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PubMedDate not supplied

Fit of veneers made by CAD-CAM and platinum foil methods.

Veneers were fabricated by CEREC CAD-CAM and the platinum foil techniques for standardized preparations on 10 artificial teeth. Mesial preparation contacts were broken, but distal contacts remained intact. The veneers were cemented in a standardized manner to their teeth. The veneers and their attached cement were embedded in epoxy resin and sectioned twice gingivally-incisally and mesially-distally to produce eight sections. Three-way ANOVA disclosed that the main effects of fabrication method, section location, and measurement point location as well as all interaction terms significantly affected fit (P < 0.05). However, the difference in mean overall fit between the fabrication methods was too small to be of clinical importance. Restoration of the broken approximal contact did not compromise fit. Incisal margins had the greatest marginal openings. Surface measurement point locations were less well adapted than internal locations. Fit maps for CEREC and platinum foil veneers were strikingly similar.

Acrylates↗
PubMed1997

Effect of fit adjustment on CEREC CAD-CAM veneers.

PURPOSE: To measure and compare the adaptation of CEREC CAD-CAM porcelain veneers with and without fit adjustment. MATERIALS AND METHODS: Two groups of porcelain veneers were fabricated using the CEREC CAD-CAM technique for standardized preparations on 10 artificial teeth. Mesial preparation contacts were broken, but distal contacts remained intact. One group was adjusted using a disclosing spray to improve fit, another group made for the same teeth was not adjusted before cementation. The veneers were cemented in a standardized manner to their teeth. The veneers and their attached cement were retrieved, embedded in epoxy resin and sectioned twice to produce eight sections. Each section was measured at three defined points from the external surface inwards. RESULTS: Three-way ANOVA disclosed that fit adjustment was relatively ineffective (P approximately 0.05), but that measurement section location, measurement point location and their interaction significantly affected fit (P < 0.05). Restoration of the broken proximal contact, or simulated diastema closure did not compromise fit. Incisal margins ranked worst for fit. Surface measurement point locations ranked worse than internal points. The fit of these CEREC CAD-CAM veneers was not substantially different from previously published fit values for conventional porcelain veneers.

Acrylates↗
PubMed2000

[Categorical loudness scaling within the scope of hearing aid management].

The loudness perception of patients with hearing aids was measured with a one-stage category loudness scaling procedure. Data were obtained from 102 ears and were studied primarily in older patients who represented the majority of patients with hearing disorders evaluated in our department. In all, 75% of the patients were older than 45 years and had a mean age of 58 years. The reduction of dynamics at high frequencies was considered to be typical for age-related hearing disorders and was easily quantified with loudness scaling. Findings demonstrated that prediction of recruitment was not possible from pure-tone thresholds or even together with uncomfortable loudness levels, since the slopes of the level-loudness functions revealed a high interindividual variability. In contrast, the desired compression ratio can be easily calculated with data from the loudness scaling. In this study the loudness perception of patients with mainly non-linear hearing aids fitted with customary procedures was evaluated. The benefit from the hearing aids was proven with the outcome from the loudness scaling, with testing also allowing for a better fitting of the aids.

Adult↗
PubMed2005

Device to measure intra-operatively the primary stability of cementless hip stems.

The primary stability of cementless prostheses is critical for the long-term outcome of the operation. Surgeons are currently driven only by their experience in evaluating the extent of stem stability achieved. The aim of the present work was to develop a new device that enables the stability of a cementless stem to be quantitatively assessed intraoperatively. The angle of the stem/femur rotation under torsion and the torque are acquired and compared in real-time to a pre-set threshold inferred from the literature. The device indicates whether the stem is stable or not. It was extensively tested and finally validated in vitro on cadaveric and composite femurs hosting different sizes of the same kind of prostheses, implanted with different levels of press-fitting. The overall accuracy (23%) takes into account not only the overall measurement error but also the variability due to differences in bone quality and stem press-fitting. This error was deemed sufficient to discriminate between stable and unstable implants.

Arthroplasty, Replacement, Hip↗
PubMed1999

A comparison of Tactaid II+ and Tactaid 7 use by adults with a profound hearing impairment.

OBJECTIVE: To evaluate and compare use of the Tactaid II+ and the Tactaid 7, in terms of speech perception, by adults with a hearing impairment. DESIGN: Eight adults used one device daily for approximately 10 wk and attended seven training sessions. Performance was measured with tests of phonetic contrast perception, closed-set vowel and consonant identification, word and phoneme recognition in monosyllabic word lists, word recognition in sentences and speechtracking rate. A questionnaire was also administered. The protocol was repeated with the alternative device. RESULTS: With each device, the group discriminated most phonetic contrasts at better-than-chance levels and demonstrated somewhat enhanced visual or auditory-visual perception when measured in terms of vowel identification, monosyllabic word recognition and speechtracking rate. An increase in speechtracking rate was also demonstrated for some individuals. Subjects generally reported little subjective improvement in speech perception and production, but were satisfied with the physical attributes of each device. Five of six subjects preferred the Tactaid 7. CONCLUSIONS: The Tactaid II+ and the Tactaid 7 provided suprasegmental and segmental information, enabling the group to discriminate phonetic contrasts and improve their perception of some speech materials. No consistent advantage was found for either device, thought most subjects preferred the Tactaid 7. Alternatives likely to provide a greater benefit to communication should be considered before a Tactaid fitting.

Acoustic Stimulation↗
PubMed2002

Visual performance and comfort with the Rose K lens for keratoconus.

PURPOSE: The "Rose K Lens for Keratoconus" is a proprietary rigid contact lens design that has been reported and marketed as a lens that provides better visual acuity and comfort than other rigid contact lens designs for keratoconus. METHODS: Twenty patients with keratoconus who were wearing rigid contact lenses were refitted into the Rose K lenses. Visual acuity measurements were taken with habitual lenses at the baseline visit and with the Rose K lenses at the completion of the study. Questionnaires were used to assess vision-specific quality of life, contact lens comfort, and self-reported assessment of vision. RESULTS: There were no statistically significant changes in high- or low-contrast visual acuity with the Rose K lenses. There was statistically significant improvement in self-reported assessment of vision and self-reported assessment of comfort in the eyes with more advanced keratoconus. At the conclusion of the study, 72% of patients preferred the Rose K lenses over their habitual lenses, and 87% reported that they would continue wearing the Rose K lenses. CONCLUSIONS: There was no difference in the visual acuity with the Rose K lenses compared with the patients' habitual lenses. Subjective assessment of vision and comfort indicate a statistical improvement for more advanced keratoconus with the Rose K lens. We could not rule out a placebo effect as a source of subjective improvement in vision and comfort. Nevertheless, the successful fit rate and patient preference demonstrate the usefulness of the Rose K lens in clinical practice.

Adult↗
PubMed2002

The clinical history and development of the low contact stress total knee arthroplasty.

Contemporary total knee arthroplasty (TKA) has evolved over the past 30 years as a result of early prosthetic design failure. Hinge-type implants demonstrated a high loosening rate because of overconstraint. Curved-on-flat prostheses, which were popular in the late 1970s, became associated with a high incidence of polyethylene failure. The Low Contact Stress (LCS) Total Knee System (DePuy Orthopaedics Inc, Warsaw, Ind), a mobile-bearing knee arthroplasty design, was introduced in 1977. The LCS Total Knee System, now in its 25th year without alterations in articular geometry, has demonstrated clinical success and has had an impact on evolving prosthetic designs. Introduced in 2001, the LCS Complete Total Knee System provides further refinements in patient fit without changing the fundamental design principles. Surgeons are cautioned to use a well-proven clinical design, as biomechanical variations critically impact clinical outcomes.

Arthroplasty, Replacement, Knee↗
PubMed1998

New developments in cochlear implants.

Essential to improve the performance with cochlear implants is a better control of the electrode-nerve interface. The long-term stability of the electrode characteristics has to be guaranteed. Most important herein is to have a low and stable electrical impedance and to prevent fibrosis. Results of electrode coating and fibrosis-inhibiting products are described. To assess the properties of the electrode-nerve interface such as stimulation threshold, spatial selectivity and channel interaction, the electrically evoked compound action potential is measured. The measurement paradigm and the first results are described. Models of auditory nerve response to electrical stimulation can be used as a tool for cochlear implant fitting. A simple model is proposed and its predictions are compared with measured responses.

Cochlear Implantation↗
PubMed1993

[Inguinal hernia repair with marlex mesh in a preperitoneal site using the classical inguinal access].

Following a brief review of the main method of prosthetic repair used for inguinal hernia: Lichtenstein, Stoppa, Rives, etc, the authors propose an original technique consisting in the placement of a marlex patch below the trasversalis fascia, in a pre-peritoneal site, using a classical inguinal access route. The prosthesis is fitted round the spermatic funicle and fixed with a single stitch to the pubis and with a few others, in resorbable material, to the posterior face of the trasversalis fascia. Above it, plastic surgery is performed to bring the triple stratum closer to the reflexio of the inguinal ligament. The prosthesis is kept in place by positive abdominal pressure. The method outlined here has been used in 71 cases of primary or recurrent inguinal hernia. Follow-up lasted for 1-24 months and showed the low morbidity (4.5%) due to sepsis of the surgical wound, which did not require reoperation, and only 1 case of recurrent hernia which was probably caused by the incorrect positioning of the prosthesis.

Evaluation Studies as Topic↗
PubMed2003

Comparison of the fit and fill between the Anatomic Hip femoral component and the VerSys Taper femoral component using virtual implantation on the ORTHODOC workstation.

The purpose of this study was to evaluate differences in fit and fill between an anatomic femoral component and a straight tapered femoral component, both of which were designed for proximal fit and fill using the preoperative planning workstation of the ROBODOC system (ORTHODOC). Anatomic Hip (Zimmer) and VerSys Taper (Zimmer) femoral components were each virtually implanted into 50 femora (25 dysplastic femora and 25 anatomically normal femora) using the ORTHODOC workstation. The fit and fill of the femoral components were measured on cross-sectional images. The VerSys Taper femoral components showed significantly better fit and fill than the Anatomic Hip femoral components at the lower corner of the femoral neck cut and the middle of the femoral component in both the dysplastic femora and the anatomically normal femora. The Anatomic Hip femoral components showed significantly better fit and fill than the VerSys Taper femoral components 1 cm proximal from the femoral component tip in both dysplastic femora and anatomically normal femora. There was no significant difference in fit and fill between the two types of femoral component at the center of the lesser trochanter or 1 cm distal from the center of the lesser trochanter in either dysplastic femora or anatomically normal femora. Overall, VerSys Taper femoral components appear to provide better proximal fit and fill than Anatomic Hip femoral components in both dysplastic and anatomically normal femora.

Adult↗
PubMed2003

Use of contact lenses for management of keratoconus.

This article describes use of contact lenses to manage patients with keratoconus. Fitting concepts, prefit evaluations, types of lenses, initial lens selection, and potential problems and solutions are discussed.

Algorithms↗
PubMed1984

Tracheoesophageal puncture for voice restoration: modification of the Blom-Singer technique.

We have used a modification of the Blom-Singer technique in our last 24 tracheoesophageal punctures, performed on 20 patients. At the time of puncture a surgical stent with an indwelling Dacron polyester suture is placed to form the fistula. Forty-eight to 72 hours later the stent is backed out of the puncture site but the suture is allowed to remain. The Blom-Singer duckbill prosthesis is fitted and taped in the routine fashion. The suture is left to traverse the tracheoesophageal tract until the time of discharge, when it is removed. At discharge the patient is given a Silastic dilator, to be used if the puncture site becomes too small to allow for insertion of the duckbill prosthesis. Seventeen of the 20 patients in this group obtained good voice. Six operations would have been failures because of the loss of the patient's prosthesis in the immediate postoperative period if the modified technique had not been used.

Esophagus↗
PubMed2001

Clinical application of the SADL scale in private practice II: predictive validity of fitting variables. Satisfaction with Amplification in Daily Life.

Predictive validity of 44 independent variables and their interactions with Satisfaction with Amplification in Daily Life (SADL) scores was assessed. SADL scores were influenced by patient age, years of hearing aid experience, hours of use per day, perceived hearing difficulty, pure-tone average, hearing aid style, processor type, and manufacturer's invoice cost. The relative importance of these variables to SADL measures was complex and very small, but the variables and their squares and interactions improved r2 predictions of SADL Global and subscale scores in a separate stepwise multiple linear regression procedure by 12 to 33 percent compared to SADL norms alone. More research with additional variables is needed to develop a clinically useful model for predicting wearer satisfaction. Clinically, SADL scores yield subscale-specific patterns of satisfaction and dissatisfaction that help in intervention planning and serve as graphic "snapshots" of satisfaction status. A series of patient profiles are presented illustrating the potential usefulness of the SADL in predicting hearing aid satisfaction. With its good construct and psychometric properties, the SADL could serve as a gold standard for satisfaction outcomes and a basis for development of a predictive model of hearing aid fitting success.

Adult↗
PubMed2003

Beyond hearing aid fitting: improving communication for older adults.

Many older adults with hearing impairment continue to have substantial communication difficulties after being fitted with hearing aids, and many do not choose to wear hearing aids. Two group communication education programs aimed at such older people are described. The 'Keep on Talking' program has a health promotion focus, and is aimed at maintaining communication for older adults living in the community. An experimental group (n = 120) attended the program, and a control group (n = 130) received a communication assessment but no intervention. Significant improvements were found in the experimental participants in terms of knowledge about communication changes with age and about strategies to maintain communication skills. At the follow-up evaluation at 1 year, 45% of the experimental group, compared to 10% of the control group, had acted to improve their communication skills. The 'Active Communication Education' program focuses on the development of problem-solving strategies to improve communication in everyday life situations. Preliminary outcomes have been assessed on a small scale (n = 14) to date. It is concluded that communication programs represent an important adjunct to, or supplement for, the traditional approach that focuses on hearing aid fitting.

Activities of Daily Living↗
PubMed1994

A quantitative in vitro assessment of fit and screw fixation on the stability of a cementless hemispherical acetabular component.

This investigation quantifies in vitro the effect of component fit, as well as the effect of adjuvant screw fixation, on the initial stability of cementless hemispherical titanium acetabular total hip arthroplasty components and assesses apposition of the acetabular components to bone. Six, fresh human hemipelvi (3 matched pairs) were harvested at autopsy. Titanium alloy acetabular components with a porous surface of commercially pure titanium fiber mesh (Harris Galante Porous acetabular components, Zimmer, Warsaw, IN) were used for implantation. Initially, each acetabulum was underreamed to achieve a 2 mm press-fit with the acetabular component. Pressure-sensitive film had been placed along the dome and medial wall at the bone-implant interface to assess the completeness of seating. After the implant was impacted into the acetabular cavity, relative motion between the implant and bone was measured during simulated single leg stance. Adjuvant fixation of the implant was then obtained with the insertion of four 6.5 mm cancellous screws. High-contrast roentgenograms of the specimens in multiple views were obtained after initial cup insertion and again after screw insertion. The stability of each implant under load was measured with four, three, two, one, and no screws in place. Further reaming of the bone was done to create a 1 mm press-fit. The sequence was then repeated. Further reaming was done to create an exact-fit and the sequence was repeated again. Under these conditions, 1 mm press-fit with or without screws provided the optimum combination of fit stability.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2006

Reverse geometry contact lens fitting in corneal scar caused by perforating corneal injuries.

PURPOSE: To describe a reverse geometry rigid gas permeable (RGP) contact lens fitting in corneal scar caused by perforating corneal injuries with intraocular strange body. METHODS: A reverse geometry RGP lens, with large diameter, was empirically fitted in a 38-year-old male patient who had previous open globe injuries due to work accident in right eye. Corneal suture, vitrectomy and lens extraction were performed. Irregular corneal surface with corneal scar in line with the visual axis were found with low uncorrected visual acuity. RESULTS: Snellen visual acuity improved from counterfinger to 0.8 with high contact lens acceptance, 6-9h per day of wear. Only three diagnostic contact lenses, in two visits, were necessary. Orbscan simulated fluorescein pattern was different to definitive fluorescein pattern. CONCLUSIONS: Reverse geometry RGP contact lens, with large diameters, could be a good alternative in irregular corneal surface with corneal scar. Fluorescein pattern analysis could be the proper fitting technique. This fitting could involve less time and fewer visits. Computer-aided fitting was of limited value in these cases.

Accidents, Occupational↗
PubMed2006

Gas permeable toric use and applications: survey of Section on Cornea and Contact Lens Diplomates of the American Academy of Optometry.

BACKGROUND: The purpose of this study was to survey Diplomates in the Section on Cornea and Contact Lenses of the American Academy of Optometry (AAO) to determine their fitting preferences for astigmatic patients, lens materials used, and their perception of simplicity or complexity of bitoric fitting. METHODS: A total of 180 practitioners, representing all active Diplomates in the Cornea and Contact Lens Section, were sent a survey of 11 questions pertaining to their astigmatic contact lens prescribing habits. Sixty-eight (38%) of those surveyed responded to the questionnaire. RESULTS: The results of this survey included the following: (1) gas permeable (GP) lenses represented 28.7% of all contact lenses fit; (2) a spherical power effect (SPE) bitoric lens was preferred (versus four other options) by 58.8% of respondents for a 3.5 diopter (D) refractive astigmat with no residual astigmatism, whereas a cylinder power effect (CPE) bitoric was preferred by 55.9% for a 3.5 D refractive astigmatic with more than 1 D of residual astigmatism; (3) only 10.4% of responding practitioners consider GP torics to be difficult to fit. CONCLUSIONS: (1) Back surface toric and bitoric GP lenses are considered easy to design and fit by most Diplomates. (2) The Mandell-Moore guide is the preferred empirical method, and the Polycon SPE is the preferred diagnostic fitting method for bitoric lenses for those responding to the survey.

Academies and Institutes↗
PubMed2006

Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the Speech, Spatial, and Qualities of Hearing Scale (SSQ).

The Speech, Spatial and Qualities of Hearing Scale (Gatehouse & Noble, 2004) was applied to three independent clinical groups: 144 people prior to being fitted with amplification; 118 people with six months experience with unilateral amplification; and 42 people with six months experience with bilateral amplification. For traditional speech hearing contexts (one-on-one, in groups, in quiet, in noise) there was benefit with one aid, and no further benefit with two. By contrast, hearing speech in demanding contexts (divided or rapidly switching attention) showed benefit with one aid and further benefit with two. In the spatial domain, directional hearing showed some benefit with one hearing aid, and particular further benefit in distance and movement discrimination from fitting with two. There was some benefit from unilateral fitting for elements of the qualities domains (clarity, naturalness, recognisability, segregation of sounds), with no consistent sign of further benefit from two. Bilateral fitting added benefit with respect to listening effort. Two hearing aids offer advantage in demanding and dynamic contexts; these contexts are argued as significant in the maintenance of social competence and emotional wellbeing. The present results go toward establishing the real-world advantages of bilateral hearing aid fitting and suggest that previous, inconclusive clinical findings reflect inquiry limited to more traditional areas of hearing function.

Aged↗