Preliminary Impression Research Articles

Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2)

An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students.

Engaged in Research/Achieving Balance: A Case Example of Teaching Research to Masters of Social Work Students

This article considers the use of participatory action research and Photovoice as a tool for engaging graduate level social work students in research education. Photovoice is an investigative tool that assists people in critically reflecting on the everyday social and political realities of their lives, enriching their understanding of their communities and the issues pertinent to them, while at the same time, giving them a voice from which to educate others on these issues. In the context of a group assignment, 26 social work students, enrolled in an introductory graduate research course, were asked to reflect upon the question, “What does balance look like for you in the MSW program?” Thirty-two photographs with captions were submitted and analyzed by class members for relevant themes. Balance was described as existing along a continuum from balanced to unbalanced and was comprised of four major themes: connection, nurturance, keeping perspective, and disengagement. Although this teaching strategy was not formally assessed, preliminary impressions are that students benefited from participating in the Photovoice activity.

가철성 국소의치 제작을 위한 인상채득

저작기능의 회복과 더불어 환자에게 편안함을 제공하며 잔존치아와 치조점막을 건강하게 유지할 수 있는 가철성 국소의치 제작을 위해서는 구강내의 형태적, 기능적 상태를 재현하는 모형제작이 필수적이다. 국소의치 제작을 위해서는 진단모형과 주모형의 제작이 필요하며 이를 위해서 예비인상과 최종인상 채득 과정을 거치게 된다. 국소의치의 인상채득은 고정성이나 총의치 인상과 다르게 치아부위와 조직부위 모두가 잘 인기되어야 하고 치아 결손 부위에 따라 교합을 지지하는 부위가 달라지므로 증례에 따른 적절한 인상재와 인상채득 방법에 대한 이해를 바탕으로 정확한 임상적 적용이 요구된다. To fabricate removable partial denture which provide patient's comfort and maintain oral health, cast fabrication which reproduce anatomical and functional state of mouth is needed. Diagnostic cast and master cast are produced through the process of preliminary impression and final impression taking. Both of remaining teeth and edentulous area should be well taken in removable partial denture impression. According to the supporting type of partial denture, impression material and method can be changed. Therefore, understanding of impression procedure is essential for the accurate clinical application.

Técnica simplificada en la rehabilitación del desdentado

In this paper we present a simplified rehabilitation technique for the edentulous through removable prosthesis that achieve the goal of the treatment in only three clinical appointments. This accomplishment is possible through the use of a photopolymerizable material, performing an impression tray directly in the mouth without making any preliminary models; it thereby enables to take preliminary and definitive impressions, and intermaxillary relations in a single session. Rev. Clin. Periodoncia Implantol. Rehabil. Oral Vol. 7(1); 17-20, 2014.

Prosthetic Rehabilitation with Collapsible Hybrid Acrylic Resin and Permanent Silicone Soft Liner Complete Denture of a Patient with Scleroderma‐Induced Microstomia

Scleroderma is an autoimmune multisystem rheumatic condition characterized by fibrosis of connective tissues of the body, resulting in hardening and impairment of the function of different organs. Deposition of collagen fibers in peri-oral tissues causes loss of elasticity and increased tissue stiffness, resulting in restricted mouth opening. A maximal oral opening smaller than the size of a complete denture can make prosthetic treatment challenging. Patients with microstomia who must wear removable dental prostheses (RDPs) often face the difficulty of being unable to insert or remove a conventional RDP. A sectional-collapsible denture is indicated for the prosthetic management of these patients, but reduced manual dexterity often makes intraoral manipulation of the prosthesis difficult. A single collapsible complete denture is a better choice for functional rehabilitation of these patients. This clinical report describes in detail the prosthodontic management of a maxillary edentulous patient with restricted mouth opening induced by scleroderma with a single collapsible removable complete denture fabricated with heat-polymerized silicone soft liner and heat-cured acrylic resin. The preliminary and secondary impressions were made with moldable aluminum trays by using putty and light-body poly(vinyl siloxane) elastomeric impression material. The collapsed denture can be easily inserted and removed by the patient and also provides adequate function in the mouth.

Rehabilitation of Non-Syndromic Oligodontia of Primary and Permanent Dentition in Young patient-A Rare Case Report

Background: Oligodontia is a genetic disorder which represents the congenital absence of more than six teeth in primary, permanent or both dentitions. It is usually a part of a syndrome and seldom occurs as an isolated entity. Genes responsible for non syndromic oligodontia are found to be MSX1 and PAX9 genes. Methods: Karyotyping was done taking sample from peripheral blood. Cytogenetic chromosome analysis revealed a normal male karyotype (46, XY) without any structural or numerical chromosome abnormalities. Hand wrists, clavicles, vertebral skeleton, skull and chest were found to be normal on radiological examination. After excluding other possible differential factors, the final diagnosis of non-syndromic Oligodontia was made. Preliminary impressions were made using impression compound and was molded on the edentulous ridge. Custom trays were fabricated and border molding was done using green stick impression compound and secondary impressions were made using zinc oxide eugenol impression paste. After maxillo-mandibular jaw relations, dentures were processed through compression molding technique. Dentures were inserted and the patient was taught about the insertion and removal of the dentures. Post insertion instructions regarding denture wear, functions of speech, mastication, hygiene and maintenance were given to the patient and the parent. Results: The patient was using prosthesis and happy with it during one year follow up. The rehabilitation with removable dentures at current age and later with osseo-integrated implants served as a satisfactory treatment outcome in such patients. Conclusion: This case report presents prosthodontic rehabilitation of a rare case of non-syndromic oligodontia in a 7-year old male patient with agenesis of all permanent teeth except the maxillary central incisors.

Modified Impression Technique for Fabrication of a Custom Made Ocular Prosthesis

Making an impression of the anophthalmic socket to facilitate the design of a custom made ocular prosthesis is a common practice. Different impression techniques can be used for its fabrication. The modified impression technique described here requires minimum laboratory procedures as the preliminary impression, secondary impression and wax trial can be done as a single stage procedure.

Three-dimensional minimally invasive video-assisted thyroidectomy: preliminary report

Three-dimensional (3D) minimally invasive video-assisted thyroidectomy (MIVAT) was carried out with a 4-mm, 3D 0-degree stereoscopic endoscope. The procedure was applied on 3 patients who underwent total thyroidectomy and data were prospectively collected. Operative time for total thyroidectomy ranged from 72 to 90 minutes. Neither intra-nor post-operative complications were reported during the study.The surgical team noticed a good perception of depth and easy recognising of anatomic structures, especially concerning the upper and lower vascular pedicle, the parathyroids, the superior and inferior laryngeal nerves. Preliminary impression emerging from this study seems to suggest that 3D MIVAT is safe and effective. Future studies with larger case series are required to determine the role of this procedure.

A Complete Denture Impression Technique Survey of Postdoctoral Prosthodontic Programs in the United States

The purpose of the study was to survey program directors of postdoctoral prosthodontic programs in the United States regarding their programs' complete denture impression techniques. The key objectives of the survey were to identify the current trends in complete denture impression making and to determine which techniques and materials are taught in US postdoctoral prosthodontic programs. An online survey was sent to all program directors of US postdoctoral prosthodontic programs. The survey comprised two sections: preliminary impressions and final impressions. The survey contained 22 questions that would take approximately 5 minutes to complete. All responses remained anonymous throughout the survey. The response rate for the survey was 87%. A majority of the programs did not separately border mold the tray prior to making the preliminary impressions (82%). The impression material of choice for the preliminary impression was irreversible hydrocolloid (88%). Selective pressure was the predominantly used impression philosophy (80%). All programs border molded the custom tray, and 95% recorded the borders in sections. The material of choice for border molding the custom tray was modeling plastic impression compound (71%). The most commonly used impression material for the final impressions was polyvinylsiloxane (PVS) (42%), and the second most commonly used impression material was polysulphide (32%). The most common technique for locating the posterior palatal seal was marking intraorally and transferring onto the final impression (65%). Most programs routinely advised their patients not to wear their existing dentures for at least 24 hours before the final impressions were made (83%). Based on the results of this study, the following conclusions can be drawn: (1) The most commonly used material for the preliminary impression was irreversible hydrocolloid and for the final impression was PVS. (2) Modeling plastic impression compound was used by most programs to border mold the custom trays. (3) Selective pressure was the predominantly used impression philosophy. (4) A majority of the programs made a special consideration for excessive movable (flabby) tissue. (5) Most programs routinely advised their patients to not wear their existing dentures for at least 24 hours before the final impressions were made.

A Comparative Evaluation of the Linear Dimensional Accuracy of Four Impression Techniques using Polyether Impression Material

There is much discussion in the dental literature regarding the superiority of one impression technique over the other using addition silicone impression material. However, there is inadequate information available on the accuracy of different impression techniques using polyether. The purpose of this study was to assess the linear dimensional accuracy of four impression techniques using polyether on a laboratory model that simulates clinical practice. The impression material used was Impregum Soft™, 3M ESPE and the four impression techniques used were (1) Monophase impression technique using medium body impression material. (2) One step double mix impression technique using heavy body and light body impression materials simultaneously. (3) Two step double mix impression technique using a cellophane spacer (heavy body material used as a preliminary impression to create a wash space with a cellophane spacer, followed by the use of light body material). (4) Matrix impression using a matrix of polyether occlusal registration material. The matrix is loaded with heavy body material followed by a pick-up impression in medium body material. For each technique, thirty impressions were made of a stainless steel master model that contained three complete crown abutment preparations, which were used as the positive control. Accuracy was assessed by measuring eight dimensions (mesiodistal, faciolingual and inter-abutment) on stone dies poured from impressions of the master model. A two-tailed t test was carried out to test the significance in difference of the distances between the master model and the stone models. One way analysis of variance (ANOVA) was used for multiple group comparison followed by the Bonferroni's test for pair wise comparison. The accuracy was tested at α=0.05. In general, polyether impression material produced stone dies that were smaller except for the dies produced from the one step double mix impression technique. The ANOVA revealed a highly significant difference for each dimension measured (except for the inter-abutment distance between the first and the second die) between any two groups of stone models obtained from the four impression techniques. Pair wise comparison for each measurement did not reveal any significant difference (except for the faciolingual distance of the third die) between the casts produced using the two step double mix impression technique and the matrix impression system. The two step double mix impression technique produced stone dies that showed the least dimensional variation. During fabrication of a cast restoration, laboratory procedures should not only compensate for the cement thickness, but also for the increase or decrease in die dimensions.

Predoctoral Prosthodontic Clinical Curriculum for Complete Dentures: Survey in Turkish Dental Schools

The aim of this study was to evaluate predoctoral complete denture curricula in the dental schools of Turkey in terms of materials, techniques, and approaches. A questionnaire with twenty-two multiple-choice questions was prepared and sent by e-mail to the directors of the prosthodontic departments of the seventeen long-established dental schools in Turkey. All schools responded for a response rate of 100 percent. All schools (100 percent) reported using irreversible hydrocolloid impression material for preliminary impression, impression compound for border molding, zinc oxide eugenol for a final impression, and heat curing technique for complete denture processing. A majority of schools said they used similar materials in complete dentures: cold cured acrylic resin in fabrication of record bases (70.5 percent) and anatomic teeth for posterior region (70.5 percent). The majority of schools did not use eccentric interocclusal records (76 percent) or occlusal equilibration and face-bow preservation (94 percent) and did not treat patients who require tooth-supported overdentures (70.5 percent). None of the schools taught treatment of implant-retained overdentures in their curriculum. Eleven schools (65 percent) used positioning mandible in centric relation techniques performed by both the clinician and the patient. It can be concluded that dental schools in Turkey have different prosthodontic curricula regarding complete dentures, although some topics are the same.

Sectional Denture for Microstomia Patient: A Clinical Report

ABSTRACT An abnormally small oral orifice is referred to as microstomia, although the intraoral structures may be of normal size. Making impression in microstomia patients is often cumbersome. Prosthetic rehabilitation of microstomia patients present difficulties at all stages, right from preliminary impressions to insertion of prostheses. To rehabilitate a patient with microstomia successfully, the methods and designs incorporated in the fabrication of prosthesis have to be modified to achieve favorable esthetics, mastication and retention. This clinical report describes the method of fabrication of sectional denture for completely edentulous patient with microstomia resulting from scleroderma with modified primary impression procedure without using tray and also method of fabricating a sectional complete denture. Fabricating the denture in two pieces enable the patient to insert and remove the denture with ease. How to cite this article Basavanna JM, Raikhy A. Sectional Denture for Microstomia Patient: A Clinical Report. Int J Prosthodont Restor Dent 2013;3(2):62-67.

Effect of Various Putty-Wash Impression Techniques on Marginal Fit of Cast Crowns

Marginal fit is an important clinical factor that affects restoration longevity. The accuracy of three polyvinyl siloxane putty-wash impression techniques was compared by marginal fit assessment using the nondestructive method. A stainless steel master cast containing three abutments with three metal crowns matching the three preparations was used to make 45 impressions: group A = single-step technique (putty and wash impression materials used simultaneously), group B = two-step technique with a 2-mm relief (putty as a preliminary impression to create a 2-mm wash space followed by the wash stage), and group C = two-step technique with a polyethylene spacer (plastic spacer used with the putty impression followed by the wash stage). Accuracy was assessed using a toolmaker microscope to measure and compare the marginal gaps between each crown and finish line on the duplicated stone casts. Each abutment was further measured at the mesial, buccal, and distal aspects. One-way analysis of variance was used for statistical analysis. P values and Scheffe post hoc contrasts were calculated. Significance was determined at .05. One-way analysis of variance showed significant differences among the three impression techniques in all three abutments and at all three locations (P < .001). Group B yielded dies with minimal gaps compared to groups A and C. The two-step impression technique with 2-mm relief was the most accurate regarding the crucial clinical factor of marginal fit.

English

While the basic process of making dentures has changed little over the past several decades, new materials and techniques can help laboratories and clinicians provide functional, esthetic restorations that offer exceptional value to patients. Unlike the conventional linear methods which follow specific steps in a cookbook fashion, the Branching Technique is a dynamic concept which can be adjusted to meet the clinical needs of each patient. This customized technique allows for a trial denture to be worn by each patient that is used to pinpoint and solve the patient's denture problems before the final denture is made. This individualized approach helps to eliminate disappointments or surprises. From the preliminary impressions and the training denture (it's actually a provisional denture) to the functional impressions and porcelain teeth to hold the patient's vertical dimension, the Branching Technique produces the most esthetically pleasing and functionally stable dentures possible.

Involving Physicians in Upstream Conversations: The Serious Illness Communication Checklist

Background: Early discussion of end-of-life issues has been found to be associated with better quality of life, reduced use of aggressive care, earlier hospice referral, improved bereavement outcomes for survivors,...

School self-evaluation at an embryonic stage: depicting teachers’ experiences with a participative project

This case study aims to enquire into the journey of a Greek-Cypriot primary school through a self-evaluating process, in accordance to the respective guidelines proposed in the national educational reform documents. The article outlines the phases involved, beginning from the collection of information, moving to the formulation of a school development plan and ending with some preliminary impressions of teachers as implementers. Analyses of minutes of the weekly staff meetings as well as questionnaires distributed to participating teachers indicate that this self-initiated participatory approach apparently had vitality and drive but also suffered due to the lack of wider systemic support. This study underlines the significance of the ideographic and nomothetic dimension of school culture for the development of school self-evaluation (SSE). Emerging considerations appear to resemble issues of school effectiveness and school improvement underpinning SSE worldwide and the need to draw links between the two paradigms. In pursuit of a mixed approach, measures such as a focus on SSE outcomes along with the establishment of school autonomy, which could facilitate the initiation and sustainability of SSE practices in Greek-Cypriot schools, are further discussed.

Transnasal Skull Base Reconstruction Using a 3-D Endoscope: Our First Impressions

Nowadays endoscopic skull base reconstruction is safely and effectively performed by means of two-dimensional (2-D) endoscopic technique. The aim of our study is to compare our 2-D experience with the novel 3-D technology in the field of skull base reconstruction techniques. In this study four patients treated with various kinds of planned duraplasty are included. The new 3-D technology was compared with the high-definition 2-D scopes during the different steps of the procedures. The 3-D endoscopic skull base reconstruction obtained primary closure without complications in all cases. According to the subjective opinion of experienced endosurgeons, this novel technique improved depth perception, distance and size estimation, ability to identify specific anatomic structures, and hand-eye coordination. The main drawbacks detected were inferior sharpness, contrast and lighting that impaired the application of the technique in narrow sinonasal spaces. According to our preliminary impressions, 3-D endoscopic skull base reconstruction is an effective and safe procedure and could represent a significant advantage for accurate managing of the skull base region.

Dynamic nonrobotic telemicroscopy via skype: A cost effective solution to teleconsultation

Context: Skype is a peer to peer software application that has been historically used for voice and video calls, instant messaging, and file transfer over the Internet. Few studies are available using Skype specifically for telepathology. Aims: Our aim is to show that dynamic nonrobotic teleconsultation is possible and even effective via means of a standard microscope camera capable of live acquisition, Skype, an established broad band internet connection, and experienced pathologists. Settings and Design: Both the consulting “sending” pathologist and consultant “receiving” pathologist are reasonably experienced general surgical pathologists at junior attending level with several years of experience in sign out. Forty-five cases were chosen encompassing a broad range of surgical pathology specimens. The cases were prospectively evaluated with the consultant diagnosis used as a preliminary pathologic impression with the final diagnosis being confirmation. Materials and Methods: Versions of Skype 5.0 and above were used along with established broadband internet connections, usually between academic medical institutions. Results: Forty of forty-five cases (89%) were essentially concordant. In four of forty-five cases (9%), the consulting impression gave a differential, but favored an entity which did not match the final diagnosis. Only one case (2%) did the consulting impression not match the final diagnosis; a discordant opinion. Conclusions: The image quality via Skype screen sharing option is excellent. Essentially no lag time was seen. We have shown in our small pilot study that Skype is an effective cost-efficient means for teleconsultation, particularly in the setting of entity-related differential diagnoses in surgical pathology and when both the consulting and consultant pathologists are reasonably experienced.

Recording ‘Sublingual Crescents’ in Lower Complete Dentures: A Technique so Effective but still Esoteric and Arcane

To achieve retention in severely resorbed mandibular ridges during impression making and to maintain the retention and stability of these dentures during function. No good method with adequate clinical photographs that will empower the dentist with the necessary skill has been reported in the literature. The technique involves making a preliminary impression in alginate to record the denture bearing area clearly, doing a border moulding procedure with excess width to fill the wide sulcus present; except in the area of anterior lingual flange from second premolar to second premolar area. The anterior lingual border of the impression is then extended sublingually without interfering with the tongue function or blocking the opening of the ducts of the sublingual gland; to maintain contact with the surrounding sublingual tissue in both protruded and retruded positions of the tongue, thereby creating good peripheral seal in the most vulnerable area in the lower denture, where the seal is easily broken during tongue movements. This impression technique, combined with arrangement of teeth on the center of the ridge in the posterior part, use of flattened cusp posterior teeth and contoured polish surface of denture base (Fisch concept) provide sufficient retention and stability to the dentures made on these severely resorbed ridges. Patients with severely resorbed ridges cannot be rehabilitated with implants also and so normally suffer with loose lower denture fabricated with normal border moulding procedures. These patients can be rehabilitated to a great extent properly.

Anatomie en de afdrukprocedure voor een volledige gebitsprothese

Making an impression of an edentulous jaw is an essential part of producing a removable complete denture, because the proper functioning of the denture is partially dependent on the volume and form of the alveolar ridge and the surrounding soft tissue, in particular the musculature. Before the impression of the maxillary and mandibular jaw is made, insight into the anatomy of the maxilla and the mandible as well as the soft oral tissues is also essential. With respect to this, a 5-phase approach for the impression-making procedure is introduced, which gives guidelines for the fabrication of the preliminary impression, the preliminary cast, the individual impression tray, the final impression and the final cast. In each phase, the concern is to achieve the best possible stability of the denture. Adequate stability can only be achieved by determining the denture borders accurately.