Biomedical subjects

Georges Van Maele

Publications and source records attributed to Georges Van Maele.

17 recordsLinked to original sources

PubMed2006

Recurrent changes in the work environment, job resources and distress among nurses: a comparative cross-sectional survey.

BACKGROUND AND OBJECTIVES: Occupational stress in nursing has frequently been considered in nursing literature. The operationalization of job demands in different work settings and its relation to distress have been discussed to identify significant interactions with job resources. In this study, job demands were defined as recurrent changes in the work environment of nurses (i.e. changing colleagues, supervisors, workplaces, working hours and tasks). In particular, we focused on the 'negative appraisal' (i.e. 'threat') of these changes. The interaction between 'threat' and job resources (i.e. timing control, method control and supervisor support) and its relation to distress among Registered Nurses was examined. METHODS: The study was part of a larger cross-sectional survey among 7863 (response rate 51%) employees belonging to 10 general hospitals in Belgium. The results are based on self-administered questionnaires of 1094 Registered Nurses employed in intensive care units (ICU) (n = 416) and surgery/medical wards (non-ICU) (n = 678). General Linear Modelling was used to test the moderating effects. RESULTS: In both study samples, 'threat' was positively associated with distress (P < 0.001). However, in contrast with non-ICU nurses, ICU nurses only considered 'supervisor support' as a significant moderator in the positive relationship between 'threat' and distress (P = 0.023). 'Timing and method control', instead of supervisor support, moderated this relation among non-ICU nurses (P = < 0.001 and 0.018, respectively). CONCLUSION: These findings provide additional evidence to consider negative appraisal of recurrent changes as occupational specific stressor in nursing. Moreover, the buffering effects which were found between 'threat' and the measured job resources in relation to distress, and the difference of these interactions in ICU and non-ICU health care settings, confirmed the suggestion to consider particular job characteristics in job stress research. Finally, the findings of our study may be of importance for nursing administrators who are dealing with distress among nurses.

Belgium↗

PubMed2006

Impact of recurrent changes in the work environment on nurses' psychological well-being and sickness absence.

AIM: This paper is a report of a study of how the occurrence and appraisal of recurrent changes in the work environment of hospital nurses affect psychological well-being (i.e. job satisfaction, eustress and distress) and absence through illness. BACKGROUND: Many researchers have demonstrated the impact of major organizational changes on employees' psychological well-being, but only a few have focused on the permanent consequences in work conditions. In a contemporary healthcare setting, an increased number of recurrent operational changes has become a normal characteristic of nurses' work environment. Specific work situations have frequently been associated with occupational stress, whereas employees' appraisal of recurrent changes as stressors and their relation to psychological well-being and health outcomes (i.e. sickness absence) have been dismissed. METHODS: A cross-sectional questionnaire survey was conducted in 2003 with 2094 Registered Nurses in 10 general hospitals. Logistic regressions were used to investigate the impact on psychological well-being and prospectively measured rates of sickness absence (frequency and duration). RESULTS: The occurrence of changes in the work environment (in the past 6 months) had had a negative impact on staff psychological well-being. Nurses who had been confronted with changes scored statistically significantly higher for distress. Changes appraised as threatening were negatively related to job satisfaction and eustress, and positively related to distress and sickness absence (frequency and duration). Changes appraised as challenging were positively related to job satisfaction and eustress but had no impact on distress and sickness absence. CONCLUSION: Future research should take into consideration the impact of the occurrence and appraisal of recurrent changes in the work environment of healthcare employees (i.e. Registered Nurses) on psychological well-being and sickness absence. This should also be considered by managers when dealing with these nursing workforce issues.

Absenteeism↗

PubMed2006

Co-operation, interaction and information-sharing: from a paper-based Diabetes Pass to an electronic alternative.

Diabetes is one of the most challenging problems in the 21st century, whereby research showed that reducing the concentration of blood glucose is thought to prevent or reduce the long-term complications. To do so, a multidisciplinary approach is favourable. In Belgium, a revalidation programme for the diabetic patients concerning self-regulation was introduced followed by the introduction of the Diabetes Pass in March 2003 whereby some goals were stipulated. In IBBT-COPLINTHO, a still ongoing project, an eHomeCare platform is implemented whereby the patient is the central actor. The analysis of the current paper-based Diabetes Pass revealed that the data can be easily extracted from the EHR. An electronic alternative for the Diabetes pass is proposed whereby the added values for the patient are underlined. Before implementing the electronic alternative, some research should still be done, but it is thought that all the actors involved--including the patient, could easily benefit from the electronic alternative.

Access to Information↗

PubMed2005

Vascular cognitive impairment in patients with late-onset seizures after an ischemic stroke.

BACKGROUND: Cognitive impairment and seizures are both common conditions in patients with cerebrovascular disease. PURPOSE: The present study investigates whether the occurrence of late-onset seizures, following an ischemic stroke, contributes to vascular cognitive impairment. PATIENTS AND METHODS: The mean Mini-Mental State Examination (MMSE) and the median modified Rankin (mR) scores were compared between 125 patients who developed late-onset seizures (66 with a single seizure and 59 with repeated seizures or epilepsy) following an ischemic stroke and 125 patients who did not during, at least, a 2-year follow-up. RESULTS: There were no differences in age, gender, etiology and degree of neurological impairment on admission for their stroke between the groups with and without seizures. Although the mean MMSE score was similar between both groups the median mR score was significantly higher in the seizure patients. Comparing the patients with a single seizure to the non-seizure ones showed the same results. On the other hand, comparison of the patients with epilepsy to the non-seizure group revealed, in addition to the higher median mR score, a significantly lower mean MMSE score in the former group. CONCLUSION: Repeated seizures following an ischemic stroke promote vascular cognitive impairment.

Adult↗

PubMed2005

Computed tomographic changes in lacunar syndromes.

BACKGROUND: Lacunes are small deep infarcts due to occlusion of long-perforating arterial branches. The clinical presentation and outcome are variable. The present study investigates the prognostic value of comparing repeated computed tomographic (CT) scans in patients with a lacunar syndrome (LACS). PATIENTS AND METHODS: From a series of 220 patients, subsequently admitted with a first-ever stroke, 32 were diagnosed as LACS. CT scans without contrast enhancement were performed on day 3 and 10 after onset of the symptoms. A lacune was considered as responsible for the LACS when its location corresponded to the expected cerebral hemisphere and when it changed in size and/or in X-ray attenuation on the CT scans from day 3 to 10. The size of the lacune was also measured and compared on both time points. The patients were divided into two groups according to the modified Rankin (R) scale at 3 months, in those who were independent (R 0-1-2) and in those who remained handicapped (R 3-4-5). RESULTS: The patients who remained disabled at 3 months were older and more severely impaired on admission, and had more frequent cardiac problems and cognitive decline than the independent ones. On CT scans of the brain a higher incidence of leukoaraiosis was observed in this group. Only in three patients of each group no relevant lacune could be observed both on day 3 and 10. The average size of the symptomatic lacune on day 3 and 10 was not statistically different between both groups, when comparing all patients with a LACS. When comparing only those patients with a visible symptomatic lacunar infarct on one of the CT scans, however, the average size of the symptomatic deep infarct was smaller in the independent than the handicapped patients on day 3 as well as on day 10. The lacune decreased in average size from day 3 to 10 in the former group but remained unchanged in the group of disabled patients. CONCLUSION: The outcome of patients with a LACS depends on several factors including age, cognitive and cardiac status, the presence of leukoaraiosis and also the size of the symptomatic lacune.

Adult↗

PubMed2005

Chronic levetiracetam treatment early in life decreases epileptiform events in young GAERS, but does not prevent the expression of spike and wave discharges during adulthood.

PURPOSE: In Genetic Absence Epilepsy Rats from Strasbourg (GAERS), age-related absence seizures start to appear from postnatal day (PN) 30 concomitant with 'spike and wave discharges' (SWDs) appearing on cortical EEG recordings. The aim of this study was to investigate the effect of early chronic levetiracetam (LEV) treatment on the development of SWDs in young and adult GAERS. METHODS: From PN 23 until PN 60, LEV (54 mg/kg, i.p.) was administered once daily to GAERS (n=8), while control GAERS (n=7) received saline (0.9% NaCl, i.p.). All animals were implanted with four epidural EEG electrodes at PN 51. EEG was recorded for 3h daily, during the last 4 days of the treatment (PN 57-PN 60) and during 4 additional days after treatment had been terminated (PN 61-PN 64). The animals were monitored again at the age of 4 months (PN 120-PN 124), about 2 months after the last administration of LEV. RESULTS: During treatment, epileptiform events in the LEV group were significantly reduced (62%, P<0.05) in comparison with the control group. During the following 4 days, epileptiform events were reduced in the LEV group, with an average difference of 53% (P=0.064). Once the animals had reached adult age, there was no difference in epileptiform events between the LEV group and controls. CONCLUSION: In this study, chronic LEV administration induced a reduction in epileptiform events in young GAERS. This effect persisted to some extent after treatment cessation (PN 61-PN 64), which might indicate a slowing down of epileptogenic processes. However, at the age of 4 months all animals revealed a similar expression of epileptiform discharges.

Aging↗

PubMed2005

Effects of hemi-portocaval shunts for inflow modulation on the outcome of small-for-size grafts in living donor liver transplantation.

Graft hyperperfusion in small-for-size grafts (SFSG) is considered the main causal factor of small-for-size syndrome (SFSS). We compared SFSG with a graft-to-recipient body ratio < or =0.8, with and without graft inflow modulation (GIM) by means of a hemi-portocaval shunt (HPCS). Thirteen patients underwent adult-to-adult living donor liver transplantation (AALDLT): G1, n = 5 [4 right livers (RL) and 1 left liver (LL)] without GIM, and G2, n = 8 (4 RL and 4 LL) with GIM. In G2 patients, portal vein flow (PVF) was significantly reduced by HPCS: 190 +/- 70 mL/min/100 g liver in G2 vs. 401 +/- 225 ml/min in G1 (p = 0.002). One- and 6-month post-transplantation graft volume/standard liver volume (GV/SLV) ratio was of 72% and 79.5% in G1; 80% and 101% in G2 (p = ns). SFSS was observed in three G1 recipients (who were retransplanted), but in none of the G2 patients. At 1-year, patient and graft survival was respectively of 40% and 20% in G1, 87.5% and 75% in G2 (p = 0.024 and 0.03). It is concluded that drastic reduction of PVF by means of HPCS improves overall patient and graft survival by averting the occurrence of SFSS. Graft inflow modulation through HPCS reduces the risk of complications when transplanting SFSG in adult recipients.

Female↗

PubMed2005

Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for the diagnosis of mediastinal lymphadenopathy.

STUDY OBJECTIVES: To analyze the accuracy of esophageal endoscopic ultrasound (EUS) with real-time, guided fine-needle aspiration (EUS-FNA) with an on-site cytopathologist in patients with (presumed) lung cancer presenting with mediastinal lymphadenopathy (ML) or a suspect left adrenal gland (LAG). DESIGN: A single-center prospective study. PATIENTS: Sixty-seven outpatients with (presumed) lung cancer with ML or a suspect LAG on either CT and/or positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) scan. INTERVENTIONS: All patients underwent EUS-FNA under conscious sedation. A cytopathologist was present during all procedures. MEASUREMENTS: EUS with and without fine-needle aspiration (FNA) as compared to FDG-PET was evaluated for accuracy in diagnosing cancer, safety, and rate of avoidance for further surgery. RESULTS: Of 67 consecutive patients (56 men; median age, 64 years), malignant ML or LAG were found in 47 patients (70.1%). In 20 patients (29.9%) without EUS-FNA proof of malignancy, confirmation was obtained by surgical procedure in 13 patients (sarcoidosis [n = 5], infection [n = 1], lung cancer [n = 7]) or by clinical follow-up in 5 patients suggesting benign disease. Sixty-five patients were included in the calculation of test characteristics. With malignancy as an end point, the accuracy for EUS-FNA was 100%. This was better than EUS without FNA (accuracy, 75.4%; p < 0.001) or FDG-PET (accuracy, 75.0% [n = 28]; p = 0.0011). When using final histopathologic diagnosis as an end point, the accuracy of EUS-FNA was 92.3%, since EUS-FNA was unable to show noncaseating granulomas in those patients with sarcoidosis diagnosed after mediastinoscopy. Related to the presence of the in situ cytopathologist, there were no inconclusive samples. No adverse events were recorded, and 67.7% of surgical interventions were avoided following EUS-FNA. CONCLUSIONS: The accuracy in this series of EUS-FNA with cytopathologist-assisted rapid on-site evaluation is high. The technique is safe and greatly reduces the number of surgical interventions.

Adult↗

PubMed2004

Tibial ultrasound velocity in women with wrist fracture.

The aim of the study was to determine whether cortical midtibial speed of sound (Soundscan 2000, Myriad Ultrasound Systems, Israel) was able to discriminate women who sustained a fracture of the distal radius from normal women and to compare the performance of tibial speed of sound with dual-energy X-ray absorptiometry (DXA) of the distal radius, hip, and lumbar spine. The study population consisted of 40 women with a wrist fracture and 41 healthy age-matched controls. Tibial ultrasound velocity correlated with bone mineral density of the distal forearm (rS = 0.64, p < 0.001), the hip (rS = 0.46, p < 0.001), and the lumbar spine (rS = 0.51, p < 0.001). The mean speed of sound value at the mid-tibia of the wrist fracture patients (3873 m/s) was lower than that of the controls (3913 m/s), but the difference was not statistically significant (p = 0.12). All DXA values were significantly lower in fracture cases. Receiver operating curve analysis showed that mid-tibial ultrasound velocity was less effective than DXA of the distal forearm to discriminate wrist fracture patients from age-matched controls.

Absorptiometry, Photon↗

PubMed2004

[Evaluation of pulpal blood flow by laser doppler flowmetry as a test of tooth vitality in long-term follow-up: case report].

The reliability of laser Doppler flowmetry in a 2-probe assessment of pulpal blood flow is well known. The purpose of this case report was to determine its use as an exclusive and reliable tool for tooth vitality diagnosis in a long-term follow-up. As a result of a traumatic injury to a 24-years old Caucasian female, tooth pulp vitality was studied in 6 maxillary front teeth over 30 weeks through use of 2-probe laser Doppler flowmetry and current sensitivity tests. A similar assessment was repeated after 228 weeks. Confronted with an alveolar bone fracture with a tooth in the fracture line, one intrusion and several luxated teeth, current sensitivity tests are found not to be so reliable indicators of revascularisation as significant results are given later (7 weeks) compared to laser Doppler flowmetry tests (1 week). A pathway with ischaemia (3 weeks), hyperaemia (7 weeks) and restored blood supply in the pulp measured by laser Doppler flowmetry tests was found and avoided endodontic treatment. Teeth vascularisation evolved normally (228 weeks). Despite a high indication in all sensitivity tests for endodontic treatment, the use of laser Doppler flowmetry tests was clear, more reliable than sensitivity tests and exclusive as denervation was postponed and pulp vascularisation was evident.

Adult↗

PubMed2003

Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization.

In acute nonvariceal gastrointestinal (GI) bleeding, immediate arteriographic haemostasis is presently assumed to be a therapeutic advantage. This study assesses whether the risk of a delayed haemostasis, caused by arteriographic findings precluding embolization, might influence patient outcome. We performed a 5.5-year retrospective database search to find all patients referred for arteriography to arrest acute nonvariceal GI bleeding with embolization. The embolized and nonembolized patients were compared for differences in baseline characteristics and bleeding parameters. In both groups the outcome of all endoscopic or surgical interventions after catheterization was included in the follow-up. Clinical success (at 30 days, after all therapy) and in-hospital mortality in the embolized and nonembolized group were compared. We retrieved 63 nonembolized bleedings in 58 patients and 49 embolized bleedings in 49 patients. In the nonembolized group, transfusion need and haemodynamic instability were significantly less severe. Forty-two of 63 (66%) nonembolized bleedings persisted requiring haemostasis by surgery (n=23), endoscopy (n=13) or supportive transfusions. Thirteen of 49 (27%) embolized bleedings recurred and were managed by surgery (n=7), endoscopy (n=3) or transfusion. Overall clinical success rate was 88.9% (56 of 63) in the nonembolized and 87.8% (43 of 49) in the embolized group. Mortality rate was 17.2% (10 of 58) in the nonembolized vs 30.6% (15 of 49) in the embolized patients (P=0.115). Whether or not arteriographic findings afforded the opportunity to embolize, outcome of acute nonvariceal GI bleeding did not differ significantly; however, patients undergoing embolization were more critically bleeding and ill.

Acute Disease↗

PubMed2003

Angiography for acute lower gastrointestinal hemorrhage: efficacy of cut film compared with digital subtraction techniques.

PURPOSE: To find out if digital subtraction angiography (DSA) has a different diagnostic power than conventional cut-film angiography in investigating acute lower gastrointestinal (GI) hemorrhage. MATERIALS AND METHODS: Retrospective analysis of two cohorts of patients investigated by angiography for acute lower GI hemorrhage was performed. One group of patients treated at one center ("hospital H") underwent conventional angiography. The other patients, treated at another center ("hospital G"), were investigated exclusively by DSA. The groups were compared for demographic characteristics, etiology, and bleeding parameters. The diagnostic power of both angiographic modalities was compared and statistically analyzed. RESULTS: Fifty-five lower GI hemorrhages investigated by conventional cut-film angiography and 53 cases studied by DSA were included. Both study groups had statistically similar demographic and bleeding characteristics. Overall sensitivity, specificity, and positive and negative predictive values of cut-film angiography for localizing the lower GI bleeding were 62%, 73%, 86%, and 42%, whereas, for DSA, the respective values were 60%, 100%, 100%, and 24% (Z-test P values were.78,.02,.03, and.16). CONCLUSIONS: DSA is as sensitive as conventional cut-film angiography for localizing acute lower GI bleeding. If a lesion is found, the chance that it will be the bleeding source is higher with DSA than with conventional angiography.

Acute Disease↗

PubMed2002

A two-probe laser Doppler flowmetry assessment as an exclusive diagnostic device in a long-term follow-up of traumatised teeth: a case report.

The reliability of laser Doppler flowmetry in a two-probe assessment of pulpal blood flow is well known. The purpose of this case report was to determine its use as an exclusive and reliable tool for tooth vitality diagnosis in a long-term follow-up. As a result of a traumatic injury to a 24-year-old Caucasian female, tooth pulp vitality was studied in six maxillary front teeth over 30 weeks using two-probe laser Doppler flowmetry and current sensitivity tests. A similar assessment was repeated after 228 weeks. Confronted with an alveolar bone fracture with a tooth in the fracture line, one intrusion and several luxated teeth, current sensitivity tests are found not to be as reliable indicators of revascularisation, as significant results are obtained later (7 weeks) than using laser Doppler flowmetry tests (1 week). A pathway with ischaemia (3 weeks), hyperaemia (7 weeks) and restored blood supply in the pulp measured by laser Doppler flowmetry tests was found and avoided endodontic treatment. Teeth vascularisation evolved normally (228 weeks). Despite a strong indication in all sensitivity tests for endodontic treatment, the use of laser Doppler flowmetry tests was clear, more reliable than sensitivity tests and exclusive, as denervation was postponed and pulp vascularisation evident.

Adult↗

PubMedDate not supplied

Predicting prognosis and effect of antibiotic treatment in rhinosinusitis.

PURPOSE: In evaluating complaints suggestive of rhinosinusitis, family physicians have to rely chiefly on the findings of a history, a physical examination, and plain radiographs. Yet, evidence of the value of signs, symptoms, or radiographs in the management of these patients is sparse. We aimed to determine whether clinical signs and symptoms or radiographic findings can predict the duration of the illness, the effect of antibiotic treatment, or both. METHODS: We analyzed data from 300 patients with rhinosinusitis-like complaints participating in a randomized controlled trial comparing amoxicillin with placebo. We used Cox regression analysis to assess the association between the presence at baseline of rhinosinusitis signs and symptoms or an abnormal radiograph and the subsequent course of the illness. We then tested for interactions to assess whether the presence of any of these findings predicted a beneficial effect of antibiotic treatment. RESULTS: Two factors at baseline were independently associated with a prolonged course of the illness: a general feeling of illness (hazard ratio = 0.77, 95% confidence interval, 0.60-0.99) and reduced productivity (hazard ratio = 0.68, 95% confidence interval, 0.53-0.88). Neither typical sinusitis signs and symptoms nor abnormal radiographs had any prognostic value. Prognosis remained unchanged whether or not patients were treated with antibiotics, no matter what symptoms patients had at baseline. CONCLUSIONS: In a large group of average patients with rhinosinusitis, neither the presence of typical signs or symptoms nor an abnormal radiograph provided information with regard to the prognosis or the effect of amoxicillin. The time to recovery was longer in patients who felt ill at baseline or who did not feel able to work, but the course of their illness was not influenced by antibiotic treatment.

Acute Disease↗

PubMedDate not supplied

An 18-year retrospective survival study of full crowns with or without posts.

PURPOSE: This study of full crowns investigated long-term survival in relationship to biologic and technical variables. MATERIALS AND METHODS: A total of 1,037 full crowns in 456 patients, made in an undergraduate university clinic, were evaluated over an 18-year period. All patients were offered a supportive maintenance program. Failures of full crowns were classified as irreversible (loss of full crown and/or tooth) or reversible (full crown intact after conservative treatment) complications and as biologic or technical/patient-related failures. RESULTS: The Kaplan-Meier survival rate after 18 years was 78%. No statistically significant differences were found between restorations in the maxilla and mandible (P= .150); between restorations on molars, premolars, and anterior teeth (P = .671); and between restorations on posts and cores compared to restorations without posts and cores (P = .602). For the surviving restorations, the improved plaque score over time was statistically significant (P = .001). Biologic failures (66.4%) resulting in removal were more common than technical and patient-related failures (33.6%). Caries was the most frequent reason for failure (irreversible complication). CONCLUSION: The survival of full crowns made in an undergraduate university clinic during an 18-year period is comparable to the results published by university departments or private practitioners. Plaque scores and bleeding on probing were not directly related to failures. Occurrence of a previously reversible complication is a predicting factor for an irreversible complication. A reversible complication within the first 2 years will probably lead to an early irreversible complication.

Adolescent↗

PubMedDate not supplied

A 20-year retrospective survival study of fixed partial dentures.

PURPOSE: This study of fixed partial dentures (FPDs) evaluated the long-term efficacy and determined frequencies and causes of failures. MATERIALS AND METHODS: A total of 322 FPDs in 193 patients, fabricated at an undergraduate university clinic, were evaluated over a 20-year period. All patients were invited to participate in a supportive maintenance program. Failures of the FPDs were divided into irreversible complications (loss of FPD/abutment) and reversible complications (FPD intact after conservative treatment) and into biologic and technical/patient-related failures. RESULTS: The Kaplan-Meier survival rate after 20 years was 66.2%. Statistically significant differences in survival rates were found between FPDs without post-and-core abutment teeth as compared to FPDs with at least one post-and-core abutment tooth (P = .002) and for vital abutments versus post-and-core abutments (P = .001), but significant differences were not found between restorations in the maxilla and mandible (P = .27). Caries and loss of retention were the main reasons for failure and accounted for 61% of the failures. CONCLUSION: The survival of FPDs by undergraduate students at a university clinic during a 20-year period was comparable to the results published by university departments or general practitioners. Occurrence of a previously reversible complication is a predictive factor for an irreversible complication later on. A reversible complication within the first 2 years will probably lead to an early irreversible complication.

Adult↗

PubMedDate not supplied

Single-tooth replacement: is a 3-unit fixed partial denture still an option? A 20-year retrospective study.

PURPOSE: This study of 3-unit fixed partial dentures (FPDs) evaluated the long-term efficacy and determined the frequencies and causes of failures. MATERIALS AND METHODS: A total of 134 FPDs made in an undergraduate university clinic for 98 patients were evaluated over a 20-year period. All patients were offered a supportive maintenance program. Failures of the FPDs were divided into irreversible (loss of FPDs) or reversible (FPDs intact after conservative treatment) complications and into biologic and technical/patient-related failures. RESULTS: The overall survival rate was 73.1% after 20 years. There was a statistically significant difference (P = .036) between the survival rates in the mandible for the vital group (96.3%) versus the root canal-treated group (69.3%). Comparing the survival rate in the vital group for the restorations in the maxilla (70.2%) versus the mandible (96.3%), a statistically significant difference (P = .045) was found. The survival rate after 20 years for the 3-unit FPDs (73.1%) was significantly different from that of the FPDs with more than 3 units (61.5%) (P = .026). The main reason for failure was caries (38.1%). CONCLUSION: The survival of 3-unit FPDs over a 20-year period is favorable and should be compared with other single-tooth replacement treatment options. There is an indication that the occurrence of a reversible complication has a predictive value for an irreversible complication later on.

Adult↗