Preliminary Impression Research Articles

Percutaneous Tibial Nerve Stimulation Twice a Week in Female Patients with Refractory Urinary Frequency: A Preliminary Study

Introduction: To determine whether percutaneous tibial nerve stimulation (PTNS) applied twice a week is effective in female patients with refractory urinary frequency. Patients and Methods: Twenty-two patients with increased daytime urinary frequency and bladder sensation were enrolled in the prospective study undergoing a total of 10 times of PTNS. The response was assessed using a voiding diary, the 36-item short-form health survey (SF-36) quality-of-life questionnaire and the patient’s self-evaluation table. Results: A statistically significant improvement was found in daytime and nighttime voiding frequency, daytime voiding volume and nighttime lowest voiding volume variables. The self-reported health status transition in SF-36 was statistically lower after the treatment. Ten patients, who evaluated the trial as having had some effect, had more significant improvement statistically in nocturia than did the other 12 patients, who evaluated the trial as having had no effect. Conclusions: Intermittent PTNS twice a week might be an alternative treatment for patients with refractory urinary frequency. However, these preliminary impressions should be further confirmed.

A SIMPLIFIED APPROACH FOR REHABILITATION OF AN EDENTULOUS PATIENT WITH ORAL SUBMUCOUS FIBROSIS – A CLINICAL REPORT

Oral sub mucous fibrosis is an insidious chronic disease and a precancerous condition, affecting any part of the oral cavity and sometimes the pharynx. Management of patient with oral sub mucous fibrosis presents difficulties at all stages, from the preliminary impressions to fabrication of prostheses. This article will present simplified approach for management of a 61year old male edentulous patient with oral sub mucous fibrosis. So that final outcome may be achieved.

Factors affecting wear of composite resin denture teeth—24-month results from a clinical study

The objectives of this study were to measure the occlusal wear of composite resin denture teeth in patients wearing a complete denture and to evaluate factors affecting wear. Fifty participants provided with complete dentures in at least one jaw were included. Gypsum casts were made from preliminary vinyl polysiloxane impressions 4 weeks after insertion, then after 6 (t(1)), 12 (t(2)), and 24 months (t(3)). Three-hundred and three posterior denture teeth were evaluated after 24 months. Wear was measured indirectly, from the casts, by means of a three-dimensional laser scanner device. Sequential images of the occlusal surfaces were digitized and superimposed (occlusal matching). Statistical analysis was performed by the use of mixed regression models, with the patient being a random effect. Mean wear (median, interquartile range; micrometer) of the entire occlusal surface was 8 (19) at t(1), 18 (34) at t(2), and 40 (61) at t(3). Maximum vertical loss (median, interquartile range; micrometer) was 92 (112) at t(1), 146 (148) at t(2), and 226 (184) at t(3). The dental status of the opposing jaw and the nature of the opposing material significantly affected the wear of denture teeth at t (3). Gender, daily wearing time, jaw, and type of tooth had no significant effects on the extent of wear. Clinically relevant vertical loss of composite resin denture teeth occurs after 24 months. Considering the limitations of this study, wear of denture teeth was affected by dental status and opposing material. The results suggest that wear of composite resin denture teeth exceeds that of enamel.

Smart magnets – a solution to microstomia: A clinical report

Prosthetic rehabilitation of microstomia patients presents difficulties at all stages right from preliminary impressions to insertion of prosthesis. Impression making in microstomia patients is often cumbersome. A modification of standard impression procedure is often necessary while treating such patients and there is a need to fabricate complete dentures that are différent from conventional ones. This clinical report describes a simplified technique used to treat a patient who had limited mouth opening by means of sectional maxillary and mandibular complete dentures. Magnets have been used as retentive elements for this sectional denture. These magnets were very light in weight and did not impede the thickness of the denture. The small size of magnets and their high strength/ attractive forces make them easily stored and carried. An attempt has been made here to describe the fabrication of a sectional prosthesis that is practical, economical, and simple in design.

A simple method for prosthodontic rehabilitation of edentulous patient with epidermolysis bullosa: a clinical case report.

An abnormally small oral orifice is defined as microstomia. Microstomia may result from epidermolysis bullosa (EB), which consists of a group of disorders characterized by the presence of mechanical fragility of the skin with recurrent de-velopment of blisters and vesicles, resulting from minor mechanical friction or trauma. Since such patients have a small oral aperture, it may be impossible to take impression and fabricate dentures using conventional methods. In this article, a simple method for taking preliminary impressions from upper and lower edentulous ridges in one patient with limited mouth opening and then preparing the complete denture with custom denture teeth in a single unit was described.

Gingival recontouring by provisional implant restoration for optimal emergence profile: report of two cases

PurposeThe emergence profile concept of an implant restoration is one of the most important factors for the esthetics and health of peri-implant soft tissue. This paper reports on two cases of gingival recontouring by the fabrication of a provisional implant restoration to produce an optimal emergence profile of a definitive implant restoration.MethodsAfter the second surgery, a preliminary impression was taken to make a soft tissue working cast. A provisional crown was fabricated on the model. The soft tissue around the implant fixture on the model was trimmed with a laboratory scalpel to produce the scalloped gingival form. Light curing composite resin was added to fill the space between the provisional crown base and trimmed gingiva. After 4 to 6 weeks, the final impression was taken to make a definitive implant restoration, where the soft tissue and tooth form were in harmony with the adjacent tooth.ResultsAt the first insertion of the provisional restoration, gum bleaching revealed gingival pressure. Four to six weeks after placing the provisional restoration, the gum reformed with harmony between the peri-implant gingiva and adjacent dentition.ConclusionsGingival recontouring with a provisional implant restoration is a non-surgical and non-procedure-sensitive method. The implant restoration with the optimal emergence profile is expected to provide superior esthetic and functional results.

Parathyroid hyperplasia of auto-transplanted tissue in forearm skin

Currently, the treatment of choice for refractory tertiary hyperparathyroidism is a total parathyroidectomy with autotransplantation of the parathyroid tissue into the forearm. Recurrent hyperparathyroidism after autotransplantation requiring surgical excision of the autograft is uncommon. We describe a female patient with recurrent hyperplasia who underwent an excision of her parathyroid autograft. The excisional specimen was submitted to pathology with the only provided history of a 'left arm mass'. The lack of clinical history led to a preliminary impression of an adnexal neoplasm by the primary pathologist.

An alternative impression technique for individuals with special care needs

Impression making may be complicated in individuals with limited ability to cooperate with caregivers. An alternative technique for obtaining full-arch casts from sectional preliminary impressions is described. The technique is a modification of the procedure advocated for impression making in subjects with limited mouth opening. A pair of partial stock trays is selected to fit the right and left side of the arch. Two sectional irreversible hydrocolloid impressions are made separately. The first cast is placed into the second impression prior to pouring, to obtain a cast of the complete arch. The procedure was used during the treatment of an uncooperative young patient with Lesch-Nyhan Syndrome and provided a simple and reliable means to obtain the diagnostic cast of the mandibular teeth. It is recommended not only for uncooperative patients, but also for patients with special needs; such as those with anatomical restrictions, functional impairment, and movement disorders.

Corrective Primary Impression Technique

The article describes a simple, quick and corrective technique for making the preliminary impression. It records the extensions better as compared to the impressions made using only impression compound. This technique is accurate and gives properly extended custom tray. Any deficiencies seen in the compound primary impression are corrected using this technique hence, this technique is called as a “corrective primary impression technique”.

Utilizing Filmed Authentic Student–Client Interactions as a Communication Teaching Tool

In the past decade, communication training within veterinary medical training programs has received extensive publicity. Now, training programs are utilizing large-group lecturing, small-group discussions, and simulated client programs to address the need for veterinarians to effectively communicate with their clients. This paper presents a communication training protocol utilized at Kansas State University. The principle focus of this protocol is utilizing filmed student interactions with authentic veterinary medical clients. All veterinary medical students are required to film two interactions with hospital clientele. After each filmed session, students attend feedback sessions where communication strengths and weaknesses are discussed. Specific communication goals are identified for future interactions. A detailed description of the protocol follows, with preliminary impressions from students and instructors noted. As a promising tool for teaching communication skills, future directions for filmed authentic interactions are discussed.

Variations of Endoscopic and Open Repair of Metopic Craniosynostosis

In contrast to sagittal craniosynostosis, the role of endoscopic, minimally invasive approaches in the treatment of metopic craniosynostosis with resulting trigonocephaly is not as well defined. We reviewed the senior authors' (H.M. and S.C.) clinical experience in the treatment of children with metopic craniosynostosis using a variety of endoscopic and open techniques. Thirty-three patients were treated at a single institution during a 5-year period with between 3 and 8 years of follow-up. Sixteen patients underwent 3 variations of endoscopic approaches, and 17 patients had open fronto-orbital advancement. Clinical parameters of the 2 groups were examined including age at surgery, blood loss, operative time, transfusion volume, hospital stay, complications, use of postoperative cranial banding, and the need for reoperation for persistent deformity. The various endoscopic and open techniques used by the authors in the treatment of metopic craniosynostosis are discussed in detail, including rational for individual technique selection and preliminary impressions regarding clinical outcome.

A method to make a preliminary impression of mobile teeth

A method to make a preliminary impression of mobile teeth

Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

Planeamento Estético na Restauração Directa de Dentes Anteriores: Técnica de Simulação Semi-Directa

In the last years, beauty and harmony stereotypes have dominated human relationships, being the word aesthetics used in several areas of our society. The definition of an ideal smile is based not only on objective measurable criteria but also includes subjective parameters. The pre-visualization of the final result of a planned anterior rehabilitation gives the opportunity for the professional and the patient to evaluate if the changes to be performed correspond to their aesthetics and functionality expectations. ObjectiveTo describe a semi-direct simulation technique of anterior teeth restorations, based on clinical cases, and enumerate its advantages and limitations. MethodIn the first appointment photographs are taken and preliminary impressions are made. The casts are articulated in centric relation. The moch-up is made with a composite resin. The cast modifications are printed using a high viscosity polivinilsiloxane to create a restoration key. On a second appointment a self-cure acrylic resin is added to the key and than is introduced in the patient's mouth in order to pre-visualize the possible final result. These provisory restorations can be cemented so that the patient can adapt herself to the new look. The silicon key can also work as guide for the definitive restoration. ConclusionThis technique proved to be of easy execution, quick and efficient, although it can’t be used in situations of vestibular position or extruded teeth. It has the advantages of being an additive and reversible technique, and the silicon key facilitates the definitive restoration execution.

Rehabilitation of a congenital palatal defect with a modified technique: a case report

IntroductionConstuction of the obturator prostheses and providing the patient's comfort with them are very difficult. Primary and the most important stage for these prostheses is to perform a proper impression.Case PresentationA 55-year-old edentulous Turkish female patient with a congenitally maxillary defect was rehabilitated with an open hollow obturator prosthesis. After the preliminary impression was completed, a metal frame suitable with the maxillary defect was constructed manually and used for making the impression of the defect area. After the first part of the obturator was finished, second part which separates nasal cavity and oral cavity was constructed by the aid of the bulb.ConclusionWhen constructing an obturator prosthesis, making a detailed impression from the defect area can be performed by the aid of a metal frame, and an intraorally shaped extension that separates oral cavity from nasal cavity might be more effective for adaptation of the prosthesis.

The Radiology Report of the Future: A Summary of the 2007 Intersociety Conference

A radiology report is the official record documenting the contribution of a radiologist to a patient's care. The use of structured reports and a common lexicon will help referring physicians better understand the contents of reports. These same features in electronic health records will enable radiologists to mine reports for utilization management information as well as form the basis for clinical investigations.

Dimensional accuracy of resultant casts made by a monophase, one-step and two-step, and a novel two-step putty/light-body impression technique: An in vitro study

Dimensional accuracy when making impressions is crucial to the quality of fixed prosthodontic treatment, and the impression technique is a critical factor affecting this accuracy. The purpose of this in vitro study was to compare the dimensional accuracy of a monophase, 1- and 2-step putty/light-body, and a novel 2-step injection impression technique. A stainless steel model with 2 abutment preparations was fabricated, and impressions were made 15 times with each technique. All impressions were made with an addition-reaction silicone impression material (Aquasil) and a stock perforated metal tray. The monophase impressions were made with regular body material. The 1-step putty/light-body impressions were made with simultaneous use of putty and light-body materials. The 2-step putty/light-body impressions were made with 2-mm-thick resin-prefabricated copings. The 2-step injection impressions were made with simultaneous use of putty and light-body materials. In this injection technique, after removing the preliminary impression, a hole was made through the polymerized material at each abutment edge, to coincide with holes present in the stock trays. Extra-light-body material was then added to the preliminary impression and further injected through the hole after reinsertion of the preliminary impression on the stainless steel model. The accuracy of the 4 different impression techniques was assessed by measuring 3 dimensions (intra- and interabutment) (5-mum accuracy) on stone casts poured from the impressions of the stainless steel model. The data were analyzed by 1-way ANOVA and Student-Newman-Keuls test (alpha=.05). The stone dies obtained with all the techniques had significantly larger dimensions as compared to those of the stainless steel model (P<.01). The order for highest to lowest deviation from the stainless steel model was: monophase, 1-step putty/light body, 2-step putty/light body, and 2-step injection. Significant differences among all of the groups for both absolute dimensions of the stone dies, and their percent deviations from the stainless steel model (P<.01), were noted. The 2-step putty/light-body and 2-step injection techniques were the most dimensionally accurate impression methods in terms of resultant casts.

A modified one-step putty-wash impression technique

aClinical Instructor, Chang Gung Memorial Hospital, Chang Gung University College of Medicine. bProfessor, School of Dentistry, University of North Carolina. (J Prosthet Dent 2007;98:245-246) Although the literature demonstrates that optimum accuracy can be achieved with custom trays and stock trays,1-4 the putty-wash impression technique using an elastomeric impression material is a popular method. Two variations of the putty-wash impression technique are commonly used, the 2-step and 1-step.5 With the 2-step technique, a preliminary preoperative putty impression is made and, subsequently, “washed” with low viscosity material after tooth preparation. In terms of the 2-step puttywash impression technique, several methods are described for control of the bulk of the wash material,6-8 which is essential for fabricating accurate stone dies. With the 1-step procedure, low viscosity impression material is injected around the prepared tooth or teeth, and then the putty impression material is immediately placed intraorally and the materials polymerize simultaneously. Accuracy of impressions resulting from the 1-step putty-wash technique is controversial. Some authors found that there was no difference in accuracy between techniques,5,9-11 while others criticized several potential disadvantages with this approach. These disadvantages include lack of control of the bulk of wash material and the high risk of capturing portions of the prepared margin in putty material rather than lower viscosity material.12 Most putty viscosity materials have inadequate fine detail reproduction for this purpose. This article describes a modified 1-step putty-wash technique using vacuum-formed resin sheets as spacers to control the wash bulk and minimize the chance of unfavorable impression results. Using this technique, the limitations of using 1-step putty-wash impression can be eliminated.

An Approach to Preventing Coparenting Conflict and Divorce in Low‐Income Families: Strengthening Couple Relationships and Fostering Fathers' Involvement

In the context of current concern about levels of marital distress, family violence, and divorce, the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children, in part by strengthening the men's relationships with their children's mothers. The study design involves a randomized clinical trial that includes assignment to a 16-week couples group, a 16-week fathers group, or a single-session control group. Couples in both group interventions and the control condition include partners who are married, cohabiting, and living separately but raising a young child together. This article presents the rationale, design, and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives, many of whom are manifesting some degree of individual or relationship distress. We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest, and the first 160 who completed one postintervention assessment 9 months after entering the study. Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families.

Effect of Clinicians’ Experience on Chair Time and the Number of Denture Adjustment Visits Required for Complete Denture Treatment

Purpose: The purpose of this study was to demonstrate how a clinician’s experience might affect the complete denture treatment.Methods: A randomized controlled parallel clinical trial at two hospitals was conducted from April 2004 to July 2006. Written informed consent was obtained from the study subjects. Permuted-block randomization was performed with a block size of 4, indicating that not only was the clinician’s experience randomized) but also the denture base materials used (conventional acrylic resin and resilient liner). The chair time required for each step of complete denture treatment was compared between the junior clinician and senior clinician groups. The clinical protocol was carried out as follows: the preliminary impression, final impression, maxillomandibular registration, trial placement, denture delivery, and the number of visits for denture adjustments. Seventy-four subjects were assigned to this trial.Results: Significant differences were observed between the junior clinician and senior clinician groups with regard to chair time required for final impressions and the number of visits required for denture adjustments. There were no differences in chair time required for the other treatment steps.Conclusion: This randomized controlled clinical trial revealed that a clinician’s experience has an obvious influence on the chair time required for a final impression and the number of visits for denture adjustment.