-
Dental Clinics of North America Apr 2019The partial edentulous population is increasing because of an increasing aging population, increased life expectancy, and individuals retaining more teeth at an older... (Review)
Review
The partial edentulous population is increasing because of an increasing aging population, increased life expectancy, and individuals retaining more teeth at an older age. Therefore, the need for fixed and removable partial denture (RPD) therapy will remain high and will continue into the future. RPDs provide minimally invasive, cost-effective, timely care, and are preferred to fixed dental prostheses using teeth or implant therapy in many clinical scenarios. This article discusses RPD classification systems to review basic concepts and special framework design considerations, and explores advancements in the field such as implant-assisted RPD, CAD/CAM RPD, and new polymer framework materials.
Topics: Aged; Computer-Aided Design; Denture Design; Denture, Partial, Removable; Humans; Jaw, Edentulous, Partially
PubMed: 30825990
DOI: 10.1016/j.cden.2018.11.007 -
Primary Dental Journal Sep 2020Improvements in oral health including increased retention of natural teeth have given rise to a partially dentate older population. Replacement of missing natural teeth...
Improvements in oral health including increased retention of natural teeth have given rise to a partially dentate older population. Replacement of missing natural teeth is important to improve function, aesthetics and quality of life for this patient group. A variety of options are available to replace missing teeth in partially dentate older adults, including fixed, removable and implant retained prostheses. This article will discuss the provision of removable partial dentures including treatment planning and denture design. When planning removable partial dentures, careful attention must be paid to stabilising the patient prior to delivering any prosthesis. Partial dentures should be designed to minimise the potential for plaque accumulation with carefully designed metal based frameworks. Acrylic resin can also be utilised with attention to detail to minimise the risk of damage to delicate supporting tissues. Removable dentures have the advantage that they can be readily added to in the event of further tooth loss which may be particularly relevant for older adults. Partial dentures which optimise support, retention and stability can function very successfully and significantly improve patients' oral health related quality of life.
Topics: Aged; Denture, Partial; Denture, Partial, Removable; Humans; Mouth, Edentulous; Quality of Life; Tooth Loss
PubMed: 32940586
DOI: 10.1177/2050168420943435 -
Seminars in Neurology Apr 2020Rasmussen encephalitis (RE) is a rare, devastating, progressive pediatric epilepsy. First described 60 years ago, RE continues to present challenges in diagnosis and... (Review)
Review
Rasmussen encephalitis (RE) is a rare, devastating, progressive pediatric epilepsy. First described 60 years ago, RE continues to present challenges in diagnosis and management. RE causes a unilateral focal epilepsy in children that typically becomes medically refractory, results in significant hemiparesis, and causes progressive cognitive decline. The etiology is a cell-mediated immune attack on one cerebral hemisphere, though the inciting antigen remains unknown. While the underlying histopathology is unilateral and RE is described as "unihemispheric," studies have demonstrated (1) atrophy of the unaffected hemisphere, (2) electroencephalographic abnormalities (slowing and spikes) in the unaffected hemisphere, and (3) cognitive decline referable to the unaffected hemisphere. These secondary contralateral effects likely reflect the impact of uncontrolled epileptic activity (i.e., epileptic encephalopathy). Hemispheric disconnection (HD) renders 70 to 80% of patients seizure free. While it has the potential to limit the influence of seizures and abnormal electrical activity emanating from the pathological hemisphere, HD entails hemiparesis and hemianopia, as well as aphasia for patients with dominant HD. With the recent expansion of available immunomodulatory therapies, there has been interest in identifying an alternative to HD, though evidence for disease modification is limited to date. We review what is known and what remains unknown about RE.
Topics: Child; Encephalitis; Epilepsies, Partial; Humans
PubMed: 32185790
DOI: 10.1055/s-0040-1708504 -
Presse Medicale (Paris, France : 1983) Nov 2021Lipodystrophies are a heterogeneous group of rare conditions characterised by the loss of adipose tissue. The most common forms are the familial partial lipodystrophy... (Review)
Review
Lipodystrophies are a heterogeneous group of rare conditions characterised by the loss of adipose tissue. The most common forms are the familial partial lipodystrophy (FPLD) syndromes, which include a set of disorders, usually autosomal dominant, due to different pathogenetic mechanisms leading to improper fat distribution (loss of fat in the limbs and gluteal region and variable regional fat accumulation). Affected patients are prone to suffering serious morbidity via the development of metabolic complications associated to insulin resistance and an inability to properly store lipids. Although no well-defined diagnostic criteria have been established for lipodystrophy, there are certain clues related to medical history, physical examination and body composition evaluation that may suggest FPLD prior to confirmatory genetic analysis. Its treatment must be fundamentally oriented towards the control of the metabolic abnormalities. In this sense, metreleptin therapy, the newer classes of hypoglycaemic agents and other investigational drugs are showing promising results. This review aims to summarise the current knowledge of FPLD syndromes and to describe their clinical and molecular picture, diagnostic approaches and recent treatment modalities.
Topics: Body Composition; Exercise Therapy; Humans; Hypoglycemic Agents; Insulin Resistance; Leptin; Lipid Metabolism; Lipodystrophy, Familial Partial; Medical History Taking; Metabolic Diseases; Phenotype; Physical Examination; Syndrome
PubMed: 34610417
DOI: 10.1016/j.lpm.2021.104071 -
Hand Clinics Nov 2017Partial wrist arthrodesis (PWA) is a well-known procedure for treating degenerative or posttraumatic wrist conditions. Four-corner fusion (4CF) is mostly used for... (Review)
Review
Partial wrist arthrodesis (PWA) is a well-known procedure for treating degenerative or posttraumatic wrist conditions. Four-corner fusion (4CF) is mostly used for scapholunate advanced collapse and scaphoid nonunion advanced collapse. The author performed 39 procedures, including 4CFs, 2-corner fusions, 3-corner fusions, scaphoid-capitate/scaphoid-capitate-lunate fusions, scaphoid-trapezium-trapezoid arthrodeses, and radioscapholunate arthroscopic PWAs (A-PWAs). There were 8 revision cases including 4 partial nonunions. All A-PWAs healed satisfactorily after revision surgery. This article discusses the surgical techniques and tips to avoid mistakes. The pros and cons for open versus arthroscopic techniques and for screws versus Kirschner wires are also discussed.
Topics: Arthrodesis; Arthroscopy; Humans; Osseointegration; Postoperative Care; Postoperative Complications; Preoperative Care; Wrist Joint
PubMed: 28991585
DOI: 10.1016/j.hcl.2017.07.013 -
Updates in Surgery Jun 2021Although safe and feasible, partial adrenalectomy is not a widespread procedure. Endorsement of robotic technologies and fluorescence techniques in adrenal surgery might...
Although safe and feasible, partial adrenalectomy is not a widespread procedure. Endorsement of robotic technologies and fluorescence techniques in adrenal surgery might help develop partial adrenalectomy and could avoid unnecessary total adrenalectomies. When performed in selected cases, partial adrenalectomy is associated with good postoperative outcomes comparable with those reported after total adrenalectomy. It has been hypothesized that one of the advantages of the robotic approach in adrenal-sparing surgery is to reduce manipulation of the gland allowing preservation of the vascularization of the residual adrenal, overcoming some limits when performing a laparoscopic conventional approach. A major drawback of the robotic surgery is its cost, but the overcost due to the use of the robotic system could be balanced by the execution of a high number of partial adrenalectomies leading to fewer life-long replacement steroid treatment. Partial adrenalectomy could become the recommended management for small benign and hormonal active adrenal tumors. Indocyanine green fluorescence (IGF) also seems to be a useful technique to help surgeons identify the adrenal gland and to locate small tumors from the normal adrenal tissue in difficult patients. It is likely that the use of a robotic approach associated with IGF may extend indications of partial adrenalectomy in the years to come.
Topics: Adrenal Gland Neoplasms; Adrenalectomy; Humans; Indocyanine Green; Laparoscopy; Robotic Surgical Procedures; Robotics
PubMed: 33411221
DOI: 10.1007/s13304-020-00957-6 -
Journal of Prosthodontic Research 2023
Topics: Denture, Partial; Denture, Partial, Removable
PubMed: 37839869
DOI: 10.2186/jpr.JPR_D_23_00246 -
Anais Da Academia Brasileira de Ciencias 2023The evolution of cooperation in microbes is a challenge to explain because microbes producing costly goods for the benefit of any strain types (cooperators) often...
The evolution of cooperation in microbes is a challenge to explain because microbes producing costly goods for the benefit of any strain types (cooperators) often withstand the threat of elimination by interacting with individuals that exploit these benefits without contributing (defectors). Here we developed an individual-based model to investigate whether partial privatization via the partial secretion of goods can favor cooperation in structured, surface-attaching microbial populations, biofilms. Whether partial secretion can favor cooperation in biofilms is unclear for two reasons. First, while partial privatization has been shown to foster cooperation in unstructured populations, little is known about the role of partial privatization in biofilms. Second, while limited diffusion of goods favors cooperation in biofilms because molecules are more likely to be shared with genetically-related individuals, partial secretion reduces goods that could have been directed towards genetically related individuals. Our results show that although partial secretion weakens the role that limited diffusion has on fostering cooperation, partial secretion favors cooperation in biofilms. Overall, our results provide predictions that future experiments could test to reveal contributions of relatedness and partial secretion to the social evolution of biofilms.
Topics: Humans; Privatization; Biofilms; Biological Evolution; Cooperative Behavior
PubMed: 38126521
DOI: 10.1590/0001-3765202320220985 -
Journal of Prosthodontics : Official... Feb 2019This clinical report describes a modification of the conventional direct retainer design, which incorporates advantages of the dual path partial denture, but with a...
This clinical report describes a modification of the conventional direct retainer design, which incorporates advantages of the dual path partial denture, but with a greater ease of design and fabrication. The main advantage of this technique is minimizing the clasp display on Class III and Class IV removable partial denture prostheses. A clinical example using this design is described.
Topics: Dental Abutments; Denture Design; Denture Retention; Denture, Partial, Removable; Esthetics, Dental; Friction; Humans; Male; Maxilla; Middle Aged
PubMed: 30569510
DOI: 10.1111/jopr.13009