Case Reports of Aesthetic Rehabilitation by Richmond Crown in Maxillary Anterior Teeth: A Forgotten State of Art.

After endodontic therapy, restoring severely broken or damaged crown structure is a difficult task in conservative dentistry. Regular post and core followed by crown repair cannot restore a crown with steep incisal guidance, very little overjet, and highly damaged crown structure. Richmond crown is better recommended in these situations since Richmond crown is a crown having post.

Florid reactive periostitis ossificans of long bones and digits associated with reaction in a patient with leprosy.

Florid reactive periostitis ossificans is a rare bone lesion usually occurring in the small, tubular bones of the hands and feet. This entity is a benign and aggressive periosteal reaction associated with soft tissue swelling that appears similar to a bone lesion that radiographically and clinically mimics an infectious or neoplastic process. Typically the lesions occurs in an adolescent or young adult and presents as a small area of painful swelling and erythema over the affected bone.

Fracture of calcaneum following drop foot surgery--a case report.

The usual protocol for correction of drop foot in leprosy, a consequence of damage to the common peroneal nerve, is a tendon transfer, immobilisation to heal the tendon juncture and post-operative exercises to put the transfer into use. Tarsal disintegrations have been reported in literature in drop foot patients when the transferred tendons were inserted into the bone making a drill hole to ensure firm anchorage. Such disintegrations are rarely seen these days because bony insertion of the tendon transfers is not performed in the leprosy-affected foot.

ECRL--a wrist extensor with multiple uses in deformity correction.

Extensor carpi radialis longus muscle has been used in various types of procedures for corrective hand surgery and is a favored muscle for correction of finger clawing due to ulnar nerve palsy in leprosy because its removal leaves an insignificant motor deficit and gives a linear scar at the donor site. It is usually not paralyzed in leprosy. The muscle, being phasic, is easy to re-educate.

Prevention-of-impairment-and-disabilities activities in leprosy after integration: role for physical medicine and rehabilitation personnel.

Referral options for specialist care for prevention of impairment and disabilities are imperative in order to make an integrated leprosy control system work. This requires an understanding of the disease, in addition to the special skills for managing specific disabilities. Physical medicine and rehabilitation (PMR) personnel are better equipped to handle leprosy-related disabilities.

Early nerve damage in leprosy: an electrophysiological study of ulnar and median nerves in patients with and without clinical neural deficits.

Background: Peripheral nerve trunk involvement in leprosy is very common. However, by the time it becomes clinically manifest, the damage is quite advanced. If the preclinical nerve damage can be detected early, the deformities and disabilities can be prevented to a large extent.

Dynamic procedures for claw-finger correction--dilemma of balancing tension in transferred tendon slips.

The critical step in dynamic claw-finger correction procedures is adjustment of tension on the tendon slips which are being sutured at the new insertion sites to correct finger-clawing. Several methods to balance and adjust the tension have been described ever since these procedures have been in use. Ultimately it is the experience of the operating surgeon that helps to decide as to the tension that is to be kept on each slip so that maximum deformity correction is obtained without compromising the functional capabilities of the hand.

Flexor digitorum superficialis--revisited.

Flexor digitorum superficialis (FDS) is a median nerve innervated forearm muscle, and is usually available for transfer in palsied hands because of leprosy. Middle and ring finger FDS tendons have been preferably used in these procedures. The removal of FDS from fingers, to be used as motor elsewhere, has its own advantages and disadvantages.

Closure of simple heel ulcers by skin stretching.

A majority of heel ulcers, at least to begin with, extend to dermis or to the fat pad in its superficial part and an appropriate skin closure can heal these ulcers as most of the padding is in tact. Since the skin is adherent to the deeper structures with fibrous bands it has to be stretched or undermined (by cutting the fibrous bands) to close the wound without tension. 17 feet in 11 patients (10 males; one female) in the 12-54 year age-group were operated upon and followed up.

Shall we continue with nerve trunk decompression in leprosy?

There is a tendency to compare the results of surgery with that of oral corticosteroid therapy in leprous neuritis as if the two are competing methods. Surgery helps by removing the external compressive force and improves circulation so that steroids can reach and effectively act at the site of inflammation, minimizing the ischaemic and compression damage to nerve fibres. Often nerve decompression in leprosy is requested rather late so that the desired results are not always achieved.

Lasso procedure to correct finger-clawing in leprosy using index or middle finger flexor digitorum superficialis split into four tails--a long-term follow-up study.

For obvious reasons, the use of flexor digitorum superficialis (FDS) from the ring finger, for correction of finger-clawing, is usually not recommended in leprosy. Hence, one has to choose either index or middle finger FDS for correction of finger-clawing. No significant differences could be made out when follow-up data of claw-finger correction by modified lasso procedure, using FDS either from index or middle finger, were compared.

Palmaris longus--a muscle with multiple uses in leprosy-affected hands.

The present paper reviews the anatomy of palmaris longus muscle and also the situations where palmaris longus muscle has been used as an independent motor or as a donor of tendon graft material. Its relevance in leprosy-affected hands is also discussed because the muscle is usually spared in hand palsies consequent to leprotic neural damage. The advantages and disadvantages of its use in different operative procedures have been analyzed.