Anesthesia Teleconsultation: Quality, Medicoeconomic Interest, and Patient Satisfaction of Preoperative Assessment-A Prospective Observational Study.

Background: Telemedicine can be defined as the use of telecommunication technology for performing medical acts remotely by health professionals. Currently in anesthesia, teleconsultation (TC) is becoming widespread, although the benefit and quality have not been well evaluated. The objective of this study was to assess the quality, the patient satisfaction, as well as the ecological and medicoeconomic impacts of the preanesthesia TC. Methods: This prospective observational multicentric study was approved by the Société Française d'Anesthésie-Réanimation ethics committee. The study took place from October 2020 to March 2021, in eight French health care institutions. Every adult patient requiring TC before elective surgery could be included. Unavailability of videoconferencing for the patient was the main exclusion criteria. Five hundred three (n) patients, scheduled for surgery, were included. Their files were analyzed for quality, 375 were successfully interviewed for the second part of the study evaluating satisfaction and medicoeconomic impact. The study's evaluation criteria were the quality of the TeleMed-Cs, the satisfaction and comprehension for the patient, and the medicoeconomic impact of a remote evaluation compared with the face-to-face consultation with the surgeon. Results: Of the 503 files, 478 (95%) were reviewed and met all the high authority of health quality criteria. The electronic format of records was associated with higher completion rate. The median satisfaction was 10.0 (IQR 8.25-10.0). The cost of a TC in anesthesia was significantly lower than that of a face-to-face surgical consultation with a median cost of 1.49€ (IQR 0.8-1.99) versus 34.81€ (IQR 14.01-91.7) p < 0.001. Conclusions: TC in anesthesia seems to be a good alternative in terms of quality, patient satisfaction, and medicoeconomic gain for our patients. By facilitating access to preoperative evaluation, it could be adopted worldwide and thus reduce surgery-related morbidity and mortality in our patients.

Immediate implant supported prosthodontic treatment of the edentulous jaw with additional implant stabilization.

AIM: To increase the reliability, quality, and incidence of favorable outcomes during mandibular direct implant prosthetic treatment using the Trefoil system. MATERIALS AND METHODS: This study included 48 patients (age: 63-85 years). Visualization assessment (CBCT) was performed using Planmeca Promax 3D Mid, and bone density was examined using dual energy X-ray absorptiometry (densitometry, DXA). The final sample consisted of 16 patients deemed suitable for immediate implant placement and loading of permanent prosthesis on the mandible. The distal implants were stabilized using a customized structure made of Titanium Ti6-Al4-V using DMLM 3D printing technology with Concept Laser machines. Modeling of the contours of the jawbone at the planned surgical site was carried out using cone-beam computed tomography and the Mimics Medical 21 software (Materialize, Germany) for each patient. A total of 32 such devices were created. RESULTS: Of these, 18 were used as the initial implant stability was less than 35 N/cm of torque in a few cases only. The implant survival rate was 100% after 18 months. This method of mandibular implant prosthetic treatment using a customized device for implant stabilization has been patented. CONCLUSION: Splinting of the compact walls of the mandible using a customized structure optimized stabilization of the Trefoil prosthetic construction on porous bone (type IV) following extraction of teeth and placement of implants. Clinical testing of the reported method confirmed its viability for dental rehabilitation of elderly patients and proved its ability to provide a good quality of life by creating stable implant prostheses with high functionality.

Clinical substantiation of the sparing and less invasive implant prosthetics of the edentulous lower jaw method.

OBJECTIVE: Proof of the effective implant prosthetics treatment of patients with the edentulous lower jaw by minimally invasive method. MATERIALS AND METHODS: As a sample of clinical research, 68 senior patients (30 men and 38 women) were diagnosed with edentulous lower jaws. The methods of the study included estimating the implant retention by frequency-resonance analysis of Osstell ISQ, the degree of retention and stabilization of the tissue supported and implant-supported dentures (author's method: patent for invention No. 2640375 of 28.12.2017) and a sociologic questionnaire "Profile of the influence of dental health OHIP-14". RESULTS: For the first time strength indicators of the retention and stabilization degree of implant-retained mandibular overdentures with attachment to one and two implants were determined. A linear relationship was shown between the degree of fixation of the prosthesis and the change in the quality of life (a statistically significant correlation was p=0.022, r=0.52 in the first group and p=0.0015; r=0.75 in the second group). The implants stability during the year increased in the first group in 2.57±1.59%, and in the second group in 2.08±1.40%. After a year using implant-retained mandibular overdentures, the life quality level concerning dental health in patients from the first and second groups remained the same (there were no statistically significant differences, p1-2=0.8392). CONCLUSIONS: The performed survey of prosthetic treatment patients with the edentulous lower jaw showed the effect use of a sparing method of implantation prosthetics. The fixation quality achieved with a single support-retaining implant was sufficient to improve the functional and comfortable using of the lower jaw prosthesis. It was found that the stability of implants statistically did not significantly depend on the number of used implants (p>0.05).