Design of Thermoplastic Oral Appliance With Mouth Opening Control to Treat Obstructive Sleep Apnea

[EN]Obstructive Sleep apnea is associated with daytime sleepiness, increased motor vehicle accidents, heart failure and stroke. Treatment options include weight loss, positive airway pressure, pharyngeal and orthognatic surgery. However, selected patients have good response to oral appliances devices that intended to protrude and stabilize the mandible mechanically during the night in order to reduce the collapsibility of the upper airway. Selection of patients includes primary snoring, mild, moderate and positional apnea. The objective of this paper is to present a new thermoadjustable chair-side oral appliance. Device integrates the best characteristics of custom made and boils and bite previous designs and minimizes inconveniences and possible side effects. The device is a titratable mandibular advancement appliance. It consists of two independent prefabricated trays adaptable to the shape of adult dental arch and linked to each other by a protrusion mechanism. Each tray contains a hard outer shell and a soft thermoplastic resin inner body. The position of the jaw can be adjusted by moving an aluminium rack into, or out from, the guide so the ratchet may get locked into a certain position ensuring the length of the mechanism. The protrusion mechanism is fixed to the splint using small rings that are articulated over a “t” button. The opening of the mouth can be limited by an integrated locking system of the “t” button. Our prototype satisfies the requirements of an effective oral appliance, in terms of retention, comfort, safety and efficacy. It is easy to fit, durable, low cost, quickly titratable, not bulky and easy cleaning. Thermoplastic appliances are specially used like a predictor of treatment response in apnea patients. The device described is a cost-effective introduction to mandibular advancement technology. A qualified dentist or trained sleep doctor could mitigate dental side effects and reduce their incidence

Maxillary reconstruction with subperiosteal implants in a cancer patient : a one-year follow-up

To describe a clinical case on cancer patient with ablative tumor surgery, from treatment planning, surgical resection and subsequent implantological rehabilitation. A 61-year-old male, diagnosed with a squamous cell carcinoma in the maxilla, requires t

Dental implants rehabilitation in a patient with head and neck radiotherapy for osteosarcoma in the jaw. A clinical case report

A 52-year-old female patient with a diagnostic of osteosarcoma in the mandible, in which it was necessary a reconstruction with a microvascularized osteomyocutaneous fibula bone. Coadjuvant chemotherapy was scheduled. Two years later, 4 osseointegrated implants (OII) were placed in the fibula a 2 OII in the right mandible, using a splint guided surgery. The final prosthodontic consisted in a metal ceramic restoration using CAD/ CAM technology

Jaw in a day: Osseointegration of the implants in the patient’s leg before reconstructive surgery of a maxilla with ameloblastoma. A 4-year follow-up case report

Background: To describe a clinical case of a cancer patient who underwent ablative tumor surgery, including treatment planning, surgical resection and subsequent implant rehabilitation. Case Report: A 61-year-old patient with a diagnosis of multicystic follicular ameloblastoma in the maxilla, in which it was necessary a muitidisciplinary approach and two surgical steps. In the first surgical intervention osseo-integrated implants (OII) were placed in the fibula, until their osseointegration period of 8 weeks was complete. Afterwards, in the second surgery, the micro-vascularized free fibular flap bearing the implants was transplanted into the oral cavity, in order to perform simultaneous reconstruction and early rehabilitation. The final prosthetic rehabilitation consisted in a hybrid prosthesis fabricated using CAD CAM technology. Results: The latest advances in medical research have improved our understanding of the oral cavity’s regenerative capacity after oncological treatment. This, aided by the advances in digital 3D technologies, has allowed meticulous treatment planning prior surgery. Conclusions: The functional and esthetic reconstructions described in these two case reports were made possible by coordinating multidisciplinary approaches involving dentists and oral and maxillofacial surgeons. Advances in medicine have improved understanding of the regenerative capacity of the oral region following oncologic treatment, facilitating meticulous advance planning, while advances in digital 3D technologies for planning make it possible to reduce the number of surgical sessions and the time taken for the patient to recover both the esthetics and function of the stomatognathic system

Effect of biofertilizers and rhizospheric bacteria on growth and root ultrastucture of lettuce

Biofertilization is a technique that uses plant and animal wastes to add organic matter and nutrients to the soil. It can also use microorganisms that can metabolize these by-products to facilitate their absorption by the plant roots. In this study, we tested the effects of rhizospheric bacteria inoculation (T1), a combination of rhizospheric bacteria with liquid fertilizer (T2) and uncombined liquid fertilizer (T3), on the growth, nutritional content, root tissue, and root cells of lettuce plants. The results showed significant positive differences in all treatments compared to control plants, in terms of morphological, nutritional, and productivity parameters. The combination of rhizospheric bacteria with liquid SEFEL fertilizer (T2) yielded the best results, showing increased fresh and dry weight, and diameter. There were no differences between treatments for nutritional content, but each treatment outperformed the control by more than 700% for all macronutrients. The best result was phosphorus content for T1, with 1272.22% more than control. Regarding root structure and ultrastructure, there was no variation in tissue organization compared to control plants, but increases in root hairs (T1), development of transfer cells (T2), and secondary growth (T3) were observed. Additionally, colonization of roots by rhizospheric bacteria was confirmed in all three treatments. In conclusion, this study suggests that inoculating with rhizospheric bacteria is a viable and environmentally friendly biofertilization for lettuce plants.This work was supported by the aid program of the Consejería de Economía, Industria, Comercio y Conocimiento for training research staff in the Canary Islands, co-financed by the Fondo Social Europeo (grant numbers: TESIS2020010011, TESIS2017010078). We also declare funding from Nertalab S.L. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.Peer reviewe

Apicectomía quirúrgica: propuesta de un protocolo basado en la evidencia

ResumenDiversos refinamientos de la técnica quirúrgica de apicectomía han propiciado que su tasa de éxito haya aumentado de modo considerable. Se revisa la bibliografía científica para determinar cuáles de estos procedimientos son superiores. Se realiza un protocolo que aúna racionalmente esas técnicas, con lo que así se optimiza el resultado final de la intervención.AbstractDiverse refinements of the apicoectomy surgical technique have considerably increased the success rate of the procedure. The scientific literature was reviewed to identify the most relevant procedures for the final outcome of surgery. A protocol was prepared to facilitate the rational selection of technique, thus optimizing the surgical outcome

Virtual Surgical Planning and Customized Subperiosteal Titanium Maxillary Implant (CSTMI) for Three Dimensional Reconstruction and Dental Implants of Maxillary Defects after Oncological Resection: Case Series

Maxillectomies cause malocclusion, masticatory disorders, swallowing disorders and poor nasolabial projection, with consequent esthetic and functional sequelae. Reconstruction can be achieved with conventional approaches, such as closure of the maxillary defect by microvascular free flap surgery or prosthetic obturation. Four patients with segmental maxillary defects that had been reconstructed with customized subperiosteal titanium maxillary implants (CSTMI) through virtual surgical planning (VSP), STL models and CAD/CAM titanium mesh were included. The smallest maxillary defect was 4.1 cm and the largest defect was 9.6 cm, with an average of 7.1 cm. The reconstructed maxillary vertical dimension ranged from 9.3 mm to 17.4 mm, with a mean of 13.17 mm. The transverse dimension of the maxilla at the crestal level was attempted to be reconstructed based on the pre-excision CT scan, and these measurements ranged from 6.5 mm in the premaxilla area to 14.6 mm at the posterior level. All patients were rehabilitated with a fixed prosthesis on subperiosteal implants with good esthetic and functional results. In conclusion, we believe that customized subperiosteal titanium maxillary implants (CSTMI) are a safe alternative for maxillary defects reconstruction, allowing for simultaneous dental rehabilitation while restoring midface projection. Nonetheless, prospective and randomized trials are required with long-term follow-up, to assess its long-term performance and safety