. PURPOSE: To examine knee function, knee muscle strength and performance in middle-aged patients with degenerative meniscal tears, eligible for arthroscopic partial meniscectomy. STUDY DESIGN: Cross......-sectional study. METHODS: Eighty-two participants with MRI verified degenerative meniscal tear (35% women, mean age 49 years) answered the Knee injury and Osteoarthritis Outcome Score (KOOS) and were tested for isokinetic knee muscle strength and lower extremity performance (one-leg hop for distance, 6 m timed...

  12. Accuracy and reproducibility of virtual edentulous casts created by laboratory impression scan protocols.

    Science.gov (United States)

    Peng, Lingyan; Chen, Li; Harris, Bryan T; Bhandari, Bikash; Morton, Dean; Lin, Wei-Shao

    2018-04-24

    Although computer-aided design and computer-aided manufacturing (CAD-CAM) complete removable dental prostheses (CRDPs) have gained popularity, conventional impressions are still common for CAD-CAM CRDP treatment. These need to be digitized and converted into virtual edentulous casts with a laboratory impression scan protocol during prosthesis fabrication. How this can best be accomplished is unclear. The purpose of this in vitro study was to compare the accuracy and reproducibility of virtual edentulous casts created by a dental laboratory laser scanner and a cone-beam computed tomography (CBCT) scanner with a digitized master cast. A master cast was digitized as the virtual reference cast. Ten polyvinyl siloxane impressions were made on the master cast and scanned with the dental laboratory laser scanner and CBCT scanner. The impressions were sprayed with antiglare spray and rescanned. Four groups of virtual study casts (N=40) were created from the impression scans. All virtual study casts and the reference cast were registered with surface-matching software, and the root mean square (RMS) values (representation of overall accuracy) and percentage of measurement data points within 1 standard deviation (SD) of mean RMS values (%, representation of overall reproducibility) among the 4 study groups were measured. Additionally, 95 numeric distance differences (representation of accuracy at each region) were measured in 5 distinct regions: the apex of the denture border, 6 mm from denture border, crest of the ridge, palate, and posterior palatal seal. The repeated-measures ANOVA and post hoc test (t grouping) were used to determine statistical differences (α=.05). The laboratory scanner group had a significantly larger RMS value (4.0 ±0.3 μm, Pvirtual edentulous casts, and the antiglare spray only significantly improved the accuracy and reproducibility of virtual edentulous casts created by the dental laboratory laser scanner. The accuracy of the virtual edentulous

  13. Molecular decay of enamel matrix protein genes in turtles and other edentulous amniotes

    Directory of Open Access Journals (Sweden)

    Meredith Robert W

    2013-01-01

    Full Text Available Abstract Background Secondary edentulism (toothlessness has evolved on multiple occasions in amniotes including several mammalian lineages (pangolins, anteaters, baleen whales, birds, and turtles. All edentulous amniote clades have evolved from ancestors with enamel-capped teeth. Previous studies have documented the molecular decay of tooth-specific genes in edentulous mammals, all of which lost their teeth in the Cenozoic, and birds, which lost their teeth in the Cretaceous. By contrast with mammals and birds, tooth loss in turtles occurred in the Jurassic (201.6-145.5 Ma, providing an extended time window for tooth gene degradation in this clade. The release of the painted turtle and Chinese softshell turtle genomes provides an opportunity to recover the decayed remains of tooth-specific genes in Testudines. Results We queried available genomes of Testudines (Chrysemys picta [painted turtle], Pelodiscus sinensis [Chinese softshell turtle], Aves (Anas platyrhynchos [duck], Gallus gallus [chicken], Meleagris gallopavo [turkey], Melopsittacus undulatus [budgerigar], Taeniopygia guttata [zebra finch], and enamelless mammals (Orycteropus afer [aardvark], Choloepus hoffmanni [Hoffmann’s two-toed sloth], Dasypus novemcinctus [nine-banded armadillo] for remnants of three enamel matrix protein (EMP genes with putative enamel-specific functions. Remnants of the AMBN and ENAM genes were recovered in Chrysemys and retain their original synteny. Remnants of AMEL were recovered in both testudines, although there are no shared frameshifts. We also show that there are inactivated copies of AMBN, AMEL and ENAM in representatives of divergent avian lineages including Galloanserae, Passeriformes, and Psittaciformes, and that there are shared frameshift mutations in all three genes that predate the basal split in Neognathae. Among enamelless mammals, all three EMP genes exhibit inactivating mutations in Orycteropus and Choloepus. Conclusions Our results

  14. Breast Cancer Patients' Preferences for Adjuvant Radiotherapy Post Lumpectomy: Whole Breast Irradiation vs. Partial Breast Irradiation-Single Institutional Study.

    Science.gov (United States)

    Bonin, Katija; McGuffin, Merrylee; Presutti, Roseanna; Harth, Tamara; Mesci, Aruz; Feldman-Stewart, Deb; Chow, Edward; Di Prospero, Lisa; Vesprini, Danny; Rakovitch, Eileen; Lee, Justin; Paszat, Lawrence; Doherty, Mary; Soliman, Hany; Ackerman, Ida; Cao, Xingshan; Kiss, Alex; Szumacher, Ewa

    2018-02-01

    This study was conducted to elucidate patients with early breast cancer preference for standard whole breast irradiation (WBI) or partial breast irradiation (PBI) following lumpectomy, as well as identify important factors for patients when making their treatment decisions. Based on relevant literature and ASTRO consensus statement guidelines, an educational tool and questionnaire were developed. Consenting, eligible women reviewed the educational tool and completed the trade-off questionnaire. Descriptive statistics were calculated, as well as chi-squares and a logistic regression model. Of the 90 patients who completed the study, 62 % preferred WBI, 30 % preferred PBI, 4 % required more information, and 3 % had no preferences. Of the patients who chose WBI, 58 % preferred hypofractionated RT, whereas 25 % preferred the conventional RT regimen. The majority of patients rated recurrence rate [WBI = 55/55 (100 %), PBI = 26/26 (100 %)] and survival [WBI = 54/55 (98 %), PBI = 26/26 (100 %)] as important factors contributing to their choice of treatment preference. Financial factors [WBI = 21/55 (38 %), PBI = 14/26 (53 %)] and convenience [WBI = 36/54 (67 %), PBI = 18/26 (69 %)] were rated as important less frequently. Significantly, more patients who preferred WBI also rated standard method of treatment as important when compared to patients who preferred PBI [WBI = 52/54 (96 %), PBI = 16/26 (61 %), χ 2  = 16.63, p = 0.001]. The majority of patients with early breast cancer who were surveyed for this study preferred WBI as an adjuvant treatment post lumpectomy, yet there was a sizeable minority who preferred PBI. This was associated with the importance patients place on standard treatment. These results will help medical professionals treat patients according to patient values.

  15. Effectiveness, safety, and cost of partial exchange transfusions in patients with sickle-cell anemia at a sickle cell disease center in sub-Saharan Africa.

    Science.gov (United States)

    Boma Muteb, P; Kaluila Mamba, J F J; Muhau Pfutila, P; Bilo, V; Panda Mulefu, J D; Diallo, D A

    2017-11-01

    The partial exchange transfusions necessary for management of some sickle-cell complications raise the issue of effectiveness in the context of limited resources and inadequate blood safety. This study evaluated the effectiveness, safety, and cost of partial exchange transfusions in 39 patients with sickle-cell anemia in Lubumbashi, looking at the patients' age and gender and the tolerability and direct cost of the transfusions. Excel and SPSS 18 were used for data entry and analysis. Chi2 and Fisher exact tests were used for comparisons. A P-value ≤ 5% was considered statistically significant. The average age of patients was 8.6 ± 6.4 years, and the majority were girls. The most frequent indications were stroke, severe infections, severe vasooclusive crises, and acute chest syndrome. Partial exchange transfusions were effective in improving hemoglobin and hematocrit as well as the percentage of HbS. No acute accident was observed during any partial exchange transfusion; one anti-Kell alloimmunization and 2 cases of iron overload were observed. The annual cost of partial exchange transfusions per patient requiring (and able to afford) regular treatment was US $ 3,345 without iron chelation and more than US $ 5000 with chelation. Partial exchange transfusions are effective and tolerated, but financially inaccessible to the majority of our sickle cell patients. Thus, an assessment is needed of the economic burden of sickle cell complications that require partial exchange transfusions in the context of countries with limited financial resources.

  16. Perampanel in the management of partial-onset seizures: a review of safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Schulze-Bonhage A

    2015-08-01

    Full Text Available Andreas Schulze-Bonhage, Mandy Hintz Epilepsy Center, University Medical Center Freiburg, Freiburg, Germany Abstract: Perampanel (PER is a novel antiepileptic drug recently introduced for the adjunctive treatment in epilepsy patients aged 12 years or older with partial-onset seizures with or without secondary generalization in the US and Europe. Its antiepileptic action is based on noncompetitive inhibition of postsynaptic AMPA receptors, decreasing excitatory synaptic transmission. Evaluation of efficacy in three placebo-controlled randomized Phase III studies showed that add-on therapy of PER decreased seizure frequencies significantly compared to placebo at daily doses between 4 mg/day and 12 mg/day. PER’s long half-life of 105 hours allows for once-daily dosing that is favorable for patient compliance with intake. Long-term extension studies showed a 62.5%–69.6% adherence of patients after 1 year of treatment, comparing favorably with other second-generation antiepileptic drugs. Whereas these trials demonstrated an overall favorable tolerability profile of PER, nonspecific central nervous system adverse effects like somnolence, dizziness, headache, and fatigue may occur. In addition, neuropsychiatric disturbances ranging from irritability to suicidality were reported in several case reports; both placebo-controlled and prospective long-term extension trials showed a low incidence of such behavioral and psychiatric complaints. For early recognition of neuropsychiatric symptoms like depression, anxiety, and aggression, slow titration and close monitoring during drug introduction are mandatory. This allows on the one hand to recognize patients particularly susceptible to adverse effects of the drug, and on the other hand to render the drug’s full potential of seizure control available for the vast majority of patient groups tolerating the drug well. Keywords: epilepsy, antiepileptic drugs, AMPA receptor, structural epilepsy, partial

  17. Effects of edentulism in obstructive sleep apnea syndrome

    African Journals Online (AJOL)

    2014-11-29

    Nov 29, 2014 ... The use of dentures may prevent or protect patients from the predisposing factors of ... their age and dental condition. .... causes systemic problems, such as cardiovascular disease, ... treatment in sleep apnea syndrome.

  18. Investigation of a Patient With a Partial Trisomy 16q Including the Fat Mass and Obesity Associated Gene (FTO): Fine Mapping and FTO Gene Expression Study

    NARCIS (Netherlands)

    van den Berg, L.; Delemarre-van d Waal, H.A.; Han, J.C.; Ylstra, B.; Eijk, P.; Nesterova, M.; Heutink, P.; Stratakis, C.A.

    2010-01-01

    A female patient with a partial trisomy 16q was described previously. Her clinical characteristics included obesity, severe anisomastia, moderate to severe mental retardation, attention deficit hyperactivity disorder, dysmorphic facies, and contractions of the small joints. In this article, we

  19. MDR-1 and MRP2 gene polymorphisms in Mexican epileptic pediatric patients with complex partial seizures.

    Directory of Open Access Journals (Sweden)

    David eEscalante-Santiago

    2014-10-01

    Full Text Available Although the Pgp efflux transport protein is overexpressed in resected tissue of patients with epilepsy, the presence of polymorphisms in MDR1 / ABCB1 and MRP2 / ABCC2 in patients with antiepileptic-drugs resistant epilepsy is controversial. The aim of this study was to perform an exploratory study to identify nucleotide changes and search new and reported mutations in patients with antiepileptic-drugs resistant epilepsy (ADR and patients with good response to anti-epileptic drugs (CTR in a rigorously selected population. We analyzed 22 samples from drug-resistant patients with epilepsy and 7 samples from patients with good response to anti-epileptic drugs. Genomic DNA was obtained from leukocytes. Eleven exons in both genes were genotyped. The concentration of drugs in saliva and plasma was determined. The concentration of valproic acid in saliva was lower in ADR than in CRT. In ABCB1, five reported SNPs and five unreported nucleotide changes were identified; rs2229109 (GA and rs2032582 (AT and AG were found only in the ADR. Of six SNPs associated with the ABCC2 that were found in the study population, rs3740066 (TT and 66744T>A (TG were found only in the ADR. The strongest risk factor in the ABCB1 gene was identified as the TA genotype of rs2032582, whereas for the ABCC2 gene the strongest risk factor was the T allele of rs3740066. The screening of SNPs in ACBC1 and ABCC2 indicates that the Mexican patients with epilepsy in this study display frequently reported ABCC1 polymorphisms; however, in the study subjects with a higher risk factor for drug resistance, new nucleotide changes were found in the ABCC2 gene. Thus, the population of Mexican patients with AED-resistant epilepsy used in this study exhibits genetic variability with respect to those reported in other study populations; however, it is necessary to explore this polymorphism in a larger population of patients with AED-resistant epilepsy.

  20. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

    Science.gov (United States)

    Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

    2018-01-01

    Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR

  1. Spontaneous Pregnancy and Partial Recovery of Pituitary Function in a Patient with Sheehan's Syndrome

    Directory of Open Access Journals (Sweden)

    Ting-Ting See

    2005-04-01

    Full Text Available Sheehan's syndrome is caused by pregnancy-related hemorrhage leading to ischemic necrosis of the anterior pituitary gland and hypopituitarism. Spontaneous pregnancy in Sheehan's syndrome is very rare. We report the case of a patient with Sheehan's syndrome who suffered from anterior pituitary insufficiency, but with sparing of gonadotropic function. The patient became pregnant spontaneously and, after her second delivery, thyrotropic function recovered. However, the patient's growth hormone and cortisol levels remained unresponsive to an insulin-tolerance test. This case demonstrates that pituitary function may recover from less extensive pituitary ischemia. We emphasize the importance of early identification of pregnancy in such cases. It is crucial to institute adequate hormone-replacement therapy during pregnancy, since hypopituitarism is associated with high fetal and maternal morbidity and mortality.

  2. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2016-12-01

    To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

  3. Partial volume effect-corrected FDG PET and grey matter volume loss in patients with mild Alzheimer's disease

    International Nuclear Information System (INIS)

    Samuraki, Miharu; Yanase, Daisuke; Yamada, Masahito; Matsunari, Ichiro; Chen, Wei-Ping; Yajima, Kazuyoshi; Fujikawa, Akihiko; Takeda, Nozomi; Nishimura, Shintaro; Matsuda, Hiroshi

    2007-01-01

    Although 18 F-fluorodeoxyglucose (FDG) PET is an established imaging technique to assess brain glucose utilisation, accurate measurement of tracer concentration is confounded by the presence of partial volume effect (PVE) due to the limited spatial resolution of PET, which is particularly true in atrophic brains such as those encountered in patients with Alzheimer's disease (AD). Our aim was to investigate the effects of PVE correction on FDG PET in conjunction with voxel-based morphometry (VBM) in patients with mild AD. Thirty-nine AD patients and 73 controls underwent FDG PET and MRI. The PVE-corrected grey matter PET images were obtained using an MRI-based three-compartment method. Additionally, the results of PET were compared with grey matter loss detected by VBM. Before PVE correction, reduced FDG uptake was observed in posterior cingulate gyri (PCG) and parieto-temporal lobes (PTL) in AD patients, which persisted after PVE correction. Notably, PVE correction revealed relatively preserved FDG uptake in hippocampal areas, despite the grey matter loss in medial temporal lobe (MTL) revealed by VBM. FDG uptake in PCG and PTL is reduced in AD regardless of whether or not PVE correction is applied, supporting the notion that the reduced FDG uptake in these areas is not the result of atrophy. Furthermore, FDG uptake by grey matter tissue in the MTL, including hippocampal areas, is relatively preserved, suggesting that compensatory mechanisms may play a role in patients with mild AD. (orig.)

  4. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Kühr, Marietta; Wolfgarten, Matthias; Stölzle, Marco; Leutner, Claudia; Höller, Tobias; Schrading, Simone; Kuhl, Christiane; Schild, Hans; Kuhn, Walther; Braun, Michael

    2011-01-01

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size ≤3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget’s disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  5. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kuehr, Marietta, E-mail: marietta.kuehr@ukb.uni-bonn.de [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Wolfgarten, Matthias; Stoelzle, Marco [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Leutner, Claudia [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Hoeller, Tobias [Department of Medical Statistics and Epidemiology, University of Bonn, Bonn (Germany); Schrading, Simone; Kuhl, Christiane; Schild, Hans [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Kuhn, Walther; Braun, Michael [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany)

    2011-11-15

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size {<=}3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  6. A review of clinical and technical considerations for fixed and removable implant prostheses in the edentulous mandible.

    Science.gov (United States)

    Zitzmann, Nicola Ursula; Marinello, Carlo Paolo

    2002-01-01

    The aim of the present article is to review some of the technical treatment options for implant prostheses restoring the edentulous mandible, mainly based on the Brånemark system. Clinical and technical aspects are discussed for the three established concepts: (1) implant-supported fixed prosthesis, (2) removable implant-supported overdenture, and (3) combined implant-retained and soft tissue-supported overdenture prosthesis. The framework of an implant-supported fixed screw-retained prosthesis can be processed in gold, Co-Cr alloy, or titanium with casting, laser-welding, or milling techniques. To improve the stability and retention of a conventional complete denture, one to four implants are indicated, and unsplinted (single attachments) or splinted designs (bar systems) can be applied. The design of the overdenture prosthesis must be carefully planned according to the requirements to ensure adequate stability and optimal form, contour, and esthetics, and the patient's best comfort. A large variety of different treatment modalities exist for both the fixed and removable mandibular implant prosthesis. Clinical and technical aspects should be considered at the beginning of the treatment to: (1) select the optimal implant position, (2) establish an adequate number of functional units, (3) select the appropriate retainers, and (4) apply the best technique for framework processing and veneering.

  7. Analysis of edentulous maxillae using computed tomography and panoramic radiography in the surgical planning of dental implants

    International Nuclear Information System (INIS)

    Sahuinco, Humberto Lazaro Choquepuma; Souza, Ricardo Pires de

    2006-01-01

    Objective: to determine agreement of three observers on analysis of linear measurements of edentulous maxillae using computed tomography and panoramic radiography in the surgical planning of dental implants. Material and Method: the samples of 17 patients were analyzed with computed tomography and panoramic radiography. Linear measurements obtained from both methods were made at the following anatomical points: left tuberosity, left canine pillar, incisive foramen, right canine pillar and right tuberosity. Kendall's W test was applied to assess the level of agreement. Results: measured W-values from the samples of the anatomical points mentioned above, analyzed with panoramic radiography and computed tomography, were: 0.75 and 0.901; 0.916 and 0.956; 0.843 and 0.964; 0.963 and 0.931; 0.95 and 0.89 respectively. Statistical analysis showed that there was no statistically significant difference. Conclusion: agreement occurred in the measurements of variables.That means that if the three observers were to select an implant to be placed in each of the anatomical regions studied, there would be a good chance whey would choose the same type. (author)

  8. Edentulism trends among middle-aged and older adults in the United States: comparison of five racial/ethnic groups.

    Science.gov (United States)

    Wu, Bei; Liang, Jersey; Plassman, Brenda L; Remle, Corey; Luo, Xiao

    2012-04-01

    This study examined edentulism trends among adults aged 50 and above in five ethnic groups in the United States: Asians, African Americans, Hispanics, Native Americans, and non-Hispanic Caucasians. Data came from the National Health Interview Surveys between 1999 and 2008. Respondents included 616 Native Americans, 2,666 Asians, 15,295 African Americans, 13,068 Hispanics, and 86,755 Caucasians. In 2008, Native Americans had the highest predicated rate of edentulism (23.98%), followed by African Americans (19.39%), Caucasians (16.90%), Asians (14.22%), and Hispanics (14.18%). Overall, there was a significant downward trend in edentulism rates between 1999 and 2008 (OR = 0.97, 95% CI: 0.96, 0.98). However, compared with Caucasians, Native Americans showed a significantly less decline of edentulism during this period (OR = 1.10, 95% CI: 1.02, 1.19). While there was a downward trend in edentulism between 1999 and 2008, significant variations existed across racial/ethnic groups. Innovative public health programs and services are essential to prevent oral health diseases and conditions for minority populations who lack access to adequate dental care. Additionally, given the increasing numbers of adults retaining their natural teeth, interventions designed to assist individuals in maintaining healthy teeth becomes more critical. © 2011 John Wiley & Sons A/S.

  9. Combined duodenal and pancreatic major trauma in high risk patients: can a partial reconstruction be safe?

    Science.gov (United States)

    Toro, A; Li Destri, G; Mannino, M; Arcerito, M C; Ardiri, A; Politi, A; Bertino, G; Di Carlo, I

    2014-04-01

    Pancreatic trauma is an uncommon injury, occurring in only about 0.2% of blunt abdominal injuries, while duodenal injuries represent approximately 4% of all blunt abdominal injuries. When trauma of the pancreas and duodenum do not permit reparation, pancreatoduodenectomy (PD) is mandatory. In the reconstructive phase, the use of ductal ligation as an alternative to standard pancreaticojejunostomy has been reported by some authors. We report a case of polytrauma with pancreatic and duodenal injury in which the initial diagnosis failed to recognize the catastrophic duodenal and pancreatic situation. The patient was submitted for PD and the pancreatic stump was abandoned in the abdominal cavity after main pancreatic ductal ligation. This technique can minimize the morbidity and mortality of PD in patients with other organs or apparatus involved severely and extensively in trauma.

  10. Differential effects of beta-adrenoceptor partial agonists in patients with postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Stadeager, C; Trap-Jensen, J

    1993-01-01

    patients with postural hypotension of different aetiologies. Blood pressure, heart rate and stroke volume were measured in the supine and head-up tilted positions. Left ventricular ejection fraction (LVEF) was measured in the supine position, and vascular resistance, left ventricular volume, and left.......min-1 and LVEF from 0.57 to 0.52, and reduced mean arterial blood pressure from 103 mm Hg to 93 mm Hg. Xamoterol showed beta-adrenoceptor agonistic effects in the supine position through increments in heart rate from 72 to 90 beats.min-1 and LVEF from 0.58 to 0.66, and raised mean arterial blood...... pressure from 108 to 123 mm Hg. It is concluded that the degree of agonist activity of a beta-adrenergic agent is of importance if it is given to a patient with postural hypotension....

  11. Hepatobiliary transporter expression and post-operative jaundice in patients undergoing partial hepatectomy.

    Science.gov (United States)

    Bernhardt, Gerwin A; Zollner, Gernot; Cerwenka, Herwig; Kornprat, Peter; Fickert, Peter; Bacher, Heinz; Werkgartner, Georg; Müller, Gabriele; Zatloukal, Kurt; Mischinger, Hans-Jörg; Trauner, Michael

    2012-01-01

    Post-operative hyperbilirubinaemia in patients undergoing liver resections is associated with high morbidity and mortality. Apart from different known factors responsible for the development of post-operative jaundice, little is known about the role of hepatobiliary transport systems in the pathogenesis of post-operative jaundice in humans after liver resection. Two liver tissue samples were taken from 14 patients undergoing liver resection before and after Pringle manoeuvre. Patients were retrospectively divided into two groups according to post-operative bilirubin serum levels. The two groups were analysed comparing the results of hepatobiliary transporter [Na-taurocholate cotransporter (NTCP); multidrug resistance gene/phospholipid export pump(MDR3); bile salt export pump (BSEP); canalicular bile salt export pump (MRP2)], heat shock protein 70 (HSP70) expression as well as the results of routinely taken post-operative liver chemistry tests. Patients with low post-operative bilirubin had lower levels of NTCP, MDR3 and BSEP mRNA compared to those with high bilirubin after Pringle manoeuvre. HSP70 levels were significantly higher after ischaemia-reperfusion (IR) injury in both groups resulting in 4.5-fold median increase. Baseline median mRNA expression of all four transporters prior to Pringle manoeuvre tended to be lower in the low bilirubin group whereas expression of HSP70 was higher in the low bilirubin group compared to the high bilirubin group. Higher mRNA levels of HSP70 in the low bilirubin group could indicate a possible protective effect of high HSP70 levels against IR injury. Although the exact role of hepatobiliary transport systems in the development of post-operative hyper bilirubinemia is not yet completely understood, this study provides new insights into the molecular aspects of post-operative jaundice after liver surgery. © 2011 John Wiley & Sons A/S.

  12. Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures.

    Science.gov (United States)

    Mumoli, Laura; Palleria, Caterina; Gasparini, Sara; Citraro, Rita; Labate, Angelo; Ferlazzo, Edoardo; Gambardella, Antonio; De Sarro, Giovambattista; Russo, Emilio

    2015-01-01

    Brivaracetam (BRV), a high-affinity synaptic vesicle protein 2A ligand, reported to be 10-30-fold more potent than levetiracetam (LEV), is highly effective in a wide range of experimental models of focal and generalized seizures. BRV and LEV similarly bind to synaptic vesicle protein 2A, while differentiating for other pharmacological effects; in fact, BRV does not inhibit high voltage Ca(2+) channels and AMPA receptors as LEV. Furthermore, BRV apparently exhibits inhibitory activity on neuronal voltage-gated sodium channels playing a role as a partial antagonist. BRV is currently waiting for approval both in the United States and the European Union as adjunctive therapy for patients with partial seizures. In patients with photosensitive epilepsy, BRV showed a dose-dependent effect in suppressing or attenuating the photoparoxysmal response. In well-controlled trials conducted to date, adjunctive BRV demonstrated efficacy and good tolerability in patients with focal epilepsy. BRV has a linear pharmacokinetic profile. BRV is extensively metabolized and excreted by urine (only 8%-11% unchanged). The metabolites of BRV are inactive, and hydrolysis of the acetamide group is the mainly involved metabolic pathway; hepatic impairment probably requires dose adjustment. BRV does not seem to influence other antiepileptic drug plasma levels. Six clinical trials have so far been completed indicating that BRV is effective in controlling seizures when used at doses between 50 and 200 mg/d. The drug is generally well-tolerated with only mild-to-moderate side effects; this is confirmed by the low discontinuation rate observed in these clinical studies. The most common side effects are related to central nervous system and include fatigue, dizziness, and somnolence; these apparently disappear during treatment. In this review, we analyzed BRV, focusing on the current evidences from experimental animal models to clinical studies with particular interest on potential use in clinical

  13. How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes.

    Science.gov (United States)

    Leader, Natasha J; Ryan, Lynne; Molyneaux, Lynda; Yue, Dennis K

    2013-02-01

    To compare patient compliance and benefits, over 12 months, of 1 versus 2 partial meal replacement (PMR) for the management of overweight/obese subjects with inadequately controlled type 2 diabetes. Thirty-six overweight patients with inadequately controlled type 2 diabetes (BMI > 27 kg/m(2) and HbA1c > 7.5% [58 mmol/mol]) were randomized to receive 1 or 2 PMR/day, while maintaining usual lifestyle. Subjects were seen monthly and adjustment of medications was made to prevent hypoglycemia. Compliance was assessed by counting unused sachets. Patients on 2 PMR/day lost almost 4 kg compared with only 0.5 kg in the 1 PMR/day group. This difference was statistically significant (P meal replacement. Reductions in weight, waist, and HbA1c were better in the 2 PMR/day group while patient dropout and compliance were not worse over a 12-month period. PMR provides a further management option for overweight/obese individuals with type 2 diabetes. The initial recommendation should be 2 PMR/day. Copyright © 2012 The Obesity Society.

  14. Partial Body Weight-Supported Treadmill Training in Patients With Parkinson Disease: Impact on Gait and Clinical Manifestation.

    Science.gov (United States)

    Ganesan, Mohan; Sathyaprabha, Talakad N; Pal, Pramod Kumar; Gupta, Anupam

    2015-09-01

    To evaluate the effect of conventional gait training (CGT) and partial weight-supported treadmill training (PWSTT) on gait and clinical manifestation. Prospective experimental research design. Hospital. Patients with idiopathic Parkinson disease (PD) (N=60; mean age, 58.15±8.7y) on stable dosage of dopaminomimetic drugs were randomly assigned into the 3 following groups (20 patients in each group): (1) nonexercising PD group, (2) CGT group, and (3) PWSTT group. The interventions included in the study were CGT and PWSTT. The sessions of the CGT and PWSTT groups were given in patient's self-reported best on status after regular medications. The interventions were given for 30min/d, 4d/wk, for 4 weeks (16 sessions). Clinical severity was measured by the Unified Parkinson Disease Rating Scale (UPDRS) and its subscores. Gait was measured by 2 minutes of treadmill walking and the 10-m walk test. Outcome measures were evaluated in their best on status at baseline and after the second and fourth weeks. Four weeks of CGT and PWSTT gait training showed significant improvements of UPDRS scores, its subscores, and gait performance measures. Moreover, the effects of PWSTT were significantly better than CGT on most measures. PWSTT is a promising intervention tool to improve the clinical and gait outcome measures in patients with PD. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures

    Directory of Open Access Journals (Sweden)

    Mumoli L

    2015-10-01

    Full Text Available Laura Mumoli,1 Caterina Palleria,2 Sara Gasparini,1 Rita Citraro,2 Angelo Labate,1 Edoardo Ferlazzo,1 Antonio Gambardella,1 Giovambattista De Sarro,2 Emilio Russo2 1Institute of Neurology, 2Institute of Pharmacology, University Magna Græcia, Catanzaro, Italy Abstract: Brivaracetam (BRV, a high-affinity synaptic vesicle protein 2A ligand, reported to be 10–30-fold more potent than levetiracetam (LEV, is highly effective in a wide range of experimental models of focal and generalized seizures. BRV and LEV similarly bind to synaptic vesicle protein 2A, while differentiating for other pharmacological effects; in fact, BRV does not inhibit high voltage Ca2+ channels and AMPA receptors as LEV. Furthermore, BRV apparently exhibits inhibitory activity on neuronal voltage-gated sodium channels playing a role as a partial antagonist. BRV is currently waiting for approval both in the United States and the European Union as adjunctive therapy for patients with partial seizures. In patients with photosensitive epilepsy, BRV showed a dose-dependent effect in suppressing or attenuating the photoparoxysmal response. In well-controlled trials conducted to date, adjunctive BRV demonstrated efficacy and good tolerability in patients with focal epilepsy. BRV has a linear pharmacokinetic profile. BRV is extensively metabolized and excreted by urine (only 8%–11% unchanged. The metabolites of BRV are inactive, and hydrolysis of the acetamide group is the mainly involved metabolic pathway; hepatic impairment probably requires dose adjustment. BRV does not seem to influence other antiepileptic drug plasma levels. Six clinical trials have so far been completed indicating that BRV is effective in controlling seizures when used at doses between 50 and 200 mg/d. The drug is generally well-tolerated with only mild-to-moderate side effects; this is confirmed by the low discontinuation rate observed in these clinical studies. The most common side effects are related to

  16. Impact of removable partial denture prosthesis on chewing efficiency

    Science.gov (United States)

    BESSADET, Marion; NICOLAS, Emmanuel; SOCHAT, Marine; HENNEQUIN, Martine; VEYRUNE, Jean-Luc

    2013-01-01

    Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. Objectives The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. Material and Methods Nineteen removable partial denture prosthesis (RPDP) wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I). All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Number of chewing cycles (CC), chewing time (CT) and chewing frequency (CF=CC/CT) were video recorded. Results With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP), F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01). With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI) determined as 4,000 µm. Conclusion RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. Clinical relevance This study encourages the clinical improvement of oral rehabilitation procedure. PMID:24212983

  17. Functional MRI of tongue motor tasks in patients with tongue cancer: observations before and after partial glossectomy

    International Nuclear Information System (INIS)

    Haupage, Samantha; Branski, Ryan C.; Kraus, Dennis; Peck, Kyung K.; Hsu, Meier; Holodny, Andrei

    2010-01-01

    The current study seeks to provide preliminary data regarding this central, adaptive response during tongue motor tasks utilizing functional magnetic resonance imaging (fMRI) before and after glossectomy. Six patients, with confirmed histological diagnoses of oral tongue cancer, underwent fMRI before and 6 months after partial glossectomy. These data were compared to nine healthy controls. All subjects performed three tongue motor tasks during fMRI: tongue tapping (TT), dry swallow (Dry), and wet swallow (Wet). Following surgery, increased activation was subjectively observed in the superior parietal lobule, supplementary motor area, and anterior cingulate. Region of interest (ROI) analysis of the precentral gyrus confirmed increased cortical activity following surgery. In addition, comparisons between pre-surgical scans and controls suggested the dry swallow task was sensitive to elicit tongue-related activation in the precentral gyrus (p ≤ 0.05). The adaptive changes in the cortex following partial glossectomy reflect recruitment of the parietal, frontal, and cingulate cortex during tongue motor tasks. In addition, post-operative activation patterns more closely approximated control levels than the pre-operative scans. Furthermore, the dry swallow task appears most specific to elicit tongue-related cortical activity. (orig.)

  18. Functional MRI of tongue motor tasks in patients with tongue cancer: observations before and after partial glossectomy

    Energy Technology Data Exchange (ETDEWEB)

    Haupage, Samantha; Branski, Ryan C.; Kraus, Dennis [Memorial Sloan-Kettering Cancer Center, Head and Neck Surgery, New York, NY (United States); Peck, Kyung K. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Medical Physics, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Medical Physics and Radiology, New York, NY (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Holodny, Andrei [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States)

    2010-12-15

    The current study seeks to provide preliminary data regarding this central, adaptive response during tongue motor tasks utilizing functional magnetic resonance imaging (fMRI) before and after glossectomy. Six patients, with confirmed histological diagnoses of oral tongue cancer, underwent fMRI before and 6 months after partial glossectomy. These data were compared to nine healthy controls. All subjects performed three tongue motor tasks during fMRI: tongue tapping (TT), dry swallow (Dry), and wet swallow (Wet). Following surgery, increased activation was subjectively observed in the superior parietal lobule, supplementary motor area, and anterior cingulate. Region of interest (ROI) analysis of the precentral gyrus confirmed increased cortical activity following surgery. In addition, comparisons between pre-surgical scans and controls suggested the dry swallow task was sensitive to elicit tongue-related activation in the precentral gyrus (p {<=} 0.05). The adaptive changes in the cortex following partial glossectomy reflect recruitment of the parietal, frontal, and cingulate cortex during tongue motor tasks. In addition, post-operative activation patterns more closely approximated control levels than the pre-operative scans. Furthermore, the dry swallow task appears most specific to elicit tongue-related cortical activity. (orig.)

  19. Obturator prostheses in post-oncological maxillofacial patients: our experience

    Directory of Open Access Journals (Sweden)

    Edoardo Brauner

    2014-12-01

    Full Text Available Background: Surgical procedures for tumors of the paranasal sinus, palatal epithelium, minor salivary glands or osteosarcoma of the upper jaw require a partial or total maxillectomy of the upper jaw. When the surgical procedure and/or radiation therapy result in a communication, the solution is necessarily prosthetical, through a palatal obturator that recreates a partition between the oral and nasal cavities. Methods: Authors selected 32 post-oncological patients with the upper maxilla completely edentulous prosthetically rehabilitated with a palatal obturator. Results: No serious complications or adverse reactions were reported during the fabrication of surgical or definitive obturators. All patients stated to benefit the palatal obturator in terms of quality of life. Conclusion: Prosthetic rehabilitation of edentulous maxillectomy with oral communication is a demanding challenge for the prosthodontist. The goals of prosthetic rehabilitation include separation of oral and nasal cavities to allow adequate deglutition and articulation of teeth, restore midfacial soft tissue contour and a satisfactory esthetic outcome. When, for any reason, the patient is not a suitable candidate for an implant-retained overdenture, a total removable prosthesis should ensure the most comfort in terms of swallowing, phonation and aesthetics.

  20. Three-Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques.

    Science.gov (United States)

    Maló, Paulo; de Araújo Nobre, Miguel; Lopes, Armando

    2016-07-01

    The aim of this prospective clinical study was to evaluate the 3-year outcome of fixed partial prostheses supported by implants with immediate provisionalization without occlusal contacts inserted in predominantly soft bone with flap and flapless protocols. Forty-one patients partially rehabilitated with 72 NobelSpeedy implants (51 maxillary; 21 mandibular) were consecutively included and treated with a flapless surgical protocol (n = 20 patients; 32 implants) and flapped surgical protocol (n = 21 patients; 40 implants). Primary outcome measure was implant survival; secondary outcome measures were marginal bone resorption (comparing the bone levels at 1 and 3 years with baseline) and the incidence of biological, mechanical, and esthetic complications. Survival was computed through life tables; descriptive statistics were applied to the remaining variables of interest. Eight patients with eight implants dropped out of the study. One implant failed in one patient (flapless group) giving an overall cumulative survival rate (CSR) of 98.6%. No failures were noted with the flapped protocol (CSR 100%), while for the implants placed with the flapless surgical technique, a 96.9% CSR was registered. The overall average marginal bone resorption at 3 years was 1.37 mm (SD = 0.94 mm), with 1.14 mm (SD = 0.49 mm) and 1.60 mm (SD = 1.22 mm) for the flap and flapless groups, respectively. Mechanical complications occurred in nine patients (n = 5 patients in the flapless group; n = 4 patients in the flap group). Implant infection was registered in three implants and three patients (flapless group), who exhibited inadequate oral hygiene levels. Partial edentulism rehabilitation through immediate provisionalization fixed prosthesis supported by dental implants inserted through flap or flapless surgical techniques in areas of predominantly soft bone was viable at 3 years of follow-up. The limitations and risks of the "free-hand" method in flapless surgery should be considered when

  1. Oral Health of Patients Treated with Acrylic Partial Dentures Using a Toothpaste Containing Bee Product

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    Karolina Wiatrak

    2017-01-01

    Full Text Available This study was carried out to investigate the influence of a propolis and tee tree oil-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Thirty-seven patients who underwent oral rehabilitation with a removable acrylic denture were selected and randomly assigned into two groups: study group (A which received a newly formulated propolis and tee tree oil-containing toothpaste or a control group (C without an active ingredient. API, S-OHI, and mSBI were assessed in three subsequent stages. During each examination swabs were employed for microbiological inoculation: in the study group after 4 weeks use of the active toothpaste showed a decrease in the number of isolated microorganisms. In the control group, after 4 weeks use of the toothpaste without active ingredients resulted in increase in the number of the isolated microorganisms. Improvements in hygiene and the condition of periodontium were observed in patients using active toothpastes. In the study group the oral flora diversity was reduced by the decrease in the number of cultured microorganism species, while in the control group an increase in the number of cultured microorganisms and their species was observed.

  2. Direct experience and the course of eating disorders in patients on partial hospitalization: a pilot study.

    Science.gov (United States)

    Soler, Joaquim; Soriano, José; Ferraz, Liliana; Grasa, Eva; Carmona, Cristina; Portella, Maria J; Seto, Victoria; Alvarez, Enric; Pérez, Víctor

    2013-09-01

    Awareness of sensory experience in the present moment is central to mindfulness practice. This type of information processing, in contrast to an analytical evaluative style of processing, could be more beneficial for the course of those psychiatric disorders characterized by ruminative and content-centred processing, such as eating disorders (EDs). We performed a pilot study to assess the relation between patients' approach to information processing and the duration and severity of EDs. Fifty-seven patients with a diagnosed ED were included in the study and participated in a self-guided eating activity to asses the primary information processing mode based on mindfulness concepts of 'Direct Experience' and 'Thinking About'. Additionally, dispositional mindfulness was assessed by the Five Factors Mindfulness Questionnaire, and anxiety during the experiment was determined by means of a 10-point visual analogue scale. We found that a higher level of self-reported Direct Experience was inversely associated with several severity variables and with anxiety levels. Direct Experience was predicted by a low anxiety level, less severe illness, and higher scores on one mindfulness facet (Observing). Our results suggest that a Direct Experience processing approach is associated with better ED outcomes. Future studies should be carried out to clarify the repercussion of mindfulness training on EDs. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

  3. Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience.

    Science.gov (United States)

    Jethwa, Krishan R; Kahila, Mohamed M; Mara, Kristin C; Harmsen, William S; Routman, David M; Pumper, Geralyn M; Corbin, Kimberly S; Sloan, Jeff A; Ruddy, Kathryn J; Hieken, Tina J; Park, Sean S; Mutter, Robert W

    2018-05-01

    Accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) are treatment options for early-stage breast cancer. The purpose of this study was to compare patient-reported-outcomes (PRO) between patients receiving multi-channel intra-cavitary brachytherapy APBI or WBI. Between 2012 and 2015, 131 patients with ductal carcinoma in situ (DCIS) or early stage invasive breast cancer were treated with adjuvant APBI (64) or WBI (67) and participated in a PRO questionnaire. The linear analog scale assessment (LASA), harvard breast cosmesis scale (HBCS), PRO-common terminology criteria for adverse events- PRO (PRO-CTCAE), and breast cancer treatment outcome scale (BCTOS) were used to assess quality of life (QoL), pain, fatigue, aesthetic and functional status, and breast cosmesis. Comparisons of PROs were performed using t-tests, Wilcoxon rank-sum, Chi square, Fisher exact test, and regression methods. Median follow-up from completion of radiotherapy and questionnaire completion was 13.3 months. There was no significant difference in QoL, pain, or fatigue severity, as assessed by the LASA, between treatment groups (p > 0.05). No factors were found to be predictive of overall QoL on regression analysis. BCTOS health-related QoL scores were similar between treatment groups (p = 0.52).The majority of APBI and WBI patients reported excellent/good breast cosmesis, 88.5% versus 93.7% (p = 0.37). Skin color change (p = 0.011) and breast elevation (p = 0.01) relative to baseline were more common in the group receiving WBI. APBI and WBI were both associated with favorable patient-reported outcomes in early follow-up. APBI resulted in a lesser degree of patient-reported skin color change and breast elevation relative to baseline.

  4. Clinical Evaluation of Periodontal Tissue Status in Prosthodontic Treatment of Patients with Partial Tooth Loss and Generalized Periodontitis

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    A. Kushlyk

    2018-01-01

    Full Text Available The problem of selection and application of dental prostheses in periodontal disease is especially relevant in case of severe generalized periodontitis, which is accompanied by mobile tooth removal resulting in overloading the periodontium of the remaining teeth as well as the increase in tooth mobility. Therefore, in generalized periodontitis, it is important to apply the method of direct dental prosthetic rehabilitation since, in case of partial tooth loss, it will prevent the development of generalized periodontitis complications. The objective of the research was to improve the effectiveness of combination therapy for patients with generalized periodontitis and partial tooth loss applying the developed method of direct fixed dental prosthetic rehabilitation based on the study of the periodontal status. Materials and methods. The study included 129 patients with general periodontitis, II-III degree and partial tooth loss over the age of 45 years. According to prosthodontic treatment, all the patients were divided into three groups: Group I consisted of 42 (20 women and 22 men patients who immediately after tooth extraction were rehabilitated with the application of direct plastic laminar immediate prosthesis and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 weeks after tooth extraction; Group II included 43 (21 women and 22 men patients who underwent traditional permanent dental prosthetic rehabilitation using fixed dental bridges 6 weeks after mobile tooth removal and wound healing; Group III comprised 44 (21 women and 23 men patients who immediately after mobile tooth removal were rehabilitated with the application of direct fixed sectional dental bridge (Ukrainian patent UA 20995. 2007 Feb 15 and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 months after tooth extraction. The control group consisted of 26 people with intact dentitions over the age of 45 years

  5. Modified Grice-Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy.

    Science.gov (United States)

    Güven, Melih; Tokyay, Abbas; Akman, Budak; Encan, Mehmet E; Altintaş, Faik

    2016-03-01

    The aim of this study was to report the experience with the use of a modified Grice-Green technique, which was performed using a partial subperiosteal fibular bone graft because of valgus unstable foot in children with cerebral palsy. Fifteen feet of 11 patients were evaluated on the basis of the appearance of the feet, clinical symptoms, and radiographic measurements. After an average follow-up duration of 24 (9-39) months, all feet showed satisfactory clinical and radiological results. Solid fusion and sustained correction took place in all feet. The gap at the donor site was bridged with new bone in all cases. No donor-site morbidity was detected. This modification of the Grice-Green technique can be used effectively in the correction of planovalgus foot in cerebral palsy.

  6. Combined study of 99mTc-HMPAO SPECT and computerized electroencephalographic topography (CET) in patients with medically refractory complex partial epilepsy

    International Nuclear Information System (INIS)

    Rodrigues, M.; Botelho, M.M.; Fonseca, A.T.; Peter, J.P.; Pimentel, T.; Vieira, M.R.

    1996-01-01

    For successful surgery for drug-resistant partial epilepsy the site of the seizure focus needs to be known exactly. The purpose of this study was to compare the evaluation of the regional cerebral blood flow (rCBF) (localization and degree of disturbances) by 99m Tc-hexamethylpropylene-amineoxime (HMPAO) single photon emission computed tomography (SPECT) with computerized electroencephalographic topography (CET) and transmission computed X-ray tomography (CT) in partial epilepsy. The study included 20 patients with medically refractory complex partial seizures. Of the 20 patients included, 15 were studied interictally, four ictally and one in both states, interictally and ictally. 99m Tc-HMPAO SPECT detected rCBF changes in 95% of the patients. Interictal studies demonstrated focal areas of hypoperfusion in 93% of the patients. Ictal studies demonstrated an area of hyperperfusion in all patients. Blood flow disturbances in deeper structures of the brain, such as basal ganglia, could be detected. The areas with abnormal 99m Tc-HMPAO uptake were concordant, in localization, with CET in 85% of the patients. Abnormal data with CT scans were found in only 45% of the patients. Focal lesions were found in 20% of the patients by CT scans. 99m Tc-HMPAO SPECT combined with CET may be a useful screening procedure prior to referral for invasive diagnostic procedures in future management of patients with medically refractory complex partial seizures. (author)

  7. Influence of adaptation of removable partial denture on masticatory performance.

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    Jorge Nakouzi

    2016-11-01

    Full Text Available Objective: To compare the masticatory performance (MP of patients with old removable partial denture (RPD, recently inserted RPD and already adapted RPD by means of the simple sieve test. Material and Methods: Twenty-nine adult (>18 years old volunteer patients were recruited, with lower and upper RPD, excluding total edentulous subjects in the upper and lower jaw, with temporomandibular disorders, severe periodontal disease, mental disability or systemic disease compromising the masticatory or nervous system. Dentures were designed and fabricated by an expert operator. MP was evaluated in old RPD (MP1, recently inserted RPD (MP2 and adapted RPD (MP3. The simple sieve test used was Edlund-Lamm in percentage of MP, using Optosil® Comfort condensation silicone tablets, with standard sizes (5.0x20mm. In each phase, the patient chewed the tablet with 20 masticatory strokes. The crushed fragments were dried at 80°C for 60 minutes and weighed on an analytical scale. A multiple vibration sieve analysis was performed, using sieves with opening sizes of 2.8mm and 1.4mm. Shapiro-Wilk test and Anova test with Bonferroni correction were performed. Results: It was observed that MP1 presented a mean of 8.40% (SD±5.59, MP2 a mean of 8.56% (SD±5.56, and MP3 a mean of 18.26% (SD±8.12. There was a significant difference (p<0.05 between the MP1-MP3 groups, as well as between the MP2-MP3 (p<0.05. Conclusion: There is a significant increase in MP thirty days after the insertion of RPD, checkups, and adjustments performed by the dentist.

  8. Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

    Science.gov (United States)

    Cano-Gutiérrez, Carlos; Borda, Miguel G; Arciniegas, Antonio J; Borda, Claudia X

    2015-01-01

    The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at peducation were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (pmeasuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

  9. Partial response to cinacalcet treatment in a patient with secondary hyperparathyroidism undergoing hemodialysis: a case report

    Directory of Open Access Journals (Sweden)

    Conzo Giovanni

    2012-12-01

    Full Text Available Abstract Introduction In the treatment of secondary hyperparathyroidism of chronic kidney disease, calcimimetics - allosteric modulators of the calcium-sensing receptor - inhibit glandular hyperplasia and significantly reduce circulating parathyroid hormone levels. They have a major impact on the management of secondary hyperparathyroidism. Case presentation We present the clinical case of a 41-year-old Caucasian man undergoing chronic hemodialysis, who had a parathyroidectomy to treat severe secondary hyperparathyroidism resistant to cinacalcet treatment. Preoperatively, 24 months after high-dose cinacalcet hydrochloride, we observed a persistently elevated intact parathyroid hormone serum level, and detected clear parathyroid gland hyperplasia regression on ultrasound. We performed a three-gland parathyroidectomy, which was assumed to be total, associated with a hemithyroidectomy. Our patient then entered a hypoparathyroid state. A histopathological examination showed that the removed parathyroid glands were of small size, with a total weight of 1g, associated with a multifocal small papillary thyroid cancer. Conclusion In the management of secondary hyperparathyroidism, cinacalcet hydrochloride effectively reduces total parathyroid gland hyperplasia. However, a persisting elevated intact parathyroid hormone serum level may be observed, demonstrating that reduced parathyroid hyperplastic tissue may still be associated with severe secondary hyperparathyroidism. Even if calcimimetics are very effective in secondary hyperparathyroidism treatment, further studies are necessary for a better understanding of their actions.

  10. Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy

    Directory of Open Access Journals (Sweden)

    Francesco Tonelli

    2012-01-01

    Full Text Available Usually, primary hyperparathyroidism is the first endocrinopathy to be diagnosed in patients with multiple endocrine neoplasia type 1, and is also the most common one. The timing of the surgery and strategy in multiple endocrine neoplasia type 1/hyperparathyroidism are still under debate. The aims of surgery are to: 1 correct hypercalcemia, thus preventing persistent or recurrent hyperparathyroidism; 2 avoid persistent hypoparathyroidism; and 3 facilitate the surgical treatment of possible recurrences. Currently, two types of surgical approach are indicated: 1 subtotal parathyroidectomy with removal of at least 3-3 K glands; and 2 total parathyroidectomy with grafting of autologous parathyroid tissue. Transcervical thymectomy must be performed with both of these procedures. Unsuccessful surgical treatment of hyperparathyroidism is more frequently observed in multiple endocrine neoplasia type 1 than in sporadic hyperparathyroidism. The recurrence rate is strongly influenced by: 1 the lack of a pre-operative multiple endocrine neoplasia type 1 diagnosis; 2 the surgeon's experience; 3 the timing of surgery; 4 the possibility of performing intra-operative confirmation (histologic examination, rapid parathyroid hormone assay of the curative potential of the surgical procedure; and, 5 the surgical strategy. Persistent hyperparathyroidism seems to be more frequent after subtotal parathyroidectomy than after total parathyroidectomy with autologous graft of parathyroid tissue. Conversely, recurrent hyperparathyroidism has a similar frequency in the two surgical strategies. To plan further operations, it is very helpful to know all the available data about previous surgery and to undertake accurate identification of the site of recurrence.

  11. Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study.

    Science.gov (United States)

    Xu, Jingyuan; Peng, Xiao; Pan, Chun; Cai, Shixia; Zhang, Xiwen; Xue, Ming; Yang, Yi; Qiu, Haibo

    2017-12-01

    Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO 2 ) in the critically ill patients. This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure 40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output 4 mmol/l, for less than 24 h in the absence of a contraindication for fluids were eligible to participate in the study. PtcO 2 was continuously recorded before and during a passive leg raising (PLR) test, and then before and after a 250 ml rapid saline infusion in 10 min. Fluid responsiveness is defined as a change in the stroke volume ≥10% after 250 ml of volume infusion. Thirty-four patients were included, and 14 responded to volume expansion. In the responders, the mean arterial pressure, central venous pressure, cardiac output, stroke volume and PtcO 2 increased significantly, while the heart rate decreased significantly by both PLR and volume expansion. Changes in the stroke volume induced either by PLR or volume expansion were significantly greater in responders than in non-responders. The correlation between the changes in PtcO 2 and stroke volume induced by volume expansion was significant. Volume expansion induced an increase in the PtcO 2 of 14% and PLR induced an increase in PtcO 2 of 13% predicted fluid responsiveness. This study suggested the changes in PtcO 2 induced by volume expansion and a PLR test predicted fluid responsiveness in critically ill patients. Trial registration NCT02083757.

  12. An update on implant placement and provisionalization in extraction, edentulous, and sinus-grafted sites. A clinical report on 3200 sites over 8 years.

    Science.gov (United States)

    Petrungaro, Paul S

    2008-06-01

    Provisionalization of dental implants at placement has become more prominent in the field of implantology over the past several years, especially in the esthetic zone. The benefits of this treatment option include immediate tooth replacement, formation and maintenance of esthetic soft-tissue contours, containment for bone-grafting and tissue-regenerative procedures, and an improved sense of the patient's perception of the implant process. The blending together of the surgical and prosthetic/esthetic phase has never been more important as implant systems, abutment options, and surgical techniques have helped optimize procedures that can be accomplished at the surgical visit. This article reviews the guidelines for surgical success first described by the author in 2003 and expands upon those results. This article highlights the results of more than 3200 immediately restored implants placed in edentulous, fresh extraction sockets, and sinus-grafted sites, over an 8-year period, and presents a case for each area of placement.

  13. Association between socioeconomic and health factors and edentulism in people aged 65 and older - a population-based survey.

    Science.gov (United States)

    Olofsson, Hanna; Ulander, Eva Lena; Gustafson, Yngve; Hörnsten, Carl

    2017-08-01

    To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland. In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study ( n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism. The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden ( p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas ( p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds ( p < 0.001), and was 23.8% in women, compared with 27% in men ( p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31-3.58), low income level (OR 1.7, CI 1.09-1.47), residence in a rural area (OR 1.43, CI 1.23-1.66), male sex (OR 1.30, CI 1.12-1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25-1.74), social isolation (OR 1.52, CI 1.17-1.98) and poor self-experienced health (OR 1.38, CI 1.17-1.62). One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.

  14. Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

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    Schneider Peter

    2010-07-01

    Full Text Available Abstract Background and aims There still is a lack of prospective studies on bone mineral development in patients with a history of early onset Anorexia nervosa (AN. Therefore we assessed associations between bone mass accrual and clinical outcomes in a former clinical sample. In addition to an expected influence of regular physical activity and hormone replacement therapy, we explored correlations with nutritionally dependent hormones. Methods 3-9 years (mean 5.2 ± 1.7 after hospital discharge, we re-investigated 52 female subjects with a history of early onset AN. By means of a standardized approach, we evaluated the general outcome of AN. Moreover, bone mineral content (BMC and bone mineral density (BMD as well as lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA. In a substudy, we measured the serum concentrations of leptin and insulin-like growth factor-I (IGF-I. Results The general outcome of anorexia nervosa was good in 50% of the subjects (BMI ≥ 17.5 kg/m2, resumption of menses. Clinical improvement was correlated with BMC and BMD accrual (χ2 = 5.62/χ2 = 6.65, p = 0.06 / p = 0.036. The duration of amenorrhea had a negative correlation with BMD (r = -.362; p th percentile. IGF-I serum concentrations corresponded to the general outcome of AN. By contrast, leptin serum concentrations showed great variability. They correlated with BMC and current body composition parameters. Conclusions Our results from the main study indicate a certain adaptability of bone mineral accrual which is dependent on a speedy and ongoing recovery. While leptin levels in the substudy tended to respond immediately to current nutritional status, IGF-I serum concentrations corresponded to the individual's age and general outcome of AN.

  15. Increased detection of lymphatic vessel invasion by D2-40 (podoplanin) in early breast cancer: possible influence on patient selection for accelerated partial breast irradiation.

    NARCIS (Netherlands)

    Debald, M.; Polcher, M.; Flucke, U.E.; Walgenbach-Brunagel, G.; Walgenbach, K.J.; Holler, T.; Wolfgarten, M.; Rudlowski, C.; Buttner, R.; Schild, H.; Kuhn, W.; Braun, M.

    2010-01-01

    PURPOSE: Several international trials are currently investigating accelerated partial breast irradiation (APBI) for patients with early-stage breast cancer. According to existing guidelines, patients with lymphatic vessel invasion (LVI) do not qualify for APBI. D2-40 (podoplanin) significantly

  16. Meta-analysis of the risk of gastric stump cancer: detection of high risk patient subsets for stomach cancer after remote partial gastrectomy for benign conditions

    NARCIS (Netherlands)

    Tersmette, A. C.; Offerhaus, G. J.; Tersmette, K. W.; Giardiello, F. M.; Moore, G. W.; Tytgat, G. N.; Vandenbroucke, J. P.

    1990-01-01

    Controversy about gastric cancer risk after partial gastrectomy exists, especially in the United States. Therefore, we performed a meta-analysis to determine overall relative risk and weighted mean relative risk for subsets of postgastrectomy patients, define possible high risk patients suitable for

  17. Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws.

    Science.gov (United States)

    Carlsson, Gunnar E

    2014-08-01

    To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

  18. Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws

    Science.gov (United States)

    2014-01-01

    PURPOSE To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results. PMID:25177466

  19. Impaired expression of mitochondrial and adipogenic genes in adipose tissue from a patient with acquired partial lipodystrophy (Barraquer-Simons syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Guallar Jordi P

    2008-08-01

    Full Text Available Abstract Introduction Acquired partial lipodystrophy or Barraquer-Simons syndrome is a rare form of progressive lipodystrophy. The etiopathogenesis of adipose tissue atrophy in these patients is unknown. Case presentation This is a case report of a 44-year-old woman with acquired partial lipodystrophy. To obtain insight into the molecular basis of lipoatrophy in acquired partial lipodystrophy, we examined gene expression in adipose tissue from this patient newly diagnosed with acquired partial lipodystrophy. A biopsy of subcutaneous adipose tissue was obtained from the patient, and DNA and RNA were extracted in order to evaluate mitochondrial DNA abundance and mRNA expression levels. Conclusion The expression of marker genes of adipogenesis and adipocyte metabolism, including the master regulator PPARγ, was down-regulated in subcutaneous adipose tissue from this patient. Adiponectin mRNA expression was also reduced but leptin mRNA levels were unaltered. Markers of local inflammatory status were unaltered. Expression of genes related to mitochondrial function was reduced despite unaltered levels of mitochondrial DNA. It is concluded that adipogenic and mitochondrial gene expression is impaired in adipose tissue in this patient with acquired partial lipodystrophy.

  20. Prospective clinical study of prosthetic treatment outcome of implantretained-removable-partial-denture during 5 year-follow-ups

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    Mehran Bahrami

    2017-11-01

    Full Text Available Background IRRPD offers patients the ability to upgrade their treatment planning to implant-supported-overdentures (ISOs or implant-supported-fixed-prostheses (ISFPs through insertion of more implants in the future after the loss of the remaining natural teeth. Aims The purpose of this prospective-clinical-study was to evaluate the success rate and treatment outcome of IRRPD for 15 patients, during at least 5-year-follow-ups after prosthetic rehabilitation with respect to implant mobility, peri-implant-marginal-bone-levels, and prosthetic complications. Methods 15 successive patients were attended the Department of Implantology and Prosthodontics in TUMS, and received Implant-Retained-Removable-Partial-Dentures (IRRPDs. Two standard-size-dental-implants (Implantium/Dentium system, internal hexagon, Seoul, South Korea were placed in distal-extension-areas for each patient. After the osseointegration period, all patients received IRRPDs using two Ball attachments. All the participated patients were followed-up at least for 5 years, and the survival rate of 30 implants was evaluated. The patients’ satisfaction of function, phonetics, and aesthetics was assessed by means of questionnaire. Results None of the studied patients reported any prosthetic complications during the follow-up-periods such as attachment loosening, metal housing loosening, or denture fracture. No implants failure was recorded, so that the cumulative-implant-survival rate was 100 per cent. The mean marginal-bone-resorption (MBR around the two implants was 0.9mm with a range of 0.5–1.4mm. Teeth aesthetics was judged as excellent or very good by 86.7 per cent of the patients, while phonetics and mastication were considered excellent or very good by 66.7 per cent and 73.3 per cent of the patients, respectively. Conclusion 15 patients received 30 implants for the fabrication of IRRPDs in the posterior-edentulous-sites. The IRRPDs were delivered to the patients by the same

  1. Partial spleen embolization reduces the risk of portal hypertension-induced upper gastrointestinal bleeding in patients not eligible for TIPS implantation.

    Science.gov (United States)

    Buechter, Matthias; Kahraman, Alisan; Manka, Paul; Gerken, Guido; Dechêne, Alexander; Canbay, Ali; Wetter, Axel; Umutlu, Lale; Theysohn, Jens M

    2017-01-01

    Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting. We retrospectively analyzed 9 patients with PH-induced UGIB who underwent partial SE between 2012 and 2016. All patients met the following criteria: (i) upper gastrointestinal hemorrhage with primary or secondary failure of endoscopic interventions and (ii) TIPS implantation not possible. Each patient was followed for at least 6 months after embolization. Five patients (56%) suffered from cirrhotic PH, 4 patients (44%) from non-cirrhotic PH. UGIB occured in terms of refractory hemorrhage from gastric varices (3/9; 33%), hemorrhage from esophageal varices (3/9; 33%), and finally, hemorrhage from portal-hypertensive gastropathy (3/9; 33%). None of the patients treated with partial SE experienced re-bleeding episodes or required blood transfusions during a total follow-up time of 159 months, including both patients with cirrhotic- and non-cirrhotic PH. Partial SE, as a minimally invasive intervention with low procedure-associated complications, may be a valuable alternative for patients with recurrent PH-induced UGIB refractory to standard therapy.

  2. Effects of Partially Ionised Medical Oxygen, Especially with O2•−, in Vibration White Finger Patients

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    Slavomír Perečinský

    2014-05-01

    Full Text Available A major symptom of hand-arm vibration syndrome is a secondary Raynaud’s phenomenon—vibration white finger (VWF—which results from a vasospasm of the digital arteries caused by work with vibration devices leading to occupational disease. Pharmacotherapy of VWF is often ineffective or has adverse effects. The aim of this work was to verify the influence of inhalation of partially ionized oxygen (O2•− on peripheral blood vessels in the hands of patients with VWF. Ninety one (91patients with VWF underwent four-finger adsorption plethysmography, and the pulse wave amplitude was recorded expressed in numeric parameters—called the native record. Next, a cold water test was conducted following with second plethysmography. The patients were divided in to the three groups. First and second inhaled 20-min of ionized oxygen O2•− or oxygen O2 respectively. Thirth group was control without treatment. All three groups a follow-up third plethysmography—the post-therapy record. Changes in the pulse wave amplitudes were evaluated. Inpatients group inhaling O2•− a modest increase of pulse wave amplitude was observed compared to the native record; patients inhaling medical oxygen O2 and the control showed a undesirable decline of pulse wave amplitude in VWF fingers. Strong vasodilatation were more frequent in the group inhaling O2•− compare to O2 (p < 0.05. Peripheral vasodilatation achieved by inhalation of O2•− could be used for VWF treatment without undesirable side effect in hospital as well as at home environment.

  3. Proposal of early retreatment with iloprost in partially responsive patients with bone marrow edema syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Simone Meini

    2012-12-01

    Full Text Available Background Avascular Necrosis (AVN is defined as the cellular death of bone components due to an alteration of the blood supply, resulting in Edema of the Bone Marrow (BME, structural collapse and bone destruction. In advanced stages, AVN requires surgery. One emerging medical treatment for supporting osseous perfusion is the administration of iloprost.Materials and methods A 38-year-old woman presented with severe BME of the left hip (primary, persisting for 6 weeks. She was treated with iloprost iv at 2 ng/kg/min for 6 hours/day for 5 days, and after 4 weeks, the treatment was repeated at 1.5 ng/kg/min for 6 hours for 5 days because she exhibited only a partial response to the first treatment. Complete remission was obtained, documented clinically and on Magnetic Resonance Imaging (MRI. Her Harris Hip Score (HHS increased from 29.90 to 97. No significant adverse events related to iloprost were registered. No surgical procedures were necessary.Conclusions In most cases, iloprost is administered in a single cycle of treatment over 5 days at 1-2 ng/kg/min for 6 hours/day, but no research has investigated the effectiveness of early retreatment after the first cycle results in only a partially response. Only a few studies examining small numbers of patients have evaluated iloprost in AVN/BME, preferring, in most cases, the dose of 1 ng/kg/min and obtaining clinical improvement both in BME and in AVN in times comparable to surgical core decompression. This case report demonstrates the safety and effectiveness of early repetition of the maximal dose of iloprost before BME evolves into AVN, as well as in cases initially appearing serious and requiring surgical procedures.

  4. Five-year outcome of a retrospective cohort study on the rehabilitation of completely edentulous atrophic maxillae with immediately loaded zygomatic implants placed extra-maxillary.

    Science.gov (United States)

    Maló, Paulo; Nobre, Miguel de Araújo; Lopes, Armando; Ferro, Ana; Moss, Steven

    2014-01-01

    To report retrospectively on the 5-year follow-up results of the rehabilitation of complete edentulous atrophied maxillae, using extra-maxillary zygomatic implants alone or in combination with conventional implants. This retrospective report includes an initial cohort of 39 patients (30 women and 9 men), with a mean age of 53 years, followed for 5 years. The patients were rehabilitated with 39 fixed prostheses and 169 implants (92 zygomatic implants inserted extra-maxillary and 77 conventional dental implants). A provisional prosthesis was manufactured and attached via multiunit abutments secured to the implants on the same day as implant placement. According to patient desires and each clinical situation, either an acrylic resin, a metal-acrylic or metal-ceramic final prosthesis was inserted approximately 6 months after implant placement. Outcome measures were: prosthesis success; implant success; complications; probing pocket depths; marginal bleeding; and marginal bone levels (only for conventional implants). Data were analysed with descriptive statistics. Two patients died after 8 and 30 months of follow-up due to causes unrelated to their oral rehabilitations, and 5 patients dropped out of the study. No prosthesis was lost; one zygomatic implant was removed after 46 months of follow-up, giving cumulative success rates of 97% and 98.8% (patient and implant related, respectively). Twelve complications occurred in 12 patients: 5 sinus infections in 5 patients, all with a previous history of sinusitis and whose sinus membrane was disrupted during surgery; one oroantral communication (leading to removal of the implant), 2 all acrylic resin prostheses fractures, 1 ceramic crown fracture (on a metal-ceramic prosthesis); and 3 screw loosenings. Bleeding on probing was recorded in 6 patients (13 implants). Probing pocket depths >4 mm were present in 13 patients (23 implants) at 5 years of follow-up. The average (standard deviation) marginal bone loss on conventional

  5. Partial response to sorafenib treatment associated with transient grade 3 thrombocytopenia in a patient with locally advanced thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pitoia Fabian; Abelleira, Erika; Jerkovich, Fernando; Urciuoli, Carolina; Cross, Graciela, E-mail: fpitoia@intramed.net [Division de Endocrinologia, Hospital de Clinicas, Universidad de Buenos Aires Buenos Aires (Argentina)

    2015-08-15

    Advanced radioactive refractory and progressive or symptomatic differentiated thyroid carcinoma (DTC) is a rare condition. Sorafenib was recently approved for the treatment of these patients. We present the case of a 67 year old woman diagnosed with DTC who underwent a total thyroidectomy with central, lateral-compartment neck dissection and shaving of the trachea and esophagus due to tumor infiltration. A local recurrence was detected 14 months later requiring, additionally, two tracheal rings resection. The patient received a cumulative {sup 131}I dose of 650 mCi and developed dysphagia and dyspnea 63 months after initial surgery. A {sup 18}FGD-PET/CT showed progression of the local mass associated to hypermetabolic pulmonary nodules. Sorafenib 800 mg/day was then prescribed. A dose reduction to 400 mg/day was necessary due to grade 3 thrombocytopenia that appeared four months after drug prescription. Platelet count went to normal after this dose reduction. Five months after initiation of sorafenib, a partial response of the local mass with significant intra-tumoral necrosis was observed. We conclude that sorafenib is a valid option for locally advanced DTC and that the platelet count should be evaluated regularly because it seems that thrombocytopenia might be more frequently observed in DTC than in other types of tumors. (author)

  6. Raised urinary glucocorticoid and adrenal androgen precursors in the urine of young hypertensive patients: possible evidence for partial glucocorticoid resistance

    Science.gov (United States)

    Shamim, W; Yousufuddin, M; Francis, D; Gualdiero, P; Honour, J; Anker, S; Coats, A

    2001-01-01

    OBJECTIVE—To evaluate urinary glucocorticoid excretion profiles in a cohort of recently diagnosed young hypertensive patients.
METHODS—After excluding patients with secondary causes, 60 individuals with premature hypertension were recruited (diagnosed by ambulatory blood pressure monitoring before the age of 36 years). In addition, 30 older hypertensive controls (age of onset > 36 years, "middle aged hypertensive controls"), and 30 normal controls (age matched to the young hypertensive group) were studied. All provided 24 hour urine collections for mass spectrometry for total cortisol metabolites and total androgen metabolites by gas chromatography.
RESULTS—Among male patients, those with premature hypertension had higher total urinary excretion of cortisol metabolites (mean (SD), 13 332 (6472) µg/day) than age matched normal controls (7270 (1788) µg/day; p = 0.00001) or middle aged hypertensive controls (8315 (3565) µg/day; p = 0.002). A similar increase was seen among the female patients, although the absolute concentrations were lower. There was no significant difference between middle aged hypertensive patients and normal controls. Urinary total androgen excretion profiles in female patients also showed an unusual increase in the premature hypertension group (2958 (1672) µg/day) compared with the other groups (middle aged hypertensive controls, 1373 (748) µg/day, p = 0.0003; normal controls, 1687 (636) µg/day, p = 0.002). In all subjects, serum sodium and creatinine concentrations were within the normal range; serum potassium concentrations were found to be low before the start of treatment.
CONCLUSIONS—Individuals presenting with premature hypertension have an abnormally high excretion of glucocorticoid metabolites in the urine. While the mechanism remains uncertain, these findings are compatible with partial resistance of the glucocorticoid receptors, with a compensatory increase in cortisol and androgen

  7. Implant-tooth-supported fixed partial prostheses: correlations between in vivo occlusal bite forces and marginal bone reactions.

    Science.gov (United States)

    Akça, Kivanç; Uysal, Serdar; Cehreli, Murat Cavit

    2006-06-01

    To evaluate maximal occlusal bite forces (MOF) and marginal bone level (MBL) changes in patients with implant-tooth-supported fixed partial prostheses (FPP). Twenty nine partially edentulous patients consecutively who received 34 three-occlusal unit FPP with terminal implant and tooth support were subjected to quantification of MOFs using a sub-miniature load cell connected to a data acquisition system and measurement of the MBL changes around implants in digitalized periapical radiographs obtained at prostheses delivery and 24-month follow-up. MOFs for implant support (mean: 353.61 N) significantly differed from tooth support (mean: 275.48 N) (P 0.05). MBL changes at mesial and distal sites of the implants at 24 months of functional loading were 0.28 and 0.097 mm respectively. Although MOFs under functional loading might indicate an increase in load participation for supporting implant, the rigid connection between implant and natural tooth via three-occlusal unit FPP does not jeopardize the time-dependent MBL stability of the implant under functional loads.

  8. Long-term evaluation of immediately loaded implants in the edentulous mandible using fixed bridges and platform shifting.

    Science.gov (United States)

    Romanos, Georgios E; Gaertner, Kathrin; Nentwig, Georg H

    2014-08-01

    The immediate loading concept has been extensively documented in the anterior part of the mandible when six primary stable implants are placed, splinted with a fixed prosthesis. The aim of this study was to evaluate the long-term success of immediately occlusal loaded implants with a progressive thread design and platform shifting in the edentulous mandible. Seventy-eight implants placed in 13 patients and were connected with their abutments immediately after surgery. The implants were splinted using a fixed temporary restoration having occlusal contacts in the centric and group function in the lateral movements of the mandible (immediate occlusal loading). The patients were advised to use soft/liquid diet for the first 6 to 8 weeks of healing in order to reduce excessive loading in the bone-to-implant interface. Abutment level impressions were taken without removing the abutments in order to fabricate the final prostheses. The final restorations were delivered 4 to 8 weeks after surgery and cemented temporarily in order to evaluate the peri-implant soft tissue condition at the different time intervals after removal of the restoration. Clinical stability and radiological indices were evaluated at the start of loading, at 3-month interval after loading, and then annually. After a mean loading period of 75.29 (± 38.18) months, no implant was lost (100% success rate). All clinical indices had values in normal levels. The Periotest values demonstrated a continuous reduction, representing high stability. The crestal bone level was relatively stable and only minimal crestal bone loss was observed in some implants. Long-term success and stability of the peri-implant tissues around immediately loaded mandibular implants are expected when implants with platform shifting are restored with bridges without abutment removal. © 2013 Wiley Periodicals, Inc.

  9. [Dual insertion paths design characteristics and short-term clinical observation of rotational path removable partial dentures].

    Science.gov (United States)

    Li, Jian; Jiang, Ting; Li, Sai; Chen, Wei

    2013-02-18

    To investigate design methods of dual insertion paths and observe a short-term clinic overview of rotational path removable partial dentures (RPDs). In the study, 40 patients with partial edentulous arches were included and divided into two groups. The patients in group one were restored with rotational path RPDs (10 Kennedy class III and 10 Kennedy class IV respectively). The patients in group two (20 patients), whose edentulous area was matched with the patients' in group one, were restored with the linear path RPDs. After surveying and simulative preparation on diagnostic casts, the basic laws of designing rotational path RPDs were summarized. The oral preparation was accurately performed under the guidance of indices made on diagnostic casts after simulative preparation. The 40 dentures were recalled two weeks and one year after the insertion. The evaluations of the clinic outcome, including retention, stability, mastication function, esthetics and wearing convenience, were marked out as good, acceptable, and poor. The comparison of the evaluation results was performed between the two groups. In the rotational path design for Kennedy class III or IV RPDs, the angles (α) of dual insertion paths should be designed within a scope, approximate 10°-15°.When the angle (α) became larger, the denture retention turned to be better, but accordingly the posterior abutments needed more preparation. In the clinical application, the first insertions of the 40 dentures were all favorably accomplished. When the rotational path RPDs were compared to linear path RPDs, the time consuming on first insertion had no statistical difference[(32±8) min and (33±8) min respectively, P>0.05]. Recalled two weeks and one year after the insertion, in the esthetics evaluation, 20 rotational path RPDs were all evaluated as "A", but only 7(two weeks after) and 6 (one year after) linear path RPDs were evaluated as "A"(P<0.05). There was no significant difference in other evaluation results

  10. Impact of ictal/postictal regional cerebral blood flow patterns on the management of patients with complex partial seizures

    International Nuclear Information System (INIS)

    Borbely, K.; Toth, M.; Solyom, A.; Balogh, A.; Juhos, V.; Neuwirth, M.; Halasz, P.

    2002-01-01

    Aims: RCBF SPECT has been proved to be a sensitive and specific method in the pre-surgical evaluation of patients with complex partial seizures (CPS). Ictal minus interictal rCBF analysis is a routine part in the assessment of epileptogenic foci. During ictal/postictal rCBF studies changes might appear not only in the epileptogenic area. The precise note of the time of the tracer injection for SPECT is the key in interpreting the brain perfusion changes. We studied ictal/postictal rCBF patterns in the brain tissue within, adjacent to, and remote from the epileptogenic foci in 64 patients with CPS. Methods: The assessment included neurological examination, ictal semiology, interictal and ictal electrophysiological recording, MRI, and neuropsychological evaluation. Baseline, ictal and/or postictal SPECT studies were carried out with a standard technique for each patient. SPECT data were analysed visually and by a special region of interests (ROIs) program. Circular ROIs were placed over the basal ganglia, thalamus, frontal, temporal, parietal, occipital cortex, and cerebellum. ROIs were normalized to the whole brain average. The statistical analysis was considered significant at P<0.05. MRI was positive in 46 patients, while in 18 cases there were no abnormalities. SPECT results were compared to electrophysiological and surgical findings. Results: The baseline SPECT demonstrated a significant hypoperfusion (P<0.05) in the epileptogenic area (EA) in 37/64 (57.81%) cases. 54/64 (84.38%) of the ictal studies showed a marked hyperperfusion (P<0.005) in the EA with low cerebellar tracer uptake (P<0.05). In 26/64 (40.63%) patients the early postictal studies demonstrated moderate or high tracer uptake in the EA (P<0.05) with diffuse perfusion abnormalities in the surrounding tissue. Late postictal studies (14/64, 21.88%) showed hypoperfusion (P<0.05) in the EA with moderate or high tracer uptake in the surrounding tissue. The results of the ictal/postictal studies

  11. Oral health-related quality of life in patients treated by implant-supported fixed dentures and removable partial dentures.

    Science.gov (United States)

    Furuyama, Chisako; Takaba, Masayuki; Inukai, Mika; Mulligan, Roseann; Igarashi, Yoshimasa; Baba, Kazuyoshi

    2012-08-01

    This study investigated the association between denture status [implant-supported fixed dentures (IDs) and removable partial dentures (RPDs)] and oral health-related quality of life (OHRQoL). Consecutive patients with IDs and RPDs were recruited from the Prosthodontics Departments at Showa University and Tokyo Medical and Dental University. The Japanese version of the Oral Health Impact Profile (OHIP-J-49) was administered to each subject. For each OHIP-J-49 question, the subjects were asked to indicate the frequency with which they had experienced a dental problem during the last month. Responses were recorded on a 5 point Likert rating scale, with 0 being never and 4, very often. Summary scores were calculated and regression analyses conducted to investigate the association between denture status and OHIP-J-49 summary score. In total 79 ID subjects (mean age±SD of 51.7±12.4 years, 44.3% men) and 109 RPD subjects (mean age of 66.5±8.6 years, 30% men) participated after giving informed consent. The regression analysis between the type of treatment and the OHIP-J-49 summary score revealed a significant association with a coefficient of 17.0 (Confidence interval, CI: 10.9-23.1). When age and duration of denture usage, which had significant associations with OHIP-J-49, were included in this model, the regression coefficient remained virtually unchanged at 17.4 (CI: 9.75-25.0), thus indicating little potential confounding by them. OHRQoL in patients with implant-supported fixed dentures is generally less impaired than it is in those patients with RPDs. © 2011 John Wiley & Sons A/S.

  12. Comparison of Dose Distributions With TG-43 and Collapsed Cone Convolution Algorithms Applied to Accelerated Partial Breast Irradiation Patient Plans

    Energy Technology Data Exchange (ETDEWEB)

    Thrower, Sara L., E-mail: slloupot@mdanderson.org [The University of Texas Graduate School of Biomedical Sciences at Houston, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F.; Bloom, Elizabeth [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Salehpour, Mohammad; Gifford, Kent [Department of Radiation Physics, The University of Texas Graduate School of Biomedical Sciences at Houston, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-08-01

    Purpose: To compare the treatment plans for accelerated partial breast irradiation calculated by the new commercially available collapsed cone convolution (CCC) and current standard TG-43–based algorithms for 50 patients treated at our institution with either a Strut-Adjusted Volume Implant (SAVI) or Contura device. Methods and Materials: We recalculated target coverage, volume of highly dosed normal tissue, and dose to organs at risk (ribs, skin, and lung) with each algorithm. For 1 case an artificial air pocket was added to simulate 10% nonconformance. We performed a Wilcoxon signed rank test to determine the median differences in the clinical indices V90, V95, V100, V150, V200, and highest-dosed 0.1 cm{sup 3} and 1.0 cm{sup 3} of rib, skin, and lung between the two algorithms. Results: The CCC algorithm calculated lower values on average for all dose-volume histogram parameters. Across the entire patient cohort, the median difference in the clinical indices calculated by the 2 algorithms was <10% for dose to organs at risk, <5% for target volume coverage (V90, V95, and V100), and <4 cm{sup 3} for dose to normal breast tissue (V150 and V200). No discernable difference was seen in the nonconformance case. Conclusions: We found that on average over our patient population CCC calculated (<10%) lower doses than TG-43. These results should inform clinicians as they prepare for the transition to heterogeneous dose calculation algorithms and determine whether clinical tolerance limits warrant modification.

  13. Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wobb, Jessica L. [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Chen, Peter Y., E-mail: PChen@beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Shah, Chirag [Department of Radiation Oncology, Summa Health System, Akron, Ohio (United States); Moran, Meena S. [Department of Therapeutic Radiology, Yale School of Medicine, Norwich, Connecticut (United States); Shaitelman, Simona F. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Vicini, Frank A. [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington, Michigan (United States); Mbah, Alfred K.; Lyden, Maureen [Biostat International Inc, Tampa, Florida (United States); Beitsch, Peter [Department of Surgery, Dallas Breast Center, Dallas, Texas (United States)

    2015-02-01

    Purpose: To develop a nomogram taking into account clinicopathologic features to predict locoregional recurrence (LRR) in patients treated with accelerated partial-breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: A total of 2000 breasts (1990 women) were treated with APBI at William Beaumont Hospital (n=551) or on the American Society of Breast Surgeons MammoSite Registry Trial (n=1449). Techniques included multiplanar interstitial catheters (n=98), balloon-based brachytherapy (n=1689), and 3-dimensional conformal radiation therapy (n=213). Clinicopathologic variables were gathered prospectively. A nomogram was formulated utilizing the Cox proportional hazards regression model to predict for LRR. This was validated by generating a bias-corrected index and cross-validated with a concordance index. Results: Median follow-up was 5.5 years (range, 0.9-18.3 years). Of the 2000 cases, 435 were excluded because of missing data. Univariate analysis found that age <50 years, pre-/perimenopausal status, close/positive margins, estrogen receptor negativity, and high grade were associated with a higher frequency of LRR. These 5 independent covariates were used to create adjusted estimates, weighting each on a scale of 0-100. The total score is identified on a points scale to obtain the probability of an LRR over the study period. The model demonstrated good concordance for predicting LRR, with a concordance index of 0.641. Conclusions: The formulation of a practical, easy-to-use nomogram for calculating the risk of LRR in patients undergoing APBI will help guide the appropriate selection of patients for off-protocol utilization of APBI.

  14. Evaluation of the evoked brain potentials of patients with asthenia and anxiety symptoms and the partial loss of sight

    Directory of Open Access Journals (Sweden)

    Tsira Abdryakhimova

    2017-03-01

    Full Text Available Background. Loss of sight, even partial, especially in adulthood, is accompanied by emotional, motivational and social consequences that directly affect the psychophysiological state of the individual himself, his communication in society and, often, the social status of the subject.  Methods. From the group of patients-volunteers (n=15 with a partial loss of sight of traumatic genesis two groups were formed for carrying out neurophysiological studies: with predominant asthenia and predominant anxiety. The controle group (CG constisted from patients of the same age (n=20 without psychiatric comorbidity. A study of acoustic event-related potentials of the brain (ERP was carried out in the oddball paradigm with the recording of the time and correctness of a simple sensorimotor reaction. Results. Comparative analysis of the asthenia group with the comparison group revealed a sufficient number of indicators of the ERP, which have significant statistical differences. The correctness of the sensorimotor reaction in this group was 98.3 ± 2.44%, whereas in the CG - 92.5 ± 5.74% (U [15; 20] = 62.5, p <0.01. The values of the amplitude of the early positivity of P1 in the asthenia group were 4.25 ± 3.312 μV, and in the CG -4.15 ± 7.933 μV (U [15, 20] = 50, p <0.001. The early negativity in that group was -2.78 ± 2.377 μV, and in the CG it was 10.55 ± 7.466 μV (U [15; 20] = 75; p <0.05.  Conclusion. In the asthenia group this is the correctness of the sensorimotor reaction and the amplitude of the components: P1, N1, P2, N2. In the anxiety group, such indicators were: latency period P1, intervals P1N1 and N2P3, amplitude swing P1N1. A specific marker of the asthenia group, distinguishing it from the CG, was the more positive values of the amplitude of the components P1, N1, P2, N2. Taking into account the low-frequency nature of the modulation of the amplitudes of these components (circa 2 Hz, it can be assumed that nonspecific brainstem

  15. Successful removable partial dentures.

    Science.gov (United States)

    Lynch, Christopher D

    2012-03-01

    Removable partial dentures (RPDs) remain a mainstay of prosthodontic care for partially dentate patients. Appropriately designed, they can restore masticatory efficiency, improve aesthetics and speech, and help secure overall oral health. However, challenges remain in providing such treatments, including maintaining adequate plaque control, achieving adequate retention, and facilitating patient tolerance. The aim of this paper is to review the successful provision of RPDs. Removable partial dentures are a successful form of treatment for replacing missing teeth, and can be successfully provided with appropriate design and fabrication concepts in mind.

  16. A study of the emotional effects of tooth loss in an edentulous Gujarati population and its association with depression

    Directory of Open Access Journals (Sweden)

    Rupal J Shah

    2015-01-01

    Conclusion: About 58% of edentulous people had difficulties accepting tooth loss, which was unrelated to denture satisfaction. Respondents appeared to be restricted in social activities mainly due to functional limitations. Those with difficulties accepting tooth loss were more likely to experience depression.

  17. Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly : a cross-sectional study

    NARCIS (Netherlands)

    Hoeksema, A. R.; Spoorenberg, S. L. W.; Peters, L. L.; Meijer, H. J. A.; Raghoebar, G. M.; Vissink, A.; Wynia, K.; Visser, A.

    ObjectiveTo assess oral status and self-reported oral health in community-living elderly and to determine differences between relevant subgroups of oral status (remaining teeth, edentulous, implant-retained overdentures) and case complexity (robust, frail, complex care needs). Subjects and methodsIn

  18. Quality of life in patients after total pancreatectomy is comparable with quality of life in patients who undergo a partial pancreatic resection.

    Science.gov (United States)

    Epelboym, Irene; Winner, Megan; DiNorcia, Joseph; Lee, Minna K; Lee, James A; Schrope, Beth; Chabot, John A; Allendorf, John D

    2014-03-01

    patients who undergo a partial pancreatic resection. Copyright © 2014. Published by Elsevier Inc.

  19. Cholecystokinin (CCK) functional cholescintigraphic findings in patients with a partial cystic duct obstruction - the cystic duct syndrome (CDS)

    International Nuclear Information System (INIS)

    Fink-Bennett, D.; DeRidder, P.; Kolozsi, W.; Gordon, R.

    1984-01-01

    Fourteen patients (pts.) with a CDS underwent CCK functional cholescintigraphy (FC). All pts. presented with persistent post-prandial right upper quadrant pain and biliary colic. None had an abnormal OCG, gallbladder (GB) ultrasound exam or upper G.I. series. All had macro- or microscopically abnormal cystic ducts (5 fibrotic, 7 elongated and narrow, 2 kinked) with (12) or without (2) concomitant chronic cholecystitis. Each pt. (NPO after 12 A.M.) received 5 mCi of technetium (TC)-99m Hepatolite. When the GB max. filled, .02 ug/kg CCK was administered (3 min.) I.V. Background corrected GBEFs were determined q.5 min. x 4 by ratioing the pre-CCK GB cts. minus post-CCK GB cts. to pre-CCK GB cts. GB EFRs were: 3 (12%), 2 (17%), and 1 each 0%, 1.3%, 3%, 4%, 6%, 11%, 14%, 18.5% and 22%. No pt. with a partially occluded cystic duct with or without concomitant chronic cholecystitis had an ejection fraction that exceeded 22%. In an appropriate clinical setting, a low ejection fraction response to CCK should alert the physician to the presence of either chronic acalculous cholecystitis, CDS, or the combination of both

  20. Quadratic function between arterial partial oxygen pressure and mortality risk in sepsis patients: an interaction with simplified acute physiology score.

    Science.gov (United States)

    Zhang, Zhongheng; Ji, Xuqing

    2016-10-13

    Oxygen therapy is widely used in emergency and critical care settings, while there is little evidence on its real therapeutic effect. The study aimed to explore the impact of arterial oxygen partial pressure (PaO 2 ) on clinical outcomes in patients with sepsis. A large clinical database was employed for the study. Subjects meeting the diagnostic criteria of sepsis were eligible for the study. All measurements of PaO 2 were extracted. The primary endpoint was death from any causes during hospital stay. Survey data analysis was performed by using individual ICU admission as the primary sampling unit. Quadratic function was assumed for PaO 2 and its interaction with other covariates were explored. A total of 199,125 PaO 2 samples were identified for 11,002 ICU admissions. Each ICU stay comprised 18 PaO 2 samples in average. The fitted multivariable model supported our hypothesis that the effect of PaO 2 on mortality risk was in quadratic form. There was significant interaction between PaO 2 and SAPS-I (p = 0.007). Furthermore, the main effect of PaO 2 on SOFA score was nonlinear. The study shows that the effect of PaO 2 on mortality risk is in quadratic function form, and there is significant interaction between PaO 2 and severity of illness.

  1. Cancer-related fatigue in breast cancer patients after surgery: a multicomponent model using partial least squares-path modeling.

    Science.gov (United States)

    Bortolon, Catherine; Krikorian, Alicia; Carayol, Marion; Brouillet, Denis; Romieu, Gilles; Ninot, Gregory

    2014-04-01

    The aim of this study is to examine factors contributing to cancer-related fatigue (CRF) in breast cancer patients who have undergone surgery. Sixty women (mean age: 50.0) completed self-rated questionnaires assessing components of CRF, muscular and cognitive functions. Also, physiological and subjective data were gathered. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to CRF after breast surgery. The tested model was robust in terms of its measurement quality (reliability and validity). According to the structural model results, emotional distress (β = 0.59; p accounting for 61% of the explained variance. Also, emotional distress (β = 0.41; p accounted for 41% of the explained variance. However, the relationship between low physical function and CRF was weak and nonsignificant (β = 0.01; p > 0.05). Emotional distress, altered vigilance capacity, and pain are associated with CRF in postsurgical breast cancer. In addition, emotional distress and pain are related to diminished physical function, which, in turn, has no significant impact on CRF. The current model should be examined in subsequent phases of the treatment (chemotherapy and/or radiotherapy) when side effects are more pronounced and may lead to increased intensity of CRF and low physical function. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Load transfer characteristics of unilateral distal extension removable partial dentures with polyacetal resin supporting components.

    Science.gov (United States)

    Jiao, T; Chang, T; Caputo, A A

    2009-03-01

    To photoelastically examine load transfer by unilateral distal extension removable partial dentures with supporting and retentive components made of the lower stiffness polyacetal resins. A mandibular photoelastic model, with edentulous space distal to the right second premolar and missing the left first molar, was constructed to determine the load transmission characteristics of a unilateral distal extension base removable partial denture. Individual simulants were used for tooth structure, periodontal ligament, and alveolar bone. Three designs were fabricated: a major connector and clasps made from polyacetal resin, a metal framework as the major connector with polyacetal resin clasp and denture base, and a traditional metal framework I-bar removable partial denture. Simulated posterior bilateral and unilateral occlusal loads were applied to the removable partial dentures. Under bilateral and left side unilateral loading, the highest stress was observed adjacent to the left side posterior teeth with the polyacetal removable partial denture. The lowest stress was seen with the traditional metal framework. Unilateral loads on the right edentulous region produced similar distributed stress under the denture base with all three designs but a somewhat higher intensity with the polyacetal framework. The polyacetal resin removable partial denture concentrated the highest stresses to the abutment and the bone. The traditional metal framework I-bar removable partial denture most equitably distributed force. The hybrid design that combined a metal framework and polyacetal clasp and denture base may be a viable alternative when aesthetics are of primary concern.

  3. [The study of chronic partial denervation and quality of life in patients with motor neuron disease treated with semax].

    Science.gov (United States)

    Serdiuk, A V; Levitskiĭ, G N; Miasoedov, N F; Skvortsova, V I

    2007-01-01

    The study of chronic partial denervation (CPD) and quality of life was carried out in 27 patients with definite, probable and possible diagnosis of motor neuron disease (MND) treated with semax (1% solution). The needle electromyography (EMG) was performed thrice with short-term 2 month interval (60 days before enrollment and on day 1 and day 48 of the study) in three muscles on bulbar, cervical and lumbosacral levels on the less affected side. According to Revised El-Escorial Criteria (1998) the needle EMG for diagnostic purposes was also performed in two muscles on the cervical and lumbosacral levels on the more affected side along with stimulation electroneuronmyography of motor and sensory fibers of the peripheral nerves of neck, upper and lower extremities. The open-label clinical trial of Semax (1% solution) was conducted in sequential groups of patients. The drug was administered intranasally in two 10-day-long courses with 2-weeks break in daily dose of 12 mg. Sixty days before enrollment, and on days 1, 10, 24, 34 and 48, patients were assessed by the Norris ALS, the ALS Functioning Rating Scale and the ALSAQ-40 quality of life in the ALS scale. It was shown that CPD on the early as well as on the late stages was characterized by forward-backward, but not unidirectional course, that did not allow to recommend the follow-up needle EMG with short-term interval for evaluation of drug efficacy monitoring. Early CPD stages were characterized by forward-backwards fluctuations reflecting the compensatory reinnervation process (a phenomenon of exchange of muscle fibers, more rational in view of reinnervation, between adjacent motor units) whereas on the late CPD stages these forward-backwards CPD fluctuations reflected the processes of progressive deterioration of muscle fibers and secondary demyelination of large motor axons. Semax (1% solution) does not influence either the course of CPD or the dynamics of clinical estimates, in particular the terms of ensuing

  4. Decline in arterial partial pressure of oxygen after exercise: a surrogate marker of pulmonary vascular obstructive disease in patients with atrial septal defect and severe pulmonary hypertension.

    Science.gov (United States)

    Laksmivenkateshiah, Srinivas; Singhi, Anil K; Vaidyanathan, Balu; Francis, Edwin; Karimassery, Sundaram R; Kumar, Raman K

    2011-06-01

    To examine the utility of decline in arterial partial pressure of oxygen after exercise as a marker of pulmonary vascular obstructive disease in patients with atrial septal defect and pulmonary hypertension. Treadmill exercise was performed in 18 patients with atrial septal defect and pulmonary hypertension. Arterial blood gas samples were obtained before and after peak exercise. A decline in the arterial pressure of oxygen of more than 10 millimetres of mercury after exercise was considered significant based on preliminary tests conducted on the controls. Cardiac catheterisation was performed in all patients and haemodynamic data sets were obtained on room air, oxygen, and a mixture of oxygen and nitric oxide (30-40 parts per million). There were 10 patients who had more than a 10 millimetres of mercury drop in arterial partial pressure of oxygen after exercise and who had a basal pulmonary vascular resistance index of more than 7 Wood units per square metre. Out of eight patients who had less than a 10 millimetres of mercury drop in arterial partial pressure of oxygen after exercise, seven had a basal pulmonary vascular resistance index of less than 7 Wood units per square metre, p equals 0.0001. A decline in arterial partial pressure of oxygen of more than 10 millimetres of mercury predicted a basal pulmonary vascular resistance index of more than 7 Wood units per square metre with a specificity of 100% and a sensitivity of 90%. A decline in arterial partial pressure of oxygen following exercise appears to predict a high pulmonary vascular resistance index in patients with atrial septal defect and pulmonary hypertension. This test is a useful non-invasive marker of pulmonary vascular obstructive disease in this subset.

  5. Clinical Outcomes and Safety of Partial Full-Thickness Myotomy versus Circular Muscle Myotomy in Peroral Endoscopic Myotomy for Achalasia Patients

    Directory of Open Access Journals (Sweden)

    Chenyu Li

    2017-01-01

    Full Text Available Background. Here we aimed to evaluate and compare the efficacy and safety between partial full-thickness myotomy and circular muscle myotomy during POEM procedure in achalasia patients. Methods. Clinical data of achalasia of cardia (AC patients who underwent POEM in our center during January 2014 to January 2015 was collected (34 cases. 19 patients who received partial full-thickness myotomy were assigned to group A and 14 patients who received circular muscle myotomy were assigned to group B. The procedure-related parameters between the two groups were compared. Symptom relief rate and postprocedure manometry outcomes were compared to evaluate the efficacy. Procedure-related adverse events and complications were compared to evaluate the safety. Results. (1 Mean operation times were significantly shorter in group A than group B (62.42±23.17 vs 87.86±26.44 min, p0.05. (3 Comparison of procedure-related adverse events and complications had no statistical differences (all p>0.05. Conclusion. Partial full-thickness myotomy had no significant differences in efficacy or safety with circular myotomy, but partial full-thickness myotomy significantly reduced the procedure time.

  6. Better recovery of kidney function in patients with de novo chronic kidney disease after partial nephrectomy compared with those with pre-existing chronic kidney disease.

    Science.gov (United States)

    Takagi, Toshio; Kondo, Tsunenori; Iizuka, Junpei; Omae, Kenji; Kobayashi, Hirohito; Hashimoto, Yasunobu; Yoshida, Kazuhiko; Tanabe, Kazunari

    2014-06-01

    We compared kidney functional recovery between patients with pre-existing chronic kidney disease, those with de novo chronic kidney disease and those with normal kidney function, after partial nephrectomy. A total of 311 patients who underwent partial nephrectomy at Tokyo Women's Medical University Hospital, Tokyo, Japan, between January 2004 and July 2011 with sufficient kidney functional data participated in the study. Patients with pre-existing chronic kidney disease (group1: 78 patients) were defined as those with estimated glomerular filtration rate under 60 mL/min/m(2) before partial nephrectomy. Patients with de novo chronic kidney disease (group 2: 49) were defined as those with estimated glomerular filtration rate over 60 mL/min/m(2) before surgery and who developed estimated glomerular filtration rate under 60 mL/min/m(2) 3 months after partial nephrectomy. Normal patients (group 3: 184) were defined as those with estimated glomerular filtration rate over 60 mL/min/m(2) both before and after partial nephrectomy. Group 1 was associated with older age and higher comorbidity, including hypertension and diabetes mellitus, compared with other groups. R.E.N.A.L. score was not significantly different between the groups. Although the percent change of estimated glomerular filtration rate between the preoperative period and 3 months after partial nephrectomy in group 2 was significantly decreased compared with that in other groups (group 1: -6.8%, group 2: -18%, group 3: -7.3%), the renal functional recovery between 3 and 12 months after partial nephrectomy in group 2 was better than that in other groups (group 1: -0.5%, group 2: 5.6%, group 3: -0.4%). Patients with de novo chronic kidney disease had better kidney functional recovery than the other two groups, which might suggest that they were surgically assaulted and developed chronic kidney disease in the early postoperative period, and were essentially different from those with pre-existing chronic kidney

  7. Effects of conventional overground gait training and a gait trainer with partial body weight support on spatiotemporal gait parameters of patients after stroke

    OpenAIRE

    Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Noh, Ji-Woong; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Kim, Junghwan

    2015-01-01

    [Purpose] The purpose of this study was to confirm the effects of both conventional overground gait training (CGT) and a gait trainer with partial body weight support (GTBWS) on spatiotemporal gait parameters of patients with hemiparesis following chronic stroke. [Subjects and Methods] Thirty stroke patients were alternately assigned to one of two treatment groups, and both groups underwent CGT and GTBWS. [Results] The functional ambulation classification on the affected side improved signifi...

  8. Flurbiprofen axetil increases arterial oxygen partial pressure by decreasing intrapulmonary shunt in patients undergoing one-lung ventilation.

    Science.gov (United States)

    Chai, Xiao-Qing; Ma, Jun; Xie, Yan-Hu; Wang, Di; Chen, Kun-Zhou

    2015-12-01

    In the present study, we investigated whether flurbiprofen axetil (FA) alleviates hypoxemia during one-lung ventilation (OLV) by reducing the pulmonary shunt/total perfusion (Q s/Q t) ratio, and examined the relationship between the Q s/Q t ratio and the thromboxane B2 (TXB2)/6-keto-prostaglandin F1α (6-K-PGF1α) ratio. Sixty patients undergoing esophageal resection for carcinoma were randomly assigned to groups F and C (n = 30 for each group). FA and placebo were administered i.v. 15 min before skin incision in groups F and C, respectively. The partial pressure of arterial oxygen (PaO2) was measured and the Q s/Q t ratio was calculated. Serum TXB2, 6-K-PGF1α, and endothelin (ET) were measured by radioimmunoassay. The relationship between TXB2/6-K-PGF1α and Q s/Q t was investigated. Compared with group C, PaO2 was higher and the Q s/Q t ratio was lower during OLV in group F (P < 0.05). After treatment with FA, both serum TXB2 and 6-K-PGF1α decreased significantly (P < 0.05) but the TXB2/6-K-PGF1α ratio increased significantly (P < 0.01). Increases in the TXB2/6-K-PGF1α ratio were correlated with reductions in the Q s/Q t ratio during OLV in group F (r = -0.766, P < 0.01). There was no significant difference in serum ET between groups F and C. Treatment with FA reduced the Q s/Q t ratio and further increased the PaO2 level during OLV, possibly due to upregulation of the vasoactive agent TXB2/6-K-PGF1α ratio.

  9. Safety and tolerability of different titration rates of retigabine (ezogabine) in patients with partial-onset seizures.

    Science.gov (United States)

    Biton, Victor; Gil-Nagel, Antonio; Brodie, Martin J; Derossett, Sarah E; Nohria, Virinder

    2013-11-01

    Retigabine (RTG; international nonproprietary name)/ezogabine (EZG; US adopted name) is an antiepileptic drug (AED) that prolongs neuronal voltage-gated potassium-channel KCNQ2-5 (Kv 7.2-7.5) opening. This double-blind study evaluated different RTG/EZG dose-titration rates. Patients (N=73) with partial-onset seizures receiving concomitant AEDs were randomized to one of three titration groups, all of which were initiated at RTG/EZG 300mg/day divided into three equal doses. Fast-, medium-, and slow-titration groups received dose increments of 150mg/day every 2, 4, and 7 days, respectively, achieving the target dose of 1200mg/day after 13, 25, and 43 days, respectively. Safety assessments were performed throughout. Discontinuation rates due to treatment-emergent adverse events (TEAEs) were numerically higher in the fast- (10/23) and medium- (7/22) titration groups than in the slow-titration group (3/23) but statistical significance was achieved only for the high-titration group compared with the low-titration group (p=0.024). Stratified analysis, with concomitant AEDs divided into enzyme inducers (carbamazepine, phenytoin, oxcarbazepine) or noninducers, showed that the risk of discontinuation due primarily to TEAEs was significantly higher in the fast- (p=0.010) but not in the medium-titration group (p=0.078) when compared with the slow-titration group. Overall, the slow-titration rate appeared to be best tolerated and was used in further efficacy and safety studies with RTG/EZG. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study.

    Science.gov (United States)

    Ribeiro, Daniela Garcia; Pavarina, Ana Cláudia; Giampaolo, Eunice Teresinha; Machado, Ana Lucia; Jorge, Janaina Habib; Garcia, Patrícia Petromilli Nordi Sasso

    2009-06-01

    The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index, as well as denture hygiene of patients provided with removable partial denture (RPD) during a 12-month follow-up. A total of 53 partially edentulous patients were recruited for this study. The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit. The plaque and gingival indexes were measured using the Löe index. Following treatment, the patients were randomly divided into three groups. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, participants were given verbal instructions and a self-educational manual on oral hygiene without illustrations. In Group III, oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces (day zero examination) and re-examined 7, 15 and 30 days, 3, 6 and 12 months following RPD placement. The state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6 and 12 months following rehabilitation. Parametric statistics was applied to dental plaque and gingival indexes. For accumulation of plaque and calculus on the RPD, non-parametric statistic was applied. The frequency of plaque found during the preliminary visit was higher than that found in the other periods. With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and III. The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance.

  11. Can repeat injection provide clinical benefit in patients with cervical disc herniation and stenosis when the first epidural injection results only in partial response?

    Science.gov (United States)

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-07-01

    Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated. One hundred eighty-four patients who underwent transforaminal ESI (TFESI) for treatment of axial neck and radicular arm pain due to HIVD or SS and could be followed up for 1 year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (numeric rating scale (NRS) ≥ 3 after the first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 76) comprised partial responders who did not receive repeat injection at the prescribed interval, but received intermittent injections only for aggravation of pain. Various clinical data were assessed, including total number of injections during 1 year, NRS duration of Group A, or after first injection in Group B (time to reinjection). Groups A and B were compared in terms of total population, HIVD, and SS. In the whole population, HIVD subgroup, and SS subgroup, patients in Group A required significantly fewer injections to obtain satisfactory pain relief during the 1-year follow-up period. Group A showed a significantly longer time to reinjection and longer NRS Group B did. Repeat TFESI conducted at 2- to 3-week intervals after the first injection in partial responders contributed to greater clinical benefit compared with intermittent TFESI performed only upon pain

  12. Reduced GABA{sub A} receptor density contralateral to a potentially epileptogenic MRI abnormality in a patient with complex partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Kuwert, T. [Dept. of Nuclear Medicine, Muenster Univ. (Germany); Stodieck, S.R.G. [Dept. of Neurology, Muenster Univ. (Germany); Puskas, C. [Dept. of Nuclear Medicine, Muenster Univ. (Germany); Diehl, B. [Dept. of Neurology, Muenster Univ. (Germany); Puskas, Z. [Inst. of Clinical Radiology, Muenster Univ. (Germany); Schuierer, G. [Inst. of Clinical Radiology, Muenster Univ. (Germany); Vollet, B. [Dept. of Nuclear Medicine, Muenster Univ. (Germany); Schober, O. [Dept. of Nuclear Medicine, Muenster Univ. (Germany)

    1996-01-01

    Imaging cerebral GABA{sub A} receptor density (GRD) with single-photon emission tomography (SPET) and iodine-123 iomazenil is highly accurate in lateralizing epileptogenic foci in patients with complex partial seizures of temporal origin. Limited knowledge exists on how iomazenil SPET compares with magnetic resonance imaging (MRI) in this regard. We present a patient with complex partial seizures in whom MRI had identified an arachnoid cyst anterior to the tip of the left temporal lobe. Contralaterally to this structural abnormality, interictal electroencephalography (EEG) performed after sleep deprivation disclosed an intermittent frontotemporal dysrhythmic focus with slow and sharp waves. On iomazenil SPET images GRD was significantly reduced in the right temporal lobe and thus contralaterally to the MRI abnormality, but ipsilaterally to the pathological EEG findings. These data suggest that iomazenil SPET may significantly contribute to the presurgical evaluation of epileptic patients even when MRI identifies potentialy epileptogenic structural lesions. (orig.)

  13. Effect of partial volume correction on muscarinic cholinergic receptor imaging with single-photon emission tomography in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Weckesser, M.; Ziemons, K.; Griessmeier, M.; Sonnenberg, F.; Langen, K.J.; Mueller-Gaertner, H.W.; Hufnagel, A.; Elger, C.E.; Hacklaender, T.; Holschbach, M.

    1997-01-01

    Animal experiments and preliminary results in humans have indicated alterations of hippocampal muscarinic acetylcholine receptors (mAChR) in temporal lobe epilepsy. Patients with temporal lobe epilepsy often present with a reduction in hippocampal volume. The aim of this study was to investigate the influence of hippocampal atrophy on the quantification of mAChR with single photon emission tomography (SPET) in patients with temporal lobe epilepsy. Cerebral uptake of the muscarinic cholinergic antagonist [ 123 I]4-iododexetimide (IDex) was investigated by SPET in patients suffering from temporal lobe epilepsy of unilateral (n=6) or predominantly unilateral (n=1) onset. Regions of interest were drawn on co-registered magnetic resonance images. Hippocampal volume was determined in these regions and was used to correct the SPET results for partial volume effects. A ratio of hippocampal IDex binding on the affected side to that on the unaffected side was used to detect changes in muscarinic cholinergic receptor density. Before partial volume correction a decrease in hippocampal IDex binding on the focus side was found in each patient. After partial volume no convincing differences remained. Our results indicate that the reduction in hippocampal IDex binding in patients with epilepsy is due to a decrease in hippocampal volume rather than to a decrease in receptor concentration. (orig.). With 2 figs., 2 tabs

  14. Assessment of the prevalence index on signs of combination syndrome in patients treated at Bauru School of Dentistry, University of Sao Paulo

    Directory of Open Access Journals (Sweden)

    Milton Carlos Gonçalves Salvador

    2007-02-01

    Full Text Available A group of destructive changes occurring in jaws in patients with maxillary complete dentures and mandibular removable partial dentures (bilaterally has been described in the literature as the combination syndrome. However, this condition is not clinically observed in all patients. The aim of this study was to establish the prevalence index on signs of combination syndrome and to verify whether these changes also occurred in patients rehabilitated with a mandibular removable partial denture (unilaterally. Sample was composed of 44 patients, completely edentulous in the maxilla. Thirty-two patients had a Kennedy Class I removable partial denture and 12 a Kennedy Class II. Three major alterations were observed in 20.5% of the studied population. Nevertheless, these changes were present only in 25% of patients with Kennedy Class I removable partial denture. Based on the findings of this study, it can be concluded that patients with Kennedy Class II removable partial denture do not have similar signs that lead to the combination syndrome's condition.

  15. Correction of malocclusion and oral rehabilitation in a case of amelogenesis imperfecta by insertion of dental implants followed by Le Fort I distraction osteogenesis of the edentulous atrophic maxilla.

    Science.gov (United States)

    Apaydin, Aysegul; Sermet, Bulent; Ureturk, Sevin; Kundakcioglu, Abdulsamet

    2014-09-17

    Amelogenesis imperfecta refers a group of hereditary diseases affecting the teeth and can present a variety of clinical forms and appearances, compromising esthetic appearance. Amelogenesis imperfecta variably reduces oral health quality and can result in severe psychological problems. We present the management of an amelogenesis imperfecta Angle class III malocclusion case with speech, esthetics and functional problems. This is an example of the rarely presented delayed eruption with multiple morphologic dental alterations and edentulous maxilla.There are only a few available reports in which this method is used method to correct sagittal discrepancies in edentulous patients.Our treatment plan consisted of a preoperative diagnostic and prosthodontics phase (including preparation of guiding prosthesis), followed by a surgical phase of Le Fort I osteotomy, distraction osteogenesis to correct the malocclusion, implant insertion and a follow up final restorative phase. Our treatment strategy attempts to serve patient needs, achieving function and esthetics while also minimizing the risk of reconstruction failure. Treatment not only restored function and esthetics, but also showed a positive psychological impact and thereby improved perceived quality of life.

  16. Partial Cancellation

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Partial Cancellation. Full Cancellation is desirable. But complexity requirements are enormous. 4000 tones, 100 Users billions of flops !!! Main Idea: Challenge: To determine which cross-talker to cancel on what “tone” for a given victim. Constraint: Total complexity is ...

  17. Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa.

    Science.gov (United States)

    Peltzer, Karl; Hewlett, Sandra; Yawson, Alfred E; Moynihan, Paula; Preet, Raman; Wu, Fan; Guo, Godfrey; Arokiasamy, Perianayagam; Snodgrass, James J; Chatterji, Somnath; Engelstad, Mark E; Kowal, Paul

    2014-10-30

    Little information exists about the loss of all one's teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO's) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%-21.7%) than China, Ghana, and South Africa (3.0%-9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention.

  18. Prevalence of Loss of All Teeth (Edentulism and Associated Factors in Older Adults in China, Ghana, India, Mexico, Russia and South Africa

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2014-10-01

    Full Text Available Little information exists about the loss of all one’s teeth (edentulism among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s Study on global AGEing and adult health (SAGE Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367, Ghana (N = 4724, India (N = 7150, Mexico (N = 2315, Russian Federation (N = 3938 and South Africa (N = 3840. Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7% than China, Ghana, and South Africa (3.0%–9.0%. In multivariate logistic analysis sociodemographic factors (older age, lower education, chronic conditions (arthritis, asthma, health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption and other health related variables (functional disability and low social cohesion were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention.

  19. The influence of partial renal function impairment on thyroid hormones level in acute renal failure-ARF patients

    International Nuclear Information System (INIS)

    Ilic, S.; Vlajkovic, M.; Rajic, M.; Bogicevic, M.

    2002-01-01

    The aim of this study was to assess the relationship of thyroid hormone levels with glomerular and tubular renal function in ARF. In thirty one patients with different underlying diseases, glomerular filtration (GFR) was estimated by measuring 99mTc-DTPA clearance and tubular function by 131I-OIH clearance. The thyroid status was evaluated by radioimmunoassays of T4, FT4, T3, FT3, rT3 and TSH, while the cortisol level was used to indicate the stress role. All the measurements were performed within 7 days as well after 1,3,6 and 12 months from the ARF onset. The results obtained were compared with those of 30 healthy subjects. At the ARF beginning, the impairment of renal function was manifested by the fall of 99mTc-DTPA clearance to 21∫7ml/min and 131I-OIH clearance to 172±34ml/min, while end values were 77±19ml/min and 395±70ml/min, respectively. The hormone analysis within 7 days, showed T3 decrease to 1.21±0.16nmol/l and the increase rT3 to 38±7ng/1ooml, as well as cortisol to 350±71ng/ml, but at the end of the study these hormone levels were normalized. Other hormone levels didn't differ significantly from control values. Regression analysis established significant correlation of 99mTc-DTPA clearance with T3 (r=0.693, p 100, OIH>500), partial recovery (DTPA 51-100, OIH 250-500) and without any recovery (DTPA<50,OIH<250), showed hormone disturbances proportional to the degree of renal function damage. The most severe disorders were found in the third group, where both total and free T4 and T3 were lowered, while rT3 and cortisol elevated at 7th day from ARF onset. After 12 months all these values associated with that of TSH were observed as declined.This study suggests thyroid hormone levels to be dependent on the renal function in ARF. Greater impairment of glomerular related to tubular function appears to be more responsible for thyroid dysfunction, due to uremic toxins retention as well as stress induced by the extreme function failure

  20. Esthetic considerations for the treatment of the edentulous maxilla based on current informatic alternatives: a case report.

    Science.gov (United States)

    Rodríguez-Tizcareño, Mario H; Barajas, Lizbeth; Pérez-Gásque, Marisol; Gómez, Salvador

    2012-06-01

    This report presents a protocol used to transfer the virtual treatment plan data to the surgical and prosthetic reality and its clinical application, bone site augmentation with computer-custom milled bovine bone graft blocks to their ideal architecture form, implant insertion based on image-guided stent fabrication, and the restorative manufacturing process through computed tomography-based software programs and navigation systems and the computer-aided design and manufacturing techniques for the treatment of the edentulous maxilla.

  1. Anthropometrics of mental foramen in dry dentate and edentulous mandibles in Coastal Andhra population of Andhra Pradesh State

    Directory of Open Access Journals (Sweden)

    Srinivas Moogala

    2014-01-01

    Full Text Available Aim: The aim of this study is to determine the morphological features and morphometrics of mental foramen with reference to surrounding anatomical landmarks in Coastal Andhra population of Andhra Pradesh State. Materials and Methods: Two-hundred and nineteen dry dentate and edentulous mandibles are examined in this study. Out of these 127 were dentate and 92 were edentulous. Various morphological and morphometrical parameters were measured by using digital Vernier caliper, metallic wire and metallic scale on both the right and left sides. Results: In the present study, the distance between most anterior margin of mental foramen and posterior border of ramus of the mandible is [MF-PR], MF-PR is 69.61 ± 6.03 mm on the right side and is 69.17 ± 6. 0 mm on left side in dentate mandible. In edentulous type, MF-PR is 68.39 ±6.4 mm on right side and 68.81 ± 6.55 mm on left side. In the present study, the distance between symphysis menti and most anterior margin of mental foramen [MF-SM] in dentate mandible is 28.24 ± 5.09 mm on right side and is 27.45 ± 3.7 mm on left side. In edentulous mandible (MF-SM is 28.51 ± 4.5 mm on right side and on left side is 27.99 ± 4.50 mm. Conclusion: Acquiring the knowledge and importance of anatomy of mental foramen is helpful in avoiding neurovascular complications, during regional anesthesia, peri apical surgeries, nerve repositioning and dental implant placement.

  2. Digital assessment of preliminary impression accuracy for edentulous jaws: Comparisons of 3-dimensional surfaces between study and working casts.

    Science.gov (United States)

    Matsuda, Takashi; Goto, Takaharu; Kurahashi, Kosuke; Kashiwabara, Toshiya; Watanabe, Megumi; Tomotake, Yoritoki; Nagao, Kan; Ichikawa, Tetsuo

    2016-07-01

    The aim of this study was to compare 3-dimensional surfaces of study and working casts for edentulous jaws and to evaluate the accuracy of preliminary impressions with a view to the future application of digital dentistry for edentulous jaws. Forty edentulous volunteers were serially recruited. Nine dentists took preliminary and final impressions in a routine clinical work-up. The study and working casts were digitized using a dental 3-dimensional scanner. The two surface images were superimposed through a least-square algorithm using imaging software and compared qualitatively. Furthermore, the surface of each jaw was divided into 6 sections, and the difference between the 2 images was quantitatively evaluated. Overall inspection showed that the difference around residual ridges was small and that around borders were large. The mean differences in the upper and lower jaws were 0.26mm and 0.45mm, respectively. The maximum values of the differences showed that the upward change mainly occurred in the anterior residual ridge, and the downward change mainly in the posterior border seal, and the labial and buccal vestibules, whereas every border of final impression was shortened in the lower jaw. The accuracy in all areas except the border, which forms the foundation, was estimated to be less than 0.25mm. Using digital technology, we here showed the overall and sectional accuracy of the preliminary impression for edentulous jaws. In our clinic, preliminary impressions have been made using an alginate material while ensuring that the requisite impression area was covered. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  3. [Effect of oxygen tubing connection site on percutaneous oxygen partial pressure and percutaneous carbon dioxide partial pressure in patients with chronic obstructive pulmonary disease during noninvasive positive pressure ventilation].

    Science.gov (United States)

    Mi, S; Zhang, L M

    2017-04-12

    Objective: We evaluated the effects of administering oxygen through nasal catheters inside the mask or through the mask on percutaneous oxygen partial pressure (PcO(2))and percutaneous carbon dioxide partial pressure (PcCO(2)) during noninvasive positive pressure ventilation (NPPV) to find a better way of administering oxygen, which could increase PcO(2) by increasing the inspired oxygen concentration. Methods: Ten healthy volunteers and 9 patients with chronic obstructive pulmonary disease complicated by type Ⅱ respiratory failure were included in this study. Oxygen was administered through a nasal catheter inside the mask or through the mask (oxygen flow was 3 and 5 L/min) during NPPV. PcO(2) and PcCO(2) were measured to evaluate the effects of administering oxygen through a nasal catheter inside the mask or through the mask, indirectly reflecting the effects of administering oxygen through nasal catheter inside the mask or through the mask on inspired oxygen concentration. Results: Compared to administering oxygen through the mask during NPPV, elevated PcO(2) was measured in administering oxygen through the nasal catheter inside the mask, and the differences were statistically significant ( P 0.05). Conclusion: Administering oxygen through a nasal catheter inside the mask during NPPV increased PcO(2) by increasing the inspired oxygen concentration but did not increase PcCO(2). This method of administering oxygen could conserve oxygen and be suitable for family NPPV. Our results also provided theoretical basis for the development of new masks.

  4. Partial processing

    International Nuclear Information System (INIS)

    1978-11-01

    This discussion paper considers the possibility of applying to the recycle of plutonium in thermal reactors a particular method of partial processing based on the PUREX process but named CIVEX to emphasise the differences. The CIVEX process is based primarily on the retention of short-lived fission products. The paper suggests: (1) the recycle of fission products with uranium and plutonium in thermal reactor fuel would be technically feasible; (2) it would, however, take ten years or more to develop the CIVEX process to the point where it could be launched on a commercial scale; (3) since the majority of spent fuel to be reprocessed this century will have been in storage for ten years or more, the recycling of short-lived fission products with the U-Pu would not provide an effective means of making refabrication fuel ''inaccessible'' because the radioactivity associated with the fission products would have decayed. There would therefore be no advantage in partial processing

  5. Polygonal Area of Prosthesis Support with Straight and Tilted Dental Implants in Edentulous Maxillae.

    Science.gov (United States)

    Wentaschek, Stefan; Lehmann, Karl Martin; Scheller, Herbert; Weibrich, Gernot; Behneke, Nikolaus

    2016-01-01

    The aim of this in vitro study was to assess the increase in the polygonal area of implant-retained prosthesis supports in edentulous maxillae with the use of tilted distal implants compared with the use of straight distal implants, using a variety of implant lengths. A total of 25 DICOM datasets of atrophic edentulous maxillae were provided. Bone augmentations in the molar region had to be avoided. Two straight reference implants were virtually inserted in the anterior region. Two additional implants were placed far distally on both sides (4 groups: [1] straight, 12-mm length; [2] straight, 10 mm; [3] straight, 8 mm; [4] tilted, 12-16 mm). The resulting implant-supported polygon was measured for each of the 4 groups using three-dimensional planning software. The mean sagittal depth of the supported polygon in Group 1 was 9.9 mm (standard deviation [SD] 4.4) on the right and 10.2 mm (SD 4.4) on the left, and it was 33.7 mm (SD 5.8) in width. For Group 2, the mean sagittal depth was 11.5 mm (SD 5.0) on the right and 11.9 mm (SD 4.7) on the left, and the width was 35.2 mm (SD 5.6). The measurements for Group 3 were 13.8 mm (SD 4.9) deep on the right, 13.8 mm (SD 5.1) deep on the left, and 37.0 mm (SD 5.4) in width. For Group 4, the depth was 15.8 mm (SD 4.9) on the right and 16.4 mm (SD 5.8) on the left, and the width was 39.0 mm (SD 5.1). The area of implant-retained prosthesis support can be enlarged by the use of tilted implants (12 to 16 mm in length, 42 to 45 degrees) compared to the use of straight 8-mm implants (resulting increase: about 15%).

  6. Application of FDM three-dimensional printing technology in the digital manufacture of custom edentulous mandible trays

    Science.gov (United States)

    Chen, Hu; Yang, Xu; Chen, Litong; Wang, Yong; Sun, Yuchun

    2016-01-01

    The objective was to establish and evaluate a method for manufacture of custom trays for edentulous jaws using computer aided design and fused deposition modeling (FDM) technologies. A digital method for design the custom trays for edentulous jaws was established. The tissue surface data of ten standard mandibular edentulous plaster models, which was used to design the digital custom tray in a reverse engineering software, were obtained using a 3D scanner. The designed tray was printed by a 3D FDM printing device. Another ten hand-made custom trays were produced as control. The 3-dimentional surface data of models and custom trays was scanned to evaluate the accuracy of reserved impression space, while the difference between digitally made trays and hand-made trays were analyzed. The digitally made custom trays achieved a good matching with the mandibular model, showing higher accuracy than the hand-made ones. There was no significant difference of the reserved space between different models and its matched digitally made trays. With 3D scanning, CAD and FDM technology, an efficient method of custom tray production was established, which achieved a high reproducibility and accuracy. PMID:26763620

  7. Partial gigantism

    Directory of Open Access Journals (Sweden)

    М.М. Karimova

    2017-05-01

    Full Text Available A girl with partial gigantism (the increased I and II fingers of the left foot is being examined. This condition is a rare and unresolved problem, as the definite reason of its development is not determined. Wait-and-see strategy is recommended, as well as correcting operations after closing of growth zones, and forming of data pool for generalization and development of schemes of drug and radial therapeutic methods.

  8. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients

    NARCIS (Netherlands)

    de Jonge, Evert; Peelen, Linda; Keijzers, Peter J.; Joore, Hans; de Lange, Dylan; van der Voort, Peter Hj; Bosman, Robert J.; de Waal, Ruud Al; Wesselink, Ronald; de Keizer, Nicolette F.

    2008-01-01

    Introduction The aim of this study was to investigate whether in-hospital mortality was associated with the administered fraction of oxygen in inspired air (FiO(2)) and achieved arterial partial pressure of oxygen (PaO2). Methods This was a retrospective, observational study on data from the first

  9. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients

    NARCIS (Netherlands)

    de Jonge, Evert; Peelen, Linda; Keijzers, Peter J.; Joore, Hans; de Lange, Dylan; van der Voort, Peter H. J.; Bosman, Robert J.; de Waal, Ruud A. L.; Wesselink, Ronald; de Keizer, Nicolette F.

    2008-01-01

    Introduction The aim of this study was to investigate whether in-hospital mortality was associated with the administered fraction of oxygen in inspired air (FiO(2)) and achieved arterial partial pressure of oxygen (PaO(2)). Methods This was a retrospective, observational study on data from the first

  10. Partial response to biotin therapy in a patient with holocarboxylase synthetase deficiency: clinical, biochemical, and molecular genetic aspects

    NARCIS (Netherlands)

    Santer, R.; Muhle, H.; Suormala, T.; Baumgartner, E. R.; Duran, M.; Yang, X.; Aoki, Y.; Suzuki, Y.; Stephani, U.

    2003-01-01

    We report the clinical course and biochemical findings of a 10-year-old, mentally retarded girl with late-onset holocarboxylase synthetase (HCS, gene symbol HLCS) deficiency and only partial response to biotin. On treatment, even with an unusually high dose of 200mg/day, activities of the

  11. Oral Rehabilitation of Parkinson’s Disease Patient: A Review and Case Report

    Directory of Open Access Journals (Sweden)

    Fouad A. Al-Omari

    2014-01-01

    Full Text Available Parkinson’s disease is usually seen in adults in their middle and late ages. Most people with this disease are less likely to opt for dental treatments unless it is an acute condition. Tremors caused by Parkinson’s disease can make dental appointments, especially prolonged treatments, a challenge. The case presented here was successfully treated with an immediate denture for the partially edentulous maxillary and mandibular arches. Early morning brief appointments were given for the procedure. Patient was instructed to take the prescribed parkinsonism medications 60 to 90 minutes before the appointment to utilize the advantage of its peak response. Sympathetic and caring approach towards the patient was employed to reduce his anxiety during the procedures. Some modification of technics and materials was adopted to suit the special situation.

  12. A cephalometric study to determine the plane of occlusion in completely edentulous patients: part I.

    Science.gov (United States)

    Hindocha, Amit D; Vartak, Vikas N; Bhandari, Aruna J; Dudani, Mohit

    2010-12-01

    To determine the relationship between the plane of occlusion and the Camper's line (ala-tragus line). Lateral cephalograms of 105 dentulous subjects were obtained after outlining the tragus and the base of the ala of the nose with radiopaque markers. Tracings of the cephalograms were done and the relationship between the plane of occlusion and the Camper's line (ala-tragus line) was noted. The most common tragal reference as a posterior landmark for determination of plane of occlusion was found to be below inferior (in 30.48% of subjects), and inferior (in 24.76% of subjects). The least common tragal reference was found to be above superior (in 3.82% of subjects) followed by superior of tragus and the point between superior and middle of the tragus (in 6.66% of subjects). The tragal reference in this study population was more towards the inferior of the tragus, with most of the times being below the inferior border. Therefore, the orientation of the plane of occlusion using the superior of tragus as a posterior landmark (according to the widely accepted definition of Camper's line) may be considered to be questionable. Further, the use of the tragus as a posterior landmark for the orientation of the plane of occlusion may be questioned on the basis of the findings of this study.

  13. Immediate loading of titanium hexed screw-type implants in the edentulous patient: case report.

    Science.gov (United States)

    Calvo, M P; Muller, E; Garg, A K

    2000-01-01

    Histologic and histomorphometric studies in both animals and humans have shown that more rapid and greater bone-to-implant contact can be achieved with implants that incorporate certain surface characteristics compared with the original machined-surface implants. Such findings are significant because various implant designs may allow the fixtures to sufficiently resist functional loading sooner than originally thought. The case report presented here indicates that immediate loading of hexed titanium screw-type implants in the anterior mandible can lead to successful osseointegration and clinical outcome. The number of implants placed, their distribution, and the type of rigid connection are critical considerations for immediate loading. A bone height that can accommodate dental implants > or = 10 mm long is recommended. Biomechanically, the implants to be immediately loaded must be stable and resistant to macromovement to ensure good osseointegration.

  14. Bilateral Anterior Opercular Syndrome With Partial Kluver?Bucy Syndrome in a Stroke Patient: A Case Report

    OpenAIRE

    Cho, Ah-Ra; Lim, Young-Ho; Chung, Sae-Hoon; Choi, Eun-Hi; Lim, Jong Youb

    2016-01-01

    Bilateral anterior opercular syndrome and partial Kluver?Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersex...

  15. Auxiliary partial liver transplantation

    NARCIS (Netherlands)

    C.B. Reuvers (Cornelis Bastiaan)

    1986-01-01

    textabstractIn this thesis studies on auxiliary partial liver transplantation in the dog and the pig are reported. The motive to perform this study was the fact that patients with acute hepatic failure or end-stage chronic liver disease are often considered to form too great a risk for successful

  16. Involuntary movement during mastication in patients with long-term facial paralysis reanimated with a partial gracilis free neuromuscular flap innervated by the masseteric nerve.

    Science.gov (United States)

    Rozen, Shai; Harrison, Bridget

    2013-07-01

    Midface reanimation in patients with chronic facial paralysis is not always possible with an ipsilateral or contralateral facial nerve innervating a free neuromuscular tissue transfer. Alternate use of nonfacial nerves is occasionally indicated but may potentially result in inadvertent motions. The goal of this study was to objectively review videos of patients who underwent one-stage reanimation with a gracilis muscle transfer innervated by the masseteric nerve for (1) inadvertent motion during eating, (2) characterization of masticatory patterns, and (3) social hindrance perceived by the patients during meals. Between the years 2009 and 2012, 18 patients underwent midfacial reanimation with partial gracilis muscle transfer coapted to the masseter nerve for treatment of midfacial paralysis. Sixteen patients were videotaped in detail while eating. Involuntary midface movement on the reconstructed side and mastication patterns were assessed. In addition, 16 patients were surveyed as to whether involuntary motion constituted a problem in their daily lives. All 16 patients videotaped during mastication demonstrated involuntary motion on the reconstructed side while eating. Several unique masticatory patterns were noted as well. Only one of the 16 patients reported involuntary motion as a minor disturbance in daily life during meals. All patients with chronic facial paralysis who plan to undergo midface reanimation with a free tissue transfer innervated by the ipsilateral masseter nerve should be told that they would universally have involuntary animation during mastication. Most patients do not consider this a major drawback in their daily lives. Therapeutic, IV.

  17. Application and analysis of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for patients with multiple renal tumor: initial experience.

    Science.gov (United States)

    Zhu, Jundong; Jiang, Fan; Li, Pu; Shao, Pengfei; Liang, Chao; Xu, Aiming; Miao, Chenkui; Qin, Chao; Wang, Zengjun; Yin, Changjun

    2017-09-11

    To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for the patients with multiple renal tumor of who have solitary kidney or contralateral kidney insufficiency. Nine patients who have undergone retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping between October 2010 and January 2017 were retrospectively analyzed. Clinical materials and parameters during and after the operation were summarized. Nineteen tumors were resected in nine patients and the operations were all successful. The operation time ranged from 100 to 180 min (125 min); clamping time of segmental renal artery was 10 ~ 30 min (23 min); the amount of blood loss during the operation was 120 ~ 330 ml (190 ml); hospital stay after the operation is 3 ~ 6d (5d). There was no complication during the perioperative period, and the pathology diagnosis after the surgery showed that there were 13 renal clear cell carcinomas, two papillary carcinoma and four perivascular epithelioid cell tumors with negative margins from the 19 tumors. All patients were followed up for 3 ~ 60 months, and no local recurrence or metastasis was detected. At 3-month post-operation follow-up, the mean serum creatinine was 148.6 ± 28.1 μmol/L (p = 0.107), an increase of 3.0 μmol/L from preoperative baseline. For the patients with multiple renal tumors and solitary kidney or contralateral kidney insufficiency, retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping was feasible and safe, which minimized the warm ischemia injury to the kidney and preserved the renal function effectively.

  18. Association of macrophage inhibitory cytokine-1 with nutritional status, body composition and bone mineral density in patients with anorexia nervosa: the influence of partial realimentation.

    Science.gov (United States)

    Dostálová, Ivana; Kaválková, Petra; Papežová, Hana; Domluvilová, Daniela; Zikán, Vít; Haluzík, Martin

    2010-04-23

    Macrophage inhibitory cytokine-1 (MIC-1) is a key inducer of cancer-related anorexia and weight loss. However, its possible role in the etiopathogenesis of nutritional disorders of other etiology such as anorexia nervosa (AN) is currently unknown. We measured fasting serum concentrations of MIC-1 in patients with AN before and after 2-month nutritional treatment and explored its relationship with nutritional status, metabolic and biochemical parameters. Sixteen previously untreated women with AN and twenty-five normal-weight age-matched control women participated in the study. We measured serum concentrations of MIC-1 and leptin by ELISA, free fatty acids by enzymatic colorimetric assay, and biochemical parameters by standard laboratory methods; determined resting energy expenditure by indirect calorimetry; and assessed bone mineral density and body fat content by dual-energy X-ray absorptiometry. ANOVA, unpaired t-test or Mann-Whitney test were used for groups comparison as appropriate. The comparisons of serum MIC-1 levels and other studied parameters in patients with AN before and after partial realimentation were assessed by paired t-test or Wilcoxon Signed Rank Test as appropriate. At baseline, fasting serum MIC-1 concentrations were significantly higher in patients with AN relative to controls. Partial realimentation significantly reduced serum MIC-1 concentrations in patients with AN but it still remained significantly higher compared to control group. In AN group, serum MIC-1 was inversely related to Buzby nutritional risk index, serum insulin-like growth factor-1, serum glucose, serum total protein, serum albumin, and lumbar bone mineral density and it significantly positively correlated with the duration of AN and age. MIC-1 concentrations in AN patients are significantly higher relative to healthy women. Partial realimentation significantly decreased MIC-1 concentration in AN group. Clinical significance of these findings needs to be further clarified.

  19. Association of macrophage inhibitory cytokine-1 with nutritional status, body composition and bone mineral density in patients with anorexia nervosa: the influence of partial realimentation

    Directory of Open Access Journals (Sweden)

    Zikán Vít

    2010-04-01

    Full Text Available Abstract Background Macrophage inhibitory cytokine-1 (MIC-1 is a key inducer of cancer-related anorexia and weight loss. However, its possible role in the etiopathogenesis of nutritional disorders of other etiology such as anorexia nervosa (AN is currently unknown. Methods We measured fasting serum concentrations of MIC-1 in patients with AN before and after 2-month nutritional treatment and explored its relationship with nutritional status, metabolic and biochemical parameters. Sixteen previously untreated women with AN and twenty-five normal-weight age-matched control women participated in the study. We measured serum concentrations of MIC-1 and leptin by ELISA, free fatty acids by enzymatic colorimetric assay, and biochemical parameters by standard laboratory methods; determined resting energy expenditure by indirect calorimetry; and assessed bone mineral density and body fat content by dual-energy X-ray absorptiometry. ANOVA, unpaired t-test or Mann-Whitney test were used for groups comparison as appropriate. The comparisons of serum MIC-1 levels and other studied parameters in patients with AN before and after partial realimentation were assessed by paired t-test or Wilcoxon Signed Rank Test as appropriate. Results At baseline, fasting serum MIC-1 concentrations were significantly higher in patients with AN relative to controls. Partial realimentation significantly reduced serum MIC-1 concentrations in patients with AN but it still remained significantly higher compared to control group. In AN group, serum MIC-1 was inversely related to Buzby nutritional risk index, serum insulin-like growth factor-1, serum glucose, serum total protein, serum albumin, and lumbar bone mineral density and it significantly positively correlated with the duration of AN and age. Conclusions MIC-1 concentrations in AN patients are significantly higher relative to healthy women. Partial realimentation significantly decreased MIC-1 concentration in AN group

  20. Evaluation of Team-Based Learning and Traditional Instruction in Teaching Removable Partial Denture Concepts.

    Science.gov (United States)

    Echeto, Luisa F; Sposetti, Venita; Childs, Gail; Aguilar, Maria L; Behar-Horenstein, Linda S; Rueda, Luis; Nimmo, Arthur

    2015-09-01

    The aim of this study was to evaluate the effectiveness of team-based learning (TBL) methodology on dental students' retention of knowledge regarding removable partial denture (RPD) treatment. The process of learning RPD treatment requires that students first acquire foundational knowledge and then use critical thinking skills to apply that knowledge to a variety of clinical situations. The traditional approach to teaching, characterized by a reliance on lectures, is not the most effective method for learning clinical applications. To address the limitations of that approach, the teaching methodology of the RPD preclinical course at the University of Florida was changed to TBL, which has been shown to motivate student learning and improve clinical performance. A written examination was constructed to compare the impact of TBL with that of traditional teaching regarding students' retention of knowledge and their ability to evaluate, diagnose, and treatment plan a partially edentulous patient with an RPD prosthesis. Students taught using traditional and TBL methods took the same examination. The response rate (those who completed the examination) for the class of 2013 (traditional method) was 94% (79 students of 84); for the class of 2014 (TBL method), it was 95% (78 students of 82). The results showed that students who learned RPD with TBL scored higher on the examination than those who learned RPD with traditional methods. Compared to the students taught with the traditional method, the TBL students' proportion of passing grades was statistically significantly higher (p=0.002), and 23.7% more TBL students passed the examination. The mean score for the TBL class (0.758) compared to the conventional class (0.700) was statistically significant with a large effect size, also demonstrating the practical significance of the findings. The results of the study suggest that TBL methodology is a promising approach to teaching RPD with successful outcomes.

  1. Partial maxillectomy

    International Nuclear Information System (INIS)

    Nishino, Hiroshi; Kawada, Kazuki

    2010-01-01

    Current goals for the treatment of maxillary sinus carcinoma include preservation of vision, eating, communication, and appearance as well as cure. 121 Japanese patients who presented with maxillary sinus carcinoma between 1979 and 2005 were analyzed retrospectively. There were 77 males and 44 females, with a median age of 63 years. All patients underwent multimodality therapy including surgery through a sublabial incision, radiotherapy, and intra-arterial chemotherapy. The regional lymph nodes were treated only in patients with neck involvement. Mean follow-up period was 79 months. The 5-year overall survival rate and local control rate were 73% and 72%, respectively. The 5-year local control rate was 70% for patients with T2 lesions, 86% for patients with T3 lesions, 55% for patients with T4a lesions, and 52% for patients with T4b lesions. In patients with squamous cell carcinoma, the 5-year local control rate was 76%. In patients with non-squamous cell carcinoma, the 5-year local control rate was 54%. There was a significant difference in local control rates among these groups. Control of the primary site is important in the curative treatment of maxillary sinus carcinoma. Combined therapy with conservative surgery, radiotherapy, and regional chemotherapy is effective for this carcinoma. (author)

  2. Multicentre prospective evaluation of implant-assisted mandibular removable partial dentures: surgical and prosthodontic outcomes.

    Science.gov (United States)

    Payne, Alan G T; Tawse-Smith, Andrew; Wismeijer, Daniel; De Silva, Rohana K; Ma, Sunyoung

    2017-01-01

    -assisted removable partial dentures for partially edentulous patients. Late implant failures and increased prosthodontic maintenance when an attachment system is used identify the need for further research, including more robust statistical analyses. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Patients and physicians agree only partially in symptoms and clinical findings before and after treatment for varicose veins

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Sillesen, Henrik; Jensen, Leif Panduro

    2018-01-01

    findings. Methods In the period January-March 2011, 379 legs in 287 patients treated for varicose veins were registered in the Danish Clinical Vein Database and compared to the Aberdeen Varicose Vein Questionnaire. Results Patients and physicians agreed in reduction of symptoms after intervention with one...... or more complaints still present in 128 (93%) patients according to Aberdeen Varicose Vein Questionnaire compared to the Danish Clinical Vein Database with only 64 (47%) patients. Patients reported cosmetic complaints and teleangiectasies both before and after treatment (p 

  4. Comparison between Total Parenteral Nutrition Vs. Partial Parenteral Nutrition on Serum Lipids Among Chronic Ventilator Dependent Patients; A Multi Center Study.

    Science.gov (United States)

    Radpay, Rojan; Poor Zamany Nejat Kermany, Mahtab; Radpay, Badiozaman

    2016-01-01

    Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method. 97 patients were enrolled and divided into two groups based on the inclusion criteria. Serum protein, serum albumin, serum transferrin, and total lymphocyte count were measured on days 7 and 14. We did not find any statistically significant differences in clinical status or laboratory values between the two groups but there were significant improvements in measured lab values between days 7 and 14 (pnutritional status in each groups. This study shows that both TPN and PPN can be used safely in chronic ICU patients to provide nutritional support and prevent catabolic state among chronic critically ill patients. We need to develop precise selection criteria in order to choose the patients who would benefit the most from TPN and PPN. In addition, appropriate laboratory markers are needed to monitor the metabolic requirements of the patients and assess their progress.

  5. Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects.

    Science.gov (United States)

    Said, Mohamed M; Otomaru, Takafumi; Yeerken, Yesiboli; Taniguchi, Hisashi

    2017-07-01

    The healing pattern after surgical resection of tumors of the oral cavity involving the maxilla may vary from one patient to another. The result may be open communication between the oral and nasal cavities (open defect) or complete oronasal separation after healing of the defect area (closed defect). The purpose of this clinical study was to compare masticatory function and oral health-related quality of life (OHRQoL) between patients with closed and open defects who had undergone a partial maxillectomy and were wearing dentomaxillary prostheses. Thirty-eight participants who had undergone a partial maxillectomy and who were wearing dentomaxillary prostheses were enrolled between September 2014 and April 2016. Participants were assigned to 2 groups according to the type of defect after healing: 19 participants had a closed defect, and 19 participants had an open defect. Masticatory function was evaluated objectively and subjectively. The objective measurement was food-mixing ability, which was assessed using color-changeable chewing gum. The subjective measurement was perceived mastication ability, rated as a masticatory score based on the patient's responses to a 35-item food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI questionnaire consists of 12 items reflecting 3 hypothesized domains of the impact of oral disease: physical function, psychosocial function, and pain or discomfort. Differences in the scores obtained by the 3 measurements were compared between the 2 groups, using the Wilcoxon rank-sum test (α=.05). No significant differences were seen between the 2 groups in objective mixing ability, subjective masticatory score, or GOHAI (P>.05). Regarding the GOHAI physical function domain, only the swallowing item was significantly lower (P=.025) in participants with an open defect than in participants with a closed defect. Regarding the GOHAI psychological function domain, the item related to

  6. Circummandibular Wires for Treatment of Dentoalveolar Fractures Adjacent to Edentulous Areas: A Report of Two Cases.

    Science.gov (United States)

    Maloney, Karl

    2015-09-01

    In general, dentoalveolar fractures are a common injury seen in emergency departments, dental offices, and oral and maxillofacial surgery practices. These injuries can be the result of direct trauma or indirect trauma. Direct trauma more often causes trauma to the maxillary dentition due to the exposure of the maxillary anterior teeth. Indirect trauma is usually the result of forced occlusion secondary to a blow to the chin or from a whiplash injury. Falls are the most common mechanism of injury seen in the pediatric group. In adolescents, many of these fractures are sustained during sporting activities. However, the use of mouth guards and other protective equipment has decreased this number. Most adult injuries are caused by motor vehicle accidents, contact sports, falls, bicycles, interpersonal violence, medical/dental mishaps, and industrial accidents. Early intervention to reduce and stabilize the fracture is required to establish a bony union and ensure correct function. Most dentoalveolar fractures have bilateral stable adjacent dentition and are treated with a closed technique utilizing an acid-etch/resin splint followed by splint removal at 4 weeks. Other inferior stabilization treatments used are arch bars and other wiring techniques. It is widely accepted that semirigid stabilization techniques, such as an acid-etch/resin splint or wiring procedures, are adequate to treat dentoalveolar fractures. This is in contrast to the treatment of mandible fractures where AO principles of rigid fixation are often followed. Fractures that are unable to be reduced sometimes necessitate an open reduction followed by internal fixation, sometimes using a secondary splint for mobile teeth. In those rare cases when there are not stable adjacent teeth bilaterally other modalities must be considered. In the present report, two cases are presented where circummandibular wires were used to treat fractured mandibular dentoalveolar segments adjacent to edentulous areas.

  7. Effects of conventional overground gait training and a gait trainer with partial body weight support on spatiotemporal gait parameters of patients after stroke.

    Science.gov (United States)

    Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Noh, Ji-Woong; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Kim, Junghwan

    2015-05-01

    [Purpose] The purpose of this study was to confirm the effects of both conventional overground gait training (CGT) and a gait trainer with partial body weight support (GTBWS) on spatiotemporal gait parameters of patients with hemiparesis following chronic stroke. [Subjects and Methods] Thirty stroke patients were alternately assigned to one of two treatment groups, and both groups underwent CGT and GTBWS. [Results] The functional ambulation classification on the affected side improved significantly in the CGT and GTBWS groups. Walking speed also improved significantly in both groups. [Conclusion] These results suggest that the GTBWS in company with CGT may be, in part, an effective method of gait training for restoring gait ability in patients after a stroke.

  8. Retention, dosing, tolerability and patient reported seizure outcome of Zonisamide as only add-on treatment under real-life conditions in adult patients with partial onset seizures: Results of the observational study ZOOM.

    Science.gov (United States)

    Hamer, Hajo; Baulac, Michel; McMurray, Rob; Kockelmann, Edgar

    2016-01-01

    Zonisamide is licensed for adjunctive therapy for partial-onset seizures with or without secondary generalisation in patients 6 years and older and as monotherapy for the treatment of partial seizures in adult patients with newly diagnosed epilepsy, and shows a favourable pharmacokinetic profile with low interaction potential with other drugs. The aim of the present study was to gather real-life data on retention and modalities of zonisamide use when administered as only add-on treatment to a current AED monotherapy in adult patients with partial-onset seizures. This multicenter observational study was performed in 4 European countries and comprised three visits: baseline, and after 3 and 6 months. Data on patients' retention, reported efficacy, tolerability and safety, and quality of life was collected. Of 100 included patients, 93 could be evaluated. After 6 months, the retention rate of zonisamide add-on therapy was 82.8%. At this time, a reduction of seizure frequency of at least 50% was observed in 79.7% of patients, with 43.6% reporting seizure freedom over the last 3 months of the study period. Adverse events were reported by 19.4% of patients, with fatigue, agitation, dizziness, and headache being most frequent. Approximately 25% of patients were older than 60 years, many of whom suffered from late-onset epilepsy. Compared to younger patients, these patients showed considerable differences with regard to their antiepileptic drug regimen at baseline, and slightly higher responder and retention rates at 6 months. Despite limitations due to the non-interventional open-label design and the low sample size, the results show that zonisamide as only add-on therapy is well retained, indicating effectiveness in the majority of patients under real-life conditions. Copyright © 2015. Published by Elsevier Ltd.

  9. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    Energy Technology Data Exchange (ETDEWEB)

    Couto, Henrique Lima, E-mail: enriquecouto@hotmail.com [Santa Fe Women' s and Maternity Hospital, Belo Horizonte, MG (Brazil); Amorim, Washington Cancado; Guimaraes, Rodrigo [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital Geral; Ramires, Leandro Cruz; Castilho, Marcus Simoes [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Fac. de Medicina; Dominguez, Lorena Lima Coto [Universidade Estacio de Sa (UNESA), Rio de Janeiro, EJ (Brazil)

    2014-07-15

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  10. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    International Nuclear Information System (INIS)

    Couto, Henrique Lima; Amorim, Washington Cancado; Guimaraes, Rodrigo

    2014-01-01

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  11. Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China

    Science.gov (United States)

    Zhu, Fei; Lang, Sen-Yang; Wang, Xiang-Qing; Shi, Xiao-Bing; Ma, Yun-Feng; Zhang, Xu; Chen, Ya-Nan; Zhang, Jia-Tang

    2015-01-01

    Background: It is important to choose an appropriate antiepileptic drug (AED) to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ) and valproate (VPA), have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods: This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate (TPM), oxcarbazepine (OXC), lamotrigine (LTG), or levetiracetam (LEV), were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results: A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months (95% confidential interval: 30.64–44.07). CBZ exhibited the highest 12-month remission rate (85.55%), which was significantly higher than those of TPM (69.38%, P = 0.006), LTG (70.79%, P = 0.001), LEV (72.54%, P = 0.005), and VPA (73.33%, P = 0.002). CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems (8.09%), rashes (7.76%), abnormal hepatic function (6.24%), and drowsiness (6.24%). Conclusion: This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing focal epilepsy as measured by time to first seizure

  12. Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China

    Directory of Open Access Journals (Sweden)

    Fei Zhu

    2015-01-01

    Full Text Available Background: It is important to choose an appropriate antiepileptic drug (AED to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ and valproate (VPA, have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods: This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate (TPM, oxcarbazepine (OXC, lamotrigine (LTG, or levetiracetam (LEV, were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results: A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months (95% confidential interval: 30.64-44.07. CBZ exhibited the highest 12-month remission rate (85.55%, which was significantly higher than those of TPM (69.38%, P = 0.006, LTG (70.79%, P = 0.001, LEV (72.54%, P = 0.005, and VPA (73.33%, P = 0.002. CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems (8.09%, rashes (7.76%, abnormal hepatic function (6.24%, and drowsiness (6.24%. Conclusion: This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing focal epilepsy as measured by time to first

  13. Comparative analysis of salivary bacterial microbiome diversity in edentulous infants and their mothers or primary care givers using pyrosequencing.

    Directory of Open Access Journals (Sweden)

    Kimberly D Cephas

    Full Text Available Bacterial contribution to oral disease has been studied in young children, but there is a lack of data addressing the developmental perspective in edentulous infants. Our primary objectives were to use pyrosequencing to phylogenetically characterize the salivary bacterial microbiome of edentulous infants and to make comparisons against their mothers. Saliva samples were collected from 5 edentulous infants (mean age = 4.6±1.2 mo old and their mothers or primary care givers (mean age = 30.8±9.5 y old. Salivary DNA was extracted, used to generate DNA amplicons of the V4-V6 hypervariable region of the bacterial 16S rDNA gene, and subjected to 454-pyrosequencing. On average, over 80,000 sequences per sample were generated. High bacterial diversity was noted in the saliva of adults [1012 operational taxonomical units (OTU at 3% divergence] and infants (578 OTU at 3% divergence. Firmicutes, Proteobacteria, Actinobacteria, and Fusobacteria were predominant bacterial phyla present in all samples. A total of 397 bacterial genera were present in our dataset. Of the 28 genera different (P<0.05 between infants and adults, 27 had a greater prevalence in adults. The exception was Streptococcus, which was the predominant genera in infant saliva (62.2% in infants vs. 20.4% in adults; P<0.05. Veillonella, Neisseria, Rothia, Haemophilus, Gemella, Granulicatella, Leptotrichia, and Fusobacterium were also predominant genera in infant samples, while Haemophilus, Neisseria, Veillonella, Fusobacterium, Oribacterium, Rothia, Treponema, and Actinomyces were predominant in adults. Our data demonstrate that although the adult saliva bacterial microbiome had a greater OTU count than infants, a rich bacterial community exists in the infant oral cavity prior to tooth eruption. Streptococcus, Veillonella, and Neisseria are the predominant bacterial genera present in infants. Further research is required to characterize the development of oral microbiota early in life

  14. Unilateral removable partial dentures.

    Science.gov (United States)

    Goodall, W A; Greer, A C; Martin, N

    2017-01-27

    Removable partial dentures (RPDs) are widely used to replace missing teeth in order to restore both function and aesthetics for the partially dentate patient. Conventional RPD design is frequently bilateral and consists of a major connector that bridges both sides of the arch. Some patients cannot and will not tolerate such an extensive appliance. For these patients, bridgework may not be a predictable option and it is not always possible to provide implant-retained restorations. This article presents unilateral RPDs as a potential treatment modality for such patients and explores indications and contraindications for their use, including factors relating to patient history, clinical presentation and patient wishes. Through case examples, design, material and fabrication considerations will be discussed. While their use is not widespread, there are a number of patients who benefit from the provision of unilateral RPDs. They are a useful treatment to have in the clinician's armamentarium, but a highly-skilled dental team and a specific patient presentation is required in order for them to be a reasonable and predictable prosthetic option.

  15. Partial revascularization plus medical treatment versus medical treatment alone in patients with multivessel coronary artery disease not eligible for CABG

    Directory of Open Access Journals (Sweden)

    M. Sadaka

    2013-06-01

    Conclusion: In patients with MVD who were not eligible for CABG; IR plus OMT was not superior to OMT alone in improving the 1year clinical outcomes except the improvement in the level of angina class, which could be the adopted strategy to improve the quality of life in such patients but with close follow up.

  16. Diagnostic stability of comorbid personality disorders among patients fully or partially remitted from first-episode depression

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Bech, Per; Kessing, Lars Vedel

    2017-01-01

    The diagnostic stability of comorbid personality disorders among patients with depression remains unclear. A total of 262 patients suffering from first-episode depression were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and reassessed after 5...

  17. Photogenic partial seizures.

    Science.gov (United States)

    Hennessy, M J; Binnie, C D

    2000-01-01

    To establish the incidence and symptoms of partial seizures in a cohort of patients investigated on account of known sensitivity to intermittent photic stimulation and/or precipitation of seizures by environmental visual stimuli such as television (TV) screens or computer monitors. We report 43 consecutive patients with epilepsy, who had exhibited a significant EEG photoparoxysmal response or who had seizures precipitated by environmental visual stimuli and underwent detailed assessment of their photosensitivity in the EEG laboratory, during which all were questioned concerning their ictal symptoms. All patients were considered on clinical grounds to have an idiopathic epilepsy syndrome. Twenty-eight (65%) patients reported visually precipitated attacks occurring initially with maintained consciousness, in some instances evolving to a period of confusion or to a secondarily generalized seizure. Visual symptoms were most commonly reported and included positive symptoms such as coloured circles or spots, but also blindness and subjective symptoms such as "eyes going funny." Other symptoms described included nonspecific cephalic sensations, deja-vu, auditory hallucinations, nausea, and vomiting. No patient reported any clear spontaneous partial seizures, and there were no grounds for supposing that any had partial epilepsy excepting the ictal phenomenology of some or all of the visually induced attacks. These findings provide clinical support for the physiological studies that indicate that the trigger mechanism for human photosensitivity involves binocularly innervated cells located in the visual cortex. Thus the visual cortex is the seat of the primary epileptogenic process, and the photically triggered discharges and seizures may be regarded as partial with secondary generalization.

  18. Comparison of false-negative/positive results of intraoperative evoked potential monitoring between no and partial neuromuscular blockade in patients receiving propofol/remifentanil-based anesthesia during cerebral aneurysm clipping surgery: A retrospective analysis of 685 patients.

    Science.gov (United States)

    Kim, Sung-Hoon; Jin, Seok-Joon; Karm, Myong-Hwan; Moon, Young-Jin; Jeong, Hye-Won; Kim, Jae-Won; Ha, Seung-Il; Kim, Joung-Uk

    2016-08-01

    Although the elicited responses of motor evoked potential (MEP) monitoring are very sensitive to suppression by anesthetic agents and muscle relaxants, the use of neuromuscular blockade (NMB) during MEP monitoring is still controversial because of serious safety concerns and diagnostic accuracy. Here, we evaluated the incidence of unacceptable movement and compared false-negative MEP results between no and partial NMB during cerebral aneurysm clipping surgery. We reviewed patient medical records for demographic data, anesthesia regimen, neurophysiology event logs, MEP results, and clinical outcomes. Patients were divided into 2 groups according to the intraoperative use of NMB: no NMB group (n = 276) and partial NMB group (n = 409). We compared the diagnostic accuracy of MEP results to predict postoperative outcomes between both groups. Additionally, we evaluated unwanted patient movement during MEP monitoring in both groups. Of the 685 patients, 622 (90.8%) manifested no intraoperative changes in MEP and no postoperative motor deficits. Twenty patients showed postoperative neurologic deficits despite preserved intraoperative MEP. False-positive MEP results were 3.6% in the no NMB group and 3.9% in the partial NMB group (P = 1.00). False-negative MEP results were 1.1% in the no NMB group and 4.2% in the partial NMB group (P = 0.02). No spontaneous movement or spontaneous respiration was observed in either group. Propofol/remifentanil-based anesthesia without NMB decreases the stimulation intensity of MEPs, which may reduce the false-negative ratio of MEP monitoring during cerebral aneurysm surgery. Our anesthetic protocol enabled reliable intraoperative MEP recording and patient immobilization during cerebral aneurysm clipping surgery.

  19. Treatment of avoidant/restrictive food intake disorder in a cohort of young patients in a partial hospitalization program for eating disorders.

    Science.gov (United States)

    Ornstein, Rollyn M; Essayli, Jamal H; Nicely, Terri A; Masciulli, Emily; Lane-Loney, Susan

    2017-09-01

    Avoidant/restrictive food intake disorder (ARFID) is a recently named condition to classify patients who present with restricted nutritional intake without body image distortion or fear of weight gain. We sought to compare treatment outcomes of patients with ARFID in a family-centered partial hospital program (PHP) to those with other eating disorders (ED). A retrospective chart review of 130 patients 7-17 years of age admitted to the program from 2008 to 2012 was performed. Intake and discharge data included: length of stay; percentage median body mass index (%MBMI); and scores on the Children's Eating Attitudes Test (ChEAT) and Revised Children's Manifest Anxiety Scale (RCMAS). Between and within group effects were measured for intake and discharge data. Patients with ARFID spent significantly fewer weeks in program than those with anorexia nervosa (AN) and experienced a similar increase in %MBMI as patients with AN and other specified/unspecified feeding and eating disorders. All patients exhibited significant improvements in psychopathology over the course of treatment as measured by scores on the ChEAT and RCMAS. Our