Retrospective study on the clinical and radiographic outcomes of 2.8 mm diameter implants supporting fixed prostheses up to 11 years.

OBJECTIVES: This study aimed to report the clinical and radiographic results of 2.8 mm two-piece narrow diameter implant (NDI) supporting fixed restorations. MATERIALS AND METHODS: Clinical and radiographic data of 54 NDIs in 32 patients were retrospectively assessed after 2 to 11 (mean 8.17) years of follow-up. Clinical and radiographic measurements were taken. Survival rate, implant and prosthesis failure, pink aesthetic scores (PES), white aesthetic scores (WES), bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL), and mechanical and biological complications were evaluated. RESULTS: An implant failed during the follow-up period, resulting in a cumulative survival rate of 98.15% at the implant level and 96.88% in the patient. The total mean values of PES and WES for 2.8 mm NDIs were 7.09 ± 1.15 (range: 3.33-9.00) and 7.42 ± 1.03 (range: 3.67-9.33). The prevalence of sites with positive BOP was 38.14 ± 29.77%. The mean PD value was 2.46 ± 0.62 mm. The average MBL was 1.15 ± 0.74 mm (range: 0.25-4.03 mm). No implant or abutment fracture was detected. A veneer chipping was present in one patient, and a loose crown appeared in another patient. Two implants (3.7%) and two patients (6.3%) were diagnosed with peri-implantitis. CONCLUSION: Within the limitation of the study, the results indicate that the use of two-piece 2.8 mm NDI for the fixed prosthetic rehabilitation of edentulous regions with reduced interdental and/or buccal-lingual width is viable.

Prostheses and Rehabilitation Principles in Pediatric Limb Deficiency.

Pediatric limb loss or limb deficiency is uncommon in the United Sates occurring 1 per 1943 live births per year, with a ratio of 2:1 upper to lower extremity.1 Causes include congenital limb deficiency, and less frequently, limb loss secondary to trauma, cancer, or other illnesses. Vascular disruption, particularly as seen in amniotic band syndrome, stands as the leading suspect in the multifaceted and intricate causes of congenital limb loss. Children with limb difference and deficiency present unique medical and rehabilitation challenges. Physical Medicine and Rehabilitation (PM&R) physicians are uniquely equipped to navigate these complexities. Prosthetic prescription and fabrication for children require balancing scientific principles with individual needs. A "one-size-fits-all" approach is ineffective. Many diverse factors impact prosthetic prescription and fabrication, including amputation level, residual limb characteristics, cognitive/developmental age, family goals, financial resources, and medical literacy.

Prosthetic Rehabilitation of a Mandibular Defect Using a Malo Bridge: A Case Report.

Prosthetic rehabilitation is necessary to improve a patient's quality of life after large cysts and tumors are removed. Although odontogenic keratocysts are benign growths, they usually cause extensive localized damage. Large abnormalities on the affected side are often the outcome of surgery. Following an odontogenic keratocyst removal, a large vertical defect was created in the right posterior mandibular region. This article provides a step-by-step description of prosthetic rehabilitation with a Malo bridge. A screw-retained framework with a custom-made abutment is used in Malo bridges, and final crowns are cemented onto it. This concept was applied in this case for the final restoration.

Prosthetic rehabilitation of segmental mandibulectomy patient using a free fibula flap and Corticobasal implant supported prosthesis: A Case report.

INTRODUCTION: Segmental mandibular reconstruction using free fibula flaps and implants is challenging for maxillofacial surgeons and prosthodontists. This case report describes the successful use of Corticobasal implant reconstructive prostheses after a free fibula flap with five years of follow-up. CLINICAL CASE PRESENTATION: A 24-year-old female presented to the clinic following segmental defect reconstruction using fibula reconstruction, owing to squamous cell carcinoma resection and seeking prosthetic treatment. An intraoral examination revealed a complete healing of the soft tissue. A panoramic radiograph showed a fibula bone graft rehabilitating the left side of the mandible supporting with a reconstructive plate. A multidisciplinary team was formed. A treatment plan included a mandibular reconstructive fixed Corticobasal implant prosthesis supported by eight basal cortical screw implants (BCS®, Dr. Ihde Dental AG, Switzerland) and a follow-up schedule was formulated. After 5-years of function, the implant demonstrated a 100 % survival rate, with no implant loss or fracture, excellent peri-implant soft tissue health, complete union of the bone graft, and a very stable prosthesis. The patient reported significant improvements in aesthetics, mastication, phonation, and self-satisfaction. DISCUSSION: The multidisciplinary team has significantly improved the treatment outcomes. The prescribed treatment modality provides the patient with a fixed treatment modality, immediate loading, reduces the risk of biological and biomechanical complications, and hence improves the patient's functions and satisfaction. CONCLUSION: A Corticobasal implant-supported prosthesis can be used in combination with a free fibula flap to reconstruct segmental mandibulectomy patients with a high survival rate and satisfactory aesthetic and functional outcomes.

Clinical-statistical study on oral rehabilitation methods using dental implants.

Background and aims: The development of dental implantology is based on a thorough examination of the interaction of implants with the surrounding tissues, as well as methods of stimulating osteogenesis around implants. The most common approach to restore lost dentition in terms of function and aesthetics is now represented by implants. The objective of our study was to comparatively assess the efficiency of prosthetic treatments performed on implants alone versus on implants in conjunction with abutment teeth. Methods: The study was carried out over seven years (2016-2023), with evaluations at one, two, three, and five years. For this analysis, MedCalc® version 12.5.0.0 (MedCalc® Software, Mariakerke, Belgium) was utilised as the medical statistical software. Results and conclusions: When using dental implants and natural teeth abutments for prosthodontic reconstruction, the failure rates rise approximately 43 times when compared to dental implant rehabilitation; similarly, osteoporosis and diabetes mellitus increase failure rates by 32 and 20 times, respectively. Gingival inflammation is a frequent event (almost 50% frequency) observed during follow-up of patients who had prosthetic restoration using dental implants alone as well as implants and abutment teeth. For both groups, difficulties usually arise two years later.

Prosthetic Rehabilitation for a Patient With Purpura Fulminans Undergoing Quadruple Amputation: A Case Report.

Purpura fulminans (PF) is a rare and life-threatening syndrome characterized by cutaneous purpura resulting from disseminated intravascular coagulation (DIC) and intravascular thrombosis. PF typically develops as a severe complication of infections and is associated with high mortality rates. Effective treatment involves early recognition, aggressive resuscitation, appropriate antibiotic therapy, and the correction of coagulation abnormalities. Nevertheless, despite effective treatment, patients often ultimately require amputation of the affected limbs. This case report details the rehabilitation process of a patient with PF who underwent quadruple amputation. The patient, a 48-year-old male, underwent quadruple amputation due to PF. After intensive care, he was admitted to a convalescent rehabilitation ward for prosthetic rehabilitation. The rehabilitation process combined physical and occupational therapy to facilitate independent living through the use of upper and lower limb prostheses and assistive devices. The patient presented with ulcerative lesions on the anterior surfaces of both knee joints upon admission. During treatment, he developed osteomyelitis of the right patella, which required intravenous antibiotics and limited rehabilitation to bed-based exercises. Following the administration of intravenous therapy, the prosthetist proceeded with the fabrication of lower limb prostheses. Subsequently, the patient was able to commence standing and gait training, and by the time of discharge, he was able to walk without a cane. Upper limb prostheses enabled independence in activities of daily living (ADLs) such as eating, dressing, and toileting. He was also able to perform cooking-related activities that are part of the instrumental activities of daily living (IADLs). This case highlights the importance and achievable outcomes of rehabilitation for patients with PF who have undergone quadruple amputation. A multidisciplinary approach utilizing both upper and lower limb prostheses, as well as assistive devices, enabled significant functional recovery.

A Comprehensive Review on a Prosthetic Finger Fabrication Approach: Clinical Rest Position (CRP) vs Palms and Fingers Extended (PFE).

Creating effective prosthetic fingers involves precise treatment planning and skilled fabrication to restore aesthetic appearance and passive function. Successful outcomes depend significantly on retention and how closely the prosthesis mimics natural finger contours. We analyzed techniques for fabricating finger prostheses with palms and fingers in clinical rest position (CRP) versus palms and fingers extended (PFE) straight out. The aesthetics and function (passive) were also examined when fabricated in these two physiological conditions. We reviewed 20 articles from national and international journals over 20 years. Most literature focuses on extended posture fabrication, with few addressing CRP. This review article compares the CRP and PFE prosthetic finger fabrication approaches and explains how a prosthetic finger fabricated in a CRP offers superior aesthetic and partial functional outcomes and emerges as a promising alternative to the PFE. The potential impact of these findings on prosthodontics is significant, emphasizing the need for further research to validate these results and the ongoing development in the field.

Short dental implants in microvascular free flap DCIA: A case report.

Placing dental implants in microvascular bone free flaps used for reconstructing the mandible or maxilla has been previously reported. However, there is scarce information available on the restorative protocol using short dental implants placed in a deep circumflex iliac artery (DCIA) microvascular free flap and the rationale behind it. This case report describes a 18-year-old patient referred to the hospital for numbness and dull pain of the left mandible, which she observed for three months. The patient underwent mandible resection and reconstruction using the DCIA free flap due to "giant cell lesion" on the left side of the mandibular angle. Short dental implants were placed and prosthetic reconstruction of the dentition involved in the resection was performed in a young patient with two integrated abutment crowns. The placement of short dental implants did not negatively affect the vascular pedicle and vitality of free flap. In our case report, two years after the healing, excellent aesthetic and function were accomplished with the DCIA flap followed by restoration with short implants.

Cirugía preprotésica de torus mandibular bilateral con impedimento del movimiento lingual / Preprosthetic surgery of a bilateral mandibular torus with tongue movement dysfunction

El torus mandibular es un crecimiento exofítico óseo benigno en la parte interna de la mandíbula, generalmente presente en ambos lados. Su etiología se relaciona a diversos factores como la herencia, grado de estrés, factores ambientales, nutricionales y trauma oclusal. Puede causar problemas funcionales y estéticos, como dificultad en la pronunciación, mal aliento, molestias al comer con prótesis mal adaptadas y ulceraciones. En la mayoría de los casos no es necesario el tratamiento, excepto cuando se requiere para mejorar la función protésica o solucionar problemas funcionales. En este artículo presentamos la situación clínica que describe la escisión exitosa del torus mandibular bilateral en un paciente de 57 años para la posterior rehabilitación protésica. La escisión del torus mandibular bilateral es un procedimiento seguro y predecible que ayuda a prevenir complicaciones protésicas y biológicas, mejorando la estabilidad y la función del sistema estomatognático (AU)

The mandibular torus is a benign bony exophytic growth in the inner part of the mandible, usually present on both sides. Its etiology is related to various factors such as heredity, degree of stress, environmental and nutritional factors, and occlusal trauma. It can cause functional and aesthetic problems, such as difficulty in pronunciation, bad breath, discomfort when eating with ill-fitting prostheses, and ulcerations. In most cases, treatment is not necessary, except when it is required to improve prosthetic function or solve functional problems. In this article we present the clinical situation that describes the successful excision of the bilateral mandibular torus in a 57-year-old patient for subsequent prosthetic rehabilitation. Bilateral mandibular torus excision is a safe and predictable procedure that helps prevent prosthetic and biological complications, improving the stability and function of the stomatognathic system (AU)

A Post-Implanto-Prosthetic Rehabilitation Study Regarding the Degree of Improvement in Patients' Quality of Life: A Before-After Study.

BACKGROUND: Implant-prosthetic rehabilitation has the ability to improve the quality of life of patients, because, in addition to the role of restoring masticatory function, they also have many other benefits, such as restoring aesthetics or improving speech. This study aimed to analyze whether patients' quality of life was improved by implanto-prosthetic rehabilitation and which were the most important aspects. MATERIALS AND METHODS: In this before-after study, we applied the Oral Health Impact Profile (OHIP-14) questionnaire to analyze the degree to which complex implanto-prosthetic rehabilitation led or not to an increase in patients' quality of life. The present study was carried out at the level of a private medical center in a city in the central region of Romania and included patients who visited this medical center between January and June 2022 and who benefited from a complex implanto-prosthetic rehabilitation, with the total number of patients eligible for inclusion in the study being 116. RESULTS: Overall, an improvement in quality of life after implant-prosthetic rehabilitation was found. Patients' gender, age, or educational level did not significantly influence their responses. The network analysis offered an overview (intuitive visual representation) of the similarities but also the differences in the OHIP-14 item relationships in both situations: before and after oral rehabilitation. CONCLUSIONS: A better understanding of how patients perceive implanto-prosthetic rehabilitation and the aspects that influence this perception can lead to an improvement in their quality of life, increasing the addressability of this type of medical procedure.

The Comprehensive Management of Patients with Rhino-Orbito-Cerebral Mucormycosis; A Perspective from Antifungal Treatment to Prosthetic Rehabilitation: A Descriptive Cohort Study.

Surgical intervention is a key element in the management of patients diagnosed with mucormycosis. A retrospective cohort study was carried out, in which patients with a proven diagnosis of mucormycosis were evaluated over a period of 10 years, according to the MSGERC criteria. A descriptive analysis of the clinical characteristics, comorbidities, imaging, and microbiology studies, as well as medical and surgical treatment and the type of prosthesis was carried out. A total of 22 cases were identified, of which 54.5% (n = 12) of the population were men. Furthermore, 77.2% (n = 17) of the population had diabetes mellitus. The main antifungal treatment implemented was liposomal amphotericin B (77.2%, n = 17). The most affected structures in our patients were the paranasal sinuses (n = 18; 81%), followed by the maxilla and orbit (n = 15; 68%), nose (n = 12; 54%), central nervous system (n = 11; 50%), and skin and soft tissues (n = 2; <1%). Of the total population, 59.09% (n = 13) of patients underwent maxillofacial surgery, of which 61.53% (n = 8) required some type of prosthetic rehabilitation. Orbital exenteration and maxillectomy were the most frequent surgeries, accounting for 69.23% (n = 9), while skull base drainage was performed in four patients (30.76%). Of the total number of patients (n = 22), eight died (36.36%). Appropriate surgical management according to the affected structures, considering not only increasing the patient's survival, but also considering the aesthetic and functional consequences, will require subsequent rehabilitation.

Prosthetic rehabilitation of patients with maxillary oncology defects using zygomatic implants.

PURPOSE: Prosthetics for patients after oncological resection of the upper jaw is a complex problem associated with the physiological and anatomical separation of the oral cavity and the nasal/paranasal region. This study reports the clinical results of the use of the zygomatic implants for prosthetic rehabilitation in patients with maxillectomy due to upper jaw tumors. MATERIALS AND METHODS: The study included 16 patients who underwent prosthetic rehabilitation using a zygomatic implant after maxillectomy period from 2021 to 2023. After the tumor was removed, immediate surgical obturators were placed. Main prosthetic rehabilitation was performed 6-12 months after tumor removal, but before that, a temporary obturator was made and used. Six-twelve months after tumor resection, 1-4 zygomatic implants were inserted into the zygomatic bone unilaterally or bilaterally. A total of 42 zygomatic implants were installed, 2 of which were unsuccessful and were removed in 1 patient. The implants were placed using the surgical guide, which was planned and prepared digitally. RESULTS: No postsurgical complications were seen, and the patients were discharged from the hospital after 7-10 days. The patients were able to return to a normal diet (hard food) after just 7 days following surgery, with no further complaints regarding function or pain, apart from the residual edema caused by the intervention. CONCLUSIONS: The use of prostheses fixed on zygomatic implants in patients with maxillary defects is an effective method of prosthodontic rehabilitation in complex clinical cases after maxillectomy.

Diagnostic and Prognostic Value of Indicators of Bone Metabolism Markers in Patients Following Mandibulectomy and Free Fibula Flap Reconstruction with Endosteal Implants.

Purpose: To evaluate and assess the indicators of bone metabolism markers osteocalcin and ß-Cross-Laps in blood serum as a tool for monitoring bone regeneration and determining the time of implantation in patients after mandibulectomy and reconstruction of a free fibular flap with subsequent endosteal implants. Materials and Methods: Forty-eight patients in a 6-year period participated in this study, due to resection for tumors. All patients underwent reconstruction with fibula free flap after tumor resection, 4-6 months after osteoectomy, dental implants were installed with further orthopedic rehabilitation. To assess the rate of bone remodeling after transplantation, the content biochemical markers of bone remodeling osteocalcin and ß-Cross-Laps serum were determined by enzyme immunoassay. Results: All 46 fibular free flaps were healed without complications and were survived. A total 326 implants installed, 8 implants failed to osseointegrate, and 6 implants failed after 5 years of loading (peri-implantitis). Success rate of implants after 5 years was 95,7%. In patients before surgery, the mean of osteocalcin levels was 8.5 ng/ml, two months later, there was a sharp increase in the content of osteocalcin by 15.4 ng/ml, after four months reached 24.7 ng/ml, after six months of 28.6 ng/ml, then the indicator began to decrease and after 12 months it was approaching the norm of 14.7 ng/ml. In patients before surgery, the mean level of ß-Cross-Laps was 0.76 ng/ml, after two months bone transplantation the mean level of ß-Cross-Laps decreased to - 0.65 ng/ml, after four months the indicator increased and reached of 0.98 ng/ml, after six months the indicator was - 1.56 ng/ml, then these indicators began to decrease and after 12 months, approaching normal values of - 0.87 ng/ml. There is a correlation between different concentrations of osteocalcin or ß-Cross- Laps and the success rate of implants. Implants were shown to be unsuccessful low concentrations of osteocalcin and high concentrations of ß-Cross-Laps in serum. Conclusion: Studies have shown that the long-term survival and success rates of implants placed in the reconstructed areas may guarantee an excellent prognosis of implant-supported prostheses. Bone markers in blood serum osteocalcin and ß-Cross-Laps can be used to evaluate the rate of bone remodeling, which allows you to determine the time of implantation.

Comparative Evaluation of Sinus Complication and Survival Rates of Quad Zygoma versus Bizygoma in Combination with two Regular Implants in Atrophic Maxilla: A Systematic Review and Meta-Analysis.

Aim: To systematically review existing scientific literature to determine, compare and evaluate the sinus complication and survival rates of quad zygoma against two zygomatic implants with combination of two regular implants in atrophic maxilla in adults. Methods: Review was performed in accordance with preferred reporting items for systematic reviews and meta-analysis guidelines and registered in PROSPERO-CRD42023392721 Electronic databases like PubMed, Google scholar and EBSCO host were searched from 2000 to December 2022 for studies reporting treatment of Atrophic maxilla with either quad zygoma or two zygomatic implants in combination with two regular implants. Quality assessment was evaluated using Cochrane risk of bias-2 tool for randomized controlled trials (RCT). The risk of bias summary graph and risk of bias summary applicability concern was plotted using RevMan software version 5.3. The odds ratio (OR) and standardized mean difference (SMD) were used as summary statistic measure with random effect model and p value < 0.05 as statistically significant. Results: Eleven studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which only nine studies were suitable for meta-analysis. The pooled estimate through the odds ratio 0.59 signifies that the quad zygomatic implants on an average has 0.59 (0.18-1.93) times or odds of developing sinus complications while the SMD signifies that better survival rate (SR) on an average is 0.35 (- 0.61 to 1.30) times more by two zygomatic implants with combination of two regular implants as compared to quad zygomatic implants (p > 0.05). Publication bias through the funnel plot showed asymmetric distribution with systematic heterogeneity. Conclusion: Two zygomatic implants in combination with two regular implants provides better survival rate and less sinus complications compared to quad zygoma in atrophic maxilla. Despite the high SR observed, there is a need to conduct more randomized controlled clinical trials to examine their efficacy in comparison with other techniques.

Challenges during implant-assisted prosthetic rehabilitation in fibula reconstructed jaws and its management: a scoping review protocol.

Introduction: Oral cancer is the sixth most prevalent cancer type worldwide. Patients are placed in a crippling predicament due to the functional and psychosocial difficulties brought on by the illness and its treatments. Both surgeons and maxillofacial prosthodontists may encounter challenges with reconstruction and therapy following cancer treatment. Over 20 years, the fibula has remained the mainstay of reconstructions for head and neck cancer. Maxillary and mandibular jaws with fibula reconstructions can use fixed or removable prosthetic rehabilitation solutions. The proposed scoping review aims to ascertain the volume and nature of evidence concerning the difficulties and corrective measures in the prosthetic rehabilitation of fibula-reconstructed head and neck cancer cases. The findings will aid in improving the prosthetic treatment care for the affected population. Materials and Methods: The Joanna Briggs Institute (JBI) scoping review protocol will be followed in developing and reporting the scoping review methodology. Methods to identify the relevant literature will involve the systematic search of databases like PubMed, Scopus, Google Scholar, Cochrane Library, and gray literature sources for pertinent articles on the subject. Only papers published in English literature will be considered for the review, and the data collection period is limited to the past 20 years. The screening process will utilize defined inclusion/exclusion criteria for Title/Abstract and Full-text screening by two independent reviewers in covidence, and a third reviewer will resolve any conflicts. The data extracted will include specific details about the participants, concept, population, study methods, challenges encountered during prosthetic rehabilitation, and their management. Inductive thematic analysis and descriptive statistics will be applied where appropriate. The narrative synthesis of the evidence will be accomplished through data extraction in a tabular format, and the results will be presented as a narrative summary.

"Ice cream cone" design of forearm free flap for orbital exenteration reconstruction.

BACKGROUNDS: Reconstruction post-orbital exenteration serves the dual purpose of expediting healing, laying the groundwork for cosmetic restoration, and minimising complications such as orbitosinusal fistulae. The aim of this study was to introduce a modified "Ice cream cone" (ICC) design of the Radial Forearm Free Flap (RFFF) technique used for reconstruction of orbital exenteration cavity, along with the oncological, functional, and aesthetic outcomes. METHODS: The authors conducted a retrospective study between January 2005 and December 2020. Inclusion criteria encompassed patients treated for orbitosinusal malignancies undergoing exenteration with subsequent ICC design of RFFF reconstruction. RESULTS: Twenty-two patients underwent exenteration with the ICC design of RFFF. At the follow-up conclusion, 65% of patients regularly used orbital prosthesis. The average waiting time until the prosthesis was 10 months. Quality of life questionnaires yielded average RFFF POSAS scores of 23.5 (SD 13,6), cervical POSAS scores of 8 (SD 13,2), and orbital cavity rehabilitation scores of 5.9 (SD: 3,32). CONCLUSIONS: ICC design of RFFF is a reliable technique. It can be proposed in cases of extended exenteration with a high risk of cerebrospinal fluid (CSF) but more generally in cases of total exenteration. This technique facilitates optimal postoperative wound healing and accommodates early radiotherapy. Importantly, the bowl-shaped aspect of the orbital socket supports effective prosthetic rehabilitation for patients opting for orbital prosthesis post-surgery.

One Piece CAD/CAM Abutment for Screw-Retained Single-Tooth Restorations: A 5-Year Prospective Cohort Study.

BACKGROUND: The use of ceramic-coated patient-specific CAD/CAM titanium abutments represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly customized abutments enables the accurate three-dimensional positioning of the prosthetic emergence. This study evaluates the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/CAM titanium abutments. MATERIALS AND METHODS: Thirty implants were placed in thirty patients and rehabilitated with thirty single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, with implant placement after post-extraction socket healing and prosthetic restoration after implant healing. Implants of lengths ranging from 6-15 mm and widths of 3.6, 4.2, and 4.8 mm were used in this study. At the time of prosthesis delivery (T0), after two years (T1), and after five years (T2), plaque (PI) and bleeding (BoP) indices, probing depths (PPD), marginal bone levels (MBL), and PES/WES were evaluated for each implant. RESULTS: No patient dropped out of the study during the follow-up period. All thirty implants were clinically successful at five years post-prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05±0.56 mm at T0, 1.992±0.6 mm at T1, and 1.867±0.439 mm at T2. The mean MBL at T0 was 0.413±0.440 mm, at T1 was 0.306±0.388 mm, and at T2 was 0.263±0.368 mm. The mean PES, WES, and PES/WES indices, 7.43±1.04, 7.57±0.82, and 15.00±1.17, respectively, indicate good integration of soft tissues, satisfactory aesthetics, and an overall positive outcome. CONCLUSIONS: The success rates, maintenance of marginal bone levels, and periodontal and aesthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns.

Prosthetic Rehabilitation After Transfemoral Amputation in a Patient With an Ipsilateral Girdlestone Hip: A Case Report.

To date, there have been no reported cases of patients walking with a prosthesis after receiving an ipsilateral transfemoral amputation following the Girdlestone procedure. We administered a four-month prosthetic rehabilitation program to a 66-year-old man after his transfemoral amputation following the Girdlestone procedure. As a result, he was able to walk using the prosthesis for his daily activities. The prosthesis socket featured a quadrilateral configuration. The patient's ability to ambulate after the Girdlestone procedure was attributed to his ischial tuberosity serving as the primary load-bearing site in the transfemoral prosthesis. With appropriate prosthetic design, fabrication, and rehabilitation, patients can walk using a transfemoral prosthesis even in cases of transfemoral amputation following the Girdlestone procedure.

Rehabilitation of Edentulous Arch Using All-on-Four Treatment Protocol: A Case Report.

In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed restorations are a well-proven treatment option for edentulism. The concepts of implant dentistry have developed over time to produce better aesthetics and functional results. To reduce cantilever length and enable prostheses with 12 teeth, the all-on-four technique entails inserting two anterior implants axially and distally orienting two posterior implants. Compared to conventional loading, immediate loading offers various benefits without compromising quality. An instantaneous fixed provisional allows patients immediate function and preserves their quality of life while also promoting a high degree of patient satisfaction in terms of aesthetics, phonetics, mastication, and psychological comfort.

An investigation of allied health and medical clinicians' viewpoint on prosthetic rehabilitation and cognition.

PURPOSE: To explore the factors that influence clinicians (occupational therapists, physiotherapists, vascular surgeons, and rehabilitation medicine physicians) when prescribing prosthetic rehabilitation. Additionally, the study aimed to gain insight into clinicians' perspectives regarding the role of patient cognition in prosthetic rehabilitation. MATERIALS AND METHODS: This research constitutes one segment of a broader action research study which was undertaken in 2022. A total of thirty-four key clinicians involved in the amputation and prosthetic rehabilitation pathway within a local health district in Australia were engaged through a combination of group and individual interviews as well as surveys. RESULTS: Five essential considerations when prescribing prosthetic rehabilitation emerged. These included patient's goals, medical history, quality of life, cognitive abilities, and the support available on discharge. This study also revealed variations in opinions among different disciplines concerning appropriateness of prosthetic rehabilitation for the patient cohort. Despite this, there was a desire to build a consensus around a shared approach of identification for patients and clinicians. CONCLUSION: The identification of these key pillars for clinician consideration has simplified a complex area of care. These pillars could be used to guide pertinent conversations regarding prosthetic rehabilitation and are closely linked with the patient's cognition.

Five key areas should be considered when prescribing prosthetic rehabilitation; patients' goals, medical history, quality of life, cognitive abilities and supports available on discharge.Qualitative findings show different clinician domains hold very different perspectives on the suitability of patients to receive a prosthesis and undergo prosthetic rehabilitation.Occupational therapists and rehabilitation medicine clinicians most frequently view patients as suitable to undergo prosthetic rehabilitation, followed by physiotherapists and finally vascular surgeons.Vascular surgeons view most patients' complex vascular medical history as a reason why only certain (younger) patients should undergo prosthetic rehabilitation.Communication of expectations between all members of the treating team is paramount for patient outcomes.