Prosthetic maintenance assessment for implant fixed complete dentures and implant overdentures: a randomized clinical trial / Avaliação da manutenção protética para próteses totais fixas suportadas por implantes e Overdentures: um ensaio clínico randomizado

Objective: The rehabilitation choice for the edentulous patients usually lies between the fixed and removable prosthetic options. The treatment decisions are affected by many factors where complications and maintenance needs are both considered crucial factors, in addition to the cost effectiveness of the chosen treatment. Material and Methods: This study was applied on 44 edentulous patients, where 22 patient for each group were enrolled in the outpatient clinic of prosthodontics, Cairo University as per a set of eligibility criteria. Four inter-foraminal implants were installed for all eligible participants. Three months later, healing abutments were used for soft tissue preparation prior to the fabrication of the final prosthesis. A prosthetic treatment option was then randomly allocated to obtain two equal groups via computer generated randomization program; Group. A received telescopic implant overdentures, and Group. B received screw retained dentures. All Complications (Screw loosening or fracture, tooth or denture base fracture and mucositis) were reported after overdenture insertion along the follow up period (1, 6, 9 and 12 months respectively). Results: The frequency of the screw loosening for hybrid overdentures where (59.1%) compared to (27.3%) of telescopic prosthesis at 12 months follow up period (p=0.035), mucositis reporting at 6m interval had shown the highest frequency in both groups (Group A (54.5%), Group B (81.8%), (p=0.045), all other reported complications that lack statistical significance either within the same group or between both groups at different time intervals. Conclusion: Both treatment modalities; telescopic implant overdenture and hybrid fixed screw-retained are reliable for restoring the completely edentulous arches, the decision whether to make a fixed or removable implant denture shall be guided with the patient preference together with the dentist assessment in relation (AU)

Objetivo: A escolha da reabilitação para pacientes edêntulos geralmente recai entre próteses fixas e removíveis. As decisões de tratamento são afetadas por muitos fatores onde as complicações e as necessidades de manutenção são consideradas critérios cruciais, além do custo-efetividade do tratamento escolhido. Material e Métodos: Este estudo foi aplicado em 44 pacientes edêntulos, onde 22 pacientes para cada grupo foram matriculados no ambulatório de prótese dentária da Universidade do Cairo de acordo com um conjunto de critérios de elegibilidade. Quatro implantes interforaminais foram instalados para todos os participantes elegíveis. Três meses depois, pilares de cicatrização foram utilizados para preparação dos tecidos moles antes da fabricação da prótese final. Uma opção de tratamento protético foi então alocada aleatoriamente para obter dois grupos iguais por meio de andomização gerada através programa de computador. O Grupo A recebeu overdentures de implantes telescópicos e o Grupo B recebeu dentaduras fixas parafusadas sobre os implantes. Todas as complicações (afrouxamento ou fratura do parafuso, fratura da base do dente ou da prótese e mucosite) foram relatadas após a inserção da overdentures ao longo do período de acompanhamento (1, 6, 9 e 12 meses, respectivamente). Resultados: A frequência do afrouxamento do parafuso para Overdentures híbridas (59,1%) em comparação com (27,3%) da prótese telescópica no período de acompanhamento de 12 meses (p=0,035), o relato de mucosite no intervalo de 6 meses mostrou a maior frequência em ambos os grupos (Grupo A (54,5%), Grupo B (81,8%), p=0,045, todas as outras complicações relatadas foram sem significância estatística dentro do mesmo grupo ou entre os dois grupos em intervalos de tempo diferentes. Conclusão: Ambas as modalidades de tratamento; overdentures sobre implantes telescópicos e próteses híbridas fixas parafusadas são confiáveis para reabilitar as arcadas completamente edêntulas. A decisão de fazer uma prótese fixa ou removível sobre implantes deve ser guiada pela preferência do paciente juntamente com a avaliação do dentista em relação ao estado geral do paciente e sua saúde bucal. (AU)

Is partial coherence interferometry more accurate than a scan ultrasonography in the estimation of anterior chamber depth?

Purpose: To assess the degree of agreement of anterior chamber depth [ACD] measurements by optical device [NIDEK AL-scan biometer] and contact ultrasound A-scan [Mentor [[R]] - Advent [[TM]] A/B system US biometry]

Setting: Department of Ophthalmology at ALAZHAR University, Cairo, Egypt

Methods: This prospective observational cross sectional comparative study of 50 normal healthy eyes were included in this study, ACD estimation was done by 2 methods partial coherence interferometry[PCI], and contact ultrasound A-scan. The measurements was performed by the same observer. The difference in measurements between the two methods was assessed using the t-test

Results: The mean ACD [ +/- SD] by the two methods were [2.8 mm] and [3.5 mm], respectively. There was a statistically significant difference between measurements recorded by the 2 methods [P<0.01]

Conclusion: there was a statistically different between the two methods the PCI values were significantly higher [by 0.7 mm] than the U/S values with no correlation between the two sets of values. So PCI is more accurate but we still need U/S measurements in some situations [e.g., tear film abnormalities, corneal pathologies]

Four petal evisceration: pros and cons

Purpose: To evaluate four petals evisceration as one of the best modifications in evisceration surgery, allowing the use of large orbital implant with low incidence of complications

Methods: We conducted a retrospective, interventional study on evisceration with placement of spherical non porous orbital implant after four petal evisceration. Preoperative examination included full history, ophthalmological examination, indication for surgery, B-scan ultrasonography, axial length in cases of atrophic and socket surface in secondary cases. All patients were operated a four petal evisceration with spherical non porous implant of size 18 to 22. Postoperative, all patients were followed for at least 6 months for presence of complications, implant and prosthesis motility and the final cosmetic results

Results: 18 eyes were included. Diagnosis necessitating evisceration was atrophia bulbi in 8 patients, endophthalmitis in 2 patients, and implant exposure in 4 patients, corneoscleral melting due to caustic exposure in 1 patient, self-eviscerated globe due to severe trauma in 1 patient and anopthalmic socket following evisceration without implant in 2 patients. Implant size was 18 in 1 patient, 20 in 6 patients, and 22 in 11 patients. No implant exposure occurred; superior sulcus deformity occurred in 3 patients, downward implant migration occurred in 1 patient. Regarding implant motility, it was good with mean of 75% in 14 patients; moderate with mean of 66% in 4 patients. The prosthesis motility was fair with mean of 35% in 12 patients [66.6%] and poor with mean [10%] in 6 patients

Conclusion: Four petals evisceration facilitates the use of large sized implant in all cases even in implant exposure with deficient sclera with good post-operative final cosmetic results, very low rate of complications and moderate prosthesis motility

Prevalence of HBV and HCV infection among multi-transfused Egyptian thalassemic patients

Though regular blood transfusion improves the overall survival of patients with p-thalassemia, it carries a definite risk of infection with blood-borne viruses. The present study was carried out to estimate the real frequency of hepatitis B virus [HBV] and hepatitis C virus [HCV] among Egyptian P-thalassemic patients, and determine the infection-associated risk factors in these patients. A prospective study conducted in a university hospital from January 2009 to January 2010. Two hundred patients with p-thalassemia major were enrolled in this study. Using enzyme-linked immunoabsorbent assay [EEISA], their sera were tested for hepatitis B surface antigen [HBsAg], antibody to hepatitis C core antigen [anti-HBc], and HCV antibody [HCV Ab]. The positive HCV Ab results were confirmed by second generation recombinant immunoblot assay [RIBA]. The study sample consisted of 111 males and 89 females, with a median age of 13 years. Eighty-one [40.5%] patients were HCV Ab positive by ELISA and 39 [19.5] were anti-HCV positive By RIBA; 58 [29.0%] were HBsAg positive and 13 [6.5%] were anti-HBc positive. Older age, an increased number of transfusion units, and HBsAg seropositivity were significantly associated with a higher prevalence of HCV and HBV. The prevalence of HCV and HBV infections are very high among Egyptian p-thalassemic patients, which calls for a critical look into the prevailing transfusion practices and adoption of stricter donor selection criteria to decrease the incidence rate of both HCV and HBV infections effectively. Furthermore, there is a compressing need for the use of more specific and sensitive methods for HCV testing in Mansoura University Hospitals