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PubMed2001

[Classification of epileptic diseases according to potential of fitting with dental prosthesis].

Epileptic patients seem to have generally poorer dental condition in comparison with the healthy population for many reasons. It is important to endeavor to provide the same dental care to epileptic patients than to others, however certain factors in connection with their disease must be taken into consideration. Among these, the most important is to concern about the type of seizure with special emphasis on the involvement of the masticatory apparatus and the chances of oral soft tissue injuries and aspiration. In addition seizure frequency and patients' mental compliance might also play a decisive role. According to these factors epileptic patients were grouped into four categories with special regard to their dental manageability from the prosthodontic point of view. The planning of their dental prosthesis was carried out according to the Fábián-Fejérdy classification like in case of any other healthy patients.

Dental Prosthesis↗
PubMed2005

Lengthening procedures of small bones of foot and foot stump.

Foot length discrepancy may result from congenital or acquired causes. If the absence of the foot is more proximal than the metatarsal level, push off and foot resilience will be disturbed and rapid walking and spring will be awkward. Those patients have to be fitted with a prosthesis extending above the ankle to the distal leg. The functional impairment and poor cosmetic appearance become social problems especially for adolescents. Twelve cases underwent a lengthening procedure of small bones of the foot in our clinic since 1995 to lengthen the foot or a foot stump. Results were satisfactory.

Adolescent↗
PubMed1990

Importance of periodic control after fitting a total prosthesis--case report.

A patient was seen at the Total Prosthesis Clinic complaining of facial pain after using the same prosthesis for 46 years. Clinical examination revealed TMJ disturbance due to a loss of the vertical dimension caused by a wearing of the teeth. Diagnosis indicated replacement with new prostheses, with a gradual recuperation in the vertical dimension by the application of resin over the lower teeth and a reconditioning of the support tissues. After the alleviation of pain, correction of the dysfunction and reestablishment of the vertical dimension of occlusion, new prostheses were made. At the end of treatment, the patient felt a relaxed facial musculature, lifting the mandible to a resting position instead of constantly maintaining it in occlusion as before. The patient was given instructions as to use, conservation and hygiene of the prostheses and oriented to return for annual evaluation of occlusion and of the supporting oral structures, as well as the stability of the prostheses.

Aged↗
PubMed1993

Biomechanical analysis of a distally interlocked press-fit femoral total hip prosthesis.

This study was undertaken to compare the stability of a distally interlocked femoral prosthesis to a standard press-fit implant (Cementless Spotorno, Protek Co., Toronto, Canada). Five human femora were studied with each acting as its own control. All were tested in the locked mode followed by unlocked testing modes. The MTS 858 Biomaterials Testing System was used to test the implanted femoral stems under both pure torsional and pure axial loading. Distal interlocking increased the torsional stability by 320% (locked 4.05 Nm/degree; unlocked 1.25 Nm/degree) (P < .01) and the axial stability by 230% (locked 1,236.26 N/mm; unlocked 527.44 N/mm) (P < .01). the use of temporary distal interlock in cases where the initial stability of a press-fit implant is suboptimal should allow for improved biological fixation by minimizing micromotion at the stem-bone interface.

Bone Cements↗
PubMed2005

Primary placement of a hydroxyapatite-coated sleeve in bioceramic orbital implants.

PURPOSE: To study a new surgical option of primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implant during enucleation or evisceration. DESIGN: Retrospective, observational case series. METHODS: A standard enucleation or evisceration was performed, followed by the preplacement of a hydroxyapatite-coated sleeve into the Bioceramic implant. Care must be taken to ensure the sleeve has been positioned centrally when the implant is put inside the orbital socket. Complications such as sleeve exposure, Bioceramic implant exposure, and infection were closely observed. RESULTS: Twenty-seven patients were treated in above fashion with five enucleation and 22 evisceration procedures. Five of the sleeves have exposed spontaneously during 1 to 4 months after original surgery. They had no further complication, except for one sleeve around which there were visible Bioceramic spicules attributable to long-term corticosteroid usage. The remaining 22 sleeves that did not spontaneously expose pursued secondary exposure of the sleeve and peg insertion by the conjunctival cutdown procedure 3 months postoperatively. One sleeve was medially positioned far away from the implant center. Re-insertion of new sleeve and peg was scheduled 2 weeks later. One additional sleeve was obliquely positioned after conjunctival cutdown procedure. Fortunately, all 27 patients were successfully fitted with a peg-coupled prosthesis with good motility. CONCLUSIONS: Primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implants has several advantages, including high patient acceptance, technical simplicity, and an office-based conjunctival cutdown pegging procedure. By avoiding the expense of postoperative imaging studies and additional prosthetic modification, a more rapid and efficient rehabilitation is possible.

Adult↗
PubMed1996

Component design affecting patellofemoral complications after total knee arthroplasty.

Three hundred one primary cemented total knee arthroplasties were performed in 289 patients. Two different prostheses were used; 148 knees received the Miller-Galante I prosthesis and 153 knees received the Press Fit Condylar prosthesis. Minimum followup was 2 years. The groups were similar in all parameters both preoperatively and postoperatively, with the exception of the patellofemoral complication rate. Knees that were implanted with the Miller-Galante I prosthesis experienced a complication rate of 10.1%, while those with the Press Fit Condylar prosthesis experienced a complication rate of 0.7%. The distinct difference in the patellofemoral complication rate may be due to the differences in design of the femoral component. Features that may have contributed to increased patellofemoral morbidity included a short, narrow anterior flange; a shallow patellar groove; and an abrupt anterior to distal transition with a smaller radius of curvature. Because subtle design difference can have a profound effect on clinical outcome, long term evaluation of new designs should be completed before widespread use. The clinician also should be aware of the desirable design features when choosing a component.

Aged↗
PubMed1999

Subjective and objective outcomes in patients reconstructed with a custom-fitted alloplastic temporomandibular joint prosthesis.

PURPOSE: This study looked at prospective subjective and objective preoperative and postoperative outcome data from a set of multiply operated, anatomically mutilated, functionless, chronic temporomandibular joint (TMJ) pain patients who have undergone TMJ reconstruction with a custom-fitted prosthetic system. PATIENTS AND METHODS: Two hundred fifteen patients (363 joints: 296 bilateral, 67 unilateral) who had undergone total TMJ reconstruction with a custom-fitted TMJ prosthesis (Techmedica; now TMJ Concepts, Camarillo, CA) made up the subjects reviewed in this study. The mean follow-up period was 30.7 months. The patients were divided into 3 groups based on the number of prior unsuccessful TMJ arthrotomies they had undergone (group 1 = 0 to 2; group 2 = 3 to 8; and group 3 = 9 or more) RESULTS: Subjective improvement ratio data indicated that postoperatively group 1 had a 61.3% improvement in subjective parameters, group 2 had a 51.0% improvement, and group 3 had only a 27.5% improvement. Objective improvement ratio data showed that postoperatively group 3 had the largest increase in maximum interincisal opening, whereas the other groups had less improvement. CONCLUSION: The data from this study confirm, as previously reported in the literature, that the greater the number of surgical procedures performed on the TMJ, the less the chance of significant subjective improvement.

Adult↗