Biomedical subjects
Publications and source records attributed to R E Lamb.
The analgesic agents most frequently employed in the critical care setting are the opioids, nonopioid analgesics, and local anesthetics. Indications for these agents are reviewed as well as their mechanisms of action, adverse reaction profiles, and available routes or methods of administration. This information can be used to ensure that the most appropriate analgesic agent is selected for the critical care patient.
"If it ain't broke, don't fix it" is a classic quote that is still heard. Although health professionals strive for continuous improvement in the understanding, prevention, and treatment of pathology, they commonly ignore the system for health care delivery. DUE provides an effective mechanism for continuous examination of the system and improvement of patient outcome as it relates to drug therapy. The movement toward integration of DUE and clinical profiles will bring the Medical Center closer to realizing the ultimate goal of total quality care.
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Many clinicians have reported on the success of immediately loaded implants supporting a bilaterally stabilized provisional fixed prosthesis. This protocol offers several advantages, including increased masticatory function, minimized uncontrolled transmucosal loading through cross-arch stabilization, improvement of psychologic well-being, and reduction in treatment time. However, the development and maintenance of proper dentogingival esthetics in the edentulous maxilla presents substantial challenges for the implant team. This article presents the specific pretreatment diagnostic requirements for immediate loading of single-stage implants and demonstrates a new surgical technique, followed by appropriate prosthodontic management, to develop an optimal gingival profile with interdental papillae surrounding a natural-looking dentition. One hundred fifty-one ITI implants were placed into 22 dental arches and immediately loaded with a 1-piece fixed prosthesis. The results of this technique over the last 5 years are presented.
Despite significant advances in dental therapeutics, there are patients for whom no reasonable treatment is available that will reliably restore or maintain their existing dentition. The causes of future edentulism include advanced caries, failing root canal therapy, inadequate numbers of teeth to support a fixed prosthesis, untreatable periodontal disease, or a history of failed previous rehabilitations. For these patients, dental implants may provide a more predictable future than retention of their remaining teeth. It is proposed that transitional fixed prostheses designed specifically for a patient with terminal dentition offer the advantage of maintenance and development of proper gingival esthetics with improved function. Prior to implant placement, the gingival frame is established, enhancing the overall appearance of the final, full-arch implant rehabilitation. The specific prosthodontic and surgical techniques required for successful treatment of these patients are presented.
Successful treatment of furcated molar teeth presents the periodontist and prosthodontist with a challenging dilemma. Accepted treatment modalities include chemotherapeutic maintenance, root planning, open flap debridement, modified Widman flap, bone grafting with and without guided tissue regeneration, and osseous resection with and without root removal. Determining the appropriate treatment for an individual patient that is both cost-effective and offers the greatest long-term prognosis can be a daunting task. The literature is replete with studies of different therapeutic alternatives for furcated molar teeth. A relatively new treatment option is complete removal of the tooth combined with ultimate placement of an endosseous implant and restoration with a single crown. A review of the relevant literature with special emphasis on root resection therapy and single molar implant placement is presented. The relative merits of each treatment modality and guidelines for their use are discussed.