Treatment Strategies for Missing Maxillary Central Incisor—An Orthodontist's Perspective

The loss of maxillary central incisors at an early age has psychological, esthetic, and functional implications. Multiple treatment options are available for replacing missing central incisors. The management demands a multidisciplinary approach involving the orthodontist, prosthodontist, and periodontist. Treatment planning requires consideration of a variety of clinical and nonclinical factors. This clinical report attempts to demonstrate different strategies for the management of unilaterally and bilaterally missing central incisors.     

Breath-by-breath determination of inspiratory occlusion pressure

Summary. In order to determine the influence of breath-by-breath measurement of inspiratory occlusion pressure (P_0.1) on the pulmonary ventilation, the respiratory timing and the central inspiratory activity as reflected by P_0.1per se, nine healthy males were studied as they breathed in a valve assembly including an externally controlled occlusion valve. A new technique was used, terminating occlusions at a preset inspiratory threshold pressure and determining P_0.1 from linear regression of the mouth pressure curve. Subjects were studied at rest and during light exercise, with the occluding function (threshold pressure) on or off during alternating periods. Breath-by-breath variability of P_0.1 was of the order of 30%. We found no detectable influence of breath-by-breath short-lasting inspiratory occlusions on tidal volume and ventilation. However, mean inspiratory flow was slightly increased due to a shortened inspiratory duration at rest and during light exercise. Also, raising the threshold pressure for occlusions from 69 to 147 Pa (0.7 to 1.5 cm H₂O) resulted in a 20% increase of P_0.1. We conclude that breath-by-breath measurement of P_0.1 is a feasible technique, and that the slightly shortened inspiratory duration and the increased P_0.1 with increased threshold pressure may not necessarily be expressions of a true stimulation of the central inspiratory activity.     

Fio‐guia perdido – lições aprendidas

Central venous catheter placement is a relatively common procedure in current practice, but it is not devoid of risks. Utmost care must be taken to follow a correct technique, and only appropriately trained and/or supervised medical professionals should perform this invasive act. One of the possible complications, completely avoidable by appropriate care, is the intravascular loss of the guide wire during insertion, which is a potentially serious complication. We describe one such case.