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Biomedical subjects

M R Heath

Publications and source records attributed to M R Heath.

49 records · Page 3Linked to original sources

Measurement of cephalometric radiographs: methods of analyzing data on a regional basis and improving reading efficiency.

Because of the complexity of craniofacial structures, it is valuable to analyze morphology and posture of one structure relative to more than one origin or region. Coordinate geometry can provide analysis of data from radiographs on a regional basis very efficiently because th data need not be remeasured relative to second or subsequent regions. This application is illustrated by analysis of lingual posture relative to the maxilla and relative to the mandible. The method, which provides efficient comparative measurement of two or more films of one patient, involves neither tracing nor marking on films. The measurements are recorded independently from each film; they can thus be free from bias and replicated for improved accuracy. The technical repeatability is analyzed.

Cephalometry↗

Electropalatography: thermo-formed pseudopalates and the use of three-dimensional display.

Electropalatography provides a method of recording contact of the tongue against the palate; this has valuable potential in linguistics, phonetics, speech therapy, oral physiology and dentistry. The application of the technique has been limited by the time required to produce a plate (pseudopalate) carrying electrodes for each person studied. The bulk of an acrylic plate also imposes some interference with speech. A simple, relatively fast, method of producing very thin plates is described. The use of models to provide three-dimensional display is illustrated and the value of slow speed play-back of data is discussed.

Data Display↗

Photo-electric recording of orofacial posture and movement providing linear, digital output.

A method for kinematic recording is evaluated. Its application for measuring both cranial and mandibular movement is described. the method provides accurate, linear, digital, co-ordinate measurement of up to four points with minimal interference with movement of the structures being examined. The field of measurement can be controlled optically; resolution being +/- 0.1% of the field width.

Humans↗

Bond strength of fiber-reinforced composite resin restorations.

Severe tooth wear is common in older dentate individuals, with one treatment option being composite resin restorations reinforced with a suitable matrix. This study evaluated the use of high modulus polyethylene (Celanese) fibers as a reinforcing matrix for composite resin. Human mandibular incisor teeth were sectioned to simulate severe tooth wear. Sectioned surfaces were measured, the teeth paired and assigned to control or test sample groups, and further assigned to be tested with a labial or lingual shearing force. A phosphorylated dentin bonding adhesive was applied to the abraded dentin surface. Labial and lingual intra-enamel bevel preparations were cut on each specimen. A piece of Celanese fabric was bonded onto the acid-etched labial and lingual bevels of the test specimens using an enamel bonding agent. Class IV composite resin restorations were then placed onto the test and control specimens. Following water storage, the specimens were subjected to shearing forces. Bond strengths for test specimens were significantly greater (p < 0.03) than the controls. Specimens with a labially applied force also had significantly higher bond strengths (p < 0.001). SEM analysis revealed adhesive bond failures over dentin surfaces, with cohesive bond failures within the composite resin. Celanese fibers maintained the restorations on the teeth, although adhesive failures were seen between the fibers and enamel bonding agent.

Analysis of Variance↗

Factors related to success and failure rates at 3-year follow-up in a multicenter study of overdentures supported by Brånemark implants.

An international prospective study of Brånemark implants retaining overdentures was conducted at nine clinical centers. One hundred thirty-three subjects were recruited in a 12-month period and provided with 510 implants, 117 of which were in maxillae and 393 were in mandibles. This study reports the 3-year follow-up status of 120 overdentures and 444 implants. There were 11 overdenture failures (9.2%). Maxillary overdenture failure rates (27.6%) were nearly nine times greater than mandibular overdenture failure rates (3.3%). Maxillary overdenture treatment was less successful than previously reported fixed implant-supported restorations. However, their mandibular counterparts had success rates slightly higher than those reported for fixed implant-supported restorations. At 3 years, 150 implants remained submerged and 66 implants had been withdrawn because the subjects discontinued study participation. Eleven mandibular and 29 maxillary implants had failed and had been removed from 21 subjects. Logistic regression with forward model selection indicated that one two-way interaction was significantly related to implant failure. At highest risk were the subjects who possessed dental arches with bone quantity E and bone quality 4. Subjects with one implant failure were likely to have more than one failure. The Generalized Estimating Equation was used to adjust for the cluster effect in this population because multiple implants (2 to 6) were placed and evaluated in each of the 133 subjects.

Adult↗

The effects of prefabricated bar design on the success of overdentures stabilized by implants.

Two groups of patients were provided with implant-stabilized mandibular overdentures supported by straight ovoid prefabricated bars with a resilient joint or parallel-sided bars with a rigid joint. Measurements of plaque index, mucosal cuff health and height, marginal bone height, pathology of the denture-bearing mucosa, and patient satisfaction were correlated with the different bar designs. Ovoid bars with a resilient joint between the denture and the bar have been shown to give a slightly increased incidence of problems associated with the denture-bearing mucosa. Furthermore, the only significant mean increase in recession of the mucosal cuff was found on the distal surfaces of the distal abutments in this group of patients.

Alveolar Bone Loss↗

A 5-year prospective multicenter follow-up report on overdentures supported by osseointegrated implants.

This report presents the results of a 5-year prospective multicenter study including nine centers worldwide. A total of 30 patients received 117 Brånemark implants in the maxillae, and 103 patients received 393 implants in the mandibles. According to the protocol, all integrated maxillary implants were to be loaded; however, only two of four mandibular implants were planned for support of the overdentures, leaving the remaining implants covered by mucosa as backup for possible implant failures. Thirty-five patients (26.3%) who were provided with 127 implants (24.9%) were withdrawn from the study. Six patients treated in the maxilla lost all their implants and resumed wearing complete dentures. The cumulative success rates for implants and for overdentures supported by two implants in the edentulous mandible were 94.5% and 100%, respectively. The corresponding cumulative success rates for implants and for overdentures supported by an optimal number of implants in the maxilla were 72.4% and 77.9%, respectively. Significantly better jawbone characteristics at the time of implant surgery were considered to contribute to the better cumulative success rates in the mandibles. Mean marginal bone loss was 0.8 mm (SD 0.8) and 0.5 mm (SD 0.8) for loaded implants during a 5-year period of time in the maxillae and mandibles, respectively. Measurements of the clinical height of the abutment cylinders indicated a mean recession (0.2 mm) of peri-implant mucosa during the follow-up period in the mandibles. Conversely, hyperplasia was observed in the maxillae.

Adult↗

Prosthodontic treatment, patient response, and the need for maintenance of complete implant-supported overdentures: an appraisal of 5 years of prospective study.

The prosthodontic methods and outcomes of treating 127 patients in nine centres over a period of 5 years is described. The benefits perceived by patients and the changes induced in the denture-bearing tissues and temporomandibular joints are reported. To sustain effective treatment outcomes, the levels of maintenance needed by the overdentures are contrasted for restoration of the edentulous mandibles and maxillae.

Alveolar Bone Loss↗