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At least 1,675 records · Page 93Linked to original sources
PubMed1994

Implant-retained mandibular overdentures: a simplified, cost-effective treatment approach.

The use of implant-retained complete overdentures is a viable treatment modality in compromised patients. Use of two separate implants in the mandible enhances the retention and stability of the denture, which is still mainly supported by soft tissues. A technique for clinical fixation of the internal attachment to a laboratory-rebased and tissue-loaded mandibular overdenture is described. The advantages, disadvantages, and the rationale of the treatment are presented.

Dental Abutments↗
PubMed1992

Finite element analysis (FEA) studies in 2.5-mm round bar design: the effects of bar length and material composition on bar failure.

The round bar/overdenture prosthesis is commonly used in the restoration of the totally edentulous implant patient. The length of bar span and types of alloys used in clinical cases have raised questions related to beam flexure and its role as a possible etiology of reported clinical failures in cast alloy systems. Three-dimensional finite element analyses were thus conducted on a 2.5-mm round bar for investigation of mechanical performance with respect to failure potential as a function of bar length and bar material property. Specifically, three bar lengths (6 mm, 12 mm, and 18 mm) and three alloy materials were analyzed, representing a clinical range of usage. The ends of each bar were modeled fixed to a 2.5-mm coping which was attached to a 3.8-mm root-form-type implant. The implant was modeled rigidly fixed in a representative block of bone. A 200-N occlusal force was applied to the model, as would be transmitted through an attachment clip, 5 mm in length, for the three respective bar lengths. The results of these analyses suggested possible yielding (or failure) in the 18-mm case. Bar length was found to play a stronger role in the adequacy of the overall design as compared with changing material properties in the range of alloy stiffnesses tested. Factors of safety with respect to static yield strength ranged from 2.82 to 66.46 for the designs evaluated. Fatigue factors of safety ranged from 1.63 to 38.88. A factor of safety of 5 or greater is suggested for the design of round bar systems in order for bar failure to be prevented.

Computer Simulation↗
PubMed1998

[Dental implants: a better anchor for dentures].

Loss of teeth results in resorption of the jaws. As a consequence the denture bearing area progressively reduces, eventually causing loss of retention and stability of the conventional denture. In three patients, two women aged 36 and 37 and a man aged 46, suffering from severe problems with their conventional dentures endosteal implants were inserted in the jawbone. After the healing period the dentist fabricated an implant-retained overdenture. The patients were very satisfied with the final result. Endosteal implants are, especially in the mandible, a reliable treatment modality for a stable implant-retained denture in case of patients suffering from retention problems with their conventional dentures.

Adult↗
PubMed2002

Midface reconstruction with the fibula free flap.

OBJECTIVE: To evaluate the use, indications, and outcomes of the fibula osteocutaneous free flap when reconstructing the midface. DESIGN: Retrospective review of a case series. SETTING: Tertiary referral center. PATIENTS: We evaluated all patients requiring midface reconstruction after tumor resection between January 1, 1994, and January 1, 2000. Twenty-seven individuals who lacked sufficient retentive surfaces and/or teeth to support a conventional prosthesis were offered vascularized bony reconstruction. INTERVENTIONS: All patients underwent fibular osteocutaneous free flap reconstruction of the midface: 16 primarily, 11 secondarily. MAIN OUTCOME MEASURES: Success of free tissue transfer, perioperative complications, oral diet, speech, type of dental reconstruction, and cosmesis. RESULTS: Twenty-six of 27 flaps survived. Four patients had wound complications managed successfully with local wound care. Fourteen patients achieved a regular diet and 13 patients maintain a soft diet. Eighteen patients had osseointegrated implants placed, and 14 patients used an implant-borne prosthesis. Cosmetic results were judged to be excellent in 14 patients; good in 8; fair in 4; and poor in 1. CONCLUSIONS: Use of the fibula osteocutaneous free flap to reconstruct the midface is highly reliable and our flap of choice for lower maxillary defects requiring bony reconstruction. However, when orbitozygomatic support is the primary objective, the utility of this flap is limited. Because of the complexity of this procedure, the choice of midface reconstruction technique should be individualized for each patient.

Adolescent↗
PubMed1978

Congenital absence of the vagina: diagnosis and plastic surgical reconstruction.

Congenital absence of the vagina was repaired in twenty patients; the longest follow-up was seventeen years. The surgical method is described, including the skin graft, the sculpted prosthesis, and the mechanic's waste bolus for retention. The patient must be oriented thoroughly before the operation. Even with an optimum surgical result, full cooperation and psychological preparation are necessary to gain a successful transformation. The phrase "psychiatry with a scalpel" is apt in these cases. Ideally, the operation is performed by a team of plastic surgeon and gynecologist. Meticulous planning and regard for detail are fundamental requirements.

Adolescent↗
PubMed2001

Retain or sacrifice the posterior cruciate ligament in total knee arthroplasty? A histopathological study of the cruciate ligament in osteoarthritic and rheumatoid disease.

BACKGROUND: The decision whether to retain or resect the posterior cruciate ligament in total knee arthroplasty is at present determined clinically by preoperative radiological variables focusing upon the amount of joint destruction, and subsequent soft tissue contractures. However, these variables give only indirect information on the histological integrity and proprioceptive properties of the posterior cruciate ligament. METHODS: Twenty posterior cruciate ligaments, obtained during total knee arthroplasty, were evaluated histologically to study the relation between the degree of preoperative radiological joint destruction, structural integrity of the posterior cruciate ligament and the neurological integrity of the targeted tissue. Eleven patients had osteoarthritis and nine patients rheumatoid arthritis. Haematoxylin and eosin, Alcian blue (mucoid degeneration), elastica von Gieson, Gomori (elastic fibres and collagen), and immunohistochemical staining for neural structures were used. RESULTS: In all but one of the posterior cruciate ligaments, morphologically intact neural tissue was present in the peritendineum of the ligaments. Structural integrity of the collagen framework was present in only seven posterior cruciate ligaments. These cases all had grade three or four radiological joint destruction. In 13 of the specimens a certain degree of mucoid degeneration of collagen was present. All patients with grade five radiological knee joint destruction displayed mucoid degeneration and irregularity of the posterior cruciate ligament fibres. CONCLUSION: Because of the extensive architectural and probably functional damage of the posterior cruciate ligament in patients who have grade five radiological knee joint destruction, retention of the posterior cruciate ligament in knee prosthesis should not be advocated.

Adult↗
PubMed1991

[Intraprostatic prosthesis: echographic monitoring].

22 patients affected by BPH have been treated with a spiral urethral prosthesis under local anesthesia with ultrasonic guidance and endoscopic technique. All the patients either refused the surgical procedure or had high operative risk. Insertion guided by ultrasound and endoscopic technique was successful in 19 patients (86%) with a follow-up of 12 months. In our experience the insertion of this prosthesis is a favorable alternative to an indwelling catheter in selected patients.

Aged↗
PubMed1994

[Bone transplantation in the orbits as a prerequisite for prosthetic management].

We report on a method of fixing orbital prostheses and artificial eyes: First the orbit is filled by cortico-spongious bone graft. Afterwards two implants are centrally located in the graft, so that the prosthesis can be kept in place by magnetic retention. The advantage of this procedure is that the implants are more stable than those located in the orbital rim.

Adult↗
PubMed1993

Common faults in complete dentures: a review.

Complete-denture therapy involves a complex interplay between biologic demands and technical limitations. Success with complete-denture therapy is reportedly high. Dissatisfied denture patients, although few, do exist. This paper reviews some of the common faults reported with complete dentures.

Denture Retention↗
PubMed1998

The importance of occlusal balance in the control of complete dentures.

OBJECTIVE: The importance of occlusal balance to the control of complete dentures during function was assessed. METHODS AND MATERIALS: The complete dentures of five patients who were having difficulty controlling their prostheses were accurately duplicated. The artificial teeth were replaced with occlusally balanced teeth. No other changes were made. Patients were asked to report their experiences with the new dentures after 1 week, 3 weeks, and 6 weeks. RESULTS: By the end of 6 weeks, improvement in denture stability and eating comfort were reported by all patients. CONCLUSION: Improvements occurred when the occlusion was balanced, despite existing jaw relationship errors, fitting inaccuracies, and peripheral extension errors.

Dental Articulators↗