Zygomatic implant-retained fixed complete denture for an elderly patient

Dental rehabilitation of a completely edentulous geriatric patient has always been a challenge to the clinician, especially in treating those with higher expectations and demands. Treatment duration and the amount of residual alveolar bone available are often important considerations when planning for dental implant-based fixed treatment for these patients. With the introduction of zygomatic implants, a graftless alternative solution has emerged for deficient maxillary bone with provision for immediate loading. This article describes the treatment of a completely edentulous elderly patient using zygomatic implants in conjunction with conventional implants. The implants were immediately loaded using a definitive acrylic resin fixed denture reinforced with a cast metal framework, to provide function and aesthetics.     

Influences of age and maxillary anterior teeth status on patient's satisfaction with dental appearance and tooth colour

doi: 10.1111/j.1741‐2358.2011.00543.x Influences of age and maxillary anterior teeth status on patient’s satisfaction with dental appearance and tooth colour Objectives: To study the impact of age, gender, tooth colour and maxillary anterior teeth status on patient’s satisfaction with their dental appearance. Material and methods: A total of 259 Caucasian subjects participated in the study (119 men, mean age 56 years; 140 women, mean age 61 years) divided into three age groups (young <35 age; middle aged 35–54 age; old ≥55 age). Their maxillary anterior teeth status was classified into three groups: (1) natural teeth (NTG) group; (2) composite filling group (CFG) and (3) porcelain‐fused‐to‐metal fixed prosthodontic restoration group (FPDG). The participants judged appearance and tooth colour using a scale with three categories: completely dissatisfied, moderately dissatisfied and completely satisfied. Results: Almost half of the participants were completely satisfied with their dental appearance and tooth colour. Half of the ‘young’ and ‘middle‐aged’ participants with natural maxillary anterior teeth were completely satisfied and half of the ‘old’ participants were moderately satisfied with their dental appearance and tooth colour. The majority of participants with composite restorations (45–51%) were moderately satisfied with their dental appearance, one‐third of ‘young’ and ‘middle‐aged’ participants were moderately satisfied or dissatisfied with their tooth colour and more than 70% of older participants were dissatisfied with their tooth colour (p > 0.05). Conclusions: Satisfaction with the appearance of the maxillary anterior teeth differed both between individuals of different age and different dental status.     

The effect of attachment type and implant number on satisfaction and quality of life of mandibular implant-retained overdenture wearers

doi: 10.1111/j.1741‐2358.2011.00531.x The effect of attachment type and implant number on satisfaction and quality of life of mandibular implant‐retained overdenture wearers Objective: The aim of this study was to compare the quality of life and patient satisfaction outcomes of two attachment systems in mandibular overdentures with different numbers of supporting implants. Materials and methods: Sixty‐two edentulous patients with either splinted or single attachments in mandibular implant overdentures with different numbers of supporting interforaminal implants were investigated for patient satisfaction and quality of life in this retrospective study. Comparisons between groups were perceived by the Mann–Whitney U test. Relations among the parameters were investigated by Spearman’s rho correlation analysis. The results were evaluated statistically at a significance level of p < 0.05. Results: No statistically significant association is found between visual analogue scales scores and attachment type as well as implant number (p > 0.05), whereas Oral Health Impact Profile (OHIP)‐14 total scores for patients with 4‐implant‐supported bars were significantly lower than all the other attachment types (p < 0.05). Additionally, a negative (rate = 32.2%), statistically significant association between period of edentulism and total OHIP‐14 scores was detected (p < 0.05). Conclusions: A mandibular implant‐retained overdenture supported with four implants and bar attachments shows the highest ‘quality of life’ score and patient satisfaction is not influenced by the number of implants or attachment type.     

Oral health related quality of life of edentulous patients after denture relining with a silicone-based soft liner

doi: 10.1111/j.1741‐2358.2011.00503.x Oral health related quality of life of edentulous patients after denture relining with a silicone‐based soft liner Background: Knowledge of benefits caused by a treatment on quality of life is very relevant. Despite the wide use and acceptance of soft denture liners, it is necessary to evaluate the patient’s response about the use of these materials with regard to improvement in oral health related quality of life (OHRQoL). Objectives: The aim of this study was to evaluate the influence of denture relining in the OHRQoL of edentulous patients. Materials and methods: Thirty‐two complete denture wearers had their lower dentures relined with a silicone‐based material (Mucopren soft, Kettenbach, Germany) according to chairside procedures. OHRQoL was assessed before and after 3 months of relining by means of OHIP‐EDENT, and the median scores were compared by Wilcoxon test (p ≤ 0.05). Results: After 3 months of relining, participants reported significant improvement of their OHRQoL (p ≤ 0.01). Conclusion: Denture relining with a soft liner may have a positive impact on the perceived oral health of edentulous patients.     

Oral rehabilitation of severely worn dentition using an overlay for immediate re-establishment of occlusal vertical dimension

The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patient's immediate aesthetics and function at low cost.     

The influence of mandibular implant-retained overdentures in masticatory efficiency

doi: 10.1111/j.1741‐2358.2011.00539.x The influence of mandibular implant‐retained overdentures in masticatory efficiency Objective: To evaluate the masticatory efficiency of patients rehabilitated with conventional dentures (CDs) or implant‐retained mandibular overdentures. Background: Despite the evident benefits of implants on mastication as assessed by subjective patient‐based outcomes, the extent of implant overdenture treatment effect on food comminution is not well established. Materials and methods: A randomised clinical trial was carried out with 29 completely edentulous patients divided into two groups. The first group was rehabilitated with a mandibular overdenture retained by two splinted implants with bar‐clip system, while the second group was rehabilitated with a mandibular CD. Both groups also were rehabilitated with maxillary CDs. Masticatory efficiency and patient satisfaction were assessed 3 months after denture insertion. Masticatory efficiency was evaluated through the colorimetric method with the beads as the artificial test‐food. Comparisons for masticatory efficiency and patient satisfaction were performed using Student’s t‐test (α = 0.05). Results: No significant statistical difference was found for masticatory efficiency (p = 0.198). Patient overall satisfaction was significantly higher for the mandibular overdenture (p < 0.001). In addition, mandibular overdenture patients were significantly more satisfied with chewing experience (p < 0.05) and retention of the lower denture (p < 0.005). Conclusion: The results of this study suggest that mandibular overdenture significantly improves chewing experience, although limited effect on masticatory efficiency has been observed.     

老年患者就医流向及影响因素调查研究

??????? 目的 分析老年患者就医流向的原因与因素,为合理引导老年患者适宜就医、提高医疗有效利用率、缓解医疗供需矛盾提出参考建议。方法 利用SPSS20.0描述性统计和X²检验对数据进行分析。结果 老年患者在生病时首选三级医院就医的比例最高,其次为社区卫生服务中心,二级医院比例最低。就医流向的影响因素有：年龄、医疗保障情况、文化程度、家庭平均月收入。结论 应通过加强宣教、合理引导,强化社区医疗机构服务能力建设,畅通双向转诊/转查渠道,积极推进二级医院的转型发展,来吸引老年就医群,优化老年人群就医流向,提高医疗资源的有效使用效率。     

101例肺炎死亡病例分析

目的：探讨成年肺炎死亡病例的特征,以提高救治率。方法：利用医院住院病案管理系统软件及人工收集我院2008年1月1日-2011年4月26日的全部成年肺炎死亡病例临床资料,共计101例,对其进行回顾性分析。结果：101例观察病例中男性共计71例（占70_30％）,女性共计30例（占29．70％）,大于65岁者共计95例（占94．06％）,44-58岁者共计6例（占5．9％）,平均年龄80．30岁。单侧肺部病变22例（占21．78％）,双侧肺部病变79例（占78．22％）,观察病例均伴有多种基础病及并发症,并且多数病例存在多种致病茵感染及多重耐药茵感染。结论：成年肺炎死亡的发生与患者年龄（65岁以上）、性别（男性）、双侧肺部病变、基础病及并发症、多种致病茵感染及多重耐药茵感染等因素密切相关。     

美常安治疗老年人抗生素相关性腹泻的疗效观察

目的:观察美常安治疗老年人抗生素相关性腹泻的疗效.方法:将79例老年人抗生素相关性腹泻患者随机分为2组,对照组为常规治疗,治疗组在常规治疗的基础上加用美常安治疗.结果:治疗组患者的总有效率明显高于对照组,2组有显著差异(P＜0.05).结论:美常安治疗老年人抗生素相关性腹泻疗效显著.