Maxillary full-arch reconstruction using a sequenced digital workflow.

OBJECTIVE: Multi-staged treatment of a terminal maxillary arch from tooth-supported provisional to implant-supported final reconstruction using a fully digital workflow is reported. Each stage of the phased esthetically-guided reconstruction treatment plan, provisional restorations, and final restoration were executed in a virtual 3D environment prior to clinical treatment, providing CAD/CAM manufactured precision provisionals and final restoration that preserved the natural gingival architecture, function, and esthetics demanded by the patient. Demonstrate the efficacy of using a digital workflow to fully restore a terminal maxillary arch with a precision implant-supported final prosthetic by instituting a multi-phase treatment plan designed to preserve the patient's gingival architecture, facial esthetics, and natural function. CLINICAL CONSIDERATIONS: Sophisticated digital tools and software allow the dental team to work in a virtual environment to envision and execute the outcome of each stage of treatment prior to the patient appointment and to deliver an esthetically-guided precision final prosthesis that replicates the form, function, and occlusion of existing natural teeth. CONCLUSIONS: Digital technologies provide clinicians and dental ceramists with sophisticated tools and software that advance the precision and execution of each phase of maxillary arch reconstruction in fewer patient visits and elevate the patient experience and treatment outcome. CLINICAL SIGNIFICANCE: Sophisticated digital tools and software allow the dental team to work in a virtual environment to envision and execute the outcome of each stage of treatment prior to the patient appointment and to deliver an esthetically-guided precision final prosthesis that replicates the form, function, and occlusion of existing natural teeth.

The effect of ethanol evaporation on the properties of inkjet produced liposomes.

BACKGROUND: Inkjet method has been used to produce nano-sized liposomes with a uniform size distribution. However, following the production of liposomes by inkjet method, the solvent residue in the product could have a significant effect on the properties of the final liposomes. OBJECTIVE: This research paper aimed to find a suitable method to remove ethanol content and to study its effect on the properties of the final liposomal suspension. METHOD: Egg phosphatidylcholine and lidocaine were dissolved in ethanol; and inkjet method at 80 kHz was applied to produce uniform droplets, which were deposited in an aqueous solution to form liposomes. Dry nitrogen gas flow, air-drying, and rotary evaporator were tested to remove the ethanol content. Liposome properties such as size, polydispersity index (PDI), and charge were screened before and after ethanol evaporation. RESULTS: Only rotary evaporator (at constant speed and room temperature for 2 h) removed all of the ethanol content, with a final drug entrapment efficiency (EE) of 29.44 ± 6.77%. This was higher than a conventional method. Furthermore, removing ethanol led to liposome size reduction from approximately 200 nm to less than 100 nm in most samples. Additionally, this increased the liposomal net charge, which contributed to maintain the uniform and narrow size distribution of liposomes. CONCLUSION: Nano-sized liposomes were produced with a narrow PDI and higher EE compared to a conventional method by using an inkjet method. Moreover, rotary evaporator for 2 h reduced effectively the ethanol content, while maintaining the narrow size distribution. Graphical abstract.

Review and update of benign prostatic hyperplasia in general practice.

BACKGROUND: Benign prostatic hyperplasia (BPH) is the most common benign tumour in men. Although men with BPH often need medical or surgical management from a urologist at some point throughout the timeline of their disease, most men are initially assessed and managed by a general practitioner (GP) in the primary healthcare setting. OBJECTIVE: The aim of this article is to highlight the principles of the pathogenesis, presentation, assessment and management of BPH in a primary care setting. DISCUSSION: Between 2009 and 2011, BPH was managed by GPs at approximately 228,000 general practice visits per annum in Australia. Several changes in pharmaceutical agents and surgical intervention have occurred over the past decade. As a result, it is imperative that GPs remain up to date with assessment and management of BPH, are aware of new therapies and understand when to refer to a urologist.

The Application of 3D Printing in the Formulation of Multilayered Fast Dissolving Oral Films.

Fast-dissolving oral films (FDFs) provide an alternative approach to increase consumer acceptance by advantage of rapid dissolution and administration without water. Usually, FDFs require taste-masking agents. However, inclusion of these excipients could make developing the formulation a challenging task. Hence, this work employed fused-deposition modeling three-dimensional printing to produce single-layered FDFs (SLFDFs), or multilayered FDFs (MLFDFs) films, with taste-masking layers being separated from drug layer. Filaments were prepared containing polyethylene oxide (PEO) with ibuprofen or paracetamol as model drugs at 60°C. Also, filaments were produced containing polyvinyl alcohol and paracetamol at 130°C. Furthermore, a filament was prepared containing PEO and strawberry powder for taste-masking layer. FDFs were printed at temperatures of 165°C (PEO) or 190°C (polyvinyl alcohol) with plain or mesh designs. High-performance liquid chromatography and mass spectroscopy analysis indicated active ingredient stability during film preparation process. SLFDFs had thicknesses as small as 197 ± 21 µm, and MLFDFs had thicknesses starting from 298 ± 15 µm. Depending on the formulation and design, mesh SLFDFs presented disintegration time as short as 42 ± 7 s, and this was 48 ± 5 s for mesh MLFDFs. SLFDFs showed drug content uniformity in the range of 106.0%-112.4%. In conclusion, this study provides proof-of-concept for the manufacturing of FDFs by using 3D printing.

Strategies for integrating new restorative materials with digital technology and sound restorative principles.

Restorative dental materials have experienced a significant evolution over the past 40 years. The pace of change has especially accelerated in the past decade, while, concurrently, advances in implant technology and digital dentistry have paralleled this rapid growth. This article outlines the strengths and weaknesses of various popular ceramic restorative materials and how today's technology can be effectively utilized to fabricate these materials into exceptional restorations.

Treating a young adult with bonded porcelain veneers.

BACKGROUND: Esthetic dental treatment for young adults can be challenging. Practitioners often use direct composite bonding in children and teenagers, and often it serves them for many years. However, direct composite bonding has its limitations (such as staining and chipping), and bonded porcelain often is needed. CASE DESCRIPTION: The authors describe an 18-year-old woman who sought esthetic dental treatment. After her dentist discussed treatment options with her, she opted to receive bonded porcelain veneers. The dentist chose a lithium disilicate material on the basis of its strength and esthetic properties. Although the first set of veneers matched the patient's natural teeth well, they did not satisfy her objective of eliminating the white mottling that existed on her natural teeth. Therefore, the dental technician prepared a second set of restorations by cutting back the facial incisal areas slightly in wax to allow creation of incisal effects and by pressing them with a brighter ingot. CLINICAL IMPLICATIONS: Collaboration between the dentist and dental technician is essential to achieving treatment success. Likewise, it is important to secure the patient's input during the process, as he or she often has ideas regarding his or her smile that are different from those of the dental team.

Collaborative development of a natural-looking smile: case presentation.

Sophisticated patients want their dental concerns treated without appearing as if they have been restored. This case presentation describes the planning and treatment steps for the recreation of an aesthetic smile. The patient had dento-facial asymmetries and an elevated occlusal risk of fracture due to bruxism. Lithium disilicate glass ceramic in a pressed version with stocked veneering porcelain was selected as an ideal restorative material for natural aesthetics and to fulfill the strength requirements for the maxillary anterior restorations.

Achieving optimal aesthetics using contemporary porcelain materials: a case report.

While the selection of an appropriate material contributes to restorative success, a thorough treatment plan with enhanced clinician/technician communication is required to ensure an appropriate and aesthetic result. A concise understanding of the patient's existing condition, desires, and expectations is critical to ensure restorative success. This case presentation demonstrates the clinical and laboratory protocols for the development of predictable, functional, and aesthetic porcelain restorations in treating severely compromised maxillary anterior dentition.