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PubMedDate not supplied

The effect of fatigue damage on the force required to remove a restoration in a cement-retained implant system.

PURPOSE: To evaluate the luting agents and retentive forces before and after mechanical stressing. MATERIALS AND METHODS: Sample size N was 12 for each group, and 12 Cera-One closed-end gold cylinders were cemented with three types of luting cements (ImProv, UltraTemp, and TempBond). The force required to remove the gold cylinders from the abutments was determined with an MTS testing machine. After cleaning and recementing the cylinders, the samples were placed in the housings of an Alabama-type three-body wear machine and load of 110 N was applied to the gold cylinders at a frequency of 80 cycles/min for 50,000 cycles. Then each cylinder was pulled from its abutment and the force at which the failure occurred was recorded. The procedure was repeated with 300,000 cycles. RESULTS: Statistical analysis arising from two-way ANOVA found that the forces required to remove the abutments were significantly different. The most retentive cement was ImProv. Before cyclic loading, on average, ImProv produced a retentive value 85% higher than that yielded by TempBond, and 25% higher than that of UltraTemp. The three cements were significantly different at each of the three cycle levels. CONCLUSIONS: These results might suggest TempBond luting agent as the material of choice for provisional cementation because it allows easier removal of the prosthesis and maintains enough retention to prevent loosening of the restoration. The clinical implication is that the effect of cyclic load on the strength of the cements is different, an important factor in selection of a cement. ImProv had the highest retentive value before and after the two cycles, and TempBond had the lowest. UltraTemp had the highest percentage of retentive value lost. TempBond had no significant loss under loading even though initially it was the weakest.

Acrylic Resins↗
PubMed1993

Management of infected knee and hip prostheses.

Infection following total hip or total knee arthroplasty can be devastating. It can result in instability of the hip or knee, diminished function, amputation, or death. Fulminant infection is unusual. Chronic low-grade infection is more commonly seen clinically. Differentiation of pain in a total hip or total knee replacement from loosening or infection may be difficult. Aspiration of the hip or knee for three aerobic and anaerobic cultures and sensitivities is the most reliable method of diagnosing infection. In the hip joint, aspiration should be performed under radiographic control. Treatment of the infected total hip or total knee by antibiotics alone is ineffective. Debridement of the hip or knee joint with retention of the prosthesis and intravenous antibiotics is successful in 18% to 40% of cases. Resection arthroplasty of the hip or knee usually results in eradication of the infection but leaves a painful, unstable, and shortened extremity and diminished ability to ambulate. Arthrodesis of the knee usually clears the infection but imposes the disability of a stiff knee. Two-stage reimplantation of the hip or knee is the most successful means of treating the infected total hip or knee replacement. In the knee, the success rate with two-stage reimplantation is 80% to 97%. In the hip joint, the success rate of two-stage reimplantation is 83% to 87%. Recently, debridement of the hip or knee with retention of the prosthesis and the local installation of antibiotics for a prolonged period has been used in cases of acute infection of less than 3 months' duration without evidence of implant loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

Hip Prosthesis↗
PubMed2002

Salmonella prosthetic joint septic arthritis.

We describe a case of Salmonella enteritidis infection of a prosthetic knee joint that was cured with ceftriaxone therapy for 6 weeks and replacement of the tibial component of the prosthesis. Eleven other cases of salmonella prosthetic joint infection have been reported in the English-language literature. Five infections occurred within 20 days of prosthesis placement, and seven occurred several months to years later; ten of 12 infections involved hip prostheses. Nine of 12 patients who had prosthesis removal were cured of the infection. Two of the three patients with retention of the prosthesis required long-term suppressive antibiotic therapy.

Arthritis↗
PubMedDate not supplied

Magnet-retained facial prosthesis combined with an implant-supported edentulous maxillary obturator: a case report.

The prosthetic rehabilitation of maxillofacial defects is especially challenging when the patient is edentulous. Although dental implants are used to enhance the retention and stability of both facial and maxillary prostheses, combining facial and maxillary prostheses is extremely difficult. This article describes the prosthetic treatment of an edentulous patient with a large maxillary and facial defect. After placing dental implants in the remaining maxilla, a maxillary obturator prosthesis supported by a milled bar attachment was fabricated. The facial prosthesis was retained by a magnetic attachment to the maxillary obturator prosthesis. As the obturator prosthesis was supported securely by this sturdy attachment, the facial prosthesis was stable during mastication and facial movement. The patient reported improvement in prosthesis retention and stability. Both the masticatory and the speech functions of the patient improved.

Aged↗
PubMed1996

The use of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancers. A prospective, multicenter study.

STUDY OBJECTIVE: To investigate the safety, efficacy, and tolerance of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancer. DESIGN: An 8-month prospective study employing either a rigid bronchoscope or a flexible delivery system for prosthesis insertion. SETTING: Multicentric setting involving four teaching hospitals in Switzerland and Germany. PATIENTS: Forty patients (29 men, 11 women), average age of 62 years, presenting with an inoperable tracheobronchial cancer. INTERVENTIONS: After partial airway recanalization with an Nd-YAG laser, the covered Wallstent was inserted 23 times using a rigid bronchoscope (Rigidstep device), and 27 times using a flexible delivery system (Telestep device) under fluoroscopic and endoscopic visualization. RESULTS: Clinical and endoscopic examination at 1, 30, and 90 days showed improvement in the bronchial lumen and in the dyspnea index. No serious complication (death, perforation, hemorrhage, inability to remove an improperly placed prosthesis) was observed during surgery. Late complications included migration (12%), inflammatory granulations or tumor regrowth at the tip of the prosthesis (36%), and symptomatic retention of secretion (38%). CONCLUSIONS: Compared with other tracheobronchial prostheses, notably the Dumon stent, the covered Wallstent presents the following advantages: insertion with visual guidance, treatment of extrinsic compressions and esophagobronchial fistulas, and little chance of migration when the prosthesis diameter is chosen correctly. The following disadvantages can be noted: high price; both repositioning and extraction of the released stent are more difficult, though certainly possible; and risk of granulations at the tips of the prosthesis and retention of secretions. Suggestions are made for potential improvements to the stent and insertion system that may result in a significant decrease in early and late complications.

Adult↗
PubMed2002

A technique for using maxillary anterior soft-tissue undercuts in denture placement: a case report.

Restoring a large edentulous space in the anterior maxilla presents many challenges, including how to utilize and manage a deep anterior soft tissue undercut. In the case reported here, a partial denture was constructed that incorporated a semi-rigid exterior flange and a soft liner to help the denture to engage the depth of the undercut. The denture was placed after extraction of the anterior teeth, and there was very little postoperative tissue trauma. With this combination of materials, known as "triple lamination", the prosthesis was able to engage the soft-tissue undercut, the undercut was actively involved in retaining the prosthesis, the denture could be placed immediately, and the prosthesis was very comfortable. Triple lamination should be considered when a deep soft-tissue undercut must be engaged to ensure retention of a prosthesis.

Aged↗
PubMed1999

Usefulness of dental implants in maxillofacial reconstruction.

Fabricating maxillofacial prosthesis can be challenging. Placement of implants can have a dramatic effect on the stability and retention of the prosthesis in patients. This article provides clinical retrospective analysis of osseointegrated implants used for maxillofacial reconstruction. Patient charts and radiographs were reviewed to determine implant status, stability of prosthesis, and masticatory and speech function. Of the 104 implants placed, there were 4 implant failures. The overall survival rate for implants in this patient population was 96.1%. The stability of maxillofacial prostheses demonstrated significant improvement after anchorage to implants. Implant-borne maxillofacial prostheses are better stabilized and retained than non-implant-borne prostheses, providing an improved quality of life to patients requiring prosthesis rehabilitation of maxillofacial defects.

Adult↗
PubMed2001

Group B streptococcal prosthetic joint infections.

We report 6 cases of group B streptococcal prosthetic joint infections seen in our institution and review 8 previously reported cases. These 14 patients (6 men and 8 women) had an average age of 69. Seven hip joints and 7 knee joints were affected. Only 4 patients had risk factors for prosthetic joint infection (diabetes mellitus in 2, cancer in 1, and myelodysplasia in 1). The average time from surgery to onset of symptoms was approximately 4 years (range, 5 months to 10 years). Pain in the affected joint was the chief complaint. Six patients had bacteremia. Seven patients had known or suspected foci of infection, which were genitourinary tract (1), skin and soft tissue trauma sites (1), gastrointestinal tract (1), and oropharynx (1). Nine patients required prosthesis removal in addition to antibiotic therapy. Two patients had apparent cure of the infection with retention of the prosthesis. Group B streptococcal prosthetic joint infections appear to be a late complication of prosthetic joint replacement surgery.

Aged↗
PubMedDate not supplied

[Model studies for determination of adhesion between prosthetic field and plate prosthesis].

The problem of retention of the complete plate prostheses is complex and determined by a series of factors. The authors follow up the effect of the components of the adhesives for complete prostheses on the alteration of adhesion between the plate prosthesis and mucosa, carrying out model studies. They studied the effect of silicon dioxide and nystatin on the adhesion between the plate prosthesis and mucosa making use of an adhesive based on high molecular neutral polyethylene oxide. A method has been developed for the determination of the effectiveness of adhesives for plate prostheses.

Adhesives↗
PubMed1989

Prosthodontic principles in the framework design of maxillary obturator prostheses.

The Aramany classification system of postsurgical maxillectomy defects is a useful tool for teaching and developing obturator framework designs and enhancing communication among prosthodontists. This article describes a series of Aramany-obturator design templates and discusses the relevant considerations for each. In all situations, a quadrilateral or tripodal design is favored over a linear design because this allows a more favorable leverage design application that will aid in the support, stabilization, and retention of the prosthesis.

Denture Design↗
PubMed1989

Framework night guards for implant-retained auricular prostheses.

Prosthetic ear rehabilitation with osseointegrated implants involves using a cast or preformed framework (bar) constructed to fit the implant abutments. Retention of the prosthesis is obtained through clips or magnets. Because the prosthetic ear is not worn during sleep, the ends of the retention bar are left exposed. These projections may become entangled with the linen or hair. To prevent this problem a night guard constructed of soft mouth-guard material is worn over the retentive bar while the patient is sleeping.

Ear, External↗
PubMed1998

In vitro measurement of patellofemoral force after three types of knee replacement.

Using a new, non-invasive method, we measured the patellofemoral force (PFF) in cadaver knees mounted in a rig to simulate weight-bearing. The PFF was measured from 20 degrees to 120 degrees of flexion before and after implanting three designs of knee prosthesis. Medial unicompartmental arthroplasty with a meniscal-bearing prosthesis and with retention of both cruciate ligaments caused no significant change in the PFF. After arthroplasty with a posterior-cruciate-retaining prosthesis and division of the anterior cruciate ligament, the PFF decreased in extension and increased by 20% in flexion. Implantation of a posterior stabilised prosthesis and division of both cruciate ligaments produced a decrease in the PFF in extension but maintained normal load in flexion. There was a direct relationship between the PFF and the angle made with the patellar tendon and the long axis of the tibia. The abnormalities of the patellar tendon angle which resulted from implantation of the two total prostheses explain the observed changes in the PFF and show how the mechanics of the patellofemoral joint depend upon the kinematics of the tibiofemoral articulation.

Arthroplasty, Replacement, Knee↗