A Prospective Cohort Study on Cast-Metal Slot-Retained Resin-Bonded Fixed Dental Prostheses in Single Missing First Molar Cases: Results After Up to 7.5 Years.

A Prospective Cohort Study on Cast-metal Slot-retained Resin-bonded Fixed Dental Prostheses in Single Missing First Molar Cases: Results After up to 7.5 Years.

J Adhes Dent. 2013 Jan 18;
Izgi AD, Kale E, Eskimez S

Purpose: To evaluate under controlled clinical conditions the outcomes of cast-metal slot-retained resin-bonded fixed dental prostheses (RBFDPs) in which resin composite interlocked the restoration retainers in place after cementation in cases with single missing first molars, and to collect survival data on this esthetic RBFDP design combined with an economical metal fit-surface treatment method and resin luting system. Materials and Methods: Forty-one tub-shaped inlay-retained RBFDPs were clinically observed for up to 7.7 years in 35 recipients of both genders between 18 and 52 years of age. Clinical examinations were performed at baseline and 6 and 12 months after restoration placement, and thereafter at regular 1-year intervals. Modified US Public Health Service (USPHS) parameters, sulcus bleeding index, Silness-Löe plaque index, pocket depths, tooth mobility, pulp vitality, and periapical radiographs regarding the abutment teeth were assessed at these follow-up appointments. The Kaplan-Meier survival estimation method was performed to detect the overall and functional survival rates and mean survival times of the RBFDPs at the end of the study. The Breslow (Generalized Wilcoxon) test was used to evaluate the influence of restoration location and age and gender of the patient regarding the overall survival probability at the end of the follow-up (? = 0.05). Results: At the end of the study, 34 RBFDPs (83%) were still functioning with a mean follow-up of 6.3 years. According to the Kaplan-Meier survival curve, the overall and functional survival probabilities were calculated as 76% and 83%, with mean survival times of 6.8 years and 7.2 years, respectively. All clinical parameters monitored throughout the follow-up period predominantly revealed clinically acceptable results. Breslow test statistics presented nonsignificant differences with better results for the RBFDPs placed in the mandible of female recipients younger than 30 years of age. The most common failure noted with the RBFDPs was fracture of the occlusal veneering composite restoration over the retainer of a single abutment, leading to a predisposition of the restoration to partial debonding. Conclusion: Within the limitations of this prospective cohort study, it can be concluded that cast-metal slot-retained RBFDPs utilizing the interlocking mechanism of a resin composite to obtain additional retention from the abutment cavities show acceptable clinical success rates, and can be considered a minimally invasive, economical, and time-saving treatment alternative for the prosthetic rehabilitation of single missing first molars. HubMed – rehab

 

Hypoxic-ischemic neonatal encephalopathy: animal experiments for neuroprotective therapies.

Stroke Res Treat. 2013; 2013: 659374
Sameshima H, Ikenoue T

Hypoxic-ischemic neonatal encephalopathy and ensuing brain damage is still an important problem in modern perinatal medicine. In this paper, we would like to share some of the results of our recent studies on neuroprotective therapies in animal experiments, as well as some literature reviews. From the basic animal studies, we have now obtained some possible candidates for therapeutic measures against hypoxic-ischemic neonatal encephalopathy. For example, they are hypothermia, rehabilitation, free radical scavenger, neurotrophic factors and growth factors, steroid, calcium channel blocker, vagal stimulation, some anti apoptotic agents, pre- and post conditioning, antioxidants, cell therapy with stem cells, modulators of K(+)-ATP channels, and so on. Whether combination of these therapies may be more beneficial than any single therapy needs to be clarified. Hypoxia-ischemia is a complicated condition, in which the cause, severity, and time-course are different in each case. Likewise, each fetus has its own inherent potentials such as adaptation, preconditioning-tolerance, and intolerance. Therefore, further extensive studies are required to establish an individualized strategy for neuroprotection against perinatal hypoxic-ischemic insult. HubMed – rehab

 

Long-term use of a static hand-wrist orthosis in chronic stroke patients: a pilot study.

Stroke Res Treat. 2013; 2013: 546093
Andringa A, van de Port I, Meijer JW

Background. Long-term splinting, using static orthoses to prevent contractures, is widely accepted in stroke patients with paresis of the upper limb. A number of stroke patients complain about increased pain and spasticity, which leads to the nonuse of the orthosis and a risk of developing a clenched fist. Objectives. Evaluating long-term use of static hand-wrist orthoses and experienced comfort in chronic stroke patients. Methods. Eleven stroke patients who were advised to use a static orthosis for at least one year ago were included. Semistructured telephone interviews were conducted to explore the long-term use and experienced comfort with the orthosis. Data were analyzed using descriptive statistics. Results. After at least one year, seven patients still wore the orthosis for the prescribed hours per day. Two patients were unable to wear the orthosis 8 hours per day, due to poor comfort. Two patients stopped using the orthosis because of an increase in spasticity or pain. Conclusions. These pilot data suggest that a number of stroke patients cannot tolerate a static orthosis over a long-term period because of discomfort. Without appropriate treatment opportunities, these patients will remain at risk of developing a clenched fist and will experience problems with daily activities and hygiene maintenance. HubMed – rehab

 


 

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