scholarly journals Multidisciplinary Oral Rehabilitation of a Severely Compromised Dentition

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Carlo Maiorana ◽  
Dario Andreoni ◽  
Paola Polacco ◽  
Pier Paolo Poli

The decision-making process of complex clinical cases should involve multiple specialists to obtain a predictable result on a long-term basis. In view of the above, the present report is aimed at describing the multidisciplinary management of a partially edentulous female patient presenting with a severely compromised residual dentition. To improve function and aesthetics, the treatment combined multiple extractions, temporary rehabilitation with a complete removable denture, guided bone regeneration and implant insertion, soft tissue management, tooth alignment, and restorative dentistry. Thus, several dental branches were embraced during the treatment phases, including oral surgery and implantology, periodontology, orthodontics, and prosthodontics. The involvement of different specialists ensured the achievement of a good result from biological, functional, and aesthetic aspects. The patient was satisfied with the final outcome. In conclusion, to meet the patient’s expectations particularly in complex clinical situations, the interdisciplinary approach becomes essential from the early phases in order to identify the ideal treatment plan with the correct time sequence.

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Fausto Frizzera ◽  
Mateus Tonetto ◽  
Guilherme Cabral ◽  
Jamil Awad Shibli ◽  
Elcio Marcantonio

A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient’s condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations. In this article, the zenith-driven concept is discussed and a challenging case is presented with 4-year follow-up where tooth extraction, immediate implant placement, bone regeneration, and a connective tissue graft were performed.


2010 ◽  
Vol 17 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Paula K Vuckovich

Failure to follow prescribed treatment has devastating consequences for those who are seriously and persistently mentally ill. Nurses, therefore, try to get clients to take psychotropic medication on a long-term basis. The goal is either compliance or adherence. Although current nursing literature has abandoned the term compliance because of its implications of coercion, in psychiatric nursing practice with patients suffering from serious long-term mental illness compliance and adherence are in fact different goals. The ideal goal is adherence, which requires the patient to be an active participant in the team. This goal is consistent with nurses’ ethical values, but for such patients this is frequently unrealistic. If the person is severely psychotic, treatment may be involuntary and the goal compliance. Psychiatric nurses participate in involuntary treatment and thus should acknowledge the ethical implications of compliance as a goal and not obscure the issue by calling compliance adherence.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Marko Vuletić ◽  
Ivica Pelivan ◽  
Dragana Gabrić

Oropharyngeal cancer (OPC) represents a significant portion of head and neck cancers. In most cases, it is localised in the soft palate, lingual and palatine tonsils, base of the tongue, and the surrounding tissues. Alcohol and tobacco exposure are well-known evidence-based risk factors for developing OPC; however, over the last decade, there has been a rapid increase in OPC linked to human papillomavirus (HPV). Dental implant therapy faces many challenges related to immediate and long-term success, and patients who are rehabilitated with implant prosthodontic therapy often have numerous comorbidities. Tantalum is a rare transitional metal element which has high corrosion resistance and is extremely inert. Porous tantalum trabecular metal (PTTM) has high volumetric porosity, a low modulus of elasticity, and very high friction. PTTM implant surface enhancement allows “osseoincorporation,” which means the neovascularisation and formation of new bone directly onto the implant. A 65-year-old patient presented to the Department of Oral Surgery of Clinical Hospital Centre Zagreb after resection of the mandible due to OPC had oral rehabilitation. Three Zimmer Biomet Trabecular Metal™ implants ( 4.1 × 10   mm ) were inserted in the area of lower left first incisor, lower left second premolar, and lower right second premolar, and after four months, a new upper partial denture and the bar-retained mandibular overdenture were made. Implant prosthodontic rehabilitation of head and neck cancer patients is usually challenging in terms of achieving an improvement in its main aim, quality of life; however, today it is a safe and reliable therapy. Although radiation therapy may negatively affect the patient’s oral condition and influence the short- and long-term success of the implant, the presented case report showed that the excellent properties of PTTM-enhanced dental implants may give great basis for future comparative researches of using these implants in the treatment of oncologic patients.


2017 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Noriaki Aoki ◽  
Arisa Inoue ◽  
Yasufumi Kosugi ◽  
Chika Koyama ◽  
Masaki Iida ◽  
...  

The purpose of this article is to report an innovative technique for an increase vertical dimension with screwed denture fixation and intravenous sedation for the patients with severe deep bite. Bite raising is essential to maintain a long term stability of occlusion in the case of implant treatment associated with severe deep bite. Generally, a removable denture is used to increase occlusal vertical dimension for the first step of oral rehabilitation in the case of severe deep bite. However, these patients sometimes fail wearing removable denture for increasing vertical dimension, because of severe discomfort. On the other hand, an intravenous sedation is advantage that the patients fall asleep and is completely unaware of the procedure being performed. Therefore combination screwed denture fixation and intravenous sedation allowed to raise occlusal vertical dimension in implant treatment. In conclusion, this combined method using screwed denture and intravenous sedation are the most promising technique for implant treatment to raise the vertical occlusal dimension for the patients with severe deep bite. Keywords: Severe deep bite, Screwed denture, Bite raising, Implant fracture


2019 ◽  
Vol 23 (1) ◽  
pp. 40-44
Author(s):  
Aleksandar Đorđević ◽  
Mirko Mikić ◽  
Jelena Stanišić ◽  
Filip Đorđević

SummaryBackground/Aim: Implant treatment expands extensively the possibilities of prosthetic treatment, which provide benefits, bigger comfort as well as general improvement of the patient’s life quality. In cases with no possibility of implantation, it is possible to improve conditions by using modern methods for bone tissue repair. One of factors important for the long-term success is proper oral hygiene, as well as raising awareness of its importance to patients. The aim of the paper is to present a patient rehabilitated with multiple implants and followed-up for a five-year period, and to point out the importance of raising patient’s awareness and motivation in order to preserve the results of the treatment.Case Report: A 31-year-old patient was admitted to the oral surgery clinic for rehabilitation of a poor oral health status. After taking history, clinical examination and additional analysis, the following treatment plan was suggested: to remove impacted upper canines and to put an implant supported by fixed prosthesis in the upper jaw, to make two implants supported by bridges laterally and one dental supported by bridge in the inter-canine sector in the lower jaw. The treatment was carried out in several stages that involved extraction of residual roots and impacted teeth, augmentation of bone defects with bone substitutes and bio-absorbable membranes, placing implant, and prosthetic rehabilitation. By verbal communication with the patient, we pointed out the importance of proper oral hygiene and regular check-ups. The five year follow-up showed the absence of factors that could adversely affect the success of the treatment, and the patient was still highly motivated to maintain proper oral hygiene.Conclusions: It is possible to achieve predictable results in complex cases by using a multiphase prosthetic treatment supported by implants. Concerning a long-term success, motivation, proper information and patient’s willingness to cooperate play an important role.


1976 ◽  
Vol 35 (03) ◽  
pp. 531-536 ◽  
Author(s):  
P. M Mannucci ◽  
Z. M Ruggeri

SummaryTwenty specialized centres for the care of hemophilia and allied disorders have now been established in Italy. Their geographic distribution is uneven and the number is considered inadequate. Financial support is provided by regional Health Departments or by University and General Hospitals; a bill recognizing hemophilia as a social disease entitles the centres to an annual grant from the State or Regional Boards. Less than half of factor VIII employed in the management of hemophilia A is supplied as a cryoprecipitate from hospital blood banks; the rest is imported from commercial manufacturers who also satisfy all the demand for prothrombin complex concentrates. Commercial freeze-dried concentrates can also be obtained free of charge at pharmacies by hemophiliacs covered by national social security schemes. This arrangement facilitates home treatment, which appears the ideal form of management in a country with the geographical features of Italy. In Lombardy, a bill allows hemophiliacs or their relatives to give infusions after adequate instruction. All this has been a great help in achieving more modern management of hemophilia; however, dependence on imported commercial concentrates appears unreasonable on a long-term basis, and major efforts should be directed towards developing a national program for manufacturing blood components.


VASA ◽  
2001 ◽  
Vol 30 (Supplement 58) ◽  
pp. 6-14 ◽  
Author(s):  
Edmonds ◽  
Foster

The diabetic ischaemic foot has become an increasingly frequent problem over the last decade. However, we report a new approach consisting of a basic classification, a simple staging system of the natural history and a treatment plan for each stage, within a multi-disciplinary framework. This approach of "taking control" consists of two parts: 1. long-term conservative care including debridement of ulcers (to obtain wound control), eradication of sepsis (micribiological control), and provision of therapeutic footwear (mechanical control), and 2. revascularisation by angioplasty and arterial bypass (vascular control). This approach has led to a 50% reduction in the rate of major amputations in patients attending with ischaemic ulceration and absent foot pulses from 1989 to 1999 (from 4.6% to 2.3% per year). Patients who underwent angioplasty increased from 6% to 13%. Arterial bypass similarly increased from 3% to 7% of cases. However, even with an increased rate of revascularisation, 80% of patients responded to conservative care alone. This,we conclude, is an essential part of the management of all patients with ischaemic feet.


Think India ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 296-304
Author(s):  
Biplab Tripathy ◽  
Tanmoy Mondal

India is a subcontinent, there huge no of people lived in river basin area. In India there more or less 80% of people directly or indirectly depend on River. Ganga, Brahamputra in North and North East and Mahanadi, Govabori, Krishna, Kaveri, Narmoda, Tapti, Mahi in South are the major river basin in India. There each year due to flood and high tide lots of people are suffered in river basin region in India. These problems destroy the socio economic peace and hope of the people in river basin. There peoples are continuously suffered by lots of difficulties in sort or in long term basis. Few basin regions are always in high alert at the time of monsoon seasons. Sometime due to over migration from basin area, it becomes empty and creates an ultimate loss of resources in India and causes a dis-balance situation in this area.


Shore & Beach ◽  
2020 ◽  
pp. 34-43
Author(s):  
Nicole Elko ◽  
Tiffany Roberts Briggs

In partnership with the U.S. Geological Survey Coastal and Marine Hazards and Resources Program (USGS CMHRP) and the U.S. Coastal Research Program (USCRP), the American Shore and Beach Preservation Association (ASBPA) has identified coastal stakeholders’ top coastal management challenges. Informed by two annual surveys, a multiple-choice online poll was conducted in 2019 to evaluate stakeholders’ most pressing problems and needs, including those they felt most ill-equipped to deal with in their day-to-day duties and which tools they most need to address these challenges. The survey also explored where users find technical information and what is missing. From these results, USGS CMHRP, USCRP, ASBPA, and other partners aim to identify research needs that will inform appropriate investments in useful science, tools, and resources to address today’s most pressing coastal challenges. The 15-question survey yielded 134 complete responses with an 80% completion rate from coastal stakeholders such as local community representatives and their industry consultants, state and federal agency representatives, and academics. Respondents from the East, Gulf, West, and Great Lakes coasts, as well as Alaska and Hawaii, were represented. Overall, the prioritized coastal management challenges identified by the survey were: Deteriorating ecosystems leading to reduced (environmental, recreational, economic, storm buffer) functionality, Increasing storminess due to climate change (i.e. more frequent and intense impacts), Coastal flooding, both Sea level rise and associated flooding (e.g. nuisance flooding, king tides), and Combined effects of rainfall and surge on urban flooding (i.e. episodic, short-term), Chronic beach erosion (i.e. high/increasing long-term erosion rates), and Coastal water quality, including harmful algal blooms (e.g. red tide, sargassum). A careful, systematic, and interdisciplinary approach should direct efforts to identify specific research needed to tackle these challenges. A notable shift in priorities from erosion to water-related challenges was recorded from respondents with organizations initially formed for beachfront management. In addition, affiliation-specific and regional responses varied, such as Floridians concern more with harmful algal blooms than any other human and ecosystem health related challenge. The most common need for additional coastal management tools and strategies related to adaptive coastal management to maintain community resilience and continuous storm barriers (dunes, structures), as the top long-term and extreme event needs, respectively. In response to questions about missing information that agencies can provide, respondents frequently mentioned up-to-date data on coastal systems and solutions to challenges as more important than additional tools.


Author(s):  
Michael Atar ◽  
Egbert Körperich

The present report follows the case of a young boy with solitary median maxillary central incisor (SMMCI) syndrome between the ages of 4 and 7 years. This condition is characterized by the presence of one single maxillary central incisor in the midline instead of two central incisors. No other developmental abnormalities involving growth or brain function were noted at, or subsequent, to birth. This report includes a discussion of the aetiology of SMMCI syndrome and its association with birth defects such as holoprosencephaly (HPE), CHARGE and VACTERL, as well as a discussion of the long-term prognosis and associated dental and medical issues for this particular patient


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