A Partial Palatal Coverage Overdenture Retained by Zygomatic Implants

Prosthodontic rehabilitation of an atrophic edentulous maxilla can be challenging and is further complicated when multiple risk factors are present. Fixed prostheses require multiple implants for support/retention organized in biomechanically favorable positions in order to afford a good prognosis. Such suitable implant arrangements in an atrophic edentulous ridge can often be difficult to achieve. Removable prostheses require fewer implants for a favorable prognosis and can furthermore take advantage of the additional anatomical structures for support/retention. This clinical treatment will describe the fabrication of a partial palatal coverage overdenture retained by zygomatic implants.     

Esthetic Proportions versus Biologic Width Considerations: A Clinical Dilemma

Abstract: Combining harmonious proportions of final restorations with periodontal health and stability surrounding these restorations is a basic fundamental in esthetic dentistry. However, when one can adversely affect the other, a clinical dilemma arises. This article describes a case with unfavorable proportions that may be worsened due to an existing unfavorable preparation design. A simple approach for diagnosis and treatment of such a situation is presented.     

Treatment of an Edentulous Patient with CAD/CAM Technology: A Clinical Report

CAD/CAM (computer-aided design/computer-aided manufacturing) technology with large-scale industrial applications has been developed and used over the last 3 decades. Implant Innovations, Inc. (Palm Beach Gardens, FL), has recently introduced a version of this technology for use in implant restorative dentistry. Different software programs were written to design and machine individual implant abutments and bar-type frameworks. This report provides a literature review of CAD/CAM technology in dentistry and describes the treatment of one edentulous patient restored with individual implant abutments and conventional cemented fixed partial dentures in the edentulous maxilla and a fixed, screw-retained prosthesis that replaced the missing mandibular teeth. The abutments were made using The Encode Restorative System; the mandibular framework was made with a CAM StructSURE Precision Milled Bar. The benefits and limitations of this technology are also discussed. Additional clinical and laboratory studies are needed to further validate this technology.     

Repair of tears of the subscapularis tendon

Tears of the subscapularis are much less common than tears of the supraspinatus and infraspinatus. Subscapularislesions are usually traumatic in etiology and occur in younger patients. These lesions can be complete or limited to the superior insertion of the subscapularis, and they may be isolated or occur with other rotator cuff lesions. In most instances, treatment of subscapularis tears is surgical. In this article, we present the clinical and radiographic findings, discuss operative indications, and illustrate our preferred surgical technique for tears of the subscapularis tendon.     

Directional Preference Following Epidural Steroid Injection in Three Patients with Acute Cervical Radiculopathy

Cervical radiculopathy is typically characterized by neurologic symptoms that are traced to disturbances of discrete spinal nerve root(s) due to inflammatory or mechanical etiologies. Here we present three patients diagnosed with cervical radiculopathy, whose directional preference only surfaced after either a cervical transforaminal or intralaminar nerve root epidural steroid injection. This retrospective observational case series describes three men who presented with cervical radiculopathy with 7‐9/10 neck pain, neck disability index (NDI) ranging between 44% and 90%, and an irreducible derangement upon McKenzie mechanical diagnosis and therapy (MMDT) evaluation. These patients demonstrated weaknesses, sensory changes, and/or decreased reflexes in the C5, C6, or C7 distributions. They each underwent a cervical transforaminal or intralaminar epidural injections at one or two levels, which uncovered their directional preference and facilitated further conservative treatment. These three patients experienced drastic improvements with each postinjection physical therapy session. They demonstrated decreased pain scores, centralization of pain, and a decreasing NDI trends throughout their treatments. They were all discharged with stable 0‐3/10 pain severity after four physical therapy sessions and NDI scores of 0%. These cases suggest an interplay between inflammatory and mechanical contributors to spine‐mediated pain and the treatment challenge this presents. Dissecting the components of spine pain can be challenging; however, delivery of skilled multidisciplinary care in an algorithmic fashion may be beneficial and provide the future framework for the management of cervical radiculopathy and other spine‐related conditions.     

Third nerve palsy due to cerebral artery aneurysm in a child

We report a case of cerebral aneurysm in a seven-year-old girl who presented with subacutely progressive third nerve palsy. To our knowledge this is the youngest reported patient with this condition. Confusion with myasthenia gravis occurred because of improvement in the patient's ptosis after intravenous edrophonium chloride. Cerebral CT revealed a hyperdense mass that was characterised on cerebral angiography as an aneurysm of the posterior communicating artery. Another occult aneurysm of the posterior cerebral artery was found at surgery. This case demonstrates that third nerve palsy due to cerebral aneurysm may affect patients at a younger age than has previously been recognised. Therefore we suggest that even young children should have aneurysm excluded by cerebral CT and angiography if they present with acquired third nerve palsy involving the pupil. In addition this case highlights the false-positive results that may occur with the edrophonium chloride test for myasthenia gravis.     

数字化工作流程和跨学科规划在种植中创造高端美学效果——一位高级技师的观点

本篇文章概述了美学区种植的修复概念，以期达到最佳的美学效果和长期稳定性，强调了理解和应用影响治疗结果的生物因素和治疗技术。作者展示了令人振奋的数字化技术，它改变了美学修复理念，修复技术和外科技术。数字化工作流程提供高质量修复体的同时，保持了非常自然的外观，使得多种修复类型达到很高水平。数字系统领域的快速发展，使治疗效果具有更高的可预测性和精确度，以及更高的准确性，从而提高设计质量。数字化也缩短了牙科治疗和牙科技术的时间。从模型工作流程过渡到数字化工作流程需要模式的转换，在实践和实验室中改进日常工作流程的技术集成了先进的CAD/CAM技术，还有3D打印模型和高端美学陶瓷牙齿修复技术。本文详述的跨学科方法可为相关病例管理提供最佳方案。