Wearing complete dental prostheses - Effects on perioral morphology.

BACKGROUND: To adequately perform rehabilitation of edentulous patients by a complete removable dental prosthesis (CRDP) is from basic interest to dentists to understand the morphologic changes caused by re-establishment of a physiologic jaw relationship. Anthropometric analyses of standardized frontal view and profile photographs may help elucidate such changes. MATERIAL AND METHODS: Photographs of 31 edentulous patients were compared in relaxed lip closure and after insertion of a CRDP in stable occlusion. 2232 anthropometric distances were raised. Eighteen anthropometric indices reflecting the perioral morphology and its integration in the vertical facial harmony were investigated. RESULTS: The intercanthal - mouth width index (p>.001), medial - lateral cutaneous upper lip height index (p=.007), lower vermilion contour index (p=.022), vermilion - total upper lip height index (p=.018), cutaneous - total upper lip height index (p=.023), upper lip - nose height index (p=.001), nose - upper face height index (p=.002), chin - mandible height index (p=.013), upper lip - mandible height index (p=.045), nose - lower face height index (p=.018), and nose - face height index (p=.029) showed significant pre- to post-treatment changes. CONCLUSIONS: The investigated anthropometric indices presented reproducible results related to an increase in occlusal vertical dimension. Their application may be helpful in assessment, planning, and explanation of morphologic effects of CRDPs on the perioral and overall facial morphology, which may helps to improve the aesthetic outcome.

[Acute pulmonary and cardiovascular effects of continuous axial rotation (kinetic therapy) in respiratory failure]. / Akute pulmonale und kardiovaskuläre Effekte der kontinuierlichen axialen Rotation (Kinetische Therapie) beim Lungenversagen.

AIM: Continuous lateral rotational therapy (kinetic therapy) is advocated to improve pulmonary gas exchange in patients with severe respiratory failure, by promoting mobilization of secretions and reducing mismatch of ventilation and perfusion. We analyzed the acute pulmonary and hemodynamic changes before and after beginning kinetic therapy in critically ill patients with inotropic support. PATIENTS AND METHODS: Due to severe respiratory failure, 18 patients with "systemic inflammatory response syndrome" had been placed in a kinetic bed (Rotorest, KCI Mediscus). Retrospective analysis included several indices of arterial oxygenation, intrapulmonary "shunt fraction", cardiac index, arterial and pulmonary arterial pressure, systemic vascular resistance and systemic oxygen consumption. RESULTS: After the start of kinetic therapy, we found a statistically significant improvement of pulmonary gas exchange and a reduction of shunt fraction 12 hours later. Cardiac index and arterial and pulmonary arterial pressure remained unchanged. Systemic oxygen consumption was increased. CONCLUSION: The continuous axial rotation of patients with severe respiratory failure results in a prompt improvement of arterial oxygenation. Even in hemodynamically unstable patients we did not observe harmful effects.