Elastomers for maxillofacial applications.
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OBJECTIVES: The purpose of this study was to investigate the stress patterns associated with prefabricated endodontic posts during the various stages of insertion according to a number of design characteristics. METHODS: In a photoelastic material with elastic properties comparable to dentin, analyses were performed of the overall stress patterns with polarized light revealing substantial differences in stresses generated by the various posts. The effects of variations in design for certain configurations of the posts were also assessed. RESULTS: One geometric feature was the retentive thread of the post. The stress patterns within the photoelastic material revealed a homogeneous distribution of stress along the entire length of the thread, and more threads induced additional stress. The stress recorded with a vent when the pitch of the thread was 0.8-1.0 mm was classified as minimal-to-mild stress. Another geometric feature considered was the head (coronal extension) of the post. Minimal stress was recorded in the material in contact with the head and the apical end of the post when the contact surface of head was more than 3 mm2. CONCLUSIONS: This study suggests that during insertion of threaded posts the least stress occurs when the head contact surface is sufficient (> or = 3 mm2). A thread with a pitch of 0.8-1.0 mm is most desirable in stress reduction. The number of windings should also be limited (less than six windings) as samples with a substantial number of windings (N = 13 or 30) produce severe stress.
PURPOSE: We have previously observed endothelium on two human vascular prostheses explanted under optimal conditions for flow surface preservation. In this study we sought to further verify the hypothesis that endothelialization can occur on clinical grafts and that it can be detected in specimens that have been promptly removed and properly preserved in a timely manner. METHODS: We studied 29 aortic grafts. Of these, 11 Dacron bypass grafts were in a condition suitable for analysis with light microscopy and immunocytochemistry staining, and scanning and transmission electron microscopy. RESULTS: Three grafts had endothelium beyond the pannus, identified by factor VIII/ vWF, Ulex europaeus agglutinin, and collagen IV positivity. Specimen A, a knitted 6-year implant, was preserved by embalming 3 hours after the patient's death and had a firmly attached outer capsule with fibroblasts, collagen, giant cells, and microvessels in the interstices. Specimen B, a woven 18-year implant, was retrieved at reoperation and immediately fixed in 10% formalin; it had no outer capsule and no tissue ingrowth. Specimen C, a woven 7-year implant, was removed and fixed 5 hours after the patient's death; it had a firmly attached outer capsule but no tissue ingrowth beyond the outer portion of the wall. CONCLUSIONS: The rapidity with which the specimens were fixed probably enabled identification of endothelium. These findings suggest that endothelialization of synthetic arterial grafts may occur more frequently in human beings than previously recognized.
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In this study, a maxillofacial silicone elastomer was stained with cigarette smoke. The stain was then removed by solvent extraction using 1,1,1-trichloroethane. The cigarette smoke produced large color changes in the elastomer as measured from spectrophotometric reflectance curves. The solvent was totally effective in removing the cigarette stain without changing the color of the silicone base.
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An interim denture technique is presented describing the fabrication of an esthetic prosthesis that is used for short periods of time. The prosthesis conditions the patient for the acceptance of an artificial substitute for missing natural teeth until more definitive prosthodontic therapy can be provided. All the teeth in the arch are extracted simultaneously, and the interim prosthesis is inserted immediately thereafter. The prosthesis duplicates the morphology, color, and position of the extracted teeth. This technique satisfies a great need of socially and business-active patients because there is no interruption in their activities and no change in facial esthetics. Two case histories are presented.
The purpose of this study was to observe the tooth colors and retention of a cosmetic veneer Fiche Pearl On containing shellac and five experimental formulations containing benzoin gum and ethyl cellulose. Tooth color was measured with a spectrophotometer before and after application of the veneers to the buccal or labial surface of experimental teeth. Through both in vitro and in vivo studies, the retention rates of veneers were assessed. In terms of color difference (deltaE*ab) between before and after veneer application, it ranged from 4.3 (Fiche Pearl On) to 15.0 (experimental formulation White Plus). In terms of retention rate, in vitro test found the retention rate of experimental formulation White Plus was significantly higher than that of Fiche Pearl On. In in vivo test where subjects were permitted to drink water and tea, it was found that the retention rate after two hours ranged from 94.0 to 98.5%. In conclusion, teeth applied with the experimental cosmetic veneer formulations showed better color and retention than teeth with Fiche.
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Effective cosmetic rehabilitation of patients with anophthalmia can be activated if methods based on the use of the cosmetic parameters for prostheses, listed below, are employed: (1) eyelid position and relief, (2) eye opening, (3) position of the iris and pupil, (4) diameters of the iris and pupil, (5) position and decline of the prosthesis, (6) depth of the prosthesis position in the orbit, (7) cavity filling with the prosthesis, (8) prosthesis mobility, (9) sclera color, (10) iris color. These prosthetic cosmetic parameters are of paramount importance for effective cosmetic rehabilitation of anophthalmia patients.
PURPOSE: The aim of this study was to acquire information on the types and longevity of implant-retained facial prostheses and the opinions of patients on several factors related to their prostheses. MATERIALS AND METHODS: A survey of 75 maxillofacial prosthetic patients currently under treatment and review at the Maxillofacial Unit, Morriston Regional Hospital was conducted through a 23-question postal questionnaire. These patients were selected as representative of a group of individuals receiving treatment or under review for the fabrication of maxillofacial prostheses. RESULTS: Of the prosthetic replacements, 83% were ear prostheses, 8% nose, 6% eye, and 2% combination prostheses. Of the 47 respondents, 8 (17%) reported that they were currently wearing their original prostheses. The remaining 39 (83%) respondents had all been provided with at least 1 replacement prosthesis. The mean lifetime of the prostheses was found to be 14 months (range: 4-36 months). The majority of replacement prostheses in this study were provided as a result of color fade or wear of the silicone material of the previous prosthesis. Individuals with no previous experience wearing a prosthesis had an unrealistic expectation of their prosthesis longevity, with a mean value of 17.8 months. In comparison, individuals with previous experience had reduced expectations, with a mean of 14.4 months. In terms of the patients' opinions of the overall quality of their prostheses, the results demonstrated that a large number of patients were satisfied. Thirty-five patients rated their prostheses as excellent and 9 as good. At 7-12 months, 4 patients rated their prostheses as excellent and 8 as good. At 13 months, 4 patients rated their prostheses as excellent and 5 as good. CONCLUSIONS: It is important that advice be given to patients on the expected average longevity of their prostheses, together with information on factors affecting the longevity (i.e., environmental staining, cosmetics, and cleaning regimes). In this study, 26% of the replacement prostheses were provided due to color fading of the original prosthesis. This highlights the need for continuing research in the development of materials used for the construction of facial prostheses with improved properties, and in particular, improved color stability.
A method of facilitating facial prosthesis production using specially designed equipment and a color notation record has been described. Application to facial and auricular prosthesis production has been discussed. Advantages in time saved and staff utilization have been realized through the use of this approach.
After numerous years in situ, ceramic fixed prostheses appear high in value when compared with the adjacent natural teeth, and the patient may desire the replacement of the prosthesis primarily for aesthetic reasons. This article provides exact information on preoperative shade evaluation, modification of a manufactured shade tab, custom shade fabrication, and soft tissue cast fabrication to help to ensure optimal results. The learning objective of this article is an enhanced understanding of the principles of aesthetic restorations.
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The purpose of this study was to indicate change in an auricular prosthesis resulting from environmental factors. An auricular prosthesis was made from a commercially maxillo-facial dental materials. The patient used this prosthesis. After one year, the auricular prosthesis was changed, it was nonesthetic. The prosthesis was made over again from the beginning. The prosthesis was changed from environmental factors such as sunlight, wetting and drying, cleaning and secretions. Facial prosthesis was fabricated anew because of color changes and surface changes.