Development and virtual validation of a novel digital workflow to rehabilitate palatal defects by using smartphone-integrated stereophotogrammetry (SPINS).

Palatal defects are rehabilitated by fabricating maxillofacial prostheses called obturators. The treatment incorporates taking deviously unpredictable impressions to facsimile the palatal defects into plaster casts for obturator fabrication in the dental laboratory. The casts are then digitally stored using expensive hardware to prevent physical damage or data loss and, when required, future obturators are digitally designed, and 3D printed. Our objective was to construct and validate an economic in-house smartphone-integrated stereophotogrammetry (SPINS) 3D scanner and to evaluate its accuracy in designing prosthetics using open source/free (OS/F) digital pipeline. Palatal defect models were scanned using SPINS and its accuracy was compared against the standard laser scanner for virtual area and volumetric parameters. SPINS derived 3D models were then used to design obturators by using (OS/F) software. The resultant obturators were virtually compared against standard medical software designs. There were no significant differences in any of the virtual parameters when evaluating the accuracy of both SPINS, as well as OS/F derived obturators. However, limitations in the design process resulted in minimal dissimilarities. With further improvements, SPINS based prosthetic rehabilitation could create a viable, low cost method for rural and developing health services to embrace maxillofacial record keeping and digitised prosthetic rehabilitation.

Oral Health: supporting adults who require assistance second edition

BPGs promote consistency and excellence in clinical care, administrative policies, procedures and education, with the aim of achieving optimal health outcomes for people, communities and the health system as a whole. This BPG replaces the RNAO BPG Oral Health: Nursing Assessment and Intervention, which was released in 2008. The purpose of this BPG is to provide nurses, the interprofessional team and caregivers with evidence-based recommendations for the provision of oral care for adults (18 years of age and older) that will: promote an interprofessional approach to providing oral care, enhance the delivery of oral care interventions, and ultimately lead to positive oral healthG outcomes for persons. This BPG recognizes that a person- and familycentredG approach to care is essential for providing oral care (or providing assistance with oral care) to adults across the continuum of care. This BPG also recognizes that when providing any form of oral care, infection control practices should be followed.

Dental appliance therapy in pantothenate kinase-associated neurodegeneration: Case report.

Pantothenate kinase-associated neurodegeneration (PKAN) is a rare condition associated with severe protrusive lingual dystonia, a form of oromandibular dystonia. Dental appliance therapy has been described for oromandibular dystonia however there is a lack of literature regarding its application specifically to PKAN. In this report, the authors describe the use of an appliance in conjunction with botulinum toxin injections for the symptomatic treatment of this condition. A satisfactory outcome is achieved which suggests this technique may be of use to other clinicians.

[Personal response to disease at paresthesia oral mucosa].

A study related to the disease in 39 (7 men and 32 women) people aged 61-86 years, suffering from paresthesia oral mucous membranes (POMM). To determine the type of relationship to the patient's illness was used clinical test method which employs a clinical-psychological typology of relationship to the patient's illness. It was found that for patients with middle and old age (69,2 %), suffering from severe and moderate POMM severity of pathology characteristic intrapsychic focus of personal response to the disease, is caused due to the presence of a constant burning sensation in the mouth, often accompanied by the syndrome of «dry mouth¼ violation of social adaptation of patients. For the older age groups suffering POMM, which proceeded in a light, at least moderate disease severity (28,2 %) is characteristic orientation interpsychic personal response to the disease, also causes disturbances of social adaptation of patients. The obtained information about the type of relationship the patients of elderly and senile age, suffering POMM show that to achieve a positive therapeutic outcome and successful rehabilitation is necessary to change their existing inadequate response to disease, it is possible by attracting clinical pharmacologist and (or) the therapist.

Intensive swallowing and orofacial contracture rehabilitation after severe burn: A pilot study and literature review.

BACKGROUND: Dysphagia following severe burns can be significant and protracted, yet there is little evidence describing the rehabilitation principles, process or outcomes. PURPOSE: Outline current evidence and detail the clinical outcomes of two cases who underwent a multifaceted intensive treatment programme aimed at rehabilitating dysphagia by strengthening swallow function and minimising orofacial contractures after severe head and neck burns. METHODS: Two men (54 and 18 years) with full-thickness head and neck burns and inhalation injury underwent intensive orofacial scar management and dysphagia rehabilitation. Therapy was prescribed, consisting of scar stretching, splinting and pharyngeal swallow tasks. Horizontal and vertical range of movement (HROM; VROM), physiological swallow features, functional swallowing outcomes and related distress, were collected at baseline and routinely until dysphagia resolution and scar stabilisation. RESULTS: At presentation, both cases demonstrated severely reduced HROM and VROM, profound dysphagia and moderate dysphagia related distress. Therapy adherence was high. Resolution of dysphagia to full oral diet, nil physiological swallowing impairment, and nil dysphagia related distress was achieved by 222 and 77 days post injury respectively. VROM and HROM achieved normal range by 237 and 204 days. CONCLUSION: Active rehabilitation achieved full functional outcomes for swallowing and orofacial range of movement. A protracted duration of therapy can be anticipated in this complex population.

Manejo prostodóntico convencional de una paciente con síndrome de CREST: reporte de caso / Conventional prosthodontics management of a patient with Crest syndrome: case report

El síndrome de CREST se caracteriza por calcinosis, síndrome de Raynaud, dismotilidad esofágica, esclerodactilia y telangiectasia. Presenta signos y síntomas en el sistema estomatognático que merecen consideración en un tratamiento. El objetivo del presente artículo fue reportar las manifestaciones orales de un caso de síndrome de CREST y describir su tratamiento protésico realizado en el Departamento de Rehabilitación Oral de la Universidad Nacional de Colombia. Se reporta una paciente mujer de 42 años, con diagnóstico de síndrome de CREST por su médico tratante, que acude a la facultad de odontología para un tratamiento restaurador. El manejo prostodóntico incluyó coronas, prótesis parcial fija metal-cerámicas y prótesis parcial removible. Los resultados obtenidos nos permiten recomendar las alternativas restaurativas convencionales similares a las usadas en un paciente sin esta condición sistémica, pero manteniendo un control estricto.

The CREST syndrome is characterized by calcinosis, Raynaud's syndrome, esophageal dysmotility, sclerodactyly, and telangiectasia. It has signs and symptoms in the stomatognathic system that deserve consideration in its treatment. The objective of this paper is to report the oral manifestations of a case of CREST syndrome and describe the prosthetic treatment performed in the Department of Oral Rehabilitation in the National University of Colombia. The case is presented of a patient female aged 42 years, diagnosed with CREST syndrome by the treating doctor. She came to the Faculty of Dentistry for restorative treatment. The prosthodontic management included metal-ceramic crowns, fixed partial denture, and removable partial denture. The results demonstrate that conventional restorative alternatives, similar to that used in a patient without this systemic condition, while maintaining strict control of it, can be recommended.

Perfil de los pacientes rehabilitados por medio de prótesis atendidos en servicio público de salud en Ribeirão Preto, Brasil / Patients profile rehabilitated with dental prosthesis assisted by the health public service in Ribeirão Preto, Brazil

La prevalencia de sexo y el padrón de edad relacionado a los diferentes tipos de rehabilitaciones protésicas son variables importantes que deben ser estudiadas. De esta manera, el objetivo de este estudio fue evaluar el perfil de edad y género en pacientes rehabilitados con prótesis dentales en un curso de Odontología durante un periodo de cinco años. Fueron evaluados 638 fichas de pacientes que recibieron prótesis parcial fija (PPF), prótesis parcial removible (PPR) y prótesis total (PT). Las prótesis de los pacientes rehabilitados con PPR fueron clasificadas en dentomucosoportada (DM) o dentosoportadas (D). Para el análisis de los resultados, los pacientes fueron divididos en 2 grupos: A) >50 años y B) <50 años. Los datos fueron analizados estadísticamente por el test exacto de Fisher o chi-cuadrado (p<0,05). No se observaron diferencias significativas en relación a la edad y tipo de prótesis. Para la PPF 74% fueron <50 años, para la PPR 52%, >50 años y para la PT 92%, >50 años. En todas las prótesis, existió una mayor prevalencia del género femenino. Con relación a la clasificación de las PPRs, 47% fueron D y 53% DM, sin identificar diferencias estadísticamente significativas. De esta manera se puede concluir que la necesidad de rehabilitación de un mayor numero de elementos dentales aumenta con la edad, siendo prevalente en todos los periodos de la vida adulta, principalmente, en mujeres

The prevalence of gender and age related pattern of the different types of prosthetic restorations are important variables to be estimated. The aim of this study was to evaluate the profile of age and gender in patients rehabilitated with dental prostheses on School of Dentistry during five years. Were evaluated 638 records of patients who received fixed prosthesis (FP), removable partial (RP) or total dentures (T). Rehabilitated patients with RP had their prostheses classified into dental-mucous-supported (DM) or tooth-supported (D). To analyze the results, patients were divided into 2 groups: A) >50 years or B) <50 years. Data were statistically analyzed by Fisher's exact test or chi Square (p<0.05). No statistical significance relation to age and types of prostheses was observed. On RP, 47% was D and 53% DM, there was no statistically significant difference. It was possible to conclude that the rehabilitation of greater number of the teeth increases with age and is prevalent in all periods of adulthood, especially in women

[Transoral coronoidectomy: Technical note]. / Coronoïdectomie intra-orale: note technique.

INTRODUCTION: Among the skeletal causes of limited mouth opening, uni- or bilateral coronoid process hypertrophy, or Langenbeck disease, is the most frequent. It can be associated with an osteochondroma or a coronoid-malar bone conflict and is then called Jacob disease, an unilateral pathology. Treatment rests on coronoidectomy in both cases. This technique is illustrated via two cases, one Langenbeck and one Jacob disease. TECHNICAL NOTE: A transoral approach was performed. After subperiosteal dissection, the coronoid process was cleared. The process was than severed at its base by means of a burr, freed from its temporal muscular fibers and removed. Mouth opening improved peroperatively. The surgical procedure was completed by active long-term physiotherapy beginning immediately after surgery. DISCUSSION: Transoral coronoidectomy is a simple, quick and safe procedure. Extra-oral approaches present a high risk of facial nerve injury. In our first case, mouth opening improved from 24 to 36 mm after bilateral coronoidectomy and to 40 mm after physiotherapy. In our second case, mouth opening improved from 22 to 38 mm after unilateral coronoidectomy and to 43 mm after one year physiotherapy. Long-term post-operative physiotherapy is mandatory to get and maintain good results.

Orofacial contracture management outcomes following partial thickness facial burns.

PURPOSE: To examine clinical outcomes following non-surgical exercise for contracture management post partial thickness orofacial burn. METHODS: A cohort of 229 patients with partial thickness orofacial burn was recruited over 3 years. Orofacial contracture management combining exercise and stretching was initiated within 48h of admission and continued until functional goals were consistently achieved. A second cohort of 120 healthy controls was recruited for normative comparison. Vertical and horizontal mouth opening measures were recorded at the start and completion of orofacial intervention for patients and once only for controls. RESULTS: At commencement of intervention, participants with orofacial burns had significantly (p<0.001) reduced vertical and horizontal mouth opening. Treatment duration averaged 30.7 days (SD=52.3). Post treatment significant (p<0.001) improvements in vertical and horizontal opening were noted. At treatment conclusion, a significant (p<0.01) difference remained between the burns cohort and control group for vertical mouth opening, though horizontal mouth opening was now statistically comparable to the controls. CONCLUSION: This study supports positive outcomes following orofacial contracture management for patients with partial thickness orofacial burn. Despite this, some functional loss remained with patients demonstrating persistent reduced vertical mouth opening at conclusion of treatment compared to their healthy counterparts.

Concepciones en los usuarios de un servicio odontológico público sobre salud-enfermedad bucal / Conceptions users of a public dental service on oral health-disease

Introducción: el estudio y análisis de la salud no debe excluir la trama de concepciones, creencias, significados y percepciones que los sujetos poseen, construidos sobre la base de su interacción social. Objetivo: identificar las concepciones de la salud/enfermedad bucal en usuarios de un servicio odontológico público. Método: investigación descriptiva, transversal, de campo y fuente viva. Se seleccionó muestra de conveniencia (50 pacientes) de acuerdo a los criterios de inclusión: Personas entre los 18 a 60 años y más. Ambos sexos, que asistieran durante el mes de octubre de 2012 al Servicio Odontológico del Ambulatorio Sur-Veritas del Instituto Venezolano de los Seguros Sociales; Maracaibo, Zulia , Venezuela. Las variables del estudio fueron: salud/enfermedad bucal, atención del profesional de la odontología, y edentulismo. Se empleó un cuestionario semi-estructurado y se aplicaron técnicas de análisis cuantitativo y cualitativo a los datos obtenidos. Resultados: la significación de estar sano de la cavidad bucal estuvo vinculada a la ausencia de la enfermedad (53 por ciento). El 82 por ciento de los usuarios señaló la buena presencia, imagen y belleza como uno de los mayores beneficios de tener buena salud bucal. Expresaron el 74 por ciento de los entrevistados que lo que más les afectaba de tener una enfermedad bucal era los gastos en tratamientos rehabilitadores. El 76 por ciento manifestó que su experiencia con la atención del profesional de la odontología fue buena. El 58 por ciento asoció el edentulismo con fealdad, y descuido personal, y 42 por ciento lo vinculó a la vejez. Conclusiones: las concepciones de la salud-enfermedad bucal de los individuos de este estudio resultaron muy vinculadas con la estética en sus referentes de belleza e imagen; aun cuando se encontraron avances respecto a reconocer a la salud bucal como un componente de la salud general(AU)

Introduction: the study and analysis of health cannot exclude the plot of concepts, beliefs, meanings and perceptions that patients have, built on the basis of their social interaction. Objective: to identify the oral health/disease conceptions on the users of a public dental service. Method: A descriptive, cross-sectional study was carried out.A convenience sampling was applied. The sample was constituted by 50 patients, from 18 to 60 and more years of age, which attended to the dental service of the Ambulatorio Sur-Veritas of the Venezuelan Social Security Institute, Maracaibo ­ Zulia state, Venezuela; during October 2012. The variables defined for this study were: Oral health/disease, dentistry professional's attention and edentulism. A semi-structured questionnaire was used and quantitative and qualitative data analysis techniques were applied. Results: the significance of having a healthy oral cavity was strongly linked to the absence of disease (53 percent). 82 percent of users stood out the good presence, image and beauty as one of the greatest benefits of having a good oral health. 74 percent of the respondents expressed that the expenses implied in the rehabilitation treatments were the thing that most affected them about having an oral disease. 76 percent of users said that their experience with the dentistry professional's attention was good. Regarding edentulism 58 percent associated it with ugliness, disgust or personal carelessness, and 42 percent linked it to old age. Conclusions: the conceptions about oral health/disease of the individuals considered in this study were strongly associated with aesthetics in its relating of beauty and image; even though advances were found with respect to recognize oral health as a component of general health(AU)

Prosthetic rehabilitation of palatal perforation in a patient with 'syphilis: the great imitator'.

Syphilis is a sexually transmissible disease caused by treponema palladium, a microaerophilic spirochete. Syphilis may progress from primary to tertiary stage if left unnoticed and untreated. Dentists should be vigilant and suspect sexually transmitted infections such as syphilis in the differential diagnosis of oral inflammatory or ulcerative lesions with palatal perforation. Moreover, it is imperative that dentists should have knowledge about its stages, characteristic features, oral presentation and prosthetic rehabilitation. This case report describes a case of tertiary syphilis with palatal perforation and the prosthetic rehabilitation of the defect with a prosthetic obturator.

Association between seeking oral health information online and knowledge in adults with spinal cord injury: a pilot study.

OBJECTIVE: To characterize adults with spinal cord injury (SCI) who seek oral health information online, and investigate whether seeking oral health information online is associated with oral health knowledge and behaviors. METHODS: An online oral health survey was posted on the South Carolina Spinal Cord Injury Association website. Respondents were 192 adult residents of the US ages 19-83 years who identified themselves as having SCI occurring at least 1 year before the survey date. RESULTS: About 12% (n=23) of the respondents searched oral health information online in the past 12 months. Significant associations between the proportion of respondents who searched for oral health information online and socio-demographic and the proportion of respondents who engaged in various oral health behaviors were not detected. However, multivariable logistic regression indicated that respondents who searched oral health information online in the past 12 months have 3.4 times the odds of possessing adequate oral health knowledge compared to respondents who did not search oral health information online (adjusted odds ratio=3.41, 95% confidence interval = 1.35, 8.62, P=0.01). CONCLUSIONS: Given the significant association between seeking oral health information online and adequate oral health knowledge, this study suggests that online oral health information may be a potential avenue for dental health professionals to supplement oral health education in adults with SCI.

Prosthetic rehabilitation of a midfacial defect resulting from lethal midline granuloma--a clinical report.

Prosthetic rehabilitation of the midfacial defects has always perplexed maxillofacial prosthodontists. These midfacial defects lead to functional and cosmetic deficiencies. One of the causes of such defects is midline lethal granuloma, which is a destructive granulomatous lesion of uncertain aetiology, involving the nose, paranasal sinuses and the palate. Presented here is a clinical report of a 22-year-old male patient diagnosed to have lethal midline granuloma, who was referred to the Department of Prosthodontics, SDM College of Dental Sciences Dharwad. The patient had a severe midfacial defect involving the nose, the paranasal sinuses, the palate and the soft tissues of the face. Although the lesion was not of the rapidly progressive type at the time of rehabilitation, the non-specific inflammatory process was persisting. The patient was treated with chemotherapy and palliative therapy. The primary objective of the prosthetic rehabilitation was to provide closure of the severe defect to protect the soft tissues from environmental exposure. Secondarily the prosthesis also provided acceptable aesthetics and psychological benefit to the patient.

Complete prosthodontic rehabilitation of a patient with Graves' disease.

Graves' disease is the most common form of hyperthyroidism. A brief summary of hyperthyroidism is given with the common symptoms that characterize a thyroid storm. This is followed by a case report of a method of restoring dental health to a patient with Graves' disease.

[Laser physiotherapy of stomatological diseases]. / Lazernaia fizioterapiia stomatologicheskikh zabolevanii.

Modern methods of laser prophylaxis and physiotherapy of numerous dental diseases in cariesology, endodontia, periodontology, surgery, orthodonty, pedodontics, implantology, etc., using new-generation laser technologies, are reviewed.