Edentulous Patient Satisfaction with Conventional Complete Dentures.

Background and Objectives: Edentulism is considered to be an impediment impacting both patients' quality of life and their nutrition. Conventional complete dentures are still a preferred treatment. However, there is no consensus on the most important factors which could substantially reduce the risk of patient dissatisfaction. This study evaluated the following determinants concerning patient satisfaction with complete maxillary and mandibular dentures: sex, denture-related functional and aesthetic aspects, and the degree of bone resorption. Materials and Methods: This study included 70 patients aged 34-81 years of age. All complete dentures were made by following the same technology. Visual analogue scales were used to assess patients' overall satisfaction with dentures, comfort, ability to speak and chew, denture aesthetics, stability, and ease of prosthesis cleaning. Satisfaction with upper and lower dentures was rated separately. The degree of bone resorption was classified by using the Kalk and de Baat (1989) method. Results: The mean (SD) age of the study participants was 67.3 (10.4) years; 65.7% (n = 46) were females and 34.3% (n = 24) were males. There were no significant sex-based differences in resorption of the maxilla or mandibula. There were significant differences between maxillary and mandibular dentures, with lower mean satisfaction scores concerning chewing and maxillary complete dentures, and in regard to stability and comfort for mandibular complete dentures. There was a non-significant overall lower satisfaction with increased age. In multivariate analysis for mandibular complete dentures, aesthetics and stability significantly predicted the patient's comfort levels, and the patient's comfort significantly predicted overall satisfaction. For maxillary complete dentures, patient comfort and aesthetics significantly predicted overall patient satisfaction. Conclusions: Age, sex, and degree of resorption were not associated with patient satisfaction with complete dentures. Overall, patient satisfaction with both maxillary and mandibular complete dentures was related to their comfort level and denture aesthetics, and patient comfort itself was associated with stability of the mandibular denture.

The European Medicines Agency Review of Gilteritinib (Xospata) for the Treatment of Adult Patients with Relapsed or Refractory Acute Myeloid Leukemia with an FLT3 Mutation.

On October 24, 2019, a marketing authorization valid through the European Union (EU) was issued for gilteritinib monotherapy for adult patients who have relapsed or refractory acute myeloid leukemia (AML) with an Fms-like tyrosine kinase 3 (FLT3) mutation. Gilteritinib inhibits FLT3 receptor signaling and proliferation in cells exogenously expressing FLT3 including FLT3 internal tandem duplication (ITD), FLT3 D835Y, and FLT3 ITD D835Y, and it induced apoptosis in leukemic cells expressing FLT3 ITD. The recommended starting dose of gilteritinib is 120 mg (three 40 mg tablets) once daily. Gilteritinib was evaluated in one, phase III, open-label, multicenter, randomized study of gilteritinib (n = 247, gilteritinib arm) versus salvage chemotherapy (n = 124, salvage chemotherapy arm) in patients with relapsed or refractory AML with FLT3 mutation. Overall survival (OS) was statistically significantly different between the two groups with a median OS of 9.3 months in the gilteritinib arm compared with 5.6 months for salvage chemotherapy (hazard ratio, 0.637; 95% confidence interval, 0.490-0.830; p = .0004 one-sided log-rank test). The most common adverse reactions with gilteritinib treatment were blood creatine phosphokinase increase, alanine aminotransferase increase, aspartate aminotransferase increase, blood alkaline phosphatase increase, diarrhea, fatigue, nausea, constipation, cough, peripheral edema, dyspnea, dizziness, hypotension, pain in extremity, asthenia, arthralgia, and myalgia. The objective of this article is to summarize the scientific review of the application leading to regulatory approval in the EU. IMPLICATIONS FOR PRACTICE: Xospata was approved in the European Union as monotherapy for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with an Fms-like tyrosine kinase 3 (FLT3) mutation. Gilteritinib resulted in a clinically meaningful and statistically significant improvement of overall survival compared with salvage chemotherapy. At the time of the marketing authorization of gilteritinib, there were no approved standard therapies specifically for adult patients diagnosed with relapsed or refractory AML with FLT3 mutation. In terms of safety, the overall accepted safety profile was considered manageable.

Lips and noses in 10-year old patients with repaired complete unilateral clefts of lip, alveolus, and palate. A prospective three-centre study of the Baltic Cleft Network.

This multicenter study aimed at comparing different techniques of lip and nose repair with or without NAM and primary anterior rhinoplasty in pre-adolescent children. Patients with unilateral clefts of lip, alveolus, and palate who had undergone cleft lip and nose repair were evaluated in a prospective three-centre study using standardized monochromatic, cropped photographs. Four cleft surgeons evaluated the aesthetics of the central part of the face when the patients had reached age ten years. Seventy-six sets of photographs out of 87 patients were evaluated. The overall ratings of lips and noses did not differ much between centres. However, noses of centres 1 (mean 0.74; SD 0.57) and 2 (mean 0.76; SD 0.60) had been rated better than centre 3 (mean 1.32; SD 0.78; p = 0.0078), especially "Deformation of upper part of nostril rim or poor position of alar cartilage". Centre 3 had produced better looking scars (mean 0.33; SD 0.48); p = 0.0036. Within the limitations of the study it seems that NAM and primary anterior rhinoplasty including postoperative nasal stents should be performed whenever possible in order to achieve a favorable shape of the nose and to reduce the need for secondary corrective surgery.

Trends of Extemporaneous Drug Prescription in Latvia in 2017.

Despite the numerous industrially manufactured medicines available in the market, extemporaneously prepared drugs still have their niche among the services offered by the pharmacies. The physicians prescribe extemporaneously prepared drugs for special patient groups that require custom approach. Therefore, physicians' knowledge about extemporaneously prepared drugs and experience in prescribing them is the main precondition for satisfying patients' needs. The purpose of this article is to analyze the prescribing practice for extemporaneous formulations prepared in pharmacies in Latvia in order to identify the healthcare specialists who prescribe extemporaneously prepared drugs most frequently and the most common dosage forms. A database was created that includes the following data on each prescription form: 1) the name of the pharmacy where the medicine was prepared; 2) the region or the city where the pharmacy is located; 3) the month when the prescribed medicine was prepared; 4) the speciality of the healthcare professional who prescribed the medicine; 5) the dosage form; 6) all the active ingredients; 7) the number of active ingredients in the dosage form; 8) all the excipients. Data on 2,647 extemporaneously prepared drug prescriptions from 15 pharmacies in Latvia were collected. The extemporaneously prepared drugs were prescribed by physicians of 24 specialities, as well as dentists and physician assistants. The majority of the extemporaneously prepared drug prescriptions (87.5%) were from these 4 specialities: 1) general practitioners, 2) dermatovenereologists, 3) otorhinolaryngologists, and 4) pediatricians. General practitioners most commonly prescribed nasal drops, solutions for cutaneous application, and semisolid dosage forms. Dermatovenereologists mostly prescribed semi-solid dosage forms, suspensions, and solutions for cutaneous application. Otorhinolaryngologists most commonly prescribed nasal drops and semi-solid dosage forms. Pediatricians, as well as general practitioners and otorhinolaryngologists, favored nasal drops. To find out the opinion of general practitioners, dermatovenereologists, otorhinolaryngologists, and pediatricians on extemporaneously prepared drugs and the factors that hinder or facilitate their prescription, an extension of the study is planned that will include partially structured, in-depth, qualitative interviews.

Condylar and mandibular morphological criteria in the 2D and 3D MSCT imaging for patients with Class II division 1 subdivision malocclusion.

UNLABELLED: The condyle has a special multidirectional capacity for the growth and adaptive remodeling of temporomandibular joint (TMJ). Being part of TMJ structure, it plays an important role in the stability of long-term treatment results for orthodontic and orthognatic patients with Class II division 1 subdivision malocclusions. Several computed tomography (CT) investigation modes have been used to evaluate the craniofacial morphology and particularly, for TMJ. Dimensional images, acquired using new generation multislice CT (MSCT) and cone beam CT scanning data, are becoming increasingly popular in the clinical work and research. The aim of the study was to develop a new CT investigation protocol for the quantification of morphological structures and skeletal landmarks of condyle, procesus condylaris and mandible. For this purpose we created two dimensional (2D) and three dimensional (3D) reconstruction images from primary axial MSCT scans using IAC review and Transparent bone programms and acquired accordant measurements of condylar and mandibular structures. This technic allowed to get truly volumetric reflexion of the joint components in its real anatomical size and avoided the bony superimpositions. Our material included 12 patients with skeletal Class II division 1 subdivision malocclusion who had indications for combined orthodontic and orthognatic treatment. CT examination was performed before the start of treatment. For statistical analysis paired Student t-tests were applied to test the diferences of mean values and correlation coefficients were calculated to assess possible interrelations between measurements. The preliminary results showed weak corrrelation between condylar and mandibular measurements. More significant correlation was observed between procesus condylaris and mandible. It was a significant difference between right and left side in the height of procesus condylaris in patients without clinicaly relevant facial asymetry which could be considered in the individual planning of orthognatic treatment. CONCLUSION: The developed combined 2D and 3D MSCT investigation protocol for condylar and mandibular measurements provides precise and demonstrative quantitative images of condylar and mandibular structures and its dimensional relationships., which could be qualified as informative criteria for the individual treatment planning for patients with Class II division 1 subdivision malocclusion.

The severity of malocclusion and need for orthodontic treatment in correspondence with the age.

Awareness of the age related situation as to the malocclusion prevalence in population and orthodontic treatment need is very important and useful for planning an orthodontic care, especially taking into account the interdisciplinary aspect of the problem. The aim of this study was to investigate the degree of severity of malocclusion and the need of orthodontic treatment in three different age groups of population in Latvia. The study group comprised samples of 12-13-yr-olds (n=46), 18-yr-olds (n=32) and 35-44-yr-olds (n=278). The Index of Complexity, Outcome and Need (ICON) was used for the assessment of the results. In order to provide the accuracy use of ICON, more than 4 missing teeth and prosthetic restorations were chosen as an exclusion factor for the age group 35-44 years. A statistically significant difference was determined between the mean ICON values in 12-13 and 18 year-old age groups. Professionally defined orthodontic treatment need according to ICON score >43 was determined to be higher in the age group 18 year-olds. Overall, the tendency for orthodontic treatment complexity grade was observed to increase with the age.

Changes in the periodontal condition after replacement of swaged crowns by metal.

Evidence based clinical studies have shown exact recommended design for artificial crown reconstruction with acceptable long-term results taking into an account the biological price. Previous histological and clinical studies proved that fixed prostheses might influence the periodontal condition of crowned teeth, if not all biological criteria have been considered. The aim of the present study was to assess the periodontal condition of the crowned teeth after stainless steel swaged crowns were replaced by cast metal ceramic crowns. Participants were selected at the Institute of Stomatology, Stradin's University. Selection criteria included need to replace existing swaged crowns by metal ceramic crowns for patients with absence of any systemic disease. Following symptoms of periodontal condition were examined - presence of inflammation (clinical signs, probing) and pocket depth. Assessments were carried out at four different points of time (first appointment after replacement existing swaged crowns by temporary crowns; two weeks after cementation of permanent metal ceramic restoration; after three month; after six month). Overall bleeding score "2" and "3" at the first measurement was observed in majority of study population. Bleeding scores between the 1st and the 4th measurement was significantly lower (p<0.01). The same trend was observed also in the reduction of pocket depth. Overall mean value of pocket depth gradually decreased from the 1st till the 4th measurement. Replacement of swaged crowns by metal ceramic improves gingival health and leads to better long-term prognosis for restored teeth. It is recommended that swaged crowns be replaced with more biologically friendly crowns.

Validation of a Latvian and a Russian version of the Oral Health Impact Profile for use among adults.

BACKGROUND. The need for appraisal of oral health-related quality of life has been increasingly recognized over the last decades. The aim of this study was to develope a Latvian and a Russian version and test the validity of the Oral Health Impact Profile (OHIP-49) for use among adults in Latvia. METHODS. The original English version of the OHIP-49 was translated using the forward-backward technique, pilot-tested, and then applied to 60 adults aged 18 years and above. The questionnaire was filled out during face-to-face interviews conducted by one specialist. The internal consistency of the questionnaire was evaluated using Cronbach's alpha (α) coefficient and inter-item and item-total correlations. Discriminant and convergent validities were assessed. RESULTS. Cronbach's α was estimated to be 0.96. Inter-item correlations coefficients ranged from 0.19 to 0.91, with averige value 0.35, while item-total correlations coefficients from 0.14 to 0.86. CONCLUSIONS. The OHIP-49 is a reliable and valid questionnaire for the assessment of OHRQoL among adults in Latvia.