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PubMedDate not supplied

Commonly asked questions about nightguard vital bleaching.

There are three basic classes of materials and techniques used for the bleaching of vital teeth. These include the in-office bleaching technique with 35 percent hydrogen peroxide, the Nightguard vital bleaching technique with 10 percent carbamide peroxide, and the over-the-counter bleaching kits with three-to-six percent hydrogen peroxide. The most popular of these techniques is Nightguard vital bleaching, also referred to as dentist-prescribed, home-applied bleaching. This article looks at the current status of the Nightguard vital bleaching technique, with a special emphasis on the clinical aspects of the treatment, along with the most commonly asked questions concerning the procedure. It would still appear than this form of dentist-prescribed, home-applied bleaching, when preceded by a proper examination and correct diagnosis, applied with a properly fitted prosthesis, and monitored as needed by a dentist, is as safe as other accepted dental procedures or commonly ingested foodstuffs.

Carbamide Peroxide↗
PubMed1997

Telephone speech comprehension in children with multichannel cochlear implants.

Telephone speech comprehension is being evaluated in six prelingually deaf children implanted with the Nucleus 22 prosthesis fitted with the Speak strategy. All of them have had at least 1.5 years of experience with their implant. When the tests began, they had already had at least 2 months' experience with the same map in their speech processor. The children were trained in the use of the telephone as part of the rehabilitation program. None of them used it regularly but as a game that they found very entertaining. A special battery, the Bate-fon (batería para teléfono = telephone battery), was designed for training and evaluation purposes. It includes the five Spanish vowels in isolation, diphthongs, onomatopoetic animal voices, two-syllable, and three-syllable words. The tests were administered 1.5-2 years after the switch-on of their speech processor. Standard acoustic telephone coupling was used. The speech material was presented to the child on colored cards. Stimuli were presented twice. Children were informed when the response was incorrect. Averaged results indicated that the percentages of correct responses for all the speech material increase in the second presentation. All children have shown some degree of telephone communication abilities. As a result of the training, some of the children are using the telephone to communicate with their families.

Child, Preschool↗
PubMed1998

Early inducible displacement of tibial components in total knee prostheses inserted with and without cement: a randomized study with roentgen stereophotogrammetric analysis.

The fixation of tibial components randomized to insertion with or without cement in twenty-six knees was examined for inducible displacement at six weeks and one year postoperatively with use of roentgen stereophotogrammetric analysis. Furthermore, migration was studied during the first two postoperative years. Inducible displacement was found in all knees at both the six-week and the one-year follow-up examination, but no differences were detected with respect to the type of fixation (p > 0.05). All tibial components migrated for as long as one year postoperatively, after which most stabilized. No difference was found between the groups with respect to migration during the first two years postoperatively (p > 0.05), with the exception of subsidence of the component, which was found to be 0.0+/-0.1 millimeter (mean and standard error of the mean) for the components inserted with cement and 0.5+/-0.1 millimeter for the components inserted without cement (p < 0.01). Migration after one year was the same for both groups. We found a relationship between inducible displacement at six weeks and at one year as well as one between inducible displacement and migration at one year. To our knowledge, the present study is the first in which the micromotion of an interference-fit prosthesis was found to be similar to that of a device inserted with cement. The results of the present study emphasize the importance of the initial prosthetic fixation.

Aged↗
PubMedDate not supplied

Commonly asked questions about nightguard vital bleaching.

There are three basic classes of materials and techniques used for the bleaching of vital teeth. These include the in-office bleaching technique with 35 percent hydrogen peroxide, the Nightguard vital bleaching technique with 10 percent carbamide peroxide, and the over-the counter bleaching kits with three-to-six percent hydrogen peroxide. The most popular of these techniques is Nightguard vital bleaching also referred to as dentist-prescribed, home-applied bleaching. This article looks at the current status of the Nightguard vital bleaching technique, with a special emphasis on the clinical aspects of the treatment, along with the most commonly asked questions concerning the procedure. It would still appear that this form of dentist-prescribed, home-applied bleaching, when preceded by a proper examination and correct diagnosis, applied with a properly fitted prosthesis, and monitored as needed by a dentist, is as safe as other accepted dental procedures or commonly ingested foodstuffs.

Appointments and Schedules↗
PubMed1998

Ocular prostheses.

Explore the source record for details and available documents.

Contact Lenses↗
PubMed2001

Qualitative and quantitative evaluation of some vocal function parameters following fitting of a prosthesis.

The insertion of a prosthesis and restoration with pectoralis major myocutaneous flaps for patients subjected to total pharyngolaryngectomy is a technique now universally accepted; however the literature on the subject is lacking. Our study considers 10 patients subjected to total pharyngolaryngectomy and restoration with pectoralis major myocutaneous flaps who were fitted with vocal function prostheses and a control group of 50 subjects treated with a total laryngectomy without pectoralis major myocutaneous flaps and who were fitted with vocal function prostheses. Specific qualitative and quantitative parameters were compared. The quantitative measurement of the levels of voice intensity and the evaluation of the harmonics-to-noise ratio were not statistically significant (p > 0.05) between the two study groups at either high- or low-volume speech. On the contrary, statistically significant differences were found (p < 0.05) for the basic frequency of both the low and the high volume voice. For the qualitative analysis seven parameters were established for evaluation by trained and untrained listeners: on the basis of these parameters the control group had statistically better voices.

Carcinoma, Squamous Cell↗
PubMed1993

Lower-limb amputations.

The current epidemiological situation with regard to lower-limb amputations in southern Finland was analysed for the year 1989. Lower-limb amputations were performed on 268 patients. The amputation rate was 22.0 per 100,000 inhabitants, and the mean age of amputees was 70 years. Peripheral vascular disease was the main reason for amputation (79%). The most common level of amputation was above-knee (49%) followed by below-knee (29%). Two thirds (64%) of the patients lived over one year, and half (53%) over two years after the amputation. In the group of patients undergoing unilateral amputation and surviving over two months, 26% of the above-knee and 63% of the below-knee amputation patients received a prosthesis. The (average) time lag between surgery and fitting the prosthesis was 97 days. Incidence and mortality were decreased after 1985. The rate of prosthesis fitting was still low but the time lag between surgery and prosthetic fitting had decreased.

Adult↗
PubMed2004

Critical radiological analysis after Austin Moore hemiarthroplasty.

The aim of this study is to investigate the causes of prosthesis loosening in patients treated with Austin Moore hemiarthroplasty (AMA). The clinical and radiological outcomes were documented in a quantitative manner after 7 years follow-up of 144 patients. At the time of final follow-up, 52 patients had died and 48 patients were lost to follow-up, leaving a total of 44 patients for analysis. Immediate post-operative X-rays were studied for the initial alignment of prosthesis, the fit of the prosthesis and the degree of osteoporosis. X-rays on latest follow-up were studied for evidence of loosening. All patients were assessed clinically with the hip score of hospital for special surgery. It was found that hip pain was significantly related to subsidence and pivoting of the prosthesis (P = 0.014 and 0.035, respectively). Significant increase in subsidence was noted if the stem of prosthesis was not fitting well within the shaft of femur (P = 0.006). When the patient was younger than 73 years old at the time of operation, there was more subsidence of the prosthesis at the final follow-up (P = 0.001). It was concluded that the fill of AMA within the shaft of femur should be greater than 70% to avoid early loosening. Relatively younger patients with acute fracture of the neck of femur should be treated by methods other than cementless AMA.

Age Factors↗
PubMed2002

Early failure of a press-fit carbon fiber hip prosthesis with a smooth surface.

We investigated a press-fit anatomically shaped hip stem made of carbon fiber-reinforced composite material in a prospective clinical study. The intention of the design was that a surface of interlaced carbon fibers in the proximal part would achieve metaphyseal fixation. A total of 51 carbon stems were implanted in 48 patients (30 women and 22 men). Mean age at operation was 59 years. The patients were followed clinically, radiologically, and with computed tomography. At 6-year follow-up, aseptic loosening was observed in 47 hips (92%). Forty stems were revised on average 30 months (range, 9-58 months) postoperatively. All revised carbon stems showed fibrous fixation without any bony on-growth. No osteolysis was seen. Histologically, no carbon wear or inflammatory reactions were observed. Only 4 cases had a good clinical result with bony fixation on computed tomography scan. The carbon fiber prosthesis without effective ingrowth or on-growth irregularities showed a high rate of early loosening.

Arthroplasty, Replacement, Hip↗
PubMed1994

Improved fit by asymmetric tibial prosthesis for total knee arthroplasty.

The adequacy of the fit of the prosthesis to the tibia is an important variable in the outcome of total knee arthroplasty. A good fit covers the cancellous bone of both condyles, involves the denser bone of the tibial shell, but does not overhang beyond the bone at any point. In this research, an anatomically shaped tibial prosthetic base plate was developed from tibial measurements. A series of five template sizes, chosen to fit our patient database, was then evaluated for fit in the operating room by one surgeon. The assessment included bone exposure and the overhang of the prosthesis beyond the bone perimeter. The measurements of overhang or bone exposure were analysed. A commercial prosthesis was used as a control. An asymmetrical tibial plate conformed well to the anatomical shape of the resected upper tibia resulting in very little exposed bone and very few cases of overhang. The absence of such overhang provides better function in the surrounding stabilizing soft tissues, and so permits recovery of the maximum range of motion post-operatively.

Anthropometry↗
PubMedDate not supplied

[Comparative periprosthetic bone density measurements of the proximal femur shaft using dual energy x-ray absorptiometry (DEXA) with experimental "Press Fit-gliding Stem Prosthesis"].

PROBLEM: Periprosthetic bone atrophy caused by stress shielding is one of the problems of non-cemented femoral stems of hip arthroplasty. Stress shielding and thus the loss of bone mass and their dissemination in the proximal part of the femur of conventional non-cemented femoral stems depends on stiffness (E-modules of the material and the geometry) of the implant and on the bonding between implant and bone. All currently implanted non-cemented femoral stems lead to proximal bone loss which goes up to 40-50% of the original bone mineral content. The senior author (E. M.) developed a femoral stem (Press Fit-Gliding Stem PFGS) which shifts relative movements of force-transmission from the bone-implant interface into the interior of the prosthetic system (Inner Bearing-System) and which only transfers forces proximal into the femur. METHOD: The examinations were made in 21 patients between 1 and 6 years after implantation of a Press Fit-Gliding Stem compared with a normal contralateral femur (12), with bilateral PFGS (3) and other bilateral arthroplasty (6). RESULTS: In all 21 patients supplied with a PFGS an increase of bone mineral content (BMC) and bone mineral density (BMC) in zone 7 as well as a marked smaller deviation around the mean value in all zones respectively could be noticed. CONCLUSIONS: With the Dual Energy X-ray Absorptiometry (DEXA)-measurement of bone mineral content (BMC) and bone mineral density (BMD) in all zones according to Gruen could be shown that it is not only possible with regard to a favorable force transmission to avoid the inevitable bone atrophy but on the contrary to induce an increase of bone at the point of local force transmission that is in the region of the calcar femorale (zone 7). CLINICAL RELEVANCE: The Press Fit-Gliding Stem is still in the clinical test-program.

Absorptiometry, Photon↗
PubMed2006

Loss in mechanical contact of cementless acetabular prostheses due to post-operative weight bearing: a biomechanical model.

The primary stability of cementless acetabular components is a prerequisite for their clinical success. The target of the present study was to analyse possible effects of post-operative joint loading on the initial mechanical stability of a press-fitted acetabular prosthesis. For this purpose, a three-dimensional finite element model of the pelvic bone with acetabular reconstruction was set-up. The analysis included two steps: (1) simulation of the prosthesis press-fit implantation and (2) simulation of the instant of peak resultant hip loading during the one-legged stance. The difference between the contact pressures at the bone/implant interface, at the end of the second step and those at the end of the first step was calculated and assumed as an index of variation in mechanical contact due to post-operative weight bearing. The results show that, due to hip loading, contact pressures given by press-fit increase in the postero-superior acetabular region but decrease in the antero-inferior acetabular region. The calculated area in which the contact pressures decrease extend to about 30% of the total contact surface. These results imply that post-operative joint loading significantly reduces the mechanical stability given by press-fit. The decrease in contact pressures at the bone/implant interface may result in a lack of osteointegration, possibly hindering the implant secondary stability. It may also create a route for wear debris, possibly favouring periprosthetic osteolysis, which may lead to further loss in contact and clinical failure of the implant due to loosening.

Acetabulum↗
PubMed2000

New osmotically active hydrogel expander for enlargement of the contracted anophthalmic socket.

BACKGROUND: Clinical anophthalmia is characterized by the absence of an eyeball within the orbit and can result in overall growth retardation of the facial skeleton. The goal of treatment consists of fitting a serial prosthesis following rapid expansion of the contracted socket as soon as possible to achieve cosmetically acceptable eyelid and orbital symmetry. METHODS: Four children, aged 3-11 months, were treated by implantation of an anhydrous, highly hydrophilic tissue expander into the rudimentary conjunctival sac. With hydration of up to 98% in 72 h, the copolymer of methylmethacrylate and vinylpyrrolidone acts like an osmotically self-inducing socket expander. RESULTS: In the course of 2 months the previous contracted socket was enlarged, the horizontal lid length increased and the hydrated expander could be exchanged for a custom-made glass prosthesis. CONCLUSION: Preliminary results suggest that this new device can be used to avoid early plastic surgery of the eyelid. In addition, it also may enlarge the volume of the bony orbit.

Anophthalmos↗
PubMed1991

Calcar resorption beneath a well-fitting flanged femoral prosthesis.

Forty-three of 51 Link SP hip prostheses inserted 4 years previous to this study were clinically and radiographically reviewed. All demonstrated bone resorption in excess of 2 mm under the collar, but this resorption was not progressive. No prosthesis had loosened. The collar of a prosthesis, even when securely cemented into the femur with a carefully matched neck cut, was decoupled from its functional position in all the reviewed cases at 4 years. Its only remaining function was to prevent subsidence within the cement mantle, should it ever become necessary to provide stability.

Bone Cements↗
PubMed1999

Transfemoral amputation. Biomechanics and surgery.

The technique of transfemoral amputation has evolved during the last decade whereby muscle stabilization and biomechanical principles have gained new significance. Maintenance of the femoral shaft axis close to normal can be achieved by preservation of the adductor magnus and by myodesis of the muscle to the residual femur. By following established biomechanical principles, and satisfactory surgical techniques, patients undergoing transfemoral amputation are easier to fit with a prosthesis and more likely to remain able to ambulate. Reduction in stump problems can be achieved, and improvement in stump strength is seen.

Adult↗