Type Of Prosthesis Research Articles

Standardized multi-institutional data analysis of fixed and removable prosthesis: estimation of life expectancy with regards to variable risk factors.

This study aims to assess and predict lifespan of dental prostheses using newly developed Korean Association of Prosthodontics (KAP) criteria through a large-scale, multi-institutional survey. Survey was conducted including 16 institutions. Cox proportional hazards model and principal component analysis (PCA) were used to find out relevant factors and predict life expectancy. 1,703 fixed and 815 removable prostheses data were collected and evaluated. Statistically significant factors in fixed prosthesis failure were plaque index and material type, with a median survival of 10 to 18 years and 14 to 20 years each. In removable prosthesis, factors were national health insurance coverage, antagonist type, and prosthesis type (complete or partial denture), with median survival of 10 to 13 years, 11 to 14 years, and 10 to 15 years each. For still-usable prostheses, PCA analysis predicted an additional 3 years in fixed and 4.8 years in removable prosthesis. Life expectancy of a prosthesis differed significantly by factors mostly controllable either by dentist or a patient. Overall life expectancy was shown to be longer than previous research.

Epidemiological profile of oral and maxillofacial prosthesis rehabilitated patients in the Brazilian National Cancer Institute: a cross-sectional study

Introduction: Maxillofacial prostheses represent a rehabilitative option for patients who underwent head and neck tumor resection. Objective: To describe the epidemiological profile of maxillofacial prostheses rehabilitated patients in an oncology reference center, from 2015 to 2020. Materials and methods: This is a retrospective, descriptive, observational study, based on secondary data. The maxillofacial prostheses were identified through the prosthesis laboratory records. The socio-demographic, clinical, and maxillofacial prosthesis data were collected from medical records and were descriptively analyzed according to the prosthesis types. Results: A total of 202 patients and 282 maxillofacial prostheses were identified. Obturator prostheses (37%) were the most frequent, and 2019 was the year with the largest production (54%). Males (55%), with 45 years, and incomplete primary education (32%) prevailed. Most tumors were carcinomas (43%), in the palate (40%), with 15.5 months of evolution, at stage III (25%) Surgery and surgery associated with radiotherapy were the most commonly used therapeutic modalities (40% each). At the last visit, most patients had complete remission of the disease (67%). Maxillofacial prostheses were mostly in acrylic resin (92%), with 9.5 months of use, and hygiene was considered satisfactory (87%). Most patients reported good adaptation (82%), satisfaction (76%), satisfactory hygiene (87%), and no adverse events (83%) or difficulties (69%) associated with its use. Conclusion: These data highlight the importance of oral and maxillofacial prostheses as an effective and accessible tool in the rehabilitation process and reinforce the need for a multidisciplinary team to work in oncology, with the dentist as an essential player in this context.

An assessment of the impact of L.Salvadora persica and G.Tea on the surface roughness and hardness of heat-cured acrylic-based denture soft liners.

Background: Soft denture liners are a type of dental prosthesis that functions as a cushioning material, alleviating the stress induced by the act of chewing. They offer relief to persons who encounter discomfort when wearing complete or partial dentures, particularly when these dentures are situated on rigid surfaces that support the denture. The objective of this study: is to assess the effects of including L.Salvadora persica. and green tea (G.Tea) extract powders on the surface roughness and hardness characteristics of acrylic-based soft liners. Materials & Procedures: 30 specimens were constructed using wax molds and acrylic-based heat-cured denture soft lining material. The standard curing procedure was used. The samples were separated into three equal groups: group A, the control group, with no additives in the soft-liner material; group B, with 5.12% weight percept L.salvadora persica extract powder; and group C, with 5.12% weight present green tea (G.Tea) extract powder. The samples were then prepared for surface hardness and roughness testing. Results: The results revealed that there was a non-significant rise in the mean values of surface roughness for both group B and group C, group B having the highest mean values followed by group C. When compared to the control group, the results showed a considerable rise in the mean values of surface hardness in group (B), which had the highest mean value for surface hardness, followed by group (C). Conclusion: The results of this study indicate that the incorporation of L.salvadora persica at a concentration of 1.024g and green tea (G.Tea) extract powders at a concentration of 1.024g shown a positive impact on the surface hardness of denture soft lining materials

Relationship Between Staging and Grading of Periodontitis and Periimplantitis: A Retrospective Study

Objective: The purpose of this retrospective study was to determine the relationship between peri-implantitis and stage/grade of periodontitis. 
 Methods: Records of 171 periodontitis patients with 318 dental implants were screened. Classification of diagnosed patients with periodontitis were done by both stage (1, 2, 3 and 4) and grade (A, B and C). Peri-implant health status was evaluated as no peri-implantitis or with peri-implantitis. Marginal bone loss severity of implants diagnosed with peri-implantitis, prosthesis type (single, bridge), location of dental implants (maxilla, mandibula, anterior and posterior), smoking (yes/no) and diabetes history (yes/no) of the patients were also evaluated. Analysis was done at implant level.
 Results: A total of 203 (63.8%) dental implants were diagnosed with peri-implantitis. There were statistical differences in the stage and grade of periodontitis between implants diagnosed with no peri-implantitis and peri-implantitis (p

What do users and their aiding professionals want from future devices in upper limb prosthetics? A focus group study.

High rejection rates of upper limb prosthetics indicate that current prosthetic devices only partially meet user demands. This study therefore investigated the benefits and challenges with current prostheses, associated services and potential areas for improvement from the perspective of upper limb prosthesis users and various professionals working in the field of upper limb and hand prosthetics. Seven different focus group discussions were conducted with 32 participants. Participants were grouped by prosthesis type, if they were prosthesis users, or professionals. All focus group discussions were transcribed verbatim, and a summarizing content analysis was performed. Three main topic areas to be addressed emerged from the interviews: 1. a properly functioning prosthesis, 2. the infrastructure, and 3. users' psychological and physical prerequisites. The interaction between a well-functioning prosthesis and a well-developed infrastructure was shown to be important for successful use. Our study raises many of the same issues that have been reported in previous qualitative studies, dating back over several decades. This study underlines the need to include users and professionals in the future development of prosthetic devices.

Survival and Recurrence of Endocarditis following Mechanical vs. Biological Aortic Valve Replacement for Endocarditis in Patients Aged 40 to 65 Years: Data from the INFECT-Registry.

Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. Whether the type of prosthesis implanted for aortic valve replacement (AVR) for IE impacts patient survival is a matter of debate. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis AVR for IE according to prosthesis type among patients aged 40 to 65 years. This was an analysis of the INFECT-REGISTRY. Trends in proportion to the use of mechanical prostheses versus biological ones over time were tested by applying the sieve bootstrapped t-test. Confounders were adjusted using the optimal full-matching propensity score. The difference in overall survival was compared using the Cox model, whereas the differences in recurrence of endocarditis were evaluated using the Gray test. Overall, 4365 patients were diagnosed and operated on for IE from 2000 to 2021. Of these, 549, aged between 40 and 65 years, underwent AVR. A total of 268 (48.8%) received mechanical prostheses, and 281 (51.2%) received biological ones. A significant trend in the reduction of implantation of mechanical vs. biological prostheses was observed during the study period (p < 0.0001). Long-term survival was significantly higher among patients receiving a mechanical prosthesis than those receiving a biological prosthesis (hazard ratio [HR] 0.546, 95% CI: 0.322-0.926, p = 0.025). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (HR 0.268, 95%CI: 0.077-0.933, p = 0.039). The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical aortic valve prosthesis implant for IE in middle-aged patients.

Clinical and radiographic outcomes of a combined surgery approach to treat peri-implantitis

Peri-implant infra-bony defects are difficult to treat, and data on the management of peri-implantitis are lacking. The aim of this study was to evaluate the effect of a combined surgical approach to manage peri-implantitis: implantoplasty with xenogeneic bone grafting and a concentrated growth factor membrane. Two independent examiners analysed the medical records and radiographs taken before surgery and at the last follow-up. Data were analysed at the implant level; some patient-level data (age, sex, smoking habit) were also considered. Linear regression analysis with generalized estimating equations (GEE) was used to explore the effect of variables of interest (including marginal bone level (MBL)) on implantitis treatment success and resolution rates. The effect of the prosthesis type on postoperative clinical and radiographic parameters was also explored by GEE, with adjustment for age, sex, tooth site, location, follow-up duration, and implant length (model IV including all). Thirty patients with 72 implants were investigated. The implant survival rate was 100% over a mean observation period of 3.3 years (range 2–11 years). The treatment success rate (bone loss <0.5 mm, no bleeding on probing (BOP), no suppuration, probing depth (PD) < 5 mm) was higher in females than males (50% vs 19.0%; P = 0.008). At the last postoperative follow-up, the MBL (1.51 ± 1.07 vs 4.01 ± 1.13 mm), PD (3.61 ± 0.84 vs 6.54 ± 1.01 mm), and BOP (23.38 ± 23.18% vs 79.17 ± 15.51%) were significantly reduced when compared to pre-surgery values (all P < 0.001). Furthermore, a significantly higher PD reduction (β = −1.10 mm, 95% confidence interval −1.97 to −0.23 mm, P = 0.014) was observed for implants with a single crown than a full-arch prosthesis (GEE model IV). Preliminary clinical and radiographic data indicate that implantoplasty in combination with surgery could be an effective treatment option for peri-implantitis.

Success, Survival and Prognostic Factors in Implant Prosthesis: Experimental Study

The primary objective of this study was to detect the success and short-term survival rate of dental implant prosthetic therapy. The valuation of a possible relationship between the general and local clinical conditions of the patients (presence of risk factors and type of dental implant-supported prosthesis) and the satisfaction perceived by the patient, with success and survival of implant devices was investigated. The sample trial consisted of 23 patients, for a total of 50 dental implants supporting a prosthetic therapy. Preliminarily, an analysis of averages and frequencies of the anamnestic data was presented, as numbers and percentages. The implant success rate was calculated by assessing whether the implants fulfilled the success criteria defined by the Pisa Consensus Conference. The ANOVA test was used to check whether there was an association between the success of the implant device, the anamnestic data collected, and the type of prosthesis supported by the implants. Finally, the survival rate was calculated using the Kaplan - Meier method. The 2-year success rate of 50 implants was assessed at 98%. The 2-year survival rate was 97%. Finally, sex, age, compensated diabetes, a smaller and equal number of cigarettes per day (10 per day), the BOP, and the type of titanium dental implants supported by prosthesis, do not determine a change in success and are therefore not adequate parameters to predict the outcome of implant success. Following the results obtained, it is appropriate to continue the research by expanding the clinical observation times in order to obtain more solid scientific and clinical evidence.

Acquired Thrombocytopenia in Contemporary Transcatheter Aortic Valve Prosthesis.

Postprocedural thrombocytopenia is a known phenomenon following transcatheter aortic valve implantation (TAVI). The aim of this study is to evaluate whether postinterventional platelet kinetics differ when comparing the current generation of balloon-expandable valve (BEV) and self-expanding valve (SEV) prostheses. We performed a retrospective analysis of patients undergoing TAVI at our facility between 2017 and 2019. Patients were stratified according to the type of prosthesis used: BEV or SEV. Hematocrit-corrected platelet counts were calculated to account for dilution. Nadir platelet counts (lowest recorded platelet count), drop platelet counts (DPC; highest relative platelet drop from baseline), and severity of thrombocytopenia during the discourse and at discharge were assessed. Of the 277 included patients, 212 received SEV and 65 BEV. BEV patients were younger (81.8 ± 4.4 years vs 79.7 ± 6.8 years, p = 0.03). Further demographic characteristics were similar between groups. Implanted SEV were larger (p < 0.001) and had shorter procedural times (p < 0.01). There were no significant differences in postprocedural discourse. Postinterventional platelet drop was more pronounced in BEV patients in several evaluated metrics: mean DPC (24.3 ± 10.9% vs 18.8 ± 14.8%, p < 0.01), patients with DPC > 30% (n = 19, 29.2%, vs n = 33, 15.6%, p = 0.02), and also when comparing platelet kinetics. Despite improvements in outcome, the current generation of balloon-expandable TAVI prostheses carries a predisposition for postprocedural thrombocytopenia even when the effects of dilution are accounted for.

Comparison of clinical outcomes between total hip replacement and total knee replacement.

Total hip replacements (THR) and total knee replacements (TKR) are effective treatments for severe osteoarthritis (OA). Some studies suggest clinical outcomes following THR are superior to TKR, the reason for which remains unknown. This study compares clinical outcomes between THR and TKR. To compare the clinic outcomes of THR anad TKR using a comprehensive range of patient reported outcome measures (PROMs). A prospective longitudinal observational study of patients with OA undergoing THR and TKR were evaluated using a comprehensive range of generic and joint specific PROMs pre- and post-operatively. A total of 131 patients were included in the study which comprised the THR group (68 patients) and the TKR group (63 patients). Both groups demonstrated significant post-operative improvements in all PROM scores (P < 0.001). There were no significant differences in post-operative PROM scores between the two groups: Hip and Knee Osteoarthritis Outcome scores (P = 0.140), Western Ontario and McMaster Universities Osteoarthritis Index pain (P = 0.297) stiffness (P = 0.309) and function (P = 0.945), Oxford Hip and Knee Score (P = 0.076), EuroQol-5D index (P = 0.386) and Short-Form 12-item survey physical component score (P = 0.106). Subgroup analyses showed no significant difference (P > 0.05) between cruciate retaining and posterior stabilised prostheses in the TKR group and no significant difference (P > 0.05) between cemented and uncemented fixation in the THR group. Obese patients had poorer outcomes following TKR but did not significantly influence the outcome following THR. Contrary to some literature, THR and TKR are equally efficacious in alleviating the pain and disability of OA when assessed using a comprehensive range of PROMs. The varying knee prosthesis types and hip fixation techniques did not significantly influence clinical outcome. Obesity had a greater influence on the outcome following TKR than that of THR.

Management of hemi-mandibulectomy patient with prosthetic devices

The success in rehabilitating a patient with hemi-mandibulectomy depends upon the nature and extent of the surgical defect, treatment plan, type of prosthesis, and patient co-operation. The management becomes more challenging when the prosthetic reconstruction has been delayed. The scar tissue forms and the soft tissue becomes stiff, causing severe deviation in the mandible towards the resected side. This case report presents a58year old male patient who underwent a mandibular resection surgery after he was diagnosed with buccal mucosa carcinoma. The patient had mandibular deviation and deranged occlusion making his speech, mastication and esthetics compromised.: The patient was provided with a cast guide flange prosthesis in the beginning as a training device to prevent the scar contracture and increase the mandibular movement towards healthy side to increase the intercuspation. After few months of training, when the deviation was reduced, flexible maxillary and mandibular partial dentures were fabricated with double occlusion in the maxillary denture to increase the masticatory efficiency of the patient.This case report attempts to formulate a treatment plan whereby the patient's discomfort could be minimized. The treatment starts with the fabrication of a removable guide flange as a physical therapy device to reduce the mandibular deviation followed by provision of a maxillary denture with double occlusion to obtain maximum intercuspation.The mandibulectomy patient is difficult to manage because a prosthodontist is limited in his ability to provide a reasonable and practical prosthesis. However, if the patients recognize the limitations of their rehabilitation, they would be more appreciative of the prosthodontic therapy that enhances their rehabilitative progress.

Evaluation of the effectiveness and practicality of erbium lasers for ceramic restoration removal: A retrospective clinical analysis

Background The purpose of this study was to assess the effectiveness and practicality of erbium lasers in the removal of ceramic restorations and appliances from natural teeth and dental implant abutments in clinical practice. Methods A retrospective analysis was conducted, involving 29 clinical cases with a total of 52 abutments requiring the removal of various ceramic restorations. The analysis evaluated the clinical procedures performed, including the type and material of the prosthetic, the type of cement used, laser setting parameters, retrieval time, and retrieval success. Results Out of the 52 abutments, 50 were successfully retrieved without causing any damage (&gt;95%) using either an Er,Cr:YSGG laser (N = 6) or an Er:YAG laser (N = 46). In one case, a crown was partially sectioned to prevent any negative impact of laser irradiation on the adhesive strength between the post and tooth, and in another case, a fracture occurred during debonding. The restorations consisted of 13 lithium disilicate and 39 zirconia units, including six veneers, 38 single crowns, and three fixed partial dentures (FPDs). The retrieval time varied depending on the restoration type, material thickness, cement type, retention form/fitting of the abutment and restoration, ranging from 2.25 ±0.61 minutes for veneers, 6.89 ±8.07 minutes for crowns, to 25 ±10 minutes per abutment for FPDs. Removal of a zirconia crown required more time, 7.12±8.91 minutes, compared to a lithium disilicate crown, 5.86 ±2.41 minutes. The debonding time was influenced by the laser settings as well as materials and types of prosthesis. Conclusions Erbium lasers present a safe and effective alternative to invasive methods for removing ceramic restorations, without causing harm to the abutment or prosthesis. Laser-assisted debonding allows for recementation of the restorations during the same appointment, making it a conservative and viable option for ceramic crown retrieval in clinical settings.

Long-term results (after a mean 11.3 years, and up to 22 years, of follow-up) of the Legacy Constrained Condylar Knee (LCCK™) in primary total knee arthroplasty

IntroductionThe use of a sliding prosthesis in total knee arthroplasty (TKA) with increased stress is an intermediate solution in primary surgery, between posteriorly stabilized prostheses and hinged prostheses, in cases of ligamentous laxity and/or loss of bone substance. Favorable results have been reported in the medium term but to our knowledge, this type of prosthesis has not been evaluated in Europe beyond 10 years of follow-up. We therefore conducted a retrospective study in order to carry out: 1) the study of the survival of the Legacy Constrained Condylar Knee (LCCK™) prosthesis in primary surgery, 2) the analysis of complications, functional scores and radiographic data, 3) the analysis of the link between the diaphyseal filling rate and prosthetic loosening. HypothesisThe LCCK™ sliding prosthesis with increased constraint has equivalent long-term survival and clinical results to standard posteriorly stabilized TKA and superior to hinged TKA. Material and methodA retrospective series of 141 LCCK™ implanted in 134 patients between 1997 and 2010 was analyzed. Survival was assessed with censoring through an evaluation of partial or total revision of the implants. The functional results were evaluated using the IKS and Oxford 12 scores. Data regarding the Canal Fill Ratio (CFR) and the presence of pathological periprosthetic lines were also collected. ResultsThe average follow-up was 11.3±5.3years with a maximum follow-up of 22.7years. Survival at 20years was 90.8% [95% CI: 83.7–95.7]. The rate of early complications was 13.5% (19/141), predominantly comprised of venous thrombosis (6/141), hematomas (3/141 including two requiring surgical drainage), stiffness (3/141) and early infections (3/141). The rate of late complications was 17% (24/141), led by stiffness (4.4%; 6/141), infections (2.9%; 4/141) and hardware failure (2. 2%; 3/141). Ten of the 141 patients (7.1%) had LCCK failure, including 3 (2.1%) for stiffness, 3 (2.1%) for hardware failure, 2 (1.4%) for infection, 1 (0.7%) for laxity and 1 (0.7%) for a periprosthetic fracture. No aseptic loosening was found. The total IKS score went from 65 [0–116] to 143 [79–200] at follow-up, the IKS knee score went from 30 [0–66] to 85 [44–100], and the IKS function score went from 35 [0–70] to 57 [0–100]. The Oxford score went from 14 [2–25] to 34 [15–48] at follow-up. Only two patients (1.4%) presented with a partial periprosthetic line. The tibial CFR was 0.81 and the femoral CFR was 0.76. The influence of the CFR could not be analyzed due to the absence of loosening. DiscussionThe LCCK™ prosthesis in primary surgery has good medium-term survival, a significant improvement in functional scores and a complication rate comparable to posteriorly stabilized prostheses. The complication rate is lower than that of hinged prostheses. Level of evidenceIV; single-center retrospective study.

Results of a study of zinc-phosphate cements for fixation of fixed orthopedic structures under the influence of material hardening time

Patients often prefer non-removable prosthesis designs to replace dental row defects, given their undeniable benefits. However, there is a possibility of developing complications during prosthetics, it is impossible to completely exclude medical errors and errors of the dental technician.&#x0D; Dentists know that in 20% of cases, prosthetics with non-removable types of prostheses end unsuccessfully due to errors in treatment, as well as improper use of fixing cements at the stage of storing the prosthesis. About 20% of cases are complications in the near future after prosthetics during the operation of the prosthesis. The proportion of complications due to carious tooth damage under prostheses can reach more than 49%.&#x0D; Non-removable prostheses, firmly fixed by zinc-phosphate cements, gain a number of advantages by choosing this particular material: a slight percentage of shrinkage; low percent solubility; increased strength; creation of a holding layer between tissues of the oral cavity and a selected type of prosthesis.&#x0D; Our study is devoted to the issues of assessing the most significant qualities of fixing cements, which is of great practical importance.

Design of 3D-printed prostheses for reconstruction of periacetabular bone tumors using topology optimization.

Background: Prostheses for the reconstruction of periacetabular bone tumors are prone to instigate stress shielding. The purpose of this study is to design 3D-printed prostheses with topology optimization (TO) for the reconstruction of periacetabular bone tumors and to add porous structures to reduce stress shielding and facilitate integration between prostheses and host bone. Methods: Utilizing patient CT data, we constructed a finite element analysis (FEA) model. Subsequent phases encompassed carrying out TO on the designated area, utilizing the solid isotropic material penalization model (SIMP), and this optimized removal area was replaced with a porous structure. Further analyses included preoperative FEA simulations to comparatively evaluate parameters, including maximum stress, stress distribution, strain energy density (SED), and the relative micromotion of prostheses before and after TO. Furthermore, FEA based on patients' postoperative CT data was conducted again to assess the potential risk of stress shielding subsequent to implantation. Ultimately, preliminary follow-up findings from two patients were documented. Results: In both prostheses, the SED before and after TO increased by 143.61% (from 0.10322 to 0.25145mJ/mm3) and 35.050% (from 0.30964 to 0.41817mJ/mm3) respectively, showing significant differences (p < 0.001). The peak stress in the Type II prosthesis decreased by 10.494% (from 77.227 to 69.123MPa), while there was no significant change in peak stress for the Type I prosthesis. There were no significant changes in stress distribution or the proportion of regions with micromotion less than 28μm before and after TO for either prosthesis. Postoperative FEA verified results showed that the stress in the pelvis and prostheses remained at relatively low levels. The results of follow-up showed that the patients had successful osseointegration and their MSTS scores at the 12thmonth after surgery were both 100%. Conclusion: These two types of 3D-printed porous prostheses using TO for periacetabular bone tumor reconstruction offer advantages over traditional prostheses by reducing stress shielding and promoting osseointegration, while maintaining the original stiffness of the prosthesis. Furthermore, in vivo experiments show that these prostheses meet the requirements for daily activities of patients. This study provides a valuable reference for the design of future periacetabular bone tumor reconstruction prostheses.

Outcomes after bioprosthetic versus mechanical mitral valve replacement for infective endocarditis in the United States

ObjectiveIn patients who underwent mitral valve replacement for infectious endocarditis, we evaluated the association of prosthesis choice with readmission rates and causes (the primary outcomes), as well as with in-hospital mortality, cost, and length of stay (the secondary outcomes). MethodsPatients with infectious endocarditis who underwent isolated mitral valve replacement from January 2016 to December 2018 were identified in the United States Nationwide Readmissions Database and stratified by valve type. Propensity score matching was used to compare adjusted outcomes. ResultsA weighted total of 4206 patients with infectious endocarditis underwent bioprosthetic mitral valve replacement (n = 3132) and mechanical mitral valve replacement (n = 1074) during the study period. Patients in the bioprosthetic mitral valve replacement group were older than those in the mechanical mitral valve replacement group (median 57 vs 46 y, P < .001). After propensity matching, the bioprosthetic mitral valve replacement group (n = 1068) had similar in-hospital mortality, length of stay, and costs compared with the mechanical mitral valve replacement group (n = 1056). Overall, 90-day readmission rates were high (28.9%) and comparable for bioprosthetic mitral valve replacement (30.5%) and mechanical mitral valve replacement (27.5%, P = .4). Likewise, there was no difference in readmissions over a calendar year by prosthesis type. Readmissions for infection and bleeding were common for both bioprosthetic mitral valve replacement and mechanical mitral valve replacement groups. ConclusionsOutcomes and readmission rates were similar for mechanical mitral valve replacement and bioprosthetic mitral valve replacement in infectious endocarditis, suggesting that valve choice should not be determined by endocarditis status. Additionally, strategies to mitigate readmission for infection and bleeding are needed for both groups.

Conventional maxillary denture versus maxillary implant-supported overdenture opposing mandibular implant-supported overdenture: Patient's satisfaction.

This study sought to determine the impact of age, gender, and use of maxillary implant-supported overdenture (UISOD) versus conventional denture (CMD) opposing mandibular implant-supported overdenture (LISOD) and the number of years the patient has used their prosthesis on the ratings of satisfaction. This study aimed to assess the long-term influence of different factors on patients'satisfaction with LISODs needing a maxillary prosthesis, helping dentists choose a treatment pathway that leads to a higher satisfaction rate. This cross-sectional study included 84 participants. They were treated with LISOD opposing either CMD or UISOD from 2015 to 2020. They were all eligible to participate in the study. An oral health impact profile (OHIP-14) questionnaire was given to each patient and filled out by them. OHIP-14 scores were gathered and went under statistical analysis with PASS-11 software to determine the relationship between patients'satisfaction with the scores. Age and gender had no significant influence on how satisfied patients were. Patients with maxillary overdentures showed more satisfaction than the CMD group (p < .05). Moreover, patients'satisfaction decreased with increasing years of prostheses usage (p < .05). This study demonstrated that satisfaction is related to the type of maxillary prosthesis (conventional or implant-supported) used opposing LISODs and the number of years the patient had used the prostheses.

Chest wall reconstruction, prosthesis and allografts: a narrative review.

What is the best material in the case of prosthesis used to replace major chest wall resection is still unknown. We reviewed most significant literature focused on the type of prosthetic materials available by highlighting their relative pros and cons. We reviewed most significant articles, including clinical results of relevant case series (retrospective studies), published in English in the last 23 years: PubMed, Embase and Scopus databases were used in our search in the period between the 1st January 1999 and 31st December 2022. Overall, our literature review revealed lack of uniformity or conformity in the surgical strategies described for chest wall reconstruction with no internationally accepted standard in terms of decisions and optimal prosthetic materials and type of prostheses (soft, rigid, biological). Despite the increased interest in chest wall reconstruction, we observed a general lack of substantial prospective and multicentric studies. Likewise, there are not substantial data which may guide to the choice of optimal prosthetics in terms of characteristics and biocompatibility. A variety of materials are available for reconstruction, including synthetic and biological meshes, flexible and rigid patches, and metal osteosynthesis systems. The material chosen should be optimized to each patient and damaged tissues to be restored. Prospective and multicentric studies are necessary to address current limits in this surgical field.

Evidence-based frozen elephant trunk practice: a narrative review.

The frozen elephant trunk (FET) allows a single-stage repair of complex arch pathologies due to its stented and non-stented hybrid prosthesis (HP) features. FET inherently has its own related complications including distal stent graft-induced new entry (dSINE), failure of aortic remodelling, endoleak, reintervention, and kinking of the stent. The aim of this narrative review is to discuss the latest evidence regarding the postoperative clinical outcomes of the FET procedure. Another aim is to provide an overview of results achieved using different FET devices on the global arch prostheses market. A comprehensive literature search was conducted using multiple electronic databases to identify and extract the relevant data and information. This review found that the literature reported a 5-12% mortality rate post-FET, with varying figures depending on the prosthesis type. Between 0-18.2% of patients developed dSINE, while 0.1-28% developed endoleak. Reintervention occurred in 0-28% of patients and the incidence of kinking has been quoted between 0-8% in the literature. Reporting aortic remodelling rates was challenging due to the lack of standardisation and various measurements reported; however, all studies included in this review reported relative increase in true lumen diameter, reduction in the false lumen diameter, and/or false lumen thrombosis. In conclusion, FET can achieve a favourable postoperative profile in terms of survival, complications and aortic remodelling, and remains the gold-standard treatment for thoracic aortic pathologies implicating the arch and descending thoracic aorta.

Cusp-overlap view reduces conduction disturbances and permanent pacemaker implantation after transcatheter aortic valve replacement even with balloon-expandable and mechanically-expandable heart valves.

Conduction disturbances demanding permanent pacemaker implantation (PPI) remain a common complication after transcatheter aortic valve replacement (TAVR). Optimization of the implantation depth (ID) by introducing the cusp-overlap projection (COP) technique led to a reduced rate of PPI when self-expanding valves were used. The aim of the present study was to determine if using the novel COP view is applicable for all types of TAVR prosthesis and results in a higher ID and reduced incidence of new conduction disturbances and PPI. In this prospective case-control study 586 consecutive patients undergoing TAVR with either balloon-expandable Edwards SAPIEN S3 (n = 280; 47.8%), or mechanically expandable Boston LOTUS Edge heart valve prostheses (n = 306; 52.2%) were included. ID as well as rates of periprocedural PPI and left bundle branch block (LBBB) were compared between the conventional three-cusp coplanar (TCC) projection and the COP view for implantation. Of 586 patients, 282 (48.1%) underwent TAVR using COP, whereas in 304 patients (51.9%) the TCC view was applied. Using COP a significantly higher ID was achieved in Edwards SAPIEN S3 TAVR procedures (ID mean difference -1.0 mm, 95%-CI -1.9 to -0.1 mm; P = 0.029), whereas the final platform position did not differ significantly between both techniques when a Boston LOTUS Edge valve was used (ID mean difference -0.1 mm, 95%-CI -1.1 to +0.9 mm; P = 0.890). In Edwards SAPIEN S3 valves, higher ID was associated with a numerically lower post-procedural PPI incidence (4.9% vs. 7.3%; P = 0.464). Moreover, ID was significantly deeper in patients requiring PPI post TAVR compared to those without PPI [8.7 mm (6.8-10.6 mm) vs. 6.5 mm (6.1-7.0 mm); P = 0.005]. In Boston LOTUS Edge devices, COP view significantly decreased the incidence of LBBB post procedure (28.1% vs. 47.9%; P < 0.001), while PPI rates were similar in both groups (21.6% vs. 25.7%; P = 0.396). The present study demonstrates the safety, efficacy and reproducibility of the cusp-overlap view even in balloon-expandable and mechanically-expandable TAVR procedures. Application of COP leads to significantly less LBBB in repositionable Boston LOTUS Edge valves and a numerically lower PPI rate in Edwards SAPIEN S3 valves post TAVR compared to the standard TCC projection. The results should encourage to apply the COP view more widely in clinical practice.