Clinical Longevity of Obturators in Patients with Jaw Defects: a Retrospective Cohort Study.

OBJECTIVES: The primary objective of the present retrospective clinical study was to determine the survival time of obturators while analyzing possible influencing factors. MATERIALS AND METHODS: This retrospective clinical cohort study analyzed the influence of various clinical factors on the survival probability of obturators and their follow-up outcomes using Kaplan‒Meier analysis. RESULTS: A total of 76 patients with 115 obturators were included in the study (47 men and 29 women, mean age 58.1 ± 18.1 years). The mean observation time was 3.0 ± 4.5 years (maximum 26.3 years). A total of 40.9% (47) of all obturators observed had to be replaced. The survival rate after 5 years was 79.5% for telescopic-crown-retained tooth-supported obturators, 86.9% for telescopic-crown-retained implant-supported obturators, 58.8% for removable full denture obturators, 22.1% for clasp-retained obturators and 0.0% for splints. The type of attachment, attendance at a regular follow-up and defect cause significantly influenced the survival of the obturators (p < .05). CONCLUSIONS: The findings obtained in this study support the recommendation of using implant-supported obturators. Telescopic-crown attachments, either tooth- or implant-supported, seem to be favorable in terms of survival time. Attendance at a strict follow-up program seems to have a major influence on the longevity of the obturators. CLINICAL RELEVANCE: The use of implant-supported obturators to cover permanent oral and maxillofacial defects is highly recommended. Additionally, the use of telescopic-crown attachments seems to be favorable in terms of survival time. Clasp-retained obturators and surgical splints should be used primarily for temporary restorations due to their shorter survival times.

Conquering the inner couch potato: precommitment is an effective strategy to enhance motivation for effortful actions.

Letting effort-free gratification derail us from effort-requiring goals is one reason why we fail to realize health-relevant intentions like 'exercise regularly'. We tested the effectiveness of the self-control strategy precommitment in such effort-related conflicts, using a novel laboratory choice paradigm, where participants could precommit to an effort-requiring large reward by pre-eliminating an effort-free small reward from their choice set. Our participants used precommitment frequently and effectively, such that they reached effort-requiring large rewards more often. Using computational modelling and Bayesian model comparisons, we assessed whether participants employed precommitment to avoid anticipated willpower failures (i.e. as a self-regulatory measure) or to maximize their motivation to choose the effort-requiring option (i.e. as a self-motivational measure). Observed choices and precommitment decisions were consistent with the motivation maximization hypothesis, but not the willpower hypothesis. Our findings show that offering precommitment is effective in helping individuals optimize their motivation and choice behaviour and thereby achieve effort-requiring goals, and strongly encourage application of precommitment schemes in exercise and rehabilitation interventions. This article is part of the theme issue 'Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications'.

Wet air as an alternative to traditional water irrigation during caloric vestibular testing.

OBJECTIVES/HYPOTHESIS: To evaluate whether caloric vestibular testing by wet air (WAI) is better than by dry air (DAI) in comparison to the gold standard using water (WAT). STUDY DESIGN: Prospective study, comparison with reference standard. METHODS: Fifty volunteers with normal ear and balance function were enrolled in a prospective study. After side-specific warm and cold DAI, WAI, and WAT experimental nystagmuses were recorded using video-oculography. Peak slow nystagmus phase velocity (SPV) data at test culmination and the subjective tolerance of the methods were analyzed by visual analog scale. RESULTS: The three methods differed significantly with respect to warm versus cold stimulation and stimulus side, with one exception. In the case of cold stimulation on the left side, SPV values did not differ between DAI and WAI. The intraclass correlation coefficients (ICCs) of WAT versus WAI were indicative of a medium to high agreement with the SPV data for all four individual irrigations. The ICCs of the WAT/DAI comparison were usually smaller. Generally, smaller individual differences were shown in Bland-Altman plots comparing WAI and WAT than plots comparing DAI and WAT. WAI had better subjective tolerability than WAT. CONCLUSIONS: WAI is an alternative caloric test method for anxious subjects oversensitive to WAT and probably for patients with suspected pathological ear canal and tympanic membrane findings.