Prosthetic Rehabilitation Of Patient Research Articles

Airway Management of a Patient with an Acute Floor of the Mouth Hematoma after Dental Implant Surgery in the Lower Jaw

BackgroundOver the last decades, dental implants have become increasingly popular in the prosthetic rehabilitation of patients. This has subsequently led to an increase of perioperative complications. Obstruction of the airway as a result of a floor of mouth hematoma after dental implant surgery is a rare but life-threatening complication. Case ReportA 62-year-old man presented to the emergency department with a compromised airway caused by a hematoma in the floor of the mouth that occurred during dental implant surgery in the edentulous anterior mandible. Computed tomography angiography images revealed an elevation of the floor of mouth with subsequent occlusion of the airway. In addition, a perforation of the lingual mandibular cortical plate was observed that was caused by two malpositioned dental implants. Awake fiberoptic intubation was immediately performed, the two malpositioned dental implants were subsequently removed, and the patient was extubated after 3 days. Why Should an Emergency Physician Be Aware of This?Perforation of the lingual mandibular cortical plate during dental implant surgery can lead to life-threatening bleeding in the floor of the mouth. This condition can be successfully treated by awake fiberoptic intubation and, if necessary, the malpositioned dental implants can be subsequently removed.

Impact of radiotherapy on implant-based prosthetic rehabilitation in patients with head and neck cancer: A prospective observational study on implant survival and quality of life-Preliminary results.

To study implant-based prosthetic rehabilitation of head and neck cancer patients with focus on implant survival and quality of life. The prospective observational study presents preliminary results of 29 edentulous head neck cancer patients (20 patients after radiotherapy) with 165 OsseoSpeed implants. Implant success after 1-year follow-up was evaluated by means of the Albrektsson criteria. Quality of life was analysed with the EORTC QLQ-C30, QLQ-H&N35, and OHIP 14 questionnaires. The overall implant survival rate after 1 year was 95.2% (157/165). Implant success measured by the Albrektsson criteria showed a lower success rate of 86.7% (143/165), mainly because of peri-implant marginal bone loss with a mean of 0.8mm after 1 year. Xerostomia (p=0.008), implant insertion within the radiation target volume (p=0.09), implantation in transplanted bone (p=0.05), and smoking (p=0.041) were the main reasons for implant failure, followed by D4 bone quality, maxillary implant site, and insufficient primary stability. Speaking, swallowing, eating, as well as social integration and individual self-confidence had considerably improved 1 year after denture placement compared to before treatment. Implant-based prosthetic rehabilitation of head and neck cancer patients is possible at a calculable risk and significantly improves patients' quality of life.

Results of prosthetic rehabilitation on managing transtibial vascular amputation with silicone liner after wound closure.

ObjectiveTo investigate the effect of a standardized silicone liner programme on the duration of prosthetic rehabilitation in patients who underwent transtibial amputation as a result of peripheral arterial disease.MethodsThis retrospective study enrolled patients who underwent transtibial amputation followed by one of two stump management programmes at the same rehabilitation centre over a period of 14 years. The study compared the duration of rehabilitation following a standardized silicone liner programme compared with that following a conventional soft dressing programme.ResultsThis study included 16 patients who underwent the silicone liner programme and 11 patients who underwent the soft dressing programme. There were no significant differences between the two groups in age, sex, interval between amputation and admission to the rehabilitation centre and stump length. The duration required for the completion of the rehabilitation programme was significantly shorter for the silicone liner programme compared with the soft dressing programme (mean ± SD: 77.3 days ± 13.4 versus 125.4 days ± 66.4 days, respectively).ConclusionA standardized silicone liner programme reduced the duration of rehabilitation and could be a valuable replacement for soft dressing-based stump management.

The Management of Patients after Surgical Treatment of Maxillofacial Tumors.

Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3.44%); loss of face tissues and surgery in other locations in the head and neck region (3.44%). The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients' return to their prior living situation, occupational and family lives.

Oral health-related quality of life after prosthetic rehabilitation in patients with oral cancer: A longitudinal study with the Liverpool Oral Rehabilitation Questionnaire version 3 and Oral Health Impact Profile-14 questionnaire.

Prosthodontic rehabilitation helps to improve the oral health-related quality of life (OHRQOL). The Liverpool Oral Rehabilitation Questionnaire (LORQ) and Oral Health Impact Profile (OHIP) are specific tools that measure OHRQOL. The primary objective of this study was to assess the impact of oral rehabilitation on patients' OHRQOL following treatment for cancer of oral cavity using LORQ version 3 (LORQv3) and OHIP-14 questionnaire. Secondary objectives were to identify issues specific to oral rehabilitation, patients compliance to prosthetic rehabilitation, the effect of radiation treatment on prosthetic rehabilitation, to achieve meaningful differences over a time before & after prosthetic intervention, to carryout and document specific patient-deprived problem. Seventy-five oral cancer patients were studied. Patients were asked to rate their experience of dental problems before fabrication of prosthesis and after 1 year using LORQv3 and OHIP-14. The responses were compared on Likert scale. Patients reported with extreme problems before rehabilitation. After 1 year of prosthetic rehabilitation, there was improvement noticed in all the domain of LORQv3 and OHIP-14. Complete compliance to the use of prosthetic appliances for 1 year study period was noted. In response to the question no. 40 (LORQv3), only 15 patients who belonged to the obturator group, brought to notice the problems which were not addressed in the LORQv3 questionnaire. The study showed that the oral cancer patients coped well and adapted to near normal oral status after prosthetic rehabilitation. This contributed to the improved overall health-related quality of life.

Réhabilitation implanto-portée des patients porteurs de fentes labio-alvéolo-palatines : étude rétrospective sur 43 patients

Implant-borne rehabilitation in cleft lip and palate patient are aimed to allow for good orofacial functions, stable occlusion, and adequate support for the naso-labial region. The goal of our study was to evaluate the functional and esthetic results of the implant-born dental rehabilitation of the cleft lip and palate patients in our department. Our retrospective study concerned patients operated between 1995 and 2010 in our department. All included patients suffered from a cleft alveolus and lip, with or without cleft palate. Dental implants were placed in the bone-grafted alveolus and the end of growth and at distance from the bone graft procedure. Criteria of implant survival and implant-borne rehabilitation success were defined. A total of 78 implants were placed in 43 patients between 1995 and 2010. Two implants were lost (implant survival rate: 97.4%). Despite this loss, all the patients could be rehabilitated with good functional and esthetic results. Implant-borne rehabilitation is a reliable solution for prosthetic rehabilitation in patients with cleft lip and palate. This solution allows for avoiding removable prosthesis and dental mutilation.

Rehabilitation of a complete maxillectomy patient: A case report of osteomyelitis of maxilla

Osteomyelitis of the jaws is osteomyelitis (which is inflammation of the bone marrow, sometimes abbreviated to OM) which occurs in the bones of the jaws (i.e. maxilla or the mandible). Historically, osteomyelitis of the jaws was a common complication of odontogenic infection (infections of the teeth). Before the antibiotic era, it was frequently a fatal condition. Today osteomyelitis of facial bones is a rare condition. Maxillary osteomyelitis is rare compared to mandible osteomyelitis because extensive blood supply & strut like bone of the maxilla make it less prone to chronic infection. We report a rare case of Osteomyelitis involving whole of the Maxilla in a 63 year old male patient, diabetic and hypertensive for the past 2 years. He presented to us with anpalatally exposed bone with offensive odour from the nose. Examination revealed a necrotic maxilla involving whole hard palate. A computerized tomography scan confirmed Osteomyelitis of whole Maxilla. Patient underwent complete surgical excision with prosthesis reconstruction. Prosthetic rehabilitation of patients with acquired defects of the maxilla present a challenging task because of inadequate retention and stability of prosthesis and these goals are even more challenging in a complete maxillectomy case. This case report describes the fabrication of prosthesis utilizing soft tissue undercuts for retention using soft liners as one technique and fabrication of a two piece prosthesis utilizing magnets to meet the goals.

Prosthetic rehabilitation in patient treated for oropharingeal carcinoma

Prosthetic rehabilitation in patient treated for oropharingeal carcinoma

Prosthetic Rehabilitation of Patients After Surgical Treatment of Maxillary Tumors with Respect to Upper Airway Protection.

As a consequence of surgical treatment of maxillary tumors, a connection between oral and nasal cavities is formed, which leads to serious functional disorders, manifested by inability to normally ingest food, proper speech articulation, and to respiratory route disorders and upper airway inflammation. These morphological and functional disorders are intensified by adjunctive radio- or chemotherapy. The aim of this paper is to present different possible methods of rehabilitation, including application of interim obturators and individually planned prosthetic restorations to improve respiratory efficiency in patients after extensive maxillary resections. In the course of prosthetic treatment, cooperation with the laryngologist to consider every aspect of chronic paranasal sinusitis, accompanied by concurrent inflammation of oral, nasal, or laryngeal mucous membranes, was of paramount importance. Based on the quality of life questionnaire, used in this study, evident improvement in the masticatory efficiency, speech articulation, and respiration was observed. Particularly good effects were obtained in edentulous patients, in whom implant-prosthetic treatment was possible to apply. Comprehensive and multidisciplinary care of postoperative patients greatly contributes to their better quality of life and facilitates their return to prior living conditions, as well as to occupational and family lives.

Rehabilitation of an edentulous mouth with severe mandibular ridge resorption using neutral zone impression technique: a case report

Alveolar ridge atrophy poses a clinical challenge towards the fabrication of a successful prosthesis. Resorption of denture bearing areas results in an unstable non-retentive dentures associated with pain and discomfort. Prosthetic Rehabilitation of a patient with severely resorbed ridge is the most challenging therapy a prosthodontist can undertake. For a favourable prognosis of the denture therapy, impression technique selected should be based on the present state of the basal tissue support. This article presents rehabilitation of a patient with severely resorbed mandibular ridge with the application of neutral zone concept being incorporated into impression making in an effort to achieve successful complete denture therapy. Finally, patient had more stable, retentive and functionally efficient complete denture. In conclusion, neutral zone impression technique proved to be a quite effective method for prosthetic rehabilitation of patient with severe mandibular ridge resorption. DOI: http://dx.doi.org/10.3329/bjms.v13i4.15605 Bangladesh Journal of Medical Science Vol.13(4) 2014 p.477-480

Prosthetic rehabilitation of patient with maxillofacial defect by hollow bulb obturator

Introduction: Post-surgical maxillary defect is mostly repaired by the use of an obturator, which is often quite heavy due to the extension into the defect that is better relieved by making it hollow. Objective: To fabricate hollow bulb obturator in simple way. Case: An 85 year old man was referred from ENT department after hemimaxillectomy to remove squamous cell carcinoma, for obturator prosthesis and was treated with hollow bulb obturator prosthesis. Conclusion: The hollow bulb reduces the weight of prosthesis making is comfortable for the patient. DOI: http://dx.doi.org/10.3126/hren.v11i3.9656 Health Renaissance 2013;11(3):284-286

Prosthetic rehabilitation of patients with maxillary defects in a nigerian tertiary hospital.

Background:Maxillary defects are managed by prosthodontic rehabilitation using obturators. This rehabilitation goes through various stages, which invariably affects the quality-of-life of the patients.Aim:This study aims to analyze the types and design of obturators used in the rehabilitation of maxillary defects at a tertiary health institution in Nigeria.Materials and Methods:This is a retrospective study of all patients with maxillary defects treated at a tertiary institution between the period of October 2010 and May 2013. The data of interest collected from the patient's register and case notes include age, gender, type of defects, design of obturators and conditions for which treatment was offered. The collected data were analyzed using Statistical Package for Social Sciences version 16.0 (Chicago, Illinois, 2010) and result presented in frequencies and tables.Results:A total of 19 case notes were retrieved. The age range was 5-73 years with the mean age of 46.37 ± 19.02 and peak age incidence at 41-60 years. The male: female ratio was 1:1.4. Surgical defects were the most common type of maxillary defects seen; accounting for 89.5% (17/19) of the cases, which were mostly associated with malignant tumors. Immediate surgical obturators were provided for 63.2% (12/19) of the subjects. Majority 70.6% (12/17) of those with surgical defects received immediate surgical obturators while all those with congenital defect were given feeding plate. There was a statistically significant association between the type of maxillary defect and type of obturator provided (P < 0.01).Conclusion:The results of this study suggest that majority of the obturators fabricated for patients with maxillary defect at the Tertiary health institution in Nigeria were immediate surgical obturators. Pre-surgical patient education and follow-up care is advocated.

Microecology of the oral mucosa at the stage of prosthetic rehabilitation in patients with acquired defects of maxilla

The morbidity of malignant neoplasms of the maxillofacial area has an annual constant increase. Surgical treatment is one of the therapy versions. The acquired defect is the result of such treatment, which also requires the reconstructive and prosthetic treatment. Production of a hollow acrylic obturator is widespread and available option of prosthetic rehabilitation after resection of maxilla. One of this treatment characteristic is the large contact area of the obturator surface to the oral cavity mucosa, and the sutural connection on the basis. This connection is a cluster of food remainders and pathogenic microflora of the oral cavity. The oral cavity mucosa is the primary place of contact not only with the aggressive elements of dental engineering materials, antigens, but also to waste products of microorganisms, which are located on prosthetic constructions. The sutural connection requires additional hygienic measures to clean the obturator for the patient. Thus, acrylic hollow obturator with sutural connection substantially reduces the level of hygiene in this patients group and promotes the accumulation of aggressive microorganisms. After prosthetic rehabilitation it can result to damage of oral microbiocenosis and development of inflammatory accidents. We developed a processing technique of a hollow obturator without sutural connection on the basis.

Prosthetic rehabilitation of patients with history of moderate to severe periodontitis: a long‐term evaluation

Long-term outcomes of conservative periodontal and prosthetic treatment of patients with moderate to severe periodontitis were to be evaluated. Groups of younger (YG) and middle-aged patients (MG) were to be compared regarding survival of fixed and removable dental prostheses (FDP, RDP) inserted after active periodontal therapy (APT). In addition, functional-occlusal status over more than 10years of supportive periodontal therapy (SPT) was analysed. The present multi-case-series retrospectively analysed data of 68 patients (34 YG and 34 MG) who had received APT and regular SPT ≥10years. Tooth loss, occlusal status and survival and complications of prosthetics were evaluated descriptively and comparatively (t-test). There was no statistical difference between YG and MG concerning tooth loss/year (p>0.05). Functional-occlusal status was retained during SPT in 75% and 69% of YG and MG. Restorations inserted after APT showed high survival for both age groups (100%). Mean survival time until the last SPT visit was 15.2 and 11.6years for FDP and RDP in YG, and 12.5 and 13.1years in MG. Prosthetic restorations in both younger and middle-aged patients with severe periodontitis showed high survival, if pre-prosthetic APT and regular SPT had been performed.

Prosthodontic Management of a Completely Edentulous Patient with Microstomia: A Case Report

Patients with microstomia who need to wear removable dental prosthesis often face difficulty of being unable to insert or remove the prosthesis because of restricted opening of the oral cavity. Prosthetic rehabilitation of patients with microstomia presents difficulties in all the clinical steps. In such patients, it is difficult to make impressions and fabricate dentures using conventional method. This clinical report describes prosthodontic management of a completely edentulous patient with microstomia developed due to oral sub mucous fibrosis. Sectional maxillary denture was fabricated using a sectional impression tray technique. With the use of magnets and palatal midline press button attachment, the denture could be easily inserted and removed in two parts. Mandibular denture was fabricated by the conventional method.

Influence of crown–implant ratio on implant success rates and crestal bone levels: a 36‐month follow‐up prospective study

The aim of this prospective study was to determine how the crown-implant ratio (C/I ratio) influences crestal bone loss and implant success rates after a 3-year follow-up, using implants with a sintered porous surface (SPS). On the basis of preestablished inclusion and exclusion criteria, 151 of a cohort of 160 patients with single or partial edentulism were selected as eligible for the study. The 151 patients were treated consecutively from 2005 to 2007 using 280 SPS implants, which were restored with a single crown or a partial fixed denture. The data collection included both clinical and anatomical C/I ratios; other implant prosthetic factors were also recorded. Implants were divided into three groups according to the C/I ratio. Clinical and radiographic examinations were scheduled over a 36-month follow-up of functional loading according to a well-established protocol generally applied to determine implant success rates and crestal bone levels. Statistical analysis was used to determine any significant differences or correlations (P = 0.05). A total of 259 SPS implants in 136 patients were followed up for 36 months. According to the success criteria, the overall implant-based success rate was 98.1%, and the mean peri-implant bone loss (PBL) was 0.48 ± 0.29 mm. Statistical analysis revealed significant correlation between implant success rate and C/I ratio (P < 0.05) and between PBL and C/I ratio (P < 0.05). The critical threshold value of the anatomical and clinical C/I ratio for avoiding excessive bone loss or implant failure was 3.10 and 3.40. This prospective cohort study revealed that SPS implants offer a predictable solution for implant prosthetic rehabilitation in patients with edentulism characterized by different alveolar bone atrophy. From the biomechanical point of view, the C/I ratio would appear to be the main parameter capable of influencing implant success and crestal bone loss. Consequently, it is important not to exceed the threshold values in order to avoid excessive stress at the bone-implant interface capable of resulting in excessive crestal bone loss or implant failure.

Prosthetic Rehabilitation of Patient with Ocular Defect using Acrylic Stock Eyes

ABSTRACT The science and art employed in the profession of dentistry can play an important role in the fabrication of an orbital prosthesis. Anophthalmia (the loss of an eye) not only impairs patient's vision but also create a noticeable deformity on facial appearance and esthetics. The condition is a psychological distress for the patient interrupting his routine work. A prosthodontist as an integral member of the craniofacial rehabilitation team can help raise the spirits and ease the mind of the affected. Mutilation of a portion of a face can cause a heavy impact on the self image and personality of an individual. Acceptable cosmetic results usually can be obtained with a orbital prosthesis. This paper describes prosthetic rehabilitation of a 30-year-old female patient having a left and right ocular defect. A technique to modify stock eye with heat polymerizing polymethyl methacrylate is illustrated. The resultant prosthesis was structurally durable and esthetically acceptable with satisfactory retention. The importance of meticulous treatment planning to tackle the challenges faced in fabricating an ocular prosthesis is explained with the relevant literature. How to cite this article Venkatakrishnan CJ, Jain AR, Pradeep R, Philip JM, Narasimman M. Prosthetic Rehabilitation of Patient with Ocular Defect using Acrylic Stock Eyes. Int J Prosthodont Restor Dent 2013;3(4):143-147.

Prosthetic rehabilitation of patient after maxilla resection due to neoplasm – case report

Prosthetic rehabilitation of patient after maxilla resection due to neoplasm – case report

Effects of hyperbaric oxygenation on prosthetic rehabilitation of patients with unilateral lower limb amputation

Objective. Hyperbaric oxygen (HBO) has been widely used in people with diseases that cause limb amputation but studies that target patients who underwent amputation itself are rare. The aim of our study was to investigate the effects of HBO on prosthetic rehabilitation in patients with unilateral lower limb amputation. Methods. The study included 60 patients with unilateral (left or right side) lower limb amputation, mean age 61.6 ± 11.5 years, of both genders. They were divided into two groups, the experimental group (with HBO) and the control group (usual care). Patients' functional skills after amputation were evaluated using the LCI test (Locomotor Capabilities Index) and with the classification of Narang and Pohjolainen. Results. Clinical characteristics of patients had relatively homogeneous distribution. After the therapy, a control measurement of both groups showed significantly higher values for LCI test (p <0.01) and lower values for Narang score (p <0.01). However, improvements were more prominent in the group of patients who underwent HBO therapy, therefore, these subjects in the control measurements were evaluated with a statistically significant lower Narang score (p <0.05) and had higher LCI score than the control group patients. Conclusion. HBO is a useful therapeutic measure in the rehabilitation of people with limb amputation who use prosthetic limbs.

The Ti-Epiplating System as an Alternative for Ear Prostheses in Burned Patients

Burned ear reconstruction remains one of the most difficult areas of plastic surgery, and the aesthetic results are not always acceptable. In this study, the authors describe the results of the prosthetic rehabilitation of patients needing burned ear total reconstruction with a plate-like system (Titanium Epiplating System, Medicon, Tuttlingen, Germany) treated in their hospital between 2006 and 2009. The goals of this study were to report on the use of bone anchor implants with a plate-like system for total ear reconstruction in burned patients, to analyze treatment outcomes, and to discuss important clinical variables encountered during treatment, as well as to determine criteria for success in the implants and prostheses. Two case reports are presented, and treatment outcomes have been analyzed. In both patients, implants became anchored, and neither demonstrated failure during the study period. The cosmetic results and patient acceptance were very satisfactory, with no postoperative complications. The plate-like system for the treatment of auricle burns is an acceptable technique that complements traditional reconstructive procedures.