BackgroundSlovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy.Patients and methodsTwenty irradiated head and neck cancer patients who received a removable implant-supported denture at the University Medical Centre Ljubljana were included in the study. Kaplan-Meier survival analysis, Cox proportional hazard models and logistic regression were used to assess the implant survival and success rate.ResultsTwenty patients had 100 implants inserted. The estimated implant survival rate was 96% after 1 year and 87% after 5 years. Failures were mostly observed before loading (91.2%). Implants inserted in the transplanted bone were significantly more likely to fail. Out of 89 implants supporting the dentures, 79 implants (88.7%) were successful, meaning that they were functionally loaded and exhibited no pain, radiolucency or progressive bone loss. Prosthetic treatment was significantly less successful in older patients. The attachment system and the number of implants did not have a statistically significant influence on the success rate.ConclusionsImplant-supported dentures have been shown to be a reliable treatment modality after head and neck cancer surgery and radiation therapy. Possible early failures should be communicated with the patients.
Clinical procedures, such as acid etching and reshaping of the teeth supporting removable partial dentures by grinding off some enamel surface, increase the permeability of dental enamel. Teeth take several months in vivo to partially recover from such damage. In the meantime, the tooth is more susceptible to carious decay. To prevent this the ground or etched enamel should be effectively protected. Using electron paramagnetic resonance (EPR) and a two-chamber diffusion cell the authors studied the influence of adhesive resin applied to the ground and acid-etched enamel surfaces on the diffusion of spin label TMAPO (2,2,6-6 tetramethyl-4-acetamido-piperidine-1-oxyl) molecules through the enamel. The enamel permeability was measured in samples exposed to 1-min etching with 37% phosphoric acid, in samples etched for 5 min, and in samples ground with a diamond bur. Next, all the treated enamel surfaces were coated with Scotchbond Multi-Purpose Plus(R) dental adhesive system and the permeability measurements repeated. Scanning electron microscopy (SEM) was used to study the porosity of enamel surfaces. The adhesive resin film covering the etched or ground enamel surfaces was found to decrease significantly the diffusion through dental enamel. This finding confirms the clinical value of dental adhesives used to protect ground or accidentally acid-etched enamel surfaces. SEM analysis showed that adhesive resin covers the porous surface of the acid-etched and ground enamel tightly.
Introduction
Edentulism and prosthodontic care are very common, especially in the elderly. The study investigated the treatment with complete dentures (CDs) and acrylic removable partial dentures (ARPDs) among people receiving new prosthodontic treatment in the Primary Health Centres of the three regions in Kosovo from 2002 to 2013.
Methods
The data on ARPDs delivery and CDs delivery was obtained from the archives of primary health centres from three Kosovo regions (Prizren, Peje, Ferizaj) from 2002 to 2013. The data was analysed concerning year of treatment, type of dentures, jaw, age, gender and urban or rural origin of the patients. The trend of treatment was determined, and the binomial logistic regression model was used for predicting odds of ARPD versus CD treatment by year of treatment and patient characteristics.
Results
From 2002 to 2013, 9,478 patients received 11,655 CDs and 4,401 ARPDs. Delivery of CDs significantly increased by 57.45 dentures per year (R2=0.609) and delivery of ARPDs by 30.39 dentures per year (R2=0.569). Each year the odds for ARPD versus CD increased by 4.2% (95% CI: 3.0%–5.4%). Younger patients have higher odds for ARPD rather than CD and odds for ARPD are decreasing as the age of patients rises. The gender, residence, and jaw all had a significant impact on prosthodontic treatment too.
Conclusions
In Primary Health Centres of Kosovo, there is a trend for higher frequencies of both dentures (more obvious for ARPD), and the frequency is highly dependent on the age of patients.
The aim of the study was to propose a method for three-dimensional evaluation and visualisation of mucosa thickness and mucosa thickness changes and to validate it in four different software implementations. Cone-beam computed tomography (CBCT) and digitised mandibular impression, i.e., optical scan, of five patients treated with a mandibular distal extension removable partial denture were acquired at baseline (T0) and 1-year follow-up (T1). CBCT images were automatically segmented and then superimposed with a corresponding optical scan and within a patient. To obtain mucosa thickness changes in the T0-T1 interval, firstly, the distances between T0 and T1 models were computed for mucosa surface, representing surface changes (dSurface) and bone surface, representing bone changes (dBone). The distances were saved as scalar field values in the mesh model. Finally, the mucosa thickness changes (dMucosa) were calculated by subtracting the corresponding dBone from dSurface values. Distance computation algorithms in four different software were tested and compared. No differences were found between all four tested software (p0.001). Mean (and standard deviation) of median dSurface, dBone, and dMucosa of right and left residual ridge (n=10) was -0.47mm (0.43), -0.44mm (0.62), and 0.00mm (0.35), respectively. High local variability of dBone and dMucosa was found on the colour-coded maps. A novel method facilitates precise three-dimensional evaluation and visualisation of mucosa thickness and thickness changes, regardless of the software used.
In this article, our clinical experience with an external ear and periorbital region reconstruction with implant-supported craniofacial epitheses are described. According to our experience, this kind of facial reconstruction is simple and reliable
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