Temporary Prosthesis Research Articles

WITHDRAWN: Interventions for replacing missing teeth: 1- versus 2-stage implant placement.

Implants may be placed penetrating the oral mucosa (1-stage procedure) or can be completely buried under the oral mucosa (2-stage procedure) during the healing phase of the bone at the implant surface. With a 2-stage procedure the risk of having unwanted loading onto the implants is minimized, but a second minor surgical intervention is needed to connect the healing abutments and more time is needed prior to start the prosthetic phase because of the wound-healing period required in relation to the second surgical intervention. To evaluate whether a 1-stage implant placement procedure is as effective as a 2-stage procedure. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching included several dental journals. Authors of all identified trials, an Internet discussion group and 55 dental implant manufacturers were contacted to find unpublished randomised controlled trials (RCTs). The last electronic search was conducted on 21 January 2009. All RCTs of osseointegrated dental implants comparing the same dental implants placed according to 1- versus 2-stage procedures with a minimum follow up of 6 months after loading. Outcome measures were: prosthesis failures, implant failures, marginal bone level changes on intraoral radiographs, patient preference including aesthetics, aesthetics evaluated by dentists, and complications. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Authors were contacted for missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Five RCTs were identified and included reporting data on 239 patients in total. On a patient, rather than per implant basis, the meta-analyses showed no statistically significant differences for prosthesis and implant failures, though trends, especially in fully edentulous patients, favoured 2-stage (submerged) implants. The number of patients included in the trials was too small to draw definitive conclusions. The 1-stage approach might be preferable in partially edentulous patients since it avoids one surgical intervention and shortens treatment times, while a 2-stage submerged approach could be indicated when an implant has not obtained an optimal primary stability or when barriers are used for guided tissue regeneration, or when it is expected that removable temporary prostheses could transmit excessive forces on the penetrating abutments especially in fully edentulous patients.

Assessment of a Novel Computer Algorithm for Printing a 3-Dimensional Nasal Prosthetic

ImportanceThe introduction and evaluation of a novel technique to create nasal prostheses with 3-dimensional (3-D) imaging software may circumvent the need for an anaplastologist.ObjectivesTo describe a novel computer algorithm for the creation of a 3-D model of a nose and to evaluate the similarity of appearance of the nasal prosthesis with that of the individual’s nose.Design, Setting, and ParticipantsA prospective pilot study with a cross-sectional survey was conducted from August 1 to October 31, 2016, at a tertiary care academic center. Five volunteers were used for creation of the nasal prostheses, and 36 survey respondents with a medical background were involved in evaluating the nasal prostheses.ExposuresA computer algorithm using a 3-D animation software (Blender; Blender Foundation) and Adobe Photoshop CS6 (Adobe Systems) were used to create a 3-D model of a nose. Photographs of 5 volunteers were processed with the computer algorithm. The model was then printed using a desktop 3-D printer. Attending physicians, residents, and medical students completed a survey and were asked to rate the similarity between the individuals’ photographs and their 3-D printed nose on a Likert-type scale.Main Outcomes and MeasuresThe similarity between 3-D printed nasal models and photographs of the volunteers’ noses based on survey data.ResultsThirty-six survey respondents evaluated 4 views for each of the 5 modeled noses (from 4 women and 1 man; mean [SD] age, 26.6 [5.7] years). The mean (SD) score for the overall similarity between the photographs and the 3-D models was 8.42 (1.34). The mean scores for each nasal comparison ranged from 7.97 to 8.62. According to the survey, respondents were able to match the correct 3-D nose to the corresponding volunteers’ photographs in 171 of 175 photographs (97.7%). All surveyed clinicians indicated that they would consider using this tool to create a temporary prosthesis instead of referring to a prosthodontist.Conclusions and RelevanceThis algorithm can be used to model and print a 3-D prosthesis of a human nose. The printed models closely depicted the photographs of each volunteer’s nose and can potentially be used to create a temporary prosthesis to fill external nasal defects. The appropriate clinical application of this technique is yet to be determined.

Peri-Implant Behavior of Sloped Shoulder Dental Implants Used for All-On-Four Protocols: An Histomorphometric Analysis in Dogs.

The aim of this study was to evaluate the soft tissue thickness and marginal bone loss around dental implants with sloped micro-threaded shoulder (35° angle) in comparing with conventional design, inserted 35° degrees angulated in post extraction sockets and immediate loaded with temporary prosthesis simulating the all-on-four protocol. Materials and Methods: Six fox hound dogs received forty-eight post extraction dental implants with the same diameter and length (Medentika, Germany), but with different neck configurations. Two group of implants were inserted 1mm subcrestal. Control group has a micro-threaded neck and the Test group has a sloped microthreaded neck. Immediate loading was applied using a constructed metallic structure. After three months, soft and hard tissue levels were assessed by histomorphometric analysis. Results: The mean soft tissue thickness (STT) was 2.5 ± 0.2 mm for the Control group and 3.3 ± 0.3 mm for Test group (p = 0.036), meanwhile the mean marginal bone loss (MBL) was 1.53 ± 0.34 mm for Control group and, 1.62 ± 0.22 mm for Test group (p > 0.05). Conclusions: Within the limitations of this experimental model in dogs, the findings showed that dental implants with microthreaded and microthreaded sloped necks installed in immediate post extraction sites with immediate load, presented a comparable perimplant tissue behavior.

Three-Dimensional Printing: A Novel Approach to the Creation of Obturator Prostheses Following Palatal Resection for Malignant Palate Tumors.

A subgroup of patients who have an oronasal fistula live in areas that have limited access to oral prosthetics. For these individuals, a temporary prosthesis, such as a palatal obturator, may be necessary in order to speak, eat, and breath properly. The creation of an obturator, which requires a highly trained prosthodontist, can take time and can be expensive. Through the current proof-of-concept study, there is an attempt to create a patient-specific palatal obturator through use of free and publicly available software, and a low-cost desktop 3-dimensional printer. The ascribed study may provide a means to increase global access to oral prosthetics if suitable biomaterials are developed. Computerized tomography data were acquired from a patient who had an oronasal fistula. Through use of free software, these data were converted into a 3-dimensional image. The image was manipulated in order to isolate the patient's maxilla and was subsequently printed. The palatal obturator models were designed, and reformed, in correspondence with the maxilla model design. A final suitable obturator was determined and printed with 2 differing materials in order to better simulate a patient obturator. Creating a suitable palatal obturator for the specified patient model was possible with a low-cost printer and free software. With further development in biomaterials, it may be possible to design and create an oral prosthesis through use of low-cost 3-dimensional printing technology and freeware. This can empower individuals to attain good healthcare, even if they live in rural, developing, or underserviced areas.

Incidence and Determinants of Dental Implant Failure: A Review of Electronic Health Records in a U.S. Dental School

The aim of this study was to use electronic health care records (EHRs) to examine retrospectively the incidence of and attributes associated with dental implant failures necessitating implant removal in a large cohort of patients treated in the student clinics of a U.S. dental school over three and a half years. EHRs were searched for all patients who received dental implants between July 1, 2011, and December 31, 2014. Characteristics of patients and implants that were actively removed due to irrevocable failure of any etiology ("failure cohort") during this period were compared to those of all other patients who received dental implants during the same time frame ("reference cohort"). Differences in the frequency distribution of various characteristics between the failure and reference cohorts were compared. Of a total 6,129 implants placed in 2,127 patients during the study period, 179 implants (2.9%) in 120 patients (5.6%) were removed. In the multivariate analysis, presence of a removable (OR=2.86) or fixed temporary prosthesis (OR=3.71) was statistically significantly associated with increased risk for implant failure. In contrast, antibiotic coverage (pre- and post-surgery OR=0.16; post-surgery only OR=0.38) and implants of certain manufacturers were associated with lower risk of implant failure. In this sizeable cohort of patients receiving care in dental student clinics, the review of EHRs facilitated identification of multiple variables associated with implant failure resulting in removal; however, these findings do not suggest causative relationships. The adopted analytical approach can enhance quality assurance measures and may contribute to the identification of true risk factors for dental implant failure.

Immediate loading of two flapless placed mandibular implants supporting cross‐arch fixed prostheses: a 5‐year follow‐up prospective single cohort study

Purpose To evaluate the clinical outcome of two implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses 5 years after loading. Materials and methods Eighty consecutive patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Forty-six laser-welded titanium and 34 cast silver-palladium frameworks with resin teeth were initially delivered within 8 and 48 h, respectively. Outcome measures, evaluated by two independent assessors included prosthesis and implant failures, complications, marginal bone level changes, implant stability quotient (ISQ) values and patient satisfaction. Results Five years after loading one patient did not return to the control and 10 prostheses were remade. Two implants failed early in two patients, but they were successfully replaced. Thirty-six complications occurred in 28 patients but were all successfully treated. After 5 years, mean marginal bone loss was 0.69 mm, mean ISQ values decreased from 75.4 to 73.8, and all patients were fully satisfied with the therapy. A post-hoc comparison between the outcome of laser-welded and cast frameworks showed that laser-welded frameworks were affected by significantly more complications (19 patients out of 46 and 6 patients out of 34, respectively; difference in proportion = 0.23, 95% CI: 0.03 to 0.43; Pearson's chi-square test, P = 0.032), therefore such a framework construction should be considered as a long-term temporary prosthesis and not a definitive prosthesis. Conclusions Immediately loaded mandibular cross-arch prostheses can be supported by only two implants up to 5 years, if made with a robust cast framework. Longer follow-ups (around 10 years) are still needed to know the prognosis of this treatment modality.

Materiales para Prótesis Provisionales

The provisional restorations used in fixed prostheses have changed and evolved in recent years as a result of recent advances in restorative dentistry and has become a factor of great demands and aesthetic demands. At present the possibility of choosing resins for temporary in the market are diverse. Each material with its advantages and disadvantages. This article addresses the materials that are currently used most frequently for the preparation of temporary prostheses in our market and what possibilities they provide us.

Kappa-splints application for the treatment of pathological dental hard tissues abrasion in combination with dentition defects and dentition deformations

Research objective: to develop and implement a new clinical method of producing a set of kappa-splints for splint therapy: treatment and prevention of various forms of pathological teeth abrasion in combination with dentition defects and dentition deformations, which will enable to prevent significant disorders in the dentition.Materials and Methods: 36 patients aged 30-59 have been selected for the targeted research with a generalized form of pathological tooth wear in combination with dentition defects and dentition deformations.Results: After studying the movements of conventional hinge axis in articulate heads of TMJ with the help of condylograph «Cadiax Compact», some asynchronous, asymmetrical bias of articulate heads during the movements of the mandible were revealed in patients with pathological tooth wear in combination with dentitiondefects and dentition deformations. While examining, the patients complained about the aesthetic defects due to the abrasion of teeth and the change of their colour, the discomfort while closing, chewing and phonetic disorders. In the clinical picture of these patients, the typical symptoms of TMJ dysfunction can be singled out, such as pain and crunch in joints, fatigue of chewing muscles and pain in the muscles, the displacement of the mandible to the side during vertical movements, a feeling of fullness in the ears, headaches and bruxism. Dentition deformations were presented as a violation of the occlusal curve. The results indicate on the presence of functional TMJ disorders and masticatory muscles dysfunction in pathological teeth abrasion in combination with dentition defects.So, in most cases, temporary prosthesis structures and occlusal splints can be applied to normalize occlusive correlations at the dysfunction of TMJ and masticatory muscles. Gradual lifting of occlusion has been done due to a set of kappa-splints in terms of 14 days, 1 month and 3 months from 1.0 to 5.0 mm to the full restoration of occlusal height, depending on the severity of pathological teeth abrasion. It is the gradual application of a kappa-splints’ set which allows prevention of further tooth wear; it doesn’t influence the periodontium of teeth; it’s aesthetic and does not violate the pronunciation of sounds. The material, which a kappa-splints set is made of, provides better fixation and bite separation with optimal thickness throughout the dentition, which allows the lower jaw to take a position that helps to restore the functional balance of the entire dentition.Conclusions:1. According to the results of the research it has been established that the orthopedic treatment with the help of occlusive splints at the preparatory stage for the patients with occlusive disorders at pathological dental hard tissues abrasion in combination with dentition defects, periodontium tissue disease and dentition deformations are urgent for the normalization of occlusive correlations of the jaws.2. After studying the movements of conventional hinge axis in articulate heads of TMJ with the help of condylograph «Cadiax Compact» and eliminating the symptoms of stress in masticatory muscles of the patients with occlusive disorders at pathological dental hard tissues abrasion, it is the gradual application of a kappa-splints set, made of hard transparent plates of Ercodent Ercodur material (Germany) with a thickness of 1.0 to 5.0 mm, which allows prevention of further tooth wear, normalization of occlusive correlations of the jaws, separating a bite with optimum thickness throughout the dentition, thus the lower jaw takes a position at which the state of functional equilibrium of the entire dentition is restored.

Systematic review describing the effect of early mobilisation after dysvascular major lower limb amputations.

To assess the effect of early mobilisation of patients after dysvascular lower limb amputation and to compare the effectiveness of different mobilisation regimens. Patients who have undergone dysvascular major lower limb amputations are at high risk of postoperative complications, which include loss of basic functions, and early mobilisation interventions might prevent these complications. Systematic review. Systematic searches were performed on PubMed (including MEDLINE), CINAHL and EMBASE databases to identify studies investigating the effects of (early) mobilisation interventions in dysvascular lower limb-amputated patients. Data collection and quality assessment were performed using the Cochrane Effective Practice and Organization of Care Review Group data collection checklist and the Cochrane Handbook for Systematic Reviews of Interventions, respectively. Five studies were included in the review: four pre- to post-case studies and one randomised controlled study. However, none of these studies were of high quality. Four studies investigated early mobilisation promoted by immediate postoperative prosthesis. One study investigated whether reorganizing care increases mobilisation and thereby functional outcome. This systematic review reveals a lack of evidence to determine whether early mobilisation interventions are beneficial to this vulnerable patient group. Nevertheless, ambulation from the first postoperative day with temporary prosthesis is possible among the heterogeneous population of dysvascular lower limb-amputated patients if the necessary interdisciplinary team is dedicated to the task. Mobilisation is a fundamental care task often missed for several reasons. Moreover, mobilisation of the newly amputated patient is complex, and knowledge of effective strategies to promote postoperative mobilisation in this vulnerable population is desired. Nurses are urged to take responsibility for this fundamental care task and to engage the necessary collaborative interdisciplinary team to develop, implement and evaluate ambitious early mobilisation interventions.

Evaluation of quality of life of a patient with malignant tumor of the oropharyngeal area during antitumor treatment

Introduction. Surgical treatment of patients with malignant neoplasms of the oropharyngeal region less disrupts the functional state of the maxillofacial region, reduces the relapse of diseases and maintains a satisfactory cosmetic result due to modern technologies. However, the future adequate rehabilitation provides a high indicator of the quality of life of such patients during antitumor treatment. The aim of this study was assessment of the quality of life of the patient with malignant neoplasm of the oropharyngeal region at the pretreatment stages, after surgical treatment with the imposition of an individual temporary prosthesis on the upper jaw, after the fabricate of obturator prosthesis, 3 months after orthopedic rehabilitation. Materials and methods. The quality of life of a patient with salivary gland cancer (T3N0M0) according to international scales for assessment of dental health of patients with head and neck tumors was analyzed: FACT-H&N, QLQ-C30 H&N35, OHIP-14; and the assessment of general health: SF-36, Karnovsky, ECOG Perfomance Status, EORTC-QLQ-C30. Results. The results of the evaluation on the questionnaires reflect the same dynamics, but they are not adapted for the analysis of the stages of dental rehabilitation, which is the final link in the treatment of patients with malignant neoplasms of the oropharyngeal region. Conclusion. The level of quality of life of a patient depends on the methods of orthopedic treatment during antitumor treatment on all scales.

Hip prosthesis in sitting posture for bilateral transfemoral amputee after burn injury

To overcome the challenges of rehabilitation of bilateral transfemoral amputees, we developed a novel "hip prosthesis in the sitting posture." Case Description and Methods: A 64-year-old male bilateral transfemoral amputee was transferred for rehabilitation 4 months following a burn injury. His wounds remained unhealed for 20 months; thus, he was unable to participate in standing training with the standard prosthetic sockets. Hip prosthesis in the sitting posture has very little friction between the sockets and residual limbs, which facilitated our patient to begin standing and walking exercises. Findings and Outcomes: The patient's refractory wounds healed 1 month after initiating exercises using hip prosthesis in the sitting posture, and he could begin rehabilitation with the standard prostheses. Hip prosthesis in the sitting posture enabled a bilateral transfemoral amputee with unhealed residual limbs to stand, walk, and begin balance training. Hip prosthesis in the sitting posture is an effective temporary prosthesis to prevent disuse until wounds are healed and to continue rehabilitation with standard prostheses. Clinical relevance Hip prosthesis in the sitting posture is useful for bilateral transfemoral amputees with unhealed residual limbs after burn injuries to prevent disuse and maintain motivation for walking.

Practical Management of Periprosthetic Leakage in Patients Rehabilitated With a Provox® 2 Voice Prosthesis After Total Laryngectomy

Introduction and objectivesPeriprosthetic leakage of liquids is a common complication in patients rehabilitated with voice prostheses. Our objective was to describe and review the results of procedures for treating periprosthetic leakage. Materials and methodsThis was a retrospective analysis of 41 patients rehabilitated with Provox® 2 voice prostheses between 1997 and 2015. We describe 3 techniques: periprosthetic silicon collar placement, injection of hyaluronic acid into the tracheoesophageal wall and the combination of the 2 techniques. We present a method to reduce the diameter of the tracheoesophageal fistula by removing the voice prosthesis and placing a nasogastric tube through the fistula. ResultsIn the 3 groups treated with silicone collar (n=5, 13 procedures), hyaluronic acid injection (n=5, 9 procedures) and the combination of both techniques (n=3, 5 procedures), we observed an increase in prosthesis lifespan of an average of 56 days (range 7–118 days), 32 days (range 3–55 days) and 63 days (range 28–136 days), respectively. The tracheoesophageal fistula diameter reduction was performed in 100% (n=6) of patients. ConclusionsThe use of silicone collars, injection of hyaluronic acid into the tracheoesophageal wall and the combination of both techniques for the treatment of periprosthesis leakage increase the lifespan of the prosthesis. Temporary prosthesis removal and placement of nasogastric tube has also been shown effective in our experience. These techniques are simple, inexpensive and reproducible, thereby reducing healthcare costs.

Значення тимчасового протезування для визначення постійної конструкції протезів у пацієнтів із вродженими незрощеннями верхньої губи та піднебіння після операційних втручань

Patients with congenital cleft lip and palate (CCLP) require long-term dental care with the involvement of many specialists, and the completion of the treatment can be considering only by their prosthetic rehabilitation. From the previous study, adequate temporary structure depends predictions and making them future prosthesis (protection is vital teeth from chemical and thermal stimuli and the choice of optimal variant incisive overlap). The study involved 21 patients with CCLP (10 men and 11 women) who underwent complex prosthetic treatment. Dissection of the teeth previously performed on the models, then conducted laboratory modeling wax temporary structures and the transfer it in plastic and only after the temporary prosthesis began preparing teeth in the mouth. If an insufficient number of teeth and a considerable disparity between the sizes of the upper and lower jaws used removable dentures with dental double row, modeled considering structural and aesthetic correction and correct occlusal relationships. In a large “false” progeny, orthopedic rehabilitation was making removable dentures with double row and three-dimensional basis modeling. The use of temporary dentures enables the patient to imagine the future prosthesis, as well as from the beginning of treatment receive appropriate orthopedic rehabilitation.

Dental Implants Placed in Periodontally Infected Sites in Humans

The purpose of the present study was to evaluate fresh socket implant outcome leaving granulomatous tissue into the bone defects. Subjects requiring tooth extractions in periodontal infected sites were selected for this prospective study. Only patients with 4-wall defects and asymptomatic ones were included. The fresh sockets were randomly scheduled into two groups: In one group (Removal Group, RG) granulomatous tissue was removed and, in the other group (Left Group, LG) granulomatous tissue was left. Implants were positioned immediately after tooth extraction, and were loaded after 3 months in both groups. Intraoral digital radiographs were performed at temporary prosthesis placement; at 12, 24 and 36 months to evaluate marginal bone levels changes. Moreover, clinical parameters were acquired at the same time points. Sixty patients were included in this study. Three-hundred seventy-two implants were placed immediately after tooth extraction and, at 3-year follow-up, a survival rate of 98.66% was reported, 2 implants were lost in RG and 3 implants in LG. At 36-month follow-up, not statistically significant differences were found between RG and LG in marginal bone level changes and clinical parameters (p > 005). Moreover, not statistically significant differences were found in intragroup comparisons over time (p > 0.05). With the limits of this study it was concluded that granulomatous tissue left in infected fresh sockets doesn't injury dental implant outcome.

Computer-aided flapless implant surgery and immediate loading. A technical note

The aim of the present technical note was to describe a prosthetic technique developed to increase the predictability of immediately loaded implants supporting a fixed prosthesis after computer-aided template-guided flapless implant placement. During a 2-year period, eight patients presenting partial edentulism underwent computer-aided template-guided implant placement. The presented technique was used during the prosthetic procedures to directly transfer the data obtained with the facebow to the surgical environment, allowing for accurate repositioning of the temporary prosthesis on the implants as previously planned with the digital software. A total of 78 dental implants were immediately loaded with an implant-supported fixed prosthesis after flapless template-guided implant placement. A survival and success rate of 100% was reported after a mean follow-up of 1year from the prosthetic loading. Neither major complications nor dropouts were observed during the healing time. From both clinical and radiological evaluations, implants appeared stable with no signs of soft tissue inflammation or infection and no evidence of pathological peri-implant bone resorption. The proposed technique associated with computer-aided implant placement and immediate loading protocol provided a high implant and prosthetic survival and success rate. No complications were reported during the recalls, suggesting predictability and reliability of the present technique over a short-term period.

Post-operative hemimaxillectomy rehabilitation using prostheses supported by zygoma implants and remaining natural teeth

OBJECTIVES:This study aimed to evaluate the stability of prostheses supported by zygoma implants and remaining teeth for subjects who had undergone hemi-maxillectomy.METHODS:Ten patients were included in the study. Oral rehabilitation was performed using a temporary prosthesis that was supported by remaining teeth for the first three months. Then, a zygoma implant was placed to provide support for a final prosthesis in addition to the remaining teeth. Each prosthesis was tailor-made according to biomechanical three-dimensional finite element analysis results. The patients were assessed using the prosthesis functioning scale of the Memorial Sloan-Kettering Cancer Center. In addition, retention and bite force were recorded for both the temporary prosthesis and the final prosthesis.RESULTS:The mean bite force of the prosthetic first molar was increased to 69.2 N. The mean retentive force increased to 13.5 N after zygoma implant insertion. The bite force on the prosthetic first molar was improved to 229.3 N.CONCLUSION:Bite force increased significantly with the support of a zygoma implant. The use of zygoma implants in the restoration of maxillary defects improved functional outcome and patient satisfaction.

Three–Dimensional Force Analysis of Gait of a Trans-Femoral Amputee with Prosthesis

Background: Prosthetic devices should provide proper alignment of segments and joints for efficient gait. Rehabilitation specialists should carefully assess the best fit of prosthesis for proper force distribution and comfort. The purpose of this paper was to examine the three-dimensional forces of a permanent prosthesis compared with the temporary prosthesis of an amputee during gait. Case description: A 58-year-old female, trans-femoral amputee, who was diagnosed with kidney disease, diabetes, and heart disease, consented to be a subject. The patient was tested for three-dimensional forces of gait wearing temporary prosthesis and the same test was performed three months later with a newly designed (permanent) prosthesis. Results: The results indicated that the patient had increased anterio-posterior and push-off forces with the permanent prosthesis. In addition, the medio-lateral forces were reduced which resulted in better balance during gait. Conclusions: Rehabilitation specialists should fit the prosthetic devices to the patients rather than fitting the patients to the prosthesis. In this study, the force analysis of gait was beneficial in assessing the best fit of prosthesis. Therefore, motion analysis should be performed to observe any deviations in balance, gait, and forcedistribution.

A Comprehensive Review on Biodegradable Polymers

Biodegradable polymers have been widely used in biomedical applications because of their known biocompatibility and biodegradability. Degradable polymeric biomaterials are preferred candidates for developing therapeutic devices such as temporary prostheses, three dimensional porous structures as scaffolds for tissue engineering and as controlled/sustained release drug delivery vehicles. Biodegradable materials are used in packaging, agriculture, medicine and other areas. In the biomedical area, polymers are generally used as implants and are expected to perform long term service. These improvements contribute to make medical treatment more efficient and to minimize side effects and other types of inconveniences for patients. The following review presents an overview of the different biodegradable polymers and their applications.

Meeting the Challenge of Feeding a New Born Infant with Cleft Lip and Palate-A Case Report

Cleft-lip-palate could be an anomalousness occurring because of malunion during development which is related to feeding issues within the new born infant. The oronasal communication reduces the creation of a negative pressure, which helps in suckling. Feeding prosthesis is an appliance to beat this challenge, aiding in feeding. Cleft anomalies are related to issues in feeding due to communication established between mouth and nasal cavity that makes it onerous for the baby to take care of adequate nutrition levels. This clinical report describes one visit technique for fabrication of feeding prosthesis for a one month new born infant born with cleft lip and palate, a congenital abnormality, which helps the newborn infant to feed milk avoiding regurgitation. The feeding plate is fabricated using acrylic resin which acts as a temporary prosthesis for feeding the baby till surgical correction is planned. The feeding prosthesis could be a prosthetic aid that helps in obturating the cleft by re-establishing and restoring the separation between the oral and nasal cavities. It helps to form a stiff platform towards which the baby will press the nipple and suck milk. This corrective prosthesis improves feeding by reducing the time needed for feeding that helps in weight gain and conjointly reduces nasal regurgitation. The prosthesis conjointly prevents and protects the tongue from getting into the cleftal defect and intrusive with the spontaneous growth of the palatal shelves towards midline. The prosthesis reduces the flow of food into the nasopharyanx, thus decreasing the incidence of Otis media and oro-naso pharyngeal infections.

New Sensations with Latest Implant Generations Allowing High Performance Strategies in Oral Implantology

In daily practice, we are constantly faced with the dilemma of choosing the right strategy between a conservative treatment and a radical one which includes extracting the tooth and replacing it with an implant… With or without setting an immediate esthetic fixed temporary prosthesis. Considering the psychological makeup of the patient (and of the practitioner!) and the real life experience of the 2 protagonists, critical situations are frequent where we must carefully weigh the pros and the cons of the various possible treatments. Latest implant generations - especially spiral implants - contribute to greater stability in poor quality bone sites, but also to improve implant placement even under precarious circumstances providing us – as practitioners and as patients as well - increased secure-pleasurable sensations while driving the implant treatments. Based on experience and advanced implant technology, this paper illustrates this purpose with a series of several case reports, challenging immediate implant placements in the esthetic zone in part 1, and full arches replacements in part 2.