Long-term maintenance and complications of fixed dental prostheses

Fixed dental prostheses (FDPs), commonly known as dental bridges, play a pivotal role in restorative dentistry, offering patients a means to regain oral function and aesthetics in cases of tooth loss. These prosthetic devices, anchored to natural teeth or dental implants, bridge the gap created by missing teeth, improving chewing, speech, and smile aesthetics. However, the successful deployment of FDPs requires not only their initial placement but also long-term maintenance and an understanding of potential complications. Effective oral hygiene, regular dental surveillance, and professional dental cleanings are essential for preserving FDP longevity. Vigilance is crucial as FDPs, while resistant to cavities themselves, can pose challenges in cleaning around abutment teeth. Complications, including dental caries, periodontal issues, crown or bridge fractures, abutment tooth deterioration, aesthetic alterations, sensory sensitivity, and even prosthetic failure, are potential concerns. Timely intervention and preventive measures are key to addressing these issues. When complications arise, dental practitioners can often repair superficial problems like crown fractures. Profound or recurrent complications may require more extensive interventions, such as fabricating a new bridge or considering alternative restorative options like dental implants or removable partial dentures. By embracing these principles of maintenance and management, patients can optimize the durability and functionality of their FDPs while minimizing associated risks, ensuring a healthy and confident smile for years to come.

Management of diabetic ketoacidosis in internal medicine: insulin protocols, electrolyte balance, and clinical outcomes

Diabetic ketoacidosis (DKA) is a critical complication of diabetes mellitus (DM), characterized by hyper-glycemia, acidosis, and ketosis. It poses a substantial risk of morbidity and mortality, especially in type 1 DM patients. DKA can be triggered by various factors, including insulin deficiency, infections, alcohol abuse, and other medical conditions. Hospital admissions for DKA are increasing, with mortality rates of up to 5-9%, often linked to severe underlying illnesses and complications such as myocardial infarction and stroke. Effective DKA management involves rehydration, correction of electrolyte imbalances, insulin administration, and addressing precipitating factors. Fluid resuscitation with isotonic saline is vital to restore hydration, and continuous intravenous insulin infusion is the preferred method to control blood glucose and suppress ketone production. Electrolyte imbalances, particularly potassium, sodium, phosphate, and magnesium, require careful monitoring and correction. Clinical outcomes in DKA management include resolving acidosis, normalizing blood glucose, and restoring electrolyte balance, all while achieving and maintaining clinical stability. Complications like cerebral edema and acute respiratory distress syndrome can significantly impact the prognosis. Long-term considerations encompass diabetes management, patient education, and follow-up care.

Factors affecting retention and relapse in orthodontics

Orthodontic treatment aims to achieve stable and harmonious occlusion by correcting malocclusions and aligning teeth. However, the long-term success of orthodontic treatment relies heavily on the effectiveness of the retention phase. Retention involves maintaining the corrected tooth positions and preventing relapse, which refers to the tendency of teeth to return to their original maloccluded positions over time. The retention phase applied after treatment is important to obtain stable results. Various factors can influence the retention phase and contribute to relapse in orthodontics. Periodontium, soft tissue pressures, growth, and occlusion are among these factors affecting stability. Understanding these factors is crucial for orthodontists to design appropriate retention protocols and enhance treatment outcomes. To achieve successful long-term stability, orthodontists must comprehensively evaluate and address the factors during the retention phase. This review article will discuss factors that affect retention and relapse in orthodontics.