Use of technopolymer clasps in prostheses for patients due to have radiation therapy.

Patients with large oral defects as a result of a maxillectomy procedure, who are due to have postoperative radiotherapy, need to have the density of the defect restored to ensure standardised radiation distribution. This is achieved with various types of boluses that often require tissue surface positioning stents to help support them. Traditional metal-clasp retained stents were discarded as the clasps caused backscatter of the radiation beams. A radiolucent material was needed to retain these prostheses. Dental D, an acetal resin was used in the fabrication of a positioning stent. It was assessed in terms of ease of manufacture, cost, fit, retention and radiolucency. The material was found to be more costly and time-consuming to manufacture than conventional metal-retained acrylic resin prostheses, but its radiolucency made it ideal for use in patients during radiotherapy treatment. Future studies will determine if the long-term strength of the material will allow the clasps to be used in a definitive prosthesis and thus help offset the initial time and costs.

Potential risk of serious oral infections in the diabetic patient: a clinical report.

Diabetes has many manifestations, including increased vulnerability to bacterial and fungal infections, that may be of concern to the dental profession. Oral candidosis and other opportunistic fungal infections may be early, nonspecific signs of uncontrolled diabetes. Rhinocerebral involvement often extends to the paranasal sinuses, pharynx, palate, orbit, and brain, causing severe tissue destruction and necrosis. This clinical report describes a young woman with diabetes who developed mucormycosis of the maxilla. Tissue destruction resulted in loss of the entire premaxilla, the anterior half of the hard palate, and all maxillary teeth except for the right and left second molars. An interim clear acrylic resin prosthesis was fabricated to restore facial contours and speech and to allow mastication. This prosthesis subsequently was duplicated, and teeth were added for improved lip support, esthetics, and mastication.

An 8-year assessment of maxillofacial prosthetic patients treated in a Department of Prosthetic Dentistry.

The Department of Prosthetic Dentistry at the University of the Witwatersrand, Johannesburg, serves as a referral centre for maxillofacial prosthetic patients from the surrounding general hospitals and local private clinics. This places a time and financial constraint on the department. The aim of this study was to establish the number of new patients seen annually, the causative factors associated with the various types of defects, the treatment provided and the cost per patient in terms of clinical hours and prosthesis fees. The data were taken from the records of patients treated in the maxillofacial prosthetics clinic during an 8-year period, from January 1991 to December 1998. The total number of new patients was calculated and the data were collated according to the year in which treatment commenced. Results were tabulated according to the number of new cases in each group, the aetiology of the defects, prosthetic treatment provided and the costs in terms of clinical hours and prostheses. The results of this study indicate that there is a need for a specialised Maxillofacial Prosthetic Unit. Although the present fee schedule needs to be revised, there is still a need for a substantial amount of state subsidy.