Traditional Prostheses Research Articles

Functional results after surgery for overt rectal prolaps

Several procedures have been designed and applied to treat overt rectal prolapse (ORP). Transperineal procedures, such Altemeier and Delorme operations, are associated with less morbidity, but higher rate of recurrence and less optimal functional results. Transabdominal procedures include a variety of rectopexies with the use of prosthesis or sutures and with or without resection of the redundant sigmoid colon. Nowadays, they are all approached by laparoscopy. Traditional prosthesis rectopexies repair ORP and improve incontinence, but are associated with increased rate of constipation. Resection sutuere-rectopexy seems to be associated with the best functional results, particular in patients with slow transit constipation and diverticular disease. More recently, prosthesis ventral coloporectopexy seems to be less invasive and to offer very satisfactory results.

Fabrication of Prototype of Artificial Retina Adapted to a Curved Image Plane Based on Arrayed PMMA Microfibers

The traditional visual prosthesis combines both a camera and an electrode array implanted on the visual neural networks. Here, we introduce a new design of artificial retina which integrate the transmission of image and the electrical stimulation of cortical neurons on a single PMMA micro fiber. It is comprised of multiple PMMA microfibers with both ends connected with one flexible and one rigid substrates. The flexible one is a PDMS mold of microrods and ready to conform to a curved image plane. The rigid one is in the form of a silica plate coated with a PMMA thin film and could be attached to a CMOS image sensor for the evaluation of its optical performance. The multiple PMMA microfibers were directly drawn from liquid PMMA thin film with PDMS rods. With arrayed PMMA microfibers, the image planes could be transferred from the flexible to rigid substrate. Each PMMA microfiber delivers a part of the image the PDMS mold transmits. Incorporated with O/E convertors, each micro fiber could function as an unit of electrical stimulation in accordance with part of the image the artificial retina delivered and is ready to function as a cortical neural prosthesis in the future application.

Revisiting Tooth Preservation in Prosthodontic Therapy

Dental implants have been established as long-term supports for tooth replacements, and they have profoundly altered treatment concepts of traditional prosthodontics. The use of teeth as prosthetic abutments is revisited relative to implants as predictable support mechanisms for fixed and removable prostheses. The purpose of this review is to appraise tooth preservation in a different manner while considering implants as additional and even preferred support mechanisms for dental prostheses. Data reviewed in this article include a comparison of implants and traditional prostheses and their effects on abutment teeth, the use of periodontally and endodontically compromised teeth as abutments, and prosthetic complications potentially created by healthy remaining teeth. The evidence presented suggests that the longstanding objective of tooth preservation during prosthetic treatment be appended to include the use of dental implants for fixed/removable prostheses, and to avoid or remove teeth presenting as liabilities that diminish the overall prognosis. Patients are not well served if they are faced with biologic, economic, and psychological burdens associated with ongoing revisions of dental rehabilitations using natural teeth. Dentists must use all means available to carefully evaluate remaining teeth to determine if they benefit or impair proposed prosthetic outcomes.

Medium Term Follow up of the Biodynamic Neck Sparing Prosthesis

Hip resurfacing (HR) and neck sparing prostheses (NSP) have been advocated for the treatment of arthritis in younger patients. Some complications following HR have been documented in the recent literature, but NSP are not yet supported by clinical follow-up studies of sufficient duration. We present an assessment of the neck sparing "Biodynamic" prosthesis. 153 patients were evaluated in a longitudinal cohort prospective study, with survival analysis, clinical score and radiographic assessment of stability and osteointegration at 41.8 months average follow up. Survival and clinical outcome were similar to most traditional prostheses in the literature. On radiographic analysis we recorded good neck preservation and osteointegration. Only two stem failures were recorded. Poor clinical outcome was related to misalignment of prostheses implanted during the 'learning curve'. The NSP system described may be a good alternative to HR for younger patients. The system is characterized by good survival and clinical and radiographic outcome combined with bone stock preservation.

Choix chirurgico-prothétiques dans la gestion alvéolaire des séquelles de fentes labio-maxillo-palatines

The question of final-phase treatment and prosthetic rehabilitation is posed for the young adult patient who has followed a program of surgical, orthopedic, and orthodontic work aimed at achieving a functional, aesthetic balance. When a toothless space has been maintained or recreated between the proximal teeth of each fragment, two solutions are at hand for the expert odontologist: implantology, or traditional joint prosthesis. Four problems are evoked here to describe the difficulties related to this therapeutic decision: confrontation of the banks, residual osseous defect, teeth bordering the cleft, and the odontologist's role in the overall responsibility for the patient. The choice of the final surgical and prosthetic context induces a multifactor analysis, and must be integrated early on, as part of a multidisciplinary therapeutic strategy. Psychological acceptance is thereby favored, along with the rational search for a durable, aesthetic result.

Quality of Life in Patients With Prosthetic Legs: A Comparison Study

ABSTRACT The loss of a limb is a devastating event. Persons with a new amputation face a complex set of tasks to return to an adaptive mobility status. The type and quality of the prosthesis affect the patient’s physical and mental ability of adaptation. Rehabilitation practitioners and researchers need measures that can distinguish among levels of disability, predict prognosis, assist in patient care, and map changes in functional status as the result of interventions. The need for accountability not only comes from insurance sources but also the recipient of the prosthesis as well. The purpose of this research project was to investigate the quality of life in two groups of persons with lower limb amputation after the placement of a prosthesis. It specifically looks at those who receive an early postoperative prosthesis (EPOP) versus those who receive a traditional prosthesis within a defined time frame. The EPOP is a device that can be applied 2 days to 6 weeks postoperatively. The goal is to establish early ambulation with increased functionality. A traditional prosthesis is usually fit from 8 weeks up to 2 years after surgery. Previous research has discussed added benefits of improved wound healing, decreased edema, and earlier rehabilitation. A well validated and reliable instrument, the prosthetic evaluation questionnaire is used to measure several areas; functionality, mobility, psychosocial experience, bodily sensations (pain), satisfaction with their prosthesis, and quality of life. The questionnaire is used in this study to collect data on lower limb amputation patients to help identify quality of life issues in persons with prostheses.

Running-Specific Prostheses Permit Energy Cost Similar to Nonamputees

Improvements in prosthesis design have facilitated participation in competitive running for persons with lower limb loss (AMP). The purpose of this study was to examine the physiological responses of AMP using a run-specific prosthesis (RP) versus a traditional prosthesis (P) and cross-referenced with nonamputee controls (C) matched by training status, age, gender, and body composition during level treadmill running (TM). Twelve trained runners completed a multistage submaximal TM exercise during which HR and oxygen uptake (VO(2)) were obtained. Steady state measures at 134 m x min(-1) were compared between RP and P in AMP. AMP using RP (AMP-RP) and C also performed a continuous speed-incremented maximal TM test until volitional fatigue. RP elicited lower HR and VO(2) compared with P in AMP. Using RP, AMP achieved similar VO(2max) and peak TM speed compared with C but with higher HR(max). Relative HR (%HR(max)) and oxygen uptake (%VO(2max)), the regression intercept, slope, SEE, and Pearson's r correlation were not different between AMP-RP and C. %HR(max) calculated with the published equation, %HR(max) = 0.73(%VO(2max)) + 30, was not significantly different from actual %HR(max) for AMP-RP or C in any stage. RP permits AMP to attain peak TM speed and aerobic capacity similar to trained nonamputees and significantly attenuates HR and energy cost of submaximal running compared with a P. Use of RP confers no physiological advantage compared with nonamputee runners because energy cost at the set speed was not significantly different for AMP-RP. Current equations on the basis of the relative HR-VO(2) relationship seem appropriate to prescribe exercise intensity for persons with transtibial amputations using RP.

Conventional or Adhesive External Breast Prosthesis?

After having been subjected to radical mastectomy for breast cancer, women are usually fitted with an external breast prosthesis. Different types of prostheses are available, but oncology nurses have few data enabling them to advise their patients adequately. In this prospective randomized crossover study of 101 women undergoing one-sided mastectomy for breast cancer, the self-adhesive breast prosthesis was compared with the traditional external prosthesis. Questionnaires were used to evaluate the woman's judgment of the prosthesis in relation to her final preference for one type of prosthesis. Complete data were available for 91 women, 59.3% of whom finally preferred the self-adhesive type. Preference was independent of age, randomization, order, or the possible use of adjuvant chemotherapy. Satisfaction with the self-adhesive prosthesis was independent of randomization order but satisfaction with the traditional type was significantly more when it was the first type of prosthesis. Preference for the self-adhesive prosthesis over the traditional type mas mainly related to an increased perception of the prosthesis as a part of the body. Preference for the traditional prosthesis over the other type was mainly related to the greater ease of application and the lesser local irritation of the skin. Findings from this study can be useful in oncology nursing practice.

A New Method of Hair Replacement Using Osseointegrated Prostheses

Osseointegrated prostheses have been used to replace teeth, eyes, ears, and noses. They may now be applied to hair replacement. Our objective is to offer patients further alternatives to traditional hair prostheses or hair replacement surgery. Standard implantology techniques were used to place maxillofacial implants in a patient's cranium. New prosthetic techniques allow attachment of a pliable hair prosthesis to a static implant abutment. The implant system has been found to be an excellent method for attachment of hair prostheses. The method introduced here incorporates surgical techniques with prosthetic hair replacement. It has all the advantages of being able to guarantee a full head of hair, while at the same time greatly decreasing surgical risks.

Osseointegration and the edentulous predicament. The 10-year-old Toronto study'

This prospective study at the University of Toronto reports the 5-10-year results of treatment of edentulous patients with osseointegrated implant supported bridges. It comprised 46 consecutively treated patients, chosen because optimisation of traditional prostheses was not successful and because they were in sufficiently good health to allow minor out-patient surgery. Two hundred and seventy-four implants were surgically placed in 49 arches (three patients were treated in both arches) between October 1979 and March 1984. At the end of the 5-10-year observation period, 242 (88.32%) of the implants remained osseointegrated and 233 or 85.04% of these implants were used to support 43 fixed bridges and five overdentures. Nine implants, though osseointegrated, were not exposed and were not used to support the prostheses. Forty-eight of the 49 arches continue to be successfully restored with implant retained prostheses

Osseointegration and the edentulous predicament. The 10-year-old Toronto study

This prospective study at the University of Toronto reports the 5-10-year results of treatment of edentulous patients with osseointegrated implant supported bridges. It comprised 46 consecutively treated patients, chosen because optimisation of traditional prostheses was not successful and because they were in sufficiently good health to allow minor out-patient surgery. Two hundred and seventy-four implants were surgically placed in 49 arches (three patients were treated in both arches) between October 1979 and March 1984. At the end of the 5-10-year observation period, 242 (88.32%) of the implants remained osseointegrated and 233 or 85.04% of these implants were used to support 43 fixed bridges and five overdentures. Nine implants, though osseointegrated, were not exposed and were not used to support the prostheses. Forty-eight of the 49 arches continue to be successfully restored with implant retained prostheses.

Cosmetic improvement of testicular prostheses for children

A new testicular prosthesis for pediatric use is presented. This differs from the model usually available in that it is pink-pigmented and opaque. Over a period of 2 years and 6 months, 57 testicular prostheses were implanted in 53 boys. Seventeen of these were opaque, pigmented ones, while the others were regular translucent prostheses. No complications occurred with either type. Even when applied in adults, the traditional translucent prosthesis gives the unpleasent impression of hydrocele. In pediatric cases, this unesthetic appearance is enhanced because of the disproportion between the scrotum and the size of the prosthesis. The cosmetic appearances of these scrota have been partially improved by the use of colored, opaque prostheses.

A simple appliance to correct mandibular deviation following hemimandibulectomy

An appliance is described for the rehabilitation of patients following hemimandibulectomy. It has the advantages, over traditional prostheses, of being quick, simple and cheap to produce.

A prosthesis to camouflage indented scars.

Traditional silicone prostheses have been found to be inflexible, heavy, and of poor color match when used on the limbs. Ten patients distressed by contour deformities on their limbs after the wide excision of malignancies or following trauma were fitted with a light-weight prosthesis whose special features include a flexible foam backing, an outer tinted skin, and finely feathered edges that draw the eye away from the margins of the defect. The prosthesis sticks dependably to the skin and is particularly effective when worn under stockings or tights. When reviewed, all patients were continuing to use the device. It is a useful alternative to surgical reconstruction in such patients.