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At least 505 records · Page 28Linked to original sources
PubMed2003

Treatment with removable partial dentures: a longitudinal study. Part I.

The aim of this study was to evaluate the effectiveness of an oral rehabilitation by removable partial denture (RPD). Between 1983 and 1994, 629 patients were provided with an RPD at the Dental School of the Université catholique de Louvain. All the RPDs were constructed with a cobalt-chromium framework. All the treatments were provided by dental students under the supervision of clinical instructors. At recall time (1998-2000), 269 patients could not be reached neither by telephone nor by mail and 27 had died. Consequently, 333 patients were called for clinical examination and 254 of these (76.3%) actually attended. For a total of 292 RPDs fitted for these 254 patients, 218 (74.7%) were still being worn at the time of the check-up. Seventy-four dentures were considered to be 'failures', either because they were replaced by another RPD or by a complete denture, or because they had actually never been worn. The statistical analysis (Mantel-Haenszel and Kaplan-Meier) shows that the number of failures is significantly higher at the lower jaw compared with the upper jaw. Most of the failures are attributable to RPDs with free-end saddles and, in particular, to class I mandibular dentures. The patients are wearing their denture(s) mostly continuously (63.6%) and award a high degree of satisfaction to their denture. In general, the results recorded may be considered as very satisfactory, all the more so as we have no regular recall procedures established at our school and as check-up asked for spontaneously by the patients in the course of the period of observation are most of the time occasional or non-existent.

Chromium Alloys↗
PubMed2003

Treatment with removable partial dentures: a longitudinal study. Part II.

The aim of this study was to evaluate the effectiveness of an oral rehabilitation by removable partial denture (RPD). Between 1983 and 1994, 629 patients were provided with an RPD at the Dental School of the Université catholique de Louvain. All the RPDs were constructed with a cobalt-chromium framework. All the treatments were provided by dental students under the supervision of clinical instructors. At recall time (1998-2000), 269 patients could not be reached neither by telephone nor by mail and 27 had died. Consequently, 333 patients were called for clinical examination and 254 of these (76.3%) actually attended. For a total of 292 RPDs checked 1893 persistent teeth were listed, with 804 serving as abutments; more than half (57.6%) of these were crowned, for which 51 debondings were recorded. For the period of observation we listed 79 abutments lost (37 at the upper jaw and 42 at the lower jaw), i.e. 9.8% of the total number of abutments. No relation could be established between the type of the abutments (natural or crowned teeth) and the losses observed (Test of Mantel-Haenszel: P=0.9496). In the upper jaw, the percentage of abutments lost was significantly higher in the presence of free-end edentulous areas as compared with bounded edentulous areas (Test of Mantel-Haenszel: P=0.0002); this difference does not appear for the lower jaws (P=0.9558). If we deduct the 25 abutments related with the 11 non-worn RPDs and the 79 abutments lost, no change becomes apparent for 92.2% of the maxillary abutments and for 85.8% of the mandibular abutments. For the 1089 other teeth, we observed the loss of 40 teeth and the appearance of caries or new fillings for 95 teeth. The fractures of cast clasps represent 3.4%.

Chromium Alloys↗
PubMed1999

[EHBMP-2. Initial BMP analog with osteoinductive properties].

For the first time a non natural BMP-variant (EHBMP-2) with osteoinductive properties was produced by expression in E. coli through specific mutation of the amino acid sequence. The substitution of 12 N-terminal amino acids by a nonsense sequence results in a neglectible affinity of EHBMP-2 to the extracellular matrix. In vitro EHBMP-2 induces dose-dependent cartilage formation in neonatal muscle tissue. Single intramuscular implantation in mice results in the formation of an ossicle with functional active bone marrow. The size of the ossicle depends on the amount of implanted EHBMP-2 and can significantly be increased by the combination with a collagen carrier. The largest bone formation is observed after injection of EHBMP-2 containing collagen suspensions. In rats a stronger osteoinductive activity can be achieved by coupling of EHBMP-2 to collagen discs than by coupling natural BMP-2 to the same collagen carrier. Critical size defects in rats' mandibular angels can be restored by the combination of granular collagenous bone matrix (ICBM) with EHBMP-2. Further investigations have to show whether the altered pharmacokinetics of EHBMP-2 has advantages regarding its therapeutical use and tissue-engineering.

Amino Acid Substitution↗
PubMed2000

[Gunshot injuries].

Gunshot wounds result in a great amount of tissue damage, relating almost always to fractures and defects of the skeleton. The damage varies in relation to the speed, size, shape, and striking angle of the projectile and to the disruption of hard tissue fragments, which multiply the tissue laceration acting as secondary missiles. The rules to be observed in treatment of gunshot wounds are based on experience which was gained during World War I and II. Most of the rules have proved to be a success and may be summarized as follows: approach from inside to outside, preservation of the anatomical relationships of the remaining bony tissues, and primary wound closure. On the other hand, considerable progress has been made concerning reconstruction and establishing a number of new methods in order to create better functional and esthetic results.

Adult↗
PubMed2003

Functional reconstruction of the oral cavity.

Reconstruction of the oral cavity is an intricate subject that reflects the complexity of the oral cavity itself. There is no perfect reconstruction. Presented here are the current optimal choices for the various regions within the oral cavity. We are constantly seeking to improve these reconstructions in an effort to restore optimal function to patients unfortunate enough to require surgical excision of this most elaborate of anatomic structures.

Adult↗
PubMed2003

[Condylar reconstruction after resection of an intracapsular stomach carcinoma metastasis].

BACKGROUND: The mandible is a very uncommon place for a metastasis of a gastric carcinoma. Normally the area of the temporomandibular joint (TMJ) remains unaffected. The separate vascularization is discussed as one reason among others. Primary reconstruction after resection of the condyle is often problematic because an early onset of adjuvant systemic therapy is required. In this case, the insertion of a Quinn joint prosthesis is presented after resection of a TMJ metastasis. CASE: We report a hematogenic metastatic gastric adenocarcinoma in a 51-year old male who initially presented with increasing disclusion in the left molar region. Suspecting a metastatic adenocarcinoma of the TMJ, a condylectomy with immediate replacement by a total joint prosthesis was performed via a preauricular approach. Corresponding to the clinically and radiologically suspected diagnosis, the decalcified histological specimen presented as a metastatic gastric adenocarcinoma within the intracapsular region. RESULTS: The healing period of the implanted modified Quinn prosthesis was fast and uncomplicated after resection of this, to our knowledge, first documented metastatic gastric adenocarcinoma of the intracapsular region. After early restoration of joint function and patient satisfaction, the required radiochemotherapy of further unresectable bony metastases could be started in time. DISCUSSION: This example of an extremely rare case of a metastasis shows that such a total joint prosthesis appears to be a very good alternative to extended autogenous reconstruction or an unsatisfactory primary resection. Due to the mating of the spherical condylar head and glenoid fossa, the modified Quinn prosthesis is very suitable for total joint replacement after extended resection or in multiply preoperated cases.

Adenocarcinoma↗
PubMed2004

[Rapid prototyping in planning reconstructive surgery of the head and neck. Review and evaluation of indications in clinical use].

PURPOSE: The aim was to define the indications for use of rapid prototyping models based on data of patients treated with this technique. PATIENTS AND METHODS: Since 1987 our department has been developing methods of rapid prototyping in surgery planning. During the study, first the statistical and reproducible anatomical precision of rapid prototyping models was determined on pig skull measurements depending on CT parameters and method of rapid prototyping. RESULTS: Measurements on stereolithography models and on selective laser sintered models confirmed an accuracy of +/-0.88 mm or 2.7% (maximum deviation: -3.0 mm to +3.2 mm) independently from CT parameters or method of rapid prototyping, respectively. With the same precision of models multilayer helical CT with a higher rate is the preferable method of data acquisition compared to conventional helical CT. From 1990 to 2002 in atotal of 122 patients, 127 rapid prototyping models were manufactured: in 112 patients stereolithography models, in 2 patients an additional stereolithography model, in 2 patients an additional selective laser sinter model, in 1 patient an additional milled model, and in 10 patients just a selective laser sinter model. CONCLUSION: Reconstructive surgery, distraction osteogenesis including midface distraction, and dental implantology are proven to be the major indications for rapid prototyping as confirmed in a review of the literature. Surgery planning on rapid prototyping models should only be used in individual cases due to radiation dose and high costs. Routine use of this technique only seems to be indicated in skull reconstruction and distraction osteogenesis.

Computer Graphics↗
PubMed2000

[Computer-assisted insertion of zygomatic implants (Brånemark system) after extensive tumor surgery].

Installation of fixtures for prosthetic reconstruction of the upper jaw in patients with extensive bone and soft tissue defects is still a challenge. The new fixture developed by Brånemark System achieves immediate prosthetic reconstruction by anchoring implants in the zygomatic bone to offer sufficient support without bone grafts. The dimension of these zygomatic fixtures and the complex anatomy due to previous surgical procedures demand specific treatment for a precise and safe insertion of the implants. On the basis of an axial spiral CT data set, the STN navigation system (Stryker-Leibinger/Zeiss) was used for preoperative planning and intraoperative control of the insertion of zygomatic fixtures after subtotal maxillectomy. Computer-assisted insertion of zygomatic fixtures was successfully completed. The implants could be positioned precisely as preoperatively planned. The use of zygomatic fixtures after ablative tumor surgery with resection of the maxillary bone provides immediate prosthetic reconstruction without additional bone grafting. Computer-assisted insertion of these implants improves preoperative planning and facilitates clinical procedure.

Computer-Aided Design↗
PubMed1979

Treatment of compromised teeth: a multidisciplinary approach.

Treatment for uprighted abutment teeth that may have infrabony pockets can be considered complete when the following criteria are met: 1. The uprighted tooth is in its proper vertical axis. 2. There is a significant decrease in soft-tissue pocket depth. 3. Crestal leveling is evident radiographically. 4. Adequate space has been created to accommodate a pontic (minimally 6.5mm). The advantages of employing this orthodontic-periodontal technique are as follows: 1. Leveling of the osseous crest fosters pocket elimination obviating the necessity for removal of a great deal of supporting bone. Concomitantly, a significant decrease in pocket depth usually eliminated the need for periodontal surgery. 2. The resulting occlusal forces are placed in favorable axial inclinations. 3. There is an improved crown-to-root ratio, since the uprighted and extruded tooth is reduced to the level of the occlusal plane. This reduction is sufficient to improve considerably the prognosis of a questionable abutment tooth. 4. A pontic space is created for an esthetic and properly contoured pontic. 5. Parallelism is attained, so that the marginal integrity is more easily accomplished. 6. The orthodontic procedures are relatively uncomplicated, efficient, and esthetic, provided there is little or no lower anterior crowding. 7. The restorative dentist has a proper abutment tooth with a good prognosis for prosthesis.

Adult↗