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At least 1,333 records · Page 74Linked to original sources

Studies of changes in occlusion after the insertion of complete dentures. Part I.

The present study aims to investigate changes in the occlusion of complete dentures after their insertion. A total of 85 edentulous patients were provided with new complete dentures. Their individual hinge axes were determined using mechanical axiography and the upper finished dentures were transferred by facebows to Dentatus articulators. The lower dentures were mounted according to an intraoral central bearing point (CBP) registration and equilibrated in terminal hinge position. An articulator specially modified for measurements in the condylar area was used. The differences between the positions of the condylar balls with CBP registration and those after equilibrating the occlusion were determined. On average, 19 days after insertion, 71 patients took part in a follow-up examination. As in the first session, the terminal hinge position was registered with the CBP method using the apex of the Gothic arch. Thus, the positions of the condylar balls immediately after the new registration could be compared with those in equilibrated intercuspation 3 weeks earlier. The differences were found to be 0.5 +/- 0.4 mm (0-2.9 mm) in the three axes (sagittal, coronal and horizontal). They are thought to result from settling into the denture bearing tissues and also from neuromuscular adjustment of the masticatory system. Compulsory remounting of complete dentures after insertion is therefore recommended.

Adaptation, Physiological↗

Comfortable zone of the mandible evaluated by the constant stimuli method.

For evaluation of the comfortable zone (CZ) and the most comfortable position (MCP) of the occlusal vertical relation of the mandible, the constant stimuli method with three subjective categories of judgements was applied in 10 edentulous subjects. The evaluated CZ was stable and about 3 mm in width. The occlusal vertical dimension (OVD) of the existing dentures was found to be located within the CZ in nine of the 10 subjects.

Aged↗

A hollow-bulb interim obturator for maxillary resection. A case report.

The treatment of hemimaxillectomy patients include the construction of an interim obturator in the wound healing period. With the aim of simplifying this process, we describe construction of an obturator in a short single visit, in the dental chair with no need for impressions or for laboratory services. The obturator comprises: (i) the surgical obturator and (ii) a hollow light-cured resin bulb built onto the base, and providing a large surface for bonding of the soft reline material. The advantages of this approach are rapid construction and ease of ongoing adjustment during the healing process.

Adult↗

Orthokeratology for myopic children: wolf in sheep's clothing?

Orthokeratology attempts to reduce myopia by remoulding the corneal shape with contact lenses. A recent resurgence is predicated on new contact lens designs with a prefigured back contact surface and higher oxygen transmissibility. This Clinical Controversy presents an analysis of the risk factors associated with orthokeratology and its suitability for children, followed by commentaries from specialists who have an interest in the method. Some state that there is a lack of data on relative risks of corneal infection and that there is a need for large-scale randomized controlled studies; however, opinion is expressed by others that orthokeratology is a clinically safe procedure using modern lenses. It is noted that the physiological and biophysical bases of orthokeratology are virtually unknown, and further research on the human cornea is indicated to scientifically establish the safety of orthokeratology. Prospective patients, and their parents in the case of children, should be fully informed of the risks.

Child↗

Practice of orthokeratology by a group of contact lens practitioners in Hong Kong. Part 2: orthokeratology lenses.

PURPOSE: The aim of the study was to provide information about the characteristics of three main types of orthokeratology (ortho-k) lenses used in Hong Kong and to report on their performance based on the clinical impressions of a group of ortho-k practitioners. METHOD: Twelve ortho-k practitioners were interviewed between 1 March and 30 June 2001. RESULTS: Most ortho-k lenses were ordered from three manufacturers: DreimLens, Fargo and Contex. The median maximum myopia reduction reported for DreimLens, Contex and Fargo lenses were 6.25 D, 6.00 D and 4.50 D respectively. The time to reduce myopia by up to 4.00 D could be up to three weeks for Contex and DreimLens and up to four weeks for Fargo. For reduction of myopia by up to 4.00 D, the treatment usually required only one or two lenses per eye for all three types of lenses. The incidence of lens binding and lens tightening after achieving the optimal reduction was reported to be higher with the DreimLens design. Good centration, less lens binding, relatively lower incidence of complications and lens tightening after achieving the optimal reduction were reported with the Fargo lenses. CONCLUSIONS: DreimLens tended to be more effective for myopia reduction. However, some practitioners were concerned with the aggressiveness of myopia reduction using this lens design and the higher potential for ocular complications. Selection of the lens design is dependent on various factors, in particular, practitioners need to be comfortable with the design they choose and to consider the needs of their patients and the final goal of the treatment.

Contact Lenses↗

An evaluation of silicone-hydrogel lenses worn on a daily wear basis.

PURPOSE: To examine the clinical performance of two brands of silicone-hydrogel lenses when worn on a daily wear basis. METHODS: Fifty-six subjects with no ocular disease were enrolled at multiple sites in Australasia. Contact lenses made from galyfilcon A or lotrafilcon A were randomly assigned to each eye of the subject and the lenses were worn on a daily wear basis for a period of two weeks. Subjects did not know the identity of the lenses they wore. Clinical data and patient responses to a questionnaire were gathered at an initial visit and after two weeks of wear. RESULTS: For both lenses, the degree of limbal hyperaemia and bulbar conjunctival hyperaemia decreased significantly over the two-week wearing period. The eyes wearing galyfilcon A lenses showed an increase in conjunctival staining compared to the baseline measures. On average, galyfilcon A lenses decentred more and moved less than the lotrafilcon A lenses. The lotrafilcon A lenses showed a greater loss of wettability, as judged by practitioner grading, than the galyfilcon A lenses over the two-week period. The subjective responses showed strong preference for the galyfilcon A lens across 26 of 27 questions relating to comfort, vision, handling, preference and other subjective outcomes. DISCUSSION: The results show that different silicone-hydrogel lenses have different performance characteristics on the eye, when worn on a daily wear basis. Striving for high oxygen transmissibility at the expense of other properties may lead to a range of undesirable performance characteristics.

Adolescent↗

A one-appointment mouthstick appliance.

Quadriplegics rely on mouthstick appliances to perform a variety of tasks to establish more self-sufficiency. Present techniques to fabricate a quality mouthstick applicance requires professional expertise, time, and laboratory expense. A technique for providing an inexpensive, durable mouthstick appliance in one appointment is described.

Equipment Design↗

Checklist for the removable prosthesis wax trial insertion appointment.

A checklist is described that is designed to permit a systematic evaluation of the factors involved in the trial insertion appointment. The checklist aids both the student and the instructor in assuring that items are not overlooked during this important appointment. More equitable grading of the student's preparation and knowledge is facilitated. The checklist also serves as an excellent patient approval form.

Denture, Complete↗

Relining an ocular prosthesis: a case report.

There are times when a patient who has an ocular prosthesis may need surgery to correct an anophthalmic socket defect or to replace an implant. When such a situation arises, it may not be possible to construct a new prosthesis soon after surgery. In this article, a technique for relining an ocular prosthesis is described.

Acrylic Resins↗

Prosthodontic management of a combination transosteal/endosteal implant reconstruction: a clinical report.

This is a clinical report of a patient who was not referred for prosthodontic evaluation and treatment until after undergoing Bränemark endosseous implant placement to supplement the previously existing mandibular staple bone plate implant. This supplemental treatment was the surgeon's attempt to resolve the patient's complaint of loose dentures. Creativity with implant biomechanics and prosthodontic design were necessary to restore the patient, in a predictable manner, to normal function. A fixed, detachable cast overdenture bar rigidly connected to all the implants was constructed utilizing resilient attachments to retain the tissue-supported mandibular overdenture. A presurgical prosthodontic evaluation could have averted many of the problems encountered with treatment. More effective conventional prosthodontic treatment may have resolved the patient's complaints and eliminated the need for additional implant placement.

Bone Plates↗

Comparison of strains transferred to a bone simulant between as-cast and postsoldered implant frameworks for a five-implant-supported fixed prosthesis.

PURPOSE: To measure and compare the strains transferred by screw-fastening one-piece full-arch prostheses as cast and after sectioning and soldering. MATERIALS AND METHODS: Photoelastic resin was applied directly to five 3.75 x 13-mm Brånemark implants, situated 7 mm apart, in a silicone mold of an edentulous mandible. Four strain gauge rosettes were also incorporated in the resin to allow strain measurements at four locations. Three frameworks were made from a single master cast produced from an impression of the five-implant model with 4-mm abutments. These frameworks were sequentially secured to the master model with five gold slot screws tightened to 10 N cm. Strain indicator readings were recorded at a standardized time following the initial fastening of each prosthesis. The test was repeated three times. Each of the three castings were subsequently sectioned and soldered in two locations, mesial to the two terminal fixtures. After soldering, the three superstructures were returned to the master model for measurement of postsolder strains three times each. A one-way repeated-measures ANOVA was performed to determine differences between mean principal strains between the as-cast and postsoldered groups. RESULTS: A statistically significant difference was found in the principal strains between the as-cast and soldered frameworks. Overall, there was a decrease in the magnitude of strain for the soldered frameworks. CONCLUSIONS: Sectioning and soldering improved the as-cast accuracy as far as the amount of strain transferred to the bone simulant.

Alveolar Process↗

Controlled retainer-screw access placement for screw-retained implant prosthesis.

An implant-supported prosthesis is often secured to the underlying gold cylinders by retaining screws. There must be access to these screws from the oral surface of the prosthesis. Conventional preparation of this access is from the oral surface. This approach is difficult because the underlying gold cylinder is obscured. It may be damaged by a rotary cutting instrument as the access is prepared above it, because the cylinder cannot be seen during the preparation. Alternatively, the access hole may be unnecessarily enlarged in an attempt to find the cylinder. This loss of structure may weaken the prosthesis. A new approach, using 18-gauge stainless steel wire as a rotary cutting instrument, permits preparation of the access chamber from the intaglio surface of the prosthesis. This reduces risk of damage to the gold cylinder and is less destructive to the overlying material.

Bone Screws↗

An effective technique for denture border evaluation.

Proper extension and adjustment of denture borders is a critical component in successful removable prosthodontic treatment. Unfortunately, commonly marketed disclosing media may not provide appropriate viscosities for the accurate assessment of denture border extensions. This article provides a technique for the mixing, unit-dose packaging, and utilization of a disclosing medium that is extremely well-suited for denture border applications. The technique employs commonly available materials and compiles with current "unit-dose" guidelines.

Denture Bases↗