risk-benefit concept in the radiographic examination of partially and completely edentulous patients

The radiographic examination of denture patients is performed either as a"routine" step or done when necessary. The harmful cumulativeeffect of radiation is well understood. In light of the benefit obtained froma radiographic examination and the risk due to the cumulative effectof radiation, this study was carried out on 248 partially and completelyedentulous patients divided into two groups. The first group included patientswith clinical findings requiring a radiographic examination. The secondincluded those only in need for a general preprosthetic evaluation. The incidence of the positive radiographic findings was higher in the firstgroup. Furthermore, in the first group only, there was a significant number ofcases which required a change in the treatment plan. Therefore, the casehistory and clinical examination should be strongly considered and the"routine" radiographic examination should be discouraged and only done, whennecessary, and when the finding expected could contribute to the diagnosis,treatment plan or prevent the progress of a disease; in other words, when thebenefit of the radiographic examination exceeds the "risk" limits

Drug therapy in the management of gagging during prosthodontic treatment

An evaluation of the frequency and severity of gagging during prosthodontictreatment was carried out in 184 male patients. Gagging was observed inapproximately 15% of the patients. The patients were categorized according to the severity of the gag reflex. A list of precautions suggested by manyinvestigators was applied to all patients with gagging tendency. In theresistant cases of the systemic anti-emetic drug, chlorpromazine hydrochloridewas taken orally by the patient as 10 mg tablets tds the day before and tillthe time of impressions making. The mild and moderate cases responded well tothe list of precautions, except very few cases. The vast majority of thesevere cases did not respond to the list of precautions but were onlyresponsive to the anti-emetic drug

inadequately supported occlusion inductive of TMJ osteoarthritis

Two groups of female patients were selected in this study being affected by TMJ osteoarthritis. The patients of the first group had an inadequately supported occlusion i.e. three or more functional molars were missing, improperly restored or badly decayed. The patients in the second group had an adequately supported occlusion. Clinical and radiographic surveys were carried out. It has been found that the incidence of both the clinical and radiographic findings was higher in the first group. For this group the occlusion has been restored by properly constructed partial dentures. Six months after restoration of occlusion the patients were reexamined. Most of the clinical findings have been imporved especially the crepitation and painful symptoms. The radiographic findings have shown no significant improvement except for restoration of the joint space. It could be concluded that the inadequately supported occlusion might be a cause of TMJ osteoarthritis, and that its restoration to a functional form preserve the joint in its normal relation and function avoiding the excessive load that may resuIt in its degeneration

Reconstruction of the severely resorbed mandible using intraosseous implants

The IMZ-implant is indicated for the edentulous lower jaw as well as for the shortened arch. The insertion technique is rather simple due to the advantage of using standard instruments with all implant types. It is atraumatic because of the internal cooling system as well as the gentle press fit of the implant. It is also predictable with the unloaded healing period under the gingival protection. The prosthetic restoration used with this implant system is simple, economical and similar to the conventional denture hence with a bar attachement

Diagnosis and prosthodontic management of a complicated posterior implant in the maxillary sinus region by radiography and sinoscopy

A case was presented in which there was a screw-vent implant inserted in the maxillary posterior edentulous area. The implant was presented with both clinical and radioographic manifestations suggestive of encroachement on the maxillary sinus and the decision was directed towards removal of the implant. An endoscopic examination of the maxillary sinus revealed that the sinus lining was completely continuous and intact. A period of three months was allowed for bone healing together with the proper medication of the patient. A suprastructure was constructed with consideration to the suitable design which offered a proper load distribution and decreased effect of the occlusal forces. A clinical-radiographic follow up of the case has denoted a successful implant without notable clinical mobility or peri-implant inflammation as well as healthy bone surrounding the implant