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Resin-bonded fixed partial denture (RBFPD)as known as Maryland bridge is is a well-known conservative method for its minimized invasion of the teeth for an anterior single tooth edentulous area. Despite of its various advantages, RBFPD was not widespread because of its high debonding rates, non-esthetic look or weak structure for material property. Currently, with the introduction of zirconia to dental material for RBFPD, Maryland bridge entered upon a new phase. Zirconia surmounts poor esthetics of metal framework, having proper strength, and overcomes ceramic’s structural weakness, being sufficiently esthetic. In this case, edentulous area of maxillary left lateral incisor was restored using zirconia resin-bonded fixed partial denture. Restoration of missing tooth in anterior area was achieved using non-invasive and esthetic prosthesis, then we report this case as satisfactory results were obtained for both the operator and the patient.
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Although tooth wear is a normal process due to aging, severe tooth wear causes various complications such as increased tooth sensitivity, loss of tooth structure, and pulp complications. In the treatment of patients with excessive tooth wear, the evaluation of loss of vertical occlusal dimension should be prioritized. If it is necessary to increase the vertical dimension to secure the restoration space, it is important to establish a treatment plan with the comprehensive analysis and determine the minimum vertical dimension elevation. In this case, 66-year-old male patient with severe worn dentition wanted to restore masticatory function and improve esthetic restoration. In order to determine the appropriate vertical dimension of the patient, we evaluated oral examination, radiographic examination, and diagnostic cast examination, and performed rehabilitation with minimum vertical dimension elevation. As a result of observation for 8 months, the definitive prosthesis was completed with contact of all teeth in centric occlusion, and proper anterior/posterior guidance. Through the above process, satisfactory aesthetic and functional outcomes were obtained.
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Purpose@#This study aimed to identify the risk factors associated with the occurrence and prognosis of hypertrophic scarring following thyroidectomy. @*Materials and Methods@#A total of 4238 patients who underwent thyroidectomy were included in this study. A multivariable logistic regression model was developed to identify the risk factors for hypertrophic scar development and its prognosis. @*Results@#Our analysis revealed that hypertrophic scar development was associated with younger age [odds ratio (OR)=0.949, p<0.0001], male sex (OR=0.562, p<0.0001), higher body mass index (OR=1.137, p<0.0001), prominent sternocleidomastoid muscles (OR=2.522, p<0.0001), scarring located within 1 cm of the sternal notch (OR=4.345, p<0.0001), and a history of keloid development (OR=2.789, p=0.0031). Additionally, scar location within 1 cm of the sternal notch (beta=4.326, p=0.0429) and a history of keloid development (beta=23.082, p<0.0001) were found to be associated with the prognosis of hypertrophic scarring. @*Conclusion@#The findings of this study provide valuable insights into the risk factors associated with hypertrophic scarring following thyroidectomy. Clinicians can use this information to predict the occurrence of hypertrophic scarring and its prognosis, and take preventative measures accordingly.
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Purpose@#Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. @*Methods@#This survey was prepared to collect participants’ demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. @*Results@#There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar’s length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). @*Conclusion@#Patients’ expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.
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When oral restoration is performed with a full mouth implant-supported fixed restoration in an edentulous patient, it is very important to determine the shape and position of the definitive prosthesis in consideration of the anatomical state and the relationship with the antagonist, and the process of placing multiple implants in the planned direction and angle is very important. In this case, implants were ideally planned based on an upper prosthesis through a computer-guided surgical procedure for an edentulous maxillary patient who visited due to discomfort in the existing denture. Through this, we would like to report this because we obtained satisfactory functional and esthetic results for both the patient and the operator with the treatment of oral restoration by manufacturing a fixed prosthesis for maxillary and full jaw implants.
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Background and Objectives@#Given the major changes in spread of COVID-19 and the contribution of technological innovation, the objective of the current study was to compare the educational needs of thyroid cancer patients between 2012 and 2020. @*Materials and Methods@#The subject of this study were 159 patients in 2012 and 149 patients in 2020 who underwent thyroid cancer surgery. Data were collected from September 2020 to December 2020. Their responses were compared with response for the 2012 survey. The survey contained 36 questions regarding demographics and 5 areas of educational needs (Treatment plan after discharge, Management of the symptom and the complication after surgery, Medication management, Postoperative wound and dietary management, Daily life). @*Results@#The most preferred teaching method for thyroid cancer surgery patients has changed from small group education to self-study with videos. The Internet accounted for the largest proportion of source of information and the preferred educator for the patient were doctors and nurses in both 2012 and 2020. ‘Current disease condition and surgical result’ was the highest ranked in both 2012 and 2020. @*Conclusion@#It is necessary to develop and utilize an educational method using video centered on medical team including doctors and nurses.
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Multiple tooth loss can cause disharmonious occlusial plane, loss of vertical dimension and deflection of mandibular movement. Therefore, restoring proper vertical dimension and occlusion in the centric relation is an important treatment goal. Implant-assisted removable partial denture is a recently used clinical technique, because it increases patient satisfaction by improving retention, support, and stability of conventional denture. The objective of this article is to present a case report describing the fabrication of treatment denture and implant assisted removable partial denture using previously placed implants for a patient with partial loss of posterior support and anterior stop.
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In removable partial dentures, abutment teeth are essential for support, maintenance, and stability of partial dentures, and are an important factor in the fabrication of functional dentures. If the number of periodontally sound abutments is sufficient and they are located on both sides, it will be easy to manufacture functional dentures with good support, maintenance, and stability. But on the contrary, if the number of teeth is insufficient or if they are located on one side, it is biomechanically disadvantageous and relatively difficult to make functional denture. On the other hand, recently, implant-supported removable dentures, which reinforce the three elements of maintenance, support, and stability by using implant surveyed crown, have been frequently selected as treatment plans.In particular, by adding an implant surveyed crown when only a small number of residual teeth remain, mastication efficiency, esthetics, patient comfort, and pronunciation can be improved. In this case, bilateral posterior extension partial denture was fabricated using implant surveyed crown as abutments by placing implants in the premolars area opposite to the residual tooth unilaterally in the mandible. As a result, the asymmetry of the abutment was resolved, and the maintenance and stability of the denture was achieved.
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Background@#Postoperative thyroid stimulating hormone (TSH) suppression therapy is recommended for patients with intermediate- and high-risk differentiated thyroid cancer to prevent the recurrence of thyroid cancer. With the recent increase in small thyroid cancer cases, the extent of resection during surgery has generally decreased. Therefore, questions have been raised about the efficacy and long-term side effects of TSH suppression therapy in patients who have undergone a lobectomy. @*Methods@#This is a multicenter, prospective, randomized, controlled clinical trial in which 2,986 patients with papillary thyroid cancer are randomized into a high-TSH group (intervention) and a low-TSH group (control) after having undergone a lobectomy. The principle of treatment includes a TSH-lowering regimen aimed at TSH levels between 0.3 and 1.99 μIU/mL in the low-TSH group. The high-TSH group targets TSH levels between 2.0 and 7.99 μIU/mL. The dose of levothyroxine will be adjusted at each visit to maintain the target TSH level. The primary outcome is recurrence-free survival, as assessed by neck ultrasound every 6 to 12 months. Secondary endpoints include disease-free survival, overall survival, success rate in reaching the TSH target range, the proportion of patients with major cardiovascular diseases or bone metabolic disease, the quality of life, and medical costs. The follow-up period is 5 years. @*Conclusion@#The results of this trial will contribute to establishing the optimal indication for TSH suppression therapy in low-risk papillary thyroid cancer patients by evaluating the benefit and harm of lowering TSH levels in terms of recurrence, metabolic complications, costs, and quality of life.
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Background@#A Korean Multicenter Prospective cohort study of Active Surveillance or Surgery (KoMPASS) for papillary thyroid microcarcinomas (PTMCs) has been initiated. The aim is to compare clinical outcomes between active surveillance (AS) and an immediate lobectomy for low-risk PTMCs. We here outline the detailed protocol for this study. @*Methods@#Adult patients with a cytopathologically confirmed PTMC sized 6.0 to 10.0 mm by ultrasound (US) will be included. Patients will be excluded if they have a suspicious extra-thyroidal extension or metastasis of a PTMC or multiple thyroid nodules or other thyroid diseases which require a total thyroidectomy. Printed material describing the prognosis of PTMCs, and the pros and cons of each management option, will be provided to eligible patients to select their preferred intervention. For the AS group, thyroid US, thyroid function, and quality of life (QoL) parameters will be monitored every 6 months during the first year, and then annually thereafter. Disease progression will be defined as a ≥3 mm increase in maximal diameter of a PTMC, or the development of new thyroid cancers or metastases. If progression is detected, patients should undergo appropriate surgery. For the lobectomy group, a lobectomy with prophylactic central neck dissection will be done within 6 months. After initial surgery, thyroid US, thyroid function, serum thyroglobulin (Tg), anti-Tg antibody, and QoL parameters will be monitored every 6 months during the first year and annually thereafter. Disease progression will be defined in these cases as the development of new thyroid cancers or metastases. @*Conclusion@#KoMPASS findings will help to confirm the role of AS, and develop individualized management strategies, for low-risk PTMCs.
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This study was to find out whether the rendering screen difference affect to measuring distance in a CAD program according to three types of CAD programs. Materials and methods: The model presented in ISO 12836 for dental scanner evaluation was reduced by 70%. This model was repeatedly scanned 15times using Trios II (3Shape, Denmark). Using the output STL file, 3Shape CAD, inLab 15, and ExoCAD programs were used to measure the horizontal distance (H) and vertical distance (V) between adjacent point angle, and for each experiment, three groups were set according to the CAD program type. Statistical analysis was performed using One-way ANOVA test and post hoc was performed using Dunnett T3 test. Results: In the horizontal and vertical distance measurement, there was no difference in the average of the measured values between the three groups according to the CAD program (P>.05). Conclusion: There were no effect of the difference in the rendering screen in the horizontal and vertical linear distance measurements of the inlay model on the dental CAD program.
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Background@#Postoperative thyroid stimulating hormone (TSH) suppression therapy is recommended for patients with intermediate- and high-risk differentiated thyroid cancer to prevent the recurrence of thyroid cancer. With the recent increase in small thyroid cancer cases, the extent of resection during surgery has generally decreased. Therefore, questions have been raised about the efficacy and long-term side effects of TSH suppression therapy in patients who have undergone a lobectomy. @*Methods@#This is a multicenter, prospective, randomized, controlled clinical trial in which 2,986 patients with papillary thyroid cancer are randomized into a high-TSH group (intervention) and a low-TSH group (control) after having undergone a lobectomy. The principle of treatment includes a TSH-lowering regimen aimed at TSH levels between 0.3 and 1.99 μIU/mL in the low-TSH group. The high-TSH group targets TSH levels between 2.0 and 7.99 μIU/mL. The dose of levothyroxine will be adjusted at each visit to maintain the target TSH level. The primary outcome is recurrence-free survival, as assessed by neck ultrasound every 6 to 12 months. Secondary endpoints include disease-free survival, overall survival, success rate in reaching the TSH target range, the proportion of patients with major cardiovascular diseases or bone metabolic disease, the quality of life, and medical costs. The follow-up period is 5 years. @*Conclusion@#The results of this trial will contribute to establishing the optimal indication for TSH suppression therapy in low-risk papillary thyroid cancer patients by evaluating the benefit and harm of lowering TSH levels in terms of recurrence, metabolic complications, costs, and quality of life.
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Background@#A Korean Multicenter Prospective cohort study of Active Surveillance or Surgery (KoMPASS) for papillary thyroid microcarcinomas (PTMCs) has been initiated. The aim is to compare clinical outcomes between active surveillance (AS) and an immediate lobectomy for low-risk PTMCs. We here outline the detailed protocol for this study. @*Methods@#Adult patients with a cytopathologically confirmed PTMC sized 6.0 to 10.0 mm by ultrasound (US) will be included. Patients will be excluded if they have a suspicious extra-thyroidal extension or metastasis of a PTMC or multiple thyroid nodules or other thyroid diseases which require a total thyroidectomy. Printed material describing the prognosis of PTMCs, and the pros and cons of each management option, will be provided to eligible patients to select their preferred intervention. For the AS group, thyroid US, thyroid function, and quality of life (QoL) parameters will be monitored every 6 months during the first year, and then annually thereafter. Disease progression will be defined as a ≥3 mm increase in maximal diameter of a PTMC, or the development of new thyroid cancers or metastases. If progression is detected, patients should undergo appropriate surgery. For the lobectomy group, a lobectomy with prophylactic central neck dissection will be done within 6 months. After initial surgery, thyroid US, thyroid function, serum thyroglobulin (Tg), anti-Tg antibody, and QoL parameters will be monitored every 6 months during the first year and annually thereafter. Disease progression will be defined in these cases as the development of new thyroid cancers or metastases. @*Conclusion@#KoMPASS findings will help to confirm the role of AS, and develop individualized management strategies, for low-risk PTMCs.
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The prosthesis of the implant installed in inappropriate positions presents aesthetic and functional problems. If the implants are placed in the wrong position, re-implantation is often limited. There are surgical and non-surgical methods for resolving complications without re-implantation. The surgical costs, healing time, discomfort and unpredictability make this choice unpopular. On the other hand, a gingival mask has the advantage of solving complications quickly and simply. The patient was a 80-year-old male with palatally installed implant in maxillary anterior region and dissatisfied with his unesthetic philtrum and food impaction between the upper lip and the prosthesis. It was difficult to predict the prognosis of surgical operation, and the patient wanted treatment economically and physically burdenless because of his age and financial situation. Thus, the gingival mask was planned and the results were satisfactory.
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Gradual teeth wear is normal physiological progress, severe tooth wear can causes dysfunction, occlusal plane disharmony and esthetic problems. If additional space is needed for prosthetic restoration due to severe attrition, full mouth rehabilitation with increase of occlusal vertical dimension may be considered. In this case, 72 year old male patient with severe worn dentition, irregular gingival zenith and deep anterior bite was treated by full mouth rehabilitation for regaining the space for restoration, improving relationship and esthetic of anterior teeth. Provisional restoration obtained by systemic analysis, diagnosis and re-evaluation for a sufficient time was replicated to final restorations through double scanning technique using monolithic zirconia blocks. Satisfactory functional and esthetic outcomes were obtained.
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It is essential to record maxillomandibular relationship accurately for the harmony of esthetic and function in complete denture. Gothic arch tracing visually demonstrates themovement of the mandible, and is useful to establish accurate and reproducible centric relation. Proper retention and stability of complete denture in patients with severe alveolarbone resorption is difficult to attain. In such case, the closed mouth impression technique might be recommended. The denture border and impression are determined bypatient’s physiologic movement in the closed mouth impression technique. And, denture peripheral border is entirely closed with oral mucous membrane. This report presentssatisfactory complete denture restoration using closed mouth impression technique and gothic arch tracing in patients with mandibular condyle fracture and severe absorptionof mandibular alveolar ridge. (J Korean Acad Prosthodont 2020;58:145-52)
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Gradual tooth wear is a natural process of aging, but pathological wear over physiologic ranges leads to functional and esthetic problems. The loss of posterior support maycause pathological wear of anterior teeth, which results in reduction of vertical dimension and disharmony of occlusal plane. To solve this problem, determination of propervertical dimension considering centric relation is necessary. This case report presented 71-year-old male, who had the severe wear of lower anterior teeth due to loss of posteriorsupport. By meticulous evaluation, a full mouth rehabilitation with elevation of vertical dimension was planned. After 8 months of follow-up, stable occlusal scheme ismaintained and patient was satisfied with clinical outcome functionally and esthetically. (J Korean Acad Prosthodont 2020;58:153-60)
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Background and Objectives@#Many patients with thyroid cancer are participating in the online community. Thyroid cancer patients write and read a variety of posts in the online community, and there is a great deal of data generated in the digital environment. However, few studies have analyzed the online community of thyroid cancer patients. The purpose of this study is to analyze the online community to understand the interests and information seeking behavior of thyroid cancer patients. @*Materials and Methods@#Data were collected from August 2017 to September 2019 using statistics from an online community of thyroid cancer patients. The frequency analysis was performed by collecting the members’ gender, age, average usage time, time-of-day views, average monthly visits, device distribution, online community inflow query, query within online community, and content of a post with more than 1000 views per month. @*Results@#Analyzing the online community of thyroid cancer patients, women accounted for 80.4% of the total, and the age group of people in their 30s and 40s accounted for 77.5%. Online community subscribers averaged 0.7 visits a day using mobile, with the most frequent use time between 10pm and 12pm. Frequently used queries are medical staff names, surgery, recurrence and scar. Posts showed informational and emotional exchanges. @*Conclusion@#Patients with thyroid cancer have searched for a lot of information about surgery and recurrence. Analyzing the online community will help to understand the experience of thyroid cancer patients and contribute to the development of online community intervention.
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In the case of a patient with a small number of unilateral remaining teeth in the mandible, a restoration with conventional removable partial denture cannot provide sufficient retention and resistance. A harmful stress from the poor stability of denture on remaining teeth occurs due to alveolar bone resorption in edentulous area. Although implant fixed prosthesis can provide multiple benefits over conventional removable partial denture, there are limitations come from anatomic structures and costs. In this case, an implant-assisted removable partial denture (IARPD) with a couple of implants placed in strategic positions can be a treatment modality. The objective of this article is to present a case report of two patients showed satisfactory clinical outcomes during three-year follow-up period describing the fabrication and advantages of removable partial denture assisted by teeth and implants (IARPD) for a patient with a small number of unilateral remaining teeth in mandible using Locator as an implant attachment.
Subject(s)
Humans , Bone Resorption , Denture, Partial, Removable , Dentures , Follow-Up Studies , Mandible , Prostheses and Implants , Rehabilitation , ToothABSTRACT
BACKGROUND AND OBJECTIVES: Most thyroid cancers progress slowly, have high survival rates, and have good prognosis. Therefore, the management of patients with thyroid cancer should be viewed from a long-term perspective, taking into account a return to normal social life. Cancer patients have a higher risk of unemployment than the general population, and so unemployment can be an economic problem for thyroid cancer patients. However, there have been few studies on factors affecting return to work in thyroid cancer patients. The purpose of this study is to investigate occupational changes and the period of leave of absence for patients with thyroid cancer and to identify factors that affect the return to work after surgery.MATERIALS AND METHODS: A total of 427 questionnaires of thyroid cancer patients were used for the analysis. The occupational changes and sick leave periods were analyzed according to general characteristics, disease-related characteristics, and side effects.RESULTS: The factors related to occupational change and leave of absence in thyroid cancer patients were sex and type of occupation. Women had more occupational changes and longer leave of absence than men, office workers had the least change in occupation, and professional workers had a longer period of sick leave. Fatigue was the primary side effect that affected the leave of absence.CONCLUSION: Occupation is very important in the life of a thyroid cancer patient. Informing the patient of possible complications and planning proper leave of absence will help the patient return to work and improve the quality of life.