Fabrication of a 3D Printing Definitive Obturator Prosthesis: a Clinical Report

Uvod: Dostignuća digitalne tehnologije u slikovnim prikazima i proizvodnim procesima omogućila su kliničarima nove terapijske mogućnosti. Tako se stereolitografijom (SLA) jednostavno, predvidivo i precizno rekonstruiraju prirođeni i stečeni tkivni defekti. Prikaz slučaja: Na pregled je došao šezdesetpetogodišnji pacijent s karcinomom pločastih stanica lijevoga maksilarnog sinusa. Upućen je na obostranu maksilektomiju, a planom terapije bila je predviđena izrada potpune gornje proteze s opturatorom. Za 3D ispis plastičnog modela defekta korišteni su CT snimka i 3D softver za planiranje. Najprije je bio izrađen voštani predložak opturatora koji je služio za izradu silikonskoga. Konačni otisak uzet je s intraoralno pozicioniranim predloškom opturatora. Radni model je udvostručen i novi je odljev uložen u kivetu. Nakon što je kiveta otvorena, vosak je uklonjen i stvoren je prostor s unutarnje strane opturatora. Transparentna zagrijana polimerizirajuća akrilatna smola na unutarnjem dijelu opturatora poslužila je da bi se poboljšala retencija između akrilatne baze proteze i silikonskog materijala za mekano podlaganje. Pacijent je šest mjeseci dolazio na redovite kontrole. Proteza se prema potrebi podlaže u ordinaciji. Zaključak: Pacijenti nakon maksilofacijalnih kirurških zahvata mogu imati poslijeoperacijske komplikacije, poput trizmusa i boli. U ovom slučaju bio je osiguran precizan protetički rad zahvaljujući kombinaciji digitalne tehnologije i konvencionalnih tehnika.Introduction: Digital technologies related to imaging and manufacturing provide the clinician with a wide variety of treatment options. Stereolithography (SLA) offers a simple and predictable way for an accurate reconstruction of congenital or acquired defects. Clinical case: A 65-years old cancer patient with non- keratinized squamous cell carcinoma of left maxillary sinus came for a prosthetic clinical evaluation. A bilateral maxillectomy was performed and the treatment plan included definite obturator prosthesis for the upper arch. CT data and 3D planning software were used to create a 3D printing plastic model of the defect. A wax pattern of the hollow bulb was fabricated and cured with heatcured silicone soft liner. A final impression was obtained with the hollow bulb placed intraorally. The master cast was duplicated and the new cast was invested and reflasked. The flasks were opened, wax was boiled out and some space was created in the internal part of the obturator. Transparent heat cured acrylic resin was sandwiched with, at the inner part of the bulb, improving the retention between the acrylic denture base and the silicone based soft lining material. The patient was then placed on a 6-month recall. The five-year follow up consists of a chair side relining, when needed, of the definite removable prostheses. Conclusion: Maxillofacial surgery patients may develop postoperative complications such as trismus and pain. In these cases, the combination of digital technology and conventional techniques provide an accurate prosthetic restoration

Double–blind control of the data manager doesn't have any impact on data entry reliability and should be considered as an avoidable cost

<p>Abstract</p> <p>Background</p> <p>Database systems have been developed to store data from large medical trials and survey studies. However, a reliable data storage system does not guarantee data entering reliability.</p> <p>We aimed to evaluate if double-blind control of the data manager might have any effect on data-reliability. Our secondary aim was to assess the influence of the inserting position in the insertion-sheet on data-entry accuracy and the effectiveness of electronic controls in identifying data-entering mistakes.</p> <p>Methods</p> <p>A cross-sectional survey and single data-manager data entry.</p> <p>Data from PACMeR_02 survey, which had been conducted within a framework of the SESy-Europe project (PACMeR_01.4), were used as substrate for this study. We analyzed the electronic storage of 6446 medical charts. We structured data insertion in four sequential phases. After each phase, the data stored in the database were tested in order to detect unreliable entries through both computerized and manual random control. Control was provided in a double blind fashion.</p> <p>Results</p> <p>Double-blind control of the data manager didn't improve data entry reliability. Entries near the end of the insertion sheet were correlated with a larger number of mistakes. Data entry monitoring by electronic-control was statistically more effective than hand-searching of randomly selected medical records.</p> <p>Conclusion</p> <p>Double-blind control of the data manager should be considered an avoidable cost. Electronic-control for monitoring of data-entry reliability is suggested.</p

Fabrication of a 3D Printing Definitive Obturator Prosthesis: a Clinical Report

Introduction: Digital technologies related to imaging and manufacturing provide the clinician with a wide variety of treatment options. Stereolithography (SLA) offers a simple and predictable way for an accurate reconstruction of congenital or acquired defects. Clinical case: A 65-years old cancer patient with non-keratinized squamous cell carcinoma of left maxillary sinus came for a prosthetic clinical evaluation. A bilateral maxillectomy was performed and the treatment plan included definite obturator prosthesis for the upper arch. CT data and 3D planning software were used to create a 3D printing plastic model of the defect. A wax pattern of the hollow bulb was fabricated and cured with heatcured silicone soft liner. A final impression was obtained with the hollow bulb placed intraorally. The master cast was duplicated and the new cast was invested and reflasked. The flasks were opened, wax was boiled out and some space was created in the internal part of the obturator. Transparent heat cured acrylic resin was sandwiched with, at the inner part of the bulb, improving the retention between the acrylic denture base and the silicone based soft lining material. The patient was then placed on a 6-month recall. The five-year follow up consists of a chair side relining, when needed, of the definite removable prostheses. Conclusion: Maxillofacial surgery patients may develop postoperative complications such as trismus and pain. In these cases, the combination of digital technology and conventional techniques provide an accurate prosthetic restoration

Investigation of Greek military nursing academy students’ death attitude

Abstarct paper presented at the 18th Congress OF Balkan Military Medical Committee, 2013, Istanbul, Turkey, 22-26 MayThe aim is to investigate death attitude of Nursing Military Academy students and possible correlation with demographic or other factors

Marketing in Greek National Health System

Introduction: The international financial situation in combination with an aging population and the appropriation of health services imposes the management of hospital services as a necessity for the survival of hospitals.Aim: To examine the perceptions of 450 upper administrative hospital executives (Nursing, Medicine and Administrative services) in the wider region of Attica, on marketing, communication, and public relations in health-care.Population study: Four hundred and fifty (450) higher health executives from the three basic fields of services in health institutions (medical, nursing, administration) constituted the total sample of the research. These people are employed at 9 of the 36 hospitals in the 3 Health Regions of Attica (H.Re).Materials and method:The type of design that was chosen (to gather data) for the study of attitudes and perceptions of the health personnel of the health institutions of G.S.H (Greek System of Health) is a cross- sectional survey.Results: The participating subjects, even though expressed some reservations at first, formed a favorable attitude towards marketing and its application in the field of health-care. Statistically important correlations emerged between the perceptions of executives and their socio-demographic background including age, sex, education, and profession, work experience in health-care and specifically in their current position in the services as well as statistically important differences between doctors, nurses and administrators as to their perceptions of some issues in marketing.Conclusions: From the comments in the survey it appears there is a need to apply marketing correctly when providing quality care, respecting the patients’ rights and using human and not financial criteria as a guide. Based on the results of the research, important proposals are being submitted in the areas of health-care research, education and clinical practice