prosthodontic rehabilitation

  • 文章类型: Journal Article
    目的:这项前瞻性临床研究旨在确定部分可摘义齿和简化饮食建议对血糖控制的口腔修复修复的影响。老年2型糖尿病患者的营养状况和口腔健康相关生活质量(OHRQoL)。
    背景:没有佩戴完整或局部假牙的牙齿脱落者更有可能面临营养风险,这表明使用假牙将有利于重建适当的营养状况,并有可能改善生活质量。营养治疗对预防糖尿病至关重要,治疗和管理,有利于血糖控制。文献很少提供关于部分可摘义齿对改善糖尿病控制的贡献的证据。老年人的营养状况和满意度,尤其是那些2型糖尿病患者。
    方法:诊断为2型糖尿病的老年人,年龄在60岁或以上,需要使用部分可移动义齿进行口腔修复,符合这项前瞻性研究的条件。主要结果指标是血糖控制,通过糖化血红蛋白(HbA1c)水平测量。口腔健康影响概况(OHIP-14)问卷和迷你营养评估短格式(MNA-SF)代表次要结果指标。这些措施在基线和12个月的随访后,假体输送,结合小册子形式的简单饮食建议。使用Wilcoxon配对检验分析数据。
    结果:选择符合纳入标准并需要使用可摘局部义齿治疗的44例患者进行本研究,进行了一年。在此期间,七名参与者拒绝参加,因为他们搬到了另一个城市。因此,37名参与者的最终样本(16名男性和21名女性,平均年龄65.8岁,研究包括60至83岁)。在研究期间,实验室参数(HbA1c水平)没有显着变化。12个月时有营养不良风险的老年人数量明显低于基线。此外,营养状态显著改善后12个月修复治疗结合饮食建议,效果大小很大。口腔修复治疗结合饮食建议后,OHRQoL明显改善。
    结论:与简单饮食建议相关的局部义齿修复治疗不会影响2型糖尿病老年人的血糖控制,但改善了营养状况和OHRQoL。
    OBJECTIVE: This prospective clinical study aimed to determine the influence of oral prosthodontic rehabilitation with partial removable dentures and simplified dietary advice on glycaemic control, nutritional status and oral health-related quality of life (OHRQoL) of older adults with type 2 diabetes.
    BACKGROUND: Individuals with tooth loss who did not wear complete or partial dentures are more likely to be at nutritional risk, suggesting that using dental prostheses would benefit the re-establishment of an adequate nutritional status and potentially improve quality of life. Nutritional therapy is essential for diabetes prevention, treatment and management, favouring glycaemic control. The literature provides little evidence on the contribution of partial removable dentures to improving diabetes control, nutritional profile and satisfaction in older adults, especially those with type 2 diabetes.
    METHODS: Older individuals diagnosed with type 2 diabetes mellitus, aged 60 years or older and needing oral rehabilitation with partial removable dentures were eligible for this prospective study. The primary outcome measure was glycaemic control, measured by glycated haemoglobin (HbA1c) levels. The Oral Health Impact Profile (OHIP-14) questionnaire and the Mini Nutritional Assessment short-form (MNA-SF) represented secondary outcome measures. These measures were assessed at baseline and 12 months of follow-up after prosthesis delivery, combined with simple dietary advice in pamphlet form. The data were analysed using the Wilcoxon matched-pairs test.
    RESULTS: Forty-four patients who met the inclusion criteria and required treatment with removable partial dentures were selected for this study, which was carried out for a year. During this period, seven participants declined to participate because they moved to another city. Hence, a final sample of 37 participants (16 men and 21 women, average age of 65.8 years, ranging from 60 to 83 years) were included in the study. No laboratory parameter (HbA1c levels) changed significantly during the investigation. The number of older adults at risk of malnutrition was significantly lower at 12 months than at baseline. Furthermore, nutritional status significantly improved 12 months after prosthodontic treatment combined with dietary advice, and the effect sizes were large. OHRQoL significantly improved after prosthodontic therapy combined with dietary advice.
    CONCLUSIONS: Prosthodontic treatment with partial dentures associated with simple dietary advice did not influence glycaemic control but improved the nutritional status and OHRQoL of older adults with type 2 diabetes.
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  • 文章类型: Journal Article
    目的:评估使用全口义齿进行康复的无牙老年人的面部特征,并将它们与牙齿个体进行比较。
    背景:带有完整假牙的Edentulism康复旨在恢复咬合和面部美学。
    方法:该研究包括102名需要全口义齿修复的无牙参与者和30名天然牙列患者(年龄>65岁)。使用Artec光学扫描仪进行3D面部扫描。发现了表面的标志,并计算了16个参数。使用两次扫描叠加的区域分析来计算11个区域中不匹配表面的平均距离和百分比。配对和独立t检验(α=0.05)用于检验组间差异,视情况而定。
    结果:全口义齿康复后,面部变化在口周区域最明显:较宽的口角,上唇更长,较宽的上朱红色,和更突出的轮廓。没有和有假牙的面部区域的比较显示脸颊更丰满和弯曲,没有假牙的直接影响。带有假牙的无牙面孔比牙齿个体看起来更短,更容易退缩。更窄的下朱红色,挤压上唇,并且在有假牙的女性中观察到比牙齿同龄人更扁平的面部轮廓。
    结论:除了全口义齿修复对口腔周围区域面部外观的预期积极影响外,有一些意想不到的变化,比如丰满的脸颊,但是在垂直面部尺寸和更扁平的面部轮廓方面仍然存在缺陷。
    OBJECTIVE: To evaluate the facial characteristics of edentulous older adults who underwent rehabilitation using complete dentures, and to compare them with dentate individuals.
    BACKGROUND: Edentulism rehabilitation with complete dentures aims to restore occlusion and facial aesthetics.
    METHODS: The study included 102 edentulous participants needing prosthodontic rehabilitation with complete dentures and 30 with a natural dentition (aged >65). The 3D facial scans were performed using an Artec optical scanner. Superficial facial landmarks were identified, and 16 parameters were calculated. Regional analysis with the superimposition of two scans was used to calculate the average distances and percentage of non-matching surfaces in the 11 regions. Paired and independent t-tests (α = .05) were used to test for group differences, as appropriate.
    RESULTS: After rehabilitation with complete dentures, facial changes were most noticeable in the perioral region: wider rima oris, longer upper lip, wider upper vermilion, and more protruded profile. The comparison of facial regions without and with dentures showed fuller and curvier cheeks, with no direct influence of dentures. The edentulous faces with dentures appeared shorter and more retruded than those of dentate individuals. A narrower lower vermilion, retruded upper lip, and more flattened facial profile were observed in females with dentures than in their dentate peers.
    CONCLUSIONS: Besides the expected positive influence of rehabilitation with complete dentures on facial appearance in the perioral region, there are some unexpected changes, such as fuller cheeks, but there is still deficiency in vertical facial dimensions and a more flattened facial profile.
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  • 文章类型: Journal Article
    This study evaluated long-term effectiveness UV functionalised short implants (≤ 6 mm) placed in the posterior segments of the atrophied maxilla. The study included 47 patients from 2018 to 2023 (aged 27 to 56 years, 24 women and 23 men) without any systemic diseases, with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. Total installed were 64 short UV-functionalized implants and 62 standard implants over 10 mm in length in segments maxilla with sufficient bone parameters. Clinical, laboratory and cone beam computed tomography (CBCT) methods were used to plan implant therapy. The clinical indices included the following parameters: ISQ, MBL, OHIP-G scale. For short implants, the median ISQ at placement was 62.2 for primary stability and the median ISQ at 5 months was 69.6 ISQ. For standard implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. After 6 months mean MBL short implants 0.87 mm, after 1 year 1.13 mm, after 5 years was 1.48 mm. After 6 months mean MBL standard implants 0.84 mm, after 1 year 1.24 mm, after 5 years was 1.58 mm. Mean OHIP-G scores-patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative success rate 5 years short implants was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Short ultraviolet functionalized implants used in the posterior resorbed segment of maxilla have been shown to be a reliable alternative to sinus lift, demonstrating fewer complications, reduction in the number of additional surgical interventions and showed satisfactory long-term survival.
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  • 文章类型: Case Reports
    半骨切除患者假肢康复的目的是恢复咀嚼功能,comfort,美学,还有自尊.本文提出了一种使用可移除的上颌双咬合台假体进行半关节切除术的计划。一个男性病人,43岁,被转诊到口腔修复病人科,抱怨美学受损,说话困难,缺乏咀嚼能力。该患者在3年前接受了手术,其中由于口腔鳞状细胞癌进行了半动脉切除术。该患者患有Cantor和CurtisII型缺陷。下颌骨从足弓右侧的犬科区域远端切除。计划使用双咬合台的口腔修复装置,也称为双闭塞假体。使用双咬合台的半关节切除术患者的康复非常重要。本报告描述了一种简单的假肢装置,可以帮助患者恢复功能和心理健康。
    The objective of prosthetic rehabilitation of patients with hemimandibulectomy is to regain the masticatory function, comfort, esthetics, and self-esteem. This article presents a plan for the management of hemimandibulectomy with a removable maxillary double occlusal table prosthesis. A male patient, aged 43 years, was referred to Prosthodontic Out Patient Department with complaints of compromised aesthetics, difficulty in speaking, and lack of ability to chew. The patient underwent surgery 3 years ago in which hemimandibulectomy was performed due to oral squamous cell carcinoma. The patient had a Cantor and Curtis Type II defect. The mandible was resected distally from canine region on the right side of the arch. A prosthodontic device was planned with a double occlusal table, also known as twin occlusion prosthesis. The rehabilitation of hemimandibulectomy patients with a double occlusal table is of considerable importance. This report describes a simple prosthetic device that will help patients in regaining their functional and psychological well-being.
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  • 文章类型: Case Reports
    唇和腭的裂口是影响口面区域的先天性异常。完全无牙的left裂患者在全口义齿制造过程中面临着独特的挑战。具有闭孔和腭延伸的完整假牙需要精确制造以实现美学功能,演讲,吞咽,和咀嚼。病例报告介绍了使用带有the闭孔和咽部延伸的全口义齿对left裂女性患者的成功修复。pal闭孔延伸为上颌义齿提供了良好的固位和稳定性。患者的技能和以前使用旧假牙的经验在成功治疗中起着重要作用。病人对假牙在美学方面很满意,咀嚼,吞咽,和演讲。
    Clefts of the lip and palate are congenital anomalies that affect the orofacial region. Completely edentulous patients with a cleft palate present a unique challenge during complete denture fabrication. Complete dentures with an obturator and palatal extension need to be accurately fabricated to fulfill the functions of esthetics, speech, deglutition, and mastication. The case report presents the successful prosthodontic rehabilitation of a cleft palate female patient using a complete denture with a palatal obturator and pharyngeal extension. The palatal obturator extension provided good retention and stability for the maxillary denture. The patient\'s skill and previous experience with her old dentures played an important role in successful treatment. The patient was satisfied with dentures in terms of esthetics, chewing, swallowing, and speech.
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  • 文章类型: Case Reports
    背景:2019年冠状病毒病(COVID-19)大流行使牙科和修复的临床实践处于新时代的门槛,由于通常影响免疫功能低下患者的相对罕见疾病的患病率增加。
    目的:本临床病例报告的目的是简要描述病因,这种不断发展的医疗状况的外科和修复管理强调了颌面修复医生在恢复患者健康方面的新作用。
    结果:将介绍一名感染COVID-19的上颌骨毛霉菌性病变患者的手术和修复。
    结论:颌面修复师的作用对于减轻这种严重的COVID-19相关发病率很重要。
    BACKGROUND: Coronavirus Disease 2019 (COVID-19) pandemic brought the clinical practice of dentistry and prosthodontics at the threshold of a new era, due to the increasing prevalence of a relative rare condition normally affecting the immunocompromised patients.
    OBJECTIVE: The aim of this clinical case report is to briefly describe the etiopathogenesis, the surgical and prosthodontic management of this evolving medical condition emphasizing the emerging role of the maxillofacial prosthodontist in restoring the patients\' well-being.
    RESULTS: The surgical and prosthodontic rehabilitation of a COVID-19 infected patient with a mucormycotic lesion of the maxilla will be presented.
    CONCLUSIONS: The role of the maxillofacial prosthodontist is important in alleviating this severe COVID-19 associated morbidity.
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  • 文章类型: Journal Article
    过去十年见证了促进外胚层发育不良的鉴别诊断的分子方法的扩展。一组以头发缺失或畸形为特征的遗传疾病,牙齿,指甲,和某些内分泌腺体。此外,转化研究的进展增加了这种罕见疾病的治疗机会,和新的牙齿,外科,眼科治疗方案可能会缓解许多受外胚层发育不良影响的患者。在X连锁多汗性外胚层发育不良(XLHED)中,甚至可以在出生前通过施用重组替代蛋白来克服信号分子胞外发育异常蛋白A1(EDA1)的遗传缺陷。至少对于患有XLHED的男性受试者的关键问题已经证明了这一点,几乎完全没有汗腺和汗水,这可能导致危及生命的高热。通过在羊水中注射EDA1替代蛋白对六个男孩进行产前治疗,可持续诱导功能性汗腺的发育。到目前为止,在子宫内接受治疗的两个年龄最大的男孩中,正常的出汗能力已持续>5年。因此,对于最常见的外胚层发育不良和可能的其他先天性疾病,及时更换缺失的蛋白质似乎是一种有希望的治疗策略。
    The past decade has witnessed an expansion of molecular approaches facilitating the differential diagnosis of ectodermal dysplasias, a group of genetic diseases characterized by the lack or malformation of hair, teeth, nails, and certain eccrine glands. Moreover, advances in translational research have increased the therapeutic opportunities for such rare diseases, and new dental, surgical, and ophthalmic treatment options are likely to offer relief to many individuals affected by ectodermal dysplasias. In X-linked hypohidrotic ectodermal dysplasia (XLHED), the genetic deficiency of the signaling molecule ectodysplasin A1 (EDA1) may even be overcome before birth by administration of a recombinant replacement protein. This has been shown at least for the key problem of male subjects with XLHED, the nearly complete absence of sweat glands and perspiration which can lead to life-threatening hyperthermia. Prenatal treatment of six boys by injection of an EDA1 replacement protein into the amniotic fluid consistently induced the development of functional sweat glands. Normal ability to sweat has so far persisted for >5 years in the two oldest boys treated in utero. Thus, timely replacement of a missing protein appears to be a promising therapeutic strategy for the most frequent ectodermal dysplasia and possibly additional congenital disorders.
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  • 文章类型: Review
    目的:中心关系(CR)是一个公认的术语,是一个可以接受的参考位置,具有悠久的成功历史。问题是关于它的定义或记录方法几乎没有共识,这引发了一场废除它的起义。
    方法:对与其定义相关的相关文献的回顾,记录的方法,解剖方面的考虑,并执行了长期原则。
    结果:中心关系是一个既定的术语,但对其定义和记录方法存在合理的担忧。对于需要全弓重建的患者,将其用作修复体位已达成共识,没有实质性的临床研究来反驳这一点。如果临床医生决定使用不同的姿势,它应该有一个不同的名字。
    结论:中心关系是一种可重复的参考位置,可用于诊断和修复牙科手术,并有大量科学证据支持该前提。有许多有据可查的技术,所有这些都是颌间,可以复制位置。几乎没有科学证据支持髁相对于窝的确切位置的前提。
    OBJECTIVE: Centric relation (CR) is a universally recognized term and an acceptable reference position with a long history of success. The problem is that there is little consensus as to its definition or the method of recording it, and this has created an uprising to abolish it.
    METHODS: A review of pertinent literature related to its definition, method of recording, anatomic considerations, and long-standing principles was conducted.
    RESULTS: Centric relation is an established term but there are valid concerns over its definition and method of recording. There is consensus on using it as a restorative position in a patient in need of full-arch reconstruction, and there is no substantive clinical research to contradict this. If a clinician decides to use a different position, it should have a different name.
    CONCLUSIONS: Centric relation is a reproducible reference position that can be utilized for diagnostic and restorative dental procedures with substantial scientific evidence to support that premise. There are numerous well-documented techniques, all of which are intermaxillary, that can replicate the position. There is little scientific evidence to support a premise as to where the exact position of the condyle should be in relation to the fossa.
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  • 文章类型: Journal Article
    目的:研究的目的是评估放置在萎缩性下颌骨后部区域的短植入物(5至6mm)的长期预后。
    方法:该研究包括81例后部骨严重垂直萎缩患者。患者在下颌后部区域放置了248个短植入物(5至6mm),在下颌前部区域放置了256个长度大于10mm的植入物。种植体和假体失效分析,累积生存率,并在随访1年和5年(58±7个月)确定了边缘骨丢失。
    结果:短植入物在假体加载1年后的平均边缘骨丢失为0.74mm,长度大于10mm的植入物为0.72mm;在假体加载5年后,短植入物为1.27mm,长度大于10mm的植入物为1.31mm。248个短植入物(5至6毫米),6例失败:4例由于种植体周围炎和2例由于骨整合不足(早期排斥).长度大于10毫米的256个植入物中,5例失败:3例由于种植体周围炎,2例由于骨整合不足(早期排斥)。平均而言,在观察期间(58±7个月),短种植体的5年累积种植体存活率为97.8%,在较长的植入物中为98.1%;假体累积生存率为98.2%。
    结论:根据结果,结论是,在后再吸收的下颌骨中使用短植入物进行假肢的预后可以认为是有利和合理的。
    OBJECTIVE: The aim of the study was to assess the long-term prognosis of short implants (5 to 6 mm) placed in the posterior region of the atrophic mandible.
    METHODS: The study included 81 patients with severe vertical atrophy of the bone in the posterior region. The patients had 248 short implants (5 to 6 mm) implants placed in the mandibular posterior region and 256 implants with length greater than 10 mm in the mandibular anterior region. Analysis of implant and prosthesis failures, cumulative survival rate, and marginal bone loss was determined at 1 year and 5 years of follow-up (58 ± 7 months).
    RESULTS: Mean marginal bone loss after 1 year of prosthetic loading was 0.74 mm for short implants and 0.72 mm for implants with length greater than 10 mm; after 5 years of prosthetic loading this was 1.27 mm for short implants and 1.31 mm for implants with length greater than 10 mm. Of 248 short implants (5 to 6 mm), six failed: four due to peri-implantitis and two due to lack of osseointegration (early rejection). Of 256 implants with length greater than 10 mm, five failed: three due to peri-implantitis and two due to lack of osseointegration (early rejection). On average, over the observation period (58 ± 7 months), the 5-year cumulative implant survival rate was 97.8% in short implants, and 98.1% in longer implants; the prosthesis cumulative survival rate was 98.2%.
    CONCLUSIONS: Based on the results, it was concluded that the prognosis of the use of short implants for prosthetics in the posterior resorbed mandible can be considered favorable and reasonable.
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  • 文章类型: Multicenter Study
    目的探讨口腔修复治疗对日本成年门诊患者可摄取食物状况的影响。并确定可能恶化概况的相关风险因素。方法参与者是277名门诊患者,他们访问了日本大学的专业诊所进行修复治疗。人口统计数据,通过口内检查评估的当前牙齿数量,在治疗前记录所有参与者的口腔健康影响总评分(OHIP-J54)和口腔健康相关生活质量.使用经过验证的食物摄入问卷记录可摄入食物概况评分(IFS)。在治疗前后回答问卷的合格参与者根据他们接受的修复治疗分为五组(即,皇冠,桥梁,可移动局部义齿,可移动的完整假牙,和可移动的完整和部分义齿)。结果多变量协方差分析显示,修复干预(时间过程:治疗前后)对平均IFS的主要影响具有统计学意义(p=0.035,F=4.526),即使在调整协变量(年龄,目前的牙齿数量,和治疗方式)。多元线性回归分析显示,基线时患者的当前牙齿数量较低(r=0.427,p<0.001)和OHIP-J54总分较高(r=-0.519,p<0.001)与基线IFSs显着相关,即使在调整了混杂变量之后。结论这项多中心随访研究的结果表明,修复修复在改善患者可摄取食物状况方面的重要性。
    OBJECTIVE: To investigate the effect of prosthodontic treatment on the ingestible food profile in adult Japanese outpatients, and to identify the related risk factors that can deteriorate the profile.
    METHODS: The participants were 277 outpatients who visited university-based specialty clinics in Japan for prosthodontic treatment. The demographic data, number of present teeth assessed via intraoral examination, and oral health-related quality of life assessed by the total Oral Health Impact Profile (OHIP-J54) scores of all participants were recorded before treatment. Ingestible food profile score (IFS) was recorded using a validated food intake questionnaire. Eligible participants who answered the questionnaire before and after treatment were categorized into five groups based on the prosthodontic treatments they received (i.e., crowns, bridges, removable partial dentures, removable complete dentures, and removable complete and partial dentures).
    RESULTS: Multivariate analysis of covariance revealed a statistically significant main effect of prosthodontic intervention (time course: before and after treatment) on mean IFS (P=0.035, F=4.526), even after adjusting for covariates (age, number of present teeth, and treatment modality). Multiple linear regression analysis revealed that the low number of present teeth (r=0.427, P<0.001) and a high OHIP-J54 total score (r=-0.519, P<0.001) of the patients at the baseline were significantly associated with their baseline IFSs, even after adjusting for confounding variables.
    CONCLUSIONS: The findings of this multicenter follow-up study indicate the importance of prosthodontic rehabilitation in improving patients\' ingestible food profiles.
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