Plastic Prostheses Research Articles

Конъюнктивиты при использовании глазного протеза. Профилактика и выбор эффективной терапии

Purpose. To determine the causes of inflammatory processes when using ocular prostheses, to develop recommendations for prevention and treatment of inflammation and contraction of the conjunctival cavity in rehabilitation of persons using ocular prostheses. Methods. We have analyzed treatment effectiveness in 62 adult patients: 26 men and 36 women, aged 18–92 years, who applied for ocular prosthetic care in 2023. Operations preceding prosthetics were performed in different medical institutions. The period after surgery ranged from 6 months to 69 years. The time elapsed after the last prosthetics was from 2 months to 69 years. Resultsand discussion. All the patients underwent routine ophthalmic examination. Prosthetics was performed depending on the duration of prosthesis use, the condition of its surface and the correspondence between the shape of the prosthesis and the cavity: selection and adaptation of a standard ocular prosthesis (12 patients); repair of the prosthesis – grinding and polishing (14 patients); manufacturing of an individual ocular prosthesis according to the shape of the cavity, taking into account all the parameters of the paired eye (36 patients). Depending on the conjunctival cavity condition, drug therapy was prescribed. To objectify the assessment of treatment results, all the patients filled out questionnaires, where satisfaction with the comfort of wearing a prosthesis and their own appearance was recorded on a 5-point scale. Three weeks after the end of treatment, the administrator and the doctor called all the patients to clarify the need for correction of the prosthesis shape and medical treatment. Conclusions. The patient is satisfied with the prosthetics when the prosthesis looks like an eye and the patient does not feel discomfort when using the prosthesis. It is possible to achieve an optimal result if the prosthesis corresponds to the appearance of the paired eye, its shape fills and repeats the conjunctival cavity, the prosthesis has a smooth surface. The discrepancy between size and shape of the prosthesis and size and configuration of the cavity, sharp edges of the prosthesis, irregularities and roughness of its surface cause inflammation of the cavity, which is accompanied by an increase of mucous discharge and infection. Appointment of antibacterial or any other drug therapy without restoring smoothness of the prosthesis gives a temporary effect and promotes selection of resistant microorganisms. An ocular prosthesis in 1 year of use loses smoothness of its surface. With the observance of conjunctival cavity hygiene and careful attitude to the prosthesis – regular (1 time per year) repair of a plastic prosthesis, it is possible to extend the period of use of a plastic prosthesis to 4–5 years without complications and inconveniences. Key words: ocular prosthesis; conjunctivitis; anophthalmos; microphthalmos; subatrophy; preventive repair; timely prosthesis replacement.

An upconverted afterglow color conversion strategy for in-situ activated persistent luminescent imaging of medical implants

Upconverted afterglow imaging presents a promising avenue for long-term auto-fluorescence-free imaging applications without the necessity of expensive time-resolved equipment. In this research, inspired by LED design, we devised a straightforward ternary upconverted afterglow conversion (UAC) strategy that amalgamates upconversion NaYbF4: Tm0.005 (UP), afterglow ZnS:Cu,Co (AP), and color conversion CaAlSiN3:Eu phosphors (CP). This fusion resulted in a UAC composite that displays a deep-red to near-infrared (NIR) afterglow with a peak at 663 nm, following a brief activation period by 980 nm light. Importantly, an enhancement of 116 times was realized by using the UAC strategy when comparing with a typical single phase afterglow phosphor, Zn3Ga2SnO8:Cr,Yb,Er. The NIR-rechargeable afterglow sustained for a minimum of 100 min after a mere 3 s of NIR wireless charging process and is chemically stable. This makes it highly suitable for long-term luminescence imaging applications. To demonstrate its potential, we employed our ternary UAC phosphor to image medical plastic prostheses through pig skin in vitro and simulated a plastic surgery on a mouse model in vivo. Such luminescent information could prove invaluable for planning future surgical interventions, such as prosthesis replacement, removal, or necessary debris cleaning.

Morphologic alterations in the mucosa of the denture site in patients with full removable dentures from acrylic plastics

Relevance. Currently, many new agents have appeared on the market for users of removable dentures to improve adhesion, i.e. fixation and stabilization of dentures. It is important to evaluate the effect of such agents on the denture bed mucosa.Objective. Morphological substantiation of the effectiveness of the use of adhesive cream for fixation of prostheses Asepta Рarodontalu patients with removable dentures made of acrylic plastic.Materials and methods. The study involved 49 patients (12 men and 37 women) of elderly age (62–75 years) who suffered complete loss of teeth on both jaws. All patients were divided into 3 study groups: 1 (control) group, who had previously refused to have full removable acrylic dentures made for them; 2 (comparison) group, patients to whom removable acrylic dentures were made and who did not use any means to improvetheir fixation; 3 (main) group, patients to whom full removable acrylic dentures were made and who during the adaptation period and subsequently for a year used a domestic adhesive cream for fixation; 3 (main) group, patients to whom full removable acrylic dentures were made. In order to solve the realization of the set goal of the study, a number of clinical and histological studies with the use of immunohistochemical method were carried out, outpatient charts of dental patients were analyzed.Results. It was found that dystrophic and chronic inflammatory changes in the soft tissues of the denture bed were most pronounced in the case of using dentures without means to improve their fixation. At use of domestic adhesive cream for fixation of dentures Asepta Рarodontal the process of keratinization of the oral mucous membrane epithelium was minimal, there was no fibrosis of the own lamina of the mucous membrane, scattered infiltration was less expressed than in people not using acrylic dentures or using them without adhesive means, and was represented at the expense of lymphocytes, single neutrophilic granulocytes on the background of single leukostases. The immunohistochemical study showed that T-lymphocytes and mast cells were predominant in the preparations of group 2 patients, and they appeared in the preparations of this group of patients comparatively more than in the 1st control and 3rd main groups of the study, which confirmed the presence of the most pronounced chronic inflammatory infiltration in group 2 patients.Conclusion. The most optimal condition of the denture bed mucosa was observed in patients who used removable acrylic dentures for a year and simultaneously applied an adhesive agent for their fixation (domestic adhesive cream for denture fixation Asepta Рarodontal). It is obviously connected with the protection of the mucous membrane of the prosthetic bed by the adhesive cream from the mechanical impact of a dense acrylic plastic prosthesis, as well as with the reduction of contact with food products aggressive in temperature and structure.

The analysis of innovative manufacturing method of complete removable dentures

BACKGROUND: The optimization of the digital protocol in the manufacture of complete removable dentures to obtain milled dentures with design close to those modeled using computer-aided design and computer-aided manufacturing software is an urgent problem in dental prosthetics.
 AIM: To analyze the manufacturing of complete removable dentures and demonstrate the results of in vitro studies of prostheses obtained according to the developed protocol using the Kravets verticulator and prostheses in which the bases are bonded to the teeth with resins of cold and hot polymerization.
 MATERIALS AND METHODS: With digital technologies, using the proposed modernized Wieland Digital Denture (Ivoclar Vivadent) protocol, 10 bases and 10 corresponding dentitions were obtained by milling, according to pre-made templates obtained using 3D printing. Then, five samples were bonded with cold cure resin using the verticulator, and five samples were made with hot cure resin and verticulator.
 RESULTS: On most of the tooth treated with hot cure resin, the interlayer between the structures of the base and dentition was not observed, or interlayers had a thickness of 804 microns. The thickness of the interlayer of the cold curing specimens was 27325 microns. Pores are not observed for plastic bonded specimens, both cold and hot cured.
 CONCLUSION: The proposed method allows the use of digital technologies to obtain a monolithic plastic prosthesis, which eliminates inaccuracies in tooth positioning, during placement in the base of the prosthesis, and bind the base of the prosthesis and teeth using hot-curing acrylic plastic.

Endoscopic Biliary Drainage in the Palliative Treatment of Klatskin Tumours: Outcomes and Factors Associated with Success or Failure

Background: Klatskin's tumour is a cholangiocarcinoma that develops from the right or left bile ducts and the upper part of the main bile duct. They are usually diagnosed at an advanced, inoperable stage, and have an extremely poor prognosis. Biliary drainage is proposed in palliative situation and carries a high risk of infectious complications. The aim of our work is to report the results of endoscopic biliary drainage as well as the factors associated with its success or failure. Methods: This is a retrospective and analytical study of 75 patients, conducted between July 2009 and August 2021, including all patients admitted with Klatskin's tumour and for whom endoscopic drainage was indicated. Factors associated with the success or failure of endoscopic treatment were studied by logistic regression analysis. Results: The average age of our patients was 62.67 years with a male predominance of 68%. Cholangiocarcinoma was classified as bismuth IV in 50.6% of patients, bismuth IIIa in 30% of patients, bismuth IIIb in 13% of patients and bismuth II in 6% of patients. Sixteen percent of patients had liver metastases. Endoscopic drainage was successfully performed in 81.3% of patients by plastic prosthesis in 32% of cases, by a metal prosthesis in 45.2% and by nasobiliary drain in 4.1% . Forty-seven percent of patients had dilatation of the stenosis prior to prosthesis placement. Causes of stenting failure were primarily related to failure of papilla catheterisation, failure to pass the guidewire through the stenosis, or duodenal invasion by the tumour. In multivariate analysis and by adjusting the studied parameters, namely the age, gender, bismuth tumour type, presence of metastases and endoscopic dilatation of the stenosis, only the presence of metastases, endoscopic dilatation of the stenosis and the bismuth tumour classification affect the success rate. Indeed, endoscopic dilatation of the stenosis prior to stenting increases the success rate fourfold. Prosthesis increases the success rate by a factor of 4 [OR=4; p=0.01], whereas the presence of metastases decreases this rate by 65% [OR=0.35; p<0.001]. However, tumours classified as bismuth IV [OR=8; p<0.001] or bismuth IIIa [OR=5; p=0.004] were associated with a risk of endoscopic treatment failure. Conclusion: Our study suggests that the presence of metastatic hilar cholangiocarcinoma classified as bismuth IV or bismuth IIIa appear to be associated with failure of endoscopic biliary drainage, whereas endoscopic dilatation prior to prosthesis placement appears to be associated with success.

Épithèse faciale par CFAO : aspects cliniques et techniques

The face is an important part of the human body from an anatomical, functional, aesthetic and psychosocial point of view.It can be the site of several mutilations resulting from trauma, treatment of neoplasms and congenital malformations.The plastic facial prosthesis is therefore indicated to restore these facial deformities and to compensate for the various consequences. Recently, digital technologies have shown an increasing impact on the future of maxillofacial rehabilitation. Computer-aided design and manufacturing technique enabled practitioners to acquire numerical data, perform three-dimensional reconstructions, and then materialize and manufacture the facial epithesis through various manufacturing processes, by addition or subtraction. The aim of this article is to describe, through a clinical case, the steps of realization of a nasal epithesis by CAD/CAM, in a patient who underwent a surgical exeresis of the nasal pyramid following a squamous cell carcinoma. Thus, the clinical and technical aspects are highlighted, as follows, the taking of the impression, the materials used, the set-up and the make-up, as well as the software and the useful concepts for the computer-assisted realization of a facial plastic prosthesis of the nasal epithesis type. Our therapy will also focus on the interest of the multidisciplinary approach in Maxillofacial Prosthodontics.

PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Background: Despite innovations in orthopedic dentistry, the manufacture of removable dentures belongs to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. According to the WHO, one-fifth of the world s population suffers or has suffered various candidiasis forms at least once. The worldwide increase in the incidence of the disease is primarily related to the fact that this infection is opportunistic, more than half of the world s population is a carrier of fungi of this kind, i.e., in most cases, it is an endogenous infection, which makes candidiasis different from other opportunistic mycoses. Aims: The purpose of this study was to study the prevalence of candidiasis in patients using removable dentures and to evaluate the effectiveness and prevention of candidiasis treatment. Methods: 100 patients with oral candidiasis of various age groups from 45 to 65 years were observed. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Results and Discussion: Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis-60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. Conclusions: The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

A safe procedure? The unusual case of a fatal airway obstruction by silicone during the production process of a tracheostomal epithesis in a 13-year-old boy

A tracheostomal epithesis is a plastic prosthesis that serves for sealing a tracheostoma and ensuring the position of the tracheostomy tube. The production of a tracheostomal epithesis requires an impression of the tracheostoma. To this end, silicone impression material is applied by an anaplastologist in and around the tracheostomal region, including the trachea. The blocked cuff of the tracheostomy tube serves to prevent aspiration of the material. We report on a 13-year-old boy who died during this procedure because the lower airways were obstructed with cured silicone. Forensic autopsy confirmed asphyctic suffocation as cause of death. Forensic physical investigation of the tracheostomy tube and its cuff revealed no structural or functional defects. Yet, the investigation results prove that the viscous silicone must have passed the cuff. To conclude, this case report demonstrates that the production of an impression of a tracheostoma is a procedure with a potentially lethal outcome. Hence, professional guidelines, including clear safety precautions, are urgently needed.

MORPHOMETRIC STUDY OF MEDIAL AND LATERAL CONDYLE OF THE TIBIA IN NORTH INDIAN POPULATION

SUMMARY: Total and unicompartmental joints replacements have become the main standard for the treatment of degenerative disorders and osteoarthritis of the knee. In total knee arthroplasty less than half an inch (9 mm) of the tibial and femoral articular surfaces are removed from the ends of bones and replace the metal and plastic prosthesis. There by the dimensions of each condyle are requisite for designing prosthesis required for knee arthroplasty. Fifty (25 right & 25 left) adult fully ossied dry tibias were taken from the Department of Anatomy and morphometric measurements of medial and lateral condyle were taken by using a Vernier caliper. Statistical analysis of the parameters was done. Present study, the mean anteroposterior, the transverse diameter of medial and lateral condyles of tibia were 45.71±3.17, 29.75±2.95, and 39.71±3.09, 30.24±2.45 mm respectively. The mean mediolateral length of total tibia and the mean circumference of the upper tibia were 69.35±5.08 and 191.49±14.85 mm respectively. The results of this study will be helpful for anatomists, anthropologists, and orthopedics in cases of unicompartmental knee arthroplasty, complete knee arthroplasty procedures, and meniscal transplantation.

FEATURES OF MANUFACTURE OF ADVANCED PROVISIONAL BRIDGE-BASED PROSTHESES

Abstract. The relevance of the topic is related to the need to improve methods of preparation of dentitions for orthopedic treatment, taking into account the defects of dentitions in patients with reduced occlusion height, taking into account the condition of the masticatory muscles and temporary use of plastic dentures, which provide gradual lifting of occlusion to normalize the masticatory group muscles and reorganization of myostatic reflexes.
 The aim of the research. Improving the effectiveness of preparation for orthopedic treatment of patients with partial tooth loss, with reduced occlusion height, by improving the design of a temporary bridge-based prosthesis.
 Materials and methods of research. We examined, treated and conducted clinical observation of 93 patients, who were divided into three groups according to the height of the reduction in occlusion, to achieve this goal and solve problems during the dissertation. Group 1 consisted of 32 patients with included dentition defects with reduced occlusion height up to 2 mm (n=32), group 2 - patients with included dentition defects with reduced occlusion height up to 2-4 mm (n=31), group 3 - these are patients with included dentition defects with reduced occlusion height up to 4-6 mm (n=30). All patients of the main groups belonged to the second and third age groups according to the WHO, aged 35-55 years. The control group (n=30) are young people who belonged to the 1st age group according to the WHO with intact dentition, without concomitant somatic and dental pathology, were admitted in one visit. Also, 123 fiberglass-reinforced plastic prostheses were made.
 Research results. When drawing up a plan for orthopedic treatment of patients with reduced occlusion height, we took into account possible complications, which are characterized by chipping of the facing material, pathological changes in the temporomandibular joint and masticatory muscle group. We have improved the method of manufacturing non-removable temporary plastic orthopedic constructions by reinforcing with fiberglass tapes and beams, to prevent them and gradually raise the bite.
 Expanded data on the dynamics of changes in myostatic reflexes and the effectiveness of the use of fixed orthopedic constructions, depending on the pathological process, the timing of adaptation of the masticatory muscle group to orthopedic constructions, according to the degree of reduction in occlusion height. The absence of complaints of breakage and other technical defects of the proposed temporary orthopedic constructions in 100% of cases, successfully allows to use it in the clinic of orthopedic dentistry.
 A new method of preparing patients for permanent orthopedic treatment by combined reinforcement of temporary non-removable bridge constructions with fiberglass tapes and beams is proposed, which differ in that after preliminary modeling of the frame of the bridge constructions, the technology of double reinforcement, model two support platforms with a step-like transition between them, in which fiberglass tapes and beams are fitted with dental tweezers, after which they are polymerized by the generally accepted method with a photopolymer lamp. Complete the modeling of the constructions and polymerize the prosthesis in the pneumopolymerizer with subsequent grinding and polymerize the prosthesis.
 Conclusion. The results of the research revealed the high efficiency of the improved method of manufacturing non-removable makeshift plastic of orthopedic constructions.

The Usage of Endobiliary Stents with Antiseptic Coating in the Treatment of Choledocholithiasis

Introduction: Choledocholithiasis is still an actual problem of treatment of complicated forms of cholelithiasis. The difficulties in treatment of this pathology are caused by the predominance of elderly and senile aged patients whom biliary stenting in most cases can be used as the only method of treatment. The purpose of the study is to justify the usage of endobiliary prostheses with antiseptic coating in the treatment of patients with choledocholithiasis. Material and methods: We analyzed the results of 95 patients’ treatment with “difficult” choledocholithiasis and in these casesbiliary endoprostheses were used at the first stage of curing. In 56 cases (group 1–58.4%), stenting was performed with “traditional” plastic prostheses without special coating, 39 stentings (group 2–41.6%) were performed with plastic stents, the surfaces of which were modified with 10% betadin solution. Results: The frequency of patient’s postoperative complications of the 1st group was 19.64% and 7.69% in the 2nd group. The decrease of specific complications such as early stent obturation and the development of purulent cholangitis was identified. The rate of complications in cases of endobiliary uncoated stenting using was 7.14% and 5.36% and these complications occurred in 2.56% and 2.56% in the group where Betadine coating was used. The term of serving of the biliary stents in the 2nd group (182.3±37.1 days) was significantly higher than the term of the uncoated stents (125.8±33.9 days). Conclusion: The usage of the antiseptic coating reduces the risk of developing of purulent-septic complications and increases the duration of functioning of biliary stents in patients with “difficult” choledocholithiasis.

Incidence and Significance of Biliary Stricture in Chronic Pancreatitis Patients Undergoing Extracorporeal Shock Wave Lithotripsy for Obstructing Pancreatic Duct Stones

Background/AimsThis study assessed the significance of biliary stricture in symptomatic chronic pancreatitis patients requiring extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP) to remove obstructing pancreatic calculi.MethodsA total of 97 patients underwent ESWL followed by ERCP to remove pancreatic calculi between October 2014 and October 2017 at Virginia Mason Medical Center. Significant biliary stricture (SBS) was defined as a stricture with upstream dilation on computed tomography scan or magnetic resonance cholangiopancreatography scans accompanied by cholestasis and/or cholangitis. SBS was initially managed by either a plastic stent or fully covered self-expandable metallic stent (fcSEMS). If the stricture did not resolve, the stent was replaced with either multiple plastic stents or another fcSEMS. Data were collected by retrospectively reviewing the medical records.ResultsBiliary strictures were noted in approximately one-third of patients (34/97, 35%) undergoing ESWL for pancreatic calculi. Approximately one-third of the biliary strictures (11/34, 32%) were SBS. Pseudocysts were more frequently found in those with SBS (36% vs 8%, p=0.02), and all pseudocysts in the SBS group were located in the pancreatic head. The initial stricture resolution rates with fcSEMSs and plastic prostheses were 75% and 29%, respectively. The overall success rate for stricture resolution was 73% (8/11), and the recurrence rate after initial stricture resolution was 25% (2/8).ConclusionsAlthough periductal fibrosis is the main mechanism underlying biliary stricture development in chronic pancreatitis, inflammation induced by obstructing pancreatic calculi, including pseudocysts, is an important contributing factor to SBS formation during the acute phase.

Acute pancreatitis secondary to a plastic prophylactic pancreatic prosthesis.

Plastic pancreatic prosthesis are indicated in the prophylactic of post-ERCP pancreatitis. But paradoxically, these prosthesis can cause pancreatitis if they are not expelled in a short period of time.

The role of restorative oral rehabilitation in orthodontic treatment of cleft lip and palate patients

In the period from 2013 to 2020, 44 patients aged 10 to 18 years with unilateral and bilateral cleft lip and palate were observed. During orthodontic treatment with active appliances all patients received a removable plastic prosthesis with an artificial tooth (or several teeth) in it covering the defect of the alveolar process in the cleft area. An experimental dental alveolar model was made in a 1:1-scale, based on an axial computed tomographic section of the upper jaw, examined in polarized light on the installation with a source of scattered white light with a 1600-2000 cd/m2 brightness to study the distribution of stresses in the dental alveolar complex using an active orthodontic arch. The assessment of chewing efficiency was carried out on the evaluation of the nut (hazelnut) crushing degree. The study of the experimental tooth-alveolar model with a bracket system with an active orthodontic arch with an included defect in the dentition in the area of the cleft of the alveolar process showed an uneven and deviant distribution of stresses in the tooth-alveolar complex, the vector of which depends on the presence or absence of a rigid connection between the alveolar fragments (imitation of the presence or absence of bone regenerate in the cleft). The use of a restorative construction reduces the time when performing a chewing test and increases the efficiency of chewing in patients with unilateral (p=0.02) and bilateral (p=0.008) cleft. It is associated not only with the restoration of the continuity of the dentition with an orthopedic structure, but also with the activation and structuring of the function of the tongue when performing chewing movements. The use of a proposed restorative appliance allows: to create the continuity of the upper dentition that harmonizes the distribution of forces from the active orthodontic arch; increases the stability of the teeth in the areas of the upper jaw adjacent to the cleft (incisors and canines) and prevents their unwanted displacement; promotes directional movement of the teeth; in the retention period, to maintain the achieved expansion of the dentition while maintaining space for the future fixed prosthesis; isolate the mouth of the anterior palate; hold the achieved position of the fragments of the upper jaw until bone grafting.

Authors' response to "Straight plastic stents in tumors at the hepatic hilum and related duodenal perforation".

We appreciate the interesting comments from García Cano et al. regarding the complications derived from the use of plastic prostheses in hilar tumors. Indeed, most of the published case reports on duodenal perforations secondary to migrated biliary prostheses occurred with plastic stents, which may be related to the entrapment phenomenon described.

Minimally invasive approach for the treatment of pancreatic pseudcyst. Transgastric drainage - where we are now?

Introduction. Minimally invasive approach for the treatment of acute pancreatitis (AP) and its complications has proven to reduce morbidity and mortality rate, length of hospitalization and costs of treatment, and improve quality of life of the patients. This approach for the AP has been implemented in developed countries, but in our region lags behind. In this case report we presented the successful endoscopic transgastric drainage of the large pancreatic pseudocyst (PPC) developed as a complication of AP. Case report. A 63-years old male patient was presented with nausea and vomiting as a consequence of the compressive effects of the PPC in the body and tail of the pancreas after episode of AP. On computed tomography (CT) scan, it was shown a cystic formation in the region of the pancreatic body and tail compressing stomach which was verified on upper endoscopy. Under fluoroscopy, using lateral duodenoscope, the biliary plastic prosthesis of 12 French and 8 cm of length was placed throughout posterior stomach wall into the PPC. The intervention was finished uneventfully, without complications. On CT scan performed 7 days after procedure, the reduction of the PPC size was significant and control CT scan one month after the procedure and removal of the prosthesis showed almost complete resolution of the PPC. Conclusion. Endoscopic transgastric drainage is safe and effective procedure for PPCs especially when the PPC has propulsion effects on stomach wall.

Endoscopic withdrawal of bariatric ring with the use of plastic prosthesis – A case report

Endoscopic withdrawal of bariatric ring with the use of plastic prosthesis – A case report

Deontological aspects of orthopedic treatment with the full plastic prostheses (review)

Deontological aspects of orthopedic treatment with the full plastic prostheses (review)

MAIN PROPERTIES OF ABRASIVE DENTISTRY MATERIALS UTILIZED IN POLISHING OF REMOVABLE DENTURE BASES

The requirements to the quality of dental prostheses are currently very high. All dental prostheses need thorough final finishing through filing and polishing in order to obtain smooth, polished, shiny and esthetic surface. In addition to comfort and aesthetics this guarantees high hygienic quality of dental prostheses and extends their operational characteristics. Smooth and even surface of plastic or thermoplastic prostheses can more efficiently resist aging and decay caused by the change of temperature and bacterial flora activity which typically occur in the mouth cavity.
 Modern orthopedic dentistry utilizes various abrasive materials for filing and polishing of removable dentures made from different materials. Filing is the method of removing roughness and unevenness from the surface of dentures. Polishing is the final process of finishing aimed at obtaining smooth, shiny surface of dentures. It has been proved that rough and badly polished surface of dentures can cause significant patient’s discomfort and complicate hygiene of the mouth cavity. Together with the aggressive environment of the mouth cavity, such surfaces can lead to dental plague and tartar deposit, which, correspondingly, leads to bad smell, stomatitis and other dental and general illnesses. It has been proved that high quality finishing of the surface of removable dentures contributes to the improvement of their sustainability, durability and aesthetic characteristics. Well-polished surface of removable dentures more efficiently resists the processes of destruction, such as aging and decay, caused by the change of temperature and bacterial flora activity.
 The analysis of bibliography has shown that the process of polishing and the quality of the surface under work depend on a number of factors. The most significant role belongs to the size of abrasive particles, the pressure of abrasive on material and its thermal conductivity, the speed at which abrasive particles move along the surface. Grains of the size 0,15-0,75 mm are used most often. It has been specified that coarse polishing can utilize grains of bigger size reaching 1,5-2 mm. It has been proved that the pressure of abrasive should be light in order to prevent the damage of dentures or instruments. Moreover, excess pressure can cause overheating of an instrument or the surface of dentures being polished. It has also been demonstrated that even short-term high temperature exposure can result in polymer deformation which reduces sustainability and durability of removable dentures. It is known that overheating can be avoided on condition of following the basic rules of polishing.
 Orthopedic dentistry utilizes pumice, silicate or aluminum oxide, silicone dioxide as abrasive filler. The particular interest presents the study of the efficiency of zirconium silicate as an abrasive component of polishing paste for finishing of thermoplastic polymer bases and providing full gloss of the surface. Stearin, paraffin, wax, petrolatum are used as the components of surfactants, as they demonstrate low surface tension and facilitate spreading the paste on the polished surface.
 There is not a wide range of locally produced polishing pastes utilized in dentistry. They leave traces, microscratchings; do not allow obtaining even, smooth shiny surface of dentures with thermoplastic polymer basis. Finishing of removable dentures requires a lot of time and expenses from professionals.

Oddi's Sphincter Macrodilation or Sphincteroplasty in the Treatment of the Large Bile Duct Stone

Introduction: Oddi's sphincter macrodilation or sphincteroplasty, is a large dilation of the papilla which complements a endoscopic sphincterotomy in case of large stones. Our aim is to clarify the results and the complications of the sphincteroplasty, as well as the factors associated. Patients and methods: it’s retrospective study of January 2008 to June 2017, including 44 patients. In whom the diagnosis of large biliary lithiasis is defined by a diameter greater than 15 mm and which required a sphincteroplasty. Results: 44 patients (27 women and 17 men) of average age 63.5 years, with sex ratio men / women is 0.6. The average diameter of the bile duct was 18 ± 4 mm, that of the stones was 18 ± 2 mm and that of the dilatation balloon was 16.9 ± 4 mm. The success rate was obtained in 91% of the cases and the extraction was impossible in 4 patients with large stones of 19mm diameter. Two of these patients benefited from a plastic biliary prosthesis and the other two were treated surgically. The complication rate was 6.8% in the form of minimal bleeding corrected by pneumatic compression. Conclusion: Oddi's sphincter macrodilation or sphincteroplasty is an effective solution for extracting large biliary stone, in our study the success rate was 91% and the immediate complications were rare (6.8%).