METHODS: A cross-sectional study using self-developed survey form was conducted at 13 Medical Rehabilitation Clinics in Malaysia among 541 upper and lower limb amputees of any duration and cause.
RESULTS: The study population had a mean age of 54 years. Majority were males, Malays, married and had completed secondary school. About 70% of amputations were performed due to DM complications and at transtibial level. Fifty-eight percent of unilateral lower limb amputees were using prosthesis with a mean (standard deviation) of 6.48 (±4.55) hours per day. Time since amputation was the true factor associated with prosthesis usage. Longer hours of prosthesis use per day was positively correlated with longer interval after prosthesis restoration (r=0.467).
CONCLUSION: Higher aetiology of DM and lower prosthesis usage among amputees may be because of high prevalence of DM in Malaysia. The prosthesis usage and hours of use per day were low compared to the international reports, which may be influenced by sampling location and time since amputation. Nevertheless, this is a novel multicentre study on the characteristics and prosthesis usage of amputees. Hopefully, this research will assist to support, facilitate and promote prosthesis rehabilitation in Malaysia.
PURPOSE: The purpose of this retrospective study was to investigate the clinical factors affecting the occlusal re-establishment and short-term complications of RBFPDPs cemented at an increased OVD.
MATERIAL AND METHODS: Occlusal re-establishment and clinical complications were reviewed in 109 participants (155 RBFPDPs) treated at the Faculty of Dentistry, Universiti Teknologi MARA from January 2013 to May 2018. Types of complications and risk factors were assessed from clinical data. Demographic factors, clinical factors, and prosthesis factors were distinguished and their association with occlusal re-establishment analyzed by using multiple regression analysis.
RESULTS: A total of 155 RBFPDPs (42 anterior, 113 posterior) were placed in 109 participants. All achieved occlusal re-establishment, 89.9% complete occlusal re-establishment and 10.1% partial occlusal re-establishment, a minimum of 4 months after the RBFPDPs had been placed at an increased OVD. The design of the metal retainer coverage was found to be a significant factor affecting occlusal re-establishment and decementation (P
PURPOSE: The purpose of this clinical study was to investigate the occlusal force and occlusal contact reestablishment of RBFPDPs cemented at an increased occlusal vertical dimension (the Dahl concept) and to evaluate the factors affecting them.
MATERIAL AND METHODS: A prospective clinical study was carried out on 28 participants receiving cantilevered RBFPDPs at an increased occlusal vertical dimension at the Faculty of Dentistry, University Teknologi MARA. Maximum occlusal forces were recorded at precementation, postcementation, and 12-week review visit by using pressure indicating film, while occlusal contact reestablishment was assessed at the precementation stage and 12-week review visit by using shim stock foils. The Wilcoxon signed-rank and chi-squared tests were used for statistical analysis (α=.05).
RESULTS: Significant differences were found for maximum occlusal force between the precementation and the postcementation and between the postcementation and the 12-week review of RBFPDPs (P.05).
CONCLUSIONS: Overall, occlusal force was reestablished after 12 weeks, and occlusal contact was completely reestablished in most participants after placement of RBFPDPs at an increased occlusal vertical dimension.
PURPOSE: The purpose of this simulation study was to establish a reference percentage value that can be used to effectively reduce the size and polygons of the 3D mesh without drastically affecting the dimensions of the prosthesis itself.
MATERIAL AND METHODS: Fifteen different maxillary palatal defects were simulated on a dental cast and scanned to create 3D casts. Digital bulbs were fabricated from the casts. Conventional bulbs for the defects were fabricated, scanned, and compared with the digital bulb to serve as a control. The polygon parameters of digital bulbs were then reduced by different percentages (75%, 50%, 25%, 10%, 5%, and 1% of the original mesh) which created a total of 105 meshes across 7 mesh groups. The reduced mesh files were compared individually with the original design in an open-source point cloud comparison software program. The parameters of comparison used in this study were Hausdorff distance (HD), Dice similarity coefficient (DSC), and volume.
RESULTS: The reduction in file size was directly proportional to the amount of mesh reduction. There were minute yet insignificant differences in volume (P>.05) across all mesh groups, with significant differences (P
CASE PRESENTATION: We present a successful aortic valve replacement with cardiopulmonary bypass in a 48 years old lady with antiphospholipid syndrome, who has severe aortic regurgitation as a result of Libman-sacks endocarditis. Antiphospholipid antibodies were positive and the clinical data showed both negative cultures and infective parameters. Surgically resected vegetations revealed sterile fibrinous and verrucous vegetations on aortic valve. Valve replacement and the course of cardiopulmonary bypass was uneventful, and the patient was discharged well.
CONCLUSIONS: Classically Libman-Sacks endocarditis is often and more commonly associated with autoimmune diseases such as systemic lupus erythematosus, although it can occur in both primary and secondary antiphospholipid syndrome. It is not a common entity, and it is a frequent underestimated disease as most clinicians do not routinely screen for valvular lesion in patients with antiphospholipid syndrome unless they are symptomatic. However, due to its high prevalence of cardiac involvement, clinicians should have a high index of suspicion in the attempt to minimize cardiovascular and haemodynamic complications. Valve surgery in patients with antiphospholipid syndrome carries considerable early and late morbidity and mortality, usually caused by thromboembolic and bleeding events. The perioperative anticoagulation management and haemostatic aspect of antiphospholipid syndrome present an exceptional challenges to clinicians, surgeons, anaesthetists and laboratory personnel.
MATERIALS AND METHODS: The literature search was carried out on two electronic databases (PubMed and Cochrane Library). Randomized controlled trials (RCT) published from January 2011 to September 2022 were included. The bias risk was evaluated using Cochrane Risk of Bias Tool 2.0. Further screening was done for meta-analysis according to modified Newcastle-Ottawa scoring criteria. Forest plot was generated using a statistical method of inverse variance of random effect with 95% confidence interval.
RESULTS: A total of 8 randomized controlled trials were included for systematic review out of which four studies were based on tooth-supported fixed prosthesis and remaining four were based on implant-supported prosthesis. Further screening was conducted and three studies were eligible for meta-analysis. Tooth-supported fixed prosthesis fabricated from digital impression showed no significant difference in the marginal fit in any region measured, except for occlusal region where conventional impression showed more favorable marginal fit. Implant-supported prosthesis fabricated from digital impression showed survival rates ranging from 97.3 to 100% and there was no statistically significant difference in marginal bone loss (p = 0.14).
CONCLUSION: Implant-supported prostheses fabricated from digital and conventional impressions show no significant differences in their clinical outcomes. Tooth-supported fixed prostheses fabricated from digital impression have shown favorable findings in terms of marginal fit. Despite that, there is still lack of clinical trials with larger sample size and longer follow-up periods. Future studies that fulfill these two criteria are deemed necessary.