It is important that dentists and technicians are able to understand the advantages and disadvantages of different attachment types for overdentures, in order to select the most appropriate technique for each patient.
Management of bilateral cleft lip and palate cases is a challenging task, and if the premaxilla is shifted to either side, it poses a problem for the surgeon to operate and also for the orthodontist to do the orthodontic alignment. The aim of this study was to reposition the shifted premaxilla for better retraction with presurgical infant orthopedics, thus reducing the tissue tension and further scarring which have detrimental effects on maxillary growth. The innovative technique with pre-directional (PD) appliance is easy to fabricate and use and works in this direction. Acrylic, springs, permasoft liner, elastics, retentive tapes. Previous approach for the shifted premaxilla was more focused on the surgical correction. In adults, surgery with osteotomy is the only option, with its own limitations and disadvantages, in repositioning the shifted premaxilla. Thus, PD appliance aids to correct the shifted premaxilla in presurgical molding stage. The premaxilla was thus shifted 5.5 mm to the left side, with premaxilla in facial symmetry, with the PD appliance. Presurgical orthopedics with PD appliance is worth in infants with shifted premaxilla in bilateral clefts cases.
AimRoutine dental treatments are frequently associated with aerosol generating procedures (AGP). Recently dental AGP have attracted significant attention as a possible vector for the transmission of SARS-CoV-2 and attempts have been made to establish when a surgery may be safely decontaminated following a dental AGP — the ‘fallow time’. There is a paucity of research in the dental literature regarding the near real time generation and dispersion of dental aerosol following a dental AGP. Study aims are to: (1) monitor dental aerosol generation and dispersal through semi-continuous particle count values (PCV), and (2) use this information to delineate a range of suitable fallow times.MethodFollowing baseline measurements, five identical dental AGP were conducted on a dental manikin for each of three groups: (SEO) saliva ejector only, (HVA) high volume aspiration, (WO) high volume aspiration with windows open. For each procedure PCV were recorded every 2.2 minutes with a Light Scattering Airborne Particle Counter (LSAPC) for 3.3 hours. Eleven dependent variables were analysed, including baseline PCV, total PCV, peak PCV, time taken to return to one sample standard deviation of baseline PCV, and a time series extending from 15 minutes to 3 hours after cessation of AGP. Due to heterogeneity, the data was analysed with Krushkall-Wallis test and Dunn-Bonferroni post hoc.ResultsBetween group mean baseline PCV were not statistically significant. Compared with SEO, WO had a statistically significant impact on peak PCV (p=.009) and HVA had a statistically significant impact on total PCV (p=.006). With the exception at 2 and 3 hours, PCV throughout the time series were statistically significantly lower for WO and HVA in comparison with SEO. WO PCV were influenced by outdoor aerosol levels.Four of the five SEO procedures failed to return to baseline PCV within 3.3 hours. Following AGP, the mean time for the HVA procedures to return to baseline PCV was 17.12 minutes, 95% CI [4.96 to 29.28]. The effect of HVA on the time taken to return to baseline PCV was very large (Glass’s Δ= -4.943, CLES=1.00).ConclusionThere is a significant benefit in opening windows during AGP. The effect of HVA on reducing fallow time is very large. Under the conditions of this study, PCV suggest that it might be safe to consider a fallow time of 29.28 minutes.
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