[Lack of retention of the upper denture: is placement of 2 palatal implants the solution?]. / Retentieproblemen van de bovenprothese: is het plaatsen van 2 palatinale implantaten de oplossing?

A 72-year-old man, edentulous in the maxilla for 20 years, presented himself at his dentist in 2006 with complaints concerning retention of his upper denture. The placement of implants was only possible if bone augmentation was undertaken; this was definitively rejected by the man. As an alternative, Muchor anchors were placed, but these did not provide an adequate solution to the retention problem. In the end, 2 palatal implants were placed, with magnetic anchoring. One year later, the man was very satisfied with this solution.

Service needs of parents with motor or multiply disabled children in Dutch therapeutic toddler classes.

OBJECTIVE: To determine parents' service needs at the start of therapeutic toddler class treatment, to analyse determinants and to investigate received help after a period of 10 months. SUBJECTS: Parents with motor or multiply disabled children in therapeutic toddler classes. SETTING: Sixteen out of 17 Dutch rehabilitation centres. DESIGN: A sample of 84 parents, stratified according to toddler class size. MAIN OUTCOME MEASURES: A questionnaire of 33 items, divided into five categories, was designed to assess parents' needs and to evaluate the amount of received help. Several measures were used to assess child, parent and family characteristics. RESULTS: Based on factor analysis, five need subscales were distinguished which only partially corresponded to the initial categories. The initial category concerning needs for help in family functioning did not come out as a factor. Needs expressed most frequently belonged to the three subscales of needs for information concerning the child. The average level of needs generally did not differ for mothers and fathers across the subscales. However, we found large variation in needs for both mothers and fathers on each subscale. The most important, positively correlated determinant of parents' needs was social isolation of the family. After 10 months a considerable level of unmet needs was found. CONCLUSIONS: A systematic and periodic assessment of individual needs of parents as well as the services offered is recommended. Professionals of the therapeutic toddler classes should especially focus on providing parents with information on their child's disability and therapy, community services and parenting.