Rupal Shah

O sucesso de uma pr tese depende de um planeamento cuidadoso do tratamento e da aten o dada aos problemas prot ticos; o engenho mec nico do encaixe importante, mas deve ficar em segundo plano. Um retentor de attachments utilizado na constru o de pr teses parciais fixas e remov veis, consistindo num recet culo met lico e numa pe a de encaixe, estando o primeiro normalmente contido nos contornos normais ou expandidos da coroa do dente pilar, e o segundo ligado a um p ntico ou estrutura da pr tese. Os encaixes de precis o representam um desafio para a compet ncia t cnica. Uma compreens o completa da biomec nica da fun o maxilo-mandibular, dos diferentes acess rios e do conhecimento da ci ncia dos materiais essencial no tratamento de um caso de acess rio de precis o. Infelizmente, na maioria das vezes, os attachments de precis o s o escolhidos a partir das descri es nos cat logos dos fabricantes, o que leva ao fracasso dos casos de attachments de precis o. Os attachments de precis o cumprem a fun o de reten o, distribui o de tens es e est tica com xito, desde que o caso seja planeado com base em fundamentos biol gicos e t cnicos s lidos e que o dentista e o doente prestem os cuidados adequados durante a fase de manuten o.

Sukces protezy zależy od starannego zaplanowania leczenia i zwr cenia uwagi na problemy protetyczne; mechaniczna pomyslowośc mocowania jest ważna, ale musi zając drugie miejsce. Element mocujący stosowany w konstrukcji stalych i ruchomych protez częściowych, skladający się z metalowego pojemnika i ściśle przylegającej części, z kt rych pierwsza jest zwykle zawarta w normalnych lub rozszerzonych konturach korony zęba lącznika, a druga jest przymocowana do przyzębia lub do szkieletu protezy. Precyzyjne mocowanie stanowi wyzwanie pod względem umiejętności technicznych. Dokladne zrozumienie biomechaniki funkcji szczękowo-żuchwowej, r żnych zamocowań i wiedzy z zakresu materialoznawstwa jest niezbędne w leczeniu przypadku precyzyjnego zamocowania. Niestety, najczęściej precyzyjne zaczepy są wybierane na podstawie opis w w katalogach producent w, co prowadzi do niepowodzeń w przypadkach precyzyjnych zaczep w. Zaczepy precyzyjne z powodzeniem spelniają funkcję retencji, rozkladu naprężeń i estetyki, pod warunkiem, że przypadek jest zaplanowany w oparciu o solidne podstawy biologiczne i techniczne, a dentysta i pacjent zapewniają wlaściwą opiekę podczas fazy konserwacji.

Il successo di una protesi dipende da un'attenta pianificazione del trattamento e dall'attenzione ai problemi ortodontici; l'ingegnosit meccanica dell'attacco importante, ma deve passare in secondo piano. Un retainer di attacchi utilizzato nella costruzione di protesi parziali fisse e rimovibili costituito da un ricettacolo metallico e da una parte strettamente aderente; il primo solitamente contenuto nei contorni normali o espansi della corona del dente pilastro, mentre il secondo attaccato a un pilastro o alla struttura della protesi. Gli attacchi di precisione rappresentano una sfida per l'abilit tecnica. Una comprensione approfondita della biomeccanica della funzione maxillomandibolare, dei diversi attacchi e della conoscenza della scienza dei materiali essenziale per trattare un caso di attacco di precisione. Purtroppo, il pi delle volte gli attacchi di precisione vengono scelti in base alle descrizioni dei cataloghi dei produttori, il che porta al fallimento dei casi di attacchi di precisione. Gli attacchi di precisione svolgono con successo la funzione di ritenzione, distribuzione dello stress ed estetica, a condizione che il caso sia pianificato sulla base di solide basi biologiche e tecniche e che l'odontoiatra e il paziente si prendano cura di loro durante la fase di manutenzione.

La r ussite d'une proth se d pend d'une planification soigneuse du traitement et de l'attention port e aux probl mes proth tiques; l'ing niosit m canique de l'attachement est importante, mais doit tre rel gu e au second plan. Il se compose d'un r ceptacle m tallique et d'une partie troitement ajust e, le premier tant g n ralement contenu dans les contours normaux ou largis de la couronne de la dent pilier, et la seconde tant attach e un pontique ou l'armature de la proth se. Les attachements de pr cision repr sentent un d fi en termes de comp tences techniques. Une compr hension approfondie de la biom canique de la fonction maxillomandibulaire, des diff rents attachements et une connaissance de la science des mat riaux sont essentielles pour traiter un cas d'attachement de pr cision. Malheureusement, la plupart du temps, les attachements de pr cision sont choisis partir des descriptions figurant dans les catalogues des fabricants, ce qui conduit l' chec des cas d'attachement de pr cision. Les attachements de pr cision remplissent leur fonction de r tention, de r partition des contraintes et d'esth tique avec succ s, condition que le cas soit planifi sur des bases biologiques et techniques solides et que le dentiste et le patient apportent les soins appropri s pendant la phase d'entretien.

Der Erfolg einer Prothese h ngt von einer sorgf ltigen Behandlungsplanung und der Beachtung der prothetischen Probleme ab; die mechanische Raffinesse des Geschiebes ist zwar wichtig, muss aber an zweiter Stelle stehen. Ein Geschiebehalter, der bei der Herstellung von festsitzendem und herausnehmbarem Zahnersatz verwendet wird, besteht aus einem Metallbeh lter und einem eng anliegenden Teil. Ersterer befindet sich in der Regel innerhalb der normalen oder erweiterten Konturen der Krone des Pfeilerzahns, und letzterer wird an einem Zwischenglied oder am Prothesenger st befestigt. Pr zisionsattachments stellen eine Herausforderung f r das technische Geschick dar. Ein gr ndliches Verst ndnis der Biomechanik der Kieferfunktion, der verschiedenen Geschiebe und Kenntnisse der Materialkunde sind f r die Behandlung eines Pr zisionsgeschiebes unerl sslich. Leider werden Pr zisionsgeschiebe meist anhand von Beschreibungen in Herstellerkatalogen ausgew hlt, was zum Scheitern von Pr zisionsgeschiebef llen f hrt. Pr zisionsgeschiebe erf llen erfolgreich die Funktion der Retention, der Spannungsverteilung und der sthetik, vorausgesetzt, der Fall wird auf der Grundlage solider biologischer und technischer Grundlagen geplant und der Zahnarzt und der Patient werden w hrend der Pflegephase angemessen betreut.

There is a subtle magic in fleeting encounters that brush against the fabric of our lives - the stranger on a train who reminds you that life is short, a country walk that evokes long-buried childhood moments, a fragment of ancient ceramic that takes you back two hundred years, a chicken flapping its wings in a forest, a strain of music that answers a question, tango dancers late at night in a street far from home. In forty-three brilliantly vivid, poignant, funny, nuanced vignettes, five authors cast back to those crossroads where past meets present - to chance encounters which, no matter how brief, hold the potential to leave a lasting impression. Like the encounters themselves, these stories are fleeting. Reminders that life is not just about the grand, sweeping gestures, but also about the small, ephemeral moments that shape who we are and who we become.

O edentulismo reconhecido como uma incapacidade f sica que compromete gravemente a nutri o, a fala, a autoestima e a est tica percebida. No entanto, os avan os na cirurgia de implantes dent rios levaram disponibiliza o de mais op es para estes doentes, incluindo pr teses retidas por implantes, pr teses remov veis suportadas por implantes e pr teses fixas suportadas por implantes. Os implantes t m sido utilizados para suportar pr teses dent rias durante muitas d cadas. A constata o de que a resposta ssea era mais favor vel quando se utilizava a t cnica all-on-six n o constituiu uma verdadeira surpresa. Obviamente, a distribui o da carga aplicada superestrutura (ou seja, a pr tese) mais favor vel quando a superestrutura suportada por seis implantes. Outra quest o era se os implantes inclinados levariam a uma resposta ssea menos favor vel em ambos os lados, de acordo com a t cnica e em compara o com os implantes n o inclinados inseridos de acordo com a mesma t cnica. Encontr mos uma perda ssea semelhante, independentemente de os implantes inclinados terem sido inseridos de acordo com o protocolo all-on-four ou all-on-six, e a perda ssea foi compar vel perda ssea observada com os implantes n o inclinados.

Zahnlosigkeit ist eine anerkannte k rperliche Behinderung, die die Ern hrung, die Sprache, das Selbstwertgef hl und die wahrgenommene sthetik stark beeintr chtigt. Die Fortschritte in der Zahnimplantatchirurgie haben jedoch dazu gef hrt, dass f r diese Patienten mehr Optionen zur Verf gung stehen, darunter implantatgetragener Zahnersatz, implantatgest tzter herausnehmbarer Zahnersatz und implantatgest tzter festsitzender Zahnersatz. Implantate werden schon seit vielen Jahrzehnten zur Unterst tzung von Zahnersatz verwendet. Die Feststellung, dass die Knochenreaktion bei der All-on-Six-Technik g nstiger ausfiel, war keine wirkliche berraschung. Offensichtlich ist die Verteilung der auf die Suprastruktur (d. h. die Prothese) einwirkenden Belastung g nstiger, wenn die Suprastruktur von sechs Implantaten getragen wird. Eine weitere Frage war, ob geneigte Implantate je nach Technik und im Vergleich zu nicht geneigten Implantaten, die nach derselben Technik inseriert wurden, zu einer ung nstigeren Knochenreaktion auf beiden Seiten f hren w rden. Wir stellten einen hnlichen Knochenverlust fest, unabh ngig davon, ob die geneigten Implantate nach dem All-on-Four- oder dem All-on-Six-Protokoll inseriert wurden, und der Knochenverlust war vergleichbar mit dem Knochenverlust, der bei den nicht geneigten Implantaten beobachtet wurde .

L' dentulisme est reconnu comme un handicap physique qui compromet gravement la nutrition, l' locution, l'estime de soi et l'esth tique per ue. Cependant, les progr s de la chirurgie implantaire dentaire ont permis d'offrir davantage d'options ces patients, notamment des proth ses dentaires implanto-port es, des proth ses amovibles implanto-port es et des proth ses fixes implanto-port es. Les implants sont utilis s pour soutenir les proth ses dentaires depuis de nombreuses d cennies. La constatation que la r ponse osseuse tait plus favorable lorsque la technique "all-on-six" tait utilis e n'est pas vraiment surprenante. Il est vident que la r partition de la charge appliqu e la superstructure (c'est- -dire la proth se) est plus favorable lorsque la superstructure est soutenue par six implants. Une autre question tait de savoir si les implants inclin s conduiraient une r ponse osseuse moins favorable de chaque c t en fonction de la technique et par rapport aux implants non inclin s ins r s selon la m me technique. Nous avons constat une perte osseuse similaire, que les implants inclin s aient t ins r s selon le protocole "tout sur quatre" ou "tout sur six", et la perte osseuse tait comparable la perte osseuse observ e avec les implants non inclin s.

L'edentulismo riconosciuto come una disabilit fisica che compromette gravemente l'alimentazione, il linguaggio, l'autostima e l'estetica percepita. Tuttavia, i progressi della chirurgia implantare hanno reso disponibili pi opzioni per questi pazienti, tra cui protesi su impianti, protesi rimovibili supportate da impianti e protesi fisse supportate da impianti. Gli impianti sono stati utilizzati per supportare le protesi dentali per molti decenni. La scoperta che la risposta dell'osso era pi favorevole quando veniva utilizzata la tecnica all-on-six non stata una vera sorpresa. Ovviamente, la distribuzione del carico applicato alla sovrastruttura (cio alla protesi) pi favorevole quando la sovrastruttura supportata da sei impianti. Un'altra domanda era se gli impianti inclinati avrebbero portato a una risposta ossea meno favorevole su entrambi i lati, a seconda della tecnica e rispetto agli impianti non inclinati inseriti secondo la stessa tecnica. Abbiamo riscontrato una perdita ossea simile indipendentemente dal fatto che gli impianti inclinati fossero inseriti secondo il protocollo all-on-four o all-on-six, e la perdita ossea era paragonabile a quella osservata con gli impianti non inclinati.

Unconventional dental implants represent a significant advancement in dental technology, catering to patients with unique needs that traditional implants may not satisfy. Unlike standard implants, which are inserted into the jawbone to mimic natural tooth roots, these alternatives offer innovative solutions that diverge in design, materials, and application. Zygomatic implants, for instance, are designed specifically for patients with severe bone loss in the upper jaw. Instead of relying on the jawbone, these implants anchor in the cheekbone (zygoma), which is denser and more stable. Beyond these designs, unconventional implants are also benefiting from advanced materials like titanium-zirconium alloys, ceramic, and biocompatible polymers. Materials like zirconia offer non-metallic, corrosion-resistant options that blend aesthetically with natural teeth, reducing the risk of allergic reactions and inflammation. Nonetheless, these unconventional options offer personalized solutions that improve outcomes for patients with complex dental needs, allowing for high-quality dental care that enhances function, aesthetics, and quality of life.

Edentulism is recognized as a physical disability that severely compromises nutrition, speech, self-esteem, and perceived aesthetics. However, advances in dental implant surgery have led to more options being available for such patients, including implant-retained dentures, implant-supported removable dentures, and implant-supported fixed dentures. Implants have been used to support dental prostheses for many decades. The finding that the bone response was more favorable when the all-on-six technique was used came as no real surprise. Obviously, the distribution of the load applied to the superstructure (i.e. the prosthesis) is more favorable when the superstructure is supported by six implants. Another question was whether inclined implants would lead to a less favorable bone response on either side according to technique and as compared to non-inclined implants inserted according to the same technique. We found similar bone loss regardless of whether the inclined implants were inserted according to the all-on-four or the all-on-six protocol, and the bone loss was comparable with the bone loss seen with the non-inclined implants.

This collection of stories from two practising GPs describes the reality of working within a failing and highly bureaucratic system, where there is a balancing act: regulation versus relationships; autonomy versus standard practice; algorithm versus individual attention. We aren’t suggesting a return to a ‘better’ time. We don’t object to being bureaucrats, embedded within and accountable to the systems we are in. But we do want to consider how and with what the gap left by the old-fashioned GP has been filled. We use stories based on our experience to describe the effect of different facets of bureaucracy on our ability to maintain a nuanced, individualised approach to each patient and encounter; and to question the prominence and effect of protocol. We are interested in the way professional relationships are influenced by protocol: between and within organisations; and most importantly with patients/clients/service users.. We are accustomed nowadays to automated telephone lines, chatbots, website FAQs- the frustration of being unable to connect with another human being who will listen to our particular question and give us something other than a generic answer. The same issues that are facing society at large have changed the way in which we work as GPs and the care we give.

Dental Implants have been used in a variety of different forms for many years. Since the mid-twentieth century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. Patient selection is critical to achieve success. Appropriate implant use ensures the achievement of predictable success for the procedure. When considering implant applications, the use of all appropriate diagnostic data is imperative. Physical and emotional health must be optimal to enhance the placement of a foreign body into bone. Medical consultations are use to determine any systemic problems that may interfere with healing or with the patient's ability to accept the proposed treatment and maintain adequate oral hygiene. Radiographic evaluation must be thorough and appropriate. The routine use of sophisticated radiographic techniques, such as CT, is no better than the underuse of standard less elaborate techniques. Articulated diagnostic casts and surgical guides are invaluable in such a determination.