Journal articles on the topic 'Surgical and Prosthetic Design'
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1
Kam, A. "40. The evolution of prosthetics." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 49. http://dx.doi.org/10.25011/cim.v30i4.2800.
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Throughout history, prosthetic limbs have undergone significant changes in design and function. For example, an ancient bronze and iron prosthesis with a wooden core, discovered in Italy and dated back to 300 BC, has evolved into a modern shock-absorbing multi-axis prosthetic foot for walking on uneven ground. Recent advances in “neuro-controlled” prosthetics with microprocessor controllers further allow their users to produce smooth, multi-joint movements, simulating “real limbs”. With an increase in government funding focusing on researches in independent mobility, it is expected that new designs will improve immensely the quality of life of amputees. Are we approaching closer to the “ideal prosthetic limb”? The objective of this paper is to examine the evolution of various prosthetic designs and to re-apply some of the old concepts into new designs. The method used is mainly literature review. Results/conclusion: N/A.
Wetz H, Gisbertz D. History of artificial limbs for the leg. Orthopade 2000; 29(12):1018-32.
Pascual G. Amputations, walking and prosthesis development. An R Acad Nac Med (Madr) 2003; 120(3):593-607.
Cottrell-Ikerd V, Ikerd F, Jenkins DW. The Syme’s amputation: a correlation of surgical technique and prosthetic management with an historical perspective 1994; 33(4):355-64.
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Patil, Pravinkumar G., and Smita Nimbalkar-Patil. "Implant-Retained Obturator for an Edentulous Patient with a Hemimaxillectomy Defect Complicated with Microstomia." Case Reports in Dentistry 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/4618510.
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Patient. A 68-year-old man was operated on for squamous cell carcinoma (T3N3M0) of the maxilla creating the hemimaxillary surgical defect on right side. The remaining arch was completely edentulous. There was remarkable limitation in the oral opening with reduced perimeter of the oral cavity due to radiation and surgical scar contracture. This article describes prosthetic rehabilitation by modifying the design of the obturator and achieving the retention with dental implant.Discussion. Severe limitation in the oral opening may occur in clinical situations following the postsurgical management of oral and maxillofacial defects. The prosthetic rehabilitation of the surgical defect in such patients becomes a challenging task due to limited access to the oral cavity. This challenge becomes even more difficult if the patient is edentulous and there are no teeth to gain the retention, stability, and support.Conclusion. In severe microstomia prosthesis insertion and removal can be achieved with modification of the maximum width of the prosthesis. Dental implant retention is useful treatment option in edentulous patients with maxillary surgical defect provided that sufficient bone volume and accessibility are there for implant placement.
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Gus'kov, Aleksandr V., Ol'ga S. Guyter, Aleksandr A. Oleynikov, and Abbass Osman. "Options to optimize the orthopedic treatment protocol to prevent inflammatory complications at the immediate prosthetic stage in patients after multiple teeth extraction." Russian Journal of Dentistry 26, no. 1 (August 31, 2022): 15–24. http://dx.doi.org/10.17816/1728-2802-2022-26-1-15-24.
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BACKGROUND: Simultaneous multiple loss of teeth significantly increases the need for immediate orthopedic treatment in dental patients, often with the use of removable immediate dentures due to general somatic pathologies and local Dental Prostheses System features.
AIM: The study aimed to optimize the orthopedic treatment protocol for patients after multiple teeth extractions.
MATERIAL AND METHODS: As part of the study, the orthopedic preparation of 18 patients was conducted for further permanent prosthetics. Patients underwent tooth extraction in the upper or lower jaw amounting to the formation of included, combined, or terminal dentition defects. The following were used for patient treatment: a standard protocol for immediate prosthetics, a modified protocol, including an improved method of vital mucous membrane staining of the prosthetic bed in the surgical intervention area using standard and immediate original design prostheses. The treatment option effectiveness was evaluated based on the results of diagnostic monitoring of wound healing zones in the prosthetic bed area of immediate prostheses, including visual-palpation assessment, vital oral mucosa staining with an iodine-containing diagnostic solution to control inflammation, and a modified Doppler observation method.
RESULTS: Study results revealed that all patients, who used standard immediate prostheses without considering the diagnostic control of inflammation areas, had objective signs of inflammation up to the 20th day of treatment with low microcirculation dynamics in the wound healing area. In 4 out of 6 patients using standard immediate prostheses, considering inflammation control, the vital staining indicators by day 20 indicated a possible trend toward chronic inflammation development in the prosthetic bed area, which was confirmed by an unstable microcirculation picture. The severity of inflammatory changes was insignificant in patients who received the original design of the immediate prosthesis, starting from the 7th day of observation and minimal by the 20th day. At this time the hemodynamics are physiologically normal.
CONCLUSIONS: Based on the study results, the orthopedic rehabilitation protocols effectiveness, with the use of a modified design based on the immediate prosthesis and permanent diagnostic, mucous membrane staining of the prosthetic bed was established to detect inflammatory complications in the wound healing areas.
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Mishra, Ananya, Kasim Mohamed, Prasanna Kumar, and Sathish Kumar Jayagandhi. "Prosthetic Rehabilitation of Maxillectomy Defects, with Single-Piece Open-Hollow Bulb Definitive Obturator." Journal of Evolution of Medical and Dental Sciences 10, no. 16 (April 19, 2021): 1169–73. http://dx.doi.org/10.14260/jemds/2021/248.
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Patients who undergo surgical resection of the maxillo-mandibular structures as a result of trauma, infection or malignancy, suffer from psycho-social setbacks which has a profound impact on their over-all quality of life. 1,2 These defects, especially those following maxillectomy, result in oroantral communication, facial deformation, impaired speech and difficulty in deglutition. For the rehabilitation of patients with such defects, surgical and prosthetic treatment options are available. As, not all patients can be successfully rehabilitated with reconstructive surgeries due to postoperative complications like graft rejection, the extent of the surgical defect and high psychological impact factor associated with repeated surgeries, prosthetic rehabilitation proves to be an alternative treatment option. The prosthetic rehabilitation of such patients is challenging as it requires restoration of the lost form, function and aesthetics, under constantly changing state of post-surgical intraoral tissues, with limited mouth opening. The maxillofacial prosthesis designed to close congenital or an acquired tissue opening, primarily of the hard palate, is known as an obturator. 3 The obturator has two functional components, one seals the surgical defect and the other replaces the lost dentoalveolarstructures.4-7 The design of an obturator may vary depending on the extent of the defect, remnant dentoalveolar complex, soft tissue undercuts and existent muscle physiology.8,9 Among the two designs, solid and hollow, hollow obturators are widely used. The bulb portion of the hollow obturator, which accommodates the surgical defect, can be open or closed9,10and its selection depends on the prosthodontist’s clinical decision-making skills and the ease of fabrication. In this article we have discussed the rehabilitated patients with single-piece, openhollow bulb definitive obturator. Patients undergo extensive maxillary surgical resections due to aggressive lesions like malignancies and deep fungal infections. Prosthetic rehabilitation of such patients with an obturator becomes of paramount importance as it separates the oropharynx from the nasopharynx, reduces the risk of recurrent infections, replaces lost dentoalveolar structures, permits intelligible speech, reinstates mastication and deglutition, restores facial contour and patient’s self-esteem. The bulb portion of the obturator extends into the defect and accommodates it, forming a hermetic seal. In this clinical report, we highlight the success of prosthetic rehabilitation of maxillectomy patients using single-piece, open-hollow bulb definitive obturator. The meticulous follow-up carried out reveals the success of the prosthesis and adds practice-based evidence to the maxillectomy rehabilitation outcome.
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Dobrzański, L. B., A. Achtelik-Franczak, J. Dobrzańska, and L. A. Dobrzański. "The digitisation for the immediate dental implantation of incisors with immediate individual prosthetic restoration." Journal of Achievements in Materials and Manufacturing Engineering 2, no. 97 (December 1, 2019): 57–68. http://dx.doi.org/10.5604/01.3001.0013.8541.
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Purpose: The purpose of this study is to present the author's method of planning the procedure of immediate implant-prosthetic restoration in place of a tooth qualified for removal by performing a surgical template and implant-prosthetic restoration based on data obtained in the CBCT test and intraoral scanning 3D model. Design/methodology/approach: The method of planning the implant surgery through the design and manufacture of surgical templates and implant prostheses performed before the start of medical procedures was described on the basis of actual clinical data from patients with anterior segment teeth qualified for extraction for reasons of complications after endodontic treatment. The placement of the implant was planned using virtual reality, where the bone model and the virtual soft tissue model were combined, which made it possible to perform a surgical template and prosthetic implant restoration. For the manufacturing, 3D printing as stereolithography SLA and selective laser sintering SLS for the surgical template manufacturing and CNC milling in the case of the prosthetic implant were used for restoration. Findings: The method allows planning the implant position based on two connected bone and soft tissue models and allows to design and manufacture a surgical guide. In this way, it becomes possible to place implants in the patient's bone during surgery procedure in the planned position and to install the prosthetic implant restoration in the form of an individual abutment and a PMMA crown during the same procedure in the surgical part. Practical implications: Thanks to the method of computer-aided design/manufacturing CAD/CAM production of surgical templates and prosthetic restoration based only on digital models and the planned position of the implant, it is possible to carry out the procedure of immediate tooth extraction and replacement with permanent prosthetic restoration. The whole process is based on the CBCT test performed at the beginning. The presented method allows shortening the procedure time by four times and the rehabilitation time by 3-6 months when performing the procedure in a minimally invasive manner. Originality/value: This article presents the original design and production method of surgical guides. It allows for precise planning of the implant position and transfer of this data to the patient's mouth during the procedure, enabling permanent prosthetic restoration before starting medical procedures.
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K, Kasim Mohamed, and Kirupa Shankar R. "Prosthetic Rehabilitation of Cancellous Osteoma – A Case Report." JOURNAL OF CLINICAL PROSTHODONTICS AND IMPLANTOLOGY 4, no. 1 (June 30, 2022): 11–13. http://dx.doi.org/10.55995/j-cpi.2022003.
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Osteomas are benign osteogenic lesions of the bone. When this involves the maxilla and requires resection, maxillectomy defect results and this in turn leads to compromised function in terms of mastication, speech and also psychological well-being. Definitive obturator prosthesis fabricated with maximum extension and incorporation of proper design rehabilitates the patient by improving masticatory efficiency, increasing speech clarity, improves the esthetics, thereby enhancing the overall quality of life. This case report presents one such case of a rare intraoral peripheral cancellous osteoma affecting the maxilla and its prosthetic rehabilitation following surgical resection
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Nguyen, Duc Quang, Thien Cong Pham, and Tho Thanh Quan. "Design, implementation and evaluation for a high precision prosthetic hand using MyoBand and Random Forest algorithm." Science & Technology Development Journal - Engineering and Technology 3, SI1 (September 19, 2020): First. http://dx.doi.org/10.32508/stdjet.v3isi1.536.
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A prosthesis is an equipment provided to people who lost one or some parts of their limbs to help them having almost normal behaviors in daily or hard activities. The convenience and intelligence of devices should create easiness and flexibility for users. Artificial devices require interdisciplinary collaboration from neurosurgeons, surgical surgeons, physiotherapists and equipment development. Computer engineering plays a crucial role in the design step, supporting manufacturing, training and recognition to match the desirability of customers. Moreover, users need a wide range of different options such as an aesthetic functional material, a myoelectric mechanism, a body-powered appliance or an activity specified device. Thus, the flexible configuration, the proper features and the cost are some important factors that drive user's selection to the prosthesis. In this article, we describe an effective and powerful solution for analyzing, designing hardware and implementing software to train and recognize hand gestures for prosthetic arms. Moreover, we provide evaluation data of the method compared with similar approaches to support our design and implementation. This is fairly a complete system, making it a convenient solution for hand-cutoff people to control prosthetic hands using their electromyography signals. Statistical results with evaluations show that the device can respond correspondingly and the method creates promisingly recognition data after correct training processes. The prosthetic hardware implementation has also been simulated using a Light-emitting diode (LED) hand model with a high accuracy result.
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Zizzari, Vincenzo Luca, and Gianmarco Tacconelli. "Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up." Case Reports in Dentistry 2018 (2018): 1–12. http://dx.doi.org/10.1155/2018/9261276.
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The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.
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Mohamed, Kasim, and Maheshwaran K.S. "Orbital Support Device Via Intranasal Approach – An Unconventional Design." Journal of Evolution of Medical and Dental Sciences 10, no. 29 (July 19, 2021): 2221–24. http://dx.doi.org/10.14260/jemds/2021/454.
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Maxilla can be considered a hexahedrium with close relationship to surrounding critical anatomic structures, and thereby invariably involved in the resection process of tumours that arise from maxillary sinus, palate, nasal cavity, orbital contents, or intro-oral mucosa.1 Maxillary defects created after tumour ablation can cause severe functional and aesthetic deficits. Orbital floor defects with displacement of the eyeball results in deformities with possible consequences of enophthalmos, diplopia and impaired visual acuity. The eyeball can become displaced either due to alteration in the position of the orbital walls caused by trauma, or due to loss of support of the orbital floor during resection of a lesion. The role of the suspensory ligament of Lockwood in maintaining the superio - inferior position of the visual apparatus is recognized. The preservation of this ligament, which acts like a hammock holding the eyeball in position, prevents any drastic downward displacement except for the small limit which the slack of the ligament allows. Surgical reconstruction of orbital floor defects is the primary treatment modality, but remains nonetheless a challenge for surgeons. Currently various types of materials such as titanium meshes, hydroxyapatite, silica gel, Teflon, Medpor and autogenous bones are used for orbital reconstruction.2,3 Prosthetic rehabilitation of maxillary surgical defects is so predictable and effective that reconstructive surgery is not indicated in most instances.4,5 Prosthetic management of defects with orbital floor resection is usually obturators with extensions to support the visual apparatus.6 In clinical situations involving the resection of the orbital floor and maxillary sinus, without the sacrifice of the floor of maxilla, no oro-antral communication is created. This eliminates the need for an obturator prosthesis. In this scenario the support for the visual apparatus will be solely dependent on surgical reconstruction. However, when dealing with invasive and progressive diseases of fungal and bacterial origin, immediate surgical reconstruction is not generally recommended till complete resolution of the disease is achieved. The potential for recurrence of tumours varies from 10 - 30 % with benign tumours and over 50 % with malignant tumours. This creates a need for long term follow up, to assess the resection margins for signs of recurrence.4
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Sharma, Vineet, Jyoti Paliwal, Kamal Kumar Meena, and Ramjee Lal Raigar. "Prosthodontic Management of Dentate Maxillectomy Patient: A Clinical Case Report." Acta Marisiensis - Seria Medica 67, no. 4 (December 1, 2021): 247–50. http://dx.doi.org/10.2478/amma-2021-0038.
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Abstract Patients with minor defects of the alveolar ridge and hard palate can easily be treated by surgical closure, while patients with larger defects are more amenable to prosthetic restoration. The case report describes the rehabilitation of a dentate maxillectomy patient with a definitive closed hollow bulb cast partial obturator. A tripod retainer design was chosen for direct retention in the case. The tripod design consisted of a T-bar clasp placed on the left first central incisor and two embrasure clasps with buccal retention and palatal bracing components between the right first & second premolar and right first & second molar. A complete palate major connector was designed to ensure uniform distribution of functional load across tissues. The remaining teeth, the palate, and the rest provided support for the prosthesis. Prosthetic rehabilitation of the defect with a definitive obturator thus seals tissue openings in the palate, improves deglutition, speech, mastication, aesthetics, and significantly improves quality of life.
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ElCharkawy, Hussein, and Omar ElSharkawy. "Management of Post COVID 19 Mucormycosis with Osteomyelitis Management of Post COVID 19 Mucormycosis with Osteomyelitis in The Maxilla, New Combined Consequences of The Pandemic. in The Maxilla, New Combined Consequences of The Pandemic. (Case Report)." Future Dental Journal 8, no. 1 (June 1, 2022): 47–52. http://dx.doi.org/10.54623/fdj.8018.
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Aim: This case report aims to demonstrate among health providers the importance of timely surgical and prosthetic management procedures of patients who suffered from the newly combined clinical entity of post COVID 19 mucormycosis and osteomyelitis of the palate. Materials and methods: Elaborate advanced diagnosis of the patients including CBCT, MRI, CT, Pathology examination, 3Ds printing reconstruction of the whole skull and digital design of reconstructive mesh that support the prosthesis were carried out. The patients undergone modified infrastructure maxillectomy and immediate prosthetic obturation of the palatal defect that was replaced later by a delayed obturator. Results: Surgical eradication of the necrotic bone and subsequent immediate obturation of the defect minimized morbidly and helped in improving the quality of life of these patients. Conclusion: Early diagnosis of this potentially fatal disease and reach-out a treatment plan immediately, is of prime importance in reducing the morbidly and mortality rate and enhance speech and eating in the two patients reported. It also decreases the psychological impact of this radical surgery.
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Gerdzhikov, Ivan. "POSSIBILITIES FOR MODIFICATION OF SURGICAL OBTURATOR INTO TEMPORARY OBTURATOR." Journal of IMAB - Annual Proceeding (Scientific Papers) 27, no. 1 (March 17, 2021): 3615–18. http://dx.doi.org/10.5272/jimab.2021271.3615.
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Background: Maxillary resection causes different types of damages in the maxillofacial area, which are treated by surgical and prosthetic restorative methods. Aim: The described clinical case follows up the initial stages of the prosthetic treatment, as well as the possible modification of surgical obturator into temporary obturator in a patient with maxillary resection. Materials and methods: The prosthetic treatment of a 55-years-old female patient with a surgical operation of upper jaw cancer is described. The surgical obturator is developed a week after the resection. The preliminary impressions are taken with irreversible hydrocolloid impression material. The occlusion height and central relation are fixed by occlusion rims. The surgical obturator was fabricated by heat cured acrylic resin with a low amount of residual monomer. Moreover, metal clasps were used for retention and stability. The borders of the obturating part were covered with a thin layer of relining silicone material after the adjustment. The surgical obturator was modified into a temporary one directly in the patient's mouth after two months by applying the same rebasing material and designing a silicone hollow-bulb obturating part. Results: The treatment results revealed a successful restoration of the patient's speaking, feeding, and swallowing abilities. The application of silicone material inhibited the appearance of decubitus ulcers and facilitated the normal healing process. The direct design of hollow-bulb silicone obturating part significantly improved the retention and stability of the obturator. Conclusion: The application of prosthetic treatment methods in the first days after the maxillary resection allows for restoration of speaking and feeding.
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Singh, Ajit. "DENTAL IMPLANT DESIGN- AN INSIGHT OVERVIEW." Journal of Medical pharmaceutical and allied sciences 10, no. 4 (August 15, 2021): 3101–5. http://dx.doi.org/10.22270/jmpas.v10i4.1254.
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Dental implants are a proven therapeutic option for replacing missing teeth, with positive long-term health outcomes. Dental implant performance is largely determined by the implant’s primary durability, which is affected by surgical procedure, bone quality and quantity, implant surface characteristics, implant geometry, and implant surface characteristics. The implant’s geometry and surface can be modified. The implant geometry and surface can be changed if needed to achieve good primary stability and long-term implant therapy effectiveness. Implant architecture refers to the implant’s three-dimensional structure, as well as all of the components and elements that make it up. Different surface topographies can affect a sequence of coordinated actions such cell proliferation, osteoblast transformation, and the production of bone tissue. At the macro, micro, and increasingly nano sizes, surface topography of implants may be detected. The surgical location of end osseous oral implants is influenced by the prosthetic architecture, as well as the shape and quality of the alveolar bone. There are several alternatives for replacing missing teeth, but within the past few decades, dental implants have been one of the most common biomaterials for replacing one (or more) missing teeth. In a substantial number of patients, titanium dental implants have been shown to be secure and reliable. This study examines the most important historical information of dental implants, as well as the various vital factors that will ensure successful Osseo-integration and a safe prosthesis anchorage. Not only
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Wight, Christian M., Brent Lanting, and Emil H. Schemitsch. "Evidence Based Recommendations for Reducing Head-Neck Taper Connection Fretting Corrosion in Hip Replacement Prostheses." HIP International 27, no. 6 (September 10, 2017): 523–31. http://dx.doi.org/10.5301/hipint.5000545.
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Introduction This systematic review seeks to summarise the published studies investigating prosthetic design, manufacture and surgical technique's effect on fretting corrosion at the head-neck taper connection, and provide clinical recommendations to reduce its occurrence. Methods PubMed, MEDLINE and EMBASE electronic databases were searched using the terms taper, trunnion, cone and head-neck junction. Articles investigating prosthetic design, manufacture and surgical technique's effect on fretting corrosion were retrieved, reviewed and graded according to OCEBM levels of evidence and grades of recommendation. Results The initial search yielded 1,224 unique articles, and 91 were included in the analysis. Conclusions There is fair evidence to recommend against the use of high offset femoral heads, larger diameter femoral heads, and to pay particular consideration to fretting corrosion's progression with time and risk with heavier or more active patients. Particular to metal-on-metal hip prostheses, there is fair evidence to recommend positioning the acetabular component to minimise edge loading. Particular to metal-on-polyethylene hip prostheses, there is fair evidence to recommend the use of ceramic femoral heads, against use of cast cobalt alloy femoral heads, and against use of low flexural rigidity femoral stems. Evidence related to taper connection design is largely conflicting or inconclusive. Head-neck taper connection fretting corrosion is a multifactorial problem. Strict adherence to the guidelines presented herein does not eliminate the risk. Prosthesis selection is critical, and well-controlled studies to identify each design parameter's relative contribution to head-neck taper connection fretting corrosion are required.
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Lukashevich, A. S. "POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS." Emergency Cardiology and Cardiovascular Risks 5, no. 1 (2021): 1151–60. http://dx.doi.org/10.51922/2616-633x.2021.5.2.1151.
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Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.
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Pearl, Michael L. "Proximal humeral anatomy in shoulder arthroplasty: Implications for prosthetic design and surgical technique." Journal of Shoulder and Elbow Surgery 14, no. 1 (January 2005): S99—S104. http://dx.doi.org/10.1016/j.jse.2004.09.025.
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Moreno-Soriano, C., A. Estrugo-Devesa, P. Castañeda-Vega, E. Jané-Salas, and J. López-López. "Postsurgical Prosthetic Rehabilitation after Mandibular Ameloblastoma Resection: A 7-Year Follow-Up Case Report." Case Reports in Dentistry 2021 (March 28, 2021): 1–5. http://dx.doi.org/10.1155/2021/5593973.
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Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.
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Catellani, Francesco, Francesca De Caro, Carlo F. De Biase, Vincenzo R. Perrino, Luca Usai, Vito Triolo, Giovanni Ziveri, and Gennaro Fiorentino. "Radial Head Resection versus Arthroplasty in Unrepairable Comminuted Fractures Mason Type III and Type IV: A Systematic Review." BioMed Research International 2018 (July 16, 2018): 1–12. http://dx.doi.org/10.1155/2018/4020625.
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Unrepairable comminuted fractures of the radial head Mason type III or type IV have poor outcomes when treated by open reduction and internal fixation. Radial head resection has been proposed as good option for surgical treatment, while in the last decades, the development of technology and design in radial head prosthesis has increased efficacy in prosthetic replacement. The present review was conducted to determine the best surgical treatment for comminuted radial head when ORIF is not possible. Better outcomes are reported for radial head arthroplasty in terms of elbow stability, range of motion, pain, and fewer complications compared to radial head excision. Nevertheless, radial head resection still can be considered an option of treatment in isolated radial head fractures with no associated ligament injuries lesion of ligaments or in case of older patients with low demanding function.
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Buzayan, Muaiyed M. "Prosthetic management of mid-facial defect with magnet-retained silicone prosthesis." Prosthetics and Orthotics International 38, no. 1 (April 26, 2013): 62–67. http://dx.doi.org/10.1177/0309364613484052.
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Background and aim:Mid-facial defect is one of the most disfiguring and impairing defects. A design of prosthesis that is aesthetic and stable can be precious to a patient who has lost part of his face due to surgical excision. Prosthesis can restore the patients’ self-esteem and confidence, which affects the patients and their life style. The aim of this case report is to describe a technique of mid-facial silicone prosthesis fabrication.Technique:To provide an aesthetic and stable facial prosthesis, the extra-oral prosthesis was fabricated using silicone material, while the intra-oral defect was restored with obturator prosthesis, and then both prostheses were connected and attached to each other using magnets.Discussion:This clinical report describes the rehabilitation of a large mid-facial defect with a two-piece prosthesis. The silicone facial prosthesis was made hollow and lighter by using an acrylic framework. Two acrylic channels were included within the facial prosthesis to provide the patient with clean and patent airways.Clinical relevanceA sectional mid-facial prosthesis was made and retained in place by using magnets, which resulted in a significant improvement in the aesthetical and functional outcome without the need for plastic surgery. Silicone prostheses are reliable alternatives to surgery and should be considered in selected cases.
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Ciocca, Leonardo, and Roberto Scotti. "Oculo-facial rehabilitation after facial cancer removal: Updated CAD/CAM procedures. A pilot study." Prosthetics and Orthotics International 38, no. 6 (December 10, 2013): 505–9. http://dx.doi.org/10.1177/0309364613512368.
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Background and aim: Leaving open or closing the oculo-facial defect by means of a myocutaneous flap mainly depends on maxillofacial surgical considerations. For those cases that present a closed defect, the authors aim to evaluate an innovative method of ocular bulb positioning using a magnetic resonance imaging dataset. Technique: Following cancer removal and plastic reconstructive surgery, a Digital Imaging and Communications in Medicine format magnetic resonance imaging dataset was used to determine the volume and position of the left ocular bulb. The exact location of the prosthetic bulb was determined by mirroring this position on the affected side. Images of the eyeglasses were imported into the virtual environment, and the designs of the substructure and facial prosthesis were projected using computer-aided design/computer-aided manufacture (CAD/CAM) technology. Discussion: The updated method presented here enables restoration with a facial prosthesis, even when a myocutaneous flap is used to close the defect, thereby resolving the problem of ocular bulb positioning and enabling the rapid and easy design of a retention system connected to eyeglasses. Clinical relevance The proposed protocol aims to develop and describe a viable method for the construction of a facial prosthesis for a patient whose face had been reconstructed using a myocutaneous free flap.
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Vaduva, Razvan Cristian, Ilaria Lorena Petrovici, Mihai Catalin Tenovici, Danut Nicolae Tarnita, Dragoş Laurenţiu Popa, Otilia Rogoveanu, and Bogdan Capitanescu. "A Three Dimensional Virtual System Used to Analyze the Normal and Prosthetic Joint of the Hip." Advanced Engineering Forum 34 (October 2019): 165–74. http://dx.doi.org/10.4028/www.scientific.net/aef.34.165.
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Treatment of hip pathology has evolved over the last two centuries, ranging from rudimentary surgical procedures to modern hip arthroplasty, with an explosion marked in the last 30 years, considered to be one of the most successful surgeries to date. Hip arthroplasty is a permanent challenge due to the desire to discover the "supreme prosthesis", for which competition is still open. Hip disorders requiring prosthesis show a change in articular morphology. Among the most common medical conditions that have as final therapeutic solution hip arthroplasty are: coxarthrosis, both primary and secondary, followed by traumatic conditions: femoral neck collapse and femoral neck pseudarthrosis, aseptic head necrosis femoral stage III, as well as rheumatic coxitis from rheumatoid arthritis, ankylosing spondylitis or juvenile art. Endoprosthetic arthroplasty can be defined as an intervention of reconstructive surgery with bone sacrifice and prosthetic replacement of the articular components. It is, in the end, an operation aimed at restoring joint mobility and normal functioning of the muscles, ligaments and other periarticular structures that control joint movement. The materials initially used (glass, metal, plastic) did not have the desired bone strength and integration capacity. It followed the development of cemented implants, obtaining different types of cement with better and better quality. Problems arising from cemented arthroplasty (decimation, involving prosthetic revision) have led to a parallel development of the design and materials used for uncured prostheses with the possibility of very good integration of prosthetic material into the bone, raising them to the top of preferences in recent years. Treatment of hip pathology has evolved over the last two centuries, ranging from rudimentary surgical procedures to modern hip arthroplasty, with an explosion marked in the last 30 years, considered to be one of the most successful surgeries to date. The purpose of this study was to obtain the three-dimensional models of the hip joint and the prosthesis for the use of these models for various analyzes and virtual experiments. At the end of the paper important conclusions were drawn based on the results obtained in the simulations using the finite element method.
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Bruneau, Michaël, Rachid Kamouni, Frédéric Schoovaerts, Henri-Benjamin Pouleau, and Olivier De Witte. "Simultaneous Image-Guided Skull Bone Tumor Resection and Reconstruction With a Preconstructed Prosthesis Based on an OsiriX Virtual Resection." Operative Neurosurgery 11, no. 4 (August 18, 2015): 484–90. http://dx.doi.org/10.1227/neu.0000000000000971.
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Abstract BACKGROUND Skull reconstruction can be challenging due to the complex 3-dimensional shape of some structures, such as the orbital walls, and for cases involving a large cranial vault. In such situations, computer-assisted design and modeling of prostheses is especially helpful to achieve an adequate reconstruction. Simultaneous tumor resection and skull defect reconstruction are also challenging because the preoperative imaging does not display the anticipated defect. Currently, sophisticated methods based on physical prototypes and templates are required to enable simultaneous resection and reconstruction techniques. OBJECTIVE To report a new technique for simultaneous tumor resection and skull reconstruction with a custom-made prosthesis. METHODS Using OsiriX software, virtual bone resection was performed using preoperative images by carefully delimiting the tumor on each slice. The modified images were integrated to predict the defect and also served as a basis for prosthesis construction. At the time of surgery, the images were projected onto the patient's skull using a surgical navigation system to delimit the area of the craniectomy. RESULTS The virtual planning method was simple and accurate and provided a precise preoperative definition of important structures that needed to be spared, such as the frontal sinus. Using this method, simultaneous tumor resection and prosthetic skull reconstruction was successfully achieved for a patient with a wide skull tumor. CONCLUSION Simultaneous skull tumor resection and prosthetic reconstruction are possible when a virtual preoperative tumor resection is performed, and a corresponding customized prosthesis subsequently is manufactured and used.
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Frank, Julia K., Paul Siegert, Fabian Plachel, Philipp R. Heuberer, Stephanie Huber, and Jakob E. Schanda. "The Evolution of Reverse Total Shoulder Arthroplasty—From the First Steps to Novel Implant Designs and Surgical Techniques." Journal of Clinical Medicine 11, no. 6 (March 10, 2022): 1512. http://dx.doi.org/10.3390/jcm11061512.
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Purpose of Review: The purpose of this review is to summarize recent literature regarding the latest design modifications and biomechanical evolutions of reverse total shoulder arthroplasty and their impact on postoperative outcomes. Recent findings: Over the past decade, worldwide implantation rates of reverse total shoulder arthroplasty have drastically increased for various shoulder pathologies. While Paul Grammont’s design principles first published in 1985 for reverse total shoulder arthroplasty remained unchanged, several adjustments were made to address postoperative clinical and biomechanical challenges such as implant glenoid loosening, scapular notching, or limited range of motion in order to maximize functional outcomes and increase the longevity of reverse total shoulder arthroplasty. However, the adequate and stable fixation of prosthetic components can be challenging, especially in massive osteoarthritis with concomitant bone loss. To overcome such issues, surgical navigation and patient-specific instruments may be a viable tool to improve accurate prosthetic component positioning. Nevertheless, larger clinical series on the accuracy and possible complications of this novel technique are still missing.
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Ge, Yanjun, Danni Guo, Xiaofeng Shan, Lei Zhang, Ruifang Lu, Pan Shaoxia, and Yongsheng Zhou. "A multidisciplinary approach for the rehabilitation of a patient with chondrosarcoma: prosthetically-driven digital workflow for maxillary reconstruction and implant treatment." STOMATOLOGY EDU JOURNAL 8, no. 3 (2021): 207–15. http://dx.doi.org/10.25241/stomaeduj.2021.8(3).art.7.
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Aim To describe a comprehensive digital therapy oriented towards the final restoration for treating an oral maxillofacial defect caused by maxillary chondrosarcoma. Summary The prosthetically-driven multidisciplinary approach was applied to achieve perfectly functional-aesthetic reconstruction for a male patient with maxillary chondrosarcoma. The complete tumor resection was ensured by the design of virtual osteotomy and surgical guide plate. A reverse engineering technique was used to reconstruct the bone defect in the maxillary aesthetic area, which offered reference for a three-dimensional printing guide plate to shape and fix the free vascularized iliac bone flap. On the solid basis of previous treatment, the implant placement was performed under the guidance of the prosthetic-driven implant plate. Vestibular extension and tissue graft were performed to increase keratinized gingiva width to improve implant-supported fixed prosthesis effect. Key learning points 1. A multidisciplinary approach including maxillofacial surgery, prosthodontic and periodontal treatment can provide better esthetic and functional results for complex rehabilitation of a patient with oral maxillofacial defect. 2. Predictability of maxillary reconstruction and implant restoration can be increased with prosthetic-driven treatment plan. 3. Applying preoperative virtual design and personalized guide plate is beneficial to achieve an ideal outline of reconstructed upper jaw. 4. Obtaining comprehensive aesthetic parameters of the expected restoration is one of the key principles of upper anterior teeth rehabilitation. 5. Digital technology provides an opportunity for consistency between the primary treatment design and the final restoration outcome.
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Gonzalez-Perez-Somarriba, B., G. Centeno, C. Vallellano, and L. M. Gonzalez-Perez. "On the Analysis of the Contact Conditions in Temporomandibular Joint Prostheses." Advances in Materials Science and Engineering 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/2687864.
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Temporomandibular joint replacement (TMJR) is a complex surgical procedure in which the artificial joints available must assure the anatomical reconstruction and guarantee a good range of the natural temporomandibular joint (TMJ) movements. With this aim, different types of TMJ prostheses, including the stock prosthetic system and custom-made prostheses, are being currently implanted. Although temporomandibular joint replacements (TMJRs) are expected to accomplish their function during a number of years, they might actually fail and need to be replaced. This paper analyzes different design factors affecting the contact stress distributions within the TMJ prosthesis interface, which are consequently involved in their deterioration and final failure of the prosthetic device. With this purpose, a numerical model based on finite elements has been carried out in order to evaluate the stress states attained in different prosthesis configurations corresponding to general types of TMJ prostheses. On the other hand, the actual degradation of resected implants has been evaluated via optical microscopy. The linkage between the numerical simulations performed and experimental evidence allowed the authors to establish the different wear and damage mechanisms involved in the failure of stock TMJ prostheses. Indeed, the results obtained show that the contact stresses at the interface between the mandible and the glenoid fossa components play a key role in the failure process of the TMJR devices.
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Awan, Omer, Lina Chen, and Charles S. Resnik. "Imaging Evaluation of Complications of Hip Arthroplasty: Review of Current Concepts and Imaging Findings." Canadian Association of Radiologists Journal 64, no. 4 (November 2013): 306–13. http://dx.doi.org/10.1016/j.carj.2012.08.003.
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Total hip arthroplasty has evolved along with improvements in component materials and design. The radiologist must accurately diagnose associated complications with imaging methods and stay informed about newer complications associated with innovations in surgical technique, prosthetic design, and novel materials. This pictorial essay presents clinical and imaging correlation of modern hip arthroplasty complications, with an emphasis on the most common complications of instability, aseptic loosening, and infection as well as those complications associated with contemporary metal-on-metal arthroplasty.
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Ceruso, Francesco Mattia, Irene Ieria, Marco Tallarico, Silvio Mario Meloni, Aurea Immacolata Lumbau, Alessandro Mastroianni, Alessio Zotti, and Marco Gargari. "Comparison between Early Loaded Single Implants with Internal Conical Connection or Implants with Transmucosal Neck Design: A Non-Randomized Controlled Trial with 1-Year Clinical, Aesthetics, and Radiographic Evaluation." Materials 15, no. 2 (January 10, 2022): 511. http://dx.doi.org/10.3390/ma15020511.
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To evaluate the implant and prosthetic of two implants with different surfaces and neck design. Enrolled patients received bone level, 12° conical connection implants (Nobel Parallel, Nobel Biocare; NOBEL group) with anodized surface (TiUnite) and roughness of 1.35 μm, or transmucosal implant system (Prama, Sweden and Martina; PRAMA group) with convergent collar, ZIrTi surface, and roughness 1.4–1.7 μm. Both implants were made of pure grade IV titanium, with similar diameter and length, chosen according to the dentistry department availability and patient’s request. After early prosthesis delivery, patients were filled for at least one year. Outcome measures were: implant and prosthetic survival and success rates, physiological marginal bone remodeling, periodontal parameters and pink esthetic score (PES). Results: Fifteen patients were allocated and treated in each group. At the one-year follow-up, three patients dropped out, one in the NOBEL group and two in the PRAMA group. During the entire time of investigation, all implants survived and the prostheses were successful. No statistically significant differences were found in term of marginal bone loss, periodontal parameters, and aesthetics (p > 0.05). Conclusion: With the limitations of the present study, both implant systems showed successful clinical results. Finally, many other clinical and surgical variables may influenced marginal bone levels, implant survival, and periodontal parameters. More homogenous clinical trials with larger samples are needed to confirm these preliminary conclusions.
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Sooriakumaran, Sellaiah, Maggie Uden, Sarah Mulroy, David Ewins, and Thomas Collins. "The impact a surgeon has on primary amputee prosthetic rehabilitation: A survey of residual lower limb quality." Prosthetics and Orthotics International 42, no. 4 (February 26, 2018): 428–36. http://dx.doi.org/10.1177/0309364618757768.
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Background: Substantial improvements have been perceived in surgical results following major lower limb amputation, but there remains observed variation in amputation quality for patients referred for prosthetic rehabilitation from different hospitals. Objectives: To assess various elements that influence residual limb quality and evaluate their impact on progress through initial prosthetic rehabilitation and mobility outcome after rehabilitation. Study design: Clinical survey. Methods: A revised 10-item residual limb scoring system was used to survey a succession of 95 primary amputees with transtibial and transfemoral amputations (100 residual limbs) presenting for rehabilitation. Results: The majority of residual limbs scored highly, supporting the perception of generally good amputation quality. There were significant differences in average residual limb scores between some hospitals. The overall scores showed weak or minimal correlation to progress through rehabilitation and mobility outcome but residual limbs scoring higher in seven of the items of the score showed significant advantages in key aspects of progress or mobility at discharge. Conclusion: There is need for continued collaboration between surgeons and rehabilitation centres to ensure consistent high standards. The revised residual limb score used in this survey needs further refinement for future use. Clinical relevance Residual limb quality is an important component influencing prosthetic rehabilitation. This survey of residual limbs at one Rehabilitation Centre suggests encouragingly good surgical results but highlights differences between hospitals. A particular issue is the need for effective collaboration between surgeons and prosthetic rehabilitation professionals to optimise residual limb preparation.
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Lu, Minxun, Li Min, Cong Xiao, Yongjiang Li, Yi Luo, Yong Zhou, Wenli Zhang, and Chongqi Tu. "Uncemented three-dimensional-printed prosthetic replacement for giant cell tumor of distal radius: a new design of prosthesis and surgical techniques." Cancer Management and Research Volume 10 (February 2018): 265–77. http://dx.doi.org/10.2147/cmar.s146434.
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Henry, Gerard D. "Historical Review of Penile Prosthesis Design and Surgical Techniques: Part 1 of a Three-Part Review Series on Penile Prosthetic Surgery." Journal of Sexual Medicine 6, no. 3 (March 2009): 675–81. http://dx.doi.org/10.1111/j.1743-6109.2008.01145.x.
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Caravelli, Silvio, Marco Di Ponte, Alberto Grassi, Stefano Zaffagnini, and Massimiliano Mosca. "Associated Corrective Procedures of Extra-Articular Asymptomatic Foot Malalignments in Total Ankle Replacement: Are They Really Mandatory?" Journal of Clinical Medicine 11, no. 15 (August 4, 2022): 4544. http://dx.doi.org/10.3390/jcm11154544.
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Witthaus, Michael W., Patrick Saba, Rachel Melnyk, Divya Ajay, David Ralph, Koenraad Van Renterghem, Gareth Warren, Ricardo Munarriz, and Ahmed Ghazi. "The Future of Penile Prosthetic Surgical Training Is Here: Design of a Hydrogel Model for Inflatable Penile Prosthetic Placement Using Modern Education Theory." Journal of Sexual Medicine 17, no. 11 (November 2020): 2299–306. http://dx.doi.org/10.1016/j.jsxm.2020.08.003.
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Yarramaneni, Varun, Dhanasekar Balakrishnan, IN Aparna, and Saumya Kapoor. "Prosthetic Management of Total Glossectomy Patients." International Journal of Prosthodontics and Restorative Dentistry 6, no. 3 (2016): 66–68. http://dx.doi.org/10.5005/jp-journals-10019-1158.
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ABSTRACT Background Total glossectomy impairs various functions of tongue, such as mastication, speech, swallowing, and also results in psychological breach for the patient during social activities. In a glossectomy patient, the new size of the oral cavity often produces a change in the resonance associated with certain sounds. Also, due to the decrease in size and function of the tongue, interruption occurs in articulation patterns between the tongue, the hard and soft palate, and the teeth. Materials and methods We performed a review with a bibliographic search in Scopus, Web of Science along with the PubMed/Medline, Google scholar and internet. We included the articles with major contribution toward management of total glossectomy, excluded articles and works about surgical treatments in anatomical locations other than the oral cavity. Conclusion To obtain maximum rehabilitation for these patients, the dentist must have a thorough knowledge of the physiologic processes involved in oral functions. The present article is an overview of various objectives and design concepts for rehabilitation of a total glossectomized patient. How to cite this article Yarramaneni V, Balakrishnan D, Aparna IN, Kapoor S. Prosthetic Management of Total Glossectomy Patients. Int J Prosthodont Restor Dent 2016;6(3):66-68.
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Rathee, Dr Manu, Dr Maqbul Alam, Dr Sanju Malik, Dr Sandeep Singh, and Dr Poonam Wakure. "3D Printing -A Revolution in Prosthetic Dentistry." Scholars Journal of Dental Sciences 8, no. 11 (December 30, 2021): 327–34. http://dx.doi.org/10.36347/sjds.2021.v08i11.004.
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3D printing has been heralded as a innovative technology that will revolutionize industry. it is already used in aerospace, defense, art, and design, which becoming a popular subject in surgery. Digital advancements, smart biomaterials, and enhanced cell culture, in combination with 3D printing, give promising ground for patient-tailored therapies. Dental applications for three-dimensional (3D) printing in various departments range from prosthodontics, oral and maxillofacial surgery, and oral implantology through orthodontics, endodontics, and periodontology. The uses of 3D printing in prosthodontics can help provide patients with lower-cost, more customized services and ease the complicated workflow associated with the manufacturing of all dental equipment due to its quick production, high precision, and personal customization. The technique comprises intraoral or model scanning and designing, 3D printing, and post-processing and is used to fabricate surgical guides, removable, fixed, and maxillofacial prostheses.They can also have drawbacks, such as expensive and lengthy postprocessing. This study gives a practical and scientific overview of 3D printing technologies, which will be the future of digital dentistry, due to the development of new materials and technology.
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Kirlys, Robertas, Rugilė Nedzinskaitė, Roberto Rongo, Marco Severino, Algirdas Puisys, and Vincenzo D’Antò. "Digital Planning Technique for Surgical Guides for Prosthetic Implants before Orthodontic Treatment." Applied Sciences 12, no. 11 (May 30, 2022): 5566. http://dx.doi.org/10.3390/app12115566.
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Background: The use of digitalization allows clinicians to plan the position of dental implants in orthodontic patients treated with aligners in the beginning of their orthodontic treatment, instead of waiting until the end of orthodontic treatment, integrating implant restorations with orthodontic biomechanics. Aim: The aim of this case report is to describe a digital workflow for aligner treatment supported by implants, in which implants are placed at the beginning of the treatment and support the orthodontic treatment. Materials and Methods: Digital planning for orthodontic treatment with clear aligners and the preparation of surgical guides for implant surgery before orthodontic treatment are used to solve two multidisciplinary cases. Cone-beam computed tomography (CBCT) and virtual dental impressions are used for the virtual planning. Successively, a surgical guide for implant placement and aligners are used in the treatment plan. Results: The digital orthodontic setup with the integration of the root position allows the clinician to plan the position of dental implants on the final occlusion. The placement of the implant before the start of the orthodontic treatment allows the implants to be used as skeletal anchorage, thereby helping the orthodontic biomechanics. Conclusions: This study describes how to perform a digital workflow with orthodontic virtual planning and the design of surgical guides for implant placement. This technique is potentially promising for complex orthodontic cases.
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Roussot, Mark Anthony, and Fares Sami Haddad. "The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?" EFORT Open Reviews 4, no. 8 (August 2019): 503–12. http://dx.doi.org/10.1302/2058-5241.4.180094.
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Total knee arthroplasty (TKA) has evolved into a successful, cost-effective treatment for end-stage knee arthrosis. The patellofemoral articulation in TKA has largely been ignored during its development despite being an important determinant of outcome. New technologies still need further development to incorporate the patella in TKA surgical planning and operative technique. Alternative approaches to alignment in TKA will have a secondary impact on patellofemoral mechanics and possibly future implant designs. Technologies that assist with precise implant positioning may alter our understanding and overall practice of TKA. Cite this article: EFORT Open Rev 2019;4:503-512. DOI: 10.1302/2058-5241.4.180094
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Dickinson, Alexander, Laura Diment, Robin Morris, Emily Pearson, Dominic Hannett, and Joshua Steer. "Characterising Residual Limb Morphology and Prosthetic Socket Design Based on Expert Clinician Practice." Prosthesis 3, no. 4 (September 23, 2021): 280–99. http://dx.doi.org/10.3390/prosthesis3040027.
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Functional, comfortable prosthetic limbs depend on personalised sockets, currently designed using an iterative, expert-led process, which can be expensive and inconvenient. Computer-aided design and manufacturing (CAD/CAM) offers enhanced repeatability, but far more use could be made from clinicians’ extensive digital design records. Knowledge-based socket design using smart templates could collate successful design features and tailor them to a new patient. Based on 67 residual limb scans and corresponding sockets, this paper develops a method of objectively analysing personalised design approaches by expert prosthetists, using machine learning: principal component analysis (PCA) to extract key categories in anatomic and surgical variation, and k-means clustering to identify local ‘rectification’ design features. Rectification patterns representing Total Surface Bearing and Patella Tendon Bearing design philosophies are identified automatically by PCA, which reveals trends in socket design choice for different limb shapes that match clinical guidelines. Expert design practice is quantified by measuring the size of local rectifications identified by k-means clustering. Implementing smart templates based on these trends requires clinical assessment by prosthetists and does not substitute training. This study provides methods for population-based socket design analysis, and example data, which will support developments in CAD/CAM clinical practice and accuracy of biomechanics research.
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Eppley, Barry L., A. Michael Sadove, David Hennon, and John A. van Aalst. "Treatment of Nasopharyngeal Stenosis by Prosthetic Hollow Stents: Clinical Experience in Eight Patients." Cleft Palate-Craniofacial Journal 43, no. 3 (May 2006): 374–78. http://dx.doi.org/10.1597/04-055.1.
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Objective A series of nasopharyngeal appliance designs is presented that represents our evolving experience over a 20-year period in the adjunctive use of prosthetic stents in the surgical correction of nasopharyngeal stenosis. Design Retrospective assessment of effectiveness of two nasopharyngeal stenosis hollow stent designs in a consecutive series of patients for relief of nasal obstructive symptoms. Setting Tertiary academic medical center, Craniofacial Program at Children's Hospital. Patients Four patients with nasopharyngeal stenosis were treated with a preoperatively fabricated stent made from a clasped palatal appliance onto which hollow acrylic conduits were extended through surgically re-created pharyngeal ports. A subsequent set of four patients with nasopharyngeal stenosis were treated with intraoperatively-fashioned silastic grommets, as opposed to palatal appliances. Interventions Postoperative intraoral stenting of nasopharyngeal ports. Main Outcome Measures Maintenance of pharyngeal port opening after 1 year, improvement in nasal airway obstructive symptoms. Results The palatal appliance stents were less well tolerated and had a lower maintenance of port patency after device removal (4 of 8, 50%). The silastic grommets provided better retention into the ports and increased patient tolerance, as well as better 1-year port maintenance (6 of 8, 75%). Conclusions The grommet stent appliance offers numerous advantages over a conventional dental-clasped appliance for prosthetic nasopharyngeal stenting, including obviation of extensive preoperative preparation, ease of insertion and removal, and exchange of air during the stenting period. Improved nasopharyngeal patency with this device may be due to greater patient tolerance and subsequent longer use.
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Salviano, Saulo Henrique, João Carlos Amorim Lopes, Igor da Silva Brum, Kelly Machado, Marco Tulio Pedrazzi, and Jorge José de Carvalho. "Digital Planning for Immediate Implants in Anterior Esthetic Area: Immediate Result and Follow-Up after 3 Years of Clinical Outcome—Case Report." Dentistry Journal 11, no. 1 (January 3, 2023): 15. http://dx.doi.org/10.3390/dj11010015.
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In this case report, we demonstrate how the correct positioning of implants, associated with optimal gingival conditioning, and the correct choice of biomaterial can yield very predictable and fantastic aesthetic results. Objective: We aimed to use dental implants to rehabilitate the area of elements #11 and #21 in a satisfactory surgical and prosthetic manner, using guided surgery, connective tissue, nano-biomaterials, and a porcelain prosthesis. Case Report: A 32-year-old male patient presented with bone loss of elements #11 and #21, which was proven radiographically and clinically. Thus, oral rehabilitation with the use of dental implants was required. It was decided to proceed via digital planning with the DSD program (Digital smile design) and with the software Exoplan, (Smart Dent-Germany) whenever it was possible to plan immediate provisional and accurate dental implant positioning through reverse diagnostics (Software Exoplan, Smart Dent-German). The dental elements were extracted atraumatically; then, a guide was established, the implants were positioned, the prosthetic components were placed, the conjunctive tissue was removed from the palate and redirected to the vestibular wall of the implants, the nano-graft (Blue Bone®) was conditioned in the gaps between the vestibular wall and the implants, and, finally, the cemented provision was installed. Results: After a 5-month accompaniment, an excellent remodeling of the tissues had been achieved by the implants; consequently, the final prosthetic stage could begin, which also achieved a remarkable aesthetic result. Conclusions: This report demonstrates that the correct planning of dental implants, which is associated with appropriate soft tissue and bone manipulation, allows for the achievement of admirable clinical results.
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Jain, S., and TR Terry. "Penile Prosthetic Surgery and its Role in the Treatment of End-Stage Erectile Dysfunction – An Update." Annals of The Royal College of Surgeons of England 88, no. 4 (July 2006): 343–48. http://dx.doi.org/10.1308/003588406x114758.
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The treatment of erectile dysfunction has been revolutionised with the introduction of orally active phosphodiesterase inhibitors which are successful in 70–80% of men. However, there remain a group of men in whom conservative treatment fails and surgical insertion of a penile prosthesis is required. This type of surgery has in the past been associated with technical difficulties and a high complication rate. This has spurred numerous developments in prosthesis design and surgical technique with the field changing at a rapid pace. Perhaps the most significant is the use of antimicrobial coatings on prostheses that have been shown to reduce the infection rate significantly. This review highlights those developments reported in the last 5 years.
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Zhou, Feng, Yuan Yuan Cui, Liang Liang Wu, Yin Chen, Jie Yang, and Nan Huang. "TRIZ Based Tool Management Applied in Mechanical Heart Valve Engineering Systems." Advanced Materials Research 569 (September 2012): 521–24. http://dx.doi.org/10.4028/www.scientific.net/amr.569.521.
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Artificial mechanical heart valve (MHV) replacement is the common cardiovascular surgical procedure, yet its effect is far from satisfaction. Most important reasons lie in the model design and choice of the materials in the fabrication of the prosthetic heart valves. Based on systematic design methodology of TRIZ theory (Russian acronym for Theory of Solving Inventive Problem), the device structure is analyzed by comparing the past successful designs generated during the evolution of MHV. This paper represents a modeling technique integrating the well-established TRIZ with the conflict and contradiction modeling, substance-field and product functional analysis tools and provides some important trends in evolutionary development of production systems in MHV design. By analyzing the structural behavior and material performance, a complex case study from the research of different structural patterns and characteristics of current tri-leaflet modeling shows the validity of TRIZ theory to guide MHV design.
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Vriesendorp, Michiel D., Rob A. F. de Lind van Wijngaarden, Vivek Rao, Michael G. Moront, Himanshu J. Patel, Edward Sarnowski, Sepehr Vatanpour, and Robert J. M. Klautz. "An in vitro comparison of internally versus externally mounted leaflets in surgical aortic bioprostheses." Interactive CardioVascular and Thoracic Surgery 30, no. 3 (November 28, 2019): 417–23. http://dx.doi.org/10.1093/icvts/ivz277.
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Abstract OBJECTIVES To improve haemodynamic performance, design modifications of prosthetic valves have been proposed with each new generation of valves. These different designs also impact the amount of mechanical wear, because mechanical stresses are distributed differently. Because long-term evidence for new prosthetic valves is lacking, this in vitro study compared hydrodynamic performance and durability among 3 currently available bioprosthetic valves with internally (IMLV) or externally mounted leaflets (EMLV). METHODS Prostheses of the internally mounted Medtronic Avalus and Carpentier-Edwards Perimount Magna Ease valves were compared to prostheses of the externally mounted Abbott Trifecta valve. For each labelled size (e.g. 19, 21 and 23) of the 3 types, 3 valves underwent accelerated wear testing for up to 600 million cycles, corresponding to ∼15 years of simulated wear. The valves underwent hydrodynamic testing and visual inspection. RESULTS EMLV had the largest effective orifice area and lowest pressure gradient for each labelled size at baseline and 600 million cycles; the effective orifice area and the pressure gradient were equivalent for the 2 types of IMLV. Five of 9 EMLVs had at least 1 hole or tear in the leaflet tissue around the stent posts, which resulted in severe regurgitation at 500 million cycles in 2 cases. All IMLVs were intact at 600 million cycles with minimal tissue wear. CONCLUSIONS EMLV showed superior hydrodynamic performance but inferior mechanical durability compared to IMLV after 600 million cycles of testing. The primary failures were because of significant mechanical abrasion in the commissural region, which may warrant close monitoring of EMLV during long-term follow-up.
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Milicic-Lazic, Minja, Aleksandra Prokic-Maric, Ana Todorovic, and Vojkan Lazic. "Basics of navigation implant prosthetics planning." Serbian Dental Journal 67, no. 4 (2020): 193–200. http://dx.doi.org/10.2298/sgs2004193m.
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Due to the development of digital technologies, the modern concept of prosthetic-guided implantology is based on non-invasive surgical and restorative techniques. Computer-aided planning, computer-guided workup and computerguided surgery have largely ensured the predictability of the therapeutic outcome. This is supported by research data related to the frequency of implant therapy, according to which in the first half of 2020 there was an increase of 9.7%. However, anatomical limitations remain a challenge for the implant team. The most common problem related to implant therapy in edentulous patients is limited edentulous space in one or more spatial planes. Improving the design of surgical guides facilitates implantation in spatially limited and complex cases. By introducing interactive computed tomography into the field of implantology, a three-dimensional approach to every aspect of planning and implantation has become possible.
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Burger, Daniel, Matthias Pumberger, and Bruno Fuchs. "An Uncemented Spreading Stem for the Fixation in the Metaphyseal Femur: A Preliminary Report." Sarcoma 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/7132838.
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Surgical treatment to restore full range of motion and full weight bearing after extensive femoral bone resection in patients with primary or metastatic femoral tumours is individually challenging. Especially when the remaining distal or proximal bone is very short, a rigid fixation of an implant is difficult to achieve due to the reverse funnel shape of the metaphysis. Herein, we present a novel implant design using a spreading mechanism in the distal part of the prosthesis for rigid, uncemented fixation in the remaining femoral bone after extensive tumour resection of the femur. We present the outcome of 5 female patients who underwent implantation of this spreading stem after extensive proximal or distal femoral bone resection. There was no radiological or clinical loosening or implant-related revision surgery in our follow-up (mean 21.46 months, range 3.5–46 months). This uncemented spreading stem may therefore represent an alternative option for fixation of a prosthetic device in the remaining metaphyseal femur.
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Caravelli, Silvio, Laura Bragonzoni, Emanuele Vocale, Raffaele Zinno, Stefano Di Paolo, Giuseppe Barone, Paolo De Blasiis, Maria Grazia Benedetti, Stefano Zaffagnini, and Massimiliano Mosca. "Mobile-Bearing Total Ankle Replacement In Vivo Kinematic Assessment: A Prospective Study Protocol." Journal of Clinical Medicine 11, no. 18 (September 10, 2022): 5328. http://dx.doi.org/10.3390/jcm11185328.
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Total ankle prosthesis as a surgical solution in the case of end-stage osteoarthritis has seen a considerable increase in the last two decades. This study protocol arises from the need to understand the in vivo kinematics of mobile-bearing, flat tibial component total ankle replacement, evaluating the real range of motion and the reciprocal relationships between the components during normal motor tasks through the use of model-based radio-stereometric analysis (MB-RSA). In addition, pre- and post-operative evaluation of walking kinematics with inertial motion sensors, proprioception through a dedicated workstation, and clinical outcomes are discussed. We expect that based on our study protocol researchers will be able to improve future prosthetic designs and validate the setup of MB-RSA, as well as to understand “how an ankle prosthesis moves” once implanted in the patient.
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Rimondini, Lia, Cinzia Della Valle, Andrea Cochis, Barbara Azzimonti, and Roberto Chiesa. "The Biofilm Formation onto Implants and Prosthetic Materials May Be Contrasted Using Gallium (3+)." Key Engineering Materials 587 (November 2013): 315–20. http://dx.doi.org/10.4028/www.scientific.net/kem.587.315.
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Bacterial contamination of implanted devices is a common cause of their failure. Microbial contamination of the biomaterials differs from that of natural tissues. In fact, the contamination modalities of medical devices depend on many peculiar factors related to them: the chemistry of the biomaterial, the physical properties of the surface, the design of the medical device, the extension of surgical invasion, and the time of application. The environment and/or the conditions and response of the host also contribute to the development of infection. Viruses, fungi, protozoas and bacteria are all involved in biomaterial contamination. They are endogenous commensals of the mouth, not virulent in planktonic form, but pathogens when arranged in biofilm.In this paper we review the potency of application of Gallium doping to the surface biomaterials addressed for surgical implantation in order to contrast the bacteria biofilm formation
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Zhou, Hai, Anmin Liu, Dongmei Wang, Xiangsen Zeng, San Wei, and Chengtao Wang. "Kinematics of lower limbs of healthy Chinese people sitting cross-legged." Prosthetics and Orthotics International 37, no. 5 (January 23, 2013): 369–74. http://dx.doi.org/10.1177/0309364612470964.
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Background:Sitting cross-legged as an activity of daily living and its kinematics have significantly different demands on the arthroplasty of hip and knee, which can be referred in the design of joint arthroplasty.Objectives:The purpose of this study was to obtain the kinematics of the lower limb in Chinese people during cross-legged sitting.Study design:This study identified the necessary requirements for joint arthroplasty to carry out sitting cross-legged activity.Methods:A total of 40 healthy Chinese participants (average age = 23.8 years) performed six cross-legged sitting trials per person. Three-dimensional kinematic data of ankle, knee, and hip joints were collected; the means of the three-dimensional angles of these three joints were calculated.Results:At the hip, the range of motion of the flexion was 101.7°, the abduction reached 43.2°, and the range of motion of the external rotation was 36.4°. At the knee, the range of motion of the flexion was 131.9° and the range of motion of the internal rotation reached 32.4°. At the ankle, the range of motion in three planes was not great.Conclusions:Such motion ranges were likely to result in prosthetic dislocation. The results would provide valuable references for prosthesis design in the Chinese population.Clinical relevanceThe kinematic data of sitting cross-legged activity provided the baseline information for physicians and therapists concerned with the surgical and functional rehabilitation, and offered reference for lower limbs prosthesis designing.
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Cristalli, Maria Paola, Gerardo La Monaca, Nicola Pranno, Susanna Annibali, Giovanna Iezzi, and Iole Vozza. "Xeno-Hybrid Composite Scaffold Manufactured with CAD/CAM Technology for Horizontal Bone-Augmentation in Edentulous Atrophic Maxilla: A Short Communication." Applied Sciences 10, no. 8 (April 12, 2020): 2659. http://dx.doi.org/10.3390/app10082659.
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The present short communication described a new procedure for the reconstruction of the horizontal severely resorbed edentulous maxilla with custom-made deproteinized bovine bone block, fabricated using three-dimensional imaging of the patient and computer-aided design/computer-aided manufacturing (CAD/CAM) technology. The protocol consisted of three phases. In the diagnosis and treatment planning, cone-beam computed tomographic scans of the patient were saved in DICOM (digital imaging and communication in medicine) format, anatomic and prosthetic data were imported into a dedicated diagnostic and medical imaging software, the prosthetic-driven position of the implants, and the graft blocks perfectly adapted to the residual bone structure were virtually planned. In the manufacturing of customized graft blocks, the CAD-CAM technology and the bovine-derived xenohybrid composite bone (SmartBone® on Demand - IBI SA - Industrie Biomediche Insubri SA Switzerland) were used to fabricate the grafts in the exact shape of the 3D planning virtual model. In the surgical and prosthetic procedure, the maxillary ridge augmentation with custom-made blocks and implant-supported full-arch screw-retained rehabilitation were performed. The described protocol offered some advantages when compared to conventional augmentation techniques. The use of deproteinized bovine bone did not require additional surgery for bone harvesting, avoided the risk of donor site morbidity, and provided unlimited biomaterial availability. The customization of the graft blocks reduced the surgical invasiveness, shorting operating times because the manual shaping of the blocks and its adaptation at recipient sites are not necessary and less dependent on the clinician’s skill and experience.
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Shrivastav, Ambika, and Siddarth Gupta. "A Simple Surgical Approach for Correction of Deficient Alveolar Ridge for Prospective Fixed Partial Denture Patients: A Clinical Report." Dental Journal of Advance Studies 02, no. 01 (April 2014): 030–35. http://dx.doi.org/10.1055/s-0038-1671983.
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AbstractRehabilitation of patients with deficient Seibert's Class-III ridge mandibular ridge is always a challenge for a dentist. This article discusses the problems faced while rehabilitating such cases and also discusses the surgical and prosthetic management of one such case. A ridge augmentation procedure called as “Roll on Technique” was used to correct the contour of the ride. Fixed partial denture with altered framework design and tissue colored porcelain was used to complete the case. These simple but effective changes helped to give predictable esthetics with illusion of natural teeth.
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Hoh, Daniel J., James B. Elder, and Michael Y. Wang. "PRINCIPLES OF GROWTH MODULATION IN THE TREATMENT OF SCOLIOTIC DEFORMITIES." Neurosurgery 63, suppl_3 (September 1, 2008): A211—A221. http://dx.doi.org/10.1227/01.neu.0000325766.21809.18.
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ABSTRACT INTRAOPERATIVE MANIPULATION TO correct scoliotic deformities relies upon spinal instrumentation for stabilization and fusion. However, novel strategies and innovative implant biotechnologies have emerged, applying natural growth and elongation of the immature spine for the treatment of scoliosis in young patients. In this work, we review the principles of growth modulation and the Hueter-Volkmann law as it applies to experimental models of scoliosis formation and correction. Current implant technologies, including shape memory alloy vertebral staples, growing rods, and vertical expandable titanium prosthetic ribs, are explored, with regards to implant design, surgical techniques, and clinical investigations. An exciting area of spinal implant technology is now becoming available to expand the surgical armamentarium for treating severe scoliotic deformity in young patients.