Rodney C. Knudson

Fabrication of a prosthesis to prevent sleep apnea in edentulous patients

This article describes clinical and laboratory technique to use in the fabrication of a prosthesis to prevent sleep apnea in the edentulous patient. The objective of the treatment is to establish a comfortable protrusive and vertical posture of the mandible that prevents or minimizes obstruction of the airway during sleep. During fabrication of the prosthesis, cephalograms are used to assess spatial changes between the base of the tongue and the posterior pharyngeal wall.

Sleep apnea prosthesis for dentate patients

This article describes clinical and laboratory techniques for the fabrication of a sleep apnea prosthesis for a dentate patient. The treatment objective is to posture the mandible at an increased vertical and protrusive position to diminish or eliminate the collapse of the base of tongue into the oropharynx. During fabrication of the prosthesis, cephalograms are used to evaluate spatial change between the base of the tongue and the posterior pharyngeal wall.

Implant transfer coping verification jig

Osseointegrated implants provide a treatment modality that should be considered for the edentulous and partially edentulous patient because of the high predictability of success. This technique article describes the fabrication of a verification jig that holds the transfer copings together in the same spatial relationship. The transfer copings can be splinted on the working cast and returned to the mouth to confirm the accuracy of the working cast.

The effect of primers and surface characteristics on the adhesion-in-peel force of silicone elastomers bonded to resin materials

Facial prostheses, when used in conjunction with craniofacial implants, require a retentive matrix to hold attachments and/or magnets. The retentive matrix is usually fabricated with autopolymerizing acrylic resin or a visible light-polymerized resin. The purpose of this study was to compare the adhesion-in-peel force of a silicone adhesive to autopolymerizing polymethyl methacrylate and light-polymerizing urethane dimethacrylate gel with two surface textures: (1) pumice polish only or (2) pumice polish and bead retention, and two surface primers: (1) Dow Corning 1205 primer or (2) Dow Corning S-2260 primer. The 1205 primer produced an adhesion-in-peel force that was statistically significantly stronger (p < 0.05) regardless of which type of resin or surface preparation was used.

The sleep apnea syndrome. Part I: Diagnosis

Part I of this two-part article presents a review of the symptoms, pathophysiology, and diagnosis of the sleep apnea syndrome. The more common obstructive type is characterized by disturbed sleep and daytime hypersomnolence. Subjective signs and symptoms should be correlated with objective findings by way of polysomnography (sleep study) to confirm the diagnosis and determine the severity of obstructive sleep apnea. Electrocardiographic monitoring during polysomnography has revealed potentially life-threatening arrhythmias during sleep. Differential diagnosis should include central sleep apnea and narcolepsy to avoid inappropriate therapy and worsening of symptoms.

The sleep apnea syndrome. Part II: Treatment

An increase in the number of obstructive sleep apnea patients has brought a paralleled demand for timely and effective treatment. Conservative measures to maintain airway patency during sleep include weight loss, lateral decubitus sleep posture, drug therapy, nasal continuous positive airway pressure, and the use of intraoral prostheses. Surgical measures are used to correct gross anatomic defects that cause or contribute to obstruction, remove redundant tissues (uvulopalatopharyngoplasty), or provide an airway below the suspected area of obstruction (tracheostomy). Part II of this article examines the rationale, benefits, disadvantages, and potential complications of each modality of treatment.

Light-cured interim palatal augmentation prosthesis. A clinical report†

The interim palatal augmentation prosthesis produced a significant improvement in function within a short period of time. With the visible light-curing system, modifications of the prosthesis were made quickly and easily. The methods described enable the treatment team to immediately assess the results of prosthesis modifications.

Radiographically detectable intraoral positional radiation stent.

The views expressed herein are those of the authors and do not necessarily reflect the views of the United States Air Force or the Department of Defense. *Lieutenant Colonel, U.S. Air Force, D.C.; Fellow, Maxillofacial Prosthetics. **Colonel, U.S. Air Force, D.C.; Assistant Chairman for Maxillofacial Prosthetics. acrylic resin and are designed to accurately direct the external radiation source. Positional stents are used to move or displace tissues out of the field of radiation. This clinical report outlines a technique used in the fabrication of a radiographically detectable intraoral positional radiation stent using a visible light-cured resin (Triad, Dentsply International Inc., York, Pa.). A 64-year-old white man was referred from radiation therapy for a radiation stent that would position the mandible and tongue out of the primary field of radiation. The patient had a 2 x 4 cm lesion of the soft palate extending from the uvula into the anterior right tonsillar pillar with central ulceration. A biopsy demonstrated invasive squamous

Olfaction through oral tracheal breathing tube

Cancer of the larynx has approximately a 90% cure rate if detected early. Advanced lesions are treated surgically by removing the larynx and creating a stoma that joins the trachea. Although speech can be learned, the patients ability to smell is permanently interrupted. This technique article describes fabrication of a simple device that permits olfaction by a laryngectomee.

Stabilized record base for maxillary removable partial denture obturator

Accurate maxillomandibular jaw relation records are enhanced by a stabilized framework used to support the occlusal rim and recording medium. Stability of the framework is often lost on the defect side because of the size of the surgical defect and/or number of missing teeth. This article introduces a technique that uses a record base stabilized with a soft resilient material that permits easy removal and replacement of the framework on the altered master cast without damage.