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At least 19 recordsLinked to original sources

Speech prosthesis retention problems in dysarthria: case report.

Prosthesis retention and adaptation problems in the management of dysarthria due to paralysis of the palatopharyngeal mechanism has been frequently reported in the literature. This report describes treatment of speech prosthesis retention difficulty in a 20-year-old woman who sustained a cranial cerebral trauma in a motor vehicle accident. Residual deficits included moderate-to-severe dysarthria with a significant palatopharyngeal valving disorder, higher level cognitive impairments, and long-term memory deficits. Speech intelligibility was maximized via the fitting of an intraoral speech prosthesis. Sensory perceptual changes created by the appliance resulted in prosthesis retention problems. When traditional desensitization techniques were unsuccessful, introduction of a topical anesthetic, Zylocaine Viscous, blocked the sensory feedback loop and eliminated the retention problem.

Adaptation, Physiological↗

Staphylococcus aureus prosthetic joint infection treated with debridement and prosthesis retention.

Debridement and retention of the prosthesis was the initial treatment modality in 30 patients with 33 Staphylococcus aureus prosthetic joint infections (PJIs) who presented to the Mayo Clinic between 1980 and 1991. Treatment failure, defined as relapse of S. aureus PJI or occurrence of culture-negative PJI during continuous antistaphylococcal therapy, occurred in 21 of 33 prosthetic joints. The 1-year and 2-year cumulative probabilities of treatment failure were 54% (95% confidence interval [CI], 36%-71%) and 69% (95% CI, 52%-86%), respectively. A median of 4 additional surgical procedures (range, 1-9) were required to control the infection in the 21 prosthetic joints for which treatment failed. Prostheses that were debrided >2 days after onset of symptoms were associated with a higher probability of treatment failure than were those debrided within 2 days of onset (relative risk, 4.2; 95% CI, 1.6-10.3). These data suggest that debridement and retention of the prosthesis as the initial therapy for PJI due to S. aureus is associated with a high cumulative probability of treatment failure and that the probability of treatment failure may be related to the duration of symptoms.

Adult↗

Hamular frenum modification: a removable denture prosthesis retention and stability enhancement.

A removable denture prosthesis, whether partial or complete, often requires preprosthetic surgery to achieve optimum stabilization and retention. While the hamular frenum may produce significant dynamic dislodging forces, a literature review did not reveal any reports dealing with this problem. A hamular frenum reduction surgical procedure using the free autogenous gingival graft procedure is described. Prosthetic function may be enhanced by eliminating the dynamic disrupting force of the hamular frenum along with improving posterior maxillary tuberosity contour and, as necessary, premaxillary form, allowing these contours to work in concert to develop a "cupping" stabilizing and retentive complex.

Aged↗

Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis.

Debridement with retention of the prosthesis was the initial treatment modality for 19 cases of penicillin-susceptible streptococcal prosthetic joint infection that occurred in 18 patients who presented to the Mayo Clinic (Rochester, Minnesota) during 1969-1998. All of the cases of prosthetic joint infection occurred >30 days after implantation of the prosthesis, which was well fixed at the time of debridement. The median duration of symptoms before debridement was 4 days (range, 1-10 days). Treatment failure (defined as relapse of infection with the original microorganism) occurred in 2 cases (10.5%) during a median follow-up period of 3.9 years (range, 0.3-21.7 years). The 1-year cumulative risk of relapse was 11% (95% confidence interval, 0%-26%). Relapse of prosthetic joint infection due to penicillin-susceptible streptococci after debridement and retention of the prosthesis is uncommon. For patients who present with a well-fixed prosthesis and a short duration of symptoms, debridement with retention appears to be an effective treatment modality.

Adolescent↗

Stress analysis after total knee arthroplasty with posterior cruciate ligament-resection type and -retention type prosthesis--with special reference to the significance of retaining the posterior cruciate ligament.

Stress analyses in knees replaced with PCL-resection type and PCL-retention type prosthesis under various loading conditions were performed by means of the three-dimensional finite element method. In the knee replaced with the PCL-resection type prosthesis, distribution of large transmitted loads was concentrated in a small area located in front of the stem and under the plateau of prosthesis. The sum of moments of transmitted loads increased as horizontal component loads on the femoral component increased. Large von Mises stresses were distributed in the anterior and proximal parts of the tibia. In the tibia replaced with the PCL-retention type, transmitted loads were observed in the whole area under the plateau and posterior cortex. The sum of moments was significantly smaller than that in the PCL-resection type. Large von Mises stresses were distributed in the posterior and proximal parts of the tibia. It was recommended that the PCL be saved in total knee arthroplasty whenever possible.

Biomechanical Phenomena↗

A 3-year retrospective study of Cresco frameworks: preload and complications.

PURPOSE: The aim of this retrospective clinical study was to evaluate the clinical outcome of fixed implant-supported complete prostheses on Astra or Brånemark implants when using either conventional cast frameworks or frameworks produced according to the Cresco Ti Precision method (Cresco Ti Systems Sàrl., Lausanne, Switzerland). MATERIALS AND METHODS: Forty-six patients treated 3 years previously were divided into four groups according to implant system and framework design. Clinical examinations were performed and case records were scrutinized. The stability for each prosthesis retention screw was recorded as the torque profile and was monitored using the Osseocare torque controller (Nobel Biocare AB, Göteborg, Sweden). Complications in association with implants and superstructures were registered. Patient opinions were recorded. The significance level was set to 5%. RESULTS: The Astra-Cresco group demonstrated a lower degree of prosthesis retention screw stability compared with the Astra group. No differences among the four groups were seen regarding plaque, bleeding on probing, or marginal bone resorption. The Brånemark group (Brånemark System, Nobel Biocare AB) demonstrated more mechanical complications than the Brånemark-Cresco group. Mobile prostheses were found in the Brånemark and the Astra-Cresco groups. Fracture of veneer was seen in 20% of the prostheses and was more frequently found in the groups with mobile prostheses. Sixty percent of the prostheses showed reactions in the surrounding soft tissues. The most common reaction was mucosal proliferation. No differences were detected in the patients' opinions. CONCLUSION: Within the limitations of this retrospective study, the following can be concluded: (1) compared with conventional frameworks, the Cresco distortion correction method does not provide a better clinical outcome after prosthesis connection in patients with fixed implant-supported complete prostheses; and (2) the two framework-producing methods behave differently on Astra implants compared with Brånemark implants concerning prosthesis retention screw stability, mechanical and biologic complications, and reactions in patients with fixed implant-supported complete prostheses.

Adult↗

Implants and sinus-inlay graft in a 1-stage procedure in severely atrophied maxillae: prosthodontic aspects in a 3-year follow-up study.

The aim of this 3-year prospective study was to evaluate the prosthetic treatment in 2 groups of maxillary edentulous patients with similar age and gender distribution: a study group of 39 patients treated with intra-sinus block bone grafts and implants in a 1-stage procedure, and a control (reference) group of 37 patients treated with implants and no grafting. In the study group, bone volumes were regarded as insufficient for implant treatment unless a bone grafting procedure was performed (posterior alveolar bone height was less than 5 mm). Self-tapping Nobel Biocare implants were used in both groups of patients. In the study group, 35 fixed partial dentures and 4 overdentures were placed, and in the control group 34 fixed partial dentures and 3 overdentures were placed. All patients were followed for at least 3 years. The 3-year follow-up examination included examination of a number of clinical parameters as well as the type of abutment and evaluation of stability of prosthesis retention screws and abutment screws. During the follow-up period, 2 patients were lost from the study group and 4 patients from the control group, giving a total of 70 patients available for examination after 3 years (8% dropout rate). Both the amount of plaque and gingival bleeding were significantly lower in the study group than in the control group. The presence of attached gingiva was 25% in the study group and 35% in the control group. The number of angulated abutments was significantly higher in the study group than in the control group. There was no significant difference in the number of prosthetic complications in the 2 groups of patients. Neither was there any significant difference in prosthesis screw or abutment screw stability between the 2 groups. The type of abutment did not significantly influence the stability of prosthesis retention screws or abutment screws in either of the groups. However, prosthesis screw stability was significantly greater than abutment screw stability in both groups of patients. It can be concluded that the prosthetic outcome was similar in the 2 groups of patients, regardless of whether or not a bone grafting procedure was used.

Adult↗

Transmolar pin and magnetic carrier for midfacial reconstruction: a clinical report.

With previous prosthetic restorations of bilateral maxillary resections, tissue erosion and bleeding on the cephalic parts of the cavity have been caused by movement and pressure from the prosthesis. Retention of a prosthesis is a major determinant in its successful use. Physical and psychologic stresses are common when one is unable to use a prosthesis comfortably. The use of a musculocutaneous flap and an obturator prosthesis had provided near-immediate reconstruction of a massive midfacial defect. This method of reconstruction resulted in soft tissue replacement for appearance and functional rehabilitation of the upper lip while maintaining sound oncologic principles.

Adult↗

Photoelastic and thermoelastic measurement of stress on the proximal femur before and after implantation of a hip prosthesis with retention of the femoral neck.

This study demonstrated the improved medial support and the transfer of load onto the retained neck of the femur using seven fresh frozen femurs. Results confirm the reliability of the thermoelastic stress analysis method, which is comparable to the photoelastic surface coating method, but with greater sensitivity. The loading pattern after stem implantation shows a homogeneous transfer of force onto the preserved femoral neck. After femoral neck removal, an inhomogeneous increase of the intertrochanteric compression loading was observed. Therefore, improved biomechanical conditions are created for a permanently stable implantation of stem prostheses with retention of the femoral neck.

Femur↗