The Tai Chi Flap: A Novel Design for the Radial Forearm Flap.

OBJECTIVE: Tai Chi is an ancient philosophy used to explain the universe. The Tai Chi symbol is represented by Yin/Yang fishes. The authors describe a novel radial forearm flap (RFF) design for the reconstruction of circular defects based on the Tai Chi symbol. METHODS: Eleven consecutive patients with craniofacial skin or mucus defects underwent reconstruction with a Tai Chi RFF. Patient perioperative and follow-up information was collected. RESULTS: The diameter of the Tai Chi RFF was 5 to 6 cm. All flaps healed uneventfully without ischemic problems, and all donor site defects were closed primarily without skin grafts. Remarkably, 2 patients received a tattoo to mark the Tai Chi symbol and greatly appreciate the shape of the flap. CONCLUSIONS: The Tai Chi flap is an economically friendly flap design that can be used to prevent skin grafts while providing psychological comfort to patients.

The Effect of Reading Aloud Exercises for Complete Denture Patients during the Functional Rehabilitation Period.

PURPOSE: The focus of this study was to evaluate the effect of reading aloud on masticatory performance and patient satisfaction of patients rehabilitated with conventional complete dentures for the first time. MATERIALS AND METHODS: Sixty-two edentulous patients who received conventional complete denture treatment for the first time were randomly divided into two equal groups. After insertion of the dentures, patients in group I were asked to read a news report three times per day for 4 weeks, while those in group II did not read. The reading duration increased by 5 minutes per week, from 5 minutes in the first week to 20 minutes in the fourth week. The patients' mouth opening during reading aloud was advised to gradually increase throughout the training project. Two and four weeks after insertion of the dentures, masticatory performance was assessed using the sieving method, and patient satisfaction was measured using a visual analogue scale, which combined the patient's perceptions in relation to comfort, esthetics, stability, ability to talk, and ability to chew. RESULTS: There were significant improvements in masticatory performance with reading aloud exercises after the insertion of complete dentures (p < 0.001) at the 2- and 4-week follow-up visits. Masticatory performance also showed significant improvement within each group in the follow-up periods (p < 0.001). No significant differences were found between the two groups in patient satisfaction (p > 0.05) at 2 weeks, but at 4 weeks, patient satisfaction regarding stability, ability to talk, and ability to chew was significantly higher for group I (p < 0.001). CONCLUSIONS: The results of this study suggest that reading aloud exercises significantly improved early masticatory performance and patient satisfaction for denture wearers who were treated with conventional complete dentures for the first time, and may be a useful clinical application for more effective denture treatment.

Bond strengths of porcelain to cobalt-chromium alloys made by casting, milling, and selective laser melting.

STATEMENT OF PROBLEM: Cobalt-chromium (Co-Cr) alloys have been widely used for metal-ceramic fixed prostheses and can be fabricated using conventionally cast or new computer-aided technology. However, the effect of different manufacturing methods on the metal-ceramic bond strength needs further evaluation. PURPOSE: The purpose of this in vitro study was to evaluate the metal-ceramic bond strength of a Co-Cr alloy made by casting, milling, and selective laser melting (SLM). MATERIAL AND METHODS: Co-Cr specimens (25×3×0.5 mm) were prepared using a cast, milled, or SLM method and layered with ceramic (8×3×1.1 mm). Metal-ceramic bond strength was measured by a 3-point bend test according to ISO9693. The area fraction of adherence porcelain (AFAP) was determined by measuring the Si content of the specimens with scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS). The metal-ceramic bond strength and AFAP results were analyzed using 1-way analysis of variance and the Bonferroni post hoc test (α=.05). SEM/EDS and metallurgic microscopy were also used to study the specimens' morphology, elemental composition, and metallurgic structure. RESULTS: No significant differences (P>.05) were found for the bond strength among cast, milled, and SLM Co-Cr alloys. The milled and SLM groups showed significantly more porcelain adherence than the cast group (P<.001). The surface morphologies and oxidation characters of cast, milled, and SLM Co-Cr alloys were similar, whereas the metallurgic structures were different. CONCLUSIONS: The bond strength between ceramics and Co-Cr alloys is independent of the manufacturing method. However, milling- and SLM-produced alloys had better porcelain adherence.

Effect of silica coating on the bond strength of milled pure titanium to dental porcelain.

The creation of a high bond strength between machined computer-manufactured pure titanium and porcelain remains problematic, and the effects of a silica coating on the bond strength of milled pure titanium bonded to dental porcelain require further investigation. The objective of this study was to evaluate the bond strength of machined pure titanium, with an intermediate coating of silica, to dental porcelain. In this work, 24 specimens of milled pure titanium were prepared and randomly divided into test and control groups, in which the test group was coated with silica using the sol-gel dipping technique. The metal-ceramic bond strength was evaluated, according to ISO 9693 standards, using the three-point bending test, and scanning electron microscopy and energy-dispersive spectroscopy were used to study the microstructure and elemental composition of the specimens. The bonding strength of the silica-coated group was significantly higher than that of the control group, and more residual porcelain on the metal surface could be observed in the silica-coated group. Therefore, the application of a silica intermediate coating produced using the sol-gel method could significantly improve the bond strength between machined pure titanium and porcelain.

Effect of heating palladium-silver alloys on ceramic bond strength.

STATEMENT OF PROBLEM: The effects of different heat treatments on the internal oxidation and metal-ceramic bond in Pd-Ag alloys with different trace elements require further documentation. PURPOSE: The purpose of this in vitro study was to determine whether heat treatment affects the metal-ceramic bond strength of 2 Pd-Ag alloys containing different trace elements. MATERIAL AND METHODS: Thirteen cast specimens (25×3×0.5 mm) from each of 2 Pd-Ag alloy groups (W-1 and Argelite 61+3) were allocated to heat treatments before porcelain application: heating under reduced atmospheric pressure of 0.0014 MPa and 0.0026 MPa and heating under normal atmospheric pressure. Bond strengths were evaluated using a 3-point bending test according to ISO9693. Results were analyzed using 2-way ANOVA and Tukey HSD test (α=.05). Visual observation was used to determine the failure types of the fractured specimens. Scanning electron microscopy and energy dispersive spectroscopy were used to study morphologies, elemental compositions, and distributions in the specimens. RESULTS: The W-1 group had a mean bond strength significantly higher than that of Argelite 61+3 (P<.001). Heating under reduced atmospheric pressures of 0.0014 MPa and 0.0026 MPa resulted in similar bond strengths (P=.331), and both pressures had significantly higher bond strengths than that of heating under normal atmospheric pressure (P=.002, P<.001). Heating under different air pressures resulted in Pd-Ag alloys that contained either Sn or In and Ga, with various degrees of internal oxidation and different quantities of metallic nodules. CONCLUSIONS: Heating under reduced atmospheric pressure effectively improved the bond strength of the ceramic-to-Pd-Ag alloys.

Effect of oxidation heat treatment on the bond strength between a ceramic and cast and milled cobalt-chromium alloys.

There is a dearth of dental scientific literature on the effect of different oxidation heat treatments (OHTs) (as surface pretreatments) on the bonding performance of cast and milled cobalt-chromium (CoCr) alloys. The objective of this study was to evaluate the effect of different OHTs on the bond strength between a ceramic and cast and milled CoCr alloys. Cobalt-chromium metallic specimens were prepared using either a cast or a milled method. Specimens were subjected to four different OHT methods: without OHT; OHT under normal atmospheric pressure; OHT under vacuum; and OHT under vacuum followed by sandblasting. The metal-ceramic bond strength was evaluated using a three-point bending test according to ISO9693. Scanning electron microscopy and energy-dispersive spectroscopy were used to study the specimens' microstructure and elemental composition. The bond strength was not affected by the CoCr manufacturing method. Oxidation heat treatment performed under normal atmospheric pressure resulted in the highest bond strength. The concentration of oxygen on the alloy surfaces varied with the different pretreatment methods in the following order: OHT under normal atmospheric pressure > OHT under vacuum > without OHT ≈ OHT under vacuum followed by sandblasting.