Biomedical subjects

T R Cowper

Publications and source records attributed to T R Cowper.

9 recordsLinked to original sources

PubMed1996

The relative value of provider work for maxillofacial prosthetic services.

The results of a national survey of members of the American Academy of Maxillofacial Prosthetics who estimated the relative value of provider work for nine existing and two proposed coded maxillofacial prosthetic services is reported. The work estimates are a necessary component of a larger effort by the Health Care Financing Administration to establish a resource-based relative value scale for reimbursement for all Medicare services. Analysis of the survey data reveals agreement regarding the relative value of work for maxillofacial services compared with other established medical procedures and that the median values for each service are acceptable initial estimates.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1996

Pharmacotherapy for hypertension.

Clinicians, in general, must understand the basis of hypertension, management principles, and complications. They must recognize that these patients require multidisciplinary treatment and coordination of care. Oral health care providers must remember that hypertension may produce adverse effects on various organ systems and management of the dental needs of these patients may require modification of routine treatment.

Age Factors↗

PubMed1996

Pharmacologic management of the patient with disorders of the cardiovascular system. Infective endocarditis.

IE, although an infrequent event, remains a serious and frequently lethal complication in patients at risk. Oral microorganisms undoubtedly play a significant role in the development of IE in such patients. For example, in a retrospective review of prosthetic cardiac valve candidates (156) at the Cleveland Clinic Foundation, 15% were found to have at least one abscessed tooth, whereas approximately 17% were found to have severe (class IV) periodontal disease. Cardiac defects in conjunction with bacteremias from such dental pathoses clearly elevate the risk, although a small but increasing number of noncardiac conditions and behavioral patterns seem also to be able to induce susceptibility. Whether dental or other medical procedures are truly direct inducers of IE, however, remains to be proven and in all probability are only minor contributors overall. Despite its ubiquitous use, antibiotic prophylaxis has not been proven in human clinical trials, and its underlying rationale is arbitrary and questionable at best; nevertheless, its efficacy in animal models has led to the current human protocols. A more profitable strategy, and certainly an adjunctive one, should be to direct one's effort at eliminating oral pathology and educating and motivating patients at risk toward meticulous oral hygiene--an exhortation published many years before the advent of antibiotics and still undoubtedly the best recommendation today.

Abscess↗

PubMed1995

Practice and malpractice expenses in maxillofacial prosthetics.

Recent changes in Medicare reimbursement methods have made the estimation of specific practice and malpractice expenses in maxillofacial prosthetics more important. New reimbursement models such as the resource-based relative value scale used by Medicare and an increasing number of private carriers require accurate and specialty-specific values for these parameters. The Health Care Financing Administration's estimates of practice expense values in all specialties of medicine are significantly lower than those suspected in maxillofacial prosthetics. There is concern that the assignment of erroneous values in maxillofacial prosthetics could lead to inadequate reimbursement. Because the American Dental Association provides only aggregate specialty values, a survey of the general membership of the Academy of Maxillofacial Prosthetics was undertaken to determine these values more accurately. Practice expense values were found to be significantly higher than those in medicine, whereas malpractice expense values were lower. In addition, practice expense values in the survey were found to be greater than the ADA's aggregate specialty calculations.

American Dental Association↗

PubMed1995

Hydroxyapatite motility implants in ocular prosthetics.

For the past 5 years, an increasing number of ophthalmologists have been using hydroxyapatite (HA) motility implants after uncomplicated enucleation or evisceration of the eye. Unlike previous implant materials, HA promotes fibrovascular ingrowth and seemingly true integration of the motility implant to the residual ocular structures. As a result, a more stable defect and greater movement of the overlying prosthesis is produced. In addition, the problems of long-term orbital implant migration and the vexing postenucleation socket syndrome are thought to be minimized. This article briefly reviews the history and development of orbital implants and HA implant surgical and prosthetic procedures. It is concluded that HA implant rehabilitation is indicated after most uncomplicated enucleations or eviscerations where there is small likelihood of complication.

Durapatite↗

PubMed1994

Maxillofacial prosthetics: a preliminary analysis of Resource Based Relative Value Scale.

A study done by the American Academy of Maxillofacial Prosthetics to evaluate the Medicare Resource Based Relative Value Scale (RBRVS) as it relates to maxillofacial prosthetics. The method of RBRVS formulation is described. The degree of difficulty and treatment time were determined for nine Physicians' Current Procedural Terminology-edition 4 (CPT-4) codified maxillofacial procedures. A preliminary survey indicates that practice expense and malpractice expense ratios were 66% and 1%, respectively. Correlation of maxillofacial procedures to other medical procedures was not performed because an additional study with a greater sample size is needed.

Ear↗

PubMed1991

Overdentures in partial anodontia: simple solutions for complex problems.

Congenital defects in children and adolescents can present complex and challenging dental problems, including arch discrepancies, palatal defects, and malposed or otherwise disrupted dentition. Traditional treatment is often time-consuming, expensive, and in extensive defects, frequently compromised at best. The overdenture prosthesis, often overlooked, is a relatively simple and expedient solution to many of these severe problems, and the prosthetic techniques are familiar and readily employed by dentists without specialized training. This article reviews the general principles employed in these techniques and offers examples of successful treatment for several of the more commonly occurring congenital dental defects.

Adolescent↗

PubMed1984

A quick method for processing MDX-4-4210 silicone rubber.

An alternative method for processing MDX-4-4210 silicone elastomer that eliminates the recommended de-airing phase has been described. As a result, it is possible to have the processed prosthesis in hand in 30 minutes or less (in small prostheses). In addition, the use of a relatively large and costly vacuum machine is avoided. No clinical differences with respect to stability, strength, or duration between prostheses processed in this manner or the standard method have been noted.

Chemical Phenomena↗

PubMedDate not supplied

The use of colored elastomeric "O"s as a motivational instrument for patients with anodontia: report of case.

Complete and/or removable partial dentures are the most commonly selected treatment for the prosthodontic management of young patients who present with oligodontia or anodontia such as in the case of patients with ectodermal dysplasia. Bakri, Belanger and Nowak have reported on the different ways that these prostheses can be modified to ease the child's burden of growing up with missing teeth and having to wear prostheses that make them different from their peers. Some of their suggestions include the placement of diastemas, the use of artificial "baby" teeth and their subsequent replacement with permanent teeth to simulate the primary and mixed dentition stages. They have also recommended deleting primary teeth to mimic the normal exfoliation pattern. The purpose of this article is to report the attitude change and improvement in self-esteem experienced by two young girls from the simple addition of colored elastomeric molded "O"s to the orthodontic appliances placed on their prostheses.

Adaptation, Psychological↗