Florent Destruhaut

The purpose of this clinical report was to describe the use of a piezographic impression associated with computer‐aided design and computer‐aided manufacturing (CAD–CAM) for teeth setup and of digital tools for neuro‐musculo–kinetic analyses. An edentulous patient with hemiglossectomy and heavily resorbed mandible consulted for complete denture rehabilitation to improve their masticatory function and speech. Master casts, wax rims, and piezographic impression were scanned for digital prosthetic work. Two digital try‐ins were performed to respect the neutral zone: try‐in 1 with posterior crossbite and try‐in 2 without crossbite. Muscle activity and mandibular kinetics were performed for each try‐in following the MAC2 protocol (six criteria): muscular tone, contraction synchrony, contraction efficiency, interocclusal rest distance, amplitude of mandibular movement, and velocity. Try‐in 2 showed better data than try‐in 1 in all criteria: muscle tone (respectively 71% vs. 59%), contraction synchrony (79% vs. 75%), contraction efficiency (85% vs. 77%), an increase in range of motion of 3.3 mm, and a better velocity (0.35 ± 0.12 s vs. 0.57 ± 0.14 s, p = 0.008). The piezographic impression, in combination with CAD–CAM, allowed the comparison of two prosthetic designs and the selection of the try‐in with the best neuro‐musculo–kinetic results.

Introduction. The objective of this study was to establish a baseline of current use in practice of the Canadian Occupational Performance Measure (COPM) by consulting 33 expert French occupational therapists, who trained in this method between 2012 and 2017 and use of the COPM with their clients. The areas of health intervention are pediatrics, psychiatry, neurology, and geriatrics. An email invitation to participate in the research was therefore sent to 113 occupational therapists. We received 33 responses. Methods. A novel mixed method study combined a Delphi method with a lexical analysis of experts’ responses and principal component analysis (PCA). Results. In the last Delphi round, the consensus of the expert group was attained on 31 benefits and 1 limitation, confirming the generally positive influence of the COPM in French health services. Discussion. The COPM was clearly identified as a tool that supports occupational therapy clinical reasoning, facilitates team decision-making for care pathways, and enables people with disabilities and health conditions to make decisions for their care. Conclusion. The Delphi study revealed that the COPM appears to be well adapted to French culture and should be widely incorporated into preregistration training.