Esthetic Integration Between Ceramic Veneers and Composite Restorations: A Case Report.

Esthetic integration between ceramic veneers and composite restorations: a case report.

Filed under: Rehab Centers

Ann Stomatol (Roma). 2012 Jul; 3(3-4): 132-7
Farronato D, Mangano F, Pieroni S, Giudice GL, Briguglio R, Briguglio F

The tooth structure preservation is the best way to postpone more invasive therapies. Especially in young patients more conservative techniques should be applied. Bonded porcelain veneers and even more the direct composite restorations, are the two therapeutic procedures that require the fewer sacrifice of dental tissue, finalized to the optimal recovery of aesthetic and functional outcome.Although the two techniques require different methods and materials, is possible to achieve a correct integration of both the methods by some technical and procedural measures. In the presented case is planned a rehabilitation of the four upper incisors by ceramic veneers and direct composite restorations.Care is taken for the surface treatment of ceramic restorations, with the objective of achieving integration, not only between natural teeth and restorations, but also between the different materials in use.The purpose of this article is to show how a proper design of the treatment plan leads to obtain predictable results with both direct and indirect techniques.
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Total and Distributed Plantar Loading in Subjects With Stage II Tibialis Posterior Tendon Dysfunction During Terminal Stance.

Filed under: Rehab Centers

Foot Ankle Int. 2013 Jan; 34(1): 131-9
Neville C, Flemister AS, Houck J

Background: In subjects with stage II tibialis posterior tendon dysfunction (TPTD), the function of the tibialis posterior muscle is altered and may be associated with a change in total and distributed loading. Methods: Thirty subjects with a diagnosis of stage II TPTD and 15 matched control subjects volunteered to participate in a study to examine the total and distributed plantar loading under the foot during the terminal stance phase of gait. Plantar loading, measured as the subject walked barefoot, was assessed using instrumented flexible insoles. A secondary analysis was done to explore the contribution of flatfoot kinematics to plantar loading patterns. Results: Overall, there was reduced total plantar loading in subjects with stage II TPTD compared with controls. Accounting for differences in total loading, the presence of clinically measured weakness in subjects with TPTD was associated with reduced lateral forefoot loading. Medial longitudinal arch height was significantly correlated with loading patterns but explained only 21% of the variance in observed loading patterns. Conclusion: Subjects with TPTD who are strong exhibited loading patterns similar to controls. Changes in total and distributed loading during terminal stance suggest there are altered ankle mechanics at push-off during the functional task of gait. Clinical Relevance: Strength, in the presence of TPTD, may be important to stabilize the midfoot during gait and might be important in rehabilitation protocols.
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Early Weight-Bearing After Percutaneous Reduction and Screw Fixation for Low-Energy Lisfranc Injury.

Filed under: Rehab Centers

Foot Ankle Int. 2013 Feb 5;
Wagner E, Ortiz C, Villalón IE, Keller A, Wagner P

Background:Anatomic restoration and postoperative rehabilitation of displaced fracture-dislocations of the tarsometatarsal junction of the foot are essential. Our objective was to report percutaneous reduction and screw fixation results in low-energy Lisfranc fracture dislocation injuries that were treated with early weight-bearing and rehabilitation.Methods:We retrospectively evaluated patients with low-energy Lisfranc injuries who underwent surgery between May 2007 and April 2011. The study reviewed 22 patients (12 men and 10 women) with an average age of 36.2 years (range, 16-50 years) and an average follow-up of 33.2 months (range, 12-50 months). We report the mechanism of trauma; quality of reduction in the postoperative digital radiographs; subjective satisfaction; AOFAS score; time required to return to work, recreational activities, and low-impact sports; and complications. Postoperatively, all of the patients were instructed to be non-weight-bearing for 3 weeks, and the stitches were removed after 2 weeks. At the third postoperative week, the patients were encouraged to bear weight as tolerated.Results:Quality of reduction was anatomic or near anatomic in 100% of cases. The subjective satisfaction reported by patients was very good, with complete satisfaction in 20 of them (90.9%). The AOFAS average was 94 points (range, 90-100 points). Average return to work was at 7 weeks (range, 6-9 weeks), recreational activities 7.2 weeks (range, 6-9 weeks), training for low-impact sports 7.6 weeks (range, 7-8 weeks), and symptom-free sport activities 12.4 weeks (range, 11-13 weeks).Conclusion:In this selected group of patients with low-energy Lisfranc fracture dislocation, anatomic or near-anatomic reduction can be achieved with percutaneous reduction and screw fixation. Early weight-bearing is possible in these patients, and early return to regular activities and low-impact sport can be expected.Level of Evidence: Level IV, retrospective case series.
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