La rehabilitación protésica implantomucosoportada en el desdentado total / Removable prosthetic rehabilitation in the total toothless patient

Introducción: la rehabilitación sobre implantes con sobredentaduras mejora la calidad de vida de los pacientes y las técnicas para la rehabilitación son simples y preserva mayor cantidad de tejido dentario. Objetivo: caracterizar el comportamiento de la rehabilitación protésica implantomucosoportada en el desdentado total. Material y método: se realizó un estudio descriptivo, longitudinal y retrospectivo en los pacientes rehabilitados con sobredentaduras implantomucosoportadas en la Clínica Estomatológica "Antonio Briones Montoto" de Pinar del Río, en el período comprendido entre el año 2013 y 2014. El universo estuvo constituido por 28 pacientes, coincidente con la muestra. La información se recopiló a través de datos obtenidos en la historia clínica. Resultados: se encontró la mayor cantidad de implantes en la mandíbula. Se comprobó que la mayoría de los pacientes con mucositis perimplantaria el 14,3%, presentaban una higiene bucal regular o mala. Existió una dependencia estadísticamente significativa entre los períodos de tiempo en que les fue necesario el cambio de la cápsula de teflón. Conclusiones: se caracterizó el comportamiento de la rehabilitación protésica implantomucosoportada en el desdentado total.

Introduction: overlay dentures rehabilitation improves the quality of life of patients, while the rehabilitation techniques are simple and more dental tissue is preserved. Objective: to characterize the behavior of removable prosthetic rehabilitation in the total toothless patient. Material and method: a descriptive, longitudinal and retrospective study was performed in patients rehabilitated with overlay dentures in Antonio Briones Montoto Dental Clinic of Pinar del Río, in the time between the years 2013 and 2014. The target group consisted of 28 patients and coincided with the sample. Data was compiled from the clinical records. Results: most dentures were localized in the mandible. The majority of the patients with peri-implant mucositis (14.3%) practiced fair or bad oral hygiene. A statistically significant dependency existed between the two periods of time when changing the Teflon capsule was required. Conclusions: the behavior of removable prosthetic rehabilitation in the total toothless patient was characterized.

Prótese Parcial Removível Provisória Tipo Overlay na Reabilitação Oral de Paciente com Colapso Oclusal Posterior / Provisional Overlay Removable Partial Denture in Oral Rehabilitation of a Patient with Posterior Occlusal Collapse

Nos casos clínicos em que se verifica a diminuiçãoda Dimensão Vertical de Oclusão (DVO) e o desequilíbrio dosistema estomatognático, vários estudos sugerem areabilitação oral provisória com Próteses Parciais Removíveis(PPR) de recobrimento oclusal (tipo Overlay), associadas ounão com a confecção de restaurações, de modo a recuperara DVO, restabelecer o plano oclusal e eliminar alteraçõesenvolvidas com o desequilíbrio da oclusão, servindo comoguia orientadora da reabilitação final. Relato de caso: Esteartigo descreve o uso de PPR provisória tipo Overlay nareabilitação oral de paciente do sexo feminino, 56 anos, comcolapso oclusal posterior e desgastes dentários excessivos.Essa opção de abordagem foi adotada com o objetivo depreparar o meio bucal e reestabelecer a DVO previamente àreabilitação com próteses definitivas. A sequência detratamento envolveu os procedimentos de exame clínico eradiográfico, moldagem, determinação estética e funcionaldos planos oclusais, através do registro da DVO e da RelaçãoCêntrica (RC), montagem em Articulador Semi-Ajustável(ASA), provas clínicas e instalação/ajustes. Conclusão: Ainstalação da PPR provisória do tipo overlay contribuiu paraproteção e condicionamento dos tecidos orais, reestabelecimentosdas relações intermaxilares, e favorecimentoda estética, fonética e função mastigatória. Esses benefíciosproporcionaram conforto ao paciente e adaptação do indivíduoà nova configuração do sistema estomatognático...

Several studies have shown that in clinicalcases in which there is a decrease in the Occlusal VerticalDimension (OVD) and imbalance of the stomatognathicsystem, oral rehabilitation can be performed with the use ofRemovable Partial Dentures (RPD) with occlusal coverage(overlay type), associated or not with restorations, in orderto reestablish the OVD and occlusal plane and to eliminateocclusion alterations, thus functioning as a guide to finalrehabilitation. Clinical case report: This article describes theuse of provisional overlay RPD in oral rehabilitation of a femalepatient, 56 years old, with posterior occlusal collapse andexcessive tooth wear. This approach was adopted in orderto prepare the oral environment and restore the OVD prior torehabilitation with final prostheses. The sequence of treatmentinvolved clinical and radiographic examination procedures,tooth casting, aesthetic and functional reestablishment ofocclusal planes through the determination of OVD and CentricRelation (CR), cast-mounting in semi-adjustable articulator,prosthesis try-in and insertion, and follow-up. Conclusions:The installation of provisional overlay RPD contributed toprotection and conditioning of the oral tissues, reestablishmentof inter-maxillary relations and improvement of aesthetic,phonetic and masticatory functions. These benefits providedcomfort to the patient and individual adaptation to the newconfiguration of the stomatognathic system...

Performance of attachments used in implant-supported overdentures: review of trends in the literature

The purpose of this review is to examine the performance of attachments used in implant-supported overdenture (IOD) in both clinical and in vitro settings and report the compiled findings, comparisons, and trends in the research literature. Articles published in PubMed on IOD attachment systems and performance were reviewed. Non-original articles were excluded. For each article included, the type of study, number of implants, number of attachment systems, and study outcome were recorded. Of the 283 articles found, 158 met the inclusion criteria. Ninety-four articles were clinical studies and 64 articles were in vitro studies. Studies on retention were the most common for in vitro studies, and four or more attachment systems were compared in most articles with significant differences in outcome. A clinical outcome of one attachment system was most common for clinical studies, while most studies had neutral outcomes overall. Ball attachment was the most commonly tested IOD attachment system. The trend in the literature showed that there is a large discrepancy between the study designs and outcomes between the clinical and the in vitro studies for IOD. Further clinical studies that can validate in vitro research should be encouraged to address this discrepancy between the two areas.

Wear of double crown systems: electroplated vs. casted female part

OBJECTIVES: The wear of telescopic crowns is a common problem often reducing the patient's satisfaction with the denture and resulting in a renewal of the denture. The study aims to compare the wear behavior of conical crowns using electroplated copings (group E ) with standard telescopic crowns with cast female parts (group C). MATERIAL AND METHODS: 10 conical crowns were milled for each group of a cast gold alloy. The specimen of group E had a conicity of 2º. The cast secondary crowns of group C had a 0º design. The electroplated coping was established by direct electroforming. An apparatus accomplishing 10,000 wear cycles performed the wear test. The retentive forces and the correlating distance during insertion and separation were measured. The wear test was separated in a start phase, an initial wear phase and the long term wear period. The retention force value and the force-distance integral of the first 0.33 mm of each cycle were calculated. RESULTS: The retentive forces were significantly higher for group E and the integrals were significantly lower for this group except the integral at cycle 10,000. The changes of retention force and integral did not differ significantly between both groups in all phases. The change of the integrals as well as the integral at the particular cycles showed higher interquartile distances for group C. CONCLUSIONS: Within the limitations of this study the tested conical crowns showed clinically acceptable retentive properties. The values reached a range comparable to retentive elements tested in recent literature. The values of group C showed higher ranges. The force measured for group E was significantly higher than for group C but the integrals showed an opposite tendency. The results indicate that an exclusive analysis of the force is not sufficient as the integral is not equivalent to the force although it describes the retentive property of the system in a better way than the force over a distance is described. Both systems seem to be suitable for clinical practice.

Seeing The Unseen : Preventive Prosthodontics : Use Of Overlay Removable Dental Prosthesis.

Preventive prosthodontics emphasizes the importance of any procedure that can delay or eliminate future prosthodontic problems. In the past when patients presented themselves as candidates for a denture with teeth that were badly broken down with periodontal involvement or without the ability to financially support an extensive restorative treatment, those teeth were extracted that could have been retained under more favourable conditions. Retention of the roots of one or more teeth for overdenture offers the patient a lot of advantages like better stability, proprioception, support among a few. The following case report focuses on the merits of using anterior teeth as overdenture abutments to aid in increasing stability of the long span kennedy class IV design removable dental prosthesis.

Prótese parcial removível overlay: fundamentos clínicos e relatos de casos / Overlay removable partial denture: underluing principles and cases reports

A prótese parcial removível (PPR) de recobrimento oclusal, também conhecida como PPR overlay, se caracteriza por recobrir a face oclusal de um ou mais dentes, podendo até mesmo recobrir as oclusais de todos os dentes posteriores e as incisais dos dentes anteriores para apoio ou sustentação. O presente trabalho teve como objetivo revisar os princípios envolvidos na sua indicação clínica, planejamento e execução, com o objetivo de discutir a viabilidade clínica e efetividade deste tipo de tratamento, identificando suas indicações, vantagens e desvantagens através da apresentação de casos clínicos. Concluiu-se que a PPR overlay pode ser indicada como alternativa de tratamento para situações especiais de arcadas parcialmente desdentadas, em pacientes com necessidade de alteração da dimensão vertical e/ou realinhamento do plano oclusal, podendo ser empregada como tratamento temporário ou definitivo. Apresenta como vantagens principais a maior simplicidade do tratamento, reversibilidade e custo relativamente baixo. No entanto, estudos adicionais são necessários para assegurar a viabilidade clínica e efetividade deste tipo de tratamento.

Overlay removable partial denture (RPD) is a prosthesis that recovers and uses for support, the occlusal surface of teeth, or even the occlusal of all posterior teeth and incisal edge of the anterior teeth. This review presents and discusses clinical and technical aspects involved in treatment with overlay partial dentures. It was concluded that overlay RPD can be indicated as an alternative treatment for partially edentulous patients who present reduced vertical dimension and changes of the occlusal plan. Treatment may be a definitive or temporary solution. The main advantages of overlay RPD are technical simplicity, reversibility and relative low cost. However, additional studies are needed to assure clinical viability and effectiveness of this treatment.

Stress distribution of implanted complete overdentures retained with two types magnetic attachment / 实用口腔医学杂志

Objective:To study the stress distribution of Magsoft (cushion type) and Magnedisk magnetic attachment. Methods: 2 overdentures were prepared on each of 5 edentulous jaw models. The overdentures were pared and retained with Magnedisk and Magsoft magnetic attachments respectively.Photoelastic analysis was used to study the stress distribution for the implanted complete overdentures. Results: Under the same load, around the implants, the stress under the overdentures retained with Magsoft was lower than that with Magnedisk. Compared with Magnedisk, the stress around the abutments under the overdenture retained with Magsoft were distributed in a more even manner. Conclusion: Magsoft magnetic attachment has better biomechanical characteristic than Magnedisk and can distribute stress more evenly throughout the whole supporting structure for its special cushioned design.