Factors influencing edentulous patients' preferences for prosthodontic treatment.

The aim of this study was to identify factors influencing edentulous patients' preferences for treatment using conventional or implant dentures (ID). A consecutive sample of 112 patients was selected in a university facility. All patients responded to a questionnaire concerning preferences about treatment and factors influencing preferences for conventional complete dentures (CD), implant-retained overdentures (IRO) and fixed implant-supported prostheses (FISP). Subsequently, a set of 21 questions was presented, and patients were requested to rate the importance of various potential reasons influencing their choice of treatment. Preference for CD was more prevalent for maxilla (52·7%) and mandible (41·1%). Fixed implant-supported prostheses and IRO were preferred for the mandible (FISP=37·5%; IRO=21·4%) rather than maxilla (FISP=27·7%; IRO=19·6%). The most preferred treatment option among the subjects when evaluating both arches was the implant-supported fixed or removable prosthesis (FISP/IRO). A preference for combined upper and lower CD was also commonly reported (39·3%). Factor analysis identified six components that accounted for 72·2% of the total variance: (i) psychosocial benefits, (ii) functional performance, (iii) technical and financial concerns, (iv) post-insertion complaints, (v) removability and (vi) longevity. Technical and financial concerns (cost, complexity, surgery risks and duration of treatment) were more relevant for those who preferred ID (P<0·001). With the exception of post-insertion complaints, all mean scores of component factor loadings were positive for ID. Conventional complete dentures are associated with lower expected outcomes by patients, and cost-related issues are the major factors associated with the preferences for implant treatment of edentulous patients.

Hormonal response during a fenfluramine-associated panic attack

Secretion curves for prolactin, cortisol, TSH, and GH from a 37-year old woman with dysthymia and panic disorder with agoraphobia were determined one day prior to (day I), and during a panic attack (day II) associated with an oral dose of 60 mg dl-fenfluramine, a drug known to increase anticipatory anxiety. The increased cortisol secretion observed is discussed in relation to the hormonal correlates of anxiety and the possible role of depresion, dl-fenfluramine, and serotonergic receptor sensitivity.