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PubMed2006

Presurgical implant-supported prosthesis: technique for cementation of a definitive prosthesis immediately after surgery.

A fixed prosthesis, supported by implants, was fabricated prior to surgery and cemented with passive fit immediately after placement of 14 implants in the mandible. The prosthesis was constructed before implant surgery on a plaster cast that precisely reproduced the patient's hard and soft tissues. The cast was built using a method that allowed the transfer of hard and soft tissue anatomy from computerized tomograms. A rigid surgical stent, cast in gold, was used to place the implants into prosthetically ideal positions under three-dimensional control. The prosthesis was placed immediately after implant placement, using an occlusion-driven method, which avoided the need for occlusal adjustments to the prosthesis.

Cementation↗
PubMed2006

[Traumatic dislocation of the hip in a 3-year-old boy with a painful knee].

A 3-year-old boy had pain on the medial side of his left knee after his father fell on him. When the pain still persisted 4 days later, further diagnostics revealed dislocation of the hip. The pain disappeared and function was restored after closed reposition under fluoroscopic control followed by immobilisation with a plaster cast. Traumatic dislocation of the hip in childhood is a relatively rare injury, but may have far-reaching consequences. As the sensitivity to pain in children differs from that in adults, an examiner must be on the alert for a traumatic dislocation of the hip whenever a child presents with a fitting history and dysfunction ofthe leg, regardless of the localisation of the pain. Pain in the knee is often reported in case of hip disorders. Avascular necrosis of the caput femoris is a well-known and dreaded complication of traumatic dislocation of the hip in children. The risk of complications is certainly increased sharply if the hip luxation goes unnoticed and reposition takes place after more than 6 hours. Closed reposition as rapidly as possible or alternatively open reposition of the dislocated hip under general anaesthesia is the indicated treatment.

Child, Preschool↗
PubMed2006

A comparison of the clinical effectiveness of spinal orthoses manufactured using the conventional manual method and CAD/CAM method in the management of AIS.

Spinal orthoses are commonly prescribed to patients with moderate AIS for prevention of further deterioration. In a conventional manufacturing method, plaster bandages are used to get patient's body contour and plaster cast is rectified manually. With the introduction of CAD/CAM system, a series of automated processes from body scanning to digital rectification and milling of positive model can be performed in a fast and accurate fashion. This project is to study the impact of CAD/CAM method as compared with the conventional method. In assessing the 147 recruited subjects fitted with spinal orthoses (43 subjects using conventional method and 104 subjects using CAD/CAM method), significant decreases (p<0.05) were found in the Cobb angles when comparing the pre-intervention data with that of the first year of intervention. Regarding the learning curve, Orthotists are getting more competent with the CAD/CAM technique in four years time. The mean productivity of the CAD/CAM method is 2.75 times higher than that of the conventional method. The CAD/CAM method could achieve similar clinical outcomes and with its high efficiency, could be considered as substitute for conventional methods in fabricating spinal orthoses for patients with AIS.

Adolescent↗
PubMed1991

Rupture of the distal tendon of the biceps brachii muscle.

Rupture of the distal tendon of the biceps brachii muscle is easy to diagnose. For functional and cosmetic reasons the tendon to the radial tuberosity should be re-inserted. Two patients had early treatment, and one was operated upon after four weeks, all three with a good result. After treatment consisted of immobilization in a plaster cast with the arm in flexion and full supination for four weeks. Physical therapy is recommended. Complete functional repair and full recovery of strength can be expected in most cases.

Arm↗
PubMed1991

Orthodontic anomalies and differences in gnathometric variables in twins.

Actuality of gnathometric measurements by means of plaster casts persisting to the present days is stressed and the major research of the kind in twins mentioned. The study included 96 pairs of twins of both sexes (36 monozygotic and 60 dizygotic). Both qualitative and quantitative variables were evaluated and the results computer-processed. For most parameters evaluated, statistical processing revealed a markedly higher compatibility in monozygotes than in dizygotes. This held particularly true for types and severity of anomalies as well as for all qualitative variables, with the exception of over bite, overjet, class and class severity. The maxilla-related variables were shown to be highly genetically determined, which might be explained by the dynamics of mandibular movements and, possibly, a stronger effect of external factors on its growth and development.

Adolescent↗
PubMed1991

[Craniometric and gnathometric characteristics of anomalies Angle Class II in deciduous dentition].

The study was performed in 30 subjects with class II/1 and 30 subjects with class II/2 anomalies. The aim of the study was to assess the extent to which class II anomalies influenced individual craniometric and gnathometric dimensions as well as to determine whether there were any significant differences between the two subgroups. Craniometric dimensions were measured in each subject by means of standard measuring devices, while gnathometric analysis was carried out on plaster casts of their dental arches. Statistical processing was performed on an IBM PC-AT computer, with a SPSS/PC program support. The study results indicated the maxillomandibular and craniofacial growth to follow a specific pattern as early as in the deciduous dentition in subjects with class II anomalies. Differences between class II subgroups manifested in the range of the following parameters: all transversal craniometric dimensions were greater in class II/2, which was statistically significant in case of Eu-Eu dimension; height of the maxillary part of the face was significantly greater in class II/2; horizontal incisal step was significantly greater in class II/1; although all transversal dimensions of dental arches were considerably greater in class II/2, the differences were not statistically significant; the upper and lower dental arches were longer in class II/1 and II/2, respectively.

Cephalometry↗
PubMed1991

An adaptation of the Moyers mixed dentition space analysis for a Western Cape Caucasian population.

200 dental plaster casts of Western Cape Caucasoid subjects, all of whom were under the age of 21 years, were used in this study. Mesio-distal measurements (MD lengths) were obtained of all the teeth, disregarding the third molars. This data was used to develop regression equations, for maxillary and for mandibular arches, to enable the prediction of the mesio-distal lengths of the canine and two premolars. The study identified the sum of the MD lengths of the permanent lower incisors as the best predictor. It appears that separate predictions for male and female are not warranted. The equations and the predicted values were compared with those of Moyers (1973 and 1988) and some significant differences were found. The Prediction Tables will be useful in analysis of the mixed dentition phase in patients from this population group.

Adolescent↗
PubMed1991

[The rafter osteotomy of the first metatarsal with immediate weight bearing in the treatment of anterior and medial pes cavus in adults].

The difficulty of the exact adjustment of the first metatarsal's raising by dorsal cuneiform cutting and osteosynthesis, brought the authors to prefer proximal rafter osteotomy of the first metatarsal in the treatment of adult's anterior and medial pes cavus. Early weight bearing with a plaster cast or a wooden-shoe allowed the spontaneous raising of the metatarsal and an equal distribution of load between all the metatarsals. The excellent results reached by that single procedure in nine cases during ten years justify to suggest it for treatment of adult's anterior and medial pes cavus.

Adolescent↗
PubMed1991

[The indications for and limits of "extensive" posterior lysis in the surgical treatment of congenital clubfoot (talipes equinovarus supinatus)].

The authors present the preliminary results (after 4-7 years) of 69 cases of congenital torsive equino-varus-supinated foot treated operatively from 1982 to 1985 (of a total of 25% cases treated from 1982 to 1989). Both the modalities and the stages of execution of the treatment are described. After the initial clinical evaluation and the first weeks of manipulation, the feet were immobilized in corrective plaster casts, which were carefully constructed to correct the varus and supination. After 4-8 months, thorough clinical and radiographic assessment enabled the authors to plan the surgical procedure for correction of the remaining deformity, customizing it for each individual patient. There is an in-depth discussion of the stages of the "widened" posterior release procedure. Using this procedure, the authors achieved satisfactory intraoperative correction in 85% of the patients, correction which was maintained over time in 76.5% of the cases. In this way the medial stage of the surgical procedure, associated "ab initio" to the posterior release, may be reserved to a fewer number of patients (15-20%) under one year of age.

Achilles Tendon↗
PubMed1991

[Experience with plating of intra-articular fractures of the calcaneus].

There have been various attempts to improve the results of treatment of fractures of the calcaneus in recent decades. Descriptions of conservative treatment with plaster cast, functional treatment and several methods of closed and open reduction and stabilization have been published. We believe that, especially in young patients, intraarticular fractures with depression of the posterior articular facet should be treated by open anatomical reduction, autologous bone grafting and stabilization with plates. In our clinic 15 fractures of the calcaneus have been treated in this manner in the last few years, and the results are very satisfying.

Adult↗
PubMed1991

[After care and rehabilitation following surgery of peripheral nerves].

In cases with direct nerve repair we consider a plaster cast immobilization of three weeks as adequate; for those with nerve grafts, two weeks are sufficient. In the later course, the patient should regularly be examined also for Tinel's sign, to make sure that this progresses distally corresponding to normal nerve regeneration. If after four to five months the Tinel's sign has not progressed distally, the regenerating nerve fibres are most likely to be blocked by scar tissue formation, and revisional surgery may be indicated. As in all surgery of the hand, the role of a postoperative hand therapy program is of critical importance. In many cases specific sensory reeducation may definitely contribute to improve the final functional result after restoration of peripheral nerves.

Causalgia↗
PubMed1990

[Humeral fractures with paralysis of the radial nerve].

Forty fractures of the humerus associated with radial nerve palsy were reviewed after an average follow-up of 11 years. Early exploration of the radial nerve and internal fixation of the fracture was performed in 20 patients, while the other 20 patients were treated by closed reduction and immobilization in a plaster cast. In four patients of the latter group the radial nerve did not recover and a delayed exploration was performed. In each treatment group functional recovery of the radial nerve was observed in 16 patients (80%). On the basis of these results the authors suggest treating fractures of the humerus with radial nerve palsy by closed reduction. If there is no evidence of spontaneous recovery within 3-4 months, an exploration of the radial nerve should be performed.

Adolescent↗
PubMed1990

[Augmentation surgery of the anterior cruciate ligament using a carbon fiber band. Results of follow-up studies of 21 cases. I. (clinical aspects)].

Clinic and radiological follow-ups after implanting unidirectional carbon fibres in 21 cases (17 recent traumas, 1 older trauma and 3 chronic instabilities) approximately 34 months after operation. With the recent traumas we only found intraligamental ruptures or longitudinal fraying with ruptures of the femoral or tibial insertion. Postoperative plaster cast fixation for 6 weeks. Stability was examined by the "Arthrostress" (19 kp). In 11 cases no instability of clinical importance could be found, in 6 cases there was a +, in 3 cases a ++ and in 1 case a 3-plus instability.

Adolescent↗
PubMed1977

[Operative treatment of fractures of the patella (author's transl)].

Relative incongruance and great pressure in the femoro-patella joint are, besides the primary traumatic damage of the cartilage, responsible for frequent posttraumatic arthrosis and posttraumatic chondropathy of the patella after patellafracture. An operative reconstruction with a smooth joint surface of the patella is necessary. The only reliable method to fulfil these demands is the tension wire osteosynthesis by Pauwels, which, according to the type of fracture, can be combined with Kirschner wires and small fragment screws. The best access to the patella is established by diagonal incision. Open fractures must and closed fractures should be operated immediately. In comminuted fractures with devitalised cartilagefragments there is no indication to preserve the patella. Primary patellectomy has better results as late patellectomy. According to stability the after-treatment requires 4 to 6 weeks rest in a plaster cast. Although the operation can be performed with technical skill, arthrosis and chondropathy of the patella cannot always be avoided.

Aftercare↗
PubMed1991

Diskitis in children.

Thirty-six patients diagnosed with diskitis from 1978 to 1988 and followed for an average of 29.2 months were reviewed. The study included 23 boys and 13 girls with an average age of 5.3 years. The initial symptoms varied, but distinct clinical patterns emerged and were identifiable in different age groups. Both the leukocyte count and sedimentation rate were elevated. Routine roentgenograms were positive for intervertebral disk space narrowing in 82% of cases, technetium bone scans positive in 72%, and magnetic resonance imaging positive in all recent cases. Treatment consisted of bed rest for all patients, plaster casts for 50%, antibiotics for 40%, and traction for 23%. Regardless of the treatment combination, the course of the disease in most children is benign. At the completion of the study, all patients were asymptomatic including three children who had recurrences. In spite of being asymptomatic, 74% had persistent roentgenographic changes. The administration of antibiotics appears to be appropriate when indicated, i.e., failure to respond to immobilization. Disk space aspiration or biopsy should be reserved for those cases that are refractory to immobilization and antibiotics.

Adolescent↗
PubMed1991

Three-dimensional digitization: method for evaluating morphological differences between teeth.

A new comparative method has been developed for evaluating morphological differences between a pair of teeth. This method consists of five steps: 1) digitization of the surface morphology of the teeth, 2) standardization to enable comparison of the teeth on a common axis, 3) reversal of data on one tooth to enable comparison with the opposite tooth, 4) qualitative evaluation by computer graphic superimposition and 5) quantitative evaluation by the set operation. To illustrate its effectiveness, this method was applied to a pair of extracted premolars. Application to the dental crown on a clinical plaster cast was also discussed.

Bicuspid↗
PubMed1991

[Treatment of Monteggia fracture in children].

Described in this paper is a therapeutic concept by which to cope with Monteggia's fracture in childhood. It is based on experience obtained from 72 cases with injuries of that kind and their evaluation in a group study. Therapeutic approach to the individual case was determined by the following criteria: age of infant, localisation and shape of ulnar fracture, reducibility of capitulum radii, and accompanying injuries requiring treatment on the same arm. The need for surgical stabilisation of ulnar fracture was found to increase along with growing age of the affected child. High-stability anatomic reduction of the ulnar fracture proved to be a prerequisite for safe stabilisation of the radial capitulum. Close reduction has proved to be sufficient in many instances. Open reduction and internal fixation were found to be necessary in cases in which an ulnar fracture was irreducible or instable and/or a radial head was not reducible. Minimal osteosynthesis and plaster cast is considered to be an optional therapy for younger children, whereas ulnar stabilisation by means of plates is preferred for children in somewhat advanced age of childhood. The radial head may be fixed by trans-articular Kirschner's wire (WITT) or primary reconstruction of the annular ligament, using a strip of biceps or triceps tendon, or adaptation around the collum radii and ulna of the proximal radio-ulnar joint by means of a sling of Dexon or Vicryl suture.

Child↗