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Angleena Y Daniel
2015-01-01
Full Text Available The surgical management of maxillary pathosis results in direct communication between the oral and nasal cavity, imposing problems such as nasal regurgitation, unintelligent speech, difficulty in deglutition and compromised esthetics. A restoration of these defects is not always possible surgically, but prosthetic rehabilitation is an established treatment modality. Early rehabilitation can improve the quality of life and reduce the psychological trauma caused by surgical excision. Surgical and interim obturators placed during the initial phase can improve the outcome of the definitive prosthesis. This article presents a case report of a patient with partial maxillectomy who has been rehabilitated with a delayed surgical and an interim obturator.
Palatal obturators in patients after maxillectomy.
Cardelli, P; Bigelli, E; Vertucci, V; Balestra, F; Montani, M; DE Carli, S; Arcuri, C
2014-01-01
Prosthodontic management of palatal defects is fundamental to improve patient's life undergoing to a maxillary surgical treatment. A lot of maxillary defects are a direct consequence of surgical treatment of malformations, neoplasms or trauma. The obturators are prosthesis used to close palatal defects after maxillectomy, to restore masticatory function and to improve speech. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissue and to provide comfort, function, and aesthetics to the patients. Different materials and retention methods are a characteristic of new types of obturators.
Prosthetic Rehabilitation of Maxillectomy Patient with Post-Surgical Obturator: A Case Report
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Meena Kumari Mishra
2015-07-01
Full Text Available Case description: A 60 year old female patient presented to Department of Prosthodontics, CODS, BPKIHS, Dharan with a chief complain of loose obturator. History revealed that patient had undergone partial maxillectomy for squamous cell carcinoma 7 years back. The patient also has been wearing obturator which was loose when the patient reported to the department. On examination, the site of surgery was the maxillary right buccal sulcus area and a part of the hard palate including teeth number 11, 12, 13, 14, 15, 16, 17. The presented defect situation corresponded to a Class I situation (resection performed along the palatalmidline according to the Aramany classification of defects. The surgical site showed complete healing. A hollow-bulb obturator was fabricated for rehabilitation of the defect. Conclusion: The extensive surgical procedures necessary to eradicate cancer of the head and neck and to prevent local recurrence or regional metastasis often leave extremely large physical defects which present almost insurmountable surgical difficulties in restoring acceptable function or esthetics. The prosthesis rehabilitated the patient in terms of function by providing better masticatory efficiency, phonetics by adding resonance to the voice, hence improving the clarity of speech and also improved the esthetics of the patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i4.12976 JCMS Nepal 2014; 10(4:32-36
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Aruna Jawahirlal Bhandari
2017-01-01
Full Text Available Defects in the maxillary jaw can be congenital, developmental, acquired, traumatic or surgical involving the oral cavity and related anatomic structure. Absence or loss of some or all of the soft palate and / or hard palate results in insufficient structure or altered function of the remaining tissues. Defects can cause disruption of articulation and airflow during speech production and also nasal reflux during deglutition. Patients after surgical resection have altered anatomy due to scaring, tissue contracture, lack of bony support and tissue edema. These patients have problem of regurgitation of water and food through nose and difficulty in speech. These changes require the fabrication of prosthesis and also sometimes repeated prosthesis adjustments to confirm to the soft tissue changes. To prevent this and to help the patient in deglutition and speech defects must be restored with prosthesis. In such situation an obturator is designed to close the opening between the residual hard and / or soft palate and the pharynx. The prosthesis provided for these patients are called as obturators. An obturator is a prosthesis which is fabricated for the patients with the palatal defects in the form of cleft lip and palate, oroantral fistula or surgical resection after removable of pathology like tumor or cancer. This review article will highlight on the Prosthetic Rehabilitation of the maxillary defects and the types of obturators.
Obturator prostheses in post-oncological maxillofacial patients: our experience
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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.
Modified snap-on attachment with ′O-ring′ for two piece hollow bulb obturator
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C Gunasekar
2013-01-01
Full Text Available Restoration of near normal functions in patients who have been treated with hemimaxillectomy is generally difficult, in view of the restriction in mouth opening following healing of large surgical wound. Further, the extent and nature of the surgical defect differ from patient to patient. Thus, design of an obturator needs to be patient oriented. In this report, we describe a novel snap-on attachment with O-ring in a conventional two piece hollow bulb obturator for a 70-year-old male treated for carcinoma of the left maxilla and sinus.
Sipliviy, V A; Yevtushenko, D V; Naumova, O V; Andreyeshchev, S A; Yevtushenko, A V
2016-02-01
Abstract The results of surgical treatment of 184 patients for obturation jaundice, caused by choledocholithiasis, were analyzed. Morphological changes of the liver were studied in 20 patients. There were three groups of patients delineated, depending on the obturation jaundice duration: up to 7 days, from 8 to 14 days, more than 15 days, and also a group of patients after the bile outflow restoration. The obturation jaundice occurrence in choledocholithiasis is accompanied by significant morphological changes in the liver, severity of which is enhancing while the obturation jaundice persistence increasing. While persistence of obturation jaundice through 8 days and more the connective tissue volume is enhancing, a relative volume of hepatocytes is reducing and a stromal-parenchymatous index is increasing. The bile outflow restoration secures significant reduction of intensity of alterative and inflammatory changes in hepatic parenchyma, as well as activation of reparative processes in the tissue. In cholangitis, caused by P. aeruginosa and E. coli, according to morphological investigations data, in the liver a diffuse purulent cholangitis on background of chronic changes in accordance to duration of the obturation jaundice persists.
RTV-silikon sebagai Bahan Protesa Obturator Palatum
Chandrasegar, Akila
2011-01-01
Protesa Obturator palatum adalah protesa yang digunakan untuk menutup jaringan yang terbuka secara kongenital atau yang diperdapat, terutama bagian palatum keras atau lunak serta struktur alveolar yang berdekatan. Obturator palatum dapat diklasifikasikan berdasar pada tahap perawatannya yaitu obturator selama pembedahan (surgical obturator), obturator interim dan obturator definitif. Terdapat beberapa tipe obturator selain dari obturator palatum seperti obturator palato fari...
A conservative method of retaining an interim obturator for a total maxillectomy patient
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Nirmal Famila Bettie
2017-01-01
Full Text Available Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.
A Conservative Method of Retaining an Interim Obturator for a Total Maxillectomy Patient.
Bettie, Nirmal Famila
2017-11-01
Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.
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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.
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.
Artopoulou, Ioli Ioanna; Karademas, Evangelos C; Papadogeorgakis, Nikolaos; Papathanasiou, Ioannis; Polyzois, Gregory
2017-12-01
Restoration of maxillary defects resulting from tumor ablative surgery presents a difficult challenge, with both functional and esthetic issues. Whether rehabilitation with an obturator prosthesis could significantly contribute to improved quality of life in patients with maxillary resection has been scarcely studied, with relatively small study samples. The purpose of this survey study was to assess the overall functioning of the obturator prosthesis and the effect of specific sociodemographic, medical, and treatment variables on obturator functioning and quality of life in patients with maxillectomy. Global quality of life (QOL) and satisfaction with the obturator prosthesis of 57 patients who underwent maxillectomy and prosthetic rehabilitation at the National and Kapodistrian University of Athens were assessed using 3 questionnaires: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30), the EORTC QLQ-HN35, and the obturator functioning scale. The data were analyzed using the Kruskal-Wallis 1-way ANOVA on ranks, hierarchical multiple regression analysis, and the Spearman rank order correlation (α=.05). Satisfactory functioning of the obturator prosthesis was the most significant predictor of improved QOL (Pmaxillectomy defect (Pmaxillectomy defect had a significant effect on QOL but did not influence the functional outcome. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Obturator foramen dissection for excision of symptomatic transobturator mesh.
Reynolds, W Stuart; Kit, Laura Chang; Kaufman, Melissa R; Karram, Mickey; Bales, Gregory T; Dmochowski, Roger R
2012-05-01
Groin pain after transobturator synthetic mesh placement can be recalcitrant to conservative therapy and ultimately requires surgical excision. We describe our experiences with and technique of obturator foramen dissection for mesh excision. The records of 8 patients treated from 2005 to 2010, were reviewed. Obturator dissection was performed via a lateral groin incision over the inferior pubic ramus at the level of the obturator foramen, typically in conjunction with orthopedic surgery. Five patients had transobturator mid urethral sling surgery for stress urinary incontinence, 2 had mid urethral sling and trocar based anterior vaginal wall mesh kits with transobturator passage of mesh arms for stress urinary incontinence and pelvic organ prolapse, and 1 had an anterior vaginal wall mesh kit for pelvic organ prolapse. Patients had 0 to 2 prior transvaginal mesh excisions before obturator surgery. All patients presented with intractable pain in the area of the obturator foramen and/or medial groin for which conservative treatment measures had failed. Six patients underwent concurrent vaginal and obturator dissection and 2 underwent obturator dissection alone. In all cases residual mesh (3 to 11 cm) was identified and excised from the obturator foramen. Mesh was closely associated to or traversing the adductor longus muscle and tendon with significant fibrous reaction in all cases. Postoperatively 5 patients were cured of pain and/or infection, and 3 reported no or some improvement at a mean followup of 6 months (range 1 to 12). Our experience suggests that surgical excision of residual mesh can alleviate many of the symptoms in many patients. In all cases mesh remnants were identified and removed, and typically involved neuromuscular structures adjacent to the obturator foramen. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Dental lesions and restorative treatment in molars
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Gheorghiu Irina-Maria
2017-08-01
Full Text Available This article review specific clinical issues of the molar teeth, as well as the therapeutic approach of their pathology. The dental pathology we face in the group of molars is related to: dental caries, dental trauma (crown and crown-root fractures, dental wear phenomena. The therapeutic approach of the molar teeth is represented by: restoration of the loss of hard dental tissues; endodontic treatments of pulpal and periapical complications; surgical treatment. The restorative treatments in molars are: direct restorations, with or without supplementary anchorage for obturations; inlay, onlay; prosthetic crown.
Rehabilitation of large maxillary defect with two-piece maxillary obturators
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Kanchan P Dholam
2015-01-01
Full Text Available The insertion and removal of an obturator in large maxillary defects with or without trismus is difficult. Fabrication of a two-piece obturator in such cases overcomes this problem. This article describes rehabilitation of large maxillary defects with two piece maxillary obturator of three types. All these obturators have a maxillary plate and a bulb component, which are approximated together by various techniques namely, silicone cover, embedded magnets, and press studs. Prosthetic rehabilitation of large maxillary defects with two-piece obturators offers the possibility of adequate oral rehabilitation by fabricating light weight prosthesis, which is easy to use. The bulb covers the undercut areas of the defect enhancing the facial contour and retention. It facilitates easy examination of underlying tissues, recreation of the anatomic barrier between the oral and nasal cavities and restoration of the function and esthetics. Thus, it adds to the quality of life.
Obturator Definitive Mandibula Post Hemimandibulectomy Sinistra
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Paul Sugiyo
2012-12-01
Full Text Available Latar Belakang. Operasi bedah pemotongan mandibula pada kasus tumor jinak maupun tumor ganas dapat menyebabkan deviasi mandibula. Tindakan perawatan bedah tergantung pada lokasi dan perluasan tumor mandibula, tindakan perawatan bedah tersebut meliputi bedah marginal, segmental, hemimandibulectomy, dan total mandibulectomy. Tujuan. Makalah ini menjelaskan tentang perawatan rehabilitasi dengan obturator definitive mandibula. Para klinisi harus menunggu masa penyembuhan yang sempurna sebelum disarankan untuk dibuatkan onturator definitive mandibula. Sejak awal penyembuhan diperlukan intervensi prostodontis untuk mencegah deviasi mandibula. Protesa ini membantu pergerakan mandibula secara normal tanpa terjadi penyimpangan pada fungsi bicara dan pengunyahan. Laporan Kasus. Pada bulan Maret 2012, pasien laki-laki, berumur 46 tahun datang ke RSGM Bagian Prostodonsia atas rujukan dari RS. Dr. Sardjito Bagian Bedah Mulut setelah dilakukan operasi tumor ameloblastoma mandibula sinistra (post hemimandibulectomy mandibula sinistra dengan pemasangan plat rekonstruksi tiga bulan sebelumnya untuk dibuatkan obturator definitive mandibula. Pasien mengeluh bibir bawah sebelah kiri sering tergigit, fungsi bicara, fungsi pengunyahan, dan penampilannya terganggu. Hasil. Setelah dilakukan perawatan dengan memakai obturator definitive mandibula dalam kurun waktu 8 bulan, hingga saat ini hasil perawatan ini dapat mengembalikan fungsi bicara, fungsi pengunyahan, dan fungsi estetik sehingga pasien merasa lebih nyaman dan percaya diri. Kesimpulan. Deviasi mandibula setelah operasi hemimandibulectomy diatasi dengan bedah rekonstruksi menggunakan plat rekonstruksi, kemudian segera setelah penyembuhan perlu melibatkan prostodontis untuk pemasangan obturator definitive mandibula. Background. Surgical restion of the mandible due to presence of benign or malignant tumor is the common cause of the mandibular deviation. Depending upon the location and extent of the tumor in
Trans-obturator Tape in surgical treatment of urinary incontinence
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Ashrafi M
2008-06-01
Full Text Available Background: The aim of this study was to assess the efficacy and safety of a new minimally-invasive surgical procedure using trans-obturator Tape (TOT to treat female stress urinary incontinence.Methods: This clinical trial study was performed from 2003 to 2004 in the Gynecology Department of Imam Hospital, Vali-e-Asr, Tehran, Iran. A total of 35 women with stress urinary incontinence underwent the TOT procedure. All patients underwent pre-operative clinical examination, cough-stress test (full bladder, uroflowmetry and post-voiding residual volume assessment. Results: The mean age of patients was 50 years, ranging from 26 to 74 years, with an average urinary stress incontinence duration of six years. The mean time of follow-up was 14 months (at 1, 6, 12 and 24 months and the average duration of surgery was about 20 minutes. The perioperative complication rate was 9% with no vascular, nerve or bowel injuries. The rate of hemorrhagic side effects (spontaneously-absorbed hematoma and blood loss not requiring blood transfusion was 2.9%. Post-operative urinary retention and vaginal erosion occurred in one case each; the former was treated by intermittent self-catheterization. In total, 91.4% of patients were completely cured and 8.6% were improved without failure of treatment. Conclusions: The present study confirms the results obtained by Delorme and coworkers, and allows us to consider TOT as a safe, minimally invasive and efficient short-term surgical technique for the treatment of female stress urinary incontinence, alone or in combination with prolapse repair. Following this study, a randomized control trial is recommended to compare TOT with the gold standard surgery for women with urinary incontinence.
Examination of Articulation in Patient Using Obturator by Means of Computer Planning
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Somaieh Allahiary
2013-02-01
Full Text Available Background and Aims: Approximately 5% of cancers involve structures of oral cavity. Partial resection of maxilla (maxillectomy may be performed in these cases. Maxillectomy often results in significant functional disabilities such as inability in mastication, deglutition and speech with adverse impact on psychological statusand social life of patients. Obturator prosthesis is a prosthodontic treatment to separate nasal and oral cavities and restore the critical above mentioned functions. The assessment of speech is considered to examine speech function restored by the treatment. The purpose of this study was to evaluate the speech in patients with resected maxilla who have been treated by obturator prosthesis from a pool of related patients in the Prosthodotnics department ofdental faculty, Tehran University of Medical Sciences. The evaluation was performed with computer software using sentence intelligibility (SI test. Materials and Methods: This cross sectional study was conducted on 10 subjects (23-66 years referred to the Prosthodontics department of the faculty and received an obturator. After primary examination of the prosthesis,the patients completed SI test in an acoustic room under guidance of a speech therapist. The performed tests were analyzed by the speech therapist. In addition, the SI with and without the prosthesis was evaluate by lay audience. The statistical analyses were performed using Wilcoxon-signed rank test and Weighted Kappa. Results: Significant differences were found between SI tests with and without the obturators (P<0.001. Two of 10 patients showed problems in speech function using obturator. Conclusion: Within the limitations of the present study, obturators had significant effect on improvement of the speech outcomes of examined patients. Improvement of the quality of life could be predicted.
Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation
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Cheng Chen
2016-04-01
Full Text Available ABSTRACT INTRODUCTION: Maxillary defects are usually rehabilitated by a prosthetic obturator. OBJECTIVE: This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. METHODS: Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS. RESULTS: From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP, 11 (39% with an enhanced retentive obturator prosthesis with stud attachment (POP and 8 (28% with an enhanced retentive obturator prosthesis with magnetic attachment (POM. The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p < 0.05 among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p < 0.05 both in MOP and AOP groups. CONCLUSION: Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function.
Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation.
Chen, Cheng; Ren, Wenhao; Gao, Ling; Cheng, Zheng; Zhang, Linmei; Li, Shaoming; Zhi, Pro Ke-qian
2016-01-01
Maxillary defects are usually rehabilitated by a prosthetic obturator. This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS). From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP), 11 (39%) with an enhanced retentive obturator prosthesis with stud attachment (POP) and 8 (28%) with an enhanced retentive obturator prosthesis with magnetic attachment (POM). The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p<0.05) among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p<0.05) both in MOP and AOP groups. Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Bowel obstruction in obturator hernia: A challenging diagnosis
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L. Conti
2018-01-01
Conclusion: Obturator hernia is a rare type of hernia due to his diagnosis, which is often unclear; a prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.
A cast partial obturator with hollow occlusal shim and semi-precision attachment
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Mukesh Kumar Singhal
2018-01-01
Full Text Available A maxillofacial patient's quality of life is distorted and social integration becomes difficult. An obturator is a maxillofacial prosthesis used to close a congenital or acquired tissue defect, primarily of the hard palate and/or contiguous alveolar/soft-tissue structures. Subsequently, it restores the esthetics, speech, and function. The present clinical report aimed for the prosthetic rehabilitation of a maxillectomy defect by the incorporation of a semi-precision attachment as PRECI-SAGIX – male part of 2.2 mm on fixed partial denture (#22 and #23 teeth and matrix – plastic female part of size 2.2 mm and height 4.2 mm of yellow on cast partial in polymer base. It aids in the retention of a hollow lightweight obturator. The technique also described the method to make a bulbless obturator with a hollow self-cured acrylic resin occlusal shim. A patient is quite satisfied with bulb less, lightweight cast partial and hollow shim palatal obturator.
Obturator with soft liner in the management of hard palate defect: A ...
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Maxillary defects are created following surgical treatment of patients with congenital defects, trauma, or neoplasm. Oral cancer is one of the more common malignanciesif detected lately massive tissues will be excised surgically and correction will be challenging. One of the treatment strategies is obturator, the retention of ...
Obturator nerve schwannoma presenting as an adnexal mass: case report
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Mehta, M.; Thurston, W.A.; Merchant, N. [The Toronto Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada); Murphy, K.J. [The Toronto Hospital, Dept. of Obstetrics and Gynecology, Toronto, Ontario (Canada)
1999-02-01
Schwannomas are relatively common, benign nerve-sheath tumours. They arise most commonly from either cranial nerves or the dorsal root of spinal nerves. Schwannomas have also been reported to occur in peripheral nerve-root trunks, although this location is much less common. We report a case of a 45-year-old woman with a large pelvic mass originally believed to be an ovarian tumour. Following surgical excision, the tumour was found to be a schwannoma of the obturator nerve. To our knowledge, there are no reported cases of an obturator nerve schwannoma. The imaging features of schwannomas are reviewed. (author)
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R.T. Velázquez-Cayón
2011-03-01
Full Text Available Los defectos creados en el maxilar, principalmente tras cirugía resectiva de tumores malignos, traumatismo o defectos congénitos, deben ser corregidos con el fin de recuperar los consecuentes déficits en el habla, la deglución, la masticación y la estética. Para ello contamos con dos amplias posibilidades: reconstrucción quirúrgica o colocación de un obturador protésico maxilar. En este artículo llevamos a cabo una revisión de la literatura reciente y clásica sobre obturadores palatinos, ilustrándola mediante 5 casos clínicos con esta opción terapéutica. Hemos encontrado descritas una amplia variedad de modificaciones para los distintos tipos de obturadores, como la fabricación de aletas nasales, colocación de obturadores de forma inmediata tras la cirugía, el hecho de ahuecar el aditamento obturador, etc. En nuestra práctica hemos observado una serie de ventajas en la colocación de este tipo de prótesis de forma posquirúrgica diferida y en estrecha colaboración con su médico responsable.Defects created in the maxillary bone, principally after surgical resection of malignant tumors, trauma or congenital defects, must be corrected to eliminate the resulting speech, swallowing, and chewing defects and restore the cosmetic appearance. Two major options available are surgical reconstruction or the placement of a maxillary obturator prosthesis. The recent and classic literature on palatal obturators is reviewed and five clinical cases treated with a palatal obturator are reported. A large variety of modifications have been reported for different types of obturators, such as nasal wings, immediate postoperative obturator prosthesis placement, etc. In the authors' experience, deferred postoperative obturator placement in close collaboration with the responsible doctor has advantages.
Quality of life after maxillectomy and prosthetic obturator rehabilitation.
Chigurupati, Radhika; Aloor, Neelam; Salas, Richard; Schmidt, Brian L
2013-08-01
Surgical resection of midface neoplasms and subsequent reconstruction have been shown to have significant negative effects on quality of life (QOL). The purpose of this pilot study was to assess individuals' health-related QOL after maxillectomy and reconstruction with a prosthetic obturator. The QOL of 25 of 43 patients who underwent maxillectomy and prosthetic obturator reconstruction at the University of California-San Francisco was assessed using 3 questionnaires: University of Washington Quality of Life version 4 (UWQOL), Obturator Functioning Scale (OFS), and Mental Health Inventory (MHI). The response rate to the QOL questionnaires was 92% (23 of 25 patients). Time elapsed from maxillectomy and prosthetic obturator reconstruction to the QOL survey response ranged from 0.3 to 6.6 years (mean, 2.7 years; standard deviation [SD], 1.9 years). The post-treatment mean QOL scores were 77.3 (SD, 13.6) for UWQOL, 72.0 (SD, 12.6) for OFS, and 4.5 (SD, 0.9) for Mental Health Inventory. Individuals who received adjuvant radiation scored lower for speech and appearance (OFS, P = .05, P = .03, respectively) as well as for saliva and overall QOL (UWQOL, P = .02, P = .08, respectively). There was a strong correlation between QOL scores in OFS and UWQOL questionnaires (r = 0.78, P maxillectomy and prosthetic obturator reconstruction. There is further need for a multicenter trial with a larger sample to identify how factors affecting QOL of patients after maxillectomy might influence the choice of reconstruction. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Marvel, Richard P
2018-05-12
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit. She underwent a trial of peripheral neuromodulation of the obturator nerve with laparoscopic placement of a quadripolar lead. During the 6-day trial she had almost complete relief of her pain; therefore, she underwent permanent implantation of an intermittent pulse generator. Over the next 6 months she was completely weaned completely off her chronic opioids. At 23 months post implantation, she had essentially no pain and is no longer on any analgesic, antidepressant or membrane stabilizing medications. Peripheral Neuromodulation has the potential to alleviate pain and significantly improve quality of life in women with longstanding neuropathic chronic pelvic pain who have failed multimodal conservative therapy. Copyright © 2018. Published by Elsevier Inc.
Michelinakis, George
2017-01-01
This case report presents an alternative method for fabricating an obturator for patients that develop xerostomia and mild trismus following radiation to the Head and Neck region. Multiple initial impression stages are avoided leading to less irritation to soft tissues and less discomfort to the patient. A 69-year-old male patient was referred to our dental practice by the Maxillofacial Surgery Department of the local General Hospital. The patient had undergone a right maxillectomy for removal of a Squamous Cell Carcinoma 2 weeks prior. Four endosseous dental implants were placed in the remaining upper jaw and 2 implants were inserted into the canine region of his edentulous mandible 3 weeks after ablative surgery. Five months following completion of radiotherapy and chemotherapy, a cone beam computed tomography of the maxilla was obtained, and a three dimensional model was constructed using an appropriate resin. Using the model as the detailed primary cast, a custom acrylic special tray was fabricated for the final impression of the remaining maxilla and the maxillary defect. An implant retained maxillary obturator and an implant retained mandibular overdenture were constructed to restore patient's speech, mastication and deglutition. The method presented here can limit the impression stages needed for construction of a maxillary obturator prosthesis to a single impression procedure advocating a partial digital workflow process. This can be very beneficial to the patient suffering from postradiation side-effects such as trismus, mucositis, and xerostomia.
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George Michelinakis
2017-01-01
Full Text Available This case report presents an alternative method for fabricating an obturator for patients that develop xerostomia and mild trismus following radiation to the Head and Neck region. Multiple initial impression stages are avoided leading to less irritation to soft tissues and less discomfort to the patient. A 69-year-old male patient was referred to our dental practice by the Maxillofacial Surgery Department of the local General Hospital. The patient had undergone a right maxillectomy for removal of a Squamous Cell Carcinoma 2 weeks prior. Four endosseous dental implants were placed in the remaining upper jaw and 2 implants were inserted into the canine region of his edentulous mandible 3 weeks after ablative surgery. Five months following completion of radiotherapy and chemotherapy, a cone beam computed tomography of the maxilla was obtained, and a three dimensional model was constructed using an appropriate resin. Using the model as the detailed primary cast, a custom acrylic special tray was fabricated for the final impression of the remaining maxilla and the maxillary defect. An implant retained maxillary obturator and an implant retained mandibular overdenture were constructed to restore patient's speech, mastication and deglutition. The method presented here can limit the impression stages needed for construction of a maxillary obturator prosthesis to a single impression procedure advocating a partial digital workflow process. This can be very beneficial to the patient suffering from postradiation side-effects such as trismus, mucositis, and xerostomia.
El Fattah, H; Zaghloul, A; Pedemonte, E; Escuin, T
2012-03-01
After maxillectomy, prosthetic restoration of the resulting defect is an essential step because it signals the beginning of patient's rehabilitation. The obturator used to restore the defect should be comfortable, restore adequate speech, deglutition, mastication, and be cosmetically acceptable, success will depend on the size and location of the defect and the quantity and integrity of the remaining structures, in addition to pre-prosthetic surgical preparation of defect site. Preoperative cooperation between the oncologist surgeon and the maxillofacial surgeon may allow obturation of a resultant defect by preservation of the premaxilla or the tuberosity on the defect side and maintaining the alveolar bone or teeth adjacent to the defect. This study evaluates the importance of pre-prosthetic surgical alterations at the time maxillectomy on the enhancement of the prosthetic prognoses as part of the rehabilitation of oral cancer patient. The study was carried out between 2003- 2008, on 66 cancer patients(41 male-25 female) age ranged from 33 to 72 years, at National Cancer Institute, Cairo University, whom underwent maxillectomy surgery to remove malignant tumor as a part of cancer treatment. Patients were divided in two groups. Group A: Resection of maxilla followed by preprosthetic surgical preparation. Twenty-four cancer patients (13 male - 11 female). Group B: Resection of maxilla without any preprosthetic surgical preparation. Forty-two cancer patients (28 male-14 female). Outcome variables measured included facial contour and aesthetic results, speech understandability, ability to eat solid foods, oronasal separation, socializing outside the home, and return-to-work status. Flap success and donor site morbidity were also studied. To improve the prosthetic restoration of maxillary defect resulting maxillary resection as part treatment of maxillofacial tumor depends on the close cooperation between prosthodontist and surgeon, by combination of pre
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Arif Rachman
2009-06-01
Full Text Available Background: Replacing tooth lost caused by caries, periodontal disease, trauma and neoplasm including ameloblastoma which requires mandibular resection is important. Purpose: The aim of the study to rehabilitation of post mandibular resection with combination of hollow obturator and hybrid prosthesis. Case: A patient 25 years old, male, for having prosthesis to cover defect due to post right mandibular resection. Case Management: In this presented case, mandibular plate was applied due to spreading defect with losing almost a half body of mandible (class II modification 2 according to cantor and curtis classification. The design of therapy was mandibular obturator using hybrid prosthesis (removable partial denture metal frame and fixed splint crown with precision attachment with hollow obturator. The application was based on several advantages: good aesthetic performance, retention, stability, lighter weight and equal share of vertical load for teeth on non surgical site. The result of control I, II, III, showed that aesthetic performance, masticatory function, speech and swallowing were in good condition. Conclusion: The design of mandibular obturator using hybrid denture with hollow obturator could rehabilitate aesthetic performance, masticatory function, speech and swallowing for patient with post mandibular resection.
Two-piece hollow bulb obturator
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Subramaniam Elangovan
2011-01-01
Full Text Available There are various types of obturator fabrication achievable by prosthodontist. Maxillectomy, which is a term used by head and neck surgeons and prosthodontists to describe the partial or total removal of the maxilla in patients suffering from benign or malignant neoplasms is a defect for which to provide an effective obturator is a difficult task for the maxillofacial prosthodontist. Multidisciplinary treatment planning is essential to achieve adequate retention and function for the prosthesis. Speech is often unintelligible as a result of the marked defects in articulation and nasal resonance. This paper describes how to achieve the goal for esthetics and phonetics and also describes the fabrication of a hollow obturator by two piece method, which is simple and maybe used as definitive obturator for maximum comfort of the patient.
Ozdemir-Karatas, Meltem; Balik, Ali; Evlioglu, Gülümser; Uysal, Ömer; Peker, Kadriye
2018-03-01
The aim of this study was to determine the sociodemographic, behavioral, and clinical factors affecting obturator function and satisfaction using the obturator functioning scale (OFS) in maxillectomy patients rehabilitated with obturator prostheses. The study sample consisted of 41 maxillectomy patients. The OFS was translated into Turkish and adapted for assessing obturator functioning and patient satisfaction among Turkish patients. Data were collected from patients' medical records and self-completed questionnaires, including the Turkish version of the OFS, sociodemographic and behavioral characteristics. Descriptive statistics, Mann-Whitney U test, Spearman's correlation coefficient, and backward stepwise multiple linear regression were used for data analysis. Internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (intraclass correlation coefficient = 0.86) were acceptable for the OFS. The most frequently reported problem was "difficulty chewing." Bivariate analysis revealed significant differences in total OFS scores in terms of surgery type, defect size, and education level, except for the other clinical and sociodemographic characteristics and behavioral factors. Education level and surgery type were found to be the most important predictors of patient satisfaction and functioning of the obturator. The Turkish version of the OFS might be a useful tool for clinicians to identify patients who are at risk for poor functioning of the obturator, lack of satisfaction, and unmet needs. Copyright © 2017 Elsevier Inc. All rights reserved.
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Harsha S Nalawade
2017-01-01
Full Text Available The aim of this systematic review is to use the principles of evidence-based dentistry to evaluate the outcome of zinc oxide eugenol (ZOE paste as an obturating material in primary teeth pulpectomies. Moderate-to-high success rates are reported with ZOE in preserving chronically infected primary teeth. However, it fails to meet many of the criteria for an ideal obturating material. Databases searched were PubMed, EBSCOhost, and Google Scholar. Articles published between January 1, 1993, and June 30, 2016, with in vivo studies for obturating materials in primary teeth pulpectomy with placement of preformed crown, reporting follow-up period of at least 12 months with clinical and radiographic success rates were selected for this review. In total, 122 articles were retrieved. After the removal of duplicates and screening, full-text articles were analyzed; of which eight articles were selected for the systematic review. No significant difference was seen in the outcome of obturating materials used in comparison with ZOE in the included studies. Outcomes of ZOE paste obtained with clinical and radiographic evaluation were similar when compared to the newer combinations of materials available for obturating primary teeth today. More number of randomized controlled clinical trials for primary teeth pulpectomies with at least 12 months follow-up period and placement of crown as final restoration need to be carried out for testing the newer materials in comparison with ZOE to conclude a suitable alternative obturating material.
Herniography off femoral, obturator and perineal hernias
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Ekberg, O.; Nordblom, I.; Fork, F.T.; Gullmo, A.
1985-01-01
Positive contrast herniography was used in the workup of 550 patients with unclear groin pain. The majority of these patients had rather characteristic hernias of indirect, direct or femoral type. However, now and then diagnostic problems arose. A femoral hernia may look like a direct or even obturator hernia. There is also a variety of multilocular femoral hernias and other types. A femoral hernia may be present together with other hernias in the ipsilateral or contralateral groin. Obturator hernias are usually small but are always confined to the obturator canal laterally in the obturator foramen. Abnormalities in the pouch of Douglas may include a deep rectogenital pouch, diverticula and true herniations. These uncommon herniographic findings are described and discussed. (orig.) [de
Mayes, Susan; Ferris, April-Rose; Smith, Peter; Cook, Jill
2018-06-02
To compare the cross-sectional area (CSA) of hip external rotators, obturator externus (OE) and obturator internus (OI), in ballet dancers and nondancing athletes, and evaluate the relationship between obturator muscle size and hip pain. Case-control study. Elite ballet and sport. 33 male and female professional ballet dancers and 33 age and sex-matched athletes. CSA's of OE and OI measured on magnetic resonance imaging (MRI) of one hip. Hip pain was scored with the Copenhagen Hip and Groin Outcome Score (HAGOS): HAGOS pain score of 100 was defined as no pain and a score less than 100 was defined as pain. Participants weight and height. Estimated marginal mean CSA of OE was 14% larger in dancers than athletes (p = 0.01, ηp2 = 0.1); the size of OI was similar (p > 0.05). Men and women in both groups had similar sized OI and OE. There was no interaction between the estimated marginal mean CSA of either obturator and hip pain. It appears that ballet selectively increases muscle size of OE, but not OI. Obturator size was not related to mild hip pain, as OE and OI size was similar in dancers and athletes with and without pain. Copyright © 2018. Published by Elsevier Ltd.
Shaughnessy, Magen; Monnet, Eric
2015-02-01
To evaluate the outcome of dogs with perineal hernia treated with transposition of the internal obturator muscle. Retrospective case series. 34 dogs. Medical records of dogs with perineal hernia surgically treated from 1998 to 2012 were reviewed. Diagnostic methods and surgical techniques were recorded. Dogs were assigned preoperative and postoperative clinical sign scores. Complication and recurrence rates were evaluated over time. Risk factors were determined. Median follow-up time was 345 days (range, 22 to 1,423 days). Complications were observed in 10 dogs. Tenesmus (n = 9), dyschezia (7), fecal impaction (3), stranguria (4), hematochezia (2), urinary incontinence (2), diarrhea (1), urinary tract infection (1), and megacolon (1) occurred following surgery. Bladder retroflexion at the time of initial evaluation or surgery was not a risk factor for complication (hazard ratio, 1.72). One year after surgery, 51.2% dogs were free of complications. Three dogs developed a perineal hernia on the contralateral side between 35 and 95 days after surgery. The 1-year recurrence rate was 27.4%. Median time for recurrence was 28 days after surgery (range, 2 to 364 days). Postoperative tenesmus was a risk factor for the development of recurrence (hazard ratio, 2.29). Internal obturator muscle transposition was used for primary repair of perineal hernia in dogs. Recurrence was recorded as long as 1 year after surgery. Tenesmus was a risk factor for the development of recurrence after treatment of perineal hernia with internal obturator muscle transposition.
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Vishwas Bhatia
2015-06-01
Full Text Available What could be better than improving the comfort and quality of life of a patient with a life-threatening disease? Maxillectomy, the partial or total removal of the maxilla in patients suffering from benign or malignant neoplasms, creates a challenging defect for the maxillofacial prosthodontist when attempting to provide an effective obturator. Although previous methods have been described for rehabilitation of such patients, our goal should be to devise one stage techniques that will allow the patient an improved quality of life as soon as possible. The present report describes the aesthetic rehabilitation of a maxillectomy patient by use of a hollow obturator. The obturator is fabricated through a processing technique which is a variation of other well-known techniques, consisting of the use of a single-step flasking procedure to fabricate a single-unit hollow obturator using the lost salt technique. As our aim is to aesthetically and functionally rehabilitate the patient as soon as possible, the present method of restoring the maxillectomy defect is cost-effective, time-saving and beneficial for the patient.
MR Imaging Features of Obturator Internus Bursa of the Hip
International Nuclear Information System (INIS)
Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh
2008-01-01
The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium
Kortes, J; Dehnad, H; Kotte, A N T; Fennis, W M M; Rosenberg, A J W P
2018-04-07
Partial or complete resection of the maxilla during tumour surgery causes oronasal defects, leading to oral-maxillofacial dysfunction, for which the surgical obturator (SO) is an important treatment option. Traditional manufacturing of SOs is complex, time-consuming, and often results in inadequate fit and function. This technical note describes a novel digital workflow to design and manufacture a three-dimensional (3D)-printed hollow SO. Registered computed tomography and magnetic resonance imaging images are used for gross tumour delineation. The produced RTStruct set is exported as a stereolitography (STL) file and merged with a 3D model of the dental status. Based on these merged files, a personalized and hollow digital SO design is created, and 3D printed. Due to the proper fit of the prefabricated SO, a soft silicone lining material can be used during surgery to adapt the prosthesis to the oronasal defect, instead of putty materials that are not suitable for this purpose. An STL file of this final SO is created during surgery, based on a scan of the relined SO. The digital workflow results in a SO weight reduction, an increased fit, an up-to-date digital SO copy, and overall easier clinical handling. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Institute of Scientific and Technical Information of China (English)
Jun Sang Yoo; Qiang Zhu; Kee-Yeon Kum; Seok-Woo Chang; So Ram Oh; Hiran Perinpanayagam; Sang-Min Lim; Yeon-Jee Yoo; Yeo-Rok Oh; Sang-Bin Woo; Seung-Hyun Han
2014-01-01
The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n560) were instrumented to an apical size #50/0.06 using ProFile and treated as follows:Group 1 (n510) was filled with phosphate buffered saline (PBS);Group 2 (n510) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS;Group 3 (n520) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS;and Group 4 (n520) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
MR Imaging Features of Obturator Internus Bursa of the Hip
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Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)
2008-08-15
The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium
2016-01-01
Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth. PMID:27826392
Strangulated obturator hernia - an unusual presentation of intestinal obstruction.
LENUS (Irish Health Repository)
Zeeshan, Saqib
2012-01-31
An 81-year-old Caucasian emaciated female presented with 3 days history of colicky abdominal pain nausea, projectile vomiting and abdominal distension. A pre-operative diagnosis of mechanical bowel obstruction was made. The absence of characteristic clinical signs in this thin elderly woman with a small bowel obstruction failed to provide a pre-operative diagnosis. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved.
DEFF Research Database (Denmark)
Lenz, Katja; Jensen, Kenneth; Tanggaard, Katrine
2018-01-01
BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block in p...
Faus-Llácer, Vicente; Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente
2015-04-01
The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation.
Finite element analysis of maxillary bone stress caused by Aramany Class IV obturator prostheses.
Miyashita, Elcio Ricardo; Mattos, Beatriz Silva Câmara; Noritomi, Pedro Yoshito; Navarro, Hamilton
2012-05-01
The retention of an Aramany Class IV removable partial dental prosthesis can be compromised by a lack of support. The biomechanics of this obturator prosthesis result in an unusual stress distribution on the residual maxillary bone. This study evaluated the biomechanics of an Aramany Class IV obturator prosthesis with finite element analysis and a digital 3-dimensional (3-D) model developed from a computed tomography scan; bone stress was evaluated according to the load placed on the prosthesis. A 3-D model of an Aramany Class IV maxillary resection and prosthesis was constructed. This model was used to develop a finite element mesh. A 120 N load was applied to the occlusal and incisal platforms corresponding to the prosthetic teeth. Qualitative analysis was based on the scale of maximum principal stress; values obtained through quantitative analysis were expressed in MPa. Under posterior load, tensile and compressive stresses were observed; the tensile stress was greater than the compressive stress, regardless of the bone region, and the greatest compressive stress was observed on the anterior palate near the midline. Under an anterior load, tensile stress was observed in all of the evaluated bone regions; the tensile stress was greater than the compressive stress, regardless of the bone region. The Aramany Class IV obturator prosthesis tended to rotate toward the surgical resection when subjected to posterior or anterior loads. The amount of tensile and compressive stress caused by the Aramany Class IV obturator prosthesis did not exceed the physiological limits of the maxillary bone tissue. (J Prosthet Dent 2012;107:336-342). Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.
Manufacturing hollow obturator with resilient denture liner on post hemimaxillectomy
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Michael Josef Kridanto Kamadjaja
2006-03-01
Full Text Available A resilient denture liner is placed in the part of the hollow obturator base that contacts to post hemimaxillectomy mucosa. Replacing the resilient denture liner can makes the hollow obturator has an intimate contact with the mucosa, so it can prevents the mouth liquid enter to the cavum nasi and sinus, also eliminates painful because of using the hollow obturator. Resilient denture liner is a soft and resilient material that applied to the fitting surface of a denture in order to allow a more distribution of load. A case was reported about using the hollow obturator with resilient denture liner on post hemimaxillectomy to overcome these problems.
Speech rehabilitation of maxillectomy patients with hollow bulb obturator.
Kumar, Pravesh; Jain, Veena; Thakar, Alok
2012-09-01
To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients. A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery), after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software. The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation. Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.
Speech rehabilitation of maxillectomy patients with hollow bulb obturator
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Pravesh Kumar
2012-01-01
Full Text Available Aim: To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients. Materials and Methods: A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery, after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software. Results: The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation. Conclusion: Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.
Starosek, V N; Khil'ko, S S; Vlakhov, A K
2009-04-01
The article is devoted to the problem of efficacy of the hepatic insufficiency (HI) prophylaxis and treatment methods in obturation jaundice. The role of energy-depending processes and the oxygen deficiency in tissues in the HI occurrence and progressing, the possibilities of medicinal correction of such disorders were studied up. The authors follow the concept of expediency of the oxygen-bearing preparations, which improve the erythrocytes function and oxygen delivery to the tissues in combination with miniinvasive decompression of bilioefferent ways, incorporation into the treatment complex of HI of mechanic genesis.
Oral function after maxillectomy and reconstruction with an obturator
Kreeft, A.M.; Krap, M.; Wismeijer, D.; Speksnijder, C.M.; Smeele, L.E.; Bosch, S.D.; Muijen, M.S.A.; Balm, A.J.M.
2012-01-01
Maxillectomy defects can be reconstructed by a prosthetic obturator or (free) flap transfer, but there is no consensus about the optimal method. This study evaluated 32 maxillectomy patients with prosthetic obturation regarding function (mastication, subjective oral and swallowing complaints and
Brief reports: ultrasound-guided obturator nerve block: a proximal interfascial technique.
Taha, Ahmad Muhammad
2012-01-01
In this report, I describe and evaluate a proximal ultrasound (US)-guided obturator nerve block technique using an interfascial local anesthetic (LA) injection deep to the pectineus muscle. The pectineus muscle was identified and followed, while the US probe was tilted cranially until the superior pubic ramus was visualized. In this plane, LA was injected interfascially between the pectineus and obturator externus. The median time required to identify the injection site was 4 seconds (95% confidence interval, 3-5 seconds). The median motor block onset was 4 minutes (95% confidence interval, 3-5 minutes). Both obturator nerve branches were blocked successfully in all patients (100%). The US-guided obturator nerve block using interfascial LA injection inferior to the superior pubic ramus, between the pectineus and obturator externus muscles, was shown to be a simple and successful technique.
Stress analysis in oral obturator prostheses: imaging photoelastic
Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Haddad, Marcela Filié; Andreotti, Agda Marobo; Moreno, Amália
2013-06-01
Maxillary defects resulting from cancer, trauma, and congenital malformation affect the chewing efficiency and retention of dentures in these patients. The use of implant-retained palatal obturator dentures has improved the self-esteem and quality of life of several subjects. We evaluate the stress distribution of implant-retained palatal obturator dentures with different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus-nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge (incisive, canine, and first molar regions) and the other did not receive implants. Afterwards, a conventional palatal obturator denture (control) and two implant-retained palatal obturator dentures with different attachment systems (O-ring; bar-clip) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine, and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using a software (Adobe Photoshop). The bar-clip system exhibited the highest stress concentration followed by the O-ring system and conventional denture (control). Images generated by the photoelastic method help in the oral rehabilitator planning.
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Sila Cagri Isler
2018-03-01
Full Text Available Background/purpose: An ideal therapeutic procedure for the treatment of gingival recession associated with an NCCL has presented a challenge to clinicians. Various dental materials and surgical approaches have been used to manage gingival recessions associated with NCCLs for the most predictable combined surgical/restorative treatment. The objective of this study was to evaluate the treatment of gingival recessions associated with non-carious cervical lesions (NCCL using a modified coronally advanced flap (MCAF in combination with a connective tissue graft (CTG on restored root surfaces. Materials and methods: Twenty-three systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were enrolled in the study. The NCCL were each restored prior to surgery by using one of three different materials: nanofilled composite resin (NCR, resin-modified glass ionomer cement (RMGI or giomer. The gingival recession defects were treated by CTG. Results: Inter-group differences were not statistically significant for probing depth (PD, relative recession height (rRH, relative clinical attachment level (rCAL, keratinized tissue width (KTW or keratinized tissue thickness (KTT (p > 0.05 among the groups at any time. The mean percentage of defect coverage was 71.18 ± 23.16% for NCR + CTG group; 71.33 ± 22.33% for RMGI + CTG group; and 64.23 ± 20.33% for giomer + CTG group at 1 year postoperatively (p > 0.05. Conclusion: The combined surgical/restorative treatments provided successful clinical results. Giomer + CTG may be less effective compared to other groups for treatment of gingival recession associated with NCCL. Keywords: cervical lesions, connective tissue grafts, gingival recession, restorative materials
Obturator hernia: a rare case of acute mechanical intestinal obstruction.
Aydin, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali
2013-01-01
Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.
A hollow definitive obturator fabrication technique for management of partial maxillectomy.
Patil, Pravinkumar Gajanan; Patil, Smita Pravinkumar
2012-11-01
Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.
Miklos, John R; Moore, Robert D; Chinthakanan, Orawee
2015-01-01
To show a technique of retropubic tension-free vaginal tape (TVT) removal using both a transvaginal and laparoscopic approach in the treatment of a rare condition, obturator neuralgia. A step-by-step explanation of the patient's condition, diagnosis, surgical technique, and postoperative results using video, pictures, and medical illustrations (education video). TVT retropubic slings have become the gold standard for the treatment of stress urine incontinence over the last decade. Despite high cure rates, the TVT is not without potential complications. Typical complications include urine retention, incomplete bladder emptying, frequency, urgency, urethral erosion, vaginal extrusion, vaginal pain, and dyspareunia. The most common complication for sling removal/revision is chronic pain. The TVT obturator neuralgia is a rare and specific type of chronic pain that is normally associated with transobturator tape slings. The purpose of this video is to present an extremely rare complication of TVT retropubic slings, present symptoms and signs of obturator nerve compression, show the normal and the actual position of this patient's TVT sling, describe the laparoscopic removal of the TVT sling, and present the postoperative course and resolution of the patient's pain. The patient signed a release for her video to be used for educational and teaching purposes. A combined transvaginal and laparoscopic approach in a patient with lower abdominal, levator, and obturator-type pain after a TVT retropubic procedure. In patients suffering from obturator neuralgia after a retropubic sling, surgeons should include the sling as a potential causative factor in the differential diagnosis. Surgeons should consider removing the sling based on the patient's symptoms. If the patient suffers from only vaginal pain and dyspareunia, then the surgeon should consider only the removal of the vaginal portion of the sling. In patients with obturator neuralgia, retropubic, and/or lower abdominal
Obturator Hernia: A Rare Case of Acute Mechanical Intestinal Obstruction
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Ibrahim Aydin
2013-01-01
Full Text Available Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.
Hou, Yue-Zhong; Huang, Zhi; Ye, Hong-Qiang; Zhou, Yong-Sheng
2012-01-01
The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot be considered. This case report described the use of an air valve in a hollow silicone obturator to manufacture an inflatable obturator that could be extended further into undercut area to retain itself. The inflatable obturator exhibited adequate retention, stability and border sealing, thereby improving the masticatory, pronunciation and swallowing functions of patients. It may be a suitable alternative treatment option to an implant-retained obturator. PMID:22653550
Küçükkaya Eren, Selen; Askerbeyli Örs, Sevinc; Yılmaz, Zeliha
2017-07-01
The purpose of this study was to evaluate the obturation quality of root canals filled with different techniques and to determine whether post space preparation had an effect on the quality of apical obturation using micro-computed tomographic (micro-CT) imaging. The root canals of 30 human mandibular premolar teeth were instrumented, and the specimens were divided into 3 groups according to the obturation technique used: cold lateral compaction (CLC), warm vertical compaction (WVC), or single-cone (SC) techniques. The specimens were stored at 37°C and 100% humidity for 1 week. Then, the coronal root filling material was removed in order to create a post space. Micro-CT scans were performed before and after post space preparation for the volumetric analysis of voids and filling materials. Data were analyzed using repeated-measures analysis of variance and Bonferroni tests. The CLC and SC groups showed a significantly greater percentage volume of voids than the WVC group (P space preparation (P > .05). The post space preparation caused a significant increase in the percentage volume of voids in the CLC and SC groups (P space preparation (P > .05). No root fillings were void free. The WVC group presented the best obturation quality. The post space preparation negatively influenced the apical integrity of the filling materials in the CLC and SC groups, whereas it had no significant effect in the WVC group. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Restoring accommodation: surgical technique and preliminary evaluation in rabbits
Tahi, Hassan; Chapon, Pascal F.; Hamaoui, Marie; Lee, William E.; Holden, Brien; Parel, Jean-Marie A.
1999-06-01
Purpose. To evaluate an innovative surgical technique for phaco-ersatz, a cataract surgery designed to restore accommodation. Techniques for very small capsulorhexis as well as the refilling procedure were developed. This study evaluates the feasibility and reproducibility of the surgical technique. Methods. The right eye of 8 NZW rabbits (~ 2 Kg) were operated following the ARVO Statements for the Use of Animals in Ophthalmic and Vision Research. The surgery is begun by making a small peripheral capsulorhexis of about 1 mm using. The lens content is then removed. The lens is then refilled with a novel in situ polymerizable gel and the corneal incision is closed using one 10/0 Nylon interrupted stitch. Results. The capsulorhexis technique was succesfully performed and reproducible in all animals. The average size of the capsulorhexis opening was 1. 2 mm (+/-0.14). Lens material removal and refilling of the capsular bag with an in situ polymerizable material was also performed in each trial study. Conclusion. This surgical technique seemed feasible and reproducible.
Yap, Wai Ying; Che Ab Aziz, Zeti Adura; Azami, Noor Hayati; Al-Haddad, Afaf Yahya; Khan, Asfand Ali
2017-01-01
To evaluate the push-out bond strength and failure modes of different sealers/obturation systems to intraradicular dentin at 2 weeks and 3 months after obturation compared to AH Plus®/gutta-percha. A total of 180 root slices from 60 single-canal anterior teeth were prepared and assigned to 5 experimental groups (n = 36 in each group), designated as G1 (AH Plus®/gutta-percha), G2 (TotalFill BC™ sealer/BC-coated gutta-percha), G3 (TotalFill BC™ sealer/gutta-percha), G4 (EndoREZ® sealer/EndoREZ®-coated gutta-percha), and G5 (EndoREZ® sealer/gutta-percha). Push-out bond strengths of 18 root slices in each group were assessed at 2 weeks and the other 18 at 3 months after obturation using a universal testing machine. Data were analyzed using repeated measures ANOVA. An independent t test was used to compare the mean push-out bond strength for each group at 2 weeks and 3 months after obturation. The mean push-out bond strengths of G4 and G5 were significantly lower than those of G1, G2, and G3 (p strengths of G2 (3.69 ± 1.20 MPa) and G3 (2.84 ± 0.83 MPa) were higher at 3 months compared to 2 weeks after obturation (G2: 1.74 ± 0.43 MPa, G3: 1.33 ± 0.29 MPa). The TotalFill BC™ obturation system (G2) and the TotalFill BC™ sealer/gutta-percha (G3) showed comparable bond strength to AH Plus®. Their bond strength increased over time, whereas the EndoREZ® obturation system (G4) and EndoREZ sealer (G5) had low push-out bond strength which decreased over time. © 2017 The Author(s) Published by S. Karger AG, Basel.
Obturator hernia should be considered in the differential diagnosis of hip and knee pain.
Belli, Ahmet Korkut; Memiş, Gündüz; Dere, Özcan; Koşan, Ulaş; Nazlı, Okay
2016-11-01
Obturator hernia is a rare disease usually occurring in debilitated elderly women. Pain radiating down the medial thigh and knee (Howship-Romberg sign) is a specific sign of the disease. Presently described is a case of obturator hernia in a 73-year-old female patient who presented with severe left hip pain radiating down the medial thigh and knee, nausea, and loss of appetite. Initially, vertebral disc herniation was thought to be cause, but abdomino-pelvic computed tomography scan revealed left strangulated obturator hernia. Diagnosis of obturator hernia can be challenging. Physicians should consider obturator hernia in the differential diagnosis of knee and hip pain, and investigate for Howship-Romberg sign. Early diagnosis of the disease not only decreases morbidity and mortality, but also presents opportunity to treat with minimally invasive methods.
Murat, Sema; Gurbuz, Ayhan; Isayev, Abulfaz; Dokmez, Bahadir; Cetin, Unsun
2012-01-01
The majority of maxillary defects can be rehabilitated with conventional simple obturator prosthesis. However, inadequate retention, stability and support may be associated with the use of an obturator. Precision attachments have been used to retain obturators for some time. The use of precision attachments in a dentate maxillectomy patient can yield significant functional improvement while maintaining the obturator’s aesthetic advantages. This clinical report describes the prosthetic rehabil...
Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material
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Bidhan Shrestha
2015-01-01
Full Text Available Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration.
Sreeraj, R; Krishnan, Vinod; V, Manju; Thankappan, Krishnakumar
This study compared masticatory and swallowing functional outcomes in maxillectomy patients who underwent surgical and prosthetic rehabilitation or prosthetic rehabilitation only following surgical resection. This comparative cross-sectional study involved 20 maxillectomy patients and compared their masticatory and swallowing functions following combined surgical and prosthodontic management vs an exclusively prosthodontic approach. Masticatory performance was measured by an originally modified sieve method using hydrocolloid material, and video fluoroscopic examination was employed for swallowing assessments. Masticatory performance was significantly better in the patient group treated with flaps and removable denture prostheses compared to patients treated with obturator prosthesis alone. Swallowing outcomes were comparable in both groups. Flap reconstruction followed by an obturator prosthesis seems to be a preferable option when planning for functional rehabilitation in maxillectomy patients. Further research is needed to substantiate the functional outcomes noted in this study.
Oral function after maxillectomy and reconstruction with an obturator.
Kreeft, A M; Krap, M; Wismeijer, D; Speksnijder, C M; Smeele, L E; Bosch, S D; Muijen, M S A; Balm, A J M
2012-11-01
Maxillectomy defects can be reconstructed by a prosthetic obturator or (free) flap transfer, but there is no consensus about the optimal method. This study evaluated 32 maxillectomy patients with prosthetic obturation regarding function (mastication, subjective oral and swallowing complaints and maximal mouth opening). Outcomes were related to the extent of the resection (Brown maxillectomy classification), dentition and history of adjuvant radiotherapy. Maxillectomy defects ranged from 2-1 to 4B on the Brown classification, and most had a defect graded as 2-A or 2-B. Mean mixing ability test after 10 chewing strokes was 24.2 and after 20 chewing strokes 19.7, which compares to edentulous healthy individuals. None of the outcomes was influenced by Brown classification. Radiotherapy negatively influenced mean maximal mouth opening (29.1mm versus 40.9 mm, p=0.017) and subjective outcomes. Edentate obturated patients had worse outcomes than dentate patients, measured by mixing ability test and questionnaire. In conclusion, mastication after obturator reconstruction of a maxillectomy defect is comparable to mastication with full dentures. Size of the maxillectomy defect did not significantly influence functional outcome, but adjuvant radiotherapy resulted in worse mouth opening and self-reported oral and swallowing problems. Residual dentition had a positive influence on mastication and subjective outcomes. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
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Mehran Bahrami
2017-01-01
Full Text Available A 61-year-old female patient with adenoid cystic carcinoma (ACC of the right maxilla and Angle class II division 1 malocclusion had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. After implants placement, a maxillary interim immediate obturator (IIO and then a definitive obturator using six endosseous implants were fabricated. During one-year follow-up, the patient was completely satisfied. Ideally, after implants placement in edentulous patients suffering from hemimaxillectomy, an implant-supported obturator (ISO is designed in order to prevent nasal reflux and to improve speech and swallowing. However, in the following case, because of skeletal class II division 1 malocclusion and implants insertion in the premaxilla, using an ISO was impossible because it would cause excessive upper lip protrusion and lack of anterior teeth contact. Therefore, a five-unit implant-supported fixed partial denture (FPD was fabricated in the maxillary anterior segment so that anterior teeth contacts were possible and the patient’s normal lip support was achieved. A bar and three ball attachments were used in the maxillary posterior segment. A closed-hollow-bulb ISO was preferred. Conventional ISO in these patients results in several problems. Using a maxillary anterior FPD along with ISO caused satisfactory results in the current patient.
Fabrication of a 3D Printing Definitive Obturator Prosthesis: a Clinical Report
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Georgios Kouveliotis
2017-01-01
Full Text Available Introduction: Digital technologies related to imaging and manufacturing provide the clinician with a wide variety of treatment options. Stereolithography (SLA offers a simple and predictable way for an accurate reconstruction of congenital or acquired defects. Clinical case: A 65-years old cancer patient with non- keratinized squamous cell carcinoma of left maxillary sinus came for a prosthetic clinical evaluation. A bilateral maxillectomy was performed and the treatment plan included definite obturator prosthesis for the upper arch. CT data and 3D planning software were used to create a 3D printing plastic model of the defect. A wax pattern of the hollow bulb was fabricated and cured with heatcured silicone soft liner. A final impression was obtained with the hollow bulb placed intraorally. The master cast was duplicated and the new cast was invested and reflasked. The flasks were opened, wax was boiled out and some space was created in the internal part of the obturator. Transparent heat cured acrylic resin was sandwiched with, at the inner part of the bulb, improving the retention between the acrylic denture base and the silicone based soft lining material. The patient was then placed on a 6-month recall. The five-year follow up consists of a chair side relining, when needed, of the definite removable prostheses. Conclusion: Maxillofacial surgery patients may develop postoperative complications such as trismus and pain. In these cases, the combination of digital technology and conventional techniques provide an accurate prosthetic restoration.
Obturator yang Berfungsi Sebagai Protesa pada Perawatan Pasien Sumbing Langitan (Laporan Kasus
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Avy Permata Sari
2015-11-01
Full Text Available Palatal cleft is opening of palatal including palatum mole and durum. It is caused by growth and development disturbance intra uterine. There are some etiology lke genetic factor, infection, drugs, mutagenic material, malnutrition, and psychological problem during pregnancy. In this case the patient came to our clinic to be made obturator to close the palatal fistule that caused speech and nutrition problems. Because there were some missing teeth, the obturator was combined with prosthetic design. At recall visit the obturator improved speech, swallow, and mastication functions and aesthetics and patient showed the ability to use it by himself.
Candida albicans in patients with oronasal communication and obturator prostheses
MATTOS, Beatriz Silva Câmara; SOUSA, Andréa Alves de; MAGALHÃES, Marina Helena C. G. de; ANDRÉ, Marcia; BRITO E DIAS, Reinaldo
2009-01-01
Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis...
The influence of obturators on the respiration of patients with maxillary defects: a clinical study.
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Xian Dong
Full Text Available The study evaluated the effects of obturators on respiratory function by analyzing the changes in nasal anatomic structures and physiologic function in maxillectomy patients with and without obturators. Twenty-six patients who underwent maxillectomy were chosen and rehabilitated with obturators by a single maxillofacial prosthodontist. The geometric shape of the nasal cavity, the nasal airway resistance, and the ratio of residual volume to total lung capacity (RV/TLC were evaluated using acoustic rhinometry, rhinomanometry, and a pulmonary function test apparatus, respectively. All patients were tested twice, with and without their obturators. The results were statistically analyzed with a paired t-test. The nasal cavities (0-7 cm to the anterior nostril of the patients with obturators had a significantly smaller volume ([-8.92, -0.60], P = 0.027, smaller effective nasal cross-sectional area MCA2 ([-3.80, -1,81], P < 0.0001, increased airflow in the nasal cavity ([17.76, 147.39], P = 0.015, reduced nasal airway resistance ([-0.11, -0.02], P = 0.009, and reduced RV/TLC ([-5.32, -1.30], P = 0.004 compared with the patients without obturators. According to the results of this study, obturators can improve respiratory function by effectively decreasing the volume of enlarged nasal cavities as well as the nasal air resistance and volume of anatomical dead space after maxillectomy.
Quality of Life in Patients After Maxillectomy and Placement of Prosthetic Obturator.
Chen, Cheng; Ren, Wen-Hao; Huang, Rui-Zhe; Gao, Ling; Hu, Zhi-Ping; Zhang, Lin-Mei; Li, Shao-Ming; Dong, Kai; Qi, Hong; Zhi, Ke-Qian
2016-01-01
The aim of this study was to assess quality of life (QoL) and obturator functioning in patients having undergone a maxillectomy as a tumor ablative resection and rehabilitation with a prosthetic obturator. The University of Washington Quality of Life scale version 4 (UW-QoLv4) and the Obturator Functioning Scale (OFS) were used to evaluate the self-reported QoL and obturator functioning. The effects of demographic and treatment variables on QoL were assessed using age, defect size, postoperative radiotherapy (RT), neck dissection, and dentition. The study included 16 men and 13 women with a mean age of 48.8 years. Of the 29 patients, 16 had a Brown Class 2a or smaller defect and 13 had a Brown Class 2b or larger defect. The mean OFS score (P = .004) and the physical (P = .001) and social-emotional function scores (P = .001) of the patients who received postoperative RT were significantly lower than those who did not receive postoperative RT. The subscales for swallowing (P = .008), saliva (P = .001), pain (P = .001), and shoulder function (P = .002) correlated strongly with postoperative RT on the UW-QoL. The subscales for pronunciation (P = .007) and saliva (P = .002) correlated significantly with RT on the OFS. The mean OFS scores were significantly lower for the patients with a Brown Class 2a or smaller defect than for Brown Class 2b or larger (P = .005). Postoperative RT was the strongest variable affecting QoL in patients with maxillectomy and prosthetic obturator reconstruction. The size of the defect slightly influenced the obturator function; however, it did not influence the overall QoL.
Chen, Boqing; Rispoli, Leia; Stitik, Todd; Leong, Michelle
2017-10-01
This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.
Obturator or "lateral" bypass in the management of infected vascular prostheses at the groin
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Davidović Lazar B.
2002-01-01
Full Text Available The infection of the previously implanted vascular graft at the groin, is associated with great mortality and morbidity rate [1]. The authors present a retrospective study in which they analyzed management of infected vascular prostheses at the groin, using obturator bypass in 26 cases, and "lateral" bypass in 15 cases. The indications for obturator bypass reconstructions included: 20 infections of aorto-femoral grafts, two infected pse udoaneurysms in the groin after RTA of the superficial femoral artery, and 4 infections of iliac-femoral grafts. The indications for lateral bypass reconstructions were: infections after aorto-femoral reconstructions - 8 cases; infection after femora-popliteal reconstructions - 4 cases; infection after iliac-femoral reconstruction - 2 patients, and one infected pseudoaneurysm in the groin after RTA of the superficial femoral artery. In 3 subjects obturator bypass was performed using extraperitoneal approach while in other 23 patients transperitoneal approach was done by donor's artery. The obturator bypass was performed using a PTFE graft in 3 cases and Dacron graft in 23. The donor's artery used for obturator bypass was a noninfected proximal part of aortofemoral graft in 20 cases, and iliac artery in 6 patients. The superfical femoral artery was recipient artery for obturator bypass in 3 cases, deep femoral artery in one case, and above the knee popliteal artery in 22 cases (Figure 1. In two patients transperitoenal approach to donors artery for "lateral" bypass has been used, and in 13 cases extraperitoneal. The proximal noninfected part of aorto femoral graft was used as a donor's artery for lateral bypass in 8 patients, while common iliac artery in 7 subjects. In 5 cases recon structions were performed using PTFE grafts, in 3 using autologous saphenous vein grafts, and in 7 using Dacron grafts. The recipient artery for "lateral" bypass was deep femoral in 8 cases, superficial femoral in three patients and
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Makedonova Y.A.
2012-03-01
Full Text Available Simple, reliable and predictable obturation of root canals side by side with their cleaning and forming is an essential part of the endodontic treatment. The aim of this research is investigation of obturation density of root canals. Canals filled by means of lateral condensation of the new obturative system «Real Seal/Resilon» and by means of traditional method of canals obturation with the help of gutta-percha and sealer АН-plus. The results of the research proved a ligher hermetizing ability of the new experimental material «Real Seal» in comparison with obturation by means of gutta-percha pins. The obtained data reflects an objective picture and can be applied as a unique quality monitoring obturation of root canals.
Closed hollow bulb obturator--one-step fabrication: a clinical report.
Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah
2013-10-01
A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing. © 2013 by the American College of Prosthodontists.
Li, W L; Lu, Z W; Li, F P; Yu, H Y
2016-07-26
To compare the effectiveness and complications of TVT-Abbrevo (tension-free vaginal tape-Abbrevo) and TVT-Obturator (tension-free vaginal tape-obturator) for the treatment of female stress urinary incontinence (SUI). From Nov.2012 to Nov.2013, 117 patients suffering from SUI were treated with TVT-Abbrebo (n=79) or TVT-Obturator (n=38) procedure, the clinical efficacy and operation-correlated complications were observed. A total of 117 cases, 107 cases of urinary incontinence symptoms disappeared completely, 10 cases were improved. 72 cases (91.1%) were cured and 7 cases (8.9%) were improved in TVT-Abbrevo group; 35 cases (92.1%) were cured and 3 cases (7.9%) were improved in TVT-Obturator group. No significant differences could be found for the curing rates between two groups (P>0.05). Compared with the TVT-Obturator group, the TVT-Abbrevo group had less patients complaining of inner thigh pain at 24 h and 1 w after surgery (PTVT-Abbrevo and TVT-Obturator group (P>0.05). No intraoperative complications such as blood vessel, nerve, bladder damage were recorded and no postoperative retropubic hematoma, tape adjustment and other complications occurred in two goups. No recurrence after 1 year follow-up. The study shows that TVT-Abbrevo procedure is safe and efficacy in treatment of SUI, and associated with low incidence of recent postoperative inner thigh pain.
Kustryo, V I; Langazo, O V
2015-11-01
Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.
[Clinical-diagnostic estimation of carbohydrates metabolism in obturation jaundice].
Nychytaĭlo, M Iu; Malyk, S V
2004-07-01
Complex examination of 175 patients with obturation jaundice was conducted, peculiar attention was spared to the carbohydrates metabolism changes, characterizing hepatic state. It was established, that in obturation jaundice in the liver there are occurring inflammatory changes and disturbances of all kinds of metabolism, including that of carbohydrates, severity of which depends on duration of jaundice, the concurrent diseases presence, they shows lowering of the glucose and glycogen level in the blood, as well as the hepatic glycogen content, that's why they may be applied as a complex of prognostic criterions for the disease course. An early conduction of operative treatment, elimination of the biliary ducts impassability promote the rehabilitation period shortening and the hepatic functional activity normalization.
Houwert, R. Marijn; Roovers, Jan Paul W. R.; Venema, Pieter L.; Bruinse, Hein W.; Dijkgraaf, Marcel G. W.; Vervest, Harry A. M.
2010-01-01
OBJECTIVE: We sought to determine and compare surgical therapeutic indices (STIs) of the retropubic tension-free vaginal tape (TVT) and 2 kinds of transobturator tape (TOT), Monarc (American Medical Systems, Minneapolis, MN), and tension-free vaginal tape obturator. STUDY DESIGN: This was a
Obturator Hernia: diagnosis and management under conditions of ...
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85.7%) underwent full resection and anastomosis, and one (14.3%) had partial resection. Hernia defect was closed in four (57.1%). Wound infection was common (71.4%) and three (43%) died. Conclusion: Obturator hernia is mainly a disease ...
Hiremath, Mallayya C; Srivastava, Pooja
2016-01-01
The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. The results showed significant differences between the four groups for the length of obturation (P tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.
Akhil, Jose E J; Prashant, Babaji; Shashibushan, K K
2018-05-10
Successful pulpectomy in primary teeth depends on quality of obturation. It can be evaluated using digital intra-oral receptor (D.I.O.R) and cone beam computed tomography (C.B.C.T). The purposes of this study were to compare 3 different obturation techniques such as lentulospiral, insulin syringe, and endodontic plugger in primary incisors and to evaluate its quality of obturation using D.I.O.R and C.B.C.T technique. Thirty-three extracted primary incisors were biomechanically prepared and obturated with zinc oxide eugenol cement by 3 different obturation techniques. The obturation was evaluated for length of obturation and voids using D.I.O.R and C.B.C.T methods. There was a statistically significant difference between all the groups in length of obturation (P = 0.02) in both D.I.O.R and C.B.C.T. Significant differences (P = 0.03) were present in number of voids among 3 obturation techniques in C.B.C.T. Statistically more voids were observed with D.I.O.R in lentulospiral (P = 0.04) group and in insulin syringe (P = 0.02) group. Acceptable result was obtained with lentulospiral in length of obturation compared to insulin syringe and endodontic plugger technique. Insulin syringe technique resulted in increased underfilling with least number of voids. More number of voids were seen in middle one-third and least number of voids were observed at apical one third of the root among all the 3 techniques of obturation. The study concluded that void identification is improved with D.I.O.R compared to C.B.C.T. Lentulospiral reported effective length of obturation, while insulin syringe with least number of voids. D.I.O.R (2-Dimensional) is efficient in detecting voids compared to C.B.C.T (3-Dimensional) in obturated primary teeth.
Hiremath, Mallayya C.; Srivastava, Pooja
2016-01-01
Purpose: The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. Materials and Methods: A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presenc...
Application of palatal RB obturator in babies with isolated palatal cleft
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Radojičić Julija
2009-01-01
Full Text Available Background. Isolated cleft of secondary palate has a specific clinical picture due to a wide communication between the mouth and nose cavity. As a consequence of that, babies born with this malformation are often subject to infections of the upper bronchial tubes, middle ear, speech disorders, and certainly the most difficult existential problem they face at the very beginning of their lives, the impossibility of suckling (breast feeding. Such babies have to be fed with gastric probe. The difficulties in their nutrition have often been described in literature, yet a singular attitude toward early orthodontic therapy has not been adopted still. The aim of the paper was to describe a design and application of obturator immediately after the birth of a baby with isolated palatal cleft, and the role in feeding. Case report. We presented a female neonate, born on 27th December 2007, with a wide fissure in the shape of the letter U over the entire secondary palate. The baby was referred to the Stomatology Clinic due to nutrition impossibility. To avoid feeding with gastric probe, the formation of RB obturator was performed (artificial palate. Hereby, the procedure of obturator making with an explanation of its function is presented. Conclusion. The application of RB obturator and the necessary education of parents have a major role in shortening the time of breast feeding and increasing the amount of food intake and, thus, for the normal growth and development of newborn infants with isolated palate cleft.
A method for obturating microscopic ports in parts submitted to stresses, e.g. heat-exchangers
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Halstead, W.D.
1975-01-01
The invention relates to the obturation of cracks in metal-parts. It refers to a method for obturating the micropores of a member adapted to be submitted to stresses, said method being characterized in that it comprises the steps of exposing one surface of said member to a mixture of nickel-carbonyl and hydrogen sulfide with an inert gaseous carrier, and exposing the member other surface to air or nitrogen with oxygen or steam, the gases being at substantially the same pressure and at a temperature of from 290 to 330 deg K. This can be applied to the obturation of micropores in the heat exchangers of sodium cooled nuclear reactor [fr
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Shalini Chandrasekhar
2018-01-01
Full Text Available Background: The aim of this study was to evaluate the efficiency of four different obturating techniques in filling the radicular space in primary teeth. Materials and Methods: This clinical trial was carried out on 34 healthy, cooperative children (5–9 years who had 63 carious primary teeth indicated for pulpectomy. They were divided into four groups, such that in each group, a total of 40 canals were allotted for obturation with respective technique. The root canals of selected primary teeth were filled with Endoflas obturating material using either bi-directional spiral (Group 1; incremental technique (Group 2, past inject (Group 3 or lentulo spiral (Group 4 according to the groups assigned. The effectiveness of the obturation techniques was assessed using postoperative radiographs. The assessment was made for a depth of fill in the canal, the presence of any voids using Modified Coll and Sadrian criteria. The obtained data were analyzed by using ANOVA test and unpaired t-test. Results: Bi-directional spiral and lentulo spiral were superior to other techniques in providing optimally filled canals (P< 0.05. The bi-directional spiral was superior to lentulo spiral in preventing overfill (P< 0.05. Conclusion: Based on the present study results, bi-directional spiral can be recommended as an alternate obturating technique in primary teeth.
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Cesur, M.; Erdem, Ali F.; Alici, Haci A.; Yuksek, Mustafa S.; Yapanoglu, T.; Aksoy, Y.
2008-01-01
Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, hematoma and 4 obturator nerve reflex events, despite the block, were observed and these patients were subjected to general anesthesia with succinylcholine. Fifty-six patients (32 patients initially had general anesthesia and 24 converted from epidural to general anesthesia) were all given succinylcholine prior to resection. Due to its mechanisms of action, succinylcholine is completely effective and represents a simple alternative to obturator nerve block. No contraction was observed in any patient given succinylcholine. (author)
Siotia, Jaya; Acharya, Shashi Rashmi; Gupta, Sunil Kumar
2011-01-01
Objective. To compare the efficacy of ProTaper retreatment files in removing three different obturating materials. Study Design. Forty-five human, single-rooted premolars were divided into three experimental groups. Group 1 was obturated with gutta-percha and AH Plus sealer, Group 2 was obturated with gutta-percha and zinc oxide eugenol sealer, and Group 3 was obturated with GuttaFlow. Retreatment was done using the ProTaper universal rotary retreatment files. Root halves were visualized using magnifying loops at 3X magnification and optical stereomicroscope at 10X magnification. Images were analyzed using AutoCAD 2004 software to calculate area of the remaining debris in the canal. For statistical analysis were used variance test and ANOVA. Results. Total debris/canal area ratio between the three groups showed a statistically significant difference (P < 0.001). Conclusion. ProTaper retreatment system did not produce completely clean canals in any of the groups. However, it had the best efficacy towards removing silicon based obturating material GuttaFlow. PMID:22114598
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...
Waltregny, David; de Leval, Jean
2012-12-01
Tension-free suburethral tapes have revolutionized the surgical treatment of female stress urinary incontinence (SUI). These tapes are inserted by way of a retropubic or transobturator route. The inside-out tension-free vaginal tape transobturator approach, or TVT-Obturator system (TVT-O, Ethicon Women's Health and Urology, Somerville, NJ), was developed ten years ago with the aim of minimizing the risk of urinary tract injuries associated with retropubic and outside-in transobturator tapes while reproducibly ensuring minimal tissue dissection. Cadaveric studies have shown that the anatomical trajectory of the TVT-O tape is strictly perineal and courses away from neighboring obturator and pudendal neurovascular structures. Several meta-analyses have shown similar SUI cure rates after retropubic and transobturator tape procedures. Yet, the transobturator route may be associated with less voiding dysfunction, blood loss, bladder perforation, and shorter operating time. The original TVT-O procedure was modified with the aim of reducing the incidence of postoperative groin pain as well as the rather theoretical risk of obturator nerve injury. This modified procedure, named TVT-ABBREVO (Ethicon Women's Health and Urology, Somerville, NJ), utilizes a shortened, 12-cm-long polypropylene tape. In addition, perforation of the obturator membrane with the scissors and guide is avoided in order to reduce the depth of lateral dissection, and consequently, to maximize securing of the tape within the obturator muscular/aponeurotic structures. In a comparative anatomical study, it was indeed observed that the shorter tape traversed less muscular structures (with no or only a minimal amount of tape lying in the adductor muscles) than its original counterpart, while still consistently anchoring in the obturator membrane at a similarly safe distance from the obturator canal. In a single-center randomized clinical trial, after a 3-year minimum follow-up, the modified TVT-O procedure
Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants
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Sankalp Mittal
2018-01-01
Full Text Available Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS. The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.
Management of maxillectomy defect with a hybrid hollow bulb obturator
Singh, Kamleshwar; Singh, Saumyendra V; Mishra, Niraj; Agrawal, Kaushal Kishor
2013-01-01
A woman having already undergone maxillectomy came to the department complaining of difficulty in eating and speech. During the construction of an obturator, the bulb area should be hollowed to reduce weight so that the teeth and supporting tissues are not stressed unnecessarily. The conventional open design drains fluid from the adjacent mucosa, possibly increasing the weight of the prosthesis, and is difficult to clean. The closed bulb design does not drain secretions and may cause obstruction and susceptibility to infection in the paranasal and pharyngeal regions, though it is easier to maintain. An alternative to the two designs, combining their advantages, is presented in this report. As the open hollow part of the obturator was shallow, it was easy to clean. Making the inferior part of the bulb hollow and closed led to a reduction in the overall weight of the prosthesis while increasing its resonance. PMID:23436886
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Eliasziw Misha
2011-07-01
Full Text Available Abstract Background We recently completed a randomized clinical trial of two minimally invasive surgical procedures for stress urinary incontinence, the retropubic tension-free vaginal tape (TVT versus the trans-obturator tape (TOT procedure. At one year postoperatively, we were concerned to find that a significant number of women had tape that was palpable when a vaginal examination was undertaken. Because the risk factors for adverse outcomes of tape surgery are not clearly understood, we are unable to say whether palpable tapes will lead to vaginal erosions or whether they merge into vaginal tissue. We do not know whether patients go on to have further adverse consequences of surgery, leading to additional cost to patients and healthcare system. Our current study is a 5 year follow-up of the women who took part in our original trial. Methods/Design All 199 women who participated in our original trial will be contacted and invited to take part in the follow-up study. Consenting women will attend a clinic visit where they will have a physical examination to identify vaginal erosion or other serious adverse outcomes of surgery, undertake a standardized pad test for urinary incontinence, and complete several health-related quality of life questionnaires (15D, UDI-6, IIQ-7. Analyses will compare the outcomes for women in the TOT versus TVT groups. The cost-effectiveness of TOT versus TVT over the 5 years after surgery, will be assessed with the use of disease-specific health service administrative data and an objective health outcome measure. A cost-utility analysis may also be undertaken, based on economic modeling, data from the clinical trial and inputs obtained from published literature. Discussion This study is needed now, because TOT and TVT are among the most frequently conducted surgical procedures for stress urinary incontinence in Canada. Because stress urinary incontinence is so common, the impact of selecting an approach that causes
2011-01-01
Background We recently completed a randomized clinical trial of two minimally invasive surgical procedures for stress urinary incontinence, the retropubic tension-free vaginal tape (TVT) versus the trans-obturator tape (TOT) procedure. At one year postoperatively, we were concerned to find that a significant number of women had tape that was palpable when a vaginal examination was undertaken. Because the risk factors for adverse outcomes of tape surgery are not clearly understood, we are unable to say whether palpable tapes will lead to vaginal erosions or whether they merge into vaginal tissue. We do not know whether patients go on to have further adverse consequences of surgery, leading to additional cost to patients and healthcare system. Our current study is a 5 year follow-up of the women who took part in our original trial. Methods/Design All 199 women who participated in our original trial will be contacted and invited to take part in the follow-up study. Consenting women will attend a clinic visit where they will have a physical examination to identify vaginal erosion or other serious adverse outcomes of surgery, undertake a standardized pad test for urinary incontinence, and complete several health-related quality of life questionnaires (15D, UDI-6, IIQ-7). Analyses will compare the outcomes for women in the TOT versus TVT groups. The cost-effectiveness of TOT versus TVT over the 5 years after surgery, will be assessed with the use of disease-specific health service administrative data and an objective health outcome measure. A cost-utility analysis may also be undertaken, based on economic modeling, data from the clinical trial and inputs obtained from published literature. Discussion This study is needed now, because TOT and TVT are among the most frequently conducted surgical procedures for stress urinary incontinence in Canada. Because stress urinary incontinence is so common, the impact of selecting an approach that causes more adverse events, or is
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Anisha Kumar
2016-01-01
Full Text Available Introduction: Voids in the sealer mass have the potential to allow leakage through obturation. They are more critical in single cone (SC obturation as the volume of sealer used in this obturation is larger when compared to other obturations. Aim: To compare the area of voids in mineral trioxide aggregate (MTA-based, resin-based, and zinc oxide-eugenol-based sealers when employed with SC obturation technique. Materials and Methods: Fifteen teeth were cleaned and shaped and divided into three groups for SC obturation using MTA Fillapex, AH26, and Pulpdent sealers, respectively. The obturated teeth were sectioned at apical, middle, and coronal third, and area of voids in the sealer was assessed using a stereomicroscope and digital images and image software. The results were statistically analyzed using SPSS software and Kruskal-Wallis and Mann-Whitney tests. Results: The three tested sealers showed voids in all the sections except MTA Fillapex, which was void free in apical and middle sections. There were significant differences between these sealers regarding their section wise area of voids (P < 0.05. Similarly, there were significant differences in their overall area of voids (P < 0.05 with MTA Fillapex showing significantly least area of voids followed by AH26. Conclusions: SC obturation with MTA Fillapex sealer, which showed void free apical and middle third sections, had significantly least area of voids in the sealer followed by the one with AH26 sealer, whereas SC obturation with Pulpdent sealer had significantly most area of voids.
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Abhishek Khairwa
2014-01-01
Full Text Available Background: Pulp therapy for pulpally involved primary teeth continues to be a challenge to clinicians. One of the major areas of continued research is in the area of finding obturating materials to suit the specific properties of these teeth. Zinc oxide eugenol is used frequently in pulpectomy for the obturation of the primary teeth. Aims: To evaluate clinically and radiographically a mixture of zinc oxide eugenol and aloe vera as an obturating material. Materials and Methods: A total of 50 children, aged between 4 and 9 years, who were screened for unilateral or bilateral carious deciduous molars were studied. Out of these, 15 children were randomly selected for endodontic treatment. Obturation was done with a mixture of zinc oxide powder and aloe vera gel. Clinical and radiographic evaluation was done after 7 days, 1 month, 3 months, 6 months, and 9 months. The data were statistically analyzed. Results and Conclusion: Endodontic treatment using a mixture of zinc oxide powder and aloe vera gel in primary teeth has shown good clinical and radiographic success. A detailed observational study with longer follow-up will highlight the benefits of aloe vera in primary teeth as an obturating medium.
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Pécora Jesus Djalma
2002-01-01
Full Text Available The objective of this research was to evaluate, in vitro, the importance of the correct manipulation of endodontic sealers, correlating it with flow rate and with the consequent obturation of root canals. Twenty-four human canines were prepared, 1 mm from the apex, with K-files up to size 50, by means of the step-back technique. Six lateral canals were then drilled in each tooth, with size 10 file fixed to a low-speed handpiece. The teeth were randomly divided into 4 groups, and root canals were obturated either with the EndométhasoneÒ sealer or Grossman sealer, prepared at ideal or incorrect clinical consistency. After obturation by means of the lateral condensation technique, the teeth were radiographed and evaluated as to the number of sealed lateral canals. Statistical analysis revealed significant differences (p < 0.001 between the tested sealers, and indicated the higher capacity of the well-manipulated Grossman sealer to fill lateral canals. It can be concluded that the flow rate of a sealer and its correct manipulation are very important for the satisfactory obturation of lateral canals.
Sartipy, Ulrik; Albåge, Anders; Insulander, Per; Lindblom, Dan
2007-09-01
This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided.
Li, Xiao-ye; Yan, Ai-hui; Hao, Shuai; Li, Wei; Jiang, Xue-jun; Lu, Li; Qin, Xing-jun; Yan, Hai-xin
2011-05-01
The feasibility and clinical effects of hollow obturator prosthesis for the repair of maxillofacial defect immediately after maxillectomy for cancer were assessed. Thirteen patients with T3-4aN0M0 maxillary neoplasm were treated by the prostheses immediately after maxillectomy. According to the 3D-CT reconstruction of nasal sinus, the 3D stereoscopic prototype was constructed before the surgery. Simulating surgery with Surgicare 5.0 software and then the prosthesis 3D stereoscopic model was shaped. The prosthesis was made quickly and precisely with methacrylate resins according to the model and the print mold before surgery, with supplementary tooth at the bottom of prosthesis. In the surgery, the prosthesis was installed instantly after maxillectomy. The patients were followed up at 1, 3 and 6 month after the surgery, respectively. The facial features and the pronunciation clarity were examined and the questionnaires were carried out in the patients, with comparation by paired t-test. The hollow obturator prosthesis would be replaced by permanent prosthesis made of methacrylate resins at 6 month after the surgery. The hollow obturator prostheses were installed accurately and maxillofacial defects were repaired immediately after maxillectomy in the 13 patients. Postoperative follow-up showed there were significant differences in eyeball sagging (t = 4.67, P maxillectomy can improve survival quality of patient.
SPEECH EVALUATION WITH AND WITHOUT PALATAL OBTURATOR IN PATIENTS SUBMITTED TO MAXILLECTOMY
de Carvalho-Teles, Viviane; Pegoraro-Krook, Maria Inês; Lauris, José Roberto Pereira
2006-01-01
Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well. The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years), who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6%) significantly improved their speech intelligibility, and 16 patients (69.9%) exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy. PMID:19089242
Transfer of obturator nerve for femoral nerve injury: an experiment study in rats.
Meng, Depeng; Zhou, Jun; Lin, Yaofa; Xie, Zheng; Chen, Huihao; Yu, Ronghua; Lin, Haodong; Hou, Chunlin
2018-07-01
Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method. Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment. At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05). Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.
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Girish
2016-03-01
Full Text Available BACKGROUND Three dimensional obturation of the root canal is important for success of root canal treatment. Microleakage is one of the reason for root canal failure. Numerous materials have been used for obturation of which Gutta-percha is the most successful with variety of sealers. One of the recent material to further improve root canal treatment success rate is use of Resilon with Epiphany root canal sealer to apply adhesive concepts in to endodontics. An adhesive bond forms between Epiphany sealer, Resilon and dentin, making it monolithic hence less microleakage if any significantly. METHODS 60 single rooted mandibular premolars were dissected at cement enamel junction with diamond disc. Root canals were explored and working length measured using K file. Root canals of all 60 samples were prepared with ProTaper and irrigated with 5% sodium hypochlorite and 17% EDTA solution. Teeth were divided in to group A and B, each having 30 samples. Group A teeth obturated with Resilon Epiphany obturation system and group B with Gutta-percha and AH-plus sealer. All specimens were stored in incubator for 30 days. Clearing process of samples done with Robertson’s technique to make them transparent. All the specimens were immersed in 2% methylene blue dye solution for 7 days. Specimens were then examined under stereomicroscope with 10x magnification to measure dye penetration in mm with image analysis software. The data collected were analysed statistically. RESULTS This study showed that Resilon Epiphany group has a mean leakage of 1.2307, while the Gutta-percha/AH-plus had a mean leakage of 3.6133. There was statistically significant differences between Resilon and Gutta-percha groups. CONCLUSIONS 1. Resilon Epiphany group showed less apical microleakage than Gutta-percha/AH-plus obturation. 2. Based on result obtained it is suggested that Resilon Epiphany can be recommended for root canal obturation.
Flores-Ruiz, Rafael; Castellanos-Cosano, Lizette; Serrera-Figallo, María-Angeles; Gutiérrez-Corrales, Aida; Gonzalez-Martin, Maribel; Gutiérrez-Pérez, Jose-Luis; Torres-Lagares, Daniel
2017-08-01
Radical surgical resection as a treatment modality for oral cancer often leads to an extensive deficit in both the maxillary and mandibular levels, where the use of a palatal obturator prosthesis (POP) or removable partial denture (RPP). The aim of this study was to evaluate the treatment with POP and RPP in patients treated for oral cancer in the Unit of Prosthetic Rehabilitation of the University Hospital Virgen del Rocío in a period of 20 years. Retrospective descriptive study during the years 1991 and 2011 analyzing oral cancer type, characteristics, treatment and follow-up. The sample consisted of patients whose tumor had previously been removed and who had been referred to the Oncological Rehabilitation Unit of the Oral and Maxillofacial Surgery Unit of the "Virgen del Rocío" University Hospital for rehabilitation. The inclusion criteria were patients whose underlying pathology was any type of neoplasia, which after its treatment had been referred to the aforementioned Oncological Prosthetic Rehabilitation unit. Of the 45 patients included in our study, 15 patients were rehabilitated with palatal obturator (33.3%) and 5 patients with removable partial denture (11.1%). The mean age of the sample of patients with POP was 57.3 ± 9.23, while the mean age of the sample of patients with RPP was 58 ± 13.5. The most common underlying pathology in patients with POP was squamous cell carcinoma (60%), whereas in patients with RPP it was 100%. The most frequent location found among POP patients was the upper jaw, while in the PRP patients there was no predominant location. The univariate and multivariate logistic regressions did not show any statistically significant association between the independent variables age, sex, smoking habit and alcoholic habit with the dependent variable type of rehabilitating prosthesis. Based on our data, we can conclude that RPP is used in few cases of oncological rehabilitation. The POP has a greater use, as long as the defect in the
Colorectal cancer complicated by perforation. Specific features of surgical tactics
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S. N. Shchaeva
2015-01-01
Full Text Available Objective: to assess the immediate results of surgical interventions for colorectal cancer complicated by perforation.Materials and methods. The immediate results of surgical treatment were retrospectively analyzed in 56 patients with colorectal cancer complicated by perforated colon cancer, who had been treated at Smolensk surgical hospitals in 2001 to 2013. Patients with diastatic perforation of the colon in the presence of decompensated obturation intestinal obstruction of tumor genesis were not included into this investigation.Results. The immediate results of uni- and multistage surgical interventions were analyzed in relation to the extent of peritonitis and the stage of colon cancer. More satisfactory immediate results were observed after multistage surgical treatment. Following these interventions, a fatal outcome of disseminated peritonitis in the presence of performed colorectal cancer was recorded in 8 (53.3 % cases whereas after symptomatic surgery there were 11 (67.8 % deaths. A fatal outcome was noted in 1 case (7.7 % after multistage surgery.Discussion. The results of surgical treatment in the patients with perforated colorectal cancer are directly related to the degree of peritonitis and the choice of surgical tactics.
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Kassarjian, Ara; Llopis, Eva; Schwartz, Richard B.; Bencardino, Jenny T.
2009-01-01
The purpose of the study was to demonstrate the prevalence of communication between the hip joint and the obturator externus bursa on hip MR arthrography. Following institutional review board approval, 200 hip MR arthrograms in 196 subjects were independently reviewed by two musculoskeletal radiologists. Discrepancies were resolved by adjudication. The presence or absence of communication between the hip joint and the obturator externus bursa was recorded. Associated lesions involving the acetabular labrum and articular cartilage were recorded. The obturator externus bursa was shown to communicate with the hip joint in 11 of the 200 (5.5%) hip MR arthrograms. Of these, six were in men and five were in women. The age range was 15-63 years with a mean age of 34 years. All 11 patients had labral tears. Eight of the 11 had cartilage lesions. The obturator externus bursa can be seen to communicate with the hip joint in 5.5% of hip MR arthrograms. Associated labral and cartilage lesions are common. (orig.)
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Kassarjian, Ara [Corades, S.L., Majadahonda-Madrid (Spain); Massachusetts General Hospital, Division of Musculoksleletal Radiology, Boston, MA (United States); Llopis, Eva [Hospital de la Ribera, Department of Radiology, Alzira (Valencia) (Spain); Schwartz, Richard B. [Longwood MRI Specialists, Brookline, MA (United States); Bencardino, Jenny T. [NYU Department of Radiology, New York, NY (United States)
2009-11-15
The purpose of the study was to demonstrate the prevalence of communication between the hip joint and the obturator externus bursa on hip MR arthrography. Following institutional review board approval, 200 hip MR arthrograms in 196 subjects were independently reviewed by two musculoskeletal radiologists. Discrepancies were resolved by adjudication. The presence or absence of communication between the hip joint and the obturator externus bursa was recorded. Associated lesions involving the acetabular labrum and articular cartilage were recorded. The obturator externus bursa was shown to communicate with the hip joint in 11 of the 200 (5.5%) hip MR arthrograms. Of these, six were in men and five were in women. The age range was 15-63 years with a mean age of 34 years. All 11 patients had labral tears. Eight of the 11 had cartilage lesions. The obturator externus bursa can be seen to communicate with the hip joint in 5.5% of hip MR arthrograms. Associated labral and cartilage lesions are common. (orig.)
Mohamed Usman, Jafar Abdulla; Ayappan, Anuroopa; Ganapathy, Dhanraj; Nasir, Nilofer Nisha
2013-01-01
Resection of a malignant lesion involving the maxilla produces severe oromaxillary defect that can seriously jeopardize the normal phonetics of the patient. These defects are effectively managed by well-designed and fabricated obturator. This paper discusses the oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator. PMID:23533823
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Jafar Abdulla Mohamed Usman
2013-01-01
Full Text Available Resection of a malignant lesion involving the maxilla produces severe oromaxillary defect that can seriously jeopardize the normal phonetics of the patient. These defects are effectively managed by well-designed and fabricated obturator. This paper discusses the oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator.
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George Francis
2015-01-01
Full Text Available Background: Prosthetic reconstruction of partial maxillectomy defects is a challenging procedure that requires multidisciplinary expertise to achieve an acceptable function, speech and esthetics. This procedure improves the quality of life for the patient as a normal individual. Obturation of the defect depends on its volume and position of remaining hard and soft tissues which determine the retention, stability and support for the prosthesis. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight and convenient for future adjustments. This case report describes a clinical case of partial maxillectomy which was successfully rehabilitated with a definitive closed hollow bulb obturator and cast metal denture base.
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Ayça YILMAZ
2017-04-01
Full Text Available Purpose: To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA. Materials and Methods: One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20 according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC, G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. Results: The mean of the PGFA in Thermafil (G2, ProTaper-Obturator (G5 and HEROfill (G8 groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. Conclusion: The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.
Yilmaz, Ayca; Karagoz-Kucukay, Isil
2017-01-01
To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA). One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20) according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC), G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. The mean of the PGFA in Thermafil (G2), ProTaper-Obturator (G5) and HEROfill (G8) groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.
Grubbs, S Lee; Alley, Larry W; Eleazer, Paul D
2014-07-01
The intrapulpal (IP) injection technique is 1 of several ways of obtaining profound anesthesia. There is evidence to suggest that pressure is the primary factor in obtaining anesthesia using IP injection. This is an ex vivo comparison of pressures within dental pulp space using the conventional anesthetic technique versus a needle-mounted obturator technique. Twenty extracted anterior and premolar teeth were accessed with a high-speed 169L bur. A saline-filled tube connected to a digital pressure gauge was attached to the apical 10 mm of each tooth in a fixed mount. One operator performed all the injections under moderate pressure. Each tooth was injected twice; first, the tooth was given an IP injection with a normal setup, and then the same tooth was given an IP injection with the modified obturator syringe. The pressure at the apex was recorded for each tooth. A paired sample t test was completed to determine statistical significance. The pressure generated was considerably higher for the obturator group in every tooth when compared with the normal group (P < .001). IP injection with the obturator resulted in increased pressure at the apex of each tooth. This pressure increase may allow for increased anesthesia when IP injections are indicated. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Chao, Wei-Ting; Liu, Chia-Hao; Chen, Yi-Jen; Wu, Hua-Hsi; Chuang, Chi-Mu; Wang, Peng-Hui
2018-02-09
Pelvic masses are a common gynecologic problem, and majority of them are diagnosed as ovarian tumors finally. Sometimes, it is hard to distinguish the origin of these pelvic masses. The following case is a solitary neurofibroma arising from the right-side obturator nerve, which was impressed as a right-side ovarian tumor initially. We reported this case, and also performed a PRISMA-driven systematic review to summary the similar cases in the literature. This review includes image, molecular and pathological findings and outcome of neurofibroma. A 33-year-old woman with a regular menstrual period denied any symptoms or signs. During her physical check-up, image examination revealed a right-side heterogeneous pelvic mass; it was suggestive of a complex of right-side ovarian tumor. A provisional diagnosis of retroperitoneal pelvic mass, probably a benign ovarian tumor, was made. Excision of the right-side pelvic mass was performed. We sent the specimens for frozen pathology, which indicated neurofibroma and lipomatous tumor and that the possibility of liposarcoma cannot be excluded. A segment of the obturator nerve was attached to the tumor and was severed. A right-side obturator nerve tear during tumor excision was observed, and a neurosurgeon was consulted for obturator nerve grafting and repair. The patient complained of mild weakness and paresthesia affecting the right leg, and we consulted a rehabilitation doctor for neuron injury. The patient's recovery was uneventful, and she was discharged eight days after the drain was removed. Further rehabilitation treatment was arranged. A neurofibroma is an uncommon pelvic retroperitoneal tumor, and it can be misdiagnosed as an adnexal mass. To our knowledge, this is a rare case of a solitary neurofibroma arising from the obturator nerve. It usually does not have any neurological deficit. We present this case to demonstrate that pelvic neurofibroma can be mistaken for an adnexal mass. This fact should be borne in mind
Sabots, Obturator and Gas-In-Launch Tube Techniques for Heat Flux Models in Ballistic Ranges
Bogdanoff, David W.; Wilder, Michael C.
2013-01-01
For thermal protection system (heat shield) design for space vehicle entry into earth and other planetary atmospheres, it is essential to know the augmentation of the heat flux due to vehicle surface roughness. At the NASA Ames Hypervelocity Free Flight Aerodynamic Facility (HFFAF) ballistic range, a campaign of heat flux studies on rough models, using infrared camera techniques, has been initiated. Several phenomena can interfere with obtaining good heat flux data when using this measuring technique. These include leakage of the hot drive gas in the gun barrel through joints in the sabot (model carrier) to create spurious thermal imprints on the model forebody, deposition of sabot material on the model forebody, thereby changing the thermal properties of the model surface and unknown in-barrel heating of the model. This report presents developments in launch techniques to greatly reduce or eliminate these problems. The techniques include the use of obturator cups behind the launch package, enclosed versus open front sabot designs and the use of hydrogen gas in the launch tube. Attention also had to be paid to the problem of the obturator drafting behind the model and impacting the model. Of the techniques presented, the obturator cups and hydrogen in the launch tube were successful when properly implemented
Epstein, Jeffrey S
2004-05-01
In the specialty of surgical hair restoration, men comprise more than 90% of the patients treated; however, in the last few years the number of women undergoing the procedure has increased significantly. The reasons for this growth are many and include the increase in public awareness of the efficacy of hair transplantation from such sources as the media,the Internet, advertising and word of mouth. More importantly, advances in technique have significantly improved results, increasing the confidence level in women to undergo the procedure and in hair transplant specialists to offer it.
Restorative surgery of combined injuries of neurovascular structures of limbs
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I. V. Pertsov
2015-02-01
Full Text Available Combined damage of neurovascular structures is complicate pathology and require repeated surgical interventions and often lead to permanent disability. Aim. To define the features of restorative surgical treatment of traumatic injuries of limbs neurovascular structures and to study the effect of regional hemodynamics on the nerve function restore. Methods and results. In 98 patients with combined trauma of the neurovascular structures microcirculation indicators were established with laser Doppler flowmetry and determine the degree of restoration of nerve function. Conclusion. Strong direct correlation between the degree of restoration of nerve function and microcirculation was detected, the correlation coefficient was +0.72 at t = 3,16 p<0,05. Careful surgical restoration of blood flow helps to improve microcirculation in the limbs, makes positive impact on the recovery of limb function.
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Iqbal, Z.; Qureshi, A. H.
2014-01-01
Ten patients presented with non-vital immature teeth for root canal treatment. In all these cases the pre-operative clinical examination revealed apical periodontitis with a buccal sinus tract of endodontic origin. These cases were treated by a mineral trioxide aggregate (MTA) monoblock obturation technique. Follow-up evaluations were performed at 1 - 2 years after treatment. Eight out of 10 cases were associated with periradicular healing at follow-up evaluation. Mineral trioxide aggregate Monoblock obturation technique appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps. (author)
Adhyapak, Srilakshmi M; Menon, Prahlad G; Rao Parachuri, V
2014-02-01
Several issues that are inherent in the surgical techniques of surgical ventricular restoration (SVR) need specialized devices or techniques to overcome them, which may not always result in optimal outcomes. We used a non-invasive novel in silico modelling technique to study left ventricular (LV) morphology and function before and after SVR. The cardiac magnetic resonance imaging derived actual pre- and postoperative endocardial morphology and function was compared with the in silico analysis of the same. Cardiac magnetic resonance steady state free precession (SSFP) cine images were employed to segment endocardial surface contours over the cardiac cycle. Using the principle of Hausdorff distance to examine phase-to-phase regional endocardial displacement, dyskinetic/akinetic areas were identified at the instant of peak basal contraction velocity. Using a three-dimensional (3D) surface clipping tool, the maximally scarred, dyskinetic or akinetic LV antero-apical areas were virtually resected and a new apex was created. A virtual rectangular patch was created upon the clipped surface LV model by 3D Delaunay triangulation. Presurgical endocardial mechanical function quantified from cine cardiac magnetic resonance, using a technique of spherical harmonics (SPHARM) surface parameterization, was applied onto the virtually clipped and patched LV surface model. Finally, the in silico model of post-SVR LV shape was analysed for quantification of regional left ventricular volumes (RLVVs) and function. This was tested in 2 patients with post-myocardial infarction antero-apical LV aneuryms. Left ventricular mechanical dysynchrony was evaluated by RLVV analysis of pre-SVR, in silico post-SVR and actual post-SVR LV endocardial surface data. Following exclusion of the scarred areas, the virtual resected LV model demonstrated significantly lesser areas of akinesia. The decreases in regional LV volumes in the in silico modelling were significant and comparable with the actual
Modified prepubic TVT-obturator tape procedure versus the conventional method: a preliminary study.
Long, Cheng-Yu; Wu, Ming-Ping; Wang, Chiu-Lin; Lin, Kun-Ling; Liu, Cheng-Min; Wu, Shu-Hui; Juan, Yung-Shun
2013-12-01
To compare the efficacy and safety of the modified prepubic tension-free vaginal tape-obturator (PTVT-O) system procedure with the original TVT-O methods. One hundred and ninety women with urodynamic stress incontinence (USI) were included in this study (93 cases in the TVT-O group and 97 in the PTVT-O group). Clinical assessments before and one year after surgery included urinalyses, 1-h pad tests, urodynamic studies, and a personal interview with the overactive bladder symptom score (OABSS) questionnaire. There were no differences between the two groups in mean age, parity, menopausal status, mean operative time and subjective cure rates (P>0.05), but the efficacy of surgery (cure and improvement) in the PTVT-O group was significantly higher than that in the TVT-O group (P=0.038). Complication rates and visual analog scale (VAS) scores were found to be similar (P>0.05). OABSS decreased significantly after surgery in both groups (P0.05). Our modified procedure is a safe and effective treatment for female USI. It has an advantage over the original TVT-O with better surgical efficacy and comparable postoperative pain, although the follow-up times in this study are different. Copyright © 2013. Published by Elsevier Ireland Ltd.
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Syed Gufran Ali
2012-01-01
Full Text Available Aim: This prospective randomized clinical study (1 investigated the prevalence of post-obturation pain after single visit root canal treatment and (2 evaluated the influence of factors affecting the pain experience. Materials and Methods: One thousand three hundred and twenty eight (1328 patients were included in this study. Conventional single visit root canal treatment was carried out. The chemicomechanical preparation of root canals was done by a rotary protaper system with a combination of hand instruments. Post-operative pain was recorded by each patient by using visual analogue scale in well-defined categories at three time intervals, 12 h, 24 h, and 48 h. The data were analyzed using Fisher′s exact test. Results: The prevalence of post-obturation pain (severe within 48 h after treatment was 4% ( n = 54 but less as compared to the pain experienced after 12 h (9% and 24 h (8.6%. The factors that significantly influenced post-obturation pain experience were: Age (Fishers exact test = 46.387, P = 0.0, gender (Fishers exact test = 23.730, P = 0.0, arch (Fishers exact test = 11.710, P = 0.001, and presence of pre-operative pain (Fishers exact test = 67.456, P = 0.0. Conclusion: The presence of post-operative pain was low (4%. The important prognostic determinants of post-obturation pain were: Old age, female, mandibular teeth, and presence of pre-operative pain. The vital condition of the tooth does not affect the intensity and frequency of post-obturation pain.
Breeze, J; Rennie, A; Morrison, A; Dawson, D; Tipper, J; Rehman, K; Grew, N; Snee, D; Pigadas, N
2016-10-01
Health-related quality of life (QoL) reported by patients has the potential to improve care after ablative surgery of the midface, as existing treatment algorithms still generally revolve around outcomes assessed traditionally only by clinicians. Decisions in particular relate to reconstruction with a flap compared with rehabilitation with an obturator, the need for adjuvant treatment, and morbidity related to the size of the defect. We prospectively collected health-related QoL assessments for 39 consecutive patients treated by maxillectomy between 01 January 2010 and 31 December 2014 using the University of Washington Quality of Life Questionnaire, and who had a mean (SD) duration of follow-up of 14 (4). We made sub-group analyses using paired t tests and analysis of variance (ANOVA) to compare reconstruction with a flap with rehabilitation with obturators, size of the vertical defect, and whether adjuvant treatment with radiotherapy or chemoradiotherapy adversely affected it. Overall there was a significant decrease in health-related QoL after treatment compared with before (p<0.001), but there was no significant difference in the effects of any of the paired reconstructive and rehabilitation treatments on it. Obturators remain an important option for rehabilitation in selected patients in addition to reconstruction with a flap. We found that neither increasing the size of the vertical defect (in an attempt to ensure clear margins) nor the use of postoperative radiotherapy seemed to have any adverse effect on QoL. More patients are required before we can conclude that the potential survival benefits of such measures may outweigh any adverse effects. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Hsu, Wei-Ching; Hsu, Jin-Yi; Chen, Michael Yu-Chih; Liang, Chung-Chao
2016-07-01
Pyomyositis is a pyogenic infection of the skeletal muscles causing myalgia and fever in patients. Hematogenous seeding engendered by persistent bacteremia and septic embolism is usually the underlying cause of the disease. Trauma, intravenous drug use, and immunodeficiency are the main predisposing factors.Obturator internus pyomyositis with sciatica has not previously been reported. We report a rare case of a patient with subacute bacterial endocarditis presenting with left buttock pain and sciatica.Computed tomography confirmed the diagnosis of obturator internus pyomyositis. The patient was discharged uneventfully after successful antibiotic treatment.The mortality rate of patients who have pyomyositis comorbid with another condition or disease is extremely high. Early diagnosis and aggressive management are imperative.
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M. Adel
2016-08-01
Full Text Available Background: Both nickel titanium and stainless-steel spreaders are available. The obvious advantage of nickel titanium spreader over stainless steel spreaders is greater penetration in curved canals. Objective: To compare the radiographic density and compaction index of root canal obturation using nickel-titanium or stainless-steel spreaders in curved canals. Methods: In this experimental study the primary weight of 30 acrylic blocks with 45o degrees of apical curvature were measured by a scale (W1. After canals were prepared by step back master apical up to file #30 all blocks were weighed again (W2 and randomly divided in two groups of 15each. All canals were obturated by Cold lateral compaction technique (with nickel-titanium in one group and stainless-steel finger spreaders in another group. After all blocks were reweighed (W3, compaction index (W3-W2/W1-W2 was calculated. One radiograph was taken for each sample. Apical density of the apical third of each canal was measured by digital transmission densitometer. Data were analyzed statistically using T-test. Findings: Mean compaction index for nickel-titanium group was 7.67±2.38 and for stainless-steel group was 9.14±4.06. There was no significant difference between two groups. Mean radiographic density of obturation was 2.05±0.14 in nickel-titanium group and was 2.07±0.21 in stainless-steel group. There was no significant difference between two groups. Conclusion: It is concluded that nickel-titanium spreaders are not superior than stainless-steel spreaders in obturating curved canal.
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Lone, M.M.; Khan, F.; Lone, M.A.
2018-01-01
Objective:To compare apical microleakage of extracted, single-rooted teeth obturated with thermoplasticized injectable gutta-percha using two different endodontic sealers (calcium-hydroxide and resin based). Study Design:An experimental study. Place and Duration of Study:The Aga Khan University Hospital (AKUH), Dental Clinics and Laboratory from June to September 2015. Methodology:The study was conducted using extracted teeth. After access cavities were made, cleaning and shaping of root canals was done in 70 teeth. Teeth were randomly allocated into two groups and obturated with thermoplasticized injectable gutta-percha (Obtura II) using two sealers (Sealapex vs.AH plus). After immersing the teeth in 2.0% methylene blue, they were split longitudinally, viewed under light microscope (magnification X4) and images were taken by a camera connected to microscope. The extent of dye penetration was assessed from apex to its coronal part and recorded in millimeters. Independent sample t-test was used to compare microleakage in the two groups. Pearson correlation coefficient was used for inter-examiner reliability of dye penetration measurements. A p-value of <0.05 was taken as statistically significant. Results:Teeth obturated with Obtura II gutta-percha with AH plus sealer had a mean dye penetration of 1.20 +- 0.79 mm. This was significantly better than Obtura II with Sealapex sealer (p=0.003). Conclusion:Obtura II-AH plus sealer was a better combination for obturation as it showed a lesser degree of microleakage. Obtura II with Sealapex group showed higher microleakage, so this combination should be avoided in single-rooted teeth. (author)
PWR pressurizer with heaters well which can be obturate and sealing process
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Godin, B.; Guicherd, L.
1991-01-01
Each heater well is prolongated at the end located outer the pressurizer containment by a sleeve internally tapped which is prolongated at the other end by a guiding and fixation sleeve for welding the heater. The heater well can be obturated by a threaded plug introduce in the tapped part of the sleeve after cutting the welding sleeve and extraction of the heater [fr
Flexible resins in the rehabilitation of maxillectomy patient
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Pavan Kumar Tannamala
2012-01-01
Full Text Available Surgical resection is an established and common method for treatment of maxillofacial tumors. Such intervening surgery in this region may involve the destruction of antral, nasal, or orbital contents and jaws. Normally, the end result is a defect which may affect speech, swallowing, mastication and facial appearance. Prosthodontic restoration of functions and facial form is an excellent method in the replacement of missing parts and restoration of contour. Pertinent research in materials, designs and methods have resulted in whole array of possible prosthess that can be provided to meet specific patient needs. This case report describes the fabrication of definitive obturator prosthesis made of flexible acrylic resin on a chrome cobalt base.
Matsuyama, Miwa; Tsukiyama, Yoshihiro; Koyano, Kiyoshi
2005-01-01
Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment. The swallowing ability of 38 postmaxillectomy patients consecutively treated with obturator prostheses was objectively evaluated with the "water-drinking test" that was developed for the assessment of dysphagia patients after cerebrovascular disease. In this test, the subjects were instructed to drink 30 mL of water in one swallow. The profile was evaluated with the combination of the time required for drinking the water and the incidence of cough reflex. Statistical analysis was performed using the Wilcoxon signed-rank test, the paired t test, and the Chi-square test with StatView 5.0 for the Macintosh. Performance improved significantly when the patients wore prostheses (P = .0026, Wilcoxon signed-rank test). The mean drinking times without and with prostheses were 8.2 +/- 6.3 s and 5.0 +/- 3.5 s, respectively. Drinking time was shortened significantly when the prosthesis was worn (P = .0002, paired t test). The assessment of behavior and episodes revealed that the swallowing ability of the maxillectomy patients was significantly improved when a prosthesis was worn (P = .0002, Chi-square test). The swallowing ability of maxillectomy patients was quantitatively and qualitatively improved with obturator prostheses.
Simple direct composite resin restoration on endodontically treated tooth: A case report
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Wahyuni Suci Dwiandhany
2016-06-01
Full Text Available Endodontically treated teeth generally havegreat structure loss so that the resistance to fracture is reduced. Therefore, the post-endodontic restoration design that covers the entire cusp (full cuspal coverage is necessary to increase the resistance of teeth to fracture. The aim of this case report is to present direct onlay restoration technique using composite resin material in non-vital tooth with chronic apical periodontitis. A 74-years-old male patient came to the clinic complaining of discomfort in the lower right posterior tooth related to eating since 1 week ago. Clinical examination revealed a large amalgam restoration on the second lower right molar, the tooth is negative to pulp sensitivity test, and tender to percussion. Radiographically, the tooth showed periapical radiolucency at distal and mesial root. The diagnosis of the tooth was chronic apical periodontitis. The treatment plan is a non-vital root canal treatment with multiple visit. Root canal preparation with rotary files (ProTaper Next, Dentsply, Germany was performed on the first visit and irrigated with NaOCl. On the next visit, during subjective examination, there was no pain complaints and the percussion test was negative so the obturation with a single cone technique can be done. On the final visit, direct onlay restoration using nano-hybrid composite resin material (Polofil NHT, Voco, Germany was performed. In conclusion, after 3 months follow up, the marginal integrity of the restoration remains intact and the tooth were functioned properly.
Wang, C; Xu, P; Ren, L; Dong, G; Ye, L
2010-08-01
To compare the incidence and intensity of post-obturation pain after one- or two-visit root canal treatment (RCT) on anterior teeth with vital pulps and a single root and canal in a randomized controlled trial. One hundred patients requiring RCT on permanent anterior teeth with vital pulps preoperatively were included. The patients were assigned randomly into two groups of 50 patients each. After local anaesthesia, isolation, access and pulp extirpation, the canals of all teeth were prepared using engine-driven rotary ProTaper nickel-titanium instruments in a crown-down technique and irrigated with 2.5% NaOCl. The teeth in group 1 (n = 50) were filled with AH Plus sealer and gutta-percha using a lateral compaction technique at the first visit, whilst those in group 2 (n = 50) were medicated with a calcium hydroxide paste, a sterile dry cotton pellet and Caviton and scheduled for a second visit 7 days later. A modified verbal descriptor scale was used to measure preoperative pain and post-obturation pain at 6, 24, 48 h and 1 week after operation. Chi-square tests and independent-sample T-tests were used to compare the incidence and intensity of post-obturation pain of two groups at each interval. Eleven patients were excluded from the study as they failed to follow the scheduled revisit or their selected teeth had more than one root canal. Data were obtained from the remaining 89 patients. Forty-three patients were undergoing one-visit treatment (group 1) and 46 undergoing two-visit treatment (group 2). Most patients in both groups reported no pain or only slight pain within each post-obturation interval, only one in group 1 and one in group 2 had flare-ups and slight swelling. There was no statistically significant difference in the incidence and intensity of post-obturation pain experienced by two groups. The incidence and intensity of post-obturation pain experience following one- or two-visit RCT on teeth with vital pulps and a single canal were not
Root canal obturation of primary teeth: Disposable injection technique
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S K Bhandari
2012-01-01
Full Text Available The aim of the study was to outline a simple, cost-effective technique for obturation of primary tooth root canals. A total of 75 primary teeth were treated in 52 subjects by the technique discussed, i.e. injecting plastic flowable material into the root canals after desired preparation, using disposable needle and syringe. All the patients were followed up for 3 years and 6 months, with no clinical or radiologic evidence of pathology or need for untimely extraction. In conclusion, the technique described is simple, economical, can be used with almost all filling materials used for the purpose, and is easy to master with minimal chances of failure.
Colebeck, Amanda C.; Kase, Michael T.; Nichols, Cindy B.; Golden, Marjorie; Huryn, Joseph M.
2016-01-01
The basic objective in prosthetic restoration of confluent maxillary and orbital defects is to achieve a comfortable, cosmetically acceptable prosthesis that restores speech, deglutition, and mastication. It is a challenging task complicated by the size and shape of the defects. The maxillary obturator prosthesis often satisfies the objective of adequate deglutition; however, orbital defects that are not obturated in the medial septal or posterior walls allow air to escape, negatively impacting phonation. This article describes a technique to achieve favorable prosthetic rehabilitation in a patient with a maxillectomy and ipsilateral orbital exenteration. The prosthetic components include maxillary obturator, orbital conformer, and orbital prosthesis connected using rigid magnetic attachments. PMID:25953143
A Novel Surgical Template Design in Staged Dental Implant Rehabilitations
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Michael Patras
2012-05-01
Full Text Available Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning. Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts. Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.
Niemi, Tuomas K; Marchesan, Melissa A; Lloyd, Adam; Seltzer, Robert J
2016-10-01
The aim of this study was to compare the effectiveness of TRUShape (TS) instruments with ProFile Vortex Blue (VB) instruments for the removal of obturation materials during retreatment of single-canal mandibular premolars performed through 2 access outlines. Initial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented to an F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into 2 groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity (TEC). Retreatment was initiated by using ProTaper Retreatment instruments (D1-D3). Specimens were then stratified, further divided (n = 12), and reinstrumented up to TS 40 .06v or 40 .06 VB. Irrigation was performed by using 8.25% NaOCl and QMix 2in1. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation materials was measured. Data were analyzed with Kruskal-Wallis analysis of variance for two-factor tests (α canal surface when compared with TEC-VB, CEC-TS, and TEC-TS (P ≤ .05). None of these other combinations were different from each other (P > .05). Significantly more time was required for retreatment with CEC-TS (27.68 ± 1.4 minutes) than the other groups (P root canal surface of mandibular premolars. However, in the presence of a CEC access design, using TS instruments removed more obturating material in single-rooted, oval-shaped canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Changing trends in hair restoration surgery
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Venkataram Mysore
2006-01-01
Full Text Available Androgenetic alopecia is an important and common cause for baldness. Despite recent advances, the drug therapy of this condition remains unsatisfactory. Surgical hair restoration is the only permanent method of treating this condition. Introduction of recent techniques such as follicular unit transplantation have improved the cosmetic results and patient satisfaction. This article discusses the latest trends in hair restoration surgery.
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Vijay Shekhar
2013-01-01
Full Text Available Management of a tooth with open apex is a challenge to the dental practitioners. Evaluation of the periapical healing is required in such cases by radiographic techniques. The objective of this paper was to assess the healing of a periapical lesion in a non-vital tooth with open apex treated with mineral trioxide aggregate (MTA obturation using cone beam computed tomography (CBCT. The endodontic treatment of a fractured non-vital discolored maxillary left lateral incisor with an open apex was done with MTA obturation. The clinical and radiographic followup done regularly showed that the tooth was clinically asymptomatic and that the size of the periapical lesion observed by intraoral periapical (IOPA radiographs and CBCT was decreased remarkably after two years. CBCT and IOPA radiographs were found to be useful radiographic tools to assess the healing of a large periapical lesion in a non-vital tooth with open apex managed by MTA obturation.
Leonardo, Mario Roberto; Barnett, Frederick; Debelian, Gilberto J; de Pontes Lima, Regina Karla; Bezerra da Silva, Léa Assed
2007-11-01
The purpose of this study was to evaluate in vivo the response of the periradicular tissues after endodontic treatment and root filling with Epiphany/Resilon (Penntron Clinical Technologies, LLC, Wallingford, CT) or gutta percha and new Sealapex (SybronEndo, Glendora, CA) in dogs' teeth with or without coronal restoration. Teeth without coronal restorations were used to assess the influence of continuous exposure to the oral environment on the periradicular tissues. Sixty root canals with vital pulps in three dogs were instrumented and obturated in a single session and randomly assigned to one of four groups as follows. group 1: root canal filling with Epiphany/Resilon with coronal restoration, group 2: root canal filling with Sealapex sealer and gutta percha with restoration, group 3: root canal filling with Epiphany/Resilon without restoration, and group 4: root canal filling with Sealapex sealer and gutta percha without coronal restoration. After 90 days, the animals were euthanized, and the maxillas and mandibles were removed and submitted for histologic processing. Longitudinal sections were obtained and stained with hematoxylin and eosin, Mallory's trichrome, and Brown and Brenn stains and examined under light microscopy. There were significant differences found between the four groups (p < 0.05). The results showed that roots canals filled with Epiphany/Resilon, with coronal restoration, had significantly less periradicular inflammation than roots canals filled with gutta percha and Sealapex, with coronal restoration (p = 0.021). No significant difference was observed in the intensity of inflammation between roots canals filled with Epiphany/Resilon with no restoration and roots filled with gutta percha and Sealapex with restoration (p = 0.269). Roots canals filled with gutta percha and Sealapex sealer without coronal restoration showed the greatest degree of periradicular inflammation.
Farag, A
1997-01-01
In this study 20 patients suffering from chronic constipation due to spastic anal sphincters were operated upon using a new surgical technique. The technique aimed at constructing an active anal dilator mechanism using the obturator internus muscles mobilized from both sides and sutured to the side wall of the anal canal in order to overcome the spastic anal sphincters during defaecation. This series included 3 failures (15%), 16 successful cases (80%), and 1 dissatisfied patient despite normal postoperative investigations (5%). Eleven patients (55%) showed immediate postoperative normalization of their defaecation. Five patients (25%) showed normalization of their defaecation after 10 sessions of electric stimulation of the transposed muscles given 1 month postoperatively for 10 successive days. All the successful cases (16 patients) maintained their good results during the period of follow-up which ranged from 16 to 45 months (average = 30.31 months). For the successful cases, follow-up was from 16 to 42 months (average = 26.72 months). Immediate postoperative complications included 3 cases of wound infection and 2 cases of transient incontinence to gases which responded completely to postoperative Faradic stimulation. No cases of persistent incontinence of any degree were detected among the 20 patients studied. The 3 failures were mainly due to avoidable technical problems. The technique was safe, easy, and physiological, using a strictly perineal approach.
Maslow, Ken; Gupta, Chander; Klippenstein, Peter; Girouard, Lise
2014-07-01
This prospective randomized study aimed to compare the safety and efficacy of the TVT-Secur (TVT-S) with the trans vaginal obturator tape (TVT-O) for the treatment of stress urinary incontinence. We set out to enroll 136 patients in our study. 106 patients with stress urinary incontinence were randomized to either the TVT-S (n = 56) or TVT-O (n = 50) procedure. Patients were evaluated postoperatively at 2 months and 1 year. Our primary outcome was objective cure measured by the cough test. Secondary outcomes of subjective symptoms, questionnaires, pain scores, complications, and urodynamic studies were also included. Statistical analysis was by Chi-squared, Kruskal-Wallis, Wilcoxon, and Fisher's exact tests as appropriate. P values of TVT-O compared with TVT-S at 1 year (86 % and 63 % respectively, p = 0.01). Subjective cure rates were 88 % for TVT-O and 63 % for TVT-S. Quality of life scores through questionnaires improved in both groups and were not statistically different. Initial post-operative groin pain was more prevalent in the TVT-O group; however, this resolved quickly with time. TVT-O was superior to TVT-S in the objective cure of stress urinary incontinence at 1-year follow-up.
System for sampling liquids in small jugs obturated by screwed taps
International Nuclear Information System (INIS)
Besnier, J.
1995-01-01
This invention describes a machine which samples automatically liquids in small jugs obturated by screwed taps. This device can be situated in an isolated room in order to work with radioactive liquids. The machine can be divided in three main parts: a module to catch the jug, in order to take and fix it, a module to open and to close it, and a module to sample. The later takes the liquid thanks to a suction device and puts it in a container, in order to analyse the sample. (TEC)
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Sudhir Bhandari
2018-01-01
Full Text Available The most imminent issue to be addressed in a child born with cleft lip and/or palate is restoration of normal feeding. Early surgical treatment for cleft repair is crucial but may need to be postponed until certain age and weight gain is attained in an infant. When other feeding interventions fail in these children, prosthetic obturation of the defect with feeding instructions in the interim period is indicated to ward off the prevailing concerns. However, the entire prosthetic management presents a significant challenge with respect to the child's age, scope of iatrogenic injury to the delicate oral tissues, and potential for life-threatening situation during the procedures. This article draws attention toward preemptive measures which should be undertaken in the clinical setting during the fabrication of obturator to ascertain a desirable outcome without experiencing a grave complication that may arise due to ignorance and/or lack of facilities.
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Özgür Genç
2011-08-01
Full Text Available OBJECTIVE: The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. MATERIAL AND METHODS: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. RESULTS: All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05. Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05. CONCLUSIONS: Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.
Maraqa, Tareq I; Shin, Ji-Sun J; Diallo, Ismael; Sachwani-Daswani, Gul R; Mercer, Leo C
2017-11-17
Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A 23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries. The patient underwent a successful coil-embolization of the right OA. Given the density of structures within the pelvis, patients who sustain gunshot wounds to the pelvic region are at high risk for injury to the small bowel, sigmoid colon, rectum, bladder, and/or vascular structures. While bleeding is the major cause of early mortality in PT, rectal injuries carry the highest mortality due to visceral injuries. A high clinical index of suspicion is needed to diagnose an iliac artery injury or injury to its branches. Prompt computed tomographic angiogram (CTA) and embolization of the OA is the best method to control and stop the bleeding and improve the mortality outcome. Clinicians caring for patients presenting with pelvic gunshot wounds should pay attention to the delayed presentation of internal hemorrhage from the OAs. A multidisciplinary team approach is crucial in the successful management of penetrating injuries to the obturator artery.
Maini, Lalit; Kumar, Santosh; Batra, Sahil; Gupta, Rajat; Arora, Sumit
2016-08-01
Avascular necrosis (AVN) of femoral head is a recognised complication of fracture dislocation of the hip joint but is not studied frequently in relation to acetabulum fractures. The aim was to establish the relationship between obturator externus and piriformis muscle morphology in acetabulum fractures and potenital development of AVN of the femoral head. Twenty-five fractures were included in this prospective study and were subjected to radiological assessment and computed tomography of the pelvis. Magnetic resonance imaging (MRI) of the hip was performed to assess the morphology of obturator externus and piriformis, and findings were compared intraoperatively (in 15 cases). Serial radiographs were taken at monthly intervals to assess the development of avascular necrosis. The patients with no evidence of AVN on radiographs at 6 months had additional MRI scans to look for such changes. Three patients developed AVN of femoral head and two had complete tears of piriformis and/or obturator externus muscles on the pre-operative MRI with the findings confirmed intraoperatively (p = 0.013). None of the patients without changes of AVN at 6-month follow-up had complete tears of either or both muscles. Of these patients, there was one case each of T-type fracture, isolated posterior wall fracture with hip dislocation, and posterior wall with transverse fracture of the acetabulum. Complete tears of obturator externus and/or piriformis muscles are a strong predictor of future development of AVN of the femoral head.
[Nonsurgical retreatment of lateral radiopacity after surgical treatment].
Arias de Luxan, A
1990-01-01
A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months.
Application of microcomputed tomography for quantitative analysis of dental root canal obturations
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Anna Kierklo
2014-03-01
Full Text Available Introduction: The aim of the study was to apply microcomputed tomography to quantitative evaluation of voids and to test any specific location of voids in tooth’s root canal obturations. Materials and Methods: Twenty root canals were prepared and obturated with gutta-percha and Tubli-Seal sealer using the thermoplastic compaction method (System B + Obtura II. Roots were scanned and three-dimensional visualization was obtained. The volume and Feret’s diameter of I-voids (at the filling/dentine interface and S-voids (surrounded by filling material were measured.Results: The results revealed that none of the scanned root canal fillings were void-free. For I-voids, the volume fraction was significantly larger, but their number was lower (P = 0.0007, than for S-voids. Both types of voids occurred in characteristic regions (P < 0.001. I-voids occurred mainly in the apical third, while S-voids in the coronal third of the canal filling.Conclusions: Within the limitations of this study, our results indicate that microtomography, with proposed semi-automatic algorithm, is a useful tools for three-dimensional quantitative evaluation of dental root canal fillings. In canals filled with thermoplastic gutta-percha and Tubli-Seal, voids at the interface between the filling and canal dentine deserve special attention due to of their periapical location, which might promote apical microleakage. Further studies might help to elucidate the clinical relevance of these results.
Stress analysis in oral obturator prostheses, part II: photoelastic imaging
Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; da Silva, Emily Vivianne Freitas; Haddad, Marcela Filié; Moreno, Amália; Zahoui, Abbas; dos Santos, Daniela Micheline
2014-06-01
In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC-splinted implants with a bar connected to two centrally placed O-rings, and BOD-splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis.
[Surgical complications of colostomies].
Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam
2014-07-01
The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.
Evaluation of the Sealing Ability of Three Obturation Techniques Using a Glucose Leakage Test
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Katarzyna Olczak
2017-01-01
Full Text Available The aim of this study was to evaluate the sealing ability of three different canal filling techniques. Sixty-four roots of extracted human maxillary anterior teeth were prepared using ProTaper® rotary instruments. The specimens were then randomly divided into 3 experimental groups (n=16 and 2 control groups (n=8. The root canals were filled using cold lateral compaction (CLC group, continuous wave condensation technique using the Elements Obturation Unit® (EOU group, and ProTaper obturators (PT group. For the negative control group, 8 roots were filled using lateral compaction as in the CLC group, and the teeth were covered twice with a layer of nail varnish (NCG group. Another 8 roots were filled using lateral compaction, but without sealer, and these were used as the positive control (PCG group. A glucose leakage model was used for quantitative evaluation of microleakage for 24 hours and 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12 weeks. No significant difference in the cumulative amount of leakage was found between the three experimental groups at all observation times. The lateral condensation of cold gutta-percha can guarantee a similar seal of canal fillings as can be achieved by using thermal methods, in the round canals.
Govindaraju, Lavanya; Jeevanandan, Ganesh; Subramanian, E M G
2017-01-01
In permanent dentition, different rotary systems are used for canal cleaning and shaping. Rotary instrumentation in pediatric dentistry is an emerging concept. A very few studies have compared the efficiency of rotary instrumentation for canal preparation in primary teeth. Hence, this study was performed to compare the obturation quality and instrumentation time of two rotary files systems - Protaper, Mtwo with hand files in primary molars. Forty-five primary mandibular molars were randomly allotted to one of the three groups. Instrumentation was done using K-files in Group 1; Protaper in Group 2; and Mtwo in Group 3. Instrumentation time was recorded. The canal filling quality was assessed as underfill, optimal fill, and overfill. Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey test. No significant difference was observed in the quality of obturation among three groups. Intergroup comparison of the instrumentation time showed a statistically significant difference between the three groups. The use of rotary instrumentation in primary teeth results in marked reduction in the instrumentation time and improves the quality of obturation.
Tsurumachi, Tamotsu; Hayashi, Makoto
2003-10-01
A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.
Bonte, Katrien; Huvenne, Wouter; De Loof, Marie; Deron, Philippe; Viaene, Annick; Duprez, Fréderic; Vermeersch, Hubert
2015-12-01
Intractable aspiration is a serious, often life-threatening condition due to its potential impact on pulmonary function. Aspiration requires therapeutic measures, starting with conservative management but often necessitating surgical treatment. The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis. In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients, representing the largest reported cohort thus far. LTS is a reliable surgical technique to treat intractable aspiration, with restoration of oral intake, thereby improving the general condition and quality of life of these unfortunate patients. Furthermore, voice restoration can be achieved in selected patients, by placement of a voice prosthesis.
Govindaraju, Lavanya; Jeevanandan, Ganesh; Subramanian, Emg
2017-09-01
Pulp therapy in primary teeth has been performed using various instrumentation techniques. However, the conventional instrumentation technique used for root canal preparation in primary teeth is hand instrumentation. Various Nickel-Titanium (Ni-Ti) instruments are available to perform efficient root canal preparation in primary teeth. These Ni-Ti instruments has been designed to aid in better root canal preparation in permanent teeth but are rarely used in primary teeth. It is necessary to assess the feasibility of using these adult rotary files with a modified sequence in primary teeth. To compare the quality of obturation and instrumentation time during root canal preparation using hand files and modified rotary file systems in primary molars. Forty-five primary mandibular molars were randomly assigned to three experimental groups (n=15). Group I was instrumented using k-hand files, Group II with S2 ProTaper universal file and Group III with 0.25 tip 4% taper K3 rotary file. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS Software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation was done using ANOVA and Chi-square test with the level of significance set at 0.05. No significant differences were noted with regard to the quality of obturation (p=0.791). However, a statistically significant difference was noted in the instrumentation time between the three groups (pProTaper rotary system had significantly lesser instrumentation time when compared to that of K3 rotary system and hand file system. The hand files, S2 ProTaper Universal and K3 0.25 tip 4% taper files systems performed similarly with respect to the quality of obturation. There was a significant difference in instrumentation time with manual instrumentation compared to the modified rotary file systems in primary
Hazewinkel, Menke H.; Hinoul, Piet; Roovers, Jan-Paul
2009-01-01
Groin pain after a tension-free vaginal tape-obturator (TVT-O) procedure can occur but mostly disappears within 4 weeks. Persistent groin pain is extremely rare and there is a paucity of literature on how to diagnose and manage this adverse event. We present two cases with severe persistent groin
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Chye CL
2015-03-01
Full Text Available Cien-Leong Chye,1 Cheng-Loong Liang,1 Kang Lu,1 Ya-Wen Chen,2,3 Po-Chou Liliang1 1Department of Neurosurgery, E-Da Hospital, I-Shou University, 2Department of Nursing, I-Shou University, 3School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Purpose: Chronic hip pain is a common symptom experienced by many people. Often, surgery is not an option for patients with multiple comorbidities, and conventional drugs either have many side effects or are ineffective. Pulsed radiofrequency (PRF is a new method in the treatment of pain. We attempt to compare the efficacy of PRF relative to conservative management for chronic hip pain.Patients and methods: Between August 2011 and July 2013, 29 patients with chronic hip pain were divided into two groups (PRF and conservative treatment according to consent or refusal to undergo PRF procedure. Fifteen patients received PRF of the articular branches of the femoral and obturator nerves, and 14 patients received conservative treatment. Visual analog scale (VAS, Oxford hip scores (OHS, and pain medications were used for outcome measurement before treatment and at 1 week, 4 weeks, and 12 weeks after treatment.Results: At 1 week, 4 weeks, and 12 weeks after treatment initiation, improvements in VAS were significantly greater with PRF. Improvements in OHS were significantly greater in the PRF group at 1 week, 4 weeks, and 12 weeks. Patients in the PRF group also used less pain medications. Eight subjects in the conservative treatment group switched to the PRF group after 12 weeks, and six of them had >50% improvement.Conclusion: When compared with conservative treatment, PRF of the articular branches of the femoral and obturator nerves offers greater pain relief for chronic hip pain and can augment physical functioning. Keywords: pulsed radiofrequency, obturator and femoral nerves, hip joint pain, osteoarthritis
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G. P. V Srikumar
2012-01-01
Full Text Available Context: Walking bleach technique uses 30% hydrogen peroxide and sodium perborate, and this paste mixture causes loosening of the coronal temporary restorative materials and thus decreasing its clinical effectiveness and causing irritation to the patients oral tissues. In the present study, sealing ability of hygroscopic coronal temporary restorative materials were compared with the other commonly used temporary restorative materials. Aim: To evaluate the effects of walking bleach material on the marginal sealing ability and coronal microleakage of the hydrophilic temporary restorative materials with that of the other commonly used temporary restorative materials in endodontic practice. Materials and Methods: Seventy-five extracted human maxillary central incisor teeth were prepared chemo-mechanically and obturated with gutta-percha in lateral condensation technique. Surface of each tooth was double coated with cyanoacrylate glue. All the teeth were randomly divided in to five groups. Out of 15 teeth in each group, 10 teeth served as experimental specimens, in which bleaching agent was placed in the pulp chamber and 5 teeth served as control, in which no bleaching agent was placed. The access cavities were restored with temporary restorative materials being tested per each group respectively. The specimens were then immersed in 1% India ink dye and subjected to thermo cycling for 7 days. All the teeth were longitudinally sectioned and observed with stereomicroscope and were graded according to the depth of linear dye penetration. Statistical Analysis Used: Mann-Whitney U test and Kruskal-Wallis test. Results: Hydrophilic temporary restorative materials Cavit G and Coltosol F have shown minimal coronal dye leakage with better sealing ability when exposed to walking bleach paste mixture in the dye penetration tests compared to other commonly used temporary restorative materials. Conclusion: Marginal sealing ability of Cavit G and Coltosol F were
Jorgensen, Ben; Williamson, Anne; Chu, Rene; Qian, Fang
2017-06-01
This ex vivo study aimed to evaluate the efficacy of retreating GuttaCore (Dentsply Tulsa Dental Specialties, Tulsa, OK) and warm vertically condensed gutta-percha in moderately curved canals with 2 different systems: ProTaper Universal Retreatment (Dentsply Tulsa Dental) and WaveOne (Dentsply Tulsa Dental). Eighty mesial roots of mandibular molars were used in this study. The mesiobuccal canals in each sample were prepared to length with the WaveOne Primary file (Dentsply Tulsa Dental). The canals were obturated with either a warm vertical approach or with GuttaCore and divided into 4 retreatment groups with the same mean root curvature: warm vertical retreated with ProTaper, warm vertical retreated with WaveOne, GuttaCore retreated with ProTaper, and GuttaCore retreated with WaveOne. The warm vertical groups were obturated using a continuous-wave technique of gutta-percha compaction, and the GuttaCore groups were obturated according to the manufacturer's instructions. After allowing sealer to set, each specimen was retreated with either the ProTaper Universal Retreatment files D1, D2, or D3 or with the WaveOne Primary file to the predetermined working length. The time taken to reach the working length was recorded. Instrument fatigue and failure were also evaluated. The post hoc 2-sample t tests showed that the overall mean total time taken to reach the working length for the warm vertical groups was significantly greater than that observed for the GuttaCore groups (mean = 87.11 vs 60.16 seconds, respectively), and the overall mean total time taken to reach the working length for WaveOne was significantly greater than that observed for ProTaper (99.09 vs 48.18 seconds, respectively). Two-way analysis of variance showed a significant main effect for both the type of experiment groups (F 1,76 = 15.32, P = .0002) and the type of retreatments (F 1,76 = 54.67, P file underwent more separations than the ProTaper files. The WaveOne Primary file underwent
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Shahi Sh.
2008-10-01
Full Text Available "nBackground and Aim: The use of proper temporary restorative materials between appointments is critical in successful root canal treatment. The purpose of this study was to compare the coronal microleakage of four temporary restorative materials including Zonalin, Zamherir, Coltosol and IRM. "nMaterials and Methods: In this in vitro study, standard access cavities were prepared in 120 intact extracted maxillary and mandibular human first molars. Canal preparation was carried out by the step-back technique, and obturation was performed with gutta-percha and AH26 sealer using the lateral condensation technique. Teeth were randomly divided into 4 experimental groups of 25 teeth each and two positive and negative control groups, each containing 10 teeth. In each experimental group the access cavity was restored with one of the tested materials (Zamherir, Zonalin, IRM and Coltosol. In the negative control group the access cavity was filled entirely with sticky wax and in the positive control group no restorative material was applied. Dye penetration technique was used to evaluate microleakage which was measured under a stereomicroscope. Data were analyzed with one way ANOVA and post hoc Tukey tests. P<0.05 was considered as the limit of significance. "nResults: Dye penetration was observed in all groups. Zonalin and Coltosol had the highest and the lowest dye penetration respectively, with a statistically significant difference (p<0.001. There was no significant difference in dye penetration between IRM, and either Coltosol or Zamherir (p>0.05. "nConclusion: The results of this study showed that using Coltosol as a temporary restorative material can provide a better coronal seal in endodontic treatments
Canel, Virginie; Thubert, Thibault; Wigniolle, Ingrid; Fernandez, Hervé; Deffieux, Xavier
2015-10-01
Placement of a transobturator midurethral sling (MUS) is the standard surgical treatment for stress urinary incontinence. Most recent MUS procedures have been poorly evaluated. We compared the results using a "new" device expected to reduce postoperative pain, the TVT ABBREVO® system (TVT-Abb), with those using the TVT™ obturator system (TVT-O). This was a retrospective study comparing the use of the TVT-Abb (in 50 patients) and the TVT-O (in 50 patients). The main outcomes were the amount of postoperative pain, the success rate (no reported urinary leakage and negative cough test) with both MUS procedures, and the prevalence of complications. The mean follow-up time was 12 months. The preoperative characteristics of the two groups were comparable. There was less postoperative pain (VAS, 0 to 100) in the TVT-Abb group than in the TVT-O group (12.2 vs. 24.4, p TVT-Abb group and the TVT-O group (8 % vs. 12 %, p = 0.74). The prevalences of perioperative and postoperative complications (bladder/urethral injury, haemorrhage) in the two groups were equal. The success rates were similar at 12 months after surgery (88 % vs. 78 %, p = 0.29). The success rates with TVT-Abb and TVT-O were equal at 12 months after surgery, but there was less immediate postoperative pain with TVT-Abb.
Current strategies for the restoration of adequate lordosis during lumbar fusion
Barrey, Cédric; Darnis, Alice
2015-01-01
Not restoring the adequate lumbar lordosis during lumbar fusion surgery may result in mechanical low back pain, sagittal unbalance and adjacent segment degeneration. The objective of this work is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. Theoretical lordosis can be evaluated from the measurement of the pelvic incidence and from the analysis of spatial organization of the lumbar spine with 2/3 of the lordosis given by the L4-S1 segment and 85% by the L3-S1 segment. Technical aspects involve patient positioning on the operating table, release maneuvers, type of instrumentation used (rod, screw-rod connection, interbody cages), surgical sequence and the overall surgical strategy. Spinal osteotomies may be required in case of fixed kyphotic spine. AP combined surgery is particularly efficient in restoring lordosis at L5-S1 level and should be recommended. Finally, not one but several strategies may be used to achieve the need for restoration of adequate lordosis during fusion surgery. PMID:25621216
Surgical templates for dental implant positioning; current knowledge and clinical perspectives
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Mohammed Zaheer Kola
2015-01-01
Full Text Available Dental implants have been used in a variety of different forms for many years. Since the mid-20 th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.
Rehabilitation of patient with acquired maxillary defect, using a closed hollow bulb obturator
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Abhilasha S Bhasin
2011-01-01
Full Text Available Palliative care means providing support and care for patients with life-threatening or debilitating illness so that they can live their life as comfortably as possible. The fact that cure is no longer a reality does not mean that care cannot be made available. Partial maxillectomy defect presents a prosthodontic challenge in terms of re-establishing oronasal separation. Such defect has direct effect on cosmetic, function and psychology of the patient. This article describes step by step clinical and laboratory procedures involved in the rehabilitation of a hemimaxillectomy patient, using a definitive closed hollow bulb obturator, which improved his physical, emotional, functional, social and spiritual needs.
Chye, Cien-Leong; Liang, Cheng-Loong; Lu, Kang; Chen, Ya-Wen; Liliang, Po-Chou
2015-01-01
Chronic hip pain is a common symptom experienced by many people. Often, surgery is not an option for patients with multiple comorbidities, and conventional drugs either have many side effects or are ineffective. Pulsed radiofrequency (PRF) is a new method in the treatment of pain. We attempt to compare the efficacy of PRF relative to conservative management for chronic hip pain. Between August 2011 and July 2013, 29 patients with chronic hip pain were divided into two groups (PRF and conservative treatment) according to consent or refusal to undergo PRF procedure. Fifteen patients received PRF of the articular branches of the femoral and obturator nerves, and 14 patients received conservative treatment. Visual analog scale (VAS), Oxford hip scores (OHS), and pain medications were used for outcome measurement before treatment and at 1 week, 4 weeks, and 12 weeks after treatment. At 1 week, 4 weeks, and 12 weeks after treatment initiation, improvements in VAS were significantly greater with PRF. Improvements in OHS were significantly greater in the PRF group at 1 week, 4 weeks, and 12 weeks. Patients in the PRF group also used less pain medications. Eight subjects in the conservative treatment group switched to the PRF group after 12 weeks, and six of them had >50% improvement. When compared with conservative treatment, PRF of the articular branches of the femoral and obturator nerves offers greater pain relief for chronic hip pain and can augment physical functioning.
Pawińska, M; Kierklo, A; Tokajuk, G; Sidun, J
2011-01-01
To comparatively evaluate adhesive properties of selected root canal fillings through the measurement of the material-dentine interfacial bond strength. Fifty extracted single-rooted human teeth with one canal each were prepared using Hero instruments to size 30.04. Teeth were divided into four subgroups depending on the root canal filling material and the method of obturation: Resilon/Epiphany - a thermoplastic method (IA), Resilon/Epiphany - a matching single-point method (IB), gutta-percha/Roeko Seal Automix - a thermoplastic method (IIA) and gutta-percha/Roeko Seal Automix - a matching single-point method (IIB). The obturated roots were cut perpendicular to the long axis to create 1.7 mm thick slices. The bond strength was measured for each test slice with push -out testing machine. The highest push-out bond strength was registered in subgroup IB (3.98 ± 1.33 MPa). Significantly lower bond strength was observed in subgroups IA (0.50 ± 0.24 MPa), IIA (0.33 ± 0.18 MPa) and IIB (0.08 ± 0.03 MPa) (pmaterial-dentine interfacial bond strength values were observed between IA and IIA, IA and IIB, IIA and IIB subgroups (p > 0.05). The push-out bond strength of the material-dentine interface was dependent on the type of material used and the root canal filling technique. The R/E system exhibited better adhesion ability to intraradicular dentine than G/RSA. The highest bond strength was observed for Resilon/Epiphany introduced with the single-cone technique.
Scalco, Elisa; Rancati, Tiziana; Pirovano, Ileana; Mastropietro, Alfonso; Palorini, Federica; Cicchetti, Alessandro; Messina, Antonella; Avuzzi, Barbara; Valdagni, Riccardo; Rizzo, Giovanna
2018-04-01
To investigate the potential of texture analysis applied on T2-w and postcontrast T1-w images acquired before radiotherapy for prostate cancer (PCa) and 12 months after its completion in quantitatively characterizing local radiation effect on the muscular component of internal obturators, as organs potentially involved in urinary toxicity. T2-w and postcontrast T1-w MR images were acquired at 1.5 T before treatment (MRI1) and at 12 months of follow-up (MRI2) in 13 patients treated with radiotherapy for PCa. Right and left internal obturator muscle contours were manually delineated upon MRI1 and then automatically propagated on MRI2 by an elastic registration method. Planning CT images were coregistered to both MRIs and dose maps were deformed accordingly. A high-dose region receiving >55 Gy and a low-dose region receiving evaluated. A signal increase was highlighted in both T2-w and T1-w images in the portion of the obturators near the prostate, i.e., in the region receiving medium-high doses. A change in the spatial organization was identified, as an increase in homogeneity and a decrease in contrast and complexity, compatible with an inflammatory status. In particular, the region receiving medium-high doses presented more significant or, at least, stronger differences. Texture analysis applied on T1-w and T2-w MR images has demonstrated its ability in quantitative evaluating radiation-induced changes in obturator muscles after PCa radiotherapy. © 2018 American Association of Physicists in Medicine.
Surgical repair of idiopathic scrotal elephantiasis.
Zacharakis, Evangelos; Dudderidge, Tim; Zacharakis, Emmanouil; Ioannidis, Evangelos
2008-02-01
Scrotal lymphedema (scrotal elephantiasis) is uncommon outside of filariasis endemic regions. We present a case of a 65-year-old with idiopathic lymphedema of the scrotum and functional impairment of the penis. The patient underwent surgical excision of the edematous subcutaneous tissues and plastic reconstruction of his penis and scrotum. Three years later, the patient showed no signs of local recurrence, had complete restoration of urinary and sexual function and was extremely satisfied with the result. Surgical management was an effective strategy in the management of scrotal lymphedema in this case.
Alkahtani, Ahmed; Al-Subait, Sara; Anil, Sukumaran
2013-01-01
The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.
Directory of Open Access Journals (Sweden)
Ahmed Alkahtani
2013-01-01
Full Text Available The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.
Corrosive Space Gas Restores Artwork, Promises Myriad Applications
2007-01-01
Atomic oxygen's unique characteristic of oxidizing primarily hydrogen, carbon, and hydrocarbon polymers at surface levels has been applied in the restoration of artwork, detection of document forgeries, and removal of bacterial contaminants from surgical implants. The Electro-Physics Branch at Glenn Research Center built on corrosion studies of long-duration coatings for use in space, and applied atomic oxygen's selectivity to instances where elements need to be removed from a surface. Atomic oxygen is able to remove organic compounds high in carbon (mostly soot) from fire-damaged artworks without causing a shift in the paint color. First successfully tested on oil paintings, the team then applied the restoration technique to acrylics, watercolors, and ink. The successful art restoration process was well-publicized, and soon a multinational, nonprofit professional organization dedicated to the art of forensic analysis of documents had successfully applied this process in the field of forgery detection. The gas has biomedical applications as well-Atomic Oxygen technology can be used to decontaminate orthopedic surgical hip and knee implants prior to surgery, and additional collaborative research between the Cleveland Clinic Foundation and the Glenn team shows that this gas's roughening of surfaces improves cell adhesion, which is important for the development of new drugs.
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Gautham Prabhakar
2018-01-01
Full Text Available Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature. We present a unique case of open reduction and internal fixation of a high-energy femoral neck fracture with extrusion of the head through the obturator foramen into the pelvis without associated acetabular or pelvic injury.
Directory of Open Access Journals (Sweden)
Alla V. Ovechkina
2017-12-01
Full Text Available Introduction. The modern approach to the treatment of unstable fractures of the thoracolumbar and lumbar spine in children is surgical stabilization at the early stages after trauma by using metal structures that quickly restore vertical functionality to the patient and shorten the period of inpatient treatment. However, the issues related to restorative treatment have not been sufficiently addressed. Aim. To develop an algorithm for restorative treatment of children at the inpatient stage after surgical treatment of unstable uncomplicated fractures of the thoracolumbar and lumbar spine. Material and methods. Based on the results of treatment of 73 patients aged 9 to 17 years with unstable uncomplicated vertebral fractures, an algorithm of stage-by-stage rehabilitation by means of therapeutic gymnastics depending on the severity of the injury, method of surgical stabilization of the spine, physical condition of the child, and time passed after the operation was developed. Results and discussion. The use of differentiated groups of respiratory gymnastics and isometric and dynamic exercises for muscle groups restored vertical functionality to patients in 1–3 days after surgery, restored spine and motor functions, and shortened the duration of inpatient treatment to a range of 10–14 days. Conclusion. The developed algorithm for physical rehabilitation of children after surgical treatment of unstable injuries of the thoracic and lumbar spine by using metal structures at the inpatient stage contributed to the selection of the most rational and effective program of restorative treatment.
Surgical-orthodontic correction of a Class III dentofacial deformity.
Devanna, Raghu; Kakkirala, Neelima
2010-04-01
This case report describes the surgical-orthodontic treatment of a 26-year-old post-pubertal male patient with a Class III dentofacial deformity. In the pre-surgical orthodontic phase of treatment, a reverse overjet of 5.5 mm was created and arch compatibility was obtained. A mandibualr set back with BSSO was performed during surgery to restore ideal overjet, overbite, occlusion and optimal esthetics. After 1 year of treatment, the results remained stable.
3-D diagnosis-assisted management of anomalous mandibular molar
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Neelam Mittal
2012-01-01
Full Text Available This case report describes the successful non-surgical endodontic management of carious exposed three-rooted mandibular molar with four root canals detected on the pre-operative radiograph taken with 20 degrees mesial angulation and confirmed with a 64-slice helical computed tomography scan-assisted 3-D-reconstructed images. Access cavity shape was modified to locate the extra canal with respect to the distolingual root in the left mandibular first molar. Copious irrigation was accomplished with 5.25% sodium hypochlorite and 17% EDTA. Biomechanical preparation was done using protapers. Calcium hydroxide dressing was done for 1 week. The tooth was obturated using gutta percha and AH 26 root canal sealer, and it was permanently restored with composite. Clinical examination on follow-up visits revealed no sensitivity to percussion and palpation in the left mandibular first molar. Thorough knowledge of root canal variations and use of advanced diagnostic modalities lead to successful non-surgical management of the complex cases.
Directory of Open Access Journals (Sweden)
Yi Yang
2016-04-01
Full Text Available OBJECTIVE: To investigate the feasibility of using free gracilis muscle transfer along with the brachialis muscle branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury according to an anatomical study and a case report. METHODS: Thirty formalin-fixed upper extremities from 15 adult cadavers were used in this study. The distance from the point at which the brachialis muscle branch of the musculocutaneous nerve originates to the midpoint of the humeral condylar was measured, as well as the length, diameter, course and branch type of the brachialis muscle branch of the musculocutaneous nerve. An 18-year-old male who sustained an injury to the left brachial plexus underwent free gracilis transfer using the brachialis muscle branch of the musculocutaneous nerve as the donor nerve to restore finger and thumb flexion. Elbow flexion power and hand grip strength were recorded according to British Medical Research Council standards. Postoperative measures of the total active motion of the fingers were obtained monthly. RESULTS: The mean length and diameter of the brachialis muscle branch of the musculocutaneous nerve were 52.66±6.45 and 1.39±0.09 mm, respectively, and three branching types were observed. For the patient, the first gracilis contraction occurred during the 4th month. A noticeable improvement was observed in digit flexion one year later; the muscle power was M4, and the total active motion of the fingers was 209°. CONCLUSIONS: Repairing injury to the lower trunk of the brachial plexus by transferring the brachialis muscle branch of the musculocutaneous nerve to the anterior branch of the obturator nerve using a tension-free direct suture is technically feasible, and the clinical outcome was satisfactory in a single surgical patient.
Surgical-orthodontic correction of a Class III dentofacial deformity
Directory of Open Access Journals (Sweden)
Raghu Devanna
2010-01-01
Full Text Available This case report describes the surgical-orthodontic treatment of a 26-year-old post-pubertal male patient with a Class III dentofacial deformity. In the pre-surgical orthodontic phase of treatment, a reverse overjet of 5.5 mm was created and arch compatibility was obtained. A mandibualr set back with BSSO was performed during surgery to restore ideal overjet, overbite, occlusion and optimal esthetics. After 1 year of treatment, the results remained stable.
Malmstrom, Hans; Xiao, Jin; Romanos, Georgios E; Ren, Yan-Fang
2015-01-01
Implant therapy is rapidly becoming a standard of care for replacing missing dentition. Predoctoral dental curricula include some training in the implant restorative phase but offer limited exposure to the surgical phase, so it is important for postdoctoral general dentistry residency programs to provide competency training in all phases of implant therapy. The aim of this study was to determine the training needed for general dentistry residents to achieve competence in this area, specifically by defining the number of clinical experiences necessary in both the surgical and prosthetic phases of implant-retained mandibular overdenture construction (IRMOD). Fifteen Advanced Education in General Dentistry (AEGD) residents at one academic dental institution placed two implants in a total of 50 patients with edentulous mandibles and subsequently restored them with IRMOD. The supervising faculty member and the residents evaluated the competency level on a five-point scale after each implant placement and prosthetic case completion. According to the faculty evaluations, the residents achieved surgical competence after placing two implants in four to six cases and prosthetic management competence after restoring two to four cases of IRMOD. All 50 patients were satisfied with the treatment outcomes of IRMOD. This study concluded that general dentistry residents could potentially achieve competence in both the surgical and prosthetic phases of implant therapy while enrolled in an AEGD program.
Urken, Mark L; Roche, Ansley M; Kiplagat, Kimberly J; Dewey, Eliza H; Lazarus, Cathy; Likhterov, Ilya; Buchbinder, Daniel; Okay, Devin J
2018-03-14
Palatomaxillary defects were historically restored with a prosthetic obturator; however, advances in local and free tissue transfer has provided a viable alternative for appropriately selected patients with palatomaxillary defects. A retrospective chart review of patients who underwent palatomaxillary reconstruction by the lead author between 1998 and 2016 was conducted. Patients who were restored with a palatal obturator were excluded. One hundred forty patients were reconstructed with a total of 159 local, regional, and free flaps with a 96.7% success rate. Seventy-four patients (52.8%) underwent prosthodontic rehabilitation, with 183 implants placed and an 86% success rate. Palatomaxillary reconstruction applying a systematic approach, using a multitude of techniques, is a safe and effective way to restore patients without compromising the ability to maintain surveillance. Prosthodontic rehabilitation can be achieved in a high percentage of patients using dental implants, leading to optimal aesthetic and functional results. © 2018 Wiley Periodicals, Inc.
Restoration-Guided Implant Rehabilitation of the Complex Partial Edentulism: a Clinical Report
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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.
DEFF Research Database (Denmark)
Gordan, Valeria V; Bader, James D; Garvan, Cynthia W
2010-01-01
: The investigators surveyed dentists enrolled in a dental practice-based research network who reported performing at least some restorative dentistry. In the survey, dentists were asked to indicate whether they would intervene surgically in a series of cases involving occlusal caries. Each case presentation included...... a photograph of an occlusal surface displaying typical characteristics of caries penetration and a written description of a patient at a specific level of risk of developing caries. Using logistic regression, the authors analyzed associations between surgical treatment with dentists' and practices......' characteristics and patients' caries risk levels. RESULTS: A total of 517 DPBRN practitioner-investigators responded to the questionnaire. Sixty-three percent of the respondents (326 of 517) indicated that in patients at low risk of developing caries, they would surgically restore teeth with lesions located...
Medical Officers in Sierra Leone: Surgical Training Opportunities, Challenges and Aspirations.
Wilks, Lucy; Leather, Andrew; George, Peter Matthew; Kamara, Thaim Bay
2018-02-05
The critical shortage of human resources for healthcare falls most heavily on sub-Saharan nations such as Sierra Leone, where such workforce deficits have grave impacts on its burden of surgical disease. An important aspect in retention and development of the workforce is training. This study focuses on postgraduate surgical training (formal and short course) and perceptions of opportunities, challenges and aspirations, in a country where more than half of surgical procedures are performed by medical officers. The study presents findings from 12 in-depth semi-structured interviews conducted with medical officers by the primary investigator in Sierra Leone between April and June 2017. Each interview was transcribed alongside an introspective reflexive journal to acknowledge and account for researcher biases. Two interviewees had accessed postgraduate surgical training and 10 (83%) had accessed short course surgically relevant training. The number of short courses accessed grew higher the more recently the medical officers had graduated. Supervision, short length and international standards were the most appreciated aspects of short training courses. Some medical officers perceived the formal postgraduate surgical training programme to be ill-equipped, doubting its credibility. This demotivated some from applying. Training is an essential aspect of developing an adequate surgical workforce. Faith must be restored in the capabilities of Sierra Leone's Ministry of Health and Sanitation to provide adequate and sustainable training. This study advocates for the use of short courses to restore this faith and the expansion of postgraduate surgical training to the districts through developing a regional teaching complex to provide short courses and eventually formal postgraduate training in the future. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Prosthetic Rehabilitation of Patients with Maxillary Defects in a ...
African Journals Online (AJOL)
Surgical defects were the most common type of maxillary defects seen; accounting for 89.5% (17/19) of the cases, which were mostly associated with malignant tumors. Immediate surgical obturators were provided for 63.2% (12/19) of the subjects. Majority 70.6% (12/17) of those with surgical defects received immediate ...
Surgical Patients\\' Knowledge and Acceptance of Autologous Blood ...
African Journals Online (AJOL)
Background: Homologous blood transfusion carries a well-documented array of risks especially in an HIV endemic environment like Nigeria. It is therefore imperative to consider other forms of restoring blood volume in surgical patients. Autologous blood transfusion (ABT) is one of the ways the problem of HIV transmission ...
[Composite digital allotransplants: surgical technique and different applications].
Casoli, V; Rousvoal, A; Zirak, C; Bakhach, J; Guimberteau, J-C
2007-10-01
Microsurgery and human allotransplantation progress as well as the improvement of immunosuppressive drugs actually allow the development of the composite tissue allotransplantation. One of the latest challenges in plastic surgery is to restore the anatomic and functional structures using similar tissues. Composite tissue allotransplantation will probably reach this goal. Our work is to find new surgical techniques for the reconstruction of the osteotendinous apparatus of the long digits. In this paper, we will demonstrate the surgical technique to harvest the allotransplant and its modulation in the reconstruction of various digital defects.
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Sudhir Bhandari
2011-01-01
Full Text Available Treacher Collins syndrome has been described as a syndrome involving 1st and 2nd branchial arches, affecting various organs in the craniofacial region. Affected infants report with nasal regurgitation and minimal dietary intake due to cleft palate, consequently show delayed and retarded growth. The situation is further complicated when the repair of the palatal defect is postponed due to delayed milestones. At this juncture, it is of paramount importance to intervene prosthetically and close the defect with the aid of an interim obturator. Herein we describe a simple, yet successful, chairside approach to make an impression of an infant without the aid of any kind of anesthesia.
Surgical and prosthetic reconsiderations in patients with maxillectomy.
Lethaus, B.; Lie, N.; Beer, F. de; Kessler, P.; Baat, C. de; Verdonck, H.W.
2010-01-01
The purpose of this study was to establish and evaluate new possibilities for rehabilitation of patients with obturator prosthesis who had undergone partial or total maxillectomy because of tumour ablation surgery. Eleven patients with maxillary defects were reconstructed with a computer-aided
Waltregny, David; de Leval, Jean
2009-03-01
Six years ago, the inside-out transobturator tape TVT-O procedure was developed for the surgical treatment of female stress urinary incontinence (SUI) with the aim of minimizing the risk of urethra and bladder injuries and ensuring minimal tissue dissection. Initial feasibility and efficacy studies suggested that the TVT-O procedure is associated with high SUI cure rates and low morbidity at short term. A recent analysis of medium-term results indicated that the TVT-O procedure is efficient, with maintenance, after a 3-year minimum follow-up, of cure rates comparing favorably with those reported for TVT. No late complications were observed. As of July 2008, more than 35 clinical papers, including ten randomized trials and two national registries, have been published on the outcome of the TVT-O surgery. Results from these studies have confirmed that the TVT-O procedure is safe and as efficient as the TVT procedure, at least in the short/medium term.
Assessment of the quality of life in maxillectomy patients: A longitudinal study.
Kumar, Pradeep; Alvi, Habib Ahmad; Rao, Jitendra; Singh, Balendra Pratap; Jurel, Sunit Kumar; Kumar, Lakshya; Aggarwal, Himanshi
2013-02-01
To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of Pmaxillectomy defects.
Tret'iakov, A A; Slepykh, N I; Kornilov, A K; Karimov, Z Kh
1998-01-01
The analysis of 70 cases of surgical treatment for intraoperative injuries and cicatricial strictures of extrahepatic bile ducts was carried out. In 25 patients surgical procedure was restorative and in 45--reconstructiver. Most common causes of corrective operations were: iatrogenic injuries of extrahepatic bile ducts (14) and cicatricial strictures of hepaticocholedochal duct due to intraoperative trauma (31). The problems of operative technique in performing biliobilio-, hepato-hepatico and hepatico-jejuno-anastomoses are considered. There were three deaths in the early postoperative period: 2 patients died of hepatic failure, pyogenic cholangiogenic intoxication caused by cholangioectasies and intrahepatic abscesses, and 1-due to generalyzed peritonitis caused by acute gastric ulcer perforation. Special attention is paid to the choice of the method of prolonged drainage used in reconstructive as well as in restorative operations.
“Evaluation of fracture strength of teeth restored with different types ...
African Journals Online (AJOL)
2014-11-24
Nov 24, 2014 ... tooth with damaged pulp in function. ... fluid tight obturation along with adequate postendodontic ... radicular dentin to supporting tissues and thus protect and ... modulus, which is similar to that of dentin, resin cements,.
Surgical reconstruction of spinal cord circuit provides functional return in humans
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Thomas Carlstedt
2017-01-01
Full Text Available This mini review describes the current surgical strategy for restoring function after traumatic spinal nerve root avulsion in brachial or lumbosacral plexus injury in man. As this lesion is a spinal cord or central nervous injury functional return depends on spinal cord nerve cell growth within the central nervous system. Basic science, clinical research and human application has demonstrated good and useful motor function after ventral root avulsion followed by spinal cord reimplantation. Recently, sensory return could be demonstrated following spinal cord surgery bypassing the injured primary sensory neuron. Experimental data showed that most of the recovery depended on new growth reinnervating peripheral receptors. Restored sensory function and the return of spinal reflex was demonstrated by electrophysiology and functional magnetic resonance imaging of human cortex. This spinal cord surgery is a unique treatment of central nervous system injury resulting in useful functional return. Further improvements will not depend on surgical improvements. Adjuvant therapy aiming at ameliorating the activity in retinoic acid elements in dorsal root ganglion neurons could be a new therapeutic avenue in restoring spinal cord circuits after nerve root avulsion injury.
Zygoma Implant-Supported Prosthetic Rehabilitation of a Patient After Bilateral Maxillectomy.
Celakil, Tamer; Ayvalioglu, Demet Cagil; Sancakli, Erkan; Atalay, Belir; Doganay, Ozge; Kayhan, Kivanc Bektas
2015-10-01
Maxillectomy defects may vary from localized to extensive soft and hard tissue loss. In addition to physical and psychologic damages, functional and aesthetic aspects must be restored. This clinical report describes the rehabilitation of a patient with a zygoma implant-supported obturator prosthesis caused by a subtotal bilateral maxillectomy due to a squamous oral cell carcinoma. Prosthetic rehabilitation of this patient was performed after zygoma implant surgery. A maxillary obturator prosthesis supported by 2 osseointegrated zygoma implants was fabricated. Despite limited mouth opening and anatomic deficiencies, the patient's aesthetic and functional demands were fulfilled.
Surgical reconstruction of pelvic floor descent: anatomic and functional aspects.
Wagenlehner, F M E; Bschleipfer, T; Liedl, B; Gunnemann, A; Petros, P; Weidner, W
2010-01-01
The human pelvic floor is a complex structure and pelvic floor dysfunction is seen frequently in females. This review focuses on the surgical reconstruction of the pelvic floor employing recent findings on functional anatomy. A selective literature research was performed by the authors. Pelvic floor activity is regulated by 3 main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor organs, bladder and rectum. A variety of symptoms can derive from pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, fecal incontinence, obstructive bowel disease syndrome and pelvic pain. These symptoms mainly derive, for different reasons, from laxity in the vagina or its supporting ligaments as a result of altered connective tissue. Pelvic floor reconstruction is nowadays driven by the concept that in case of pelvic floor symptoms, restoration of the anatomy will translate into restoration of the physiology and ultimately improve patients' symptoms. The surgical reconstruction of the anatomy is almost exclusively focused on the restoration of the lax pelvic floor ligaments. Exact preoperative identification of the anatomical lesions is necessary to allow for exact anatomical reconstruction with respect to the muscular forces of the pelvic floor. Copyright 2010 S. Karger AG, Basel.
Surgical Treatment with Locoregional Flaps for the Eyelid: A Review
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Federico Lo Torto
2017-01-01
Full Text Available Reconstruction of the eyelids after skin cancer excision can be challenging. Surgical treatment options are multiple; deep anatomy knowledge of lamellar components is mandatory to choose the most adequate surgical planning. Eyelids’ role in vision and social relationship is critical; both function and aesthetics are tough to restore. Using a flap provides a satisfying texture and colour match with adjacent tissues and ensures short contraction during healing; furthermore, grafts are sometimes necessary to achieve pleasing results. Hundreds of surgical techniques have been described aiming for eyelid reconstruction; in our paper, we want to provide for our audience the most reliable and useful procedures for subtotal and total eyelid reconstruction following NMSC full-thickness excision.
Arthroscopic medial meniscus trimming or repair under nerve blocks: Which nerves should be blocked?
Taha, AM; Abd-Elmaksoud, AM
2016-01-01
Background: This study aimed to determine the role of the sciatic and obturator nerve blocks (in addition to femoral block) in providing painless arthroscopic medial meniscus trimming/repair. Materials and Methods: One hundred and twenty patients with medial meniscus tear, who had been scheduled to knee arthroscopy, were planned to be included in this controlled prospective double-blind study. The patients were randomly allocated into three equal groups; FSO, FS, and FO. The femoral, sciatic, and obturator nerves were blocked in FSO groups. The femoral and sciatic nerves were blocked in FS group, while the femoral and obturator nerves were blocked in FO group. Intraoperative pain and its causative surgical maneuver were recorded. Results: All the patients (n = 7, 100%) in FO group had intraoperative pain. The research was terminated in this group but completed in FS and FSO groups (40 patients each). During valgus positioning of the knee for surgical management of the medial meniscus tear, the patients in FS group experienced pain more frequently than those in FSO group (P = 0.005). Conclusion: Adding a sciatic nerve block to the femoral nerve block is important for painless knee arthroscopy. Further adding of an obturator nerve block may be needed when a valgus knee position is required to manage the medial meniscus tear. PMID:27375382
DEFF Research Database (Denmark)
Fellows, Jeffrey L; Gordan, Valeria V; Gilbert, Gregg H
2014-01-01
PURPOSE: Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice...... characteristics associated with restoration of enamel caries, while accounting for other factors. METHODS: Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229...... participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal...
Directory of Open Access Journals (Sweden)
Sandeep S Sattur
2011-01-01
Full Text Available There is more than one way to manage hair loss surgically. Apart from hair transplantation, there are other techniques which have been used by many to treat baldness. This article attempts to review the surgical methodology and philosophy that have acted as guiding lights in the approach to surgical treatment of baldness over the years and reviews the current role of other techniques in the armamentarium of hair restoration surgeons today.
Association between fundus autofluorescence and visual outcome in surgically closed macular holes.
Lee, Young Seob; Yu, Seung-Young; Cho, Nam Suk; Kim, Moo Sang; Kim, Young Gyun; Kim, Eung Suk; Kwak, Hyung Woo
2013-06-01
To investigate the association between fundus autofluorescence (FAF) and visual acuity, recovery of foveal microstructure, and FAF in surgically closed macular holes. Twenty-six eyes with surgically closed macular hole were classified into two groups based on foveal FAF: normal autofluorescence (NAF) or increased autofluorescence (IAF). The association between foveal FAF and visual acuity was analyzed. In addition, we examined the relationship between recovery of the foveal microstructure assessed by spectral domain optical coherence tomography and FAF after macular hole surgery. At 1 month and 6 months after surgery, there were 9 NAF eyes and 17 IAF eyes. There were no differences between NAF and IAF eyes at 1 month and 6 months after surgery. Preoperative best-corrected visual acuity (logarithm of the minimum angle of resolution) did not differ between groups. Best-corrected visual acuity was significantly higher in the NAF group than in the IAF group at 1 month postoperatively (0.59 ± 0.34 vs. 0.91 ± 0.36, P = 0.044) and tended to be higher at 6 months (0.37 ± 0.38 vs. 0.69 ± 0.53, P = 0.126). Restoration of photoreceptor external limiting membrane differed significantly in 8 NAF eyes (89%) and 4 IAF eyes (24%) at postoperation 1 month (P = 0.001). After 6 months, external limiting membrane was restored in all 9 NAF eyes (100%) and in only 11 IAF eyes (65%) (P = 0.042). Fundus autofluorescence findings observed in surgically closed macular holes correlated with visual improvement and photoreceptor status. Eyes with visual improvement had restoration of normal foveal autofluorescence and retinal microstructure, whereas eyes with persistent foveal hyperautofluorescence did not achieve complete restoration of the retinal microstructure, and visual improvement was not as significant.
Corona mortis: an anatomical variation with clinical relevance. Case report.
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Guillermo Adrián Rivera-Cardona
2010-12-01
Full Text Available The obturator artery is one of the parietal branches arising from the internal iliac artery, the anatomical variation from which this artery originates is called “The corona mortis”, generally from the external iliac artery or the inferior epigastric artery. This finding was observed bilaterally in a male cadaver during a pelvis dissection. Clinical consideration of the anatomical variation in the obturator artery, during surgical procedures, is of great importance due to the risk of pelvic hemorrhage.
Basic science and surgical treatment options for articular cartilage injuries of the knee.
Tetteh, Elizabeth S; Bajaj, Sarvottam; Ghodadra, Neil S
2012-03-01
The complex structure of articular cartilage allows for diverse knee function throughout range of motion and weight bearing. However, disruption to the structural integrity of the articular surface can cause significant morbidity. Due to an inherently poor regenerative capacity, articular cartilage defects present a treatment challenge for physicians and therapists. For many patients, a trial of nonsurgical treatment options is paramount prior to surgical intervention. In instances of failed conservative treatment, patients can undergo an array of palliative, restorative, or reparative surgical procedures to treat these lesions. Palliative methods include debridement and lavage, while restorative techniques include marrow stimulation. For larger lesions involving subchondral bone, reparative procedures such as osteochondral grafting or autologous chondrocyte implantation are considered. Clinical success not only depends on the surgical techniques but also requires strict adherence to rehabilitation guidelines. The purpose of this article is to review the basic science of articular cartilage and to provide an overview of the procedures currently performed at our institution for patients presenting with symptomatic cartilage lesions.
Bareka, Metaxia; Hantes, Michael; Arnaoutoglou, Eleni; Vretzakis, George
2018-02-01
The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance. The two groups were comparable in terms of age, sex, BMI and athletic activity. The time needed to perform the nerve blocks was significantly shorter for the FOS group (p block under dual guidance for arthroscopic ACL reconstructive surgery is a safe and tempting anaesthetic choice. The success rate of this technique is higher in comparison with PLPS and results in less peri- and post-operative pain with less opioid consumption. This study provides support for the use of peripheral nerve blocks as an exclusive method for ACL reconstructive surgery in an ambulatory setting with almost no complications. I.
Portland cement with additives in the repair of furcation perforations in dogs.
Silva Neto, José Dias da; Schnaider, Taylor Brandão; Gragnani, Alfredo; Paiva, Anderson Paulo de; Novo, Neil Ferreira; Ferreira, Lydia Masako
2012-11-01
To evaluate the use of Portland cements with additives as furcation perforation repair materials and assess their biocompatibility. The four maxillary and mandibular premolars of ten male mongrel dogs (1-1.5 years old, weighing 10-15 kg) received endodontic treatment (n=80 teeth). The furcations were perforated with a round diamond bur (1016 HL). The perforations involved the dentin, cementum, periodontal ligament, and alveolar bone. A calcium sulfate barrier was placed into the perforated bone to prevent extrusion of obturation material into the periradicular space. The obturation materials MTA (control), white, Type II, and Type V Portland cements were randomly allocated to the teeth. Treated teeth were restored with composite resin. After 120 days, the animals were sacrificed and samples containing the teeth were collected and prepared for histological analysis. There were no significant differences in the amount of newly formed bone between teeth treated with the different obturation materials (p=0.879). Biomineralization occurred for all obturation materials tested, suggesting that these materials have similar biocompatibility.
Isolated pediatric hemihyperplasia requiring surgical debulking of the thigh
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Benjamin D. Schultz
2015-02-01
Full Text Available Isolated Hemihyperplasia (IHH is a rare disorder that results in the enlargement of a portion of a limb, a complete limb or an entire half of an individual's body. We describe an 11 year-old girl with isolated hemihyperplasia of her right upper and lower extremities, breast, and vulvar region. A mass consisting of asymmetric enlargement and fatty infiltration of the right adductor compartment was first noticed at approximately 4 years of life and progressed dramatically to severely affect her gait. We surgically debulked the thigh and resected the excess skin to restore symmetry. The patient did well postoperatively, achieved excellent cosmesis, and restoration of gait.
DEFF Research Database (Denmark)
Westergaard, B; Jensen, K; Lenz, K
2014-01-01
The purpose of this study was to investigate the effects of blockade of the saphenous nerve and the posterior branch of the obturator nerve in addition to a standard analgesic regimen for patients discharged the same day after knee arthroscopy. The primary outcome was knee pain on flexion during...
Management of periodontal destruction caused by overhanging dental restoration
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Misnova Misnova
2016-06-01
Full Text Available Periodontal tissue inflammations are occasionally caused by positions of restoration margins, particularly if they are placed subgingivally. A 44-year old male was referred to the Dental and Mouth Hospital of Dentistry Faculty Hasanuddin University with the chief complaint of severe pain at right posterior maxillary. Clinical examinations demonstrate a 7-mm periodontal pocket at buccal aspect of 16 teeth with tooth mobility °2. Overhanging dental composite restorations of Class V were detected at the subgingival areas of 15, 16, and 17. Radiographic results show vertically and horizontally alveolar bone loss. This case report is aimed to describe the management of periodontal tissue destruction as a result of overhanging dental composite restorations. Scaling and root planing were conducted as the initial therapy. The periodontal surgery was performed a week after the initial therapy. A full-thickness flap design with sulcular incision from 14 to 18 was made before the pocket curretage and necrotic tissue debridement along with restoration recontouring. The flap was sutured with simple suture technique. Periodontal dressing was packed for a week. Antibiotics, analgetics and antiinflammatory drugs were prescribed per orally. There was no history of pain a week after the surgical procedure. Tooth mobility was decreased to °1 and the periodontal pocket was reduced to 3 mm. Overhanging dental restorations may lead to periodontal tissue destruction. The subgingivally placement of those restorations should consider the health of periodontal tissues.
Zafiropoulos, Gregory-George; Hoffman, Oliver
2011-01-01
Dental implants as abutments for full-arch restorations are a well-documented treatment modality. This report presents a case in which the patient was treated initially with fixed restorations supported by either implants or natural teeth and subsequently treated with a removable implant/telescopic crown-supported overdenture. Advantages and disadvantages of each approach are described and discussed. While the fixed restoration resulted in a functionally satisfactory treatment outcome, the patient was displeased with the esthetic appearance. The main concern was the unnaturally long tooth shape necessary to compensate for the insufficient alveolar ridge height. Replacement of the existing restoration with an implant-supported removable overdenture led to a functionally and esthetically acceptable result. When deciding whether to use a fixed or removable implant-supported full-arch restoration, a multitude of factors must be considered. Due to the possible need for additional surgical steps to enhance the esthetic appearance surrounding fixed restorations, removable implant-supported partial dentures often are the better choice.
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.
OUTCOMES OF SURGICAL TREATMENT OF HIATAL HERNIA
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Zhurbenko G. A.
2018-05-01
Full Text Available Background: In traditionally performed fundoplications during the treatment of sliding diaphragmatic hernias, the improvement of surgical techniques to restore acute angle of His remains topical. Aim: To develop a method of surgical treatment of hiatus hernias to restore acute angle of His. Material and methods: Patients (n = 74 were divided into two groups: the main group (I (n = 45, in which the developed operation method was applied and the control group (II (n = 29, in which Toupet method was applied to 26 patients, Nissen method – to 3 patients. GERD-Q and GERD-HRQL questionnaires were applied to all patients of the first group before the operation, during discharge from hospital and 6-12 12-18 18-24 months after surgical intervention. Patients of the second group were surveyed 6-12 months after the operation. Results: According to the results of the survey after 6-12 months statistically significant differences were not revealed in the groups: GERD-Q, p<0,386; GERD-HRQL, p<0,1089. In the main group there was a tendency to decrease the points in the GERD-Q survey when compared before and after surgery, p <0.0001. Out of 16 (55% patients of the second group hospitalized after the operation the relapse was revealed in 9 patients, 7 of them were re-operated. 20(43,3% patients of group I underwent inpatient examination, 2 relapsed and no one was re-operated. Conclusion: The efficiency of the suggested operation technique is comparable to Toupet method in the early stages, although when assessing the remote results there are a less number of relapses.
A Simple and Automatic Method for Locating Surgical Guide Hole
Li, Xun; Chen, Ming; Tang, Kai
2017-12-01
Restoration-driven surgical guides are widely used in implant surgery. This study aims to provide a simple and valid method of automatically locating surgical guide hole, which can reduce operator's experiences and improve the design efficiency and quality of surgical guide. Few literatures can be found on this topic and the paper proposed a novel and simple method to solve this problem. In this paper, a local coordinate system for each objective tooth is geometrically constructed in CAD system. This coordinate system well represents dental anatomical features and the center axis of the objective tooth (coincide with the corresponding guide hole axis) can be quickly evaluated in this coordinate system, finishing the location of the guide hole. The proposed method has been verified by comparing two types of benchmarks: manual operation by one skilled doctor with over 15-year experiences (used in most hospitals) and automatic way using one popular commercial package Simplant (used in few hospitals).Both the benchmarks and the proposed method are analyzed in their stress distribution when chewing and biting. The stress distribution is visually shown and plotted as a graph. The results show that the proposed method has much better stress distribution than the manual operation and slightly better than Simplant, which will significantly reduce the risk of cervical margin collapse and extend the wear life of the restoration.
Organization and development of surgical rehabilitation of patients with traumas and their effects
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Barabash А.P.
2012-06-01
Full Text Available Objective: To improve the efficiency of surgical rehabilitation of patients with traumas, their effects. Materials and methods: Short-term and follow-up results of the surgical treatment of patients with traumas and their effects have been analyzed. Statistical research methods have been used. Results: the efficiency of medical technologies during the early rehabilitation of patients has been demonstrated. Conclusion: Adoption of the most efficient medical technologies of general surgical treatment and postoperative rehabilitation of patients with traumas and their effects in daily practice provides high-grade restoration of the extremity's function, shortening of treatment period, decrease in number of complications and invalidism
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.
Implant rehabilitation of partial maxillectomy edentulous patient
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
Success rate of overfilled root canal treatment
International Nuclear Information System (INIS)
Yousuf, W.; Sheikh, A.
2015-01-01
Traditionally, poor obturation has been considered the primary cause of root canal treatment failures The purpose of this study was to assess the success rate of overfilled root canal treatment cases in order to decide whether a definitive restoration can be placed immediately following treatment in an overfilled case or whether the patient needs to be kept on a follow up prior to the placement of a definitive restoration. Methods: A total of 1242 patients periapical radiographs (1748 teeth) were assessed, out of which 397 teeth (in 285 patients) were found to be overfilled. Out of these 285 patients, 111 (128 cases) agreed to participate in this cross sectional study and were recalled for clinical and radiographic examination. Success was evaluated clinically by absence of symptoms (pain, swelling, tenderness to percussion and sinus tract) and radiograhically by the decrease in size of periapical lesion or no change in size. Increase in size of periapical lesion was deemed to be a failure. Results: Our findings revealed that despite overfill, the treatment was successful in 115 cases and failure was noted in 13 cases showing an overall success rate of 89.8% and failure rate of 10.2%. Out of 13 cases of failure, all 13 showed an increase in periapical lesion size, out of which 10 were accompanied with pain. Conclusion: Based on the results obtained in our study, we have determined that there is no need to delay placement of a permanent restoration on overfilled teeth (ruling out the presence of other procedural errors) nor is there any need to pursue any further surgical or non-surgical endodontic treatment. However we would suggest that patients should be kept on follow-up after placement of permanent restoration. (author)
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Yu-xiang MA
2015-07-01
Full Text Available Objective The article analyzed the curative effect of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa to explore reasonable operation method. Methods Clinical data of 61 patients with non-solid hemangioblastoma who underwent surgeries in Tianjin Huanhu Hospital during July 2007 and June 2014 were retrospectively analyzed. According to surgical approaches and the situation of foramen magnum and atlas, these patients were divided into 5 groups: midline approach opening foramen magnum and atlas (Group A, midline approach without opening foramen magnum and atlas (Group B, paramedian approach opening foramen magnum and atlas (Group C, paramedian approach without opening foramen magnum and atlas (Group D, retrosigmoid approach (Group E. By collecting clinical symptoms, imaging findings, surgical records and postoperative complications, the surgical results and occurrence of postoperative complications were summarized and reasonable operation method was discussed. Results Among 61 patients, total resection was achieved in 56 cases (91.80%, and partial resection was achieved in 5 cases (8.20% . The postoperative remission rate of 43 cases with hydrocephalus was 79.07% (34/43. Intracranial infection was the most common postoperative complication, accounting for 22.95% (14/61. There was significant difference in occurrence rate of intracranial infection among 4 subgroups: opening or not opening the foramen magnum and atlas with or without restoring bone flap (Z = 16.269, P = 0.001. In the subgroup of not opening foramen magnum and atlas with restoring bone flap, the infection rate, which accounted for 6.90% (2/29, was the lowest. Conclusions The surgical treatment options for non-solid hemangioblastoma in posterior fossa should be done according to patients' condition, and performed by a professional group. If conditions allow, not to open the foramen magnum and atlas, as well as intraoperative
Son, Mee-Kyoung; Jang, Hyun-Seon
2011-12-01
The emergence profile concept of an implant restoration is one of the most important factors for the esthetics and health of peri-implant soft tissue. This paper reports on two cases of gingival recontouring by the fabrication of a provisional implant restoration to produce an optimal emergence profile of a definitive implant restoration. After the second surgery, a preliminary impression was taken to make a soft tissue working cast. A provisional crown was fabricated on the model. The soft tissue around the implant fixture on the model was trimmed with a laboratory scalpel to produce the scalloped gingival form. Light curing composite resin was added to fill the space between the provisional crown base and trimmed gingiva. After 4 to 6 weeks, the final impression was taken to make a definitive implant restoration, where the soft tissue and tooth form were in harmony with the adjacent tooth. At the first insertion of the provisional restoration, gum bleaching revealed gingival pressure. Four to six weeks after placing the provisional restoration, the gum reformed with harmony between the peri-implant gingiva and adjacent dentition. Gingival recontouring with a provisional implant restoration is a non-surgical and non-procedure-sensitive method. The implant restoration with the optimal emergence profile is expected to provide superior esthetic and functional results.
Surgical treatment of gross posttraumatic deformations in thoracic spine
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Aleksei E. Shul’ga
2017-10-01
Full Text Available Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients’ ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra.
The Kock pouch reconsidered: an alternative surgical technique.
Crawshaw, Alison; Williams, Julia; Woodhouse, Fran
The psychological impact stoma surgery can have on an individual is well documented within the literature (White and Hunt, 1997; Borwell, 2009; Williams, 2005; Brown, 2005). For many years, surgeons have explored and developed innovations in surgical techniques, in particular restorative procedures with a view of preventing permanent stoma formation; ileal anal pouch (IAP) now being the surgical procedure of choice for treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). However, high morbidity rates are associated with pouch longevity (Castillo et al 2005; Nessar and Wu, 2012) and once removed can lead to a high-output ileostomy with risks of electrolyte imbalance and malabsorption. This then creates the dilemma of whether the Kock pouch (KP) should be offered as a surgical option. This article offers a historical perspective of the KP and its place in the surgical management of UC and FAP. This article also presents results from a recent audit funded by the Ileostomy Association (IA), highlighting how patients manage their KP and the importance of maintaining bowel control and being free of an incontinent stoma as a means of coming to terms with their condition.
Surgical approach to end-stage heart failure.
Klotz, Stefan; Scheld, Hans H
2011-02-01
End-stage heart failure is a challenging disease with growing incidence. With decreasing heart transplant rates worldwide organ preserving therapies become, again, of interest. The purpose of the present review is to examine the potential challenges of surgical therapies in patients with end-stage heart failure. The gold-standard for end-stage heart failure is and will be cardiac transplantation. However, due to organ shortage this therapy is limited to a few patients. Therefore implantation of ventricular assist devices (VADs) or long-term minimal-invasive partial support devices will increase. Improvements in device design with smaller devices, easier implantation techniques, and modified anticoagulation outcome and long-term success will likely improve. In addition, good quality of life as destination therapy is almost available. Organ conservation surgery (coronary artery bypass grafting and surgical ventricular restoration or surgical repair of mitral valve regurgitation) in end-stage heart failure patients could not prove the expected results. Transcatheter or minimal-invasive approaches of these therapies might become routine in the near future. Due to the overwhelming outcome rates, cardiac transplantation is the most established surgical therapy for end-stage heart failure. VAD therapy is increasing and minimized VADs might further open the market for destination therapy/permanent support.
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Anne N. Flynn, MD
2015-12-01
Conclusions: This study shows high patient satisfaction and low complication risk associated with surgical correction of clitoral phimosis and lysis of vulvar adhesions for VGF caused by LS. Patients reported improvement in clitoral sensation and ability to achieve orgasm, as well as decreased dyspareunia. Surgical correction of vulvar scarring is a viable option to restore vulvar anatomy and sexual function in appropriate candidates with anogenital LS. Flynn AN, King M, Rieff M, Krapf J, and Goldstein AT. Patient satisfaction of surgical treatment of clitoral phimosis and labial adhesions caused by lichen sclerosus. Sex Med 2015;3:251–255.
Conservative Surgical Treatment of the Jaw Cysts in Children: Case ...
African Journals Online (AJOL)
2017-10-26
Oct 26, 2017 ... impacted teeth was managed by orthodontic treatment. One tooth in cystic lesion had to be extracted. ... Two cases needed orthodontic alignment after eruption of impacted teeth. While the mean cusp .... Several kinds of obturators and appliances are being used in decompression of the cysts. In all our ...
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Anuja Ikhar
2013-01-01
Full Text Available Invasive cervical resorption is entirely uncommon entities and the etiology is poorly understood. A 19 year old patient presented with fractured upper left central incisor and sinus tract opening on the distobuccal aspect in cervical region. Radiographic examination shows irregular radiolucency over the coronal one-third and it extended externally towards the external invasive resorption. After sectional obturation, the defect was accessed surgically. The resorption area was chemomechanically debrided using irrigant solution. Fibre post placement using flowable composite resin and Mineral Trioxide Aggregate (MTA was used to fill the resorptive defect, and the coronal access was temporarily sealed. Composite restoration was subsequently replaced with ceramic crown after 4 years. Radiographs at 1 and 4 years showed adequate repair of the resorption and endodontic success. Clinically and radiographically the tooth was asymptomatic, and no periodontal pocket was found after a 4-year followup.
Restoring proximal caries lesions conservatively with tunnel restorations.
Chu, Chun-Hung; Mei, May L; Cheung, Chloe; Nalliah, Romesh P
2013-07-30
The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED) and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations.
Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal.
Kranjčić, Josip; Džakula, Nikola; Vojvodić, Denis
2016-09-01
The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The two-step impression technique of denture bearing area was used and the resection of cavity was performed. A primary impression-the impression of denture bearing area was made using irreversible hydrocolloid material, while the second impression - the impression of resection cavity was made using condensation silicone material and obturator prosthesis framework. The obturator prosthesis replaced lost teeth, improved oral function and esthetics at minimal costs.
Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal
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Nikola Džakula
2016-01-01
Full Text Available The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The two-step impression technique of denture bearing area and the resection cavity was performed. A primary impression- the impression of denture bearing area was made using irreversible hydrocolloid material, while the second impression – the impression of resection cavity was made using condensation silicone material and obturator prosthesis framework. The obturator prosthesis replaced lost teeth, improved oral function and esthetics at minimal costs.
Nene, Salil; Gautam, Rajaganesh; Sharif, Kanaan; Gupta, Gaurav
2012-01-01
This report describes a combined orthodontic and surgical treatment approach for a severe skeletal Class III malocclusion in a young Indian woman with serious esthetic concerns. The case required significant surgical correction in the anteroposterior and vertical planes, involving surgeries in both the maxilla and the mandible. The case required the use of mini-implant anchorage in the presurgical phase as well as postorthodontic prosthodontic rehabilitation to replace missing posterior teeth to restore the occlusal table.
Barret, Juan P
2014-01-01
The innovation of composite vascularized allotransplantation has provided plastic and reconstructive surgeons with the ultimate tool for those patients that present with facial deformities that cannot be reconstructed with classical or more traditional techniques. Transplanting normal tissues allows for a true restorative surgery. Initial experiences included the substitution of missing anatomy, whereas after the first world's full-face transplant performed in Barcelona in March 2010, a true ablative surgery with a total restoration proved to be effective. We review the world's experience and the performance of our restorative protocol to depict this change in the reconstructive paradigm of facial transplantation. Facial transplants should be performed after a careful analysis of the defect, with a comprehensive ablation plan following esthetic units with sacrifice of all required tissues with a focus of global restoration of anatomy, aesthetics and function, respecting normal functioning muscles. Nowadays, facial transplants following strict esthetic units should restore disfigurement extending to small central areas, whereas major defects may require a total ablation and restoration with full-face transplants. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Pembuatan Obturator Mata pada Pasien dengan Kehilangan Mata Akibat Cacat Bawaan
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Clara Rosalina
2010-06-01
Full Text Available Kasus kehilangan mata pada pasien dapat menimbulkan masalah fungsi dan estetik. Salah satu cara yang dapat dilakukan untuk memperbaiki masalah estetik adalah dengan membuatkan protesa mata kepada pasien tersebut. Tujuan pembuatan obturator mata pada pasien yang kehilangan mata adalah untuk membantu pasien dalam memperbaiki estetik. Pasien wan ita usia 35 tahun datang ke klinik Prostodonsia RSGM FKG UGM dengan kondisi kehilangan mata sebelah kanan yang merupakan cacat bawaan. Pemeriksaan wajah menunjukkan muka asimetris. Pada mata kanan tampak adanya cheloid yang timbul setelah operasi pengangkatan bola mata. Perawatan dilakukan dengan pembuatan protesa mata non fabricated dengan tahap-tahap: pencetakan mata dengan sendok cetak mata perorangan dan pengisian hasil cetakan terdiri dari dua bagian, yang pertama diisi dengan gips keras sampai bagian terlebar dari cetakan dasar soket dan dibuat tiga retensi sebagai kunci, kedua sampai menutupi seluruh hasil cetakan. Pembuatan model malam sklera, mencoba pola malam sklera dan packing model malam sklera. Oef/asking dan polishing untuk membuat sklera akrilik, mencoba sklera akrilik dan penentuan lokasi diameter iris, melukis iris dan pupil, penyelesaian protesa mata, packing sklera dan iris, def/asking dan polishing untuk membuat protesa mata serta insersi protesa mata. Kontrol setelah 2 minggu menunjukkan hasil yang baik, tidak ada keluhan rasa sakit, tidak ada peradangan, volume dan frekuensi air mata menjadi berkurang jumlah dan frekuensinya.
Restoring proximal caries lesions conservatively with tunnel restorations
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Chu CH
2013-07-01
Full Text Available Chun-Hung Chu1, May L Mei,1 Chloe Cheung,1 Romesh P Nalliah2 1Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China; 2Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA Abstract: The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations. Keywords: operative, practice, tunnel preparation, composite, amalgam, glass ionomer
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Sameh Azazy
2008-12-01
Full Text Available Objective. It is to assess the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift and concomitant tension-free vaginal tape-obturator (TVT-O system as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI. Patients and Methods. Between December 2006 and July 2007, 20 patients with anterior genital prolapse and voiding dysfunction were treated with the transobturator tension-free vaginal mesh (Prolift and concomitant tension-free vaginal tape-obturator (TVT-O. Sixteen patients had stress urinary incontinence and 4 patients were considered at risk for development of de novo stress incontinence after the prolapse is repaired. All patients underwent a complete urodynamic assessment. All the patients underwent pelvic examination 4–6 weeks after the operation, and anatomical and functional outcomes were recorded. Results. Twenty cystocoeles were repaired: 6 grade II, 12 grade III, and 2 grade IV. There were no vessel or bladder injuries. Eighteen patients had optimal anatomic results and 2 patients had persistent asymptomatic stage I prolapse. Conclusion. These preliminary results suggest that Prolift system offers a safe and effective treatment for female anterior vaginal wall prolapse. However, a long-term followup is necessary in order to support the good result maintenance.
Surgical treatment of distal biceps tendon rupture: a case report
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Cristina N. Cozma
2017-11-01
Full Text Available Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons.
A Review of the Surgical Management of Perineal Hernias in Dogs.
Gill, Sukhjit Singh; Barstad, Robert D
2018-05-14
Perineal hernia refers to the failure of the muscular pelvic diaphragm to support the rectal wall, resulting in herniation of pelvic and, occasionally, abdominal viscera into the subcutaneous perineal region. The proposed causes of pelvic diaphragm weakness include tenesmus associated with chronic prostatic disease or constipation, myopathy, rectal abnormalities, and gonadal hormonal imbalances. The most common presentation of perineal hernia in dogs is a unilateral or bilateral nonpainful swelling of the perineum. Clinical signs do occur, but not always. Clinical signs may include constipation, obstipation, dyschezia, tenesmus, rectal prolapse, stranguria, or anuria. The definitive diagnosis of perineal hernia is based on clinical signs and findings of weak pelvic diaphragm musculature during a digital rectal examination. In dogs, perineal hernias are mostly treated by surgical intervention. Appositional herniorrhaphy is sometimes difficult to perform as the levator ani and coccygeus muscles are atrophied and unsuitable for use. Internal obturator muscle transposition is the most commonly used technique. Additional techniques include superficial gluteal and semitendinosus muscle transposition, in addition to the use of synthetic implants and biomaterials. Pexy techniques may be used to prevent rectal prolapse and bladder and prostate gland displacement. Postoperative care involves analgesics, antibiotics, a low-residue diet, and stool softeners.
Long, R.G.; Bürki, A.; Zysset, P.; Eglin, D.; Grijpma, Dirk W.; Blanquer, Sebastien; Hecht, A.C.; Iatridis, J.C.
2016-01-01
Unrepaired defects in the annulus fibrosus of intervertebral disks are associated with degeneration and persistent back pain. A clinical need exists for a disk repair strategy that can seal annular defects, be easily delivered during surgical procedures, and restore biomechanics with low risk of
Reinforcement of the pelvic diaphragm using a purse-string suture in dogs: description of technique
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P.C. Moraes
Full Text Available ABSTRACT Recurrence of perineal hernias is frequent, and is associated to poor identification of anatomical structures during surgery, inadequate suture placement, and failure of physical support of the pelvic diaphragm after surgical reconstruction. The objective of this work is to describe a novel surgical technique for reinforcement of the pelvic diaphragm after performing the internal obturator transposition technique in dogs with perineal hernia.
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Mehran Bahrami
2017-01-01
Full Text Available Introduction: Ewings sarcoma (ES is an unusual, aggressive malignant neoplasm occurring primarily in the long bones of the lower and upper extremities followed by pelvis, ribs, vertebrae, skull, and jaws-bones. Patients with ES tumor need long-term complete oral reconstruction. The location of the primary tumor in the face is predominantly in the mandible, and usually in the posterior mandible. Case Report: Here, both surgical procedures and prosthetic reconstruction in three stages of a 10-year-old childs life presented. Definitive prosthetic reconstruction is extremely challenging in such patients after previous excessive surgical resection, especially when the patient has complex dental abnormality. Fixed dental prostheses and implant-supported fixed restorations have been selected as the preferred treatment option in this case after increasing occlusal vertical dimension (OVD to create sufficient interocclusal space (IOS. Discussion: In this case, ES patient treated in three phases. In the first-stage, only surgical resection of tumor and bone graft reconstruction with titanium plate fixation was performed. In the second-stage, Lefort I surgery for maxilla with dental implants insertion in mandible was done simultaneously. For definitive restorations fabrication, it was mandatory to increase occlusal vertical dimension (OVD to create sufficient inter-occlusal space (IOS for the restorations. OVD has been altered to achieve more stable relationship of mandibular teeth with maxillary teeth, and to obtain an optimum esthetic and functional result. Several factors should be considered as determinants for increasing the OVD such as remaining tooth structure, the space available for the restorations such as the current situation, occlusal variables, and esthetics.
Schneider, Robert
2008-01-01
The prosthetic restoration of a missing anterior tooth with a dental implant is a challenge. Treatment coordination with a multidisciplinary team is critical in the successful outcome of this type of patient treatment. Newer surgical treatment modalities in the management of hard and soft tissues are becoming common, with very good predictability and long-term stability. Additionally, the use of advanced dental technology and materials such as sintered zirconium allows the restorative practitioner the opportunity to fabricate an esthetic, precise-fitting, biocompatible, and strong definitive prosthesis for the patient, with good longevity. The use of an all-ceramic abutment and restoration is described, along with the "soft tissue sculpting" procedure through the use of a custom provisional restoration. The relative ease and convenience of the procedure is also illustrated.
Surgical correction of the webbed neck: an alternative lateral approach
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Mehri Turki, Imen
2017-03-01
Full Text Available Objective: The webbed neck deformity or pterygium colli is the number one symptom of the Turner syndrome that leads the patient to consult a doctor. Various but rare surgical approaches have been described to correct this deformity. We reviewed our experience with the surgical correction of the pterygium colli.Methods: Through five clinical cases, we describe the surgical technique with a lateral approach which provides a better control of the operative site, allows for the excision of the underlying trapezial fascial web, thus preventing recurrence seen in the posterior approach, and restores a normal hairline. Results: No postoperative wound infection occurred. No recurrence was observed through 24 months. Three patients developed hypertrophic scars.Conclusion: The lateral approach associated with an advanced flap and a Z-plasty is an effective technique for correction of this neck deformity. The presence of a multidisciplinary team, formed with maxillofacial and plastic surgeons, endocrinologists and psychologists, is required to treat these patients allowing reintegration into society and family.
Linking restoration ecology with coastal dune restoration
Lithgow, D.; Martínez, M. L.; Gallego-Fernández, J. B.; Hesp, P. A.; Flores, P.; Gachuz, S.; Rodríguez-Revelo, N.; Jiménez-Orocio, O.; Mendoza-González, G.; Álvarez-Molina, L. L.
2013-10-01
Restoration and preservation of coastal dunes is urgently needed because of the increasingly rapid loss and degradation of these ecosystems because of many human activities. These activities alter natural processes and coastal dynamics, eliminate topographic variability, fragment, degrade or eliminate habitats, reduce diversity and threaten endemic species. The actions of coastal dune restoration that are already taking place span contrasting activities that range from revegetating and stabilizing the mobile substrate, to removing plant cover and increasing substrate mobility. Our goal was to review how the relative progress of the actions of coastal dune restoration has been assessed, according to the ecosystem attributes outlined by the Society of Ecological Restoration: namely, integrity, health and sustainability and that are derived from the ecological theory of succession. We reviewed the peer reviewed literature published since 1988 that is listed in the ISI Web of Science journals as well as additional references, such as key books. We exclusively focused on large coastal dune systems (such as transgressive and parabolic dunefields) located on natural or seminatural coasts. We found 150 articles that included "coastal dune", "restoration" and "revegetation" in areas such as title, keywords and abstract. From these, 67 dealt specifically with coastal dune restoration. Most of the studies were performed in the USA, The Netherlands and South Africa, during the last two decades. Restoration success has been assessed directly and indirectly by measuring one or a few ecosystem variables. Some ecosystem attributes have been monitored more frequently (ecosystem integrity) than others (ecosystem health and sustainability). Finally, it is important to consider that ecological succession is a desirable approach in restoration actions. Natural dynamics and disturbances should be considered as part of the restored system, to improve ecosystem integrity, health and
Biniraj, K. R.; Sagir, Mohammed; Sunil, M. M.; Janardhanan, Mahija
2012-01-01
A case describing perio-restorative management of an accidental trauma in the mid portion of root on an upper left canine tooth following an ostectomy surgery is presented here. The traumatized root area was undergoing fast resorption and a chronic periodontal abscess had developed in relation to the lesion. The article illustrates the clinical and radiographic photo series of a periodontal flap surgery done to gain access into a subgingival region for the placement of Glass ionomer restoration on the root and its periodic follow up. The clinical condition of the area suggests 8 mm clinical attachment gain over the restoration and the review radiographs at definite intervals up to 18 months revealed evidence of consistent bone regeneration around the restoration. The article also highlights the various other possibilities, where this restorative material can be effectively used in conjunction with periodontal surgical procedures. PMID:23162344
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Rishi Nayyar
2010-01-01
Full Text Available Leiomyosarcoma of inferior vena cava (IVC involving bilateral renal veins presents a surgical challenge. Herein, we report the successful management of two such cases using restoration of left renal venous outflow by saphenous vein interposition graft as first step of surgery. Then radical resection of tumor and right kidney was done. IVC was lastly reconstructed using Gore-Tex graft. This report highlights the surgical challenges to ensure radical resection. Furthermore, the importance of restoring left renal outflow in presence of concomitant right nephrectomy is discussed. Both the patients were disease free at six months with no loss of left renal glomerular filtration rate.
Vamsi Krishna, C H; Babu, Jaya Krishna; Fathima, Tanveer; Reddy, G V K
2014-01-01
The prosthodontic rehabilitation of maxillary defects is a challenging and demanding task which requires careful pre-surgical and post-surgical planning. Maxillary defects can be congenital or acquired. Acquired defects include those following trauma or surgical treatment of benign or malignant neoplasms. A prosthodontist encounters problems such as absence of support, poor retention, and lack of prosthesis stability in treating these patients. The present case report describes a procedure to fabricate a definitive hollow bulb obturator prosthesis for the rehabilitation of a total maxillectomy defect. PMID:24671313
Relationship between crown placement and the survival of endodontically treated teeth.
Aquilino, Steven A; Caplan, Daniel J
2002-03-01
Crowns have been considered the restoration of choice for endodontically treated teeth, but their selection has been based primarily on anecdotal evidence. This study tested the hypothesis that crown placement (coronal coverage) is associated with improved survival of endodontically treated teeth when preaccess, endodontic, and restorative factors are controlled. A University of Iowa College of Dentistry treatment database was used to identify permanent teeth that had undergone initial obturation between July 1, 1985, and December 31, 1987. Study patients were restricted to persons with at least 1 dental visit in each 2-year interval from 1985 to 1996; a simple random sample of 280 patients (n = 400 teeth) was selected. Dental charts, radiographs, and computerized databases were examined to ascertain variables of interest and to verify study inclusion criteria. Kaplan-Meier survival estimates were generated for the 203 teeth that satisfied study inclusion criteria. Multivariate Cox proportional hazards regression models were developed, with standard errors adjusted to account for clustering of teeth within patients. When tooth type and radiographic evidence of caries at access were controlled, the final Cox model showed that endodontically treated teeth not crowned after obturation were lost at a 6.0 times greater rate than teeth crowned after obturation (95% confidence interval: 3.2 to 11.3). Within the limitations of this study, a strong association between crown placement and the survival of endodontically treated teeth was observed. These results may impact treatment planning if long-term tooth retention is the primary goal.
Fabrication of temporary speech bulb prosthesis: A clinical report
Kasim Mohamed, K.; Anand Kumar, V.; Devi, N.; Padmanaban, T. V.
2010-01-01
Maxillofacial prosthesis is an art and science which not only replaces the lost structure sometimes it restores the functions also. Pharyngeal obturator is a prosthesis which closes the palatal and pharyngeal defects and improving the speech and other function. The following case report discusses palatopharyngeal insufficiency, impression procedures, fabrication of prosthesis and improvements in speech.
Timanoplastia myringoplasty type 1 and in residency surgical results and audiometric
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Buschle, Mauricio
2010-12-01
Full Text Available Introduction: The tympanoplasty aims to reconstruct the tympanic membrane, restoring protection to the middle ear and improve hearing. In this study we evaluated the surgical results and audiometric this surgery, performed in the service of Otorhinolaryngology, HC / UFPR by residents of the second year in the year 2008 and factors that may influence the results. Method: A retrospective study through review of medical records. Results: Among the 31 patients evaluated, there was closure of the perforation in 24 (80% and hearing improvement with reduction or closure of the conductive gap by 60% and 26.7% respectively. Discussion: The success rate of surgery was satisfactory and similar to that found in the literature, and factors such as age, presence of unilateral or bilateral pathology and size of perforation were not determinants of surgical success. Conclusion: Tympanoplasty performed by residents of the second year of residence showed satisfactory results regarding both surgical audiometric.
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Vaishnavi Dasari
2016-01-01
Full Text Available Aim: To alleviate the patient's symptoms and promote periapical healing in teeth with failure of root canal treatment, without the removal of previous obturating material using lesion sterilization and tissue repair (LSTR 3 MIX-MP noninstrumentation endodontic treatment (NIET. Materials and Methods: Fifteen single-rooted teeth with a history of root canal treatment 1–2 years previously, requiring retreatment, with pain, sinus tract, swelling and periapical lesions, and having acceptable obturation were included in the study. The previous coronal restoration was removed, and a medication cavity was prepared for placement of 3MIX MP; this was followed by lining with Glass ionomer cement and a coronal restoration with composite resin. Results: At 8 weeks, all patients did not have either pain, tenderness on vertical percussion, pain on biting, or swelling (asymptomatic. Radiographically, the periapical lesions had reduced by 1 mm in five cases. In six patients, the lesion size remained unchanged. Conclusion: LSTR NIET is an excellent, inexpensive, less traumatic, and least time-consuming alternative to treat symptomatic teeth requiring endodontic retreatment.
Changes in surgical procedures for acromioclavicular joint dislocation over the past 30 years.
Takase, Katsumi; Yamamoto, Kengo
2013-10-01
Generally, surgical treatment is recommended for Rockwood type 5 traumatic acromioclavicular joint dislocations. Since 1980, the authors have performed the modified Dewar procedure, the modified Cadenat procedure, and anatomical reconstruction of the coracoclavicular ligaments for this injury. The goal of this study was to determine the ideal surgical procedure for acromioclavicular joint dislocations by comparing these 3 procedures. The modified Dewar procedure was performed on 55 patients (Dewar group), the modified Cadenat procedure was performed on 73 patients (Cadenat group), and anatomical reconstruction of the coracoclavicular ligaments was performed on 11 patients (reconstruction group). According to the UCLA scoring system, therapeutic results averaged 27.3 points in the Dewar group, 28.2 in the Cadenat group, and 28.4 in the reconstruction group. The incidence of residual subluxation or dislocation in the acromioclavicular joint was evaluated at final radiographic follow-up. Subluxation occurred in 21 patients in the Dewar group, 18 in the Cadenat group, and 3 in the reconstruction group. Dislocation occurred in 3 patients in the Dewar group. Osteoarthritic changes in the acromioclavicular joint occurred in 20 patients in the Dewar group, 9 in the Cadenat group, and 1 in the reconstruction group. The modified Cadenat procedure can provide satisfactory therapeutic results and avoid postoperative failure or loss of reduction compared with the modified Dewar procedure. However, the modified Cadenat procedure does not anatomically restore the coracoclavicular ligaments. Anatomic restoration of both coracoclavicular ligaments can best restore acromioclavicular joint function. Copyright 2013, SLACK Incorporated.
Jayme, Sérgio J; Muglia, Valdir A; de Oliveira, Rafael R; Novaes, Arthur B Júnior
2008-01-01
Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance throughout the treatment period. Placement of dental implants requires precise planning that accounts for anatomic limitations and restorative goals. Diagnosis can be made with the assistance of computerized tomographic scanning, but transfer of planning to the surgical field is limited. Recently, novel CAD/CAM techniques such as stereolithographic rapid prototyping have been developed to build surgical guides in an attempt to improve precision of implant placement. The aim of this case report was to show a modified surgical template used throughout implant placement as an alternative to a conventional surgical guide.
Prosthetic management of mid-facial defect with magnet-retained silicone prosthesis.
Buzayan, Muaiyed M
2014-02-01
Mid-facial defect is one of the most disfiguring and impairing defects. A design of prosthesis that is aesthetic and stable can be precious to a patient who has lost part of his face due to surgical excision. Prosthesis can restore the patients' self-esteem and confidence, which affects the patients and their life style. The aim of this case report is to describe a technique of mid-facial silicone prosthesis fabrication. To provide an aesthetic and stable facial prosthesis, the extra-oral prosthesis was fabricated using silicone material, while the intra-oral defect was restored with obturator prosthesis, and then both prostheses were connected and attached to each other using magnets. This clinical report describes the rehabilitation of a large mid-facial defect with a two-piece prosthesis. The silicone facial prosthesis was made hollow and lighter by using an acrylic framework. Two acrylic channels were included within the facial prosthesis to provide the patient with clean and patent airways. A sectional mid-facial prosthesis was made and retained in place by using magnets, which resulted in a significant improvement in the aesthetical and functional outcome without the need for plastic surgery. Silicone prostheses are reliable alternatives to surgery and should be considered in selected cases.
Rhee, Chanseok; Visintini, Sarah; Dunning, Cynthia E; Oxner, William M; Glennie, R Andrew
2017-10-01
It is controversial whether the surgical restoration of sagittal balance and spinopelvic angulation in a single level lumbar degenerative spondylolisthesis results in clinical improvements. The purpose of this study to systematically review the available literature to determine whether the surgical correction of malalignment in lumbar degenerative spondylolisthesis correlates with improvements in patient-reported clinical outcomes. Literature searches were performed via Ovid Medline, Embase, CENTRAL and Web of Science using search terms "lumbar," "degenerative/spondylolisthesis" and "surgery/surgical/surgeries/fusion". This resulted in 844 articles and after reviewing the abstracts and full-texts, 13 articles were included for summary and final analysis. There were two Level II articles, four Level III articles and five Level IV articles. Most commonly used patient-reported outcome measures (PROMs) were Oswestery disability index (ODI) and visual analogue scale (VAS). Four articles were included for the final statistical analysis. There was no statistically significant difference between the patient groups who achieved successful surgical correction of malalignment and those who did not for either ODI (mean difference -0.94, CI -8.89-7.00) or VAS (mean difference 1.57, CI -3.16-6.30). Two studies assessed the efficacy of manual reduction of lumbar degenerative spondylolisthesis and their clinical outcomes after the operation, and there was no statistically significant improvement. Overall, the restoration of focal lumbar lordosis and restoration of sagittal balance for single-level lumbar degenerative spondylolisthesis does not seem to yield clinical improvements but well-powered studies on this specific topic is lacking in the current literature. Future well-powered studies are needed for a more definitive conclusion. Copyright © 2017 Elsevier Ltd. All rights reserved.
Clinical decisions for anterior restorations: the concept of restorative volume.
Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang
2012-12-01
The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.
Foreign Body in the Oral Cavity Mimicking a Benign Connective Tissue Tumor
Puliyel, Divya; Balouch, Amir; Ram, Saravanan; Sedghizadeh, Parish P.
2013-01-01
Foreign bodies may be embedded in the oral cavity either by traumatic injury or iatrogenically. The commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and impression materials. This paper describes an asymptomatic presentation of a foreign body in the oral mucosa which clinically appeared like a benign connective tissue tumor.
Avinash, Alok; Dubey, Alok; Singh, Rajeev Kumar; Prasad, Swati
2014-01-01
Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. The Efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case of trauma in permanent right central maxillary incisors with tooth fragments embedded in the lower lip. Thorough clinical examination followed by soft tissue radiographs confirmed the presence of a fractured incisal fragment, which was surgically retrieved under local anesthesia. Direct composite restoration was placed. After finishing and polishing, an esthetic and natural-looking restoration was achieved; this completely satisfied the functional and esthetic expectation of the patient and dental team. How to cite this article: Avinash A, Dubey A, Singh RK, Prasad S. Surgical Removal of Coronal Fragment of Tooth Embedded in Lower Lip and Esthetic Management of Fractured Crown Segment. Int J Clin Pediatr Dent 2014;7(1):65-68.
Roumeguère, Thierry; Quackels, Th; Bollens, R; de Groote, A; Zlotta, A; Bossche, M Vanden; Schulman, C
2005-11-01
The aim of this study was to evaluate the effectiveness of a new minimally invasive surgical procedure, the Trans-obturator Vaginal Tape (TOT) in the treatment of female urodynamic stress incontinence (USI) and to analyse functional results and quality of life after one year of follow up. 120 consecutive women with stress urinary incontinence underwent the procedure since February 2002 under general or loco-regional anesthesia. Minimum follow up was one year (range 12-30 months). Mean age was 58 years (range 31-86). 70% of the patients had pure USI. 5 patients were previously operated for USI. In 10 cases, concomitant repair of pelvic floor defects was mandatory. Collection of the data included operative time, pre- and post-operative complications. Patients were post-operatively assessed at one week, one month and one year. A validated urinary incontinence-specific measure of Quality of Life (QoL) questionnaire (Contilife) was sent and completed 12 months after surgery. The mean operative time was 12 min (range 6-30) with a catheterisation time of 0,9 day (range 0-2). No severe bleeding was observed. There were 13 minor lateral tears of the vagina without any sequelae. Three perforations of the urethra and one of the bladder occurred during the learning phase. In two cases a re-intervention was necessary for tape removal when the injury was not recognised during the procedure. Two transient urinary retention needed a supra pubic catheter and tape release. Eleven women presented transient voiding outflow obstruction. After one month, 93% patients were cured with no pad and a negative cough test with a full bladder. Uroflowmetry did not show any significant changes between pre- and post-operative time in all the population. De novo urgency occurred only in 2.5% and persistent dysuria (Qmax 120 cc) in 4%. 80% of patients were completely dry after one year and 12% were greatly improved. According to the pre-operative maximal urethral closure pressure, continence rate
Kumar, M Siva; Kumar, M Hari; Vishalakshi, K; Sabitha, H
2016-04-01
Periapical cysts are the most common inflammatory odontogenic cysts arising from untreated dental caries with pulp necrosis and periapical infection. The choice of treatment is often influenced by various factors like size, extension of the lesion, proximity to vital structures, systemic condition and compliance of the patient too. The treatment protocol for management of periapical cysts is still under discussion and options vary from conservative treatment by means of endodontic technique to surgical treatment like decompression or a marsupialisation or even to enucleation. Large bony defect secondary to periapical surgery compromising the tooth integrity often requires bone graft to enhance bone formation and thus restoring function at the earliest. The present case series included 10 patients who had established periapical pathology secondary to history of trauma on upper anterior teeth as well patients with history of carious teeth with an apparent failure in root canal therapy. All ten patients were treated with cyst enucleation and apiceotomy along with 1.4cc Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge implantation at surgical defect. Radiographs and clinical examinations were done upto 3 months to evaluate healing. Radiographic and clinical assessments revealed bone regeneration and restoration of the maxillary surgical defects in all 10 patients. No evidence of graft failure was noted. The Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge carrier is thus proved to be a viable option for the treatment of maxillary periapical surgical defects.
15 CFR 990.53 - Restoration selection-developing restoration alternatives.
2010-01-01
... OIL POLLUTION ACT REGULATIONS NATURAL RESOURCE DAMAGE ASSESSMENTS Restoration Planning Phase § 990.53... justify restoration, trustees may proceed with the Restoration Planning Phase. Otherwise, trustees may not... discount all service quantities and/or values to the date the demand is presented to the responsible...
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I. G. Belenky
2017-01-01
Full Text Available The paper presents a clinical case of a staged surgical treatment according to damage control protocol for a patient with multiple limb fractures, sternum trauma as well as brain injury due to traffic accident. Following temporary external fixation during emergency treatment, 6 internal fixation procedures were performed on the patient during three surgical sessions. 4,5 months postoperatively the authors observed consolidation of all fractures with good restoration of joints function. Prophylaxis of venous thromboembolic events included low molecular heparins administration prior to the first and consequent surgical sessions as well as oral anticoagulants during intervals between procedures and for extended prophylaxis. Apart from medicinal prophylaxis the authors utilized therapeutic exercises at all treatment stages.
Fernald restoration: ecologists and engineers integrate restoration and cleanup
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Woods, Eric; Homer, John
2002-07-15
As cleanup workers excavate pits and tear down buildings at the Fernald site in southwest Ohio, site ecologists are working side-by-side to create thriving wetlands and develop the early stages of forest, prairie, and savanna ecosystems to restore natural resources that were impacted by years of site operations. In 1998, the U.S. Department of Energy-Fernald Office (DOE-FN) and its cleanup contractor, Fluor Fernald, Inc., initiated several ecological restoration projects in perimeter areas of the site (e.g., areas not used for or impacted by uranium processing or waste management). The projects are part of Fernald's final land use plan to restore natural resources over 904 acres of the 1,050-acre site. Pete Yerace, the DOE-FN Natural Resource Trustee representative is working with the Fernald Natural Resource Trustees in an oversight role to resolve the state of Ohio's 1986 claim against DOE for injuries to natural resources. Fluor Fernald, Inc., and DOE-FN developed the ''Natural Resource Restoration Plan'', which outlines 15 major restoration projects for the site and will restore injured natural resources at the site. In general, Fernald's plan includes grading to maximize the formation of wetlands or expanded floodplain, amending soil where topsoil has been removed during excavation, and establishing native vegetation throughout the site. Today, with cleanup over 35 percent complete and site closure targeted for 2006, Fernald is entering a new phase of restoration that involves heavily remediated areas. By working closely with engineers and cleanup crews, site ecologists can take advantage of remediation fieldwork (e.g., convert an excavated depression into a wetland) and avoid unnecessary costs and duplication. This collaboration has also created opportunities for relatively simple and inexpensive restoration of areas that were discovered during ongoing remediation. To ensure the survival of the plant material in heavily
Milardovic Ortolan, Sladana; Strujic, Mihovil; Aurer, Andrej; Viskic, Josko; Bergman, Lana; Mehulic, Ketij
2012-01-01
This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth. How to cite this article: Ortolan SM, Strujic M, Aurer A, Viskic J, Bergman L, Mehulic K. Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities. Int J Clin Pediatr Dent 2012;5(1):64-67.
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Tsz Leung Wong
2018-01-01
Full Text Available This case report illustrates a novel conservative restorative management of a patient with bulimia nervosa who presented with severe localized upper palatal tooth wear and an anterior reverse overjet. This was achieved by using a localized bite raising or supraoccluding appliance, cemented on the lingual side of the lower anterior teeth to create interocclusal space, obviating the need for tooth reduction of the eroded upper palatal and incisal tooth surfaces. Surgical crown lengthening was performed to create a better aesthetic gingival architecture. All-ceramic restorations were provided on the upper anterior teeth to restore the tooth surface loss and provide a positive overbite and overjet. There was no complication or other observable biological change detected at the 5-year follow-up. The use of an appliance applying the supraoccluding technique, or Dahl concept, is a safe, conservative, and useful treatment option in the management of localized tooth wear.
Reshad, Mamaly; Cascione, Domenico; Kim, Tae
2010-02-01
A technique is proposed for the restoration of a large and visible maxillary anterior defect. The importance of proper diagnosis, treatment planning, and communication is emphasized. Irreversible treatment should only be rendered once patient approval has been obtained through objective evaluation with provisional restorations. The techniques presented in this article use a combination of ceramic systems currently available to satisfy functional demands while achieving acceptable esthetics. A controlled series of steps, where the provisional restorative components are being replaced by the definitive ones is planned. The only difference between the provisional and definitive restorative components is the material used. The definitive restorations consisted of an implant-supported zirconium oxide framework. Individual pressed porcelain restorations were luted to the framework and a natural tooth. CLINICAL SIGNIFICANCE Provisional restorations allow an objective form of communication. Vertical and horizontal transitional lines can be effectively masked with appropriate treatment planning and a skilled ceramist. Many traditional dental laboratory steps may be eliminated or simplified without compromising the definitive restorations.
Restoring proximal caries lesions conservatively with tunnel restorations
Chu, Chun-Hung; Cheung,; Nalliah,Romesh; Mei,May L
2013-01-01
Chun-Hung Chu1, May L Mei,1 Chloe Cheung,1 Romesh P Nalliah2 1Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China; 2Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA Abstract: The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slo...
Long-term competence restoration.
Morris, Douglas R; DeYoung, Nathaniel J
2014-01-01
While the United States Supreme Court's Jackson v. Indiana decision and most state statutes mandate determinations of incompetent defendants' restoration probabilities, courts and forensic clinicians continue to lack empirical evidence to guide these determinations and do not yet have a consensus regarding whether and under what circumstances incompetent defendants are restorable. The evidence base concerning the restoration likelihood of those defendants who fail initial restoration efforts is even further diminished and has largely gone unstudied. In this study, we examined the disposition of a cohort of defendants who underwent long-term competence restoration efforts (greater than six months) and identified factors related to whether these defendants were able to attain restoration and adjudicative success. Approximately two-thirds (n = 52) of the 81 individuals undergoing extended restoration efforts were eventually deemed restored to competence. Lengths of hospitalization until successful restoration are presented with implications for the reasonable length of time that restoration efforts should persist. Older individuals were less likely to be restored and successfully adjudicated, and individuals with more severe charges and greater factual legal understanding were more likely to be restored and adjudicated. The significance of these findings for courts and forensic clinicians is discussed.
Sailer, Herman F.; Tarawneh, Fadi; Fourkas, Panagiotis; Antoniades, Dimitrios Z.; Athanasiou, Athanasios E.
2010-01-01
This case report describes the combined surgical, orthodontic and prosthodontic rehabilitation of an adult female patient with a previous history of follicular ameloblastoma, which was treated through partial mandibulectomy and an immediate replacement of missing bone with an autologous calvarial bone graft. Orthodontic treatment was undertaken in order to restore occlusal disturbances and obtain sufficient space for two dental implants and an optimum prosthodontic rehabilitation. PMID:20396452
SURGICAL TREATMENT OF VERTEBRAL FRACTURES ASSOCIATED WITH LOW MINERAL BONE DENSITY
Directory of Open Access Journals (Sweden)
V. V. Rerikh
2010-01-01
Full Text Available Surgical treatment of 177 patients with monolocal fractures of thoracic and lumbar vertebral bodies was performed using transpedicular fixation (n=17, transpedicular fixation and osteoplasty (n=101, vertebroplasty (n=48 or kyphoplasty (n=ll. Restoration of support ability of the fractured osteoporotic vertebrae within ventral column by means of plasty particularly in combination with internal fixation allows achievement of better clinical outcomes, improvement of the quality of life in patients in the early and late periods after surgery.
"I Was Dead Restorative Today": From Restorative Justice to Restorative Approaches in School
McCluskey, G.; Lloyd, G.; Stead, J.; Kane, J.; Riddell, S.; Weedon, E.
2008-01-01
This paper explores definitions and understandings of restorative practices in education. It offers a critique of current theoretical models of restorative justice originally derived from the criminal justice system and now becoming popular in educational settings. It questions the appropriateness of these concepts as they are being introduced to…
Directory of Open Access Journals (Sweden)
Mauro Marincola
2015-01-01
Full Text Available The functional and aesthetic restoration of teeth compromised due to aggressive periodontitis presents numerous challenges for the clinician. Horizontal bone loss and soft tissue destruction resulting from periodontitis can impede implant placement and the regeneration of an aesthetically pleasing gingival smile line, often requiring bone augmentation and mucogingival surgery, respectively. Conservative approaches to the treatment of aggressive periodontitis (i.e., treatments that use minimally invasive tools and techniques have been purported to yield positive outcomes. Here, we report on the treatment and five-year follow-up of patient suffering from aggressive periodontitis using a minimally invasive surgical technique and implant system. By using the methods described herein, we were able to achieve the immediate aesthetic and functional restoration of the maxillary incisors in a case that would otherwise require bone augmentation and extensive mucogingival surgery. This technique represents a conservative and efficacious alternative to the aesthetic and functional replacement of teeth compromised due to aggressive periodontitis.
Tlucek, Paul S; Folk, James C; Sobol, Warren M; Mahajan, Vinit B
2013-01-01
To review fibrosis of fluocinolone acetonide (FA) implants in subjects with CAPN5 autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV). A retrospective case series was assembled from ADNIV patients in which there was fibrotic encapsulation of a fluocinolone acetonide implant. CAPN5 genotypes and surgical repair techniques were reviewed. Two eyes of two ADNIV patients developed a fibrotic capsule over the fluocinolone acetonide implant. Both patients had Stage IV disease. Patient A had a c.731T > C mutation in the CAPN5 gene and patient B had a c.728G > T mutation. The fibrotic membrane was surgically excised and the implant function was restored. The exuberant fibrotic response in later stages of ADNIV may be resistant to local immunosuppression with steroids. Surgical excision of fibrotic membranes over FA implants can reestablish local steroid delivery in cases of severe proliferative vitreoretinopathy.
Ballert, Katie N; Kanofsky, Jamie A; Nitti, Victor W
2008-03-01
Variable effects on lower urinary tract symptoms (LUTS) other than stress urinary incontinence (SUI) have been reported after tension-free vaginal tape (TVT). We measured the effect of TVT on LUTS using the American Urological Association Symptom Index (AUASI). Patients undergoing TVT completed the AUASI pre- and post-operatively. Total scores (TS), storage scores (SS), and voiding scores (VS) were compared overall and among patients with SUI vs mixed urinary incontinence (MUI) and those who underwent TVT vs TVT-obturator (TVT-O). The mean change in TS and SS was -3.6 and -3.0. Mean reductions in TS and SS were significant in all patient subsets with no change in VS. There was no significant difference in the mean changes in TS between patients with SUI vs MUI or those undergoing TVT vs TVT-O. LUTS are improved after TVT in most patients. In general, voiding symptoms were not adversely affected.
Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics
Ioannou, Andreas L.; Kotsakis, Georgios A.; McHale, Michelle G.; Lareau, Donald E.; Hinrichs, James E.; Romanos, Georgios E.
2015-01-01
Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon's rationale and techniques beyond that of simply placing a functional restoration in an edentulous site to a level whereby an implant-supported restoration is placed in reconstructed soft tissue, so the site is indiscernible from a natural tooth. PMID:26124837
Gratton, David G; Aquilino, Steven A
2004-04-01
Interim restorations are a critical component of fixed prosthodontic treatment, biologically and biomechanically. Interim restoration serves an important diagnostic role as a functional and esthetic try-in and as a blueprint for the design of the definitive prosthesis. When selecting materials for any interim restoration, clinicians must consider physical properties, handling properties, patient acceptance, and material cost. Although no single material meets all the requirements and material classification alone of a given product is not a predictor of clinical performance, bis-acryl materials are typically best suited to single-unit restorations, and poly(methylmethacrylate) interim materials are generally ideal for multi-unit, complex, long-term, interim fixed prostheses. As with most dental procedures, the technique used for fabrication has a greater effect on the final result than the specific material chosen.
DEFF Research Database (Denmark)
Jacobs, Douglass F.; Oliet, Juan A.; Aronson, James
2015-01-01
of land requiring restoration implies the need for spatial prioritization of restoration efforts according to cost-benefit analyses that include ecological risks. To design resistant and resilient ecosystems that can adapt to emerging circumstances, an adaptive management approach is needed. Global change......, in particular, imparts a high degree of uncertainty about the future ecological and societal conditions of forest ecosystems to be restored, as well as their desired goods and services. We must also reconsider the suite of species incorporated into restoration with the aim of moving toward more stress resistant...... and competitive combinations in the longer term. Non-native species may serve an important role under some circumstances, e.g., to facilitate reintroduction of native species. Propagation and field establishment techniques must promote survival through seedling stress resistance and site preparation. An improved...
Schroder (Kushch), Svetlana; Lang, Zhengxin; Rabotyagov, Sergey
2018-04-01
Wetland restoration can increase the provision of multiple non-market ecosystem services. Environmental and socio-economic factors need to be accounted for when land is withdrawn from agriculture and wetlands are restored. We build multi-objective optimization models to provide decision support for wetland restoration in the Le Sueur river watershed in Southern Minnesota. We integrate environmental objectives of sediment reduction and habitat protection with socio-economic factors associated with the overlap of private land with potential wetland restoration sites in the watershed and the costs representing forward-looking farmers voluntarily taking land out of agricultural production in favor of wetland restoration. Our results demonstrate that the inclusion of these factors early on in the restoration planning process affects both the total costs of the restoration project and the spatial distribution of optimally selected wetland restoration sites.
Laparoscopic resection of an obturator schwannoma: a case report
Institute of Scientific and Technical Information of China (English)
YI Ke; WANG Yu-mei; CHEN Jie
2010-01-01
@@ Schwannomas are usually benign tumors that arise from a nerve supporting the Schwann cells, those are mostly associated with the cranial or main peripheral nerves. The occurrence of retroperitoneal schwannoma is quite rare, and in such a case, surgical excision is the first option for treatment.
Directory of Open Access Journals (Sweden)
Ana Belén Dablanca-Blanco
2017-08-01
Full Text Available The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect and the management of the cavity margin, such as the need for deep margin elevation (DME or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.
Long term outcome of ruptured vertebrobasilar artery dissection treated non-surgically
International Nuclear Information System (INIS)
Nakano, Takahiro; Ohkuma, Hiroki; Shimamura, Norihito; Munakata, Akira; Kikkawa, Tomoshige
2010-01-01
Vertebrobasilar artery dissection began to attract attention as a cause of subarachnoid hemorrhage (SAH) in the late 1970s. Although reports on this disease have gradually increased, the natural history of vertebrobasilar artery dissection remains obscure, and long-term follow-up of patients without surgical treatment is necessary to determine appropriate treatment. We describe the long-term clinical course of ruptured vertebrobasilar artery dissection treated non-surgically. Fourteen subjects with ruptured vertebrobasilar artery dissection were treated conservatively in 7 neurosurgical departments. We reviewed their clinical outcomes, image findings and the chronological changes at the dissection site from their charts. The modified Rankin Scale was Grade 0 in 13 of 14 cases, and Grade 2 in 1 case. The configuration of dissection did not change during the follow-up period in 12 of 14 cases, but occlusion and restoration were recognized in a single case each. Good prognosis was common in the patients with ruptured vertebrobasilar artery dissection who were treated non-surgically. It is essential to accumulate more data on the clinical course and changes in image findings of long-term survival cases to establish a definite strategy for ruptured vertebrobasilar artery dissection. (author)
METHODOLOGY OF PROSTHETIC TREATMENT IN PATIENTS WITH MAXILLECTOMY
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Ivan Gerdzhikov
2018-06-01
Full Text Available Aim: The aim of the described method is to present the main stages in the prosthetic treatment with hollow bulb obturator, which provides optimum defect hermetization and restoration of the damaged functions. Materials and methods: The clinical case, described is on a 70-years-old patient with edentulous jaws and maxillary defect in the right half of the upper jaw. The preliminary impressions were taken with irreversible hydrocolloid impression material, and the final impressions were taken with additive silicone material. The occlusion height and the centric relations were registered as the classical technique. After the successful trial denture appointment, the surface of the plaster master model was covered by isolation polish. After this procedure, the master model was covered by even wax layer with 5mm thickness. It was designed to be thinner in the area of the resection line. The designed cavity was filled in with silicone impression material and covered with the folio. The base plate with the arranged teeth was fixed to the model, packed in the cuvette and finished from heat-cured acrylic resin with low quantity of residual monomer. After the polymerization process, the silicone material was removed, and the obturators cap was fixed to the denture’s base plate with cold cured acrylic resin. The obturator and the complete denture of the mandible were adjusted and articulated in patient’s mouth in the final clinical stage. Results: The applied prosthetic method allowed successful defect hermetization and helped for the restoration of the speech, feeding and patient’s self-esteem. Conclusion: Prosthetic rehabilitation of patients with maxillary resection is possible only with the application of specific treatment methods.
Ecological Restoration: Guidance from Theory
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Joy Zedler
2005-09-01
Full Text Available A review of the science and practice of ecosystem restoration led me to identify key ecological theories and concepts that are relevant to planning, implementing, and sustaining restoration efforts. From experience with actual restoration projects, I provide guidance for improving the restoration process. Despite an abundance of theory and guidance, restoration goals are not always achieved, and pathways toward targets are not highly predictable. This is understandable, since each restoration project has many constraints and unique challenges. To improve restoration progress, I advise that sites be designed as experiments to allow learning while doing. At least the larger projects can be restored in phases, each designed as experimental treatments to test alternative restoration approaches. Subsequent phases can then adopt one or more of the treatments that best achieved goals in earlier phases while applying new tests of other restoration measures. Both science and restoration can progress simultaneously. This phased, experimental approach (called “adaptive restoration” is an effective tool for improving restoration when monitoring, assessment, interpretation and research are integrated into the process.
Directory of Open Access Journals (Sweden)
G. Gazzotti
2016-01-01
Full Text Available Ipsilateral obturator hip dislocation and femoral shaft fracture are rare. We report such a case in an older woman after a low-energy injury. She had a knee prostheses in the same limb. The patient was treated by open manipulative reduction of the luxation without opening joint and open reduction and internal fixation of the femur with angular stability plate and screws. We could not find a similar case in the literature. An early diagnosis of the dislocation is crucial in order to obtain good results. Great awareness and radiologic examination are fundamental to achieve precocious diagnosis of both these rare combined injuries, as treatment in these cases is considered an emergency. The first step was an attempt to reduce the dislocation by closed means but it failed. Then we performed a short approach at the trochanteric region and used Lambotte forceps to manoeuvre the proximal femur without opening the joint achieving reduction. Thereafter the femoral shaft fracture underwent open reduction and internal fixation with an angular stable plate. After a 2-year follow-up the outcome was very good.
Shi, Tao; Zhang, Ning; Kong, Fan-wen; Zhan, De-song
2010-10-01
To study the color reappearance effect of metal-ceram restoration and foundry-ceram restoration using Crystaleye spectrophotometer. 58 metal-ceram restorations and 58 foundry-ceram restorations according to the result of the Crystaleye spectrophotometer were made respectively. The deltaE between restorations and natural teeth as referenced were analyzed. And satisfaction of dentists and patients were evaluated. The deltaE between metal-ceram restorations and natural teeth was 7.13 +/- 0.74. The deltaE between foundry-ceram restorations and teeth was 1.47 +/- 0.84. There were statistical differences between the deltaE (P spectrophotometer can provide accurate reference for foundry-ceram restoration, but for metal-ceram restoration it is not accurate.
Surgical treatment of disabling conditions caused by anogenital lichen sclerosus in women
DEFF Research Database (Denmark)
Rangatchew, Filip; Knudsen, Jens; Thomsen, Michael V
2017-01-01
BACKGROUND: Anogenital lichen sclerosus (LS), a chronic dermatitis that causes scarring and introital stenosis, may prevent sexual intercourse and reduce health-related quality of life (QoL). Surgery can restore the anatomy, allowing patients to resume their sexual lives. This study investigates...... outcomes in women treated with local skin flaps. METHODS: Thirty-eight consecutive LS-verified patients, surgically treated for debilitating conditions between 1990 and 2013, were retrospectively evaluated. A survey measured patient satisfaction, benefits, and health-related QoL, and the patients were also...
Drivers of Ecological Restoration: Lessons from a Century of Restoration in Iceland
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Ása L. Aradóttir
2013-12-01
Full Text Available We analyzed the main drivers for ecological restoration in Iceland from 1907 to 2010 and assessed whether the drivers have changed over time and what factors might explain the changes, if any. Our study was based on a catalogue of 100 restoration projects, programs, and areas, representing 75% to 85% of all restoration activities in Iceland. Catastrophic erosion was an early driver for soil conservation and restoration efforts that still ranked high in the 2000s, reflecting the immense scale of soil erosion and desertification in Iceland. Socioeconomic drivers such as farming and the provision of wood products were strong motivators of ecological restoration over most of the 20th century, although their relative importance decreased with time as the number and diversity of drivers increased. In the 1960s and 1970s, the construction of hard infrastructure, and moral values such as improving the aesthetics of the countryside and "repaying the debt to the land" emerged as motivations for restoration actions. In the late 1990s, the United Nations Climate Change Convention became a driver for restoration, and the importance of nature conservation and recreation increased. Technological development and financial incentives did not show up as drivers of ecological restoration in our study, although there are some indications of their influence. Furthermore, policy was a minor driver, which might reflect weak policy instruments for ecological restoration and some counteractive policies.
Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...
Crouzeilles, Renato; Ferreira, Mariana S; Chazdon, Robin L; Lindenmayer, David B; Sansevero, Jerônimo B B; Monteiro, Lara; Iribarrem, Alvaro; Latawiec, Agnieszka E; Strassburg, Bernardo B N
2017-11-01
Is active restoration the best approach to achieve ecological restoration success (the return to a reference condition, that is, old-growth forest) when compared to natural regeneration in tropical forests? Our meta-analysis of 133 studies demonstrated that natural regeneration surpasses active restoration in achieving tropical forest restoration success for all three biodiversity groups (plants, birds, and invertebrates) and five measures of vegetation structure (cover, density, litter, biomass, and height) tested. Restoration success for biodiversity and vegetation structure was 34 to 56% and 19 to 56% higher in natural regeneration than in active restoration systems, respectively, after controlling for key biotic and abiotic factors (forest cover, precipitation, time elapsed since restoration started, and past disturbance). Biodiversity responses were based primarily on ecological metrics of abundance and species richness (74%), both of which take far less time to achieve restoration success than similarity and composition. This finding challenges the widely held notion that natural forest regeneration has limited conservation value and that active restoration should be the default ecological restoration strategy. The proposition that active restoration achieves greater restoration success than natural regeneration may have arisen because previous comparisons lacked controls for biotic and abiotic factors; we also did not find any difference between active restoration and natural regeneration outcomes for vegetation structure when we did not control for these factors. Future policy priorities should align the identified patterns of biophysical and ecological conditions where each or both restoration approaches are more successful, cost-effective, and compatible with socioeconomic incentives for tropical forest restoration.
Post surgical complications from students' large animal surgical ...
African Journals Online (AJOL)
A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...
Parslow, A; Simpson, D J
2017-06-01
A very limited safe anatomical window for transiliosacral implant placement exists in cats (sacroiliac fixation in cats using a single implant to minimise inadvertent iatrogenic damage to local structures and restore pelvic canal diameter. Eight cats underwent surgical fixation for traumatic bilateral sacroiliac luxation using a single smooth intramedullary pin. The pin spanned both ilial wings and sacrum. Implants were applied using a Universal C-guide. Pre- and postsurgery pelvic canal diameter ratios were calculated. Short-term follow-up was performed at 10 to 14 days postoperatively. Long-term follow-up was performed using the Feline Musculoskeletal Pain Index Questionnaire. Long-term radiographic assessment was available in two cases. The technique achieved safe and accurate implant position with precise sacroiliac joint reduction. Pelvic canal diameter ratios were restored to normal in all cases. Rapid return to normal hind leg function and excellent long-term clinical outcomes were achieved. This technique offers a simple, safe, repeatable and affordable technique for treating bilateral sacroiliac luxations in the cat without the aid of fluoroscopy. The procedure can be performed using surgical tools and inventory readily available in general small animal practices. © 2017 British Small Animal Veterinary Association.
Multi-characteristic opsin enabled vision restoration
Wright, Weldon; Pradhan, Sanjay; Bhattacharya, Sulgana; Mahapatra, Vasu; Tripathy, Ashutosh; Gajjeraman, Sivakumar; Mohanty, Samarendra
2017-02-01
Photodegenerative retinal diseases such as retinitis pigmentosa (RP) and dry age related macular degeneration (dry- AMD) lead to loss of vision in millions of individuals. Currently, no surgical or medical treatment is available though optogenetic therapies are in clinical development. Here, we demonstrate vision restoration using Multi- Characteristics Opsin (MCO1) in animal models with photo-degenerated retina. MCO1 is reliably delivered to specific retinal cells via intravitreal injection of Adeno-Associated Virus, leading to significant improvement in visually guided behavior conducted using a radial-arm water maze. The time to reach platform significantly reduced after delivery of MCO1. Notably, the improvement in visually guided behavior was observed even at light intensity levels orders of magnitude lower than that required for Channelrhodopsin-2 opsin. Chronic light exposure study showed that chronic light exposure did not compromise viability of vMCO1-treated retina. Safe virus-mediated MCO1-delivery has potential for effective gene therapy of diverse retinal degenerations in patients.
Langenbach, Andreas; Pinther, Melina; Krinner, Sebastian; Grupp, Sina; Ekkernkamp, Axel; Hennig, Friedrich F; Schulz-Drost, Stefan
2017-01-01
Background: Flail chest injuries (FCI) are associated with a high morbidity and mortality rate. As a concomitant clavicle fracture in FCI even worsens the outcome, the question is how can those costoclavicular injuries (CCI) be managed surgically. Methods: 11 patients with CCI were surgically treated by a locked plate osteosynthesis of the Clavicle and the underlying ribs through limited surgical approaches under general anesthesia. Patients were followed up after 2, 6, 12, 26 and 52 weeks. Results: All patients showed severe chest wall deformity due to severely displaced fractures of the ribs and the clavicle. They were suffering from pain and restriction of respiratory movements. The chest wall could be restored to normal shape in all cases with uneventful bone healing and a high patient convenience. Fractures of the clavicle and the second rib were managed through an innovative clavipectoral approach, the others through standard approaches to the anterolateral and the posterolateral chest wall. Two patients complained about numbness around the lateral approach and lasting periscapular pain. Conclusions: Surgical stabilization might be the appropriate therapy in CCI with dislocated fractures since they would cause severe deformity and loss of function of the chest wall and the shoulder. Celsius.
Baseline restoration using current conveyors
International Nuclear Information System (INIS)
Morgado, A.M.L.S.; Simoes, J.B.; Correia, C.M.
1996-01-01
A good performance of high resolution nuclear spectrometry systems, at high pulse rates, demands restoration of baseline between pulses, in order to remove rate dependent baseline shifts. This restoration is performed by circuits named baseline restorers (BLRs) which also remove low frequency noise, such as power supply hum and detector microphonics. This paper presents simple circuits for baseline restoration based on a commercial current conveyor (CCII01). Tests were performed, on two circuits, with periodic trapezoidal shaped pulses in order to measure the baseline restoration for several pulse rates and restorer duty cycles. For the current conveyor based Robinson restorer, the peak shift was less than 10 mV, for duty cycles up to 60%, at high pulse rates. Duty cycles up to 80% were also tested, being the maximum peak shift 21 mV. The peak shift for the current conveyor based Grubic restorer was also measured. The maximum value found was 30 mV at 82% duty cycle. Keeping the duty cycle below 60% improves greatly the restorer performance. The ability of both baseline restorer architectures to reject low frequency modulation is also measured, with good results on both circuits
Global Ecosystem Restoration Index
DEFF Research Database (Denmark)
Fernandez, Miguel; Garcia, Monica; Fernandez, Nestor
2015-01-01
The Global ecosystem restoration index (GERI) is a composite index that integrates structural and functional aspects of the ecosystem restoration process. These elements are evaluated through a window that looks into a baseline for degraded ecosystems with the objective to assess restoration...
Analysis of two different surgical approaches for fractures of the mandibular condyle.
Kumaran, S; Thambiah, L J
2012-01-01
Fractures of the condyle account for one third of all the mandibular fractures. Different surgical approaches to the condyle described hitherto testify to the advantages and disadvantages of the different surgical techniques used for approaching the condyle in such cases of fractures. We have described and compared two of such surgical techniques in this study. The aim of this study is to compare the outcome of dealing with condylar fractures by two different surgical techniques: the mini retromandibular approach, and the preauricular approach. A prospective study of 31 patients who had suffered with mandibular condylar fractures was carried out. Of these, 26 patients had unilateral condylar fractures, and 5 patients had a bilateral fracture. Further, 19 of these patients were treated by the mini retromandibular approach and 12 by the preauricular approach. The treated patients were followed up and evaluated for a minimum period of 1 year and assessed for parameters such as the maximum mouth opening, lateral movement on the fractured side, mandibular movements such as protrusion, dental occlusion, scar formation, facial nerve weakness, salivary fistula formation and time taken for the completion of the surgical procedure. t- test was used for statistical analysis of the data obtained in the study. Dental occlusion was restored in all the cases, and good anatomical reduction was achieved. The mean operating time was higher 63.53 (mean) ± 18.12 minutes standard deviation (SD) in the preauricular approach compared to 45.22 (mean) ± 18.86 minutes SD in the mini retromandibular approach. Scar formation was satisfactory in almost all the cases.
Reif, Molly K; Theel, Heather J
2017-07-01
Restoration monitoring is generally perceived as costly and time consuming, given the assumptions of successfully restoring ecological functions and services of a particular ecosystem or habitat. Opportunities exist for remote sensing to bolster the restoration science associated with a wide variety of injured resources, including resources affected by fire, hydropower operations, chemical releases, and oil spills, among others. In the last decade, the role of remote sensing to support restoration monitoring has increased, in part due to the advent of high-resolution satellite sensors as well as other sensor technology, such as lidar. Restoration practitioners in federal agencies require monitoring standards to assess restoration performance of injured resources. This review attempts to address a technical need and provides an introductory overview of spatial data and restoration metric considerations, as well as an in-depth review of optical (e.g., spaceborne, airborne, unmanned aerial vehicles) and active (e.g., radar, lidar) sensors and examples of restoration metrics that can be measured with remotely sensed data (e.g., land cover, species or habitat type, change detection, quality, degradation, diversity, and pressures or threats). To that end, the present article helps restoration practitioners assemble information not only about essential restoration metrics but also about the evolving technological approaches that can be used to best assess them. Given the need for monitoring standards to assess restoration success of injured resources, a universal monitoring framework should include a range of remote sensing options with which to measure common restoration metrics. Integr Environ Assess Manag 2017;13:614-630. Published 2016. This article is a US Government work and is in the public domain in the USA. Published 2016. This article is a US Government work and is in the public domain in the USA.
Rawnsley, Jeffrey D
2008-08-01
The impact of male hair loss as a personal and social marker of aging is tremendous and its persistence as a human concern throughout recorded history places it in the forefront of male concern about the physical signs of aging. Restoration of the frontal hairline has the visual effect of re-establishing facial symmetry and turning back time. Follicular unit transplantation has revolutionized hair restoration, with its focus on redistributing large numbers of genetically stable hair to balding scalp in a natural distribution. Follicular unit hair restoration surgery is a powerful tool for the facial plastic surgeon in male aesthetic facial rejuvenation because it offers high-impact, natural-appearing results with minimal downtime and risk for adverse outcome.
Directory of Open Access Journals (Sweden)
Borodulya V.L.
2017-10-01
Full Text Available Prolonged and continuous lacrimation (symptom of epiphora causes discomfort, inclination to conjunctiva infect, reduces visual acuity and ultimately the quality of life of the patient. Despite the fact that there is a large number of various surgical interventions to restore tearing in patients with chronic dacryocystitis, the problem of lacrimation remains relevant. We have studied the operation of endonasal dacryocystorhinostomy and its long-term consequences. Surgical intervention in endonasal dacryocystorhinostomy is aimed at eliminating lacrimation by eliminating stenosis and forming a new combination of the cavity of the laryngeal canal with the nasal cavity, as well as the sanation of purulent foci of infection in the throat. There were 8 surgical interventions. Period of observation of patients in the postoperative period by ophthalmologist and ENT-doctor is from 1.5 to 2 years. The evaluation of the result was carried out in 6 months or more after the operation. A complete recovery with the recovery of the tear excretion in the nasal cavity has been achieved in all patients. The formed rhinostoma was wide, well functioning. Thus, endonasal dacryocystorhinostomy is a highly effective and should be a method of choice for inflammation of the lacrimal sac at any stage of development.
Knulst, A.J.
2017-01-01
The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,
Technical framework for groundwater restoration
International Nuclear Information System (INIS)
1991-04-01
This document provides the technical framework for groundwater restoration under Phase II of the Uranium Mill Tailings Remedial Action (UMTRA) Project. A preliminary management plan for Phase II has been set forth in a companion document titled ''Preplanning Guidance Document for Groundwater Restoration''. General principles of site characterization for groundwater restoration, restoration methods, and treatment are discussed in this document to provide an overview of standard technical approaches to groundwater restoration
Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man
2009-10-01
Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.
Zirconia implants and peek restorations for the replacement of upper molars
Directory of Open Access Journals (Sweden)
José María Parmigiani-Izquierdo
2017-02-01
Full Text Available Abstract Background One of the disadvantages of the zirconia implants is the lack of elasticity, which is increased with the use of ceramic or zirconia crowns. The consequences that could result from this lack of elasticity have led to the search for new materials with improved mechanical properties. Case presentation A patient who is a 45-year-old woman, non-smoker and has no medical record of interest with a longitudinal fracture in the palatal root of molar tooth 1.7 and absence of tooth 1.6 was selected in order to receive a zirconia implant with a PEEK-based restoration and a composite coating. The following case report describes and analyses treatment with zirconia implants in molars following a flapless surgical technique. Zirconia implants are an alternative to titanium implants in patients with allergies or who are sensitive to metal alloys. However, one of the disadvantages that they have is their lack of elasticity, which increases with the use of ceramic or zirconia crowns. The consequences that can arise from this lack of elasticity have led to the search for new materials with better mechanical properties to cushion occlusal loads. PEEK-based restoration in implant prosthetics can compensate these occlusal forces, facilitating cushioning while chewing. Conclusion This procedure provides excellent elasticity and resembles natural tooth structure. This clinical case suggests that PEEK restorations can be used in zirconia implants in dentistry.
Directory of Open Access Journals (Sweden)
Nasrin Sarabi
2015-03-01
Full Text Available Introduction: The restoration of endodontically treated teeth is a topic that has been studied extensively but it is still a challenge for dental practitioners. The aim of this study was to evaluate fracture resistance, fracture patterns and fracture location of endodontically treated human maxillary premolars restored with direct and indirect composite resin and ceramic restoration. Methods: Eighty non-carious maxillary premolars were selected and divided into four groups (n=20. Endodontic treatment and mesio-occluso-distal preparations were carried out in all the groups except for the control group (group I. Subsequently, the prepared teeth were restored as follows: group II: indirect composite restoration; group III: ceramic restoration; group IV: direct composite restoration. The specimens were subjected to compressive axial loading until fracture occurred. The mode of failure was also recorded. Results: Group I had higher fracture resistance (1196.82±241.74 than the other groups (P
Lo, E C; Holmgren, C J
2001-01-01
The objectives of this study were: to provide restorations using the ART approach to pre-school children in Southern China in a kindergarten environment, using a high-strength glass-ionomer restorative material; to assess the acceptability of this approach and to evaluate on a longitudinal basis the restorations placed. A total of 170 ART restorations were placed in 95 children, aged 5.1 +/- 0.7 years, by seven final-year dental students using standard ART procedures and hand instruments. The restorations were evaluated every six months thereafter by two calibrated independent examiners using explorers and mouth-mirrors. 93% of the children reported that they did not feel pain during treatment and 86% were willing to receive ART restorations again. The cumulative 12- and 30-month survival rates of Class I restorations were 91% and 79%, respectively. The corresponding figures for Class V restorations were 79% and 70%, while those for Class II restorations were 75% and 51%. The failure rates of Class III and IV restorations were high with more than half of them scored as missing within the first year. The ART approach was shown to be acceptable to Chinese pre-school children for providing restorative dental care outside the traditional clinical setting. The success rates were high for Class I and V restorations in primary teeth, modest for Class II, and low for Class III and IV restorations.
Directory of Open Access Journals (Sweden)
Aji Markose
2016-01-01
Full Text Available Introduction: In multiple-appointment root canal treatment, a temporary filling material is used to seal the access cavity between visits. The primary function of this material is to prevent the contamination of the root canal system by fluids, organic debris, and bacteria from the oral cavity. Material and Methods: A total of fifty extracted noncarious unrestored human maxillaryanterior teeth with intact crowns and roots were selected The canals were instrumented using stepback technique and sodium hypochlorite (3% and hydrogen peroxide (3% were used as irrigants for each specimen alternatively. The coronal two-thirds of each canal were flared using Gates-Glidden drills up to no. 3 size and obturated with Gutta-percha using zinc oxide-eugenol (ZnOE as sealer. The teeth were then randomly selected and divided into six groups out of which four were experimental groups and two control groups. The teeth were then immersed in 2% methylene blue dye solution for 3 days. All sealing materials and Gutta-percha were gently removed from the walls of the canal, and the entire circumference of the canal wall examined for dye penetration. Results: The lowest mean leakage was in the Fermit-N group followed by Cavit-W, ZnOE, intermediate restorative materials (IRM, and positive control. Conclusion: Fermit-N showed better sealing ability compared to cavit, ZnOE and IRM.
Urolift - minimally invasive surgical BPH management.
Pushkaran, Anish; Stainer, Victoria; Muir, Gordon; Shergill, Iqbal S
2017-03-01
An ideal treatment option for symptomatic Benign Prostatic Hyperplasia (BPH) should relieve lower urinary tract symptoms (LUTS) and restore Quality of Life (QoL). Currently available medical therapies and surgical options for symptomatic BPH have side effects that adversely affects quality of life. Prostatic urethral lift (PUL) is a novel endourology procedure that promises to relieve LUTS without the aforementioned side effects. Areas covered: We diligently reviewed all the published literature on PUL, till July 2016 using standard search criteria. Expert commentary: There is good quality evidence to establish the efficiency of PUL in treating symptomatic BPH without adversely affecting the QoL. Based on the current literature, PUL can be considered as an option for those symptomatic BPH patients with small or medium size prostates (< 80 ml) without median lobe enlargement, who failed on medical therapy or are intolerant to it and wish to preserve their sexual function.
Predictable repair of provisional restorations.
Hammond, Barry D; Cooper, Jeril R; Lazarchik, David A
2009-01-01
The importance of provisional restorations is often downplayed, as they are thought of by some as only "temporaries." As a result, a less-than-ideal provisional is sometimes fabricated, in part because of the additional chair time required to make provisional modifications when using traditional techniques. Additionally, in many dental practices, these provisional restorations are often fabricated by auxillary personnel who may not be as well trained in the fabrication process. Because provisionals play an important role in achieving the desired final functional and esthetic result, a high-quality provisional restoration is essential to fabricating a successful definitive restoration. This article describes a method for efficiently and predictably repairing both methacrylate and bis-acryl provisional restorations using flowable composite resin. By use of this relatively simple technique, provisional restorations can now be modified or repaired in a timely and productive manner to yield an exceptional result. Successful execution of esthetic and restorative dentistry requires attention to detail in every aspect of the case. Fabrication of high-quality provisional restorations can, at times, be challenging and time consuming. The techniques for optimizing resin provisional restorations as described in this paper are pragmatic and will enhance the delivery of dental treatment.
Combined Orbital Fractures: Surgical Strategy of Sequential Repair
Directory of Open Access Journals (Sweden)
Su Won Hur
2015-07-01
Full Text Available BackgroundReconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes.MethodsWe divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients and non-comminuted IMS group (33 patients. In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant.ResultsIn the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed.ConclusionsWe recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon.
Directory of Open Access Journals (Sweden)
Kevin C. Vogler
2015-12-01
Full Text Available The implementation of US federal forest restoration programs on national forests is a complex process that requires balancing diverse socioecological goals with project economics. Despite both the large geographic scope and substantial investments in restoration projects, a quantitative decision support framework to locate optimal project areas and examine tradeoffs among alternative restoration strategies is lacking. We developed and demonstrated a new prioritization approach for restoration projects using optimization and the framework of production possibility frontiers. The study area was a 914,657 ha national forest in eastern Oregon, US that was identified as a national priority for restoration with the goal of increasing fire resiliency and sustaining ecosystem services. The results illustrated sharp tradeoffs among the various restoration goals due to weak spatial correlation of forest stressors and provisional ecosystem services. The sharpest tradeoffs were found in simulated projects that addressed either wildfire risk to the urban interface or wildfire hazard, highlighting the challenges associated with meeting both economic and fire protection goals. Understanding the nature of tradeoffs between restoration objectives and communicating them to forest stakeholders will allow forest managers to more effectively design and implement economically feasible restoration projects.
... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...
Paediatric Abdominal Surgical Emergencies in a General Surgical ...
African Journals Online (AJOL)
... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...
Surgical and endoscopic treatment of pain in chronic pancreatitis: a multidisciplinary update.
Issa, Y; van Santvoort, H C; van Goor, H; Cahen, D L; Bruno, M J; Boermeester, M A
2013-01-01
Chronic pancreatitis is an inflammatory disease of the pancreas with abdominal pain as the most prominent symptom. Adequate treatment of patients with chronic pancreatitis remains a major challenge, mainly because of the lack of evidence-based treatment protocols. The primary goal of treatment is to achieve long-term pain relief, control of the complications associated with the disease, and to restore the quality of life. Currently, a conservative step-up approach is often used for the treatment of pain; progression to severe and intractable pain is considered necessary before invasive treatment is considered. Recent studies, however, suggest that surgical intervention should not be considered only as last-resort treatment, since it can mitigate disease progression, achieve excellent pain control, and preserve pancreatic function. In this review, we present a state-of-the art overview of endoscopic and surgical treatment options for patients with painful chronic pancreatitis, and elaborate on the timing of surgery. Copyright © 2013 S. Karger AG, Basel.
Supraspinatus tendon tears: comparison of US and MR arthrography with surgical correlation
International Nuclear Information System (INIS)
Ferrari, Francesco S.; Governi, Simone; Burresi, Francesca; Vigni, Francesco; Stefani, Paolo
2002-01-01
The aim of this study was to compare the diagnostic reliability of US with MR arthrography in diagnosing supraspinatus tendon tears. Surgical findings were used as the gold standard in detecting tears. A total of 44 patients were assessed with transverse and longitudinal US scans with respect to the long axis of the rotator cuff tendons and then examined with MR arthrography. This technique involved free-hand injection of contrast medium into the shoulder joint. At surgery 20 incomplete and 24 complete tears were observed. Ultrasound offered good results for the large tears, but its sensitivity decreased proportionally with the size of the tears. Magnetic resonance arthrography correctly diagnosed 43 tears, whereas only one false-negative diagnosis of tendinosis was made for a partial tear on the bursal side. Since it improves the diagnosis of small tears, MR arthrography must be performed on all patients for whom surgical repair is necessary in order to restore normal functions. (orig.)
Supraspinatus tendon tears: comparison of US and MR arthrography with surgical correlation
Energy Technology Data Exchange (ETDEWEB)
Ferrari, Francesco S.; Governi, Simone; Burresi, Francesca; Vigni, Francesco; Stefani, Paolo [Department of Radiologic and Orthopaedic-Rehabilitative Sciences, University Hospital Siena (Italy)
2002-05-01
The aim of this study was to compare the diagnostic reliability of US with MR arthrography in diagnosing supraspinatus tendon tears. Surgical findings were used as the gold standard in detecting tears. A total of 44 patients were assessed with transverse and longitudinal US scans with respect to the long axis of the rotator cuff tendons and then examined with MR arthrography. This technique involved free-hand injection of contrast medium into the shoulder joint. At surgery 20 incomplete and 24 complete tears were observed. Ultrasound offered good results for the large tears, but its sensitivity decreased proportionally with the size of the tears. Magnetic resonance arthrography correctly diagnosed 43 tears, whereas only one false-negative diagnosis of tendinosis was made for a partial tear on the bursal side. Since it improves the diagnosis of small tears, MR arthrography must be performed on all patients for whom surgical repair is necessary in order to restore normal functions. (orig.)
Challenges of ecological restoration
DEFF Research Database (Denmark)
Halme, Panu; Allen, Katherine A.; Aunins, Ainars
2013-01-01
we introduce northern forests as an ecosystem, discuss the historical and recent human impact and provide a brief status report on the ecological restoration projects and research already conducted there. Based on this discussion, we argue that before any restoration actions commence, the ecology......The alarming rate of ecosystem degradation has raised the need for ecological restoration throughout different biomes and continents. North European forests may appear as one of the least vulnerable ecosystems from a global perspective, since forest cover is not rapidly decreasing and many...... on Biological Diversity. Several northern countries are now taking up this challenge by restoring forest biodiversity with increasing intensity. The ecology and biodiversity of boreal forests are relatively well understood making them a good model for restoration activities in many other forest ecosystems. Here...
Functional restoration of diaphragmatic paralysis: an evaluation of phrenic nerve reconstruction.
Kaufman, Matthew R; Elkwood, Andrew I; Colicchio, Alan R; CeCe, John; Jarrahy, Reza; Willekes, Lourens J; Rose, Michael I; Brown, David
2014-01-01
Unilateral diaphragmatic paralysis causes respiratory deficits and can occur after iatrogenic or traumatic phrenic nerve injury in the neck or chest. Patients are evaluated using spirometry and imaging studies; however, phrenic nerve conduction studies and electromyography are not widely available or considered; thus, the degree of dysfunction is often unknown. Treatment has been limited to diaphragmatic plication. Phrenic nerve operations to restore diaphragmatic function may broaden therapeutic options. An interventional study of 92 patients with symptomatic diaphragmatic paralysis assigned 68 (based on their clinical condition) to phrenic nerve surgical intervention (PS), 24 to nonsurgical (NS) care, and evaluated a third group of 68 patients (derived from literature review) treated with diaphragmatic plication (DP). Variables for assessment included spirometry, the Short-Form 36-Item survey, electrodiagnostics, and complications. In the PS group, there was an average 13% improvement in forced expiratory volume in 1 second (p Phrenic nerve operations for functional restoration of the paralyzed diaphragm should be part of the standard treatment algorithm in the management of symptomatic patients with this condition. Assessment of neuromuscular dysfunction can aid in determining the most effective therapy. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Dydykin, Sergey; Kapitonova, Marina
2015-01-01
Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.
Delpech, P O; Danion, J; Oriot, D; Richer, J P; Breque, C; Faure, J P
2017-02-01
Alike becoming a pilot requires competences, acquisition of technical skills is essential to become a surgeon. Halsted's theory on surgical education "See one, do one, and teach one" is not currently compatible with the reality of socio-economic constraints of the operating room, the patient's safety demand and the reduction of residents' work hours. In all countries, this brings mandatory to simulation education for surgery resident's training. Many models are available: video trainers or pelvi-trainers, computed simulator, animal models or human cadaver… Human cadaveric dissection has long been used to teach surgical anatomy. Surgery on human cadaveric model brings greatest accuracy to the haptic characteristics of surgical procedures. Learning in an appropriate and realistic simulation context increases the level of acquisition of the residents' skills and reduces stress and anxiety when performing real procedures. We present a technique of perfusion and ventilation of a fresh human cadaver that restores pulsatile circulation and respiratory movements of the model. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Song, In-Seok; Lee, Mi-Ran; Ryu, Jae-Jun; Lee, Ui-Lyong
Dental implants positioned in severely atrophied anterior maxillae require esthetic or functional compromises. This case report describes the rehabilitation of a severely atrophied alveolar ridge with a three-dimensional (3D) computer-aided design/computer-aided manufacture (CAD/CAM) surgical guide. A 50-year-old woman had a severely atrophied anterior maxilla with unfavorably positioned dental implants. Functional and esthetic prosthodontic restoration was difficult to achieve. An anterior segmental osteotomy was planned to reposition the dental implants. A 3D surgical guide was designed for precise relocation of the segment. The surgical guide firmly grasped the impression copings of the dental implants, minimizing surgical errors. Three-dimensional gingival simulation was used preoperatively to estimate the appropriate position of the gingiva. Rigid fixation to the surrounding bone allowed immobilization of the implant-bone segment. Satisfactory esthetic and functional outcomes were attained 6 months after surgery. Finally, a severely atrophied alveolar ridge with unfavorably positioned dental implants was recovered with minimal esthetic and functional deterioration using gingival simulation and a 3D CAD/CAM surgical guide.
Kumar, Amit; Bhowmick, Prolay Kumar; Singh, Vikram Jeet; Malik, Manoj; Gupta, Ashish Kumar; Seth, R; Nagarajan, M; Krishnan, S Gopala; Singh, Ashok Kumar
2017-10-01
Iso-cytoplasmic restorers possess the same male sterile cytoplasm as the cytoplasmic male sterile (CMS) lines, thereby minimizing the potential cyto-nuclear conflict in the hybrids. Restoration of fertility of the wild abortive CMS is governed by two major genes namely, Rf3 and Rf4 . Therefore, assessing the allelic status of these restorer genes in the iso-cytoplasmic restorers using molecular markers will not only help in estimating the efficiency of these genes either alone or in combination, in fertility restoration in the hybrids in different environments, but will also be useful in determining the efficacy of these markers. In the present study, the efficiency of molecular markers in identifying genotypes carrying restorer allele of the gene(s) Rf3 and Rf4, restoring male fertility of WA cytoplasm in rice was assessed in a set of 100 iso-cytoplasmic rice restorers using gene linked as well as candidate gene based markers. In order to validate the efficacy of markers in identifying the restorers, a sub-set of selected 25 iso-cytoplasmic rice restorers were crossed with four different cytoplasmic male sterile lines namely, IR 79156A, IR 58025A, Pusa 6A and RTN 12A, and the pollen and spikelet fertility of the F 1 s were evaluated at three different locations. Marker analysis showed that Rf4 was the predominant fertility restorer gene in the iso-cytoplasmic restorers and Rf3 had a synergistic effect on fertility restoration. The efficiency of gene based markers, DRCG-RF4-14 and DRRM-RF3-10 for Rf4 (87%) and Rf3 (84%) genes was higher than respective gene-linked SSR markers RM6100 (80%) and RM3873 (82%). It is concluded that the gene based markers can be effectively used in identifying fertility restorer lines obviating the need for making crosses and evaluating the F 1 s. Though gene based markers are more efficient, there is a need to identify functional polymorphisms which can provide 100% efficiency. Three iso-cytoplasmic restorers namely, PRR 300, PRR 363
The surgical manegement of metastases to humerus-clinical evaluation.
Chrobok, Adam; Spindel, Jerzy; Miszczyk, Leszek; Koczy, Bogdan; Pilecki, Bogdan; Jarosz, Adam; Mrozek, Tomasz
2003-06-30
Background. The humerus is a common localisation of cancer metastases. The restoration of anatomical order and tumor resection within humerus is important for patients quality of everyday life and for their pain relief. The surgical treatment is one of the most important part of the whole oncological ways of tratment. The study objective was a clinical assesment of tumor resection and reconstruction within humerus according to matastasis localisation and the choice of surgical technique. Material and methods. In the years 1999-2002 19 patients underwent surgery due to pathological fracture or/and cancer metastasis within humerus. The shaft localisation of the tumor was found in 8 cases and in 11 patients the metastatic foci were found in proximnal diaphysis. In patients with proximal diaphysis localisation of the tumor the partial resection with subsequent joint exchange procedure was made. The humeral shaft metastatic cancer changes were treated by the segmental resection with subsequent surgical cement filling or auto/allogenical bone grafting combined with intramedullary nail or AO/ASIF plate stabilisation. The average follow-up period was 8,5 months. Results. In patients after resection with shoulder joint alloplasty according to the Enneking test a very good result was found in 7 and very good in 4 cases. In patients with femoral shaft metastatic tumor locaslisation, 6 good and 2 fair results were found. In 1 patient after 2 months rehabilitation a reoperation was needed due to the mechanical destabilisation. The best results were found in patients after intramedullary nailing.An acute soft tissue inflamation requiering surgical treatment was found in 1 patient after shoulder joint replacement. Conclusions. After clinical analysis of the material we highly recomend the partial humeral bone resection with subsequent shoulder alloplasty in patients with proximal humeral diaphysis metastatic localisation. In cases with shaft localisation a better results were
Provisional Restorations – A Permanent Problem?
Keys, William F; Keirby, Naomi; Ricketts, David N J
2016-12-01
Provisional restorations play an important role when providing indirect restorations. There are a number of materials and techniques available for their construction. Careful planning and construction can protect the prepared tooth surface, improve the periodontal condition and help plan for the definitive restoration. A good provisional restoration can save time, money and effort. Clinical relevance: Provisional restoration construction is an integral part of the indirect restorative process for inlays, onlays, crowns and bridges.
2010-06-21
... Estuary Habitat Restoration Council's Intent to Revise its Estuary Habitat Restoration Strategy; Request... interagency Estuary Habitat Restoration Council, is providing notice of the Council's intent to revise the ''Estuary Habitat Restoration Strategy'' and requesting public comments to guide its revision. DATES...
Image restoration, uncertainty, and information.
Yu, F T
1969-01-01
Some of the physical interpretations about image restoration are discussed. From the theory of information the unrealizability of an inverse filter can be explained by degradation of information, which is due to distortion on the recorded image. The image restoration is a time and space problem, which can be recognized from the theory of relativity (the problem of image restoration is related to Heisenberg's uncertainty principle in quantum mechanics). A detailed discussion of the relationship between information and energy is given. Two general results may be stated: (1) the restoration of the image from the distorted signal is possible only if it satisfies the detectability condition. However, the restored image, at the best, can only approach to the maximum allowable time criterion. (2) The restoration of an image by superimposing the distorted signal (due to smearing) is a physically unrealizable method. However, this restoration procedure may be achieved by the expenditure of an infinite amount of energy.
Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines.
Butterworth, C; McCaul, L; Barclay, C
2016-05-01
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK and provides recommendations on the pre-treatment oral and dental assessment, during and after treatment and oral rehabilitation. Restorative dentists are core members of the multidisciplinary team treating head and neck cancer patients, involved from the treatment planning phase through to long-term rehabilitation. Recommendations • Preventative oral care must be delivered to patients whose cancer treatment will affect the oral cavity, jaws, salivary glands and oral accessibility. (G) • Close working and communication between the surgeons, oncologists and restorative dental specialists is important in ensuring optimal oral health outcomes. (G) • Intensity-modulated radiotherapy has been shown to reduce long-term xerostomia and should be offered to all appropriate patients. (R) • If patients are deemed at risk of trismus they should be warned and its progressive and potentially irreversible nature explained. (G) • Where it is known that adjuvant radiotherapy will be given, extractions should take place at primary surgery to maximise the time for healing and minimise the number of surgical events for patients. (G) • Osseointegrated implants should be considered for all patients having resection for head and neck cancer. (G).
2010-06-10
... resources, aquatic-life forms, and sport fishing; and (e) develop responsible attitudes and ethics toward..., Sport Fish Restoration, Hunter Education and Safety AGENCY: Fish and Wildlife Service, Interior. ACTION... governing the Wildlife Restoration, Sport Fish Restoration, and Hunter Education and Safety (Enhanced Hunter...
Rehabilitation of adolescents after surgical treatment of dysplastic coxarthrosis
Directory of Open Access Journals (Sweden)
Oksana V. Bortuleva
2018-03-01
Full Text Available Background. The prevalence and severity of stage II and III dysplastic coxarthrosis determine the medical and social importance of its prevention and treatment. For a practicing orthopedic surgeon, there are two established stages of orthopedic treatment: the surgical stage and the restorative stage. The domestic and foreign literature from the previous 25 years comprises few publications regarding the rehabilitation of young children after reconstructive hip joint surgeries. Thus, the issues regarding the rehabilitation of teenagers following extra-articular operations on the hip joint remain unexplored. Aim. To evaluate the effectiveness of the developed program of rehabilitation for children after the surgical treatment of dysplastic coxarthrosis stages I and II. Material and methods. We analyzed the results of the surgical and rehabilitative treatment of 40 children (100% with dysplastic coxarthrosis stage I and II; the study population included 27 girls (67.5% and 13 boys (32.5 per cent aged 13–18 years (total 54 joints. The rehabilitation period was divided into the following 4 stages: I preoperative, II postoperative day 1–2, III postoperative day 3–21, IV outpatient treatment (after hospital discharge to 1 year postoperatively. Results. By the time of discharge, the range of motion in the hip joint was as follows: bending 950° ± 40°, withdrawal 150° ± 50°, and extension 100° ± 30°. According to the results of the electromyography performed 3 months postoperatively, there was an increase in the amplitude of biopotentials for the gluteal muscle. The long-term result was evaluated after 1 year. The average modified Harris Hip Score and a scale developed in the The Turner Scientific and Research Institute for Children’s Orthopedics, significantly (p < 0.05 differed from preoperative ones. Conclusion. Early rehabilitation allows an increase in the strength and tone of muscles and restores the amplitude of movements in
Reconstruction of the Hypopharynx After Surgical Treatment of Squamous Cell Carcinoma
Directory of Open Access Journals (Sweden)
Pen-Yuan Chu
2009-07-01
Full Text Available Squamous cell carcinoma of the hypopharynx (HPSCC tends to present with an advanced stage. Surgery with postoperative radiation or chemoradiation therapy has been the standard treatment for HPSCC. Radical surgery may result in a large surgical defect of the hypopharyngeal and cervical esophageal regions. Reconstruction of the surgical defect is also important after ablation procedures. Many reconstructive methods have been developed. However, each method has its own advantages and disadvantages. The ideal method for hypopharyngeal reconstruction should have the following attributes if possible: single-stage procedure, high success rate of tissue transfer, low donor-site morbidity, low fistula and stenosis rates, restoration of the ability to speak and swallow, able to achieve successful reconstruction in a heavily radiated area and tolerance of postoperative radiotherapy. In this review article, we discuss the indications and drawbacks of several reconstructive methods that have been frequently used in our clinical practice. Finally, we will introduce the technique of laryngotracheal flap reconstruction, which was developed in our institution and has proved to be a simple and reliable method for hypopharyngeal reconstruction.
Clinical decision making in restorative dentistry, endodontics, and antibiotic prescription.
Zadik, Yehuda; Levin, Liran
2008-01-01
The purpose of this study was to evaluate the influence of geographic location of graduation (Israel, Eastern Europe, Latin America) on decision making regarding management of dental caries, periapical lesions, and antibiotic prescribing routines. A questionnaire was given to ninety-eight general practitioners regarding demographic and work habits. Photographs of lesions were shown on a screen. Participants reported recommended treatment and whether they would routinely prescribe antibiotics following regular endodontic treatment, retreatment, and impacted third molar surgical extraction in healthy patients. There was a 94 percent (n=92) response rate, of which eighty-five responses were used in the data analysis. Surgical treatment of asymptomatic enamel caries lesions was not recommended by most of the subjects, and surgery was recommended for DEJ caries lesions in low or moderate caries risk patients, both without significant differences between geographic regions of dental school graduation. Israelis had a lower frequency of retreatment in asymptomatic teeth that demonstrated periapical radiolucency with post restoration (without crown) compared to Latin Americans and East Europeans. Most of the participants would not retreat asymptomatic teeth that demonstrated periapical radiolucency with post and crown. After third molar surgery, 46 percent of participants routinely prescribed antibiotics. Significantly more Latin American graduates prescribed antibiotics following endodontic treatment, retreatment, and third molar extractions (pantibiotics) and overtreatment (caries) among young practitioners reflect failure of undergraduate education in proper use of antibiotics and management of the carious lesions according to the patient's clinical presentation and caries risk assessment rather than routinely undertaking surgical caries treatment.
Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G
2015-08-01
Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per
Orthograde endodontic retreatment of teeth with individual cast posts: Report of two cases
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Ramić Bojana
2012-01-01
Full Text Available Introduction. The failure of primary endodontic treatment is manifested by various clinical symptoms following endodontic therapy or, more frequently, by the development of chronic inflammatory process in the apex region without any subjective symptoms. In case of unfavorable outcome of the primary endodontic treatment, orthograde endodontic retreatment is the method of choice for a prolonged therapy. Outline of Cases. Two female patients, 47 and 44 years old, were presented at the Dental Clinic of Vojvodina for endodontic retreatment of teeth 22, 23 and 13, within the repeated prosthetic restoration. Intraradicular individual cast posts were removed using ultrasonic instruments. Remains of gutta-percha were removed by engine driven rotary re-treatment files, root canals were shaped and cleaned using the crown-down technique, and obturated with gutta-percha and epoxy-resin-based sealer using the lateral compaction technique. Conclusion. When there are metal posts or broken instruments in the root canal, the use of ultrasonic instruments is considered a safe method characterized by negligible tooth substance loss and minimal root damage causing fractures and perforations, and the entire procedure is effective and predictable. Non-surgical orthograde endodontic retreatment, when properly performed in accessible and penetrable root canals, achieves a high cure rate, good and lasting results and eliminates the need for radical procedures, such as apical surgery or tooth extraction. When nonsurgical endodontic retreatment is done, treated teeth must be restored by full coronal coverage as soon as possible, to prevent coronal leakage or fracture.
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Romuald N. Lipcius
2015-09-01
Full Text Available Restoration strategies for native oyster populations rely on multiple sources of information, which often conflict due to time- and space-varying patterns in abundance and distribution. For instance, strategies based on population connectivity and disease resistance can differ, and extant and historical records of abundance and distribution are often at odds, such that the optimal strategy is unclear and valuable restoration sites may be excluded from consideration. This was the case for the Lynnhaven River subestuary of lower Chesapeake Bay, which was deemed unsuitable for Eastern Oyster restoration based on physical conditions, disease challenge, and extant oyster abundance. Consequently, we (i evaluated previously unknown historical data from the 1800s, (ii quantified extant oyster recruitment and abundance, physical conditions, and disease presence on constructed restoration reefs and alternative substrates, and (iii assessed simulations from biophysical models to identify potential restoration sites in the metapopulation. The collective data distinguished numerous restoration sites (i in the polyhaline zone (salinity 18.4-22.2 where disease resistance is evolving, (ii where oysters were abundant in the late 1800s-early 1900s, (iii of recent high recruitment, abundance and survival, despite consistent and elevated disease challenge, and (iv interconnected as a metapopulation via larval dispersal. Moreover, a network of constructed restoration reefs met size structure, abundance and biomass standards of restoration success. These findings demonstrate that assumptions about the suitability of sites for oyster restoration based on individual processes can be severely flawed, and that in-depth examination of multiple processes and sources of information are required for oyster reef restoration plans to maximize success. We use these findings and previous information to recommend a strategy for successful restoration of subtidal oyster reefs
A worldwide comparison of the management of surgical treatment of advanced oral cancer.
Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen
2018-03-01
Microvascular surgery following tumor resection has become an important field of oral and maxillofacial surgery (OMFS). Following the results from management of T1/T2 floor-of-mouth and tongue squamous cell carcinoma (SCC) in German-speaking countries, Europe, and worldwide, this paper presents specific concepts for the management of resection and reconstruction of T3/T4 SCC of the maxillary and mandibular alveolar process and tongue. The DÖSAK questionnaire was distributed in three different phases to a growing number of maxillofacial units worldwide. Within this survey, clinical patient settings were presented to participants and center-specific treatment strategies were evaluated. A total of 188 OMFS units from 36 different countries documented their treatment strategies for T3/T4 maxillary and mandibular alveolar process and tongue SCC. The extent of surgical resections and subsequent reconstructions is more consistent than with T1/T2 tumors, although the controversy surrounding continuity resections and mandible-sparing procedures remains. For continuity resection of the mandible the fibula free flap is the most frequently used bone replacement, whereas maxilla reconstruction concepts are less consistent, ranging from locoregional coverage concepts and different microvascular reconstruction options to treatment via obturator prosthesis. Results from treatment strategies for T3/T4 tumors underline the limited evidence for the appropriate amount of resection and subsequent reconstruction process, especially in cases involving the mandible. Prospective randomized trials will be necessary in the long term to establish valid treatment guidelines. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.
Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B
The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.
Setting standards of restorative justice
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Kostić Miomira
2007-01-01
Full Text Available In the article the author deals with the basic theoretical statements and discussions about the practical use of restorative justice. She discusses the questions of introducing and application of restorative justice in order to reach the balance of interests between a victim, society and a delinquent. There is no unique statement about the restorative justice concept, so the authors make this concept by listing certain activities with rispect of standards and principles. Also she emphasizes the values of restorative justice process. A part of the article is dedicated to the standards for restorative justice that are harmonized with the international documents of human rights. .
Grand, Jean-Guillaume; Bureau, Stéphane; Monnet, Eric
2013-11-15
To evaluate the effects of urinary bladder retroflexion (UBR) and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia. Retrospective case series. 41 client-owned dogs with perineal hernia that underwent surgery between November 2002 and November 2009. Medical records were reviewed for information on dog signalment, history, physical examination findings, ultrasonographic findings, surgical techniques, intraoperative complications, duration of hospital stay, postoperative complications, and long-term outcome. 31 dogs had no UBR, and 10 dogs had UBR. Internal obturator muscle transposition (IOMT) was performed in 20 dogs, and a cystopexy or colopexy was performed before the IOMT (LapIOMT) in 21. Postoperative complications included tenesmus (n = 8) and urinary incontinence (1). Rates of postoperative complications were not significantly different between the no-UBR and UBR groups or between the IOMT and LapIOMT groups. Thirty-two dogs were free of clinical signs at the time of the study. The median disease-free interval did not differ significantly between dogs in the no-UBR and UBR groups, but it was significantly lower in the LapIOMT group than in the IOMT group. None of the 7 dogs with UBR that were treated without cystopexy developed recurrence of UBR. UBR was not associated with an increased rate of postoperative complications relative to no UBR and had no effect on the long-term outcome in dogs with perineal hernia. The use of IOMT alone may be recommended for clinical use because LapIOMT offered no clear advantage.
Retributive and restorative justice.
Wenzel, Michael; Okimoto, Tyler G; Feather, Norman T; Platow, Michael J
2008-10-01
The emergence of restorative justice as an alternative model to Western, court-based criminal justice may have important implications for the psychology of justice. It is proposed that two different notions of justice affect responses to rule-breaking: restorative and retributive justice. Retributive justice essentially refers to the repair of justice through unilateral imposition of punishment, whereas restorative justice means the repair of justice through reaffirming a shared value-consensus in a bilateral process. Among the symbolic implications of transgressions, concerns about status and power are primarily related to retributive justice and concerns about shared values are primarily related to restorative justice. At the core of these processes, however, lies the parties' construal of their identity relation, specifically whether or not respondents perceive to share an identity with the offender. The specific case of intergroup transgressions is discussed, as are implications for future research on restoring a sense of justice after rule-breaking.
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Karaseva T.lu.
2012-12-01
Full Text Available Aim. Analyzing the vegetative tensity of organism» functional systems before and after surgical treatment of elderly patients with metabolic-and-dystrophic gonarthrosis. Methods. The evaluation of vegetative homeostasis, reactivity of the vegetative nervous system by the data of variation pulsometry («REAN-POLY» RGPA-6/12, Taganrog in 60 patients with gonarthrosis at the age of 50-72 years and the disease duration — 9+1.5 years before and after surgical treatment: total tunnelization (Group I, tunnelization with osteotomy of leg bones for correction of limb biomechanical axis (Group II, treatment-and-diagnostic arthroscopy (Group III. Results. The reduction of the level of hypoxia tolerance and the decrease of the processes of general adaptation one month after surgery in Group I was registered in 40% of patients. As for patients of Group II, by the end of the period of fixation with the llizarov device — in 50%. As for those of Group III after arthroscopy — in 10% of patients. Among the patients whose 1С / 1С calculated parameter after surgical treatment was registered <1.0, its values were >10.0 before treatment in 70% of cases. At rest, marked vagotonia was registered with hypersympathicotonic reaction to orthotest, as well as with sharp decrease of the proportion of second-order slow waves while transition to standing position (VLF proportion <10.0%, thereby reflecting organism»s energy deficiency state. Conclusion. Preoperative examination. When VLF proportion after orthotest is registered <10.0%, such patients should be referred to risk group and prescribed in-depth examination. The index of centralization (1С dynamics for orthotest (1С test/1С rest is one of the criteria of functional recovery level for the particular patient: its increase points to the positive dynamics of restorative rehabilitative process, and the values <1.0 —to the negative one.
Restorative dentistry for children.
Donly, Kevin J
2013-01-01
This article discusses contemporary pediatric restorative dentistry. Indications and contraindications for the choice of different restorative materials in different clinical situations, including the risk assessment of the patient, are presented. The specific use of glass ionomer cement or resin-modified glass ionomer cement, resin-based composite, and stainless steel crowns is discussed so that preparation design and restoration placement is understood. Copyright © 2013 Elsevier Inc. All rights reserved.
Crouzeilles, Renato; Ferreira, Mariana S.; Chazdon, Robin L.; Lindenmayer, David B.; Sansevero, Jerônimo B. B.; Monteiro, Lara; Iribarrem, Alvaro; Latawiec, Agnieszka E.; Strassburg, Bernardo B. N.
2017-01-01
Is active restoration the best approach to achieve ecological restoration success (the return to a reference condition, that is, old-growth forest) when compared to natural regeneration in tropical forests? Our meta-analysis of 133 studies demonstrated that natural regeneration surpasses active restoration in achieving tropical forest restoration success for all three biodiversity groups (plants, birds, and invertebrates) and five measures of vegetation structure (cover, density, litter, biom...
International Nuclear Information System (INIS)
Han Hongguang; Zhang Nanbin; Wang Zengwei; Wang Huishan; Zhu Hongyu; Li Xinmin
2010-01-01
Objective: To investigate the causes of failure in treating atrial septal defect (ASD) and ventricular septal defect (VSD) with interventional procedures and to evaluate the clinical efficacy of surgical treatment in order to increase the successful rate. Methods: A total of 13 patients, who underwent surgical therapy because of unsuccessful interventional treatment for ASD or VSD during the period of January 2001-December 2007, were selected,and the clinical data were retrospectively analyzed. The surgical indications included the occluder abscission (n=7), III degree atrioventricular conduction block (n=3), valvular regurgitation (n=2), residual shunt (n=1) and interventional failure (n=1). The cardiac surgeries, including removal of the displaced occluder and / or the repair of atrioventricular septal defects, were performed with the help of cardiopulmonary bypass in all 13 cases. After surgical treatment, all patients were transferred into ICU for further supervision and treatment. Results: The average diameter of ASD on surgical exploration was 31 mm, which was greater than the preoperative average diameter (26 mm), with a significant difference (P 0.05). The III degree atrioventricular conduction block in 3 cases restored sinus rhythm after operation. All the procedures were successfully completed in all patients. No death occurred during the hospitalization period. Conclusion: Proper and timely cardiac surgery is an effective and safe measure for the treatment of the complications due to unsuccessful interventional therapy as well as the atrioventricular septal defect itself. (authors)
Selection of oncoplastic surgical technique in Asian breast cancer patients
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Eui Sun Shin
2018-01-01
Full Text Available Background Oncoplastic surgery is being increasingly performed in Korean women; however, unlike Westerners, Korean women usually have small to moderate-sized breasts. To achieve better outcomes in reconstructed breasts, several factors should be considered to determine the optimal surgical method. Methods A total of 108 patients who underwent oncoplastic surgery from January 2013 to December 2016 were retrospectively investigated. We used various methods, including glandular tissue reshaping, latissimus dorsi (LD flap transposition, and reduction oncoplasty, to restore the breast volume and symmetry. Results The mean weight of the tumor specimens was 40.46 g, and the ratio of the tumor specimen weight to breast volume was 0.12 g/mL in the patients who underwent glandular tissue reshaping (n=59. The corresponding values were 101.47 g and 0.14 g/mL, respectively, in the patients who underwent reduction oncoplasty (n=17, and 82.54 g and 0.20 g/mL, respectively, in those treated with an LD flap (n=32. Glandular tissue reshaping was mostly performed in the upper outer quadrant, and LD flap transposition was mostly performed in the lower inner quadrant. No major complications were noted. Most patients were satisfied with the aesthetic results. Conclusions We report satisfactory outcomes of oncoplastic surgical procedures in Korean patients. The results regarding specimen weight and the tumor-to-breast ratio of Asian patients will be a helpful reference point for determining the most appropriate oncoplastic surgical technique.
Strohl, Alexis M; Vitkus, Lauren
2017-08-01
The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.
Retrospective analysis of dental implants placed and restored by advanced prosthodontic residents.
Barias, Pamela A; Lee, Damian J; Yuan, Judy Chia-Chun; Sukotjo, Cortino; Campbell, Stephen D; Knoernschild, Kent L
2013-02-01
The purposes of this retrospective clinical review were to: (1) describe the demographics of implant patients, types of implant treatment and implant-supported prostheses in an Advanced Education in Prosthodontic Program, (2) evaluate the survival rate of dental implants placed by prosthodontic residents from 2006 to 2008, and (3) analyze the relationship between resident year of training and implant survival rate. All patients who received dental implants placed by prosthodontic residents from January 2006 to October of 2008 in the Advanced Prosthodontic Program at the University of Illinois at Chicago College of Dentistry were selected for this study. Age, gender, implant diameter, length, implant locations, surgical and restorative detail, and year of prosthodontic residency training were collected and analyzed. Life-table and Kaplan-Meier survival analyses were performed based on implants overall, locations, year of training, and use of a computer-generated surgical guide. A Logrank statistic was performed between implant survival and year of prosthodontic residency training, location, and use of computer-generated surgical guide (α= 0.05). Three hundred and six implants were placed, and of these, seven failed. Life-table and Kaplan-Meier analyses computed a cumulative survival rate (CSR) of 97% for overall implants and implants placed with a computer-generated surgical guide. No statistical difference was found in implant survival rates as a function of year of training (P= 0.85). Dental implants placed by prosthodontic residents had a CSR comparable to previously published studies by other specialties. The year of prosthodontic residency training and implant failure rate did not have any significant relationship. © 2012 by the American College of Prosthodontists.
McCoy, Amy L; Holmes, S Rankin; Boisjolie, Brett A
2018-03-01
Securing environmental flows in support of freshwater biodiversity is an evolving field of practice. An example of a large-scale program dedicated to restoring environmental flows is the Columbia Basin Water Transactions Program in the Pacific Northwest region of North America, which has been restoring flows in dewatered tributary habitats for imperiled salmon species over the past decade. This paper discusses a four-tiered flow restoration accounting framework for tracking the implementation and impacts of water transactions as an effective tool for adaptive management. The flow restoration accounting framework provides compliance and flow accounting information to monitor transaction efficacy. We review the implementation of the flow restoration accounting framework monitoring framework to demonstrate (a) the extent of water transactions that have been implemented over the past decade, (b) the volumes of restored flow in meeting flow targets for restoring habitat for anadromous fish species, and (c) an example of aquatic habitat enhancement that resulted from Columbia Basin Water Transactions Program investments. Project results show that from 2002 to 2015, the Columbia Basin Water Transactions Program has completed more than 450 water rights transactions, restoring approximately 1.59 million megaliters to date, with an additional 10.98 million megaliters of flow protected for use over the next 100 years. This has resulted in the watering of over 2414 stream kilometers within the Columbia Basin. We conclude with a discussion of the insights gained through the implementation of the flow restoration accounting framework. Understanding the approach and efficacy of a monitoring framework applied across a large river basin can be informative to emerging flow-restoration and adaptive management efforts in areas of conservation concern.
McCoy, Amy L.; Holmes, S. Rankin; Boisjolie, Brett A.
2018-03-01
Securing environmental flows in support of freshwater biodiversity is an evolving field of practice. An example of a large-scale program dedicated to restoring environmental flows is the Columbia Basin Water Transactions Program in the Pacific Northwest region of North America, which has been restoring flows in dewatered tributary habitats for imperiled salmon species over the past decade. This paper discusses a four-tiered flow restoration accounting framework for tracking the implementation and impacts of water transactions as an effective tool for adaptive management. The flow restoration accounting framework provides compliance and flow accounting information to monitor transaction efficacy. We review the implementation of the flow restoration accounting framework monitoring framework to demonstrate (a) the extent of water transactions that have been implemented over the past decade, (b) the volumes of restored flow in meeting flow targets for restoring habitat for anadromous fish species, and (c) an example of aquatic habitat enhancement that resulted from Columbia Basin Water Transactions Program investments. Project results show that from 2002 to 2015, the Columbia Basin Water Transactions Program has completed more than 450 water rights transactions, restoring approximately 1.59 million megaliters to date, with an additional 10.98 million megaliters of flow protected for use over the next 100 years. This has resulted in the watering of over 2414 stream kilometers within the Columbia Basin. We conclude with a discussion of the insights gained through the implementation of the flow restoration accounting framework. Understanding the approach and efficacy of a monitoring framework applied across a large river basin can be informative to emerging flow-restoration and adaptive management efforts in areas of conservation concern.
Klemp, Evelyn
2010-01-01
Introduction: According to current studies approximately 10-41% of the female population worldwide suffers from stress incontinence (SUI). After exhausting all conservative measures for treatment and clear indication the retropubic trans vaginal tape = TVT or the trans obturator tape = TVTO are the preferred operative interventions. Current publications frequently compare the two surgical options and also describe the occurrence of postoperative pain in the adductor muscles. None of the...
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Radamés Isaac Adefna Pérez
2011-09-01
Full Text Available Introducción: la incontinencia urinaria de esfuerzo constituye un problema frecuente en el sexo femenino, con una prevalencia de un 30 %. Aunque no es letal, provoca un impacto importante en las esferas psíquica, social y económica para las que la padecen. Objetivo: demostrar la posibilidad de realizar la técnica de cabestrillo suburetral transobturatriz con medios propios sin afectar la continencia ni seguridad de la paciente. Métodos: se realizó un estudio descriptivo y prospectivo para evaluar las principales variables demográficas y el impacto en la calidad de vida y continencia mediante la escala Cuestionario de Calidad de Vida para Pacientes con Incontinencia Urinaria, Forma corta. Resultados: fueron intervenidas 36 pacientes con un seguimiento de 12 meses. La edad promedio es de 51,2 años, con predominio de las de edades posmenopáusicas y multíparas. Todas presentaban incontinencia de esfuerzo genuina o mixta. Se comprobó una mejoría significativa del puntaje preoperatorio con el posoperatorio. El porcentaje de éxitos al año fue de un 86,1 %. La principal complicación fue la erosión de prótesis e infecciones urinarias. Conclusiones: la realización del cabestrillo suburetral con prótesis por vía transobturatriz es una opción real y factible de ser realizada en nuestro país en pacientes con incontinencia urinaria de esfuerzo o mixta, pues logra una continencia similar a otras técnicas, con una morbilidad menor y un ahorro económico significativo.Introduction: the stress urinary incontinence is a frequent problem in the female sex with a prevalence of 30 %. Although is not lethal it to provokes a significant impact on the psychic, social and economic spheres for those suffering this disease. Objective: to demonstrate the chance of performing the trans-obturation subureteral sling procedure with own means without involve the continence and the safety of patient. Methods: a prospective and descriptive study was
Contribution of genetics to ecological restoration.
Mijangos, Jose Luis; Pacioni, Carlo; Spencer, Peter B S; Craig, Michael D
2015-01-01
Ecological restoration of degraded ecosystems has emerged as a critical tool in the fight to reverse and ameliorate the current loss of biodiversity and ecosystem services. Approaches derived from different genetic disciplines are extending the theoretical and applied frameworks on which ecological restoration is based. We performed a search of scientific articles and identified 160 articles that employed a genetic approach within a restoration context to shed light on the links between genetics and restoration. These articles were then classified on whether they examined association between genetics and fitness or the application of genetics in demographic studies, and on the way the studies informed restoration practice. Although genetic research in restoration is rapidly growing, we found that studies could make better use of the extensive toolbox developed by applied fields in genetics. Overall, 41% of reviewed studies used genetic information to evaluate or monitor restoration, and 59% provided genetic information to guide prerestoration decision-making processes. Reviewed studies suggest that restoration practitioners often overlook the importance of including genetic aspects within their restoration goals. Even though there is a genetic basis influencing the provision of ecosystem services, few studies explored this relationship. We provide a view of research gaps, future directions and challenges in the genetics of restoration. © 2014 John Wiley & Sons Ltd.
Lorenzo, Natalia; Mendez, Irene; Taibo, Mikel; Martinis, Gianfranco; Badia, Sara; Reyes, Guillermo; Aguilar, Rio
2018-03-19
Atrial fibrillation frequently affects patients with valvular heart disease. Ablation of atrial fibrillation during valvular surgery is an alternative for restoring sinus rhythm. This study aimed to evaluate mid-term results of successful atrial fibrillation surgical ablation during valvular heart disease surgery, to explore left atrium post-ablation mechanics and to identify predictors of recurrence. Fifty-three consecutive candidates were included. Eligibility criteria for ablation included persistent atrial fibrillation valvular heart disease surgery.
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Femke Beute
2016-04-01
Full Text Available More and more people use self-tracking technologies to track their psychological states, physiology, and behaviors to gain a better understanding of themselves or to achieve a certain goal. Ecological Momentary Assessment (EMA also offers an excellent opportunity for restorative environments research, which examines how our physical environment (especially nature can positively influence health and wellbeing. It enables investigating restorative health effects in everyday life, providing not only high ecological validity but also opportunities to study in more detail the dynamic processes playing out over time on recovery, thereby bridging the gap between laboratory (i.e., short-term effects and epidemiological (long-term effects research. We have identified four main areas in which self-tracking could help advance restoration research: (1 capturing a rich set of environment types and restorative characteristics; (2 distinguishing intra-individual from inter-individual effects; (3 bridging the gap between laboratory and epidemiological research; and (4 advancing theoretical insights by measuring a more broad range of effects in everyday life. This paper briefly introduces restorative environments research, then reviews the state of the art of self-tracking technologies and methodologies, discusses how these can be implemented to advance restoration research, and presents some examples of pioneering work in this area.
Overgoor, Max L E; de Jong, Tom P V M; Kon, Moshe
2014-08-01
The "TOMAX" (TO MAX-imize sensation, sexuality, and quality of life) procedure restores genital sensation in men with low spinal lesions, improving sexual health, as shown previously. It connects the dorsal nerve of the penis to the intact ipsilateral ilioinguinal nerve, unilaterally or bilaterally. This study reports on the technical aspects based on 43 TOMAX nerve transfers. In 40 patients with no penile but intact groin sensation, 43 nerve transfers were performed. Data on patient selection, surgical history, anatomy of the ilioinguinal nerve and dorsal nerve of the penis, unilateral or bilateral surgery, surgical technique, complications, and patient information were collected prospectively. Regardless of origin, all patients with no penile but good groin sensation are eligible for the procedure, provided the ilioinguinal nerve is not damaged because of former inguinal surgery or absent because of anatomical variations. Selection of a unilateral or bilateral procedure depends on the presence or absence of reflex erections and bulbocavernosus reflex. Preliminary experience with the first three bilateral cases shows that it is technically feasible, with encouraging results. The surgical technique has evolved (described in detail, including video) to enhance outcome and reduce complications. Patients are better informed, resulting in realistic expectations. This article synthesizes the procedural and technical experience of 43 TOMAX nerve transfers. Anyone skilled in peripheral nerve surgery and microsurgery can adopt this concept and further develop it. The TOMAX procedure can then be used to restore erogenous penile sensation and improve the quality of sexual health in patients with absent penile but good groin sensation.
Ding, Jing-Yi; Zhao, Wen-Wu
2014-09-01
The 5th World Conference on Ecological Restoration was held in Madison, Wisconsin, USA on October 6-11, 2013. About 1200 delegates from more than 50 countries attended the conference, and discussed the latest developments in different thematic areas of ecological restoration. Discussions on evaluation of ecological restoration were mainly from three aspects: The construction for evaluation indicator system of ecological restoration; the evaluation methods of ecological restoration; monitoring and dynamic evaluation of ecological restoration. The meeting stressed the importance of evaluation in the process of ecological restoration and concerned the challenges in evaluation of ecological restoration. The conference had the following enlightenments for China' s research on evaluation of ecological restoration: 1) Strengthening the construction of comprehensive evaluation indicators system and focusing on the multi-participation in the evaluation process. 2) Paying more attentions on scale effect and scale transformation in the evaluation process of ecological restoration. 3) Expanding the application of 3S technology in assessing the success of ecological restoration and promoting the dynamic monitoring of ecological restoration. 4) Carrying out international exchanges and cooperation actively, and promoting China's international influence in ecological restoration research.
Restoration of ailing wetlands.
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Oswald J Schmitz
2012-01-01
Full Text Available It is widely held that humankind's destructive tendencies when exploiting natural resources leads to irreparable harm to the environment. Yet, this thinking runs counter to evidence that many ecological systems damaged by severe natural environmental disturbances (e.g., hurricanes can restore themselves via processes of natural recovery. The emerging field of restoration ecology is capitalizing on the natural restorative tendencies of ecological systems to build a science of repairing the harm inflicted by humans on natural environment. Evidence for this, for example, comes from a new meta-analysis of 124 studies that synthesizes recovery of impacted wetlands worldwide. While it may take up to two human generations to see full recovery, there is promise, given human will, to restore many damaged wetlands worldwide.
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Ashish R Jain
2013-01-01
Full Text Available Rehabilitation of a patient with severely worn dentition after restoring the vertical dimension is a complex procedure and assessment of the vertical dimension is an important aspect in these cases. This clinical report describes the full mouth rehabilitation of a patient who was clinically monitored to evaluate the adaptation to a removable occlusal splint to restore vertical dimension for a period 1 month and provisional restorations to determine esthetic and functional outcome for a period of 3 months. It is necessary to recognizing that form follows function and that anterior teeth play a vital role in the maintenance of oral health. Confirmation of tolerance to changes in the vertical dimension of occlusion (VDO is of paramount importance. Articulated study casts and a diagnostic wax-up can provide important information for the evaluation of treatment options. Alteration of the VDO should be conservative and should not be changed without careful consideration.
Gill, Chelsea; Packer, Jan; Ballantyne, Roy
2018-02-06
Attention Restoration Theory is applied to explore the causes and consequences of mental fatigue in clergy and suggest practical interventions to restore cognitive wellbeing. Previous research has investigated the physical and emotional health and wellbeing of clergy, but has largely neglected clergy cognitive wellbeing. Due to the demanding nature of their work, clergy are particularly susceptible to mental fatigue and depletion of their capacity to maintain attention. Symptoms include inability to focus attention, inhibit distractions, make decisions or solve problems. Mental fatigue can be overcome, and cognitive capacity restored, by spending time in restorative environments that allow directed attention to rest.
Infection and microleakage the caused of endodontic failure
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Kurniasri Amas Achiar
2008-03-01
Full Text Available The success of endodontic treatment depends on the quality of endodontic treatment and the final restoration. The mean reason for endodontic treatment failure is usually microleakage. That is why it becomes one of the priorities for dental research to prevent microleakage. Infection during the root canal treatment can be prevented. First, by employing strict aseptic clinical techniques follows by cleaning all bacteria and preoperative necrotic pulp-tissue remnants from the root canal. Irrigants are essential in this phase. The shaping of the canal is also an important prerequisite for endodontic success. Removal of the smear layer can enhance seal ability. Second, obturation of the root canal should leave the tooth in the most biological inert condition possible, and it must prevent reinfection as well as the growth of any microorganisms remaining in the canal. The application of an antibacterial dressing between appointments is absolutely necessary or the root canal has to be obturated at the first appointment in order to deprive the microorganisms of nutrients and space to multiply. The temporary filling must be at least 3.5 mm thick. Failure occurs because of missed canals, iatrogenic events and radicular fractures have to be avoided. At the end, clinicians have to confirm that the root canal is cleaned and hermetically obturated because hermetic root canal filling will prevent the leakage of an irritant to the apical area.
Directory of Open Access Journals (Sweden)
Elvia Christina Barros de Almeida
2008-01-01
Full Text Available Objective: The purpose of this study was to evaluate the periodontal status of interproximal surfaces restored with composite resin, in comparison with non-restored interproximal surfaces. Methods: In 65 patients, we analyzed 145 restored surfaces and 145 non-restored surfaces. Results: Most of the restored surfaces (54.3% showed radiographic alterations, which was shown to be higher among restorations with clinically detected proximal excess (56.8% x 52.8%; with lack of restorative material (64.5% x 51.4%; in restorations with proximal overhang (67.7% x 44.4%; in teeth with gingival inflammation?/bleeding (55.1% x 40.0% and in teeth with probing depth exceeding 3 mm (64.3% x 52.9%. However, there were no significant associations for these variables. Of the non-restored surfaces, 24.4% showed radiographic alterations, however there were no significant associations. Conclusion: The results showed a statistical significance for radiographic alterations in restored and non-restored surfaces.
[Effects of Surgically Treated Pelvic Ring and Acetabular Fractures on Postural Control].
Lang, P; Schnegelberger, A; Riesner, H-J; Stuby, F; Friemert, B; Palm, H-G
2016-04-01
The aim of surgical treatment of pelvic ring and acetabular fractures is to allow rapid mobilisation of patients in order to restore stance and gait stability (postural control), as this significantly correlates with a positive outcome. The regulation of postural stability is mainly controlled by transmission of proprioceptive stimuli. In addition, the pelvis serves as a connection between the legs and the spine and thus is also of great importance for mechanical stabilisation. It remains unclear whether surgical treatment of pelvic ring and acetabular fractures affects the regulation of postural control. Therefore, the aim of this study was to examine the impact of surgically treated pelvic ring and acetabular fractures on postural stability by means of computerised dynamic posturography (CDP) after a mean of 35 months and to compare the results with a healthy control group. A retrospective case control study of 38 patients with surgically treated pelvic ring and acetabular fractures and 38 healthy volunteers was carried out using CDP. The average time of follow-up was 35 (12-78) months. The most important outcome parameter in this investigation was the overall stability index (OSI). Hip joint mobility, the health-related quality of life (SF-12) and pain were supplementary outcome parameters. It was found that surgically treated pelvic ring and acetabular fractures had no influence on postural stability. The OSI was 2.1 ° in the patient group and 1.9 ° in the control group. There was no significant difference between the groups in hip joint mobility. A total of 52 % of patients showed no or only mild pain. Mean health-related quality of life was the same as in the total population. Surgically treated pelvic ring and acetabular fractures do not lead to deterioration in postural control in the mid term. This is of high prognostic importance for rapid mobilisation of the patients. Therefore no increase in the risk of falling is expected after successfully
Eliyas, S; Vere, J; Ali, Z; Harris, I
2014-02-01
Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.
Ecosystem Restoration: Fact or Fancy?
John A. Stanturf; Callie J. Schweitzer; Stephen H. Schoenholtz; James P. Barnett; Charles K. McMahon; Donald J. Tomszak
1998-01-01
Ecological restoration is generally accepted as the reestablishment of natural ecological processes that produce certain dynamic ecosystem properties of structure, function, and processes. But restore to what? The most frequently used conceptual model for the restoration process is the shift of conditions from some current (degraded) dynamic state to some past dynamic...
Ameerudden, Shakil; He, Xianghui
2011-01-01
Parathyroid crisis, also known as a parathyroid storm, is a rare and serious complication of primary hyperparathyroidism. Four cases are reported here in which patients presented to hospital with general complaints due to hypercalcemia secondary to hyperparathyroidism. Blood test results upon admission showed high levels of serum calcium and parathyroid hormone, and medical treatment initiated to lower the calcium level was ineffective. After relevant investigations, each patient underwent surgical exploration of the parathyroid glands, followed by excision of a pathological parathyroid tumor. There was a prompt decrease in parathyroid hormone level immediately after surgery. Histology reports revealed that patients had parathyroid adenoma. All patients recovered after surgery, with serum calcium levels restored back to normal and with resolution of all symptoms of hypercalcemia. This report illustrates how often this disease is initially misdiagnosed, and how prompt appropriate surgical treatment provides the best outcome for the patient.
Oak restoration trials: Santa Catalina Island
Lisa Stratton
2002-01-01
Two restoration trials involving four oak species have been implemented as part of a larger restoration program for Catalina Island. In 1997 the Catalina Island Conservancy began an active program of restoration after 50 years of ranching and farming activities on the island. The restoration program includes removing feral goats and pigs island-wide and converting 80...
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F. Mazhari
2008-06-01
Full Text Available Objective: The aim of the present study was to evaluate fracture resistance of pulpoto-mized primary molar teeth restored with extensive multisurface amalgam restorations.Materials and Methods: Eighty extracted carious human primary molar teeth were se-lected forpresent study. Teeth were divided in to eight groups of ten. Mesio- or disto-occlusal and Mesio-occluso-distal cavities with different cavity wall thickness (1.5 or 2.5mm were prepared in both first and second primary molar teeth. After restoring teeth with amalgam, all specimens were stored in distilled water at 37°C for 7 days. Then samples were thermocycled for 1000 cycles from 5°C to 55°C. The specimens then were subjected to a compressive load in a universal testing machine at a crosshead speed of 0.5 mm min-1. ANOVA and t-test were used for statistical analysis.Results: Mean fracture resistance of first and second molar teeth were 975.5 N (SD=368.8 and 1049.2 N (SD=540.1 respectively. In the first molar group, fracture resis-tance of two-surface cavities was significantly more than three-surface cavities (P<0.001, however this difference was not statistically significant in the second molar group. In both first and second molar group, fracture resistance incavities with 2.5 mm wall thickness, was significantly more than the group with 1.5 mm wall thickness.Conclusion: The mean fracture resistance in pulpotomized primary molar restored with amalgam restorations was higher than reported maximum bite force in primary teeth even in extensive multi-surface restorations. Therefore, the teeth with large proximal carious lesions in schoolchildren could be restored with amalgam.
Bearing restoration by grinding
Hanau, H.; Parker, R. J.; Zaretsky, E. V.; Chen, S. M.; Bull, H. L.
1976-01-01
A joint program was undertaken by the NASA Lewis Research Center and the Army Aviation Systems Command to restore by grinding those rolling-element bearings which are currently being discarded at aircraft engine and transmission overhaul. Three bearing types were selected from the UH-1 helicopter engine (T-53) and transmission for the pilot program. No bearing failures occurred related to the restoration by grinding process. The risk and cost of a bearing restoration by grinding programs was analyzed. A microeconomic impact analysis was performed.
Power system restoration: planning and simulation
Energy Technology Data Exchange (ETDEWEB)
Hazarika, D. [Assam Engineering Coll., Dept. of Electrical Engineering, Assam (India); Sinha, A.K. [Inidan Inst. of Technology, Dept. of Electrical Engineering, Kharagpur (India)
2003-03-01
This paper describes a restoration guidance simulator, which allows power system operator/planner to simulate and plan restoration events in an interactive mode. The simulator provides a list of restoration events according to the priority based on some restoration rules and list of priority loads. It also provides in an interactive mode the list of events, which becomes possible as the system grows during restoration. Further, the selected event is validated through a load flow and other analytical tools to show the consequences of implementing the planned event. (Author)
Mileto, C.; Vegas, F.
2017-05-01
In addition to the technological evolution over the last two centuries, survey has experienced two main conceptual leaps: the introduction of photography as a tool for an indiscriminate register for reality, and the shift from autographic to allographic survey, phenomena which can generate a distancing effect within the restoration process. Besides, this text presents the relationship between survey in its numerous forms and technologies (manual and semi-manual to more complex ones like scanner-laser) and the restoration of the building, either for establishing a diagnosis, operating or valorizating, illustrating it with examples developed by the authors, as well as the criteria to be applied when documenting a building to be restored, irrespective of the means and technology available in each case.
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C. Mileto
2017-05-01
Full Text Available In addition to the technological evolution over the last two centuries, survey has experienced two main conceptual leaps: the introduction of photography as a tool for an indiscriminate register for reality, and the shift from autographic to allographic survey, phenomena which can generate a distancing effect within the restoration process. Besides, this text presents the relationship between survey in its numerous forms and technologies (manual and semi-manual to more complex ones like scanner-laser and the restoration of the building, either for establishing a diagnosis, operating or valorizating, illustrating it with examples developed by the authors, as well as the criteria to be applied when documenting a building to be restored, irrespective of the means and technology available in each case.
Restoration of Gooseberry Creek
Jonathan W. Long
2000-01-01
Grazing exclusion and channel modifications were used to restore wet meadows along a stream on the Fort Apache Indian Reservation. The efforts are reestablishing functional processes to promote long-term restoration of wetland health and species conservation.
Dental plaque as a biofilm - a risk in oral cavity and methods to prevent
Renata Chałas; Ilona Wójcik-Chęcińska; Michał J. Woźniak; Justyna Grzonka; Wojciech Święszkowski; Krzysztof J. Kurzydłowski
2015-01-01
Bacteria living constantly in the oral cavity are in the form of a biofilm. The biofilm formed on a solid base such as the enamel of the teeth, fillings, restorations, orthodontic appliances or obturators is dental plaque. Disturbance of homeostasis of biofilm, excessive growth or increase in the number of acid-forming bacteria leads to the development of the most common diseases of the oral cavity, i.e. dental caries and periodontal disease. The presence of bacterial biofilm on the walls of ...
Noll, Douglas E.; Harvey, Linda
2008-01-01
This article will present the restorative justice model and examine how the restorative justice philosophy and process can be applied to clergy-perpetrated sexual abuse and religious sexual misconduct to resolve legal claims and allow the process of healing to begin. Restorative justice is a holistic approach to criminal, civil, and church law…
Economic barriers and incentives for biodiversity restoration
International Nuclear Information System (INIS)
Garcia Frapolli, Eduardo; Lindigcisneros, Roberto
2011-01-01
Costs related with restoration efforts, as well as the economic incentives, are fundamental issues that have not been fully considered from a formal standpoint. Through the analysis of restoration trials in collaboration with an indigenous community in western Mexico, we analyzed economic issues related with the restoration trials themselves, and with the economic context that gives incentives for ecological restoration. We reach to the conclusion that the cost-benefit relationship of the restoration process by itself can be straightforward calculated in some cases, calculating economic benefits accrued from the diversity restored to ecosystem is more difficult. In terms of the incentives for biodiversity restoration, we concluded that in many cases, economic variables out of the control of those involved in restoration are determinant.
Skjern River Restoration Counterfactual
DEFF Research Database (Denmark)
Clemmensen, Thomas Juel
2014-01-01
In 2003 the Skjern River Restoration Project in Denmark was awarded the prestigious Europa Nostra Prize for ‘conserving the European cultural heritage’ (Danish Nature Agency 2005). In this case, however, it seems that the conservation of one cultural heritage came at the expense of another cultural...... this massive reconstruction work, which involved moving more than 2,7 million cubic meters of earth, cause a lot of ‘dissonance’ among the local population, the resulting ‘nature’ and its dynamic processes are also constantly compromising the preferred image of the restored landscape (Clemmensen 2014......). The presentation offers insight into an on-going research and development project - Skjern River Restoration Counterfactual, which question existing trends and logics within nature restoration. The project explores how the Skjern River Delta could have been ‘restored’ with a greater sensibility for its cultural...
Mobile surgical skills education unit: a new concept in surgical training.
Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar
2011-08-01
Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.
The science and practice of river restoration
Wohl, Ellen; Lane, Stuart N.; Wilcox, Andrew C.
2015-08-01
River restoration is one of the most prominent areas of applied water-resources science. From an initial focus on enhancing fish habitat or river appearance, primarily through structural modification of channel form, restoration has expanded to incorporate a wide variety of management activities designed to enhance river process and form. Restoration is conducted on headwater streams, large lowland rivers, and entire river networks in urban, agricultural, and less intensively human-altered environments. We critically examine how contemporary practitioners approach river restoration and challenges for implementing restoration, which include clearly identified objectives, holistic understanding of rivers as ecosystems, and the role of restoration as a social process. We also examine challenges for scientific understanding in river restoration. These include: how physical complexity supports biogeochemical function, stream metabolism, and stream ecosystem productivity; characterizing response curves of different river components; understanding sediment dynamics; and increasing appreciation of the importance of incorporating climate change considerations and resiliency into restoration planning. Finally, we examine changes in river restoration within the past decade, such as increasing use of stream mitigation banking; development of new tools and technologies; different types of process-based restoration; growing recognition of the importance of biological-physical feedbacks in rivers; increasing expectations of water quality improvements from restoration; and more effective communication between practitioners and river scientists.
Review of Surgical Techniques of Experimental Renal Transplantation in Rats.
Shrestha, Badri; Haylor, John
2017-08-01
Microvascular surgical techniques of renal transplant in rats have evolved over the past 5 decades to achieve successful rat renal transplant; these modifications have included surgical techniques to address the anatomic variations in the renal blood vessels and those to reduce ischemic and operation durations. Here, we review the surgical techniques of renal transplant in rats and evaluate the advantages and disadvantages of individual techniques of vascular and ureteric anastomoses. For this review, we performed a systematic literature search using relevant medical subject heading terms and included appropriate publications in the review. Since the first description of a rat model of renal transplant by Bernard Fisher and his colleagues in 1965, which used end-to-side anastomosis between the renal vein and renal artery to the recipient inferior vena cava and aorta, several vascular and ureteric anastomosis techniques have been modified. Vascular anastomosis techniques now include end-to-end anastomosis, use of donor aortic and inferior vena cava conduits, sleeve and cuff anastomoses, and application of fibrin glue. Likewise, restoration of the urinary tract can now be achieved by direct anastomosis of the donor ureter to the recipient bladder, end-to-end anastomosis between the donor and recipient ureters, and donor bladder cuff to the recipient bladder. There are advantages and disadvantages attributable to individual techniques. The range of vascular and ureteric anastomosis techniques that has emerged reflects the need for mastering more than one technique to suit the vascular anatomy of individual animals and to reduce operating time for achieving successful outcomes after renal transplant.
Ecological restoration: Biodiversity and conservation
International Nuclear Information System (INIS)
Vargas Rios, Orlando
2011-01-01
In this essay the principal concepts and methods applied on projects aimed at ecological restoration are reviewed, with emphasis on the relationship between conservation, biodiversity and restoration. The most common definitions are provided and the steps to take into account to develop projects on ecological restoration, which will be determined by the level of degradation of the ecosystem to be intervened.
TVT ABBREVO: cadaveric study of tape position in foramen obturatum and adductor region.
Hubka, Petr; Nanka, Ondrej; Masata, Jaromir; Martan, Alois; Svabik, Kamil
2016-07-01
The aim of the study was to describe fixation of the TVT ABBREVO and establish whether the tape penetrates through obturator muscles and membrane (obturator complex) into the adductor region and, if so, how far it penetrates. Eight formalin-embalmed female cadavers were used to simulate TVT ABBREVO surgery (totalling 16 insertions). Following tape insertion, dissection was performed and ends of the tape were identified. In cases of penetration, the length of tape penetrating into the adductor region was measured. Of the 16 cases, the tape ended in the obturator membrane in eight, in the internal obturator muscle in one, and penetrated through the obturator membrane into the external obturator muscle in five, where it remained. In two cases, it penetrated through the obturator internus muscle, obturator membrane and obturator externus muscle into the group of thigh adductors; one penetration was by 3 mm and the second by 10 mm. No contact with the obturator nerve or its branches was noted in any case. No TVT contact with the obturator nerve was noted; tape penetrated into the adductor region in two of the 16 cases.
Directory of Open Access Journals (Sweden)
Xiangyang Yu
2014-01-01
Full Text Available Intestinal obstruction is a common disease requiring abdominal surgery with significant morbidity and mortality. Currently, an effective medical treatment for obstruction, other than surgical resection or decompression, does not exist. Si-Jun-Zi Decoction is a famous Chinese medicine used to replenish qi and invigorate the functions of the spleen. Modern pharmacological studies show that this prescription can improve gastrointestinal function and strengthen immune function. In this study, we investigated the effects of a famous Chinese herbal formula, Si-Jun-Zi Decoction, on the restoration of intestinal function after the relief of obstruction in a rabbit model. We found that Si-Jun-Zi Decoction could reduce intestinal mucosal injury while promoting the recovery of the small intestine. Further, Si-Jun-Zi Decoction could regulate the intestinal immune system. Our results suggest that Si-Jun-Zi Decoction promotes the restoration of intestinal function after obstruction by regulating intestinal homeostasis. Our observations indicate that Si-Jun-Zi Decoction is potentially a therapeutic drug for intestinal obstruction.
Surgical crown lengthening: a 12-month study - radiographic results
Directory of Open Access Journals (Sweden)
Daniela Eleutério Diniz
2007-08-01
Full Text Available OBJECTIVE: The purpose of this study was to perform a radiographic follow-up evaluation after a 12-month healing period, following crown lengthening surgery. MATERIAL AND METHODS: Twenty-three periodontally healthy subjects (mean age 32.5 years that required crown lengthening surgery in premolars were recruited. In a total of 30 premolars, full thickness flaps, osseous resection, and flap suturing were performed. The restorative margin was defined in the pre-surgical phase and maintained unaltered during the healing period, serving as a reference point. Standardized bitewing radiographs were taken before and after osseous reduction, and at 2, 3, 6, and 12-month healing periods. RESULTS: Intact lamina dura was observed at both mesial and distal alveolar crests only from the 3rd month. At 12-months, all alveolar crests presented lamina dura. The overall mean distance from the restorative margin to the alveolar crest achieved after osseous resection was 3.28±0.87 mm at mesial and 2.81±0.51 mm at distal sites. No significant radiographic changes in the bone crest were observed during a 12-month healing period. CONCLUSION: The findings of this study suggest that the radiographic proximal bone level observed on bitewing radiographs following crown lengthening surgery can be used as a reference to predict the future level of the healed alveolar crest.
Cercadillo-Ibarguren, Iñaki; Sánchez-Torres, Alba; Figueiredo, Rui; Valmaseda-Castellón, Eduard
To describe the clinical outcomes and complications related to provisional prostheses after full-arch implant-supported rehabilitation by means of an immediate loading protocol. This retrospective cohort study included patients who were consecutively treated with full-arch implant-supported restorations with a minimum of four implants (Replace Select Tapered TiUnite, Nobel Biocare AB) per arch and conical abutments (multi-unit, Nobel Biocare AB) by means of an immediate loading protocol. The surgical procedures were performed between May 2006 and June 2014 by a single oral surgeon. Demographic, surgical, and prosthetic variables were collected, and biologic and mechanical complications were registered. A total of 61 maxillae (57%) and 46 mandibles (43%) were treated in 88 patients (40 men and 48 women) with a mean age of 62.4 years. A total of 558 implants were placed, 295 in postextraction sockets. A total of 331 implants (59.3%) were placed in the maxilla and 227 (40.7%) in the mandible. Within a 9-month period, 18 prostheses (16.8%) fractured (15 maxillary and 3 mandibular); in nine of these patients the opposing dentition was a full-arch, implant-supported restoration, and in the remaining nine patients, it was natural dentition. Six (1.1%) maxillary and three (0.5%) mandibular implants failed. A high implant survival rate is expected in the short term following this immediate loading protocol. Fracture of the provisional prosthesis is a common finding, affecting 17% of patients, and is significantly more prevalent in patients with bruxism and in maxillary prostheses.
Optical properties of composite restorations influenced by dissimilar dentin restoratives.
Marjanovic, Jovana; Veljovic, Djordje N; Stasic, Jovana N; Savic-Stankovic, Tatjana; Trifkovic, Branka; Miletic, Vesna
2018-05-01
To evaluate optical properties (color and translucency) of 'sandwich' restorations of resin-based composites and esthetically unfavorable dentin restoratives. Cylindrical 'dentin' specimens (8mm in diameter and 2mm thick, N=5/group) were prepared using EverX Posterior (GC), Biodentine (Septodont), experimental hydroxyapatite (HAP) or conventional composites (Gradia Direct Posterior, GC; Filtek Z250 and Filtek Z500, 3M ESPE). Capping 'enamel' layers were prepared using composites (Gradia Direct Posterior, Filtek Z250 or Z550) of A1 or A3 shade and the following thickness: 0.6, 1 or 2mm. Color (ΔE) and translucency parameter (TP) were determined using a spectrophotometer (VITA Easyshade Advance 4.0, VITA Zahnfabrik). Data were statistically analyzed using analysis of variance with Tukey's post-hoc tests (α=0.05). TP was greatly affected by layer thickness, whilst ΔE depended on shade and layer thickness of the capping composite. HAP and Biodentine showed significantly lower TP and higher ΔE (deviation from 'ideal white') than composites (p<0.05). Greater TP was seen in EverX_composite groups than in corresponding control groups of the same shade and thickness. TP of composites combined with Biodentine or HAP was below 2, lower than the corresponding control groups (p<0.05). Within-group differences of ΔE were greatest in HAP_composite groups. EverX_Gradia and EverX_FiltekZ250 combinations showed the most comparable ΔE with the control groups. A 2mm thick layer of composite covering dentin restoratives with unfavorable esthetics is recommended for a final 'sandwich' restoration that is esthetically comparable to a conventional, mono-composite control restoration. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.
Output control of da Vinci surgical system's surgical graspers.
Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar
2014-01-01
The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.
Directory of Open Access Journals (Sweden)
Viviane de Carvalho-Teles
2006-12-01
Full Text Available Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well.The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years, who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6% significantly improved their speech intelligibility, and 16 patients (69.9% exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy.A maioria dos pacientes submetidos a ressecções de maxila apresenta alterações nas funções de fala e de deglutição. O acoplamento das cavidades oral e nasal resulta em hipernasalidade de graus variados e no comprometimento da inteligibilidade de fala. A reabilitação protética tem como objetivo separar as cavidades oral e nasal podendo reduzir as alterações de ordem estética, funcional e ainda melhorar o ajustamento social deste paciente. Este trabalho teve como objetivo avaliar a eficácia da pr
Shame and Guilt in Restorative Justice
DEFF Research Database (Denmark)
Rodogno, Raffaele
2008-01-01
In this article, I examine the relevance and desirability of shame and guilt to restorative justice conferences. I argue that a careful study of the psychology of shame and guilt reveals that both emotions possess traits that can be desirable and traits that can be undesirable for restoration. More...... in particular, having presented the aims of restorative justice, the importance of face-to-face conferences in reaching these aims, the emotional dynamics that take place within such conferences, and the relevant parts of the empirical psychology of shame and guilt, I argue that restorative justice...... practitioners have to take account of a rather more complex picture than it had hitherto been thought. Restorative conferences are not simply about "shame management," though practitioners must certainly avoid shaming and humiliation. Given the nature of shame, guilt, and restorative conferences...
Canevello, Carola; Laffi, Nicola
2014-01-01
Introduction. “Dens invaginatus” is a dental anomaly which originates from the invagination of the ameloblastic epithelium into the lingual surface of the dental crown during the odontogenesis. It can cause early pulpal necrosis, abscesses, retention or dislocation of contiguous elements, cysts, and internal resorptions. It normally affects the upper lateral incisors. In the following study the authors will discuss the etiology, the physiopathology, and the surgical-orthodontic management of a rare case of impacted canine associated with dens invaginatus and follicular cyst, with the aim of highlighting the importance of taking any therapeutic decision based on the data available in the literature. Case Report. The present study describes a combined surgical-orthodontic treatment of an impacted canine associated with a lateral incisor (2.2) suffering from type III dens invaginatus with radicular cyst, in a 15-year-old patient. Discussion. When treating a dens invaginatus there are different therapeutic solutions: they depend on the gravity of the anomaly and on the association with the retention of a permanent tooth. The aesthetic and functional restoration becomes extremely important when performing a surgical-orthodontic repositioning. PMID:24963421
Wichmann, Thomas; DeLong, Mahlon R
2016-04-01
Deep brain stimulation (DBS) is highly effective for both hypo- and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal ganglia-thalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.
Morandi, Bertrand; Piégay, Hervé; Lamouroux, Nicolas; Vaudor, Lise
2014-05-01
Since the 1990s, French operational managers and scientists have been involved in the environmental restoration of rivers. The European Water Framework Directive (2000) highlights the need for feedback from restoration projects and for evidence-based evaluation of success. Based on 44 French pilot projects that included such an evaluation, the present study includes: 1) an introduction to restoration projects based on their general characteristics 2) a description of evaluation strategies and authorities in charge of their implementation, and 3) a focus on the evaluation of results and the links between these results and evaluation strategies. The results show that: 1) the quality of an evaluation strategy often remains too poor to understand well the link between a restoration project and ecological changes; 2) in many cases, the conclusions drawn are contradictory, making it difficult to determine the success or failure of a restoration project; and 3) the projects with the poorest evaluation strategies generally have the most positive conclusions about the effects of restoration. Recommendations are that evaluation strategies should be designed early in the project planning process and be based on clearly-defined objectives. Copyright © 2014 Elsevier Ltd. All rights reserved.
Picciolo, G L; Stocum, D L
2001-01-01
Everybody hopes for better health and restoration of impaired bodily function, and now that hope is illuminated by the promise of powerful biological tools that make human cells grow and replace human tissue. ASTM Committee F04 on Medical and Surgical Materials and Devices is taking the lead by defining some of those tools as standards that can be used for the development, production, testing, and regulatory approval of medical products.
RESEARCH NEEDS IN RIPARIAN BUFFER RESTORATION
Riparian buffer restorations are used as management tools to produce favorable water quality impacts; moreover, the basis for riparian buffers as an instrument of water quality restoration rests on a relatively firm foundation. However, the extent to which buffers can restore rip...
The state-of-the-art of ART restorations.
Frencken, Jo E
2014-04-01
ART is less anxiety- and pain-provoking than traditional restorative treatments; administration of local anaesthesia is rarely required. Systematic reviews have provided evidence of the high level of effectiveness of high-viscosity glass-ionomer ART restoration in restoring single-surface cavities, both in primary and permanent posterior teeth, but its survival rates in restoring multiple-surface cavities in primary posterior teeth needs to be improved. Insufficient information is available regarding the survival rates of multiple-surface ART restorations in permanent teeth. Evidence from these reviews indicates no difference in the survival rates of single-surface high-viscosity glass-ionomer ART restorations and amalgam restorations in primary and permanent posterior teeth. Where indicated, high-viscosity glass-ionomer ART restorations can be used alongside traditional restorations. ART provides a much more acceptable introduction to dental restorative care than the traditional 'injection, drill and fill'.
Impact of stream restoration on flood waves
Sholtes, J.; Doyle, M.
2008-12-01
Restoration of channelized or incised streams has the potential to reduce downstream flooding via storing and dissipating the energy of flood waves. Restoration design elements such as restoring meanders, reducing slope, restoring floodplain connectivity, re-introducing in-channel woody debris, and re-vegetating banks and the floodplain have the capacity to attenuate flood waves via energy dissipation and channel and floodplain storage. Flood discharge hydrographs measured up and downstream of several restored reaches of varying stream order and located in both urban and rural catchments are coupled with direct measurements of stream roughness at various stages to directly measure changes to peak discharge, flood wave celerity, and dispersion. A one-dimensional unsteady flow routing model, HEC-RAS, is calibrated and used to compare attenuation characteristics between pre and post restoration conditions. Modeled sensitivity results indicate that a restoration project placed on a smaller order stream demonstrates the highest relative reduction in peak discharge of routed flood waves compared to one of equal length on a higher order stream. Reductions in bed slope, extensions in channel length, and increases in channel and floodplain roughness follow restoration placement with the watershed in relative importance. By better understanding how design, scale, and location of restored reaches within a catchment hydraulically impact flood flows, this study contributes both to restoration design and site decision making. It also quantifies the effect of reach scale stream restoration on flood wave attenuation.
Surgical rehabilitation of patients with spinal neurotrophic decubitus
Directory of Open Access Journals (Sweden)
S. G. Shapovalov
2016-01-01
Full Text Available The greatest weight neurodystrophic process develops in traumatic spinal cord injury, appears as neurotrophic decubitus (bedsores. There is a high risk of wound infection in the event of pressure ulcers. Surgical repair of the skin integrity in spinal patients of 3 and 4 grade is a basic prerequisite for the further complex of the rehabilitation measures. Work objective: to develop the concept of innovative technologies of treatment of local physical impacts and to implement it in surgical system of rehabilitation of patients with spinal cord lesion with neurotrophic decubitus of 3 and 4 grade. Clinical studies subjected 49 (100% patients with spinal cord lesions and neurotrophic decubitus of 3 and 4 grade. All patients were divided into two groups: 1– (study group 1 29 patients; 2 – (control group 2 20 patients. The managed negative pressure system S042 NPWT VivanoTec (Hartmann, a method of ultrasonic cavitation (Sonoca%180, the system for the hydro surgery Versajet Smith and Nephew were used in the 1%st group. Traditional dressings for the preparation of a plastic closure of the wound defect neurotrophic decubitus of the grade 3%4 were used in the 2nd group. Statistical analysis was performed using package of Microsoft Excel%97 Statistica for Windows 6.0, SPSS 10.0 for Windows. The study showed that the use of complex methods of vacuum therapy, ultrasound cavitation and hydro surgical in the 1st group significantly reduces the duration of treatment compared with conservative methods in the 2nd group. In group 1, the mean duration of treatment was 19.9±13.9 days, in group 2 (comparison group – 40.0±28.2 days (p<0.05. The usage of physical methods (managed negative pressure system, ultrasonic processing method, hydro surgical system local treatment is a highly effective method of preparation neurotrophic decubitus grade 3 and 4 to the early recovery of the skin. Physical methods of local treatment have a positive effect on tissue
30 CFR 874.14 - Water supply restoration.
2010-07-01
... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Water supply restoration. 874.14 Section 874.14... ABANDONED MINE LAND RECLAMATION GENERAL RECLAMATION REQUIREMENTS § 874.14 Water supply restoration. (a) Any... supply restoration projects. For purposes of this section, “water supply restoration projects” are those...
Atraumatic restorative treatment in atypical cavities
Directory of Open Access Journals (Sweden)
Letícia Simino Carvalho
2009-10-01
Full Text Available The atraumatic restorative treatment has been widely divulged among professionals in the area of Pediatric Dentistry. This restorative technique is included in the philosophy of Minimal Intervention and is considered one of the most conservative treatments, because only the layer of infected dentin caries is removed. Moreover, the atraumatic restorative treatment has been shown to be less painful than conventional approaches, and local anesthesia is rarely required. After the removal of the infected dentin, the cavities are filled with glass ionomer cement, a material that has antimicrobial capacity, good marginal sealing and constant fluorine release and recharge. In spite of the increasing number of studies about atraumatic restorative treatment, only studies related to restorations in occlusal cavities have shown scientific evidences about the technique. The aim of this study was to evaluate the feasibility of atraumatic restorative treatment in cavities with 3 or more surfaces involved, by means of a clinical case report of a patient with extensive dstruction in primary teeth, who was submitted to atraumatic restorative treatment, and observe the result of the treatment after one year of clinical and radiographic control.
The RESTORE program of restorative justice for sex crimes: vision, process, and outcomes.
Koss, Mary P
2014-06-01
The article reports empirical evaluation of RESTORE, a restorative justice (RJ) conferencing program adapted to prosecutor-referred adult misdemeanor and felony sexual assaults. RESTORE conferences included voluntary enrollment, preparation, and a face-to-face meeting where primary and secondary victims voice impacts, and responsible persons acknowledge their acts and together develop a re-dress plan that is supervised for 1 year. Process data included referral and consent rates, participant characteristics, observational ratings of conferences compared with program design, services delivered, and safety monitoring. Outcome evaluation used 22 cases to assess (a) pre-post reasons for choosing RESTORE, (b) preparation and conference experiences, (c) overall program and justice satisfaction, and (d) completion rates. This is the first peer-reviewed quantitative evaluation of RJ conferencing for adult sexual assault. Although the data have limitations, the results support cautious optimism regarding feasibility, safety, and satisfactory outcomes. They help envision how conferencing could expand and individualize justice options for sexual assault.
Energy Technology Data Exchange (ETDEWEB)
Jones, A K; Chamley, M E
1986-10-01
Many excavated quarries are subsequently used for waste disposal operations and frequently imported landfill provides the only means of restoring a former quarry to some beneficial afteruse. Concentrating solely on the final surface cover, this paper sets out some of the principles, which should be considered by those involved in landfill operations to ensure the long term success of restoration schemes. With the emphasis on restoration to agriculture, factors such as availability of cover materials and depths necessary are discussed in terms of requirements to support plant growth, protect clay capping layers and prevent damage to agricultural implements. Soil handling and appropriate after care management are considered. 4 refs.
Hartman, Brett D; Cleveland, David A
2018-03-01
Restoration ecology holds promise for addressing land degradation in impoverished rural environments, provided the approach is adapted to rural development settings. While there is a need for increased integration of social dynamics in land restoration, few systematic studies exist. We explored the socioeconomic factors that influence restoration management, including local motives and perceived benefits, incentives, land tenancy, institutional factors, conflict resolution, accessibility, off-farm labor, and outmigration. The study area is a successful watershed rehabilitation and wet meadow restoration project in the Bolivian Andes that began in 1992. We used household survey methods (n = 237) to compare the communities that had conducted the most restoration management with those that had conducted the least. Results suggest that several factors facilitate investments in land restoration, including aligning restoration objectives with local motives and perceived benefits, ensuring incentives are in place to stimulate long-term investments, conflict resolution, private land tenancy, and accessibility. However, higher levels of organization and active leadership can facilitate land restoration on communal lands. Increased livelihood benefits from land restoration helped slow the rate of rural to urban migration, with 24.5% outmigration in the highest restoration management communities compared to 62.1% in the lowest restoration management communities. Results suggest that land restoration projects that integrate community development into project planning and implementation will achieve greater success. Copyright © 2017 Elsevier Ltd. All rights reserved.
Restorative Justice as Strength-Based Accountability
Ball, Robert
2003-01-01
This article compares strength-based and restorative justice philosophies for young people and their families. Restorative justice provides ways to respond to crime and harm that establish accountability while seeking to reconcile members of a community. Restorative approaches are an important subset of strength-based interventions.
Process to identify and evaluate restoration options
International Nuclear Information System (INIS)
Strand, J.; Senner, S.; Weiner, A.; Rabinowitch, S.; Brodersen, M.; Rice, K.; Klinge, K.; MacMullin, S.; Yender, R.; Thompson, R.
1993-01-01
The restoration planning process has yielded a number of possible alternatives for restoring resources and services injured by the Exxon Valdez oil spill. They were developed by resource managers, scientists, and the public, taking into consideration the results of damage assessment and restoration studies and information from the scientific literature. The alternatives thus far identified include no action natural recovery, management of human uses, manipulation of resources, habitat protection and acquisition, acquisition of equivalent resources, and combinations of the above. Each alternative consists of a different mix of resource- or service-specific restoration options. To decide whether it was appropriate to spend restoration funds on a particular resource or service, first criteria had to be developed that evaluated available evidence for consequential injury and the adequacy and rate of natural recovery. Then, recognizing the range of effective restoration options, a second set of criteria was applied to determine which restoration options were the most beneficial. These criteria included technical feasibility, potential to improve the rate or degree of recovery, the relationship of expected costs to benefits, cost effectiveness, and the potential to restore the ecosystem as a whole. The restoration options considered to be most beneficial will be grouped together in several or more of the above alternatives and presented in a draft restoration plan. They will be further evaluated in a companion draft environmental impact statement
Directory of Open Access Journals (Sweden)
Yiliang Zeng
Full Text Available Due to the rapid development of motor vehicle Driver Assistance Systems (DAS, the safety problems associated with automatic driving have become a hot issue in Intelligent Transportation. The traffic sign is one of the most important tools used to reinforce traffic rules. However, traffic sign image degradation based on computer vision is unavoidable during the vehicle movement process. In order to quickly and accurately recognize traffic signs in motion-blurred images in DAS, a new image restoration algorithm based on border deformation detection in the spatial domain is proposed in this paper. The border of a traffic sign is extracted using color information, and then the width of the border is measured in all directions. According to the width measured and the corresponding direction, both the motion direction and scale of the image can be confirmed, and this information can be used to restore the motion-blurred image. Finally, a gray mean grads (GMG ratio is presented to evaluate the image restoration quality. Compared to the traditional restoration approach which is based on the blind deconvolution method and Lucy-Richardson method, our method can greatly restore motion blurred images and improve the correct recognition rate. Our experiments show that the proposed method is able to restore traffic sign information accurately and efficiently.
Open surgical simulation--a review.
Davies, Jennifer; Khatib, Manaf; Bello, Fernando
2013-01-01
Surgical simulation has benefited from a surge in interest over the last decade as a result of the increasing need for a change in the traditional apprentice model of teaching surgery. However, despite the recent interest in surgical simulation as an adjunct to surgical training, most of the literature focuses on laparoscopic, endovascular, and endoscopic surgical simulation with very few studies scrutinizing open surgical simulation and its benefit to surgical trainees. The aim of this review is to summarize the current standard of available open surgical simulators and to review the literature on the benefits of open surgical simulation. Open surgical simulators currently used include live animals, cadavers, bench models, virtual reality, and software-based computer simulators. In the current literature, there are 18 different studies (including 6 randomized controlled trials and 12 cohort studies) investigating the efficacy of open surgical simulation using live animal, bench, and cadaveric models in many surgical specialties including general, cardiac, trauma, vascular, urologic, and gynecologic surgery. The current open surgical simulation studies show, in general, a significant benefit of open surgical simulation in developing the surgical skills of surgical trainees. However, these studies have their limitations including a low number of participants, variable assessment standards, and a focus on short-term results often with no follow-up assessment. The skills needed for open surgical procedures are the essential basis that a surgical trainee needs to grasp before attempting more technical procedures such as laparoscopic procedures. In this current climate of medical practice with reduced hours of surgical exposure for trainees and where the patient's safety and outcome is key, open surgical simulation is a promising adjunct to modern surgical training, filling the void between surgeons being trained in a technique and a surgeon achieving fluency in that
Restoration in multi-domain GMPLS-based networks
DEFF Research Database (Denmark)
Manolova, Anna; Ruepp, Sarah Renée; Dittmann, Lars
2011-01-01
In this paper, we evaluate the efficiency of using restoration mechanisms in a dynamic multi-domain GMPLS network. Major challenges and solutions are introduced and two well-known restoration schemes (End-to-End and Local-to-End) are evaluated. Additionally, new restoration mechanisms are introdu......In this paper, we evaluate the efficiency of using restoration mechanisms in a dynamic multi-domain GMPLS network. Major challenges and solutions are introduced and two well-known restoration schemes (End-to-End and Local-to-End) are evaluated. Additionally, new restoration mechanisms...... are introduced: one based on the position of a failed link, called Location-Based, and another based on minimizing the additional resources consumed during restoration, called Shortest-New. A complete set of simulations in different network scenarios show where each mechanism is more efficient in terms, such as...
Basic research for environmental restoration
International Nuclear Information System (INIS)
1990-12-01
The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs
Basic research for environmental restoration
Energy Technology Data Exchange (ETDEWEB)
1990-12-01
The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs.
Techniques of forest restoration in restingas
Directory of Open Access Journals (Sweden)
Liliane Garcia da Silva Morais Rodrigues
2016-03-01
Full Text Available Restinga is an ecosystem of the Atlantic Forest Biome vegetation which has ecological functions and is undergoing anthropogenic occupations that result in the disturbance and its suppression of these environments. But to be the restoration of degraded restinga is necessary to know the different formations of the ecosystem and their respective characteristics. From this diagnosis, one can choose the most appropriate techniques to apply for its restoration. Thus, this study aims to conduct a literature on restoration techniques in restinga environments. It was found that forest restoration on restinga, in most cases there is use of natural regeneration techniques nucleation, and these studies highlight the successional advances and establishments of life forms preserved features of the area, thus making the restoration in these environments.
Anxiety in veterinary surgical students
DEFF Research Database (Denmark)
Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff
2012-01-01
The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...
Agarwal, Rahul; Sarma, Sridevi V
2010-01-01
Deep brain stimulation (DBS) injects a high frequency current that effectively disables the diseased basal ganglia (BG) circuit in Parkinson's disease (PD) patients, leading to a reversal of motor symptoms. Though therapeutic, high frequency stimulation consumes significant power forcing frequent surgical battery replacements and causing widespread influence into other brain areas which may lead to adverse side effects. In this paper, we conducted a rigorous study to assess whether low frequency signals can restore behavior in PD patients by restoring neural activity in the BG to the normal state. We used a biophysical-based model of BG nuclei and motor thalamus whose parameters can be set to simulate the normal state and the PD state with and without DBS. We administered pulse train DBS waveforms to the subthalamic nucleus (STN) with frequencies ranging from 1-150Hz. For each DBS frequency, we computed statistics on the simulated neural activity to assess whether it is restored to the normal state. In particular, we searched for DBS waveforms that suppress pathological bursting, oscillations, correlations and synchronization prevalent in the PD state and that enable thalamic cells to relay cortical inputs reliably. We found that none of the tested waveforms restores neural activity to the normal state. However, our simulations led us to construct a novel DBS strategy involving low frequency multi-input phaseshifted DBS to be administered into the STN. This strategy successfully suppressed all pathological symptoms in the BG in addition to enabling thalamic cells to relay cortical inputs reliably.
The Virtual Surgical Pelvis : Anatomy Visualization for Education and Surgical Planning
Smit, N.N.
2016-01-01
This thesis deals with visualizing anatomical data for medical education and surgical planning purposes. To this end, we have developed a detailed virtual atlas, the Virtual Surgical Pelvis (VSP),which unifies surgically relevant knowledge on pelvic anatomy. We provide methods to share the knowledge
Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal
Nikola Džakula; Josip Kranjčić; Denis Vojvodić
2016-01-01
The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The tw...
Deriving DICOM surgical extensions from surgical workflows
Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.
2007-03-01
The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.
The cost and feasibility of marine coastal restoration.
Bayraktarov, Elisa; Saunders, Megan I; Abdullah, Sabah; Mills, Morena; Beher, Jutta; Possingham, Hugh P; Mumby, Peter J; Lovelock, Catherine E
2016-06-01
Land-use change in the coastal zone has led to worldwide degradation of marine coastal ecosystems and a loss of the goods and services they provide. Restoration is the process of assisting the recovery of an ecosystem that has been degraded, damaged, or destroyed and is critical for habitats where natural recovery is hindered. Uncertainties about restoration cost and feasibility can impede decisions on whether, what, how, where, and how much to restore. Here, we perform a synthesis of 235 studies with 954 observations from restoration or rehabilitation projects of coral reefs, seagrass, mangroves, salt-marshes, and oyster reefs worldwide, and evaluate cost, survival of restored organisms, project duration, area, and techniques applied. Findings showed that while the median and average reported costs for restoration of one hectare of marine coastal habitat were around US$80000 (2010) and US$1600000 (2010), respectively, the real total costs (median) are likely to be two to four times higher. Coral reefs and seagrass were among the most expensive ecosystems to restore. Mangrove restoration projects were typically the largest and the least expensive per hectare. Most marine coastal restoration projects were conducted in Australia, Europe, and USA, while total restoration costs were significantly (up to 30 times) cheaper in countries with developing economies. Community- or volunteer-based marine restoration projects usually have lower costs. Median survival of restored marine and coastal organisms, often assessed only within the first one to two years after restoration, was highest for saltmarshes (64.8%) and coral reefs (64.5%) and lowest for seagrass (38.0%). However, success rates reported in the scientific literature could be biased towards publishing successes rather than failures. The majority of restoration projects were short-lived and seldom reported monitoring costs. Restoration success depended primarily on the ecosystem, site selection, and techniques
7 CFR 1410.10 - Restoration of wetlands.
2010-01-01
... 7 Agriculture 10 2010-01-01 2010-01-01 false Restoration of wetlands. 1410.10 Section 1410.10... Restoration of wetlands. (a) An owner or operator who entered into a CRP contract on land that is suitable for restoration to wetlands or that was restored to wetlands while under such contract, may, if approved by CCC...
Forest restoration, biodiversity and ecosystem functioning
2011-01-01
Globally, forests cover nearly one third of the land area and they contain over 80% of terrestrial biodiversity. Both the extent and quality of forest habitat continue to decrease and the associated loss of biodiversity jeopardizes forest ecosystem functioning and the ability of forests to provide ecosystem services. In the light of the increasing population pressure, it is of major importance not only to conserve, but also to restore forest ecosystems. Ecological restoration has recently started to adopt insights from the biodiversity-ecosystem functioning (BEF) perspective. Central is the focus on restoring the relation between biodiversity and ecosystem functioning. Here we provide an overview of important considerations related to forest restoration that can be inferred from this BEF-perspective. Restoring multiple forest functions requires multiple species. It is highly unlikely that species-poor plantations, which may be optimal for above-ground biomass production, will outperform species diverse assemblages for a combination of functions, including overall carbon storage and control over water and nutrient flows. Restoring stable forest functions also requires multiple species. In particular in the light of global climatic change scenarios, which predict more frequent extreme disturbances and climatic events, it is important to incorporate insights from the relation between biodiversity and stability of ecosystem functioning into forest restoration projects. Rather than focussing on species per se, focussing on functional diversity of tree species assemblages seems appropriate when selecting tree species for restoration. Finally, also plant genetic diversity and above - below-ground linkages should be considered during the restoration process, as these likely have prominent but until now poorly understood effects at the level of the ecosystem. The BEF-approach provides a useful framework to evaluate forest restoration in an ecosystem functioning context, but
Soft and Hard Tissue Management in Implant Therapy—Part I: Surgical Concepts
Directory of Open Access Journals (Sweden)
Antonio D'Addona
2012-01-01
Full Text Available Implant therapy has become a reliable and predictable treatment alternative for the replacement of missing teeth with conventional removable and fixed partial dentures. Recently though, in the pursuit for improved esthetics, the literature has dedicated a considerable amount of its research on the successful maintenance and regeneration of the surrounding gingiva and bone, which are lost following extraction of a tooth. Thoroughly analyzing the anatomic situation and well-planned treatment has become a requirement, because incorrectly planned and positioned implants may jeopardize long-term esthetic and functional prognosis. In addition, many types of biocompatible materials, autogenous hard and soft tissue grafts, and different surgical techniques have been developed, and their viability has been investigated. As a result, implant specialists have gained a greater understanding of the dynamics and anatomical and biological concepts of the periodontium and peri-implant tissues both at the surgical and prosthetic phases of treatment, which contributes to better soft and hard tissue management (SHTM. This may further contribute to achieving a superior final result which is obtained by having a harmonious soft tissue profile, a correctly placed and contoured final restoration, and the reestablishment of masticatory function and phonetics.
Shame and Guilt in Restorative Justice
DEFF Research Database (Denmark)
Rodogno, Raffaele
2008-01-01
In this article, I examine the relevance and desirability of shame and guilt to restorative justice conferences. I argue that a careful study of the psychology of shame and guilt reveals that both emotions possess traits that can be desirable and traits that can be undesirable for restoration. More...... in particular, having presented the aims of restorative justice, the importance of face-to-face conferences in reaching these aims, the emotional dynamics that take place within such conferences, and the relevant parts of the empirical psychology of shame and guilt, I argue that restorative justice...
Long-term evaluation of extensive restorations in permanent teeth
DEFF Research Database (Denmark)
Nieuwenhuysen, J.-P. van; D'hoore, W.D.; Carvalho, J.
2003-01-01
Biostatistics, cast crowns, complex restorations, composite resins, decision making, dental amalgam, metal ceramic crowns, multi-surfaced restorations, prosthodontics, restorative dentistry......Biostatistics, cast crowns, complex restorations, composite resins, decision making, dental amalgam, metal ceramic crowns, multi-surfaced restorations, prosthodontics, restorative dentistry...
Disposable surgical face masks for preventing surgical wound infection in clean surgery
Directory of Open Access Journals (Sweden)
Allyson Lipp
Full Text Available BACKGROUND: Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension. OBJECTIVES: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection. SEARCH METHODS: We searched The Cochrane Wounds Group Specialised Register (searched 14 September 2011; The Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library 2011, Issue 3; Ovid MEDLINE (2008 to August Week 5 2011; Ovid MEDLINE (In-Process &Other Non-Indexed Citations September 13, 2011; Ovid EMBASE (2008 to 2011 Week 35; and EBSCO CINAHL (2008 to 9 September 2011. SELECTION CRITERIA: Randomized controlled trials (RCTs and quasi-randomized controlled trials comparing the use of disposable surgical masks with the use of no mask. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently. MAIN RESULTS: Three trials were included, involving a total of 2113 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. AUTHORS' CONCLUSIONS: From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.
Directory of Open Access Journals (Sweden)
Lizet Solis-Gabriel
2017-05-01
Full Text Available Tropical dry forests (TDFs have been widely transformed by human activities worldwide and the ecosystem services they provide are diminishing. There has been an urgent call for conservation and restoration of the degraded lands previously occupied by TDFs. Restoration experiences aim to recover species diversity and ecological functions. Different restoration strategies have been used to maximize plant performance including weeding, planting or using artificial mulching. In this investigation, we evaluated whether different restoration practices influence animal arrival and the reestablishment of biotic interactions. We particularly evaluated lepidopteran larvae diversity and caterpillar predation on plants established under different restoration treatments (mulching, weeding and control in the Pacific West Coast of México. This study corroborated the importance of plant host identity for lepidopteran presence in a particular area. Lepidopteran diversity and herbivory rates were not affected by the restoration treatment but they were related to tree species. In contrast, caterpillar predation marks were affected by restoration treatment, with a greater number of predation marks in control plots, while caterpillar predation marks among plant species were not significantly different. This study highlights the importance of considering the introduction of high plant species diversity when planning TDF restoration to maximize lepidopteran diversity and ecosystem functioning.
Solis-Gabriel, Lizet; Mendoza-Arroyo, Wendy; Boege, Karina; Del-Val, Ek
2017-01-01
Tropical dry forests (TDFs) have been widely transformed by human activities worldwide and the ecosystem services they provide are diminishing. There has been an urgent call for conservation and restoration of the degraded lands previously occupied by TDFs. Restoration experiences aim to recover species diversity and ecological functions. Different restoration strategies have been used to maximize plant performance including weeding, planting or using artificial mulching. In this investigation, we evaluated whether different restoration practices influence animal arrival and the reestablishment of biotic interactions. We particularly evaluated lepidopteran larvae diversity and caterpillar predation on plants established under different restoration treatments (mulching, weeding and control) in the Pacific West Coast of México. This study corroborated the importance of plant host identity for lepidopteran presence in a particular area. Lepidopteran diversity and herbivory rates were not affected by the restoration treatment but they were related to tree species. In contrast, caterpillar predation marks were affected by restoration treatment, with a greater number of predation marks in control plots, while caterpillar predation marks among plant species were not significantly different. This study highlights the importance of considering the introduction of high plant species diversity when planning TDF restoration to maximize lepidopteran diversity and ecosystem functioning.
Ecological restoration [book review
Eric J. Gustafson
2010-01-01
Ecological restoration has increased in prominence in recent years as environmental policies have slowed the rate of environmental degradation in many parts of the world and practitioners have looked for active ways to reverse the damage. Because of the vast number of types and contexts of degraded ecological systems, the field of ecological restoration is still very...
Polat, Zelal Seyfioğlu; Tacir, Ibrahim Halil
2007-01-01
This article describes the restoration of an intruded root using a custom-made metal dowel and metal-ceramic veneer core restoration. The treatment plan for this patient consisted of restoring the missing esthetics and eliminating psychological trauma by utilizing the root of the intruded maxillary left central incisor to replace both missing central incisor crowns. This treatment will preserve space and bone until the patient is old enough for another prosthodontic restoration to be considered. As the lost fragments were not recovered, we considered this restoration of the intruded root to be the best therapeutic option, considering the effect on the patient's psyche. The patient was satisfied with the final result.
Surgical hip dislocation in treatment of slipped capital femoral epiphysis
Directory of Open Access Journals (Sweden)
Elmarghany Mohammed
2017-01-01
Full Text Available Background: Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006 Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666–679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI [Leunig M, Slongo T, Ganz R (2008 Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis. Instr Course Lect 57, 499–507]. Objective: The primary aim of our study was to report the results of the technique of capital realignment with Ganz surgical hip dislocation and its reproducibility to restore hip anatomy and function. Patients and methods: This prospective case series study included 30 patients (32 hips, 13 left (Lt hips, 19 right (Rt hips with stable chronic slipped capital femoral epiphysis (SCFE after surgical correction with a modified Dunn procedure. This study included 22 males and eight females. The mean age of our patients was 14 years (10–18 years. The mean follow-up period was 14.5 months (6–36 months. Results: Thirty hips had excellent and good clinical and radiographic outcomes with respect to hip function and radiographic parameters. Two patients had fair to poor clinical outcome including three patients who developed Avascular Necrosis (AVN. The difference between those who developed AVN and those who did not develop AVN was statistically significant in postoperative clinical scores (p = 0.0000. The mean slip angle of the femoral head was 52.5° ± 14.6 preoperatively and was corrected to a mean value of 5.6° ± 8.2° with mean correction of 46.85° ± 14.9° (p = 0.0000. The mean postoperative alpha angle was 51.15° ± 4.2° with mean correction of 46.70 ± 14.20 (p = 0.0000. In our series, the mean postoperative
Rupp, Michael A; Sweetman, Richard; Sosa, Alejandra E; Smither, Janan A; McConnell, Daniel S
2017-11-01
We investigated the effects of a passive break, relaxation activity, and casual video game on affect, stress, engagement, and cognitive performance. Reducing stress and improving cognitive performance is critical across many domains. Previous studies investigated taking a break, relaxation techniques, or playing a game; however, these methods have not been compared within a single experiment. Participants completed a baseline affective and cognitive assessment (ACA), which included the Positive and Negative Affect Schedule, shortened version of the Dundee Stress State Questionnaire, and backward digit-span. Next, participants completed a vigilance task, followed by another ACA. Participants were then assigned at random to complete a break or relaxation activity or play a casual video game, followed by a final ACA. Participants who played the casual video game exhibited greater engagement and affective restoration than the relaxation condition. The break condition slightly decreased affect and prevented cognitive restoration. Playing a casual video game even briefly can restore individuals' affective abilities, making it a suitable activity to restore mood in response to stress. However, future research is needed to find activities capable of cognitive restoration. Many activities in life require sustained cognitive demand, which are stressful and decrease performance, especially for workers in performance-critical domains. Our research suggests some leisure activities are better than others for restoring fatigued affective processes.
Directory of Open Access Journals (Sweden)
Severino R. Pinto
2014-09-01
Full Text Available In many human-modified tropical landscapes, biodiversity conservation and the provision of ecosystem services require large-scale restoration initiatives. Such initiatives must be able to augment the amount and the quality of remaining natural habitats. There is thus a growing need for long-term, multi-stakeholder and multi-purpose initiatives that result in multiple ecological and socioeconomic benefits at the biome scale. The Atlantic Forest Restoration Pact (AFRP is a coalition of 260+ stakeholders, including governmental agencies, private sector, NGOs and research institutions, aimed at restoring 15 million ha of degraded and deforested lands by 2050. By articulating, and then integrating common interests, this initiative has allowed different sectors of society to implement an ambitious vision and create a forum for public and private concerns regarding forest restoration. The AFRP adopts a set of governance tools so multiple actors can implement key processes to achieve long-term and visionary restoration goals. Having overcome some initial challenges, AFRP now has to incorporate underrepresented stakeholders and enhance its efforts to make forest restoration more economically viable, including cases where restoration could be less expensive and profitable. The AFRP experience has resulted in many lessons learned, which can be shared to foster similar initiatives across tropical regions.
The land value impacts of wetland restoration.
Kaza, Nikhil; BenDor, Todd K
2013-09-30
U.S. regulations require offsets for aquatic ecosystems damaged during land development, often through restoration of alternative resources. What effect does large-scale wetland and stream restoration have on surrounding land values? Restoration effects on real estate values have substantial implications for protecting resources, increasing tax base, and improving environmental policies. Our analysis focuses on the three-county Raleigh-Durham-Chapel Hill, North Carolina region, which has experienced rapid development and extensive aquatic ecological restoration (through the state's Ecosystem Enhancement Program [EEP]). Since restoration sites are not randomly distributed across space, we used a genetic algorithm to match parcels near restoration sites with comparable control parcels. Similar to propensity score analysis, this technique facilitates statistical comparison and isolates the effects of restoration sites on surrounding real estate values. Compared to parcels not proximate to any aquatic resources, we find that, 1) natural aquatic systems steadily and significantly increase parcel values up to 0.75 mi away, and 2) parcels 0.5 mi from EEP sites gain substantial amenity value. When we control for intervening water bodies (e.g. un-restored streams and wetlands), we find a similar inflection point whereby parcels points to the need for higher public visibility of aquatic ecosystem restoration programs and increased public information about their value. Copyright © 2013 Elsevier Ltd. All rights reserved.
Governing Forest Landscape Restoration: Cases from Indonesia
Directory of Open Access Journals (Sweden)
Cora van Oosten
2014-05-01
Full Text Available Forest landscape restoration includes both the planning and implementation of measures to restore degraded forests within the perspective of the wider landscape. Governing forest landscape restoration requires fundamental considerations about the conceptualisation of forested landscapes and the types of restoration measures to be taken, and about who should be engaged in the governance process. A variety of governance approaches to forest landscape restoration exist, differing in both the nature of the object to be governed and the mode of governance. This paper analyses the nature and governance of restoration in three cases of forest landscape restoration in Indonesia. In each of these cases, both the original aim for restoration and the initiators of the process differ. The cases also differ in how deeply embedded they are in formal spatial planning mechanisms at the various political scales. Nonetheless, the cases show similar trends. All cases show a dynamic process of mobilising the landscape’s stakeholders, plus a flexible process of crafting institutional space for conflict management, negotiation and decision making at the landscape level. As a result, the landscape focus changed over time from reserved forests to forested mosaic lands. The cases illustrate that the governance of forest landscape restoration should not be based on strict design criteria, but rather on a flexible governance approach that stimulates the creation of novel public-private institutional arrangements at the landscape level.
Cho, Won-Kyung; Jung, Su-Kyung; Paik, Ji-Sun; Yang, Suk-Woo
2016-07-01
Patients with anophthalmic or phthisis socket suffer from cosmetic problems. To resolve those problems, the authors present the surgical outcomes of deep superior sulcus (DSS) augmentation using acellular dermal matrix in patients with anophthalmic or phthisis socket. The authors retrospectively reviewed anophthalmic or phthisis patients who underwent surgery for DSS augmentation using acellular dermal matrix. To evaluate surgical outcomes, the authors focused on 3 aspects: the possibility of wearing contact prosthesis, the degree of correction of the DSS, and any surgical complications. The degree of correction of DSS was classified as excellent: restoration of superior sulcus enough to remove sunken sulcus shadow; fair: gain of correction effect but sunken shadow remained; or fail: no effect of correction at all. Ten eyes of 10 patients were included. There was a mean 21.3 ± 37.1-month period from evisceration or enucleation to the operation for DSS augmentation. All patients could wear contact prosthesis after the operation (100%). The degree of correction was excellent in 8 patients (80%) and fair in 2. Three of 10 (30%) showed complications: eyelid entropion, upper eyelid multiple creases, and spontaneous wound dehiscence followed by inflammation after stitch removal. Uneven skin surface and paresthesia in the forehead area of the affected eye may be observed after surgery. The overall surgical outcomes were favorable, showing an excellent degree of correction of DSS and low surgical complication rates. This procedure is effective for patients who have DSS in the absence or atrophy of the eyeball.
Can Viral Videos Help Beaver Restore Streams?
Castro, J. M.; Pollock, M. M.; Lewallen, G.; Jordan, C.; Woodruff, K.
2015-12-01
Have you watched YouTube lately? Did you notice the plethora of cute animal videos? Researchers, including members of our Beaver Restoration Research team, have been studying the restoration potential of beaver for decades, yet in the past few years, beaver have gained broad acclaim and some much deserved credit for restoration of aquatic systems in North America. Is it because people can now see these charismatic critters in action from the comfort of their laptops? While the newly released Beaver Restoration Guidebook attempts to answer many questions, sadly, this is not one of them. We do, however, address the use of beaver (Castor canadensis) in stream, wetland, and floodplain restoration and discuss the many positive effects of beaver on fluvial ecosystems. Our team, composed of researchers from NOAA National Marine Fisheries Service, US Fish and Wildlife Service, US Forest Service, and Portland State University, has developed a scientifically rigorous, yet accessible, practitioner's guide that provides a synthesis of the best available science for using beaver to improve ecosystem functions. Divided into two broad sections -- Beaver Ecology and Beaver Restoration and Management -- the guidebook focuses on the many ways in which beaver improve habitat, primarily through the construction of dams that impound water and retain sediment. In Beaver Ecology, we open with a discussion of the general effects that beaver dams have on physical and biological processes, and we close with "Frequently Asked Questions" and "Myth Busters". In Restoration and Management, we discuss common emerging restoration techniques and methods for mitigating unwanted beaver effects, followed by case studies from pioneering practitioners who have used many of these beaver restoration techniques in the field. The lessons they have learned will help guide future restoration efforts. We have also included a comprehensive beaver ecology library of over 1400 references from scientific journals
Energy Technology Data Exchange (ETDEWEB)
Diefenderfer, Heida L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Borde, Amy B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sinks, Ian A. [Columbia Land Trust, Vancouver, WA (United States); Cullinan, Valerie I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zimmerman, Shon A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
2016-08-31
The purpose of this study was to provide science-based information to practitioners and managers of restoration projects in the Columbia Estuary Ecosystem Restoration Program (CEERP) regarding aspects of restoration techniques that currently pose known challenges and uncertainties. The CEERP is a program of the Bonneville Power Administration (BPA) and the U.S. Army Corps of Engineers (Corps), Portland District, in collaboration with the National Marine Fisheries Service and five estuary sponsors implementing restoration. The estuary sponsors are Columbia Land Trust, Columbia River Estuary Study Taskforce, Cowlitz Tribe, Lower Columbia Estuary Partnership, and Washington Department of Fish and Wildlife. The scope of the research conducted during federal fiscal year 2015 included three aspects of hydrologic reconnection that were selected based on available scientific information and feedback from restoration practitioners during project reviews: the design of mounds (also called hummocks, peninsulas, or berms); the control of reed canarygrass (Phalaris arundinaceae); and aspects of channel network design related to habitat connectivity for juvenile salmonids.
Groundwater restoration of in-situ uranium mines
International Nuclear Information System (INIS)
Anon.
1994-01-01
In-situ leaching is a relatively new uranium production technology that is expected to account for a growing share of future output. Depending upon the leaching solution used, the process may have considerable impact on the ground water. Since restoration of ground water quality is required in most countries and since this restoration is by far the most costly aspect of reclamation of an in-situ mine, it is necessary to utilize a process that lends itself both to the efficiency of the leaching process and the restoration process. This article examines a number of techniques that may be used in the restoration efforts. These include: (1) groundwater sweep, (2) reverse osmosis, (3) chemical restoration, and (4) electrodialysis. The article also discusses disposal of the excess fluids used in the restoration process
Importance of including cultural practices in ecological restoration.
Wehi, Priscilla M; Lord, Janice M
2017-10-01
Ecosystems worldwide have a long history of use and management by indigenous cultures. However, environmental degradation can reduce the availability of culturally important resources. Ecological restoration aims to repair damage to ecosystems caused by human activity, but it is unclear how often restoration projects incorporate the return of harvesting or traditional life patterns for indigenous communities. We examined the incorporation of cultural use of natural resources into ecological restoration in the context of a culturally important but protected New Zealand bird; among award-winning restoration projects in Australasia and worldwide; and in the peer-reviewed restoration ecology literature. Among New Zealand's culturally important bird species, differences in threat status and availability for hunting were large. These differences indicate the values of a colonizing culture can inhibit harvesting by indigenous people. In Australasia among award-winning ecological restoration projects, restored areas beyond aesthetic or recreational use, despite many projects encouraging community participation. Globally, restoration goals differed among regions. For example, in North America, projects were primarily conservation oriented, whereas in Asia and Africa projects frequently focused on restoring cultural harvesting. From 1995 to 2014, the restoration ecology literature contained few references to cultural values or use. We argue that restoration practitioners are missing a vital component for reassembling functional ecosystems. Inclusion of sustainably harvestable areas within restored landscapes may allow for the continuation of traditional practices that shaped ecosystems for millennia, and also aid project success by ensuring community support. © 2017 Society for Conservation Biology.
Technical approach to groundwater restoration
International Nuclear Information System (INIS)
1993-01-01
The Technical Approach to Groundwater Restoration (TAGR) provides general technical guidance to implement the groundwater restoration phase of the Uranium Mill Tailings Remedial Action (UMTRA) Project. The TAGR includes a brief overview of the surface remediation and groundwater restoration phases of the UMTRA Project and describes the regulatory requirements, the National Environmental Policy Act (NEPA) process, and regulatory compliance. A section on program strategy discusses program optimization, the role of risk assessment, the observational approach, strategies for meeting groundwater cleanup standards, and remedial action decision-making. A section on data requirements for groundwater restoration evaluates the data quality objectives (DQO) and minimum data required to implement the options and comply with the standards. A section on sits implementation explores the development of a conceptual site model, approaches to site characterization, development of remedial action alternatives, selection of the groundwater restoration method, and remedial design and implementation in the context of site-specific documentation in the site observational work plan (SOWP) and the remedial action plan (RAP). Finally, the TAGR elaborates on groundwater monitoring necessary to evaluate compliance with the groundwater cleanup standards and protection of human health and the environment, and outlines licensing procedures
Restoration of a fractured central incisor.
Olson, Bradley J
2012-03-01
The treatment of a traumatically damaged single central incisor poses significant challenges relative to function and esthetics to the restoring clinician. Providing a good long-term prognosis is paramount when determining whether to maintain or extract a structurally compromised tooth. Successful restoration demands timely and thorough risk assessment along with excellent communication with both the patient and the laboratory fabricating the restoration.
Directory of Open Access Journals (Sweden)
Mahdi Motamedmanesh
2016-03-01
Full Text Available Preserving the authenticity of historical monuments is an inseparable part of restoration activities that has always been asserted by the international principles of historical preservation. However, the local condition of historical sites may influence such a primitive intention of restorers. While historical documents are appropriate sources which can provide restorers with the real condition of ancient structures in the course of time, investigation through these precious materials is a time-consuming process and the reliability of these old evidences is, itself, a challenging issue. The Italian Institute for Middle and Far East (IsMEO missioned long-term restoration activities in Persepolis between 1964 and the Islamic Revolution in Iran. Generally, this institute is praised for this series of projects. In this paper, the author questions the historical authenticity of restoration activities missioned by this institute in a structure so-called The Gate of All Nations. Indeed, the restoration of this structure was influenced by the 2500th anniversary of the Persian Empire, which was held in Persepolis in 1971. By tracing the context of historical evidences and presenting a method for obtaining the authenticity of these documents, this paper demonstrates a new perspective towards the arrangement of a stone-made capital, which ornaments the uppermost part of a re-erected ancient column.
Directory of Open Access Journals (Sweden)
F Abolghasemzade
2015-08-01
Results: Within 263 patients, there were 81(30.8% men and 182(69.2% women. Most patients aged 30-40(42.2%, and were reported to suffer from class Ι dental occlusion(92.4%.The mean DMF was 9.7±2.4 . Lower molars were demonstrated as the most frequent teeth group for replacing amalgam restorations as well as causing secondary caries. Furthermore, secondary caries involved the major causes of amalgam restoration replacement. The most prevalent class for amalgam restoration replacement was class II restorations. It should be noted that secondary caries were most prevalent within class II MO / DO(25 cases(44.6%. Conclusion: The study findings revealed that the most common cause of the restoration replacement involved the secondary caries which was most observed in the Class II restorations.
Kevin C. Vogler; Alan A. Ager; Michelle A. Day; Michael Jennings; John D. Bailey
2015-01-01
The implementation of US federal forest restoration programs on national forests is a complex process that requires balancing diverse socioecological goals with project economics. Despite both the large geographic scope and substantial investments in restoration projects, a quantitative decision support framework to locate optimal project areas and examine...
Restoration and repair of Earth's damaged ecosystems.
Jones, Holly P; Jones, Peter C; Barbier, Edward B; Blackburn, Ryan C; Rey Benayas, Jose M; Holl, Karen D; McCrackin, Michelle; Meli, Paula; Montoya, Daniel; Mateos, David Moreno
2018-02-28
Given that few ecosystems on the Earth have been unaffected by humans, restoring them holds great promise for stemming the biodiversity crisis and ensuring ecosystem services are provided to humanity. Nonetheless, few studies have documented the recovery of ecosystems globally or the rates at which ecosystems recover. Even fewer have addressed the added benefit of actively restoring ecosystems versus allowing them to recover without human intervention following the cessation of a disturbance. Our meta-analysis of 400 studies worldwide that document recovery from large-scale disturbances, such as oil spills, agriculture and logging, suggests that though ecosystems are progressing towards recovery following disturbances, they rarely recover completely. This result reinforces conservation of intact ecosystems as a key strategy for protecting biodiversity. Recovery rates slowed down with time since the disturbance ended, suggesting that the final stages of recovery are the most challenging to achieve. Active restoration did not result in faster or more complete recovery than simply ending the disturbances ecosystems face. Our results on the added benefit of restoration must be interpreted cautiously, because few studies directly compared different restoration actions in the same location after the same disturbance. The lack of consistent value added of active restoration following disturbance suggests that passive recovery should be considered as a first option; if recovery is slow, then active restoration actions should be better tailored to overcome specific obstacles to recovery and achieve restoration goals. We call for a more strategic investment of limited restoration resources into innovative collaborative efforts between scientists, local communities and practitioners to develop restoration techniques that are ecologically, economically and socially viable. © 2018 The Author(s).
Directory of Open Access Journals (Sweden)
Tlucek PS
2013-06-01
Full Text Available Paul S Tlucek,1 James C Folk,1 Warren M Sobol,2 Vinit B Mahajan1,3 1Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA; 2Retina Physicians and Surgeons, Dayton, OH, USA; 3Omics Laboratory, University of Iowa, Iowa City, IA, USA Objective: To review fibrosis of fluocinolone acetonide (FA implants in subjects with CAPN5 autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV. Methods: A retrospective case series was assembled from ADNIV patients in which there was fibrotic encapsulation of a fluocinolone acetonide implant. CAPN5 genotypes and surgical repair techniques were reviewed. Results: Two eyes of two ADNIV patients developed a fibrotic capsule over the fluocinolone acetonide implant. Both patients had Stage IV disease. Patient A had a c.731T > C mutation in the CAPN5 gene and patient B had a c.728G > T mutation. The fibrotic membrane was surgically excised and the implant function was restored. Conclusion: The exuberant fibrotic response in later stages of ADNIV may be resistant to local immunosuppression with steroids. Surgical excision of fibrotic membranes over FA implants can reestablish local steroid delivery in cases of severe proliferative vitreoretinopathy. Keywords: autosomal dominant neovascular inflammatory vitreoretinopathy, ADNIV, CAPN5, calpain-5, Retisert, fluocinolone acetonide, fibrotic encapsulation
Huang, Yu-Hui; Seelaus, Rosemary; Zhao, Linping; Patel, Pravin K; Cohen, Mimis
2016-01-01
Osseointegrated titanium implants to the cranial skeleton for retention of facial prostheses have proven to be a reliable replacement for adhesive systems. However, improper placement of the implants can jeopardize prosthetic outcomes, and long-term success of an implant-retained prosthesis. Three-dimensional (3D) computer imaging, virtual planning, and 3D printing have become accepted components of the preoperative planning and design phase of treatment. Computer-aided design and computer-assisted manufacture that employ cone-beam computed tomography data offer benefits to patient treatment by contributing to greater predictability and improved treatment efficiencies with more reliable outcomes in surgical and prosthetic reconstruction. 3D printing enables transfer of the virtual surgical plan to the operating room by fabrication of surgical guides. Previous studies have shown that accuracy improves considerably with guided implantation when compared to conventional template or freehand implant placement. This clinical case report demonstrates the use of a 3D technological pathway for preoperative virtual planning through prosthesis fabrication, utilizing 3D printing, for a patient with an acquired orbital defect that was restored with an implant-retained silicone orbital prosthesis.
Posterior bulk-filled resin composite restorations.
DEFF Research Database (Denmark)
van Dijken, Jan WV; Pallesen, Ulla
2016-01-01
up to 4mm as needed to fill the cavity 2mm short of the occlusal cavosurface. The occlusal part was completed with the nano-hybrid resin composite (Ceram X mono+). In the other cavity, the resin composite-only (Ceram X mono+) was placed in 2mm increments. The restorations were evaluated using...... Class II, 4 SDR-CeramX mono+ and 6 CeramXmono+-only restorations. The main reasons for failurewere tooth fracture (6) and secondary caries (4). The annual failure rate (AFR) for all restorations (Class I and II) was for the bulk-filled-1.1% and for the resin composite-only restorations 1...
Suksaphar, Warattama; Banomyong, Danuchit; Jirathanyanatt, Titalee; Ngoenwiwatkul, Yaowaluk
2018-02-01
The aim of the present study was to compare the survival rates against fracture of premolar endodontically treated teeth (ETT) restored with resin composite or crowns and to identify risk factors associated with the fracture. Data from dental records and radiographs of premolar ETT with postendodontic restorations (ie, resin composite or crowns) were collected between 2012 and 2016 and selected following selected inclusion and exclusion criteria. Tooth location, type of restoration, number of proximal contacts, and amount of tooth surface loss were recorded. The incidence and restorability of postendodontic fractures were identified. Survival rates against fracture of the 2 restoration types were calculated using Kaplan-Meier survival analysis. Any potential factors associated with fractures were identified using Cox proportional hazards models. The survival rate against fracture of ETT restored with crowns (95.1%) was higher than resin composite (77.0%). ETT restored with resin composite with 1 or 2 tooth surface losses and 2 proximal contacts had a high survival rate of 88.5% that was not significantly different from ETT with crowns. A higher incidence of restorability after fracture was observed in teeth restored with resin composite than crowns. The type of restoration and number of proximal contacts were identified as potential risk factors associated with fracture incidence. The survival rate against fracture of ETT restored with crowns was higher than resin composite. However, ETT with 1 or 2 tooth surface losses and 2 proximal contacts and restored with resin composite showed a high survival rate that was comparable with ETT restored with crowns. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
McHugh, Lauren E J; Politi, Ioanna; Al-Fodeh, Rami S; Fleming, Garry J P
2017-09-01
To assess the cuspal deflection of standardised large mesio-occluso-distal (MOD) cavities in third molar teeth restored using conventional resin-based composite (RBC) or their bulk fill restorative counterparts compared with the unbound condition using a twin channel deflection measuring gauge. Following thermocycling, the cervical microleakage of the restored teeth was assessed to determine marginal integrity. Standardised MOD cavities were prepared in forty-eight sound third molar teeth and randomly allocated to six groups. Restorations were placed in conjunction with (and without) a universal bonding system and resin restorative materials were irradiated with a light-emitting-diode light-curing-unit. The dependent variable was the restoration protocol, eight oblique increments for conventional RBCs or two horizontal increments for the bulk fill resin restoratives. The cumulative buccal and palatal cuspal deflections from a twin channel deflection measuring gauge were summed, the restored teeth thermally fatigued, immersed in 0.2% basic fuchsin dye for 24h, sectioned and examined for cervical microleakage score. The one-way analysis of variance (ANOVA) identified third molar teeth restored using conventional RBC materials had significantly higher mean total cuspal deflection values compared with bulk fill resin restorative restoration (all pmaterial selection is vital in the absence of clinical data. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Legg, Julian; Davies, Evan; Raich, Annie L; Dettori, Joseph R; Sherry, Ned
2014-04-01
Cerebral palsy (CP) is a group of nonprogressive syndromes of posture and motor impairment associated with lesions of the immature brain. Spastic quadriplegia is the most severe form with a high incidence of scoliosis, back pain, respiratory compromise, pelvic obliquity, and poor sitting balance. Surgical stabilization of the spine is an effective technique for correcting deformity and restoring sitting posture. The decision to operate in this group of patients is challenging. The aim of this study is to determine the benefits of surgical correction of scoliosis in children with spastic quadriplegia, the adverse effects of this treatment, and what preoperative factors affect patient outcome after surgical correction. A systematic review was undertaken to identify studies describing benefits and adverse effects of surgery in spastic quadriplegia. Factors affecting patient outcome following surgical correction of scoliosis were assessed. Studies involving adults and nonspastic quadriplegia were excluded. A total of 10 case series and 1 prospective and 3 retrospective cohort studies met inclusion criteria. There was significant variation in the overall risk of complications (range, 10.9-70.9%), mortality (range, 2.8-19%), respiratory/pulmonary complications (range, 26.9-57.1%), and infection (range, 2.5-56.8%). Factors associated with a worse outcome were a significant degree of thoracic kyphosis, days in the intensive care unit, and poor nutritional status. Caregivers report a high degree of satisfaction with scoliosis surgery for children with spastic quadriplegia. There is limited evidence of preoperative factors that can predict patient outcome after scoliosis. There is a need for well-designed prospective studies of scoliosis surgery in spastic quadriplegia.
Minimizing surgical skin incision scars with a latex surgical glove.
Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun
2013-04-01
The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Restorative glass: reversible, discreet restoration using structural glass components
Directory of Open Access Journals (Sweden)
Faidra Oikonomopoulou
2017-12-01
Full Text Available The application of structural glass as the principal material in restoration and conservation practices is a distinguishable, yet discreet approach. The transparency of glass allows the simultaneous perception of the monument at both its original and present condition, preserving its historical and aesthetical integrity. Concurrently, the material’s unique mechanical properties enable the structural consolidation of the monument. As a proof of concept, the restoration of Lichtenberg Castle is proposed. Solid cast glass units are suggested to complete the missing parts, in respect to the existing construction technique and aesthetics of the original masonry. Aiming for a reversible system, the glass units are interlocking, ensuring the overall stability without necessitating permanent, adhesive connections. This results in an elegant and reversible intervention.
Psycholegal abilities and restoration of competence to stand trial.
Morris, Douglas R; Deyoung, Nathaniel J
2012-01-01
Criminal defendants adjudicated incompetent to stand trial are typically hospitalized for competence restoration in state institutions. Prolonged restoration hospitalizations involve civil rights concerns and increasing financial costs, and there remains interest in determining which individuals are likely to be successfully restored. We retrospectively reviewed hospital records of 455 male defendants admitted to a forensic treatment center for competence restoration in an effort to determine whether psychiatric diagnoses, demographic factors, or psycholegal abilities were predictive of successful or failed restoration. At varying stages of restoration efforts, psychotic disorder, mental retardation, and previous state hospitalization predicted unsuccessful restoration, while substance use and personality disorders were predictive of successful restoration. Psycholegal abilities were predictive of successful restoration and appeared to form a continuum, with basic behavior and outlook, factual legal understanding, and rational attorney assistance factors demonstrating progressively increased importance in successful restoration. Copyright © 2012 John Wiley & Sons, Ltd.
Hota, Lekha S; Hanaway, Katherine; Hacker, Michele R; Disciullo, Anthony; Elkadry, Eman; Dramitinos, Patricia; Shapiro, Alexander; Ferzandi, Tanaz; Rosenblatt, Peter L
2012-01-01
This study aimed to compare TVT-Secur (TVT-S) and TVT-Obturator (TVT-O) suburethral slings for treatment of stress urinary incontinence (SUI). This was a single-center, nonblinded, randomized trial of women with SUI who were randomized to TVT-S or TVT-O from May 2007 to April 2009. The primary outcome, SUI on cough stress test (CST), and quality-of-life and symptom questionnaires (Pelvic Floor Distress Inventory [PFDI-20] and Pelvic Floor Impact Questionnaire [PFIQ-7]) were assessed at 12 weeks and 1 year. Forty-three women were randomized to TVT-S and 44 to TVT-O. There were no differences in median baseline PFDI-20 and PFIQ-7. Twenty-two (52.4%) of 42 participants randomized to TVT-S had a positive CST result at evaluation after 12 weeks or 1 year, whereas 4 (9.1%) of the 44 in the TVT-O group had a positive CST result. The intent-to-treat analysis showed that the risk of a positive CST result was 6 times higher after TVT-S than TVT-O (risk ratio, 6.0; 95% confidence interval [CI], 2.3-16.0). Among women not lost to follow-up, the risk ratio for a positive CST result after TVT-S compared with TVT-O was 17.9 (95% CI, 2.5-128.0) at 12 weeks and 3.5 (95% CI, 1.1-11.0) at 1 year. Both TVT-S and TVT-O resulted in improved quality of life and symptoms at 12 weeks. There was no difference between the groups for PFDI-20 (P = 0.40) or PFIQ-7 (P = 0.43). A similar pattern was seen at 1 year (P = 0.85 and P = 0.36). The TVT-S seems to have a higher risk of positive postoperative CST result; however, the procedures result in similar improvements in quality of life and symptoms.
2011-08-01
... these regulations on June 10, 2010, to address changes in law, regulation, policy, technology, and... Service 50 CFR Part 80 Financial Assistance: Wildlife Restoration, Sport Fish Restoration, Hunter... 80 [Docket No. FWS-R9-WSR-2009-0088; 91400-5110-POLI-7B; 91400-9410-POLI- 7B] RIN 1018-AW65 Financial...
Molina, G.F.; Cabral, R.J.; Mazzola, I.; Lascano, L.B.; Frencken, J.E.F.M.
2013-01-01
The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important. OBJECTIVE: To test the
Leadership success within disaster restoration projects.
Rapp, Randy R; Baroudi, Bassam
2014-01-01
Successful project managers draw their performance from essential leadership traits, as guided by their core values.Within disaster recovery, contractors who mitigate, repair, and reconstruct the built environment are often faced with challenges exceeding the norm. The effective leader is commonly expected to consider stakeholder motivations within distressing situations as well as other external and environmental factors when seeking to lead the project team to successful outcomes. This research is most concerned with leadership within the context of disaster restoration of the built environment. Its stimulus comes from the Restoration Industry Association (RIA)'s efforts to highlight leadership traits and core values for its Certified Restorer Body of Knowledge but would be of value to others associated with disaster recovery operations. Among organizations whose membership includes thousands of practitioners who restore and reconstruct the built environment after disasters, the RIA is the only one yet to formally and substantially research which core values and leader traits are deemed critical for the success of efforts to manage the means and methods applied on recovery job sites. Forty-six seasoned disaster restoration industry project professionals voluntarily responded to a survey questionnaire that sought their opinions about the traits and core values that they consider most important for successful disaster restoration project leadership. The most important leader traits were effective communication, professional competence, and leadership by example. The most important restoration industry values were integrity, compassion, and trustworthiness. The recognized imperative of compassion was unexpected in light of stereotypes often associated with construction-related contractors. This and other findings permit disaster response and recovery stakeholders to better understand qualities they should wish to see in leaders of contractor organizations, which
Krych, Aaron J; Pareek, Ayoosh; King, Alexander H; Johnson, Nick R; Stuart, Michael J; Williams, Riley J
2017-10-01
Optimal surgical treatment of chondral defects in an athletic population remains highly controversial and has yet to be determined. The purpose of this review was to (1) report data on return to sport and (2) compare activity and functional outcome measures following various cartilage restoration techniques. A comprehensive review was performed for studies with return-to-sport outcomes after microfracture (MFX), osteochondral autograft transfer (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI). All studies containing return-to-sport participation with minimum 2-year post-operative activity-based outcomes were included. A meta-analysis comparing rate of return to sport between each surgical intervention was conducted using a random-effects model. Forty-four studies met inclusion criteria (18 Level I/II, 26 Level III/IV). In total, 2549 patients were included (1756 M, 793 F) with an average age of 35 years and follow-up of 47 months. Return to sport at some level was 76 % overall, with highest rates of return after OAT (93 %), followed by OCA (88 %), ACI (82 %), and MFX (58 %). Osteochondral autograft transfer showed the fastest return to sports (5.2 ± 1.8 months) compared to 9.1 ± 2.2 months for MFX, 9.6 ± 3.0 months for OCA and 11.8 ± 3.8 months for ACI (P sport. In conclusion, in this meta-analysis of 2549 athletes, cartilage restoration surgery had a 76 % return to sport at mid-term follow-up. Osteochondral autograft transfer offered a faster recovery and appeared to have a higher rate of return to preinjury athletics, but heterogeneity in lesion size, athlete age, and concomitant surgical procedures are important factors to consider when assessing individual athletes. This study reports on the rate of return to sport in athletes undergoing various procedures for symptomatic chondral defects. IV.
Dorri, Mojtaba; Martinez-Zapata, Maria José; Walsh, Tanya; Marinho, Valeria Cc; Sheiham Deceased, Aubrey; Zaror, Carlos
2017-12-28
Dental caries is a sugar-dependent disease that damages tooth structure and, due to loss of mineral components, may eventually lead to cavitation. Dental caries is the most prevalent disease worldwide and is considered the most important burden of oral health. Conventional treatment methods (drill and fill) involve the use of rotary burs under local anaesthesia. The need for an electricity supply, expensive handpieces and highly trained dental health personnel may limit access to dental treatment, especially in underdeveloped regions.To overcome the limitations of conventional restorative treatment, the Atraumatic Restorative Treatment (ART) was developed, mainly for treating caries in children living in under-served areas of the world where resources and facilities such as electricity and trained manpower are limited. ART is a minimally invasive approach which involves removal of decayed tissue using hand instruments alone, usually without use of anaesthesia and electrically driven equipment, and restoration of the dental cavity with an adhesive material (glass ionomer cement (GIC), composite resins, resin-modified glass-ionomer cement (RM-GICs) and compomers). To assess the effects of Atraumatic Restorative Treatment (ART) compared with conventional treatment for managing dental caries lesions in the primary and permanent teeth of children and adults. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 22 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 1), MEDLINE Ovid (1946 to 22 February 2017), Embase Ovid (1980 to 22 February 2017), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 22 February 2017) and BBO BIREME Virtual Health Library (Bibliografia Brasileira de Odontologia; 1986 to 22 February 2017). The US National Institutes of Health Trials Registry (Clinical
Marine Ecosystem Restoration in Changing European Seas
DEFF Research Database (Denmark)
Ounanian, Kristen; Delaney, Alyne; Carballo Cárdenas, Eira
2017-01-01
and using different narratives of marine restoration, and being confronted with different forms of uncertainties. The paper’s overall contribution is the synthesis of these seemingly disparate components (narratives of restoration, uncertainty in decision making, and governance arrangements) to evaluate...... the impact of existing (maritime and environmental) policies, the governance setting, definitions of restoration and uncertainties on the effectiveness of marine restoration projects. Such a synthesis is a necessary move toward a systematic evaluation of ways to govern and formally institutionalize marine...
Restorative justice innovations in Canada.
Wilson, Robin J; Huculak, Bria; McWhinnie, Andrew
2002-01-01
As many jurisdictions move towards more retributive measures as a means to address public discontent with crime, a parallel movement has developed in regard to restorative justice. This article presents three restorative initiatives currently in use in Canada. Each initiative addresses offender behavior and community engagement at a different point in the justice continuum. The use of Sentencing Circles is an example of how restorative justice principles can be instituted at the front end, prior to an offender becoming lodged in the system. The Restorative Justice Options to Parole Suspension project demonstrates how community engagement can assist in preventing offenders from being returned to the system once they have achieved conditional release. The Circles of Support and Accountability project has enlisted the support of professionally supported volunteers in the community reintegration of high-risk sexual offenders. These initiatives are presented within a framework of effective correctional interventions and increased empowerment for a variety of stakeholders. Copyright 2002 John Wiley & Sons, Ltd.
Rashid, Rashid M; Morgan Bicknell, Lindsay T
2012-09-15
Follicular unit extraction (FUE) provides many advantages over the strip surgical method of harvesting hair grafts for hair restoration. However, FUE also has its shortcomings because it is a more time intensive approach that results in increased costs and is technically a more challenging technique of hair transplantation. In this manuscript, we seek to share approaches used at our center to help minimize and/or improve on some of the challenges of FUE.
Wetland restoration: a survey of options for restoring peatlands
International Nuclear Information System (INIS)
Lode, Elve
1999-01-01
In spite of increased attention to wetland conservation following the Ramsar Convention on Wetlands of International Importance, the peat-harvesting industry in many countries is still interested in the further exploitation of peatlands. In some of the most industrialised countries, all natural peatlands have already been lost. In others, only small areas of native peatland remain. Among other possible uses for cut-over peatlands, peatland restoration is one: there is an urgent need for the development of measures for regenerating peat-accumulation processes. The redevelopment of a fen or bog peat landscape is a long-term process, which will probably take centuries. The restoration of any peatland may therefore be considered successful if the outcome is the development and growth of plant communities able to produce peat. The renewal of the hydrological regime of such areas is a major factor which determines the re-colonisation of cut-over peat fields by peat-forming plants. The aim of this paper is to give a brief survey of wetlands, and especially of peatland restoration options, for use in terminated peat-cuttings. It aims to show how peatland management may be made sustainable by means of existing and tried methods and principles, with the goal of returning cut-over peat fields to their former peat-accumulating state. A glossary of peat and peatland terminology is included 105 refs, 5 figs
This session focuses on the importance of restoring water quality as part of the larger Gulf of Mexico restoration efforts. Water quality has been identified as a significant indicator of water body condition, and Gulf waters have been impacted by increased urban development, agr...
Rokito, Andrew S; Birdzell, Maureen Gallagher; Cuomo, Frances; Di Paola, Matthew J; Zuckerman, Joseph D
2010-06-01
Previous studies have documented a decrease in proprioceptive capacity in the unstable shoulder. The degree to which surgical approach affects recovery of strength and proprioception is unknown. The recovery of strength and proprioception after open surgery for recurrent anterior glenohumeral instability was compared for 2 surgical procedures. A prospective analysis of 55 consecutive patients with posttraumatic unilateral recurrent anterior glenohumeral instability was performed. Thirty patients (group 1) underwent an open inferior capsular shift with detachment of the subscapularis, and 25 (group 2) underwent an anterior capsulolabral reconstruction. Mean preoperative proprioception and strength values were significantly lower for the affected shoulders in both groups. At 6 months after surgery, there were no significant differences for mean strength and proprioception values between the unaffected and operative sides for group 2 patients. In group 1 patients, however, there were still significant deficits in mean position sense and strength values. Complete restoration of proprioception and strength, however, was evident by 12 months in group 1. This study demonstrates that there are significant deficits in both strength and proprioception in patients with posttraumatic, recurrent anterior glenohumeral instability. Although both are completely restored by 1 year after surgery, a subscapularis-splitting approach allows for complete recovery of strength and position sense as early as 6 months postoperatively. Detachment of the subscapularis delays recovery of strength and position sense for up to 12 months after surgery. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
A Policy Analysis Perspective on Ecological Restoration
Directory of Open Access Journals (Sweden)
Susan Baker
2013-06-01
Full Text Available Using a simple stages model of the policy process, we explore the politics of ecological restoration using an array of examples drawn across sector, different size and scale, and from different countries. A policy analysis perspective reveals how, at both the program and project levels, ecological restoration operates within a complex and dynamic interplay between technical decision making, ideologies, and interest politics. Viewed through the stages model, restoration policy involves negotiating nature across stages in the policy making process, including agenda setting, policy formulation, implementation, and evaluation. The stages model is a useful heuristic devise; however, this linear model assumes that policy makers approach the issue rationally. In practice, ecological restoration policy takes place in the context of different distributions of power between the various public and private actors involved at the different stages of restoration policy making. This allows us to reiterate the point that ecological restoration is best seen not only as a technical task but as a social and political project.
Bacterial migration through punctured surgical gloves under real surgical conditions
Directory of Open Access Journals (Sweden)
Heidecke Claus-Dieter
2010-07-01
Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.
Re-interventions after restoring teeth-Mining an insurance database.
Raedel, Michael; Hartmann, Andrea; Priess, Heinz-Werner; Bohm, Steffen; Samietz, Stefanie; Konstantinidis, Ioannis; Walter, Michael H
2017-02-01
The aim of this study was to examine re-interventions after restorative treatment. The data was collected from the digital database of a major German national health insurance company. Only permanent teeth were observed. Placing a permanent restoration other than a crown regardless of involved surfaces and material was the study intervention. The data did not allow for a differentiation between fillings and inlays that were estimated only a very small portion of the restorations. Success was defined as not undergoing any restorative re-intervention with fillings or inlays on the same tooth (primary outcome) and assessed with Kaplan-Meier survival analyses over four years. An additional analysis was conducted rating "crowning" and "extraction" of respective teeth as target events. Differences were tested with the Log-Rank-test. A multivariate Cox regression analyses was carried out. A total of 17,024,344 restorations placed in 4,825,408 anterior teeth and 9,973,177 posterior teeth could be traced. Focussing on the primary outcome re-intervention, the cumulative four-year success rate was 69.9% for one surface restorations, 74.8% for two surface restorations, 66.6% for three surface restorations and 61.0% for four surface and more extended restorations. These differences were significant (prestorations, 67.5% for two surface restorations, 63.0% for three surface restorations and 55.8% for four surface and more extended restorations. The number of restoration surfaces as well as the tooth position remained significant in the multivariate Cox regression. The sustainability of restorative dental treatment under the terms and conditions of the German national health insurance system shows room for improvement. From a public health perspective, special focus should be laid on primary and secondary prevention to minimize the restorative treatment need. This study shows that re-interventions are observed regularly after restorative treatment. Therefore, preventive and
Surgical experts: born or made?
Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger
2013-01-01
The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Arthur M Kemoli
2011-01-01
Full Text Available Background: Although Atraumatic restorative treatment (ART approach has been in existence for a while, the reasons for the poor performance of multisurface ART restorations are not very clear. Aim: The aim of this study is to investigate the effects of oral hygiene, residual caries and cervical marginal-gaps on survival of proximal ART restorations. Settings: Two rural divisions in Kenya were selected for the study. Design: A randomized clinical trial. Material and Methods: The 804 children in the study had their baseline- and 2-year dental plaque levels documented. Each child received one proximal restoration in a primary molar using ART approach, together with trained and pre-tested operators/assistants, three glass ionomer cements (GIC-brands and two tooth-isolation methods. The restorations were clinically evaluated soon after placement and after 2 years. Post-restorative bite-wing radiographs taken soon after restoration were also evaluated. Statistical analysis: Statistical Package for Social Sciences (SPSS version 14 computer programme was used and results tested using Pearson′s correlation, Cox Proportional Hazards regression analysis and Multiple Logistic regression models tests. Results: At baseline and after 2 years, the mean cumulative survival and plaque index changed from 94.4% to 30.8% and 2.34 (Standard Deviation, or SD of 0.46 to 1.92 (SD 2.1 respectively, with higher plaque indices associated with higher restoration failures. Of the 507 radiographs evaluated, 48 (9.5%, 63 (12.4% and 9 (1.8% restorations had residual caries (RC, cervical marginal-gaps (CMG and both RC/CMG respectively. Survival of the restorations with RC/CMG was significantly lower (p = 0.003 compared to those with RC or without RC. Conclusion: Low survival of proximal restorations in the study was associated with the presence of cervical marginal-gaps.
Forests planted for ecosystem restoration or conservation.
Constance A. Harrington
1999-01-01
Although the phrase, "planting for ecosystem restoration," is of recent origin, many of the earliest large-scale tree plantings were made for what we now refer to as "'restoration" or "conservation" goals. Forest restoration activities may be needed when ecosystems are disturbed by either natural or anthropogenic forces. Disturbances...
Rao, Yunzhang; Gu, Ruizhi; Guo, Ruikai; Zhang, Xueyan
2017-01-01
Whereas mining activities produce the raw materials that are crucial to economic growth, such activities leave extensive scarring on the land, contributing to the waste of valuable land resources and upsetting the ecological environment. The aim of this study is therefore to investigate various ecological technologies to restore metallurgical mine wastelands. These technologies include measures such as soil amelioration, vegetation restoration, different vegetation planting patterns, and engineering technologies. The Longnan Rare Earth Mine in the Jiangxi Province of China is used as the case study. The ecological restoration process provides a favourable reference for the restoration of a metallurgical mine wasteland.
Surgical treatment of radiation induced injuries of the intestine
Energy Technology Data Exchange (ETDEWEB)
Schmitt, E.H.; Symmonds, R.E.
1981-12-01
In the patient who has received high dose irradiation of the pelvis and abdomen, all abdominopelvic operations should be avoided, unless it is absolutely essential. Persisting obstruction, hemorrhage, intestinal perforation with peritonitis and with abscess and fistula formation are valid indications for surgical intervention. Ninety-three patients have been operated upon for these complications after irradiation. Some anastomotic dehiscence occurred in ten patients. Six operative deaths occurred. Of the 93 patients, 65 were managed by means of complete resection of the involved segment of intestine, followed by restoration of intestinal continuity by means of an end-to-end anastomosis. This is the treatment of choice when the involved area can be safely resected. In the absence of actual intestinal necrosis and when segments of strictured small intestine are adherent deep in the pelvis, and intestinal bypass procedure may represent the treatment of choice. This was accomplished in 20 patients, two of whom eventually required a second operation for resection of the bypassed segment of intestine.
Surgical treatment of radiation induced injuries of the intestine
International Nuclear Information System (INIS)
Schmitt, E.H.; Symmonds, R.E.
1981-01-01
In the patient who has received high dose irradiation of the pelvis and abdomen, all abdominopelvic operations should be avoided, unless it is absolutely essential. Persisting obstruction, hemorrhage, intestinal perforation with peritonitis and with abscess and fistula formation are valid indications for surgical intervention. Ninety-three patients have been operated upon for these complications after irradiation. Some anastomotic dehiscence occurred in ten patients. Six operative deaths occurred. Of the 93 patients, 65 were managed by means of complete resection of the involved segment of intestine, followed by restoration of intestinal continuity by means of an end-to-end anastomosis. This is the treatment of choice when the involved area can be safely resected. In the absence of actual intestinal necrosis and when segments of strictured small intestine are adherent deep in the pelvis, and intestinal bypass procedure may represent the treatment of choice. This was accomplished in 20 patients, two of whom eventually required a second operation for resection of the bypassed segment of intestine
The notion and basic principles of restorative justice
Directory of Open Access Journals (Sweden)
Ćopić Sanja
2007-01-01
Full Text Available One of the most important achievements of the contemporary criminal justice system and criminal policy is development of the concept of restorative justice. Contemporary concept of restorative justice was developed in 1970s on the basis of the criticism of the traditional criminal law and criminal justice system. Since that time, it has been developing through different programs in many countries. Reform of the criminal justice system in Serbia staring from 2002 went into direction of entering elements of restorative justice into existing criminal justice system. In that sense, development of restorative justice is still at the beginning in our country. However, it can be noticed that there is a low level of awareness on the nature and importance of restorative forms of response to crime among our professionals, as well as a lack of understanding of the concept itself. Due to that, the aim of the paper is to enable better understanding of restorative concept in general through defining restorative justice and basic principles it relies on. That may put a basis for further recognition of restorative elements in our criminal justice system, which may provide adequate implementation of relevant provisions of restorative character in practice. .
Wetland restoration, flood pulsing, and disturbance dynamics
Middleton, Beth A.
1999-01-01
While it is generally accepted that flood pulsing and disturbance dynamics are critical to wetland viability, there is as yet no consensus among those responsible for wetland restoration about how best to plan for those phenomena or even whether it is really necessary to do so at all. In this groundbreaking book, Dr. Beth Middleton draws upon the latest research from around the world to build a strong case for making flood pulsing and disturbance dynamics integral to the wetland restoration planning process.While the initial chapters of the book are devoted to laying the conceptual foundations, most of the coverage is concerned with demonstrating the practical implications for wetland restoration and management of the latest ecological theory and research. It includes a fascinating case history section in which Dr. Middleton explores the restoration models used in five major North American, European, Australian, African, and Asian wetland projects, and analyzes their relative success from the perspective of flood pulsing and disturbance dynamics planning.Wetland Restoration also features a wealth of practical information useful to all those involved in wetland restoration and management, including: * A compendium of water level tolerances, seed germination, seedling recruitment, adult survival rates, and other key traits of wetland plant species * A bibliography of 1,200 articles and monographs covering all aspects of wetland restoration * A comprehensive directory of wetland restoration ftp sites worldwide * An extensive glossary of essential terms
ROV Based Underwater Blurred Image Restoration
Institute of Scientific and Technical Information of China (English)
LIU Zhishen; DING Tianfu; WANG Gang
2003-01-01
In this paper, we present a method of ROV based image processing to restore underwater blurry images from the theory of light and image transmission in the sea. Computer is used to simulate the maximum detection range of the ROV under different water body conditions. The receiving irradiance of the video camera at different detection ranges is also calculated. The ROV's detection performance under different water body conditions is given by simulation. We restore the underwater blurry images using the Wiener filter based on the simulation. The Wiener filter is shown to be a simple useful method for underwater image restoration in the ROV underwater experiments. We also present examples of restored images of an underwater standard target taken by the video camera in these experiments.
Mini-invasive boomerang-plasty for esthetic restoration of lower third face aging.
Castro-Govea, Yanko; Cervantes-Kardasch, Victor H; Phillips, Erick; Salazar-Lozano, Abel; Vázquez-Costilla, Osvaldo
2014-01-01
There is an increased demand to improve facial appearance and preserve a youthful appearance for as long as possible. Minimally invasive facial procedures have boomed among young patients with less evidence of scars, low risk, and rapid recovery being some of the attractions. Some patients are even only interested in the treatment of specific units of the face. We present an alternative technique to treat jowls through truly limited incisions. The surgical protocol included a complete medical history, analysis of the degree of prominence of jowls, and development of a surgical plan. We obtained pre- and postoperative medium and long-term photographs and evaluated the results. The procedure is complemented with neck liposuction and platysmoplasty. In general, edema and ecchymosis disappeared within 2 weeks. The recovery period was 2 to 3 weeks. The pre- and retroauricular scars over time were nearly imperceptible. Permanence of the results has been demonstrated in a follow-up period of 4 years. Our philosophical concept lies in the preventive benefit because it is mostly performed in relatively young patients. Boomerang-plasty anatomically restores the mandibular contour from the angle to the chin by eliminating jowls and establishes an esthetically harmonious visual difference between the face and neck. It is a simple procedure with highly satisfactory and stable effects. Copyright © 2014 Elsevier Inc. All rights reserved.
Current Concepts in Restorative Implant Dentistry
Institute of Scientific and Technical Information of China (English)
Prof.Marchack
2009-01-01
Patients today are incteasingly aware of dental implants.and their expectations are for esthetically and functionally pleasingimplant restorations that mimic natural teeth.This presentation will give both the experienced and novice practitioner a better understand-ing of how restorative implant dentistry has evolved.Treatment planning and restorative options for single implants.multiple implants andfully edentulons arches will be discussed,and the use of modern materials and CADCAM technology in fabricating the most contemporaryfixed implant supported prostheses will be demonstrated.
Bortolotto, Tissiana; Melian, Karla; Krejci, Ivo
2013-10-01
The present study attempted to find a simple direct adhesive restorative technique for the restoration of Class 2 cavities. A self-etch adhesive system with a dual-cured core buildup composite resin (paste 1 + paste 2) was evaluated in its ability to restore proximo-occlusal cavities with margins located on enamel and dentin. The groups were: A, cavity filling (cf) with paste 1 (light-curing component) by using a layering technique; B, cf by mixing both pastes, bulk insertion, and dual curing; and C, cf by mixing both pastes, bulk insertion, and chemical curing. Two control groups (D, negative, bulk; and E, positive, layering technique) were included by restoring cavities with a classic three-step etch-and-rinse adhesive and a universal restorative composite resin. SEM margin analysis was performed before and after thermomechanical loading in a chewing simulator. Percentages (mean ± SD) of "continuous margins" were improved by applying the material in bulk and letting it self cure (54 ± 6) or dual cure (59 ± 9), and no significant differences were observed between these two groups and the positive control (44 ± 19). The present study showed that the dual-cured composite resin tested has the potential to be used as bulk filling material for Class 2 restorations. When used as filling materials, dual-cure composite resins placed in bulk can provide marginal adaptation similar to light-cured composites applied with a complex stratification technique.
Pyke, David A.; Chambers, Jeanne C.; Pellant, Mike; Knick, Steven T.; Miller, Richard F.; Beck, Jeffrey L.; Doescher, Paul S.; Schupp, Eugene W.; Roundy, Bruce A.; Brunson, Mark; McIver, James D.
2015-10-26
Sagebrush steppe ecosystems in the United States currently occur on only about one-half of their historical land area because of changes in land use, urban growth, and degradation of land, including invasions of non-native plants. The existence of many animal species depends on the existence of sagebrush steppe habitat. The greater sage-grouse (Centrocercus urophasianus) is a landscape-dependent bird that requires intact habitat and combinations of sagebrush and perennial grasses to exist. In addition, other sagebrush-obligate animals also have similar requirements and restoration of landscapes for greater sage-grouse also will benefit these animals. Once sagebrush lands are degraded, they may require restoration actions to make those lands viable habitat for supporting sagebrushobligate animals. This restoration handbook is the first in a three-part series on restoration of sagebrush ecosystems. In Part 1, we discuss concepts surrounding landscape and restoration ecology of sagebrush ecosystems and greater sage-grouse that habitat managers and restoration practitioners need to know to make informed decisions regarding where and how to restore specific areas. We will describe the plant dynamics of sagebrush steppe ecosystems and their responses to major disturbances, fire, and defoliation. We will introduce the concepts of ecosystem resilience to disturbances and resistance to invasions of annual grasses within sagebrush steppe. An introduction to soils and ecological site information will provide insights into the specific plants that can be restored in a location. Soil temperature and moisture regimes are described as a tool for determining resilience and resistance and the potential for various restoration actions. Greater sage-grouse are considered landscape birds that require large areas of intact sagebrush steppe; therefore, we describe concepts of landscape ecology that aid our decisions regarding habitat restoration. We provide a brief overview of
Dark diversity illuminates the dim side of restoration
DEFF Research Database (Denmark)
Moeslund, Jesper Erenskjold; Brunbjerg, Ane Kirstine; Clausen, Kevin Kuhlmann
Dark diversity consists of the species that are absent from sites where they could potentially thrive despite the fact that they are actually in the regional species pool. Successful ecological restoration requires detailed knowledge of species that are less successful in (re)colonizing restored ...... in future restoration and conservation efforts.......Dark diversity consists of the species that are absent from sites where they could potentially thrive despite the fact that they are actually in the regional species pool. Successful ecological restoration requires detailed knowledge of species that are less successful in (re)colonizing restored...
Global curriculum in surgical oncology.
Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A
2016-06-01
The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.
Priyank, Harsh; Verma, Ankita; Gupta, Komal; Chaudhary, Esha; Khandelwal, Deepak; Nihalani, Shweta
2016-12-01
Beauty standards in today's modernized world scenario are formed by well-aligned and well-designed bright white teeth. One of the major reasons behind patients reporting to dental clinics is pain. Caries in the anterior primary teeth forms one of the major concerns from a restorative point of view. Very few studies are quoted in literature which stresses on the follow-up of anterior restorations in primary teeth. Hence, we evaluated and compared the efficacy of composite resin and resin-modified glass ionomer cement (RGIC) for class III restorations in primary anterior teeth. The present study was conducted in the pediatric dental wing and included a total of 80 patients aged 3 to 5½ years who reported with the chief complaint of carious lesions in the primary anterior teeth. Patients having minimal of a pair of similar appearing small carious lesions on the same proximal surfaces of the deciduous maxillary incisors were included for the study. All the patients were randomly divided into two groups: One in which RGIC restoration was done and other in which composite restoration was done. Cavity preparation was done and filling of the cavity with the restorative materials was carried out. Assessment of the restorations was done at 4, 8, and 12 months time following criteria given by Ryge et al. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Mann-Whitney test and one-way analysis of variance (ANOVA) were used to evaluate the level of significance; p value less than 0.05 was considered as significant. For composite and RGIC restorations, the mean score for anatomic shape was 1.21 and 1.10 respectively. While comparing the clinical parameters, nonsignificant results were obtained between composite and RGIC restorative materials at 4-, 8-, and 12-month interval. On comparing the clinical parameters for individual restorative materials at different time intervals, statistically significant results were obtained only for
The observational approach in environmental restoration
International Nuclear Information System (INIS)
Smyth, J.D.; Quinn, R.D.
1991-07-01
The US Department of Energy (DOE) has committed to completing environmental restoration of its facilities within the next 28 years (DOE 1990b). In order to achieve this, DOE must ensure that its restoration activities are both effective and efficient. A key aspect of fulfilling this commitment is the recognition and management of uncertainty that is inherent in waste-site clean-up actions. The DOE Office of Environmental Restoration (DOE-ER) requested Pacific Northwest Laboratory (PNL) to investigate the applicability and implementation of what is known as the ''observational approach'' to better address these needs. PNL's initial investigation resulted in the positive conclusion that the observational approach had potential benefit to DOE during environmental restoration. In a follow-on effort, PNL supported by CH2M HILL, has been providing guidance to DOE field-offices on observational approach fundamentals, implementation, and application to waste-site remediation. This paper outlines the fundamentals of the observational approach and discusses the progress in integrating the observational approach in DOE's environmental restoration efforts. 9 refs., 2 figs
Capping of the radicular exposed surface (part II). Surgical and not surgical treatment
Grados Pomarino, Sixto; Estrada, Andrew Alejandro; Maetahara Rubio, Denis Miguel; Guzmán Vera, Yanina Sara; Tello Barbarán, Javier
2014-01-01
The gingival recession treatment can be made surgical1y with a high predictability of success due to the great advance during the last ones of the mucogingival surgical techniques. The use of connective grafts in coverage of recessions has obtained high rates of success reason why these procedures are common within the modern periodontal surgical practice. Knowing that all patients do not accept the surgical treatment, many investigators have come studying the possibility of treating non-surg...
Macroinvertebrate community assembly in pools created during peatland restoration
Energy Technology Data Exchange (ETDEWEB)
Brown, Lee E., E-mail: l.brown@leeds.ac.uk; Ramchunder, Sorain J.; Beadle, Jeannie M.; Holden, Joseph
2016-11-01
Many degraded ecosystems are subject to restoration attempts, providing new opportunities to unravel the processes of ecological community assembly. Restoration of previously drained northern peatlands, primarily to promote peat and carbon accumulation, has created hundreds of thousands of new open water pools. We assessed the potential benefits of this wetland restoration for aquatic biodiversity, and how communities reassemble, by comparing pool ecosystems in regions of the UK Pennines on intact (never drained) versus restored (blocked drainage-ditches) peatland. We also evaluated the conceptual idea that comparing reference ecosystems in terms of their compositional similarity to null assemblages (and thus the relative importance of stochastic versus deterministic assembly) can guide evaluations of restoration success better than analyses of community composition or diversity. Community composition data highlighted some differences in the macroinvertebrate composition of restored pools compared to undisturbed peatland pools, which could be used to suggest that alternative end-points to restoration were influenced by stochastic processes. However, widely used diversity metrics indicated no differences between undisturbed and restored pools. Novel evaluations of restoration using null models confirmed the similarity of deterministic assembly processes from the national species pool across all pools. Stochastic elements were important drivers of between-pool differences at the regional-scale but the scale of these effects was also similar across most of the pools studied. The amalgamation of assembly theory into ecosystem restoration monitoring allows us to conclude with more certainty that restoration has been successful from an ecological perspective in these systems. Evaluation of these UK findings compared to those from peatlands across Europe and North America further suggests that restoring peatland pools delivers significant benefits for aquatic fauna by
Macroinvertebrate community assembly in pools created during peatland restoration
International Nuclear Information System (INIS)
Brown, Lee E.; Ramchunder, Sorain J.; Beadle, Jeannie M.; Holden, Joseph
2016-01-01
Many degraded ecosystems are subject to restoration attempts, providing new opportunities to unravel the processes of ecological community assembly. Restoration of previously drained northern peatlands, primarily to promote peat and carbon accumulation, has created hundreds of thousands of new open water pools. We assessed the potential benefits of this wetland restoration for aquatic biodiversity, and how communities reassemble, by comparing pool ecosystems in regions of the UK Pennines on intact (never drained) versus restored (blocked drainage-ditches) peatland. We also evaluated the conceptual idea that comparing reference ecosystems in terms of their compositional similarity to null assemblages (and thus the relative importance of stochastic versus deterministic assembly) can guide evaluations of restoration success better than analyses of community composition or diversity. Community composition data highlighted some differences in the macroinvertebrate composition of restored pools compared to undisturbed peatland pools, which could be used to suggest that alternative end-points to restoration were influenced by stochastic processes. However, widely used diversity metrics indicated no differences between undisturbed and restored pools. Novel evaluations of restoration using null models confirmed the similarity of deterministic assembly processes from the national species pool across all pools. Stochastic elements were important drivers of between-pool differences at the regional-scale but the scale of these effects was also similar across most of the pools studied. The amalgamation of assembly theory into ecosystem restoration monitoring allows us to conclude with more certainty that restoration has been successful from an ecological perspective in these systems. Evaluation of these UK findings compared to those from peatlands across Europe and North America further suggests that restoring peatland pools delivers significant benefits for aquatic fauna by
Benefits of investing in ecosystem restoration.
DE Groot, Rudolf S; Blignaut, James; VAN DER Ploeg, Sander; Aronson, James; Elmqvist, Thomas; Farley, Joshua
2013-12-01
Measures aimed at conservation or restoration of ecosystems are often seen as net-cost projects by governments and businesses because they are based on incomplete and often faulty cost-benefit analyses. After screening over 200 studies, we examined the costs (94 studies) and benefits (225 studies) of ecosystem restoration projects that had sufficient reliable data in 9 different biomes ranging from coral reefs to tropical forests. Costs included capital investment and maintenance of the restoration project, and benefits were based on the monetary value of the total bundle of ecosystem services provided by the restored ecosystem. Assuming restoration is always imperfect and benefits attain only 75% of the maximum value of the reference systems over 20 years, we calculated the net present value at the social discount rates of 2% and 8%. We also conducted 2 threshold cum sensitivity analyses. Benefit-cost ratios ranged from about 0.05:1 (coral reefs and coastal systems, worst-case scenario) to as much as 35:1 (grasslands, best-case scenario). Our results provide only partial estimates of benefits at one point in time and reflect the lower limit of the welfare benefits of ecosystem restoration because both scarcity of and demand for ecosystem services is increasing and new benefits of natural ecosystems and biological diversity are being discovered. Nonetheless, when accounting for even the incomplete range of known benefits through the use of static estimates that fail to capture rising values, the majority of the restoration projects we analyzed provided net benefits and should be considered not only as profitable but also as high-yielding investments. Beneficios de Invertir en la Restauración de Ecosistemas. © 2013 Society for Conservation Biology.
River restoration: separating myths from reality
Friberg, N.; Woodward, G.
2015-12-01
River restorations are a social construct where degraded systems are physically modified to obtain a pre-disturbance set of attributes. These can be purely esthetic but are often linked to some kind of biotic recovery or the provision of important ecosystem services such as flood control or self-purification. The social setting of restoration projects, with a range of potential conflicts, significantly reduces scale of most interventions to a size with little room, or wish, for natural processes. We show that projects sizes are still very small and that the restoration target is not to recover natural geomorphic processes but rather to fulfil human perception of what a nice stream looks like. One case from Danish lowland streams, using a space-for-time substitution approach, shows excess use of pebble and gravel when restoring channelized sandy bottom streams, de-coupling the link between energy and substrate characteristics that are found in natural lowland systems. This has implication for both the biological structure and functioning of these systems as a direct link between substrate heterogeneity and macroinvertebrate diversity was not found in restored streams, while the density of grazer increased indicating an increased use of periphyton as a basal resource. Another case of adding woody debris to UK lowland streams, using a BACI study design, showed very little effect on the macroinvertebrate community even after a 100-year flood, which indicate that added tree trunks did not provide additional flow refugia. We suggest that restoration schemes should aim at restoring the natural physical structural complexity in the streams and at the same time enhance the possibility of re-generating the natural geomorphological processes sustaining the habitats in streams and rivers.
Restoration of variable density film soundtracks
Hassaïne , Abdelâali; Decencière , Etienne; Besserer , Bernard
2009-01-01
Full text available at http://www.eurasip.org/Proceedings/Eusipco/Eusipco2009/contents/papers/1569192297.pdf; International audience; The restoration of motion picture films has been an active research field for many years. The restoration of the soundtrack however has mainly been performed at the audio domain in spite of the fast that it is recorded as a continuous image on the film stock. In this paper, we propose a new restoration method for variable density soundtracks. The method first d...
Conservation and restoration of ornamental elements
Directory of Open Access Journals (Sweden)
Carmen Rallo Gruss
1999-12-01
Full Text Available Intervention on a building as complex and rich in ornamentation as the Palacio del Marqués de Dos Aguas requires special attention as regards the restoration of all the singular elements, both inside and outside, and the different finishes and furnishings. Within this methodology of integral restoration, it is worth pointing out especially the consolidation and cleaning of the emblematic alabaster portal, the restoration of the paintings and the treatment of the different collections of tiles.
Abortion - surgical - aftercare
... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...
[Posterior ceramic bonded partial restorations].
Mainjot, Amélie; Vanheusden, Alain
2006-01-01
Posterior ceramic bonded partial restorations are conservative and esthetic approaches for compromised teeth. Overlays constitute a less invasive alternative for tooth tissues than crown preparations. With inlays and onlays they are also indicated in case of full arch or quadrant rehabilitations including several teeth. This article screens indications and realization of this type of restorations.
Butterworth, C J; Rogers, S N
2017-12-01
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) for the primary management of maxillary malignancy with surgical closure of the resultant maxillary defect and the installation of osseointegrated support for a zygomatic implant-supported maxillary fixed dental prosthesis.The use of this technique facilitates extremely rapid oral and dental rehabilitation within a few weeks of resective surgery, providing rapid return to function and restoring appearance following low-level maxillary resection, even in cases where radiotherapy is required as an adjuvant treatment post-operatively. The ZIP flap technique has been adopted as a standard procedure in the unit for the management of low-level maxillary malignancy, and this report provides a detailed step-by-step approach to treatment and discusses modifications developed over the treatment of an initial cohort of patients.
Science, uncertainty and changing storylines in nature restoration
DEFF Research Database (Denmark)
R. Floor, Judith; (Kris) van Koppen, C.S.A.; Tatenhove, Jan P.M van
2018-01-01
Marine areas have been heavily affected by human activities, resulting in current attempts to both conserve and restore nature. In decisions about nature restoration, ecological knowledge plays a crucial role and is closely linked to nature preferences and political views. In this study......, the empirical case of seagrass (Zostera marina) restoration in the Dutch Wadden Sea (1989–2017) is analysed. The impact of storylines and uncertainty perceptions, together with socio-political context factors, on decisions concerning restoration action and research are investigated. This case illustrates...... the difficulties of establishing seagrass fields and the dynamic process in which meaning is attributed to nature restoration. Two basic storylines – authenticity and the ecological function of ecosystem engineers – supported the restoration efforts. Three different episodes are distinguished based on different...
Directory of Open Access Journals (Sweden)
Paula Bentham
2015-12-01
Full Text Available The Recovery Strategy for the Woodland Caribou (Rangifer tarandus caribou, Boreal Population in Canada (EC, 2012, identifies coordinated actions to reclaim woodland caribou habitat as a key step to meeting current and future caribou population objectives. Actions include restoring industrial landscape features such as roads, seismic lines, pipelines, cut-lines, and cleared areas in an effort to reduce landscape fragmentation and the changes in caribou population dynamics associated with changing predator-prey dynamics in highly fragmented landscapes. Reliance on habitat restoration as a recovery action within the federal recovery strategy is high, considering all Alberta populations have less than 65% undisturbed habitat, which is identified in the recovery strategy as a threshold providing a 60% chance that a local population will be self-sustaining. Alberta’s Provincial Woodland Caribou Policy also identifies habitat restoration as a critical component of long-term caribou habitat management. We review and discuss the history of caribou habitat restoration programs in Alberta and present outcomes and highlights of a caribou habitat restoration workshop attended by over 80 representatives from oil and gas, forestry, provincial and federal regulators, academia and consulting who have worked on restoration programs. Restoration initiatives in Alberta began in 2001 and have generally focused on construction methods, revegetation treatments, access control programs, and limiting plant species favourable to alternate prey. Specific treatments include tree planting initiatives, coarse woody debris management along linear features, and efforts for multi-company and multi-stakeholder coordinated habitat restoration on caribou range. Lessons learned from these programs have been incorporated into large scale habitat restoration projects near Grande Prairie, Cold Lake, and Fort McMurray. A key outcome of our review is the opportunity to provide a
Dejak, Beata; Młotkowski, Andrzej
2015-03-01
Polymerization shrinkage of composites is one of the main causes of leakage around dental restorations. Despite the large numbers of studies there is no consensus, what kind of teeth reconstruction--direct or indirect composite restorations are the most beneficial and the most durable. The aim was to compare equivalent stresses and contact adhesive stresses in molar teeth with class II MOD cavities, which were restored with inlays and direct restorations (taking into account polymerization shrinkage of composite resin) during simulated mastication. The study was conducted using the finite elements method with the application of contact elements. Three 3D models of first molars were created: model A was an intact tooth; model B--a tooth with a composite inlay, and model C--a tooth with a direct composite restoration. Polymerization linear shrinkage 0.7% of a direct composite restoration and resin luting cement was simulated (load 1). A computer simulation of mastication was performed (load 2). In these 2 situations, equivalent stresses according to the modified von Mises criterion (mvM) in the materials of mandibular first molar models with different restorations were calculated and compared. Contact stresses in the luting cement-tooth tissue adhesive interface around the restorations were also assessed and analyzed. Equivalent stresses in a tooth with a direct composite restoration (the entire volume of which was affected by polymerization shrinkage) were many times higher than in the tooth restored with a composite inlay (where shrinkage was present only in a thin layer of the luting cement). In dentin and enamel the stress values were 8-14 times higher, and were 13 times higher in the direct restoration than in the inlay. Likewise, contact stresses in the adhesive bond around the direct restoration were 6.5-7.7 times higher compared to an extraorally cured restoration. In the masticatory simulation, shear contact stresses in the adhesive bond around the direct
Infrastructure system restoration planning using evolutionary algorithms
Corns, Steven; Long, Suzanna K.; Shoberg, Thomas G.
2016-01-01
This paper presents an evolutionary algorithm to address restoration issues for supply chain interdependent critical infrastructure. Rapid restoration of infrastructure after a large-scale disaster is necessary to sustaining a nation's economy and security, but such long-term restoration has not been investigated as thoroughly as initial rescue and recovery efforts. A model of the Greater Saint Louis Missouri area was created and a disaster scenario simulated. An evolutionary algorithm is used to determine the order in which the bridges should be repaired based on indirect costs. Solutions were evaluated based on the reduction of indirect costs and the restoration of transportation capacity. When compared to a greedy algorithm, the evolutionary algorithm solution reduced indirect costs by approximately 12.4% by restoring automotive travel routes for workers and re-establishing the flow of commodities across the three rivers in the Saint Louis area.
Forest restoration is forward thinking
R. Kasten Dumroese; Brian J. Palik; John A. Stanturf
2015-01-01
It is not surprising to us that the topic of forest restoration is being discussed in the Journal of Forestry. It is a topic frequently bantered about in the literature; a quick search in Google Scholar for "forest restoration" generates more than 1 million hits. A significant portion of the debate centers on the search for succinct, holistic, universally...
Social welfare and restorative justice
Fox, Darrell
2009-01-01
"This paper explores the links and connections between social work and restorative justice. After a brief description of social work, restorative justice and family group conferencing, I will explore some the complementary theoretical links and practice applications, critically examining the potential implications and opportunities for social work practitioners and academics in relation to practice." [author's abstract
Prescribed burning for understory restoration
Kenneth W. Outcalt
2006-01-01
Because the longleaf ecosystem evolved with and is adapted to frequent fire, every 2 to 8 years, prescribed burning is often useful for restoring understory communities to a diverse ground layer of grasses, herbs, and small shrubs. This restoration provides habitat for a number of plant and animal species that are restricted to or found mostly in longleaf pine...
Cost-benefit analysis of wetland restoration
DEFF Research Database (Denmark)
Dubgaard, Alex
2004-01-01
The purpose of cost-benefit analysis (CBA) is to identify value for money solutions to government policies or projects. Environmental policy appraisal is typically complicated by the fact that thre are a number of feasible solutions to a decision problem - each yielding a different mix of environ...... is to illustrate the application of CBA within the field of river restoration. The Skjern River restoration project in Denmark is used as an empirical example of how these methods can be applied in the wetland restoration context....
Kemoli, A.M.; Opinya, G.N.; van Amerongen, W.E.; Mwalili, S.M.
2011-01-01
Purpose: The purpose of this study was to investigate the influence of 3 glass ionomer cement (GIC) brands and the postrestoration meal consumed on the survival rate of proximal atraumatic restorative treatment (ART) restorations. Methods: A total of 804 proximal restorations were placed in primary
Rangeland restoration for Hirola, the world's most endangered antelope
Rangeland restoration can improve habitat for threatened species such as the hirola antelope (Beatragus hunteri) that inhabit savannas of eastern Kenya. However, restoration success likely varies across soil types and target restoration species, as well as according to restoration approach. We teste...
2010-02-09
...-04] RIN 0648-ZC10 NOAA Great Lakes Habitat Restoration Program Project Grants under the Great Lakes... Atmospheric Administration (NOAA), Department of Commerce. ACTION: Notice of funding availability; Date... on January 19, 2010. That notice announced the NOAA Great Lakes Habitat Restoration Program Project...
Patil, Nivritti G; Cheng, Stephen W K; Wong, John
2003-08-01
Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.
Two-dimensional maximum entropy image restoration
International Nuclear Information System (INIS)
Brolley, J.E.; Lazarus, R.B.; Suydam, B.R.; Trussell, H.J.
1977-07-01
An optical check problem was constructed to test P LOG P maximum entropy restoration of an extremely distorted image. Useful recovery of the original image was obtained. Comparison with maximum a posteriori restoration is made. 7 figures
DEFF Research Database (Denmark)
Andres, Robert H; Meyer, Morten; Ducray, Angélique D
2008-01-01
There is increasing interest in the search for therapeutic options for diseases and injuries of the central nervous system (CNS), for which currently no effective treatment strategies are available. Replacement of damaged cells and restoration of function can be accomplished by transplantation of...
Tsuda, Shawn; Oleynikov, Dmitry; Gould, Jon; Azagury, Dan; Sandler, Bryan; Hutter, Matthew; Ross, Sharona; Haas, Eric; Brody, Fred; Satava, Richard
2015-10-01
The da Vinci(®) Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) is a computer-assisted (robotic) surgical system designed to enable and enhance minimally invasive surgery. The Food and Drug Administration (FDA) has cleared computer-assisted surgical systems for use by trained physicians in an operating room environment for laparoscopic surgical procedures in general, cardiac, colorectal, gynecologic, head and neck, thoracic and urologic surgical procedures. There are substantial numbers of peer-reviewed papers regarding the da Vinci(®) Surgical System, and a thoughtful assessment of evidence framed by clinical opinion is warranted. The SAGES da Vinci(®) TAVAC sub-committee performed a literature review of the da Vinci(®) Surgical System regarding gastrointestinal surgery. Conclusions by the sub-committee were vetted by the SAGES TAVAC Committee and SAGES Executive Board. Following revisions, the document was evaluated by the TAVAC Committee and Executive Board again for final approval. Several conclusions were drawn based on expert opinion organized by safety, efficacy, and cost for robotic foregut, bariatric, hepatobiliary/pancreatic, colorectal surgery, and single-incision cholecystectomy. Gastrointestinal surgery with the da Vinci(®) Surgical System is safe and comparable, but not superior to standard laparoscopic approaches. Although clinically acceptable, its use may be costly for select gastrointestinal procedures. Current data are limited to the da Vinci(®) Surgical System; further analyses are needed.