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At least 955 records · Page 53Linked to original sources
PubMed1993

Diseases, medication, and postinsertion visits in complete denture wearers.

The records of 268 patients were used to assess the effects of five disease/drug complexes on the number of postinsertion visits in complete denture wearers. The data were analyzed with SAS and BMDP computer packages. The results showed a statistically significant increase in the number of postinsertion visits in patients who had central nervous system or psychiatric disorders. Practitioners are alerted to consider the ergonomic implications at the outset of treatment.

Adult↗
PubMed1993

Retention designs for bone-anchored facial prostheses.

A facial prosthesis can be retained by bone-anchored implants and by a retentive bar. Because tissue response is critical around the abutments, the retentive bar should be constructed so that it is comfortable, conveniently hygienic, and designed without compromising the contours of the prosthesis.

Ear, External↗
PubMed1993

Treatment of lagophthalmos of the eye with a custom prosthesis.

Inability to close the eyelids (lagophthalmos) is a major problem for patients with facial paralysis. Various treatment modalities and combinations can be used to restore function and esthetics. Lid loading is an effective method of treatment and can be further enhanced by custom fabrication of the prosthesis. The dentist functions as an integral part of the treatment team, working with the plastic surgeon and ophthalmologist to achieve the most functional and esthetic result.

Eyelid Diseases↗
PubMed1994

Rotational path partial denture design: a 10-year clinical follow-up--Part I.

A conventional removable partial denture that uses a straight path of placement requires that all rests and clasps be seated simultaneously. The incorporation of a dual, curved, or rotational path of placement permits one portion of the framework to be seated first, followed by the remainder of the framework. This procedure usually permits a reduction in the number of clasps in the framework without compromising the biomechanical properties of the prosthesis. Rotational path designs that eliminate clasps reduce tooth coverage by components and often enhance esthetics, thereby contributing to improved patient acceptance.

Dental Abutments↗
PubMed1994

Rotational path partial denture design: a 10-year clinical follow-up--Part II.

A review of the rotational path removable partial denture design concept has been presented. The rigid direct retainers used in these designs satisfy the basic requirements of clasp designs. The reported results of a survey of the members of The Academy of Prosthodontics may provide insight into the reasons for reluctance on the part of some practitioners to use the concept more often when indicated. Possible reasons include the following: lack of sufficient understanding of the concept, difficulty in obtaining knowledgeable laboratory support, absence of documented evidence of long-term clinical success, and a general lack of confidence in the efficacy of the procedure as described in the literature. This article presents references that are available to improve the understanding of technicians and dentists with regard to the rotational path concept. In addition, several patients followed up for 10 or more years demonstrated long-term clinical success.

Attitude of Health Personnel↗
PubMed1994

Myoelectric prostheses in the management of Poland's syndrome. A report of 2 cases.

Two cases of Poland's syndrome are reported in whom myoelectric prostheses have been used. The rare congenital sporadic disorder of Poland's syndrome characterized by absence of pectoralis major and varying degrees of ipsilateral upper limb deficiency has been reported by various authors (Rasjad and Sutiaksa, 1991, Gausewitz et al, 1984; David, 1982; Ireland et al, 1976). Management of the upper limb deficiency depends on the degree of functional and cosmetic disability. We report two cases of Poland's syndrome where myoelectric prostheses have been successfully used. We have been unable to find any published report of the use of a myoelectric prosthesis in Poland's syndrome.

Adult↗
PubMed1993

Marginal adaptation.

A critical review of studies assessing the marginal adaptation of direct placement, plastic restorations is presented. The effects upon adaptation of cavity design and location of cavity margins are examined, together with the effects of differing placement and finishing techniques. Both the choice of restorative material and the use of liners/bases are shown to influence the quality of restoration margins. Techniques used in both in vivo and in vitro assessment are reviewed, however it appears that a wide variety of methodologies exist and the establishment of standard, published criteria for the qualitative assessment of marginal adaptation is recommended.

Composite Resins↗
PubMed1994

Shear bond strength of resin bonded ceramic after different try-in procedures.

Final cementation of porcelain laminate veneers may require a previous colour match try-in. The purpose of this in vitro study was to evaluate the effect on shear bond strength of resin bonded to porcelain after the application of different try-in procedures. Forty porcelain specimens were fabricated, flattened with 600 grit SiC, etched with hydrofluoric acid and silane treated. After 24 h the specimens were divided into four groups at random and prior to bonding of a dual cure resin composite button were treated as follows: Group 1, no treatment (control); Group 2, non-activated resin applied for 5 min, cleaned in acetone for 3 min; Group 3, as for Group 2, with silane reapplied; Group 4, as for group 3, but re-etched for 30 s before reapplication of silane. After bonding the specimens were stored in water at room temperature for 7 days. Shear bond strength data were as follows: Group 1, 18.6 +/- 1.6; Group 2, 15.9 +/- 1.7; Group 3, 16.7 +/- 2.6; Group 4, 15.3 +/- 3.0 MPa. Fractured surfaces examined, under light microscopy and scanning electron microscopy (SEM), showed cohesive failure within the porcelain in all cases. The reduction in mean bond strength after application of a try-in resin was significant in Groups 2 and 4 compared with the control (ANOVA P < 0.05). No other significant differences were measured. In conclusion a single reapplication of silane maintained the bond strength of resin to porcelain when final cementation was preceded by a try-in procedure and cleaning.

Acetone↗
PubMed2004

Prosthetic device provision to landmine survivors in Bosnia and Herzegovina: outcomes in 3 ethnic groups.

OBJECTIVE: To determine differences in prosthetic provision, use, and effectiveness among unilateral lower-extremity amputees from 3 ethnic groups in Bosnia and Herzegovina. DESIGN: Case series with a consecutive sample of patients seen in field clinics. SETTING: Multiple field clinics in Bosnia and Herzegovina from October 1998 to May 2002. PARTICIPANTS: A total of 671 patients were examined, and information about their prosthetic history was recorded from observation or verbal responses. The majority of the amputations resulted from injuries inflicted by landmines. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported walking distance per day, prosthesis functionality (functional or nonfunctional as assessed by a physician and a prothetist), prosthesis status (broken or nonbroken as assessed by a physician and a prothetist), and employment status. RESULTS: Ethnic groups differed significantly in types of prostheses provided, functional status of the prostheses, and use of the prostheses for community ambulation. CONCLUSION: Prosthetic devices and delivery of rehabilitation services for unilateral lower-extremity amputees differed between ethnic groups. Despite these differences, functional prosthetic devices increased mobility. Persons in all 3 ethnic groups with functional prostheses were more mobile than persons with nonfunctional prostheses. The employment rate was higher for people with functional prostheses.

Adult↗
PubMed2004

Rehabilitation of a child with meningococcal septicemia and quadrilateral limb loss: a case report.

Acquired quadrilateral limb loss is a rare occurrence in children. One cause of this condition is severe meningococcal septicemia. We present the case of a boy who, at 14 months of age, required extensive amputation after an episode of meningococcal septicemia. We review his medical recovery and rehabilitation, including upper- and lower-limb prosthetic prescription and training, and adaptation to his altered body. A multidisciplinary approach led to effective management of his complex clinical and psychologic needs. This case illustrates the need to address a range of medical, prosthetic, and family issues central to successful clinical outcome.

Activities of Daily Living↗
PubMed2005

Changing dynamics in lower-extremity amputation in China.

OBJECTIVE: To evaluate the current pattern of lower-extremity amputation (LEA) in a Chinese population and to identify independent risk factors for failure to ambulate in the community after LEA. DESIGN: Retrospective study. SETTING: Tertiary hospital. PARTICIPANTS: Consecutive Chinese adults (N=189) who underwent LEA from 1995 to 1997. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Pattern of LEA in comparison with previous data and risk factors for failure to ambulate in the community after LEA. RESULTS: The mean age at amputation was 74.1 years. Vascular occlusive disease and infection accounted for most of the reasons for the LEA. The pattern of LEA had changed significantly. The proportion of patients who were able to ambulate in the community decreased from 66.1% before the LEA to 29.9% 12 months after LEA. Logistic regression analysis showed that major amputation level, presence of diabetes mellitus, hypertension, inability to ambulate in the community before LEA, and failed use of prosthesis were significant independent risk factors for failure to ambulate in the community after LEA. CONCLUSIONS: A more aggressive rehabilitation approach, together with efforts targeted at various levels is required to achieve better functional ambulation level and to improve reintegration into the community after LEA.

Adult↗
PubMed2004

Effect of ion implantation on the tribology of metal-on-metal hip prostheses.

Nitrogen ion implantation (which considerably hardens the surface of the bearing) may represent one possible method of reducing the wear of metal-on-metal (MOM) hip bearings. Currently there are no ion-implanted MOM bearings used clinically. Therefore a physiological hip simulator test was undertaken using standard test conditions, and the results compared to previous studies using the same methods. N2-ion implantation of high carbon cast Co-Cr-Mo-on-Co-Cr-Mo hip prostheses increased wear by 2-fold during the aggressive running-in phase compared to untreated bearing surfaces, plus showing no wear reductions during steady-state conditions. Although 2 specimens were considered in the current study, it would appear that ion implantation has no clinical benefit for MOM.

Arthroplasty, Replacement, Hip↗
PubMed2005

Choosing your implant: cementless, patella sparing, and posterior cruciate ligament retaining.

Clinical results of total knee arthroplasty with osteointegration techniques for fixation of the femoral and tibial components in a series of 192 patients (255 knees) followed up for 15 to 18 years are comparable with the best series reported with cemented fixation. Although functional scores declined as the patients aged, pain scores did not worsen, and the mechanical failure rate remained low through follow-up. Preservation of the posterior cruciate ligament offered knee stability, especially in knees that required ligament balancing. Results with unresurfaced patellas in total knee arthroplasty are superior to resurfaced patellas in qualities related to quadriceps function such as stair climbing, likely because of femoral component design. Femoral implants with a shallow patellar groove and wide intercondylar notch produce the highest stresses on the unresurfaced patella. Those with deeper patellar grooves and supporting lateral flange surfaces have low contact stress similar to that of the normal patellofemoral joint.

Arthroplasty, Replacement, Knee↗
PubMed2004

Clinical outcomes with the Hancock II bioprosthetic valve.

BACKGROUND: The Hancock II bioprosthetic valve, which was first introduced to clinical use in 1978, differs from its predecessor in several ways. This study was designed to evaluate the durability and outcomes with this valve in patients who had isolated aortic or mitral valve replacements. METHODS: From 1991 to 1999, 459 patients underwent aortic valve replacement and 138 patients underwent mitral valve replacement with the Hancock II bioprosthesis (Medtronic Inc, Minneapolis, MN). The mean age was 73.2 +/- 0.4 and 72.6 +/- 0.8 years in the aortic and mitral groups, respectively. Most patients were in New York Heart Association Class III or IV (50% aortic group and 69% mitral group) and concomitant coronary artery bypass was performed in 49.4% and 52.8% of patients, respectively. Patients were assessed annually and follow-up was up to 129 months in the aortic group and 100 months in the mitral group. RESULTS: At 8 years, actuarial survival was 52% +/- 5% in the aortic group and 57% +/- 8% in the mitral group. Furthermore, the actuarial freedom from structural failure necessitating reoperation was 99% +/- 0.5% in the aortic group and 98% +/- 2% in the mitral group, and the actuarial freedom from repeat valve surgery due to all causes was 97% +/- 2% and 96% +/- 2%, respectively. Actuarial freedom from thromboembolic events was 89% +/- 2% in the aortic group and 90% +/- 5% in the mitral group. CONCLUSIONS: The Hancock II valve has excellent midterm durability and clinical performance in older patients.

Actuarial Analysis↗
PubMed2005

Impact of valve prosthesis-patient mismatch on left ventricular mass regression following aortic valve replacement.

BACKGROUND: Valve prosthesis-patient mismatch is a frequent problem in patients undergoing aortic valve replacement and its main hemodynamic consequence is to generate high transvalvular gradients through normally functioning prosthetic valves. The persistence of high gradients may hinder or delay the regression of left ventricular hypertrophy after aortic valve replacement. METHODS: The aim of the study was to determine the impact of prosthesis-patient mismatch on the postoperative regression of left ventricular mass. Left ventricular mass was measured by Doppler echocardiography in 109 patients undergoing aortic valve replacement with a single type of bioprosthesis (Carpentier-Edwards Perimount) for pure aortic stenosis. Prosthesis-patient mismatch was defined as a projected indexed effective orifice area less than 0.90 cm2/m2. On this basis, 58/109 (53.2%) patients had prosthesis-patient mismatch. RESULTS: There was a good correlation (r = 0.61, p < 0.001) between the postoperative mean transprosthetic gradient and the projected indexed effective orifice area. The absolute and relative left ventricular mass regression was significantly (p = 0.002 and p = 0.01, respectively) lower in patients with prosthesis-patient mismatch (-48 +/- 47 g, -17% +/- 16%) compared to those with no prosthesis-patient mismatch (-77 +/- 49 g, -24% +/- 14%). In multivariate analysis, a larger projected indexed effective orifice area, female gender and a higher preoperative left ventricular mass are independent predictors of greater left ventricular mass regression. CONCLUSIONS: This study shows that in patients with pure aortic stenosis prosthesis-patient mismatch is associated with lesser regression of left ventricular hypertrophy after aortic valve replacement. These findings may have important clinical implications given that prosthesis-patient mismatch is frequent in these patients.

Aged↗
PubMed2006

Prosthesis-patient mismatch is not clinically relevant in aortic valve replacement using the Carpentier-Edwards Perimount valve.

BACKGROUND: Previous studies have shown that prosthesis-patient mismatch (PPM) results in higher early and late mortality after bioprosthetic aortic valve replacement. Careful selection of stented bioprostheses was recommended to avoid inadequate effective orifice area. We studied the incidence of PPM and its potential effects on clinical outcome in patients undergoing aortic valve replacement using the Carpentier-Edwards Perimount bioprosthesis. METHODS: Independent predictors of early and late mortality and hospital readmission for cardiac reasons were defined in 506 patients (mean age, 73 years; range, 57 to 87 years) by multivariate analysis. Mean follow-up was 6.1 +/- 4.8 years; maximum follow-up was 18.6 years. RESULTS: The incidence of severe PPM (effective orifice area index < 0.65 cm2/m2) was 0.2% and of moderate PPM (effective orifice area index > 0.65 and < 0.85) was 20%. Multivariate analysis revealed that moderate PPM was not an independent predictor of early mortality, late mortality, or hospital readmission for cardiac reasons. Reduction of septal hypertrophy was similar in patients with and without moderate PPM. CONCLUSIONS: The incidence of severe PPM is virtually nonexistent after aortic valve replacement using the Carpentier-Edwards Perimount valve. Moderate PPM is found in 20% of cases and is clinically irrelevant in this population.

Aged↗
PubMed2006

Prosthetics and orthotics for the older adult with a physical disability.

Prosthetics and orthotics serve many functions for the elderly and disabled. Assessment of patients in need of such devices is discussed. Prosthetic and orthotic devices are described with attention to their components, biomechanical effects, and potential value to patients. Strategies for selecting the proper device are presented. Structured rehabilitation is vital to ensure that patients maximally benefit from these devices; strategies for optimizing a rehabilitation program are discussed.

Aged↗
PubMed2005

Wavefront technology: past, present and future.

After outlining what is meant by wavefront aberration, the history of the field of wavefront technology is sketched and methods for measuring ocular wavefront aberration are briefly described. The variations in aberration of the normal eye with the individual and their pupil size, accommodation and age are summarised. Potential contact lens applications are outlined, including the design and on-eye performance of single-vision lenses, lenses for presbyopes and keratoconics, orthokeratology, tear film studies, and the design and performance of customised contact lenses intended to minimise residual lens-eye wavefront error.

Contact Lenses↗