Can Impression Procedures Affect Certain Vital Functions of Edentulous Patients? A Clinical Study.

PURPOSE: The most suitable treatment conditions and timing for medically unstable patients with severe systemic diseases about to undergo invasive dental treatment are well documented in the literature; however, no medical guides or recommendations identify these conditions for noninvasive dental treatments in such patients. The aim of this clinical study was to determine the effect of impression procedures on arterial oxygen saturation (AOS) and pulse rates (PRs) of edentulous subjects. MATERIALS AND METHODS: A total of 28 Caucasian edentulous participants (15 females, 13 males) were included in the study. Pulse oximetry recordings (150 seconds) were performed for each participant at three stages; recording at rest (CON), during mandibular impressions (MANIs), and maxillary impressions (MAXIs). The mean values of PR, AOS, and event scores (ESs) indicating desaturation were obtained from the records. The comparisons of mean PR and AOS values were performed with the Bonferroni-corrected Wilcoxon-signed ranks test. The ESs were analyzed with the McNemar Test. RESULTS: The mean AOS values of MANI and MAXI did not display significant changes when compared with CON; however, the ESs obtained in both MANI and MAXI were significantly higher than those of CON (p = 0.008, p = 0.004). In addition, mean PR values obtained in MAXI were significantly higher than CON (p = 0.009). CONCLUSIONS: According to the results of this clinical study, the impression procedures may affect the PR values and lead to desaturation events in edentulous patients; however, further studies evaluating blood gas levels, which indicate precise AOS values, are necessary to support the results of this study.

Effects of complete dentures on respiratory performance: spirometric evaluation.

OBJECTIVES: There is a lack of data regarding whether edentulous subjects should remove dentures during spirometric measurements or not. The purpose of this study is to determine influences of complete dentures on spirometric parameters in edentulous subjects. MATERIALS AND METHODS: A total of 46 complete denture wearers were included in this study. Respiratory functions of the subjects were evaluated by spirometric tests that were performed in four different oral conditions: without dentures (WOD), with dentures, lower denture only and upper denture only. Forced vital capacity (FVC), peak expiratory flow, forced expiratory volume in 1 s and forced expiratory flow between 25% and 75% were evaluated. The data were analyzed with Friedman, Wilcoxon and paired-samples t tests (α = 0.05). RESULTS: Significant differences were found between spirometric parameters in different oral conditions (p < 0.05). In all spirometric parameters, the most important significant differences were found between conditions WOD, FVC and with lower dentures (FVC), and WOD (forced expiratory volume in 1 s) and with upper dentures (forced expiratory volume in 1 s) (p < 0.001). CONCLUSION: It was observed that complete dentures may unfavourably affect spirometric values of edentulous subjects. However, current findings need to be confirmed with advanced respiratory function tests.

Efficacy of a modified mandibular advancement device for a totally edentulous patient with severe obstructive sleep apnea.

BACKGROUND: It has been asserted that the success rate of oral appliances was more satisfactory for mild to moderate obstructive sleep apnea (OSA) than severe ones; besides, there is a lack of literature about mandibular advancement device (MAD) application for edentulous patients with OSA. REPORT: This clinical case shows fabrication method and treatment efficacy of a modified MAD, which is aiming to displace bulky masseter muscles laterally, to provide more space for tongue on totally edentulous patient with severe OSA.

[Diagnostic value of postbronchoscopic sputum, bronchoscopic lavage, and transbronchial biopsy in peripheral lung cancer]. / Periferik akciger kanserlerinin tanisinda bronkoskopik lavaj, brons biyopsi ve postbronkoskopik balgam sitolojisinin tani degeri.

The aim of this prospective study was to review the value of bronchoscopic lavage, transbronchial biopsy and postbronchoscopic sputum cytology in peripheral lung cancer. Two groups of patients were involved in the study who were treated in our clinic between the years 1999 and 2001: Group I (22 patients; average age 64 +/- 9 years; 18 males and four females) whose lesions were peripherally localised on chest radiographs and Group II (28 patients; average age 61 +/- 8; 26 males and two females) whose lesions were centrally localised and were visible only by diagnostic bronchoscopic procedures. The following procedures and analysis were done in all patients: Cytologic analysis of prebroncoscopic sputum, bronchoscopic lavage, bronchial biopsy, and patients were asked to give sputum in 30 minutes after bronchoscopy. The final diagnosis of all patients was primary lung cancer. In the first group none of the patients had visible endobronchial lesion on fiberoptic bronchoscopy. Sputum cytology of the patients were negative before bronchoscopy. Bronchoscopic lavage cytology was positive in five of 22 patients (22.7%). Transbronchial biopsy provided better diagnostic yield (50%) than postbronchoscopic sputum (31.8%). In the second group of patients, cytologic analysis was positive 25%, 96.4% and 42.9% in bronchoscopic lavage, bronchial biopsy and postbronchoscopic sputum respectively. Our findings suggest that postbronchoscopic sputum cytology may be an important diagnostic procedure in endoscopically nonvisible pulmonary cancer. Since its application is easy and noninvasive, cytologic analysis of postbronchoscopic sputum may be preferable to bronchoscopic biopsy although a favorable diagnostic yield is not expected.

The relationship between nicotine dependence level and community-acquired pneumonia in young soldiers: a case control study.

OBJECTIVE: Smoking is an important risk factor in the development of community-acquired pneumonia (CAP). This study was designed to investigate the relationship between nicotine dependence level and the development of CAP. MATERIALS AND METHODS: The Fagerstrom test for nicotine dependence (FTND) was performed to measure nicotine dependence level (NDL). Subjects with a Fagerstrom score (FS) of 5 or lower were defined as low dependence level and a FS score of 6 or higher was defined as high dependence level. RESULTS: The risk of pneumonia development was higher in smokers than in nonsmokers (OR=2.19, 95% CI 1.13-4.23). The pneumonia development risk was 1.91 times higher in the low dependence level group compared to nonsmokers (OR=1.91, 95% CI 0.95-3.83). In the high nicotine dependence level group pneumonia risk was 2.93 times higher than in nonsmokers (OR=2.93, 95% CI 1.34-6.36). We also studied the relationship between CAP and the time to the first cigarette of the day. Risk was the lowest in the smoker group of after 60 minutes and risk ratios increased with decreased time. CONCLUSION: In this study, a high nicotine dependence level was found to be a risk factor associated with smoking for CAP development. The time period of the first cigarette after waking up is also important in pneumonia development as well as in the nicotine dependence level.