Restoration of a dental defect in a patient with ectodermal dysplasia: a case report and literature review / 口腔疾病防治

Objective@#To explore the treatment options for congenitally missing teeth in patients with ectodermal dysplasia and provide a clinical reference.@*Methods@#A patient with ectodermal dysplasia with a concave midface, anterior protrusion of the chin, and underdevelopment of the lower third of the face presented with congenital loss of multiple maxillary teeth, malocclusion of the remaining teeth, congenital loss of mandibular dentition, small dental arches, and upper and lower alveolar bone hypoplasia. The patient was treated by means of a removable partial maxillary prosthesis, implants in the anterior region of the lower mandible designed with the assistance of digital guides, and bar-clamped implant-overlay prostheses. A literature review of the protocol for the treatment of this condition was also conducted.@*Results@#In addition to good retention and stability after denture wear, an excellent occlusal relationship, improvement of the patient's facial appearance, including upper and lower lip fullness, more equal balancing of the lower and middle 1/3 of the face, and improved masticatory function were achieved. The results of the literature review showed that patients with ectodermal dysplasia who are congenitally edentulous usually have a complex intraoral situation that makes restoration difficult, and common restorative modalities for these patients include fixed bridges, removable partial dentures, complete dentures, overdentures, and implant prostheses, which need to be selected according to the actual intraoral situation of each patient. Currently, there is no consensus on the treatment of congenitally missing teeth in patients with ectodermal dysplasia, and some scholars have suggested that fixed restorations be recommended for patients with fewer missing teeth, while the option of removable or implant-covered denture restorations should be given to patients with more missing teeth, with removeable prostheses for underage patients that are replaced with permanent fixed prostheses when the jaws have stabilized.@*Conclusion@#In patients with ectodermal dysplasia with congenital tooth loss, all factors should be taken into account, and an individualized restorative plan should be developed.

Uso de prótesis parcial removible con resina acrílica termoplástica: una revisión de literatura

La prótesis parcial removible (PPR) es una alternativa de tratamiento en pacientes que perdieron algunos elementos dentarios, debido al costo relativamente bajo y a la generación de una función masticatoria satisfactoria. Además, es una buena opción cuando hay pérdida de los tejidos óseos, dado que impide la instalación de implantes dentarios. La PPR convencional presenta una estructura metálica que ofrece retención y resistencia a la prótesis, convirtiéndola en poco agradable a los pacientes, por el hecho de dejar a la vista el metal en la cavidad oral. A partir de investigadores que decidieron ir más allá del simple estudio de la función y la estética de las PPR para adentrase en sus diversas formas de presentación, surgió la prótesis parcial flexible (PFlex). La PFlex es una prótesis parcial confeccionada con resina termoplástica, sin metal y con flexibilidad. Si bien, muchos profesionales la emplean como prótesis temporal, otros tantos la han usado como alternativa a la PPR convencional. Así, uno de los frecuentes interrogantes de los clínicos es si realmente es posible utilizar la PFlex como alternativa protética definitiva. Por tanto, el propósito de este trabajo fue realizar una revisión de la literatura para evaluar si el uso de prótesis parciales removibles con resina termoplástica puede ser una alternativa a las prótesis parciales convencionales, exponiendo las ventajas, desventajas, indicaciones, contraindicaciones y las propiedades del material protético.

Removable partial denture (RPP) is an alternative treatment when it comes to patients who have lost some dental elements, as they have the advantages of a relatively low cost and a satisfactory masticatory function. Furthermore, it is a good option when there is bone tissue loss, making dental implants placement unfeasible. Conventional PPR has a metallic frame that provides retention and resistance to the prosthesis, which makes it unpalatable to patients because it leaves the metal in the oral cavity evident. Many researchers, aiming to give back beyond function and aesthetics, are studying forms of presentation of PPR, thus emerging the flexible partial prosthesis (PFlex). PFlex is a partial denture made with thermoplastic, resin metal-free and with flexibility, however its use, for many professionals, is limited only as temporary prostheses, but there are some clinicians who use PFlex as an alternative to conventional PPR. Thus, one of the questions constantly asked by scientists is whether it is possible to use PFlex as a definitive prosthetic alternative. Therefore, the aim of this study was to conduct a literature review to assess whether the use of removable partial dentures with thermoplastic resin can be an alternative to conventional partial dentures, exposing the advantages, disadvantages, indications, contraindications, and the properties of the prosthetic material.

Bibliometric Analysis of Removable Partial Denture-related Research in Dentistry

@#The objective of this study was to characterise articles published in removable partial denture (RPD) research from 1948 to 2022 to identify the most influential journals, publications, authors, and core research areas using bibliometric analysis. The Scopus database was used to retrieve publications with titles containing the truncated search term (“removable partial denture*” OR “removable prostho*”). Data analysis and visualisation were done using Microsoft Excel, Biblioshiny software and VOSviewer. A total of 2,484 articles were analyses from 1948 till 2022, representing an annual growth rate of 4.9%. The Journal of Prosthodontic Research demonstrated the highest average normal citation rate, with productive authors with highest citations being from Japan. From 1948 to 1999, most in-vitro and clinical research focused on the basic concept of RPD using cobalt-chromium as a framework before shifting to titanium in 2000. RPD research after 2012 focuses on new technology and non-metalbased frameworks as an alternative to metal-based frameworks. Wakabayashi and Fueki were the most prominent researchers, according to a three-field plot analysis, with the Journal of Prosthetic Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthodontic Research among the authors’ preferred journals. “CAD/CAM” and “3D printing” were identified as emerging themes in year 2020 to 2022, while “selective laser melting” was the trending keyword in 2017 to 2019. Research on “oral health and quality of life” has been identified as core research area in RPD-related research. RPD research on digital dentistry and new framework materials is anticipated to increase in the future with the incorporation of research on quality of life.

Audit to assess the quality of 916 prosthetic prescriptions of removable partial dentures / 华西口腔医学杂志

OBJECTIVES@#The objectives of this study were to assess the quality of prosthetic prescriptions of removable partial dentures (RPDs) and to analyze the current situation of the communication and information delivery between clinicians and technicians.@*METHODS@#All RPD prosthetic prescriptions received by a major dental laboratory in 4 weeks were involved in a quality audit, and the prescriptions were divided into three groups in accordance with the grades of clients. The filling of prosthetic prescriptions was recorded. The items in the prescriptions for audit included the general information of the patient, the general information of the clinician, the design diagram information, other detailed information, and the return date. The prescriptions were categorized into four levels on the basis of their quality by two quality inspectors who have been working for more than 10 years.@*RESULTS@#A total of 916 prescriptions were collected and assessed. The names in the general information of the patient and the clinician were filled out best, both at the rate of 97.6% (n=894). The return date was filled out worst, only at the rate of 6.4% (n=59). Of those prescriptions, 86.8% (n=795) exhibited inadequate design diagram information. The results of the quality assessment demonstrated that 74.2% of prescriptions were assessed as noncompliant ones and failed to meet the acceptable clinical quality standard.@*CONCLUSIONS@#At present, the overall quality of RPD prosthetic prescriptions is poor. The responsibilities of clinicians and technicians are unclear, and the communication between them is not ideal.

Key Indicators of success or survival for clinical performance of fixed partial denture

@#When fixed partial dentures (FPDs) are being suggested to patients, the frequent inquiry by patients is the anticipated longevity and length of service. Previous reports have provided limited information on the accurate measurements of good clinical outcome and the length of good years in service. This confuses the clinicians as well as the patients in determining the treatment of choice. In the present article, the indicator of ‘success’ and ‘survival’ will be discussed in determining the longevity of various FPDs such as conventional, resin bonded and implant retained. After reviewing the articles, it is good if the indicator of ‘success’ can be used as an indicator of longevity and good clinical outcome. Besides that, studies with at least 10 years of observation are probably of higher evidence for longevity of restorations.

All-ceramic premolar guiding plate retains resin-bonded fixed partial dentures / 华西口腔医学杂志

OBJECTIVE@#This study aims to investigate the fracture resistance and short-term restorative effects of resin-bonded fixed partial dentures (RBFPDs) made from heat-pressed lithium-disilicate-based glass-ceramic (IPS e.max press) and zirconia ceramic (WIELAND) and retained by all-ceramic guiding plates when used to restore missing mandibular second premolars.@*METHODS@#A total of 64 human mandibular first premolars and first molars were prepared as abutments, then were randomly divided into 4 groups (n=8): E0, heat-pressed ceramic RBFPDs, no cyclic loading; E1, heat-pressed ceramic RBFPDs exposed to 300 000 cycles of dynamic loading; W0, zirconia ceramic RBFPDs, no cyclic loading; and W1, zirconia ceramic RBFPDs exposed to 300 000 cycles of dynamic loading. Fracture strength was tested in a universal testing machine.@*RESULTS@#The medians of fracture strength were 1 242.85 N±260.11 N (E0), 1 650.85 N±206.77 N (W0), 1 062.60 N±179.98 N (E1), and 1 167.61 N±265.50 N (W1). Statistical analysis showed that all the groups exhibited significantly higher fracture strength compared with the maximum bite force in the premolar region (360 N; P0.05). Significant statistical differences were found between the zirconia ceramic groups (W0 and W1, P0.05) after dynamic loading.@*CONCLUSIONS@#The RBFPDs retained by all-ceramic guiding plates exhibited promising fracture properties and optimal short-term restorative effects when used to restore missing mandibular second premolars.

Aesthetic rehabilitation of the severe bone loss on anterior region using Andrew’s Bridge: A case report

@#A patient with several missing teeth in the anterior region usually experiences severe hard and soft tissue loss, posing a greater challenge for the prosthodontist to treat. This is a case of a 50-year-old female patient who came to the RSGMP UNAIR department of prosthodontics needing to replace the old denture that felt loose and had a change of color to rehabilitate the loss of large residual ridges involving hard and soft tissue. The patient has lost the central and lateral right maxillary incisors with severe hard and soft tissue defect after cyst removal in the region. The patient considered to restore an anterior region with severe hard and tissue loss. Andrew’s Bridge successfully restores an anterior region with severe hard and soft tissue loss.

The removable acrylic partial denture in primary care: the experience and satisfaction of dental surgeons / A prótese parcial removível acrílica na atenção primária: experiência e satisfação dos cirurgiões dentistas

Introduction: The guidelines of the National Politics of Oral Health have led to the inclusion of elemental prostheses in the list of Primary Care procedures. Objective: This paper aimed to evaluate the performance and satisfaction of dental surgeons with the implementation of Acrylic Partial Dentures. Metodology: The sample was composed by 159 dental surgeons (sample calculation), in Belo Horizonte, MG, Brazil, selected via raffle (simple random sampling). A structured questionnaire was built with 72 questions on the daily practice of the performance of dental surgeons, using the SurveyMonkey platform. Result: The results showed that for most of dental surgeons, the inclusion on the list of primary care procedures was a positive initiative and they have enjoyed the experience of using Acrylic Partial Dentures. Dental surgeons who had graduated in private institutions reported to have had more failures than those who had graduated in public institutions. The better prepared dental surgeons reported less difficulties and failures, and the more satisfied professionals with the performance of Acrylic Partial Dentures related had also experienced fewer failures. Considering the indication, the majority of participants did it according to the protocol of the institution (only for anterior teeth) but many revealed the use of dentures also for premolars. Conclusion: Acrylic partial dentures have been a reality in the Brazilian social context even before their inclusion in the list of Primary Care procedures. Such inclusion indicates their relevance; however, it is necessary to have their confection systematized by a protocol in public services.

Introdução: As diretrizes da Política Nacional de Saúde Bucal orientaram para a inclusão de próteses elementares no rol de procedimentos da Atenção Primária em saúde bucal. Objetivo: Avaliou-se a experiência e satisfação dos cirurgiões-dentistas com relação à execução de Prótese Parcial Removível Acrílica no serviço público. Metodologia: A amostra foi composta de 159 cirurgiões-dentistas (cálculo amostral) da rede de atenção primária de Belo Horizonte, selecionados através de sorteio (amostra aleatória simples). Para a coleta de informações, construiu-se um questionário estruturado, com 72 questões inerentes à prática diária de sua execução. Para aplicação do questionário e facilitar a análise estatística dos resultados, utilizou-se a plataforma SurveyMonkey. Resultado: Para a maioria dos profissionais, a inclusão da prótese parcial removível acrílica como procedimento da Atenção Primária foi uma iniciativa positiva e a maioria teve boa experiência com as diversas fases de sua confecção. Os dentistas graduados em instituições privadas relataram ter mais insucessos do que os das instituições públicas. Verificou-se que quanto mais preparado se sentiu o dentista, menos dificuldade na confecção e menos relato de insucesso. Quanto mais satisfeito com a realização, maior ausência de insucesso. Com relação à indicação, a maioria o fez segundo o protocolo da instituição (somente para dentes anteriores) mas muitos revelaram a confecção incluindo também os pré-molares. Conclusão: A prótese parcial acrílica tem sido realidade no contexto social brasileiro mesmo antes da inclusão na Atenção Primária, o que dimensiona a sua relevância. No entanto, faz-se necessário ter sua confecção sistematizada por um protocolo próprio nos serviços públicos.

Acrylic partial dentures fixed to adjacent teeth: a case report on quack dentistry

The practice of quack dentistry worldwide is a challenge to the profession of dentistry as it undermines the trust of the general public and places the patients at unnecessary risks through their illegal practices. Although the ratio of patients to dentists is rapidly decreasing in Malaysia due to the increased output of qualified dentists from both local and foreign institutions, quack dentistry is still practiced in many areas. This report intends to highlight a popular treatment prescribed by these quack dentists which is removable partial dentures that is fixed to the adjacent teeth by cold cure acrylic. We also aim to discuss the design of the denture and the means employed to remove this ’fixed partial denture’. It is hoped that this case report will highlight the prevalence of the practice of quack dentistry especially in geographical area of this case report and allow the authorities to devise means to stop this illegal practice.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

Prótesis Parcial Removible con Extensión Distal y Apoyo sobre Implantes, Comportamiento y Consideraciones Clínicas / Removable Partial Denture with Distal Extension and Implant Support, Behavior and Clinical Consideration

La rehabilitación de los extremos libres, en mandíbula uni o bilaterales, suponen un gran reto para el odontólogo, siendo un problema a resolver en la práctica clínica habitual. Tales casos suelen ser resueltos mediante prótesis parcial removible, las cuales deben soportar fuerzas horizontales y de torsión, con efectos adversos durante la función, al producir fuerzas terminales de torque contra pilares y tejidos blandos principalmente por la diferente resiliencia de estas estructuras afectando así la retención, estabilidad y el soporte de la prótesis dental. En el último tiempo se han reportado prótesis parcial removible mandibular en combinación con implante en extremo libre distal como una alternativa a las tradicionales prótesis parcial removible mucodentosoportada y a las prótesis fijas implantosoportadas para el manejo de la desdentición parcial en extremo libre; sin embargo, los reportes publicados en la literatura sobre esta alternativa es limitada respecto a la funcionalidad y el pronóstico. Este artículo presenta una revisión sistematizada de la literatura cuyo objetivo fue identificar y sintetizar la mejor evidencia disponible respecto a las consideraciones y comportamiento clínico de esta modalidad de tratamiento en desdentados de la clase I y II de Kennedy mandibular.

The rehabilitation of free ends in a unilateral or bilateral jaw represents a major challenge for the dentist, and is a problem to solve in the daily clinical practice. These cases are usually resolved by removable partial dentures, which should be able to withstand horizontal forces. Torque adverse effect can occur during functioning, because of torque forces terminals against pillars and soft tissue mainly caused by the different resilience of these structures, therefore affecting retention, stability and support of the dental prosthesis. In recent times it has been reported that mandibular removable partial dentures in combination with distal free end implants can be a viable alternative to traditional removable partial dentures and implant-supported fixed partial dentures for treatment of partial toothless free end, however literature regarding functionality and prognosis of this alternative is limited. This paper presents a systematic literature review aimed to identify and synthesize the best available evidence regarding the considerations and clinical behavior of this treatment modality in edentulous Class I and II of the edentulous Kennedy mandibular.

Conexão dente-implante: uma alternativa viável? Relato de Caso Clínico usando prótese parcial removível apoiada sobre dentes e implantes / Connection tooth-implant: a viable alternative?Case report using removable partial denture supported on teeth and implants

As fissuras labiopalatinas levam os profissionais a idealizarem próteses não convencionais na busca da solução das reabilitações por se tornarem, muitas vezes, bastante complexas. Próteses totalmente implanto-suportadas devem ser o tratamento de escolha, embora haja casos em que a união de dentes com implantes é inevitável. Há autores que defendem a união rígida, outros a não rígida e outros ainda que não recomendem a união dente-implante. Os riscos relacionados a esta união são resultado de diferenças biomecânicas entre as estruturas envolvidas, ligamento periodontal e osso, e da biomecânica dos dentes e implantes apoiados sobre as próteses. Objetivo: este trabalho relata um caso clínico de reabilitação oral com uma PPR sobre dentes unidos a implantes em uma paciente com fissura labiopalatina do Hospital de Reabilitação de Anomalias Craniofaciais de Bauru. Método: relato do caso. Resultados e Discussão: paciente de 47 anos, gênero feminino, portadora de fissura pós-forame incisivo incompleta, apresentava os dentes 13, 23 e 27, sendo este extraído por problemas periodontais, e 2 implantes instalados nas regiões dos dentes 16 e 26. O planejamento reabilitador protético foi a instalação de uma PPR com encaixe tipo barra-clip retida por 3 barras metálicas unindo os dentes aos implantes por meio de um sistema tubo parafuso. A união não-rígida demonstra maior distribuição das forças, embora possa causar a intrusão dentária. Já a união rígida, apresenta maior estresse e maior perda óssea na região dos implantes. Conclusão: o correto planejamento, embasado na biomecânica, assim como controles clínicos e rádio gráficos posteriores, são de suma importância para o sucesso do tratamento reabilitador protético...

Cleft lip and palate lead professionals to idealize unconventional prostheses to find the solution for the rehabilitation that becomes, oftentimes, complex. Totally implant-supported prostheses should be the treatment of choice, although there are cases in which the connection of teeth with implants is inevitable. Some authors advocate the rigid connection, others the non-rigid connection and still others do not recommend the implant-tooth connection. The risks related to this connection are the result of biomechanical differences between the structures involved, periodontal ligament and bone, and biomechanics of teeth and implants supported on the prostheses. Objective: this report presents a case of oral rehabilitation with a removable partial prosthesis on teeth connected to implants in a patient with cleft lip and palate in Hospital of Rehabilitation of Craniofacial Anomalies of Bauru. Method: case report. Results and Discussion: a 47 year old female patient, with incomplete post foramen cleft presenting the teeth 13, 23 and 27, which was extracted by periodontal problems, and two implants placed in regions of the teeth 16 and 26. The prosthetic rehabilitation treatment was the installation of a removable partial prosthesis with a bar-clip type of fit retained by 3 metal bars connecting teeth to implants through a tube screw system. The non-rigid connection demonstrates greater distribution of forces, although it can cause tooth intrusion...

Necesidades protésicas de la población de Rio Chico Edo. Miranda: agosto-noviembre 2010 / Prosthetic needs in population of Río Chico Edo. Miranda agust-november 2010

La pérdida parcial o total de la dentición natural es el resultado más frecuente de caries dental o enfermedad periodontal. Estos, ocasionan la extracción temprana de las piezas dentarias permanentes trayendo como consecuencia la necesidad de rehabilitación al individuo afectado. Determinar las necesidades protésicas de los pacientes de la población de Río Chico-Edo. Miranda. Estudio descriptivo y transversal. El instrumento de recolección de datos fue la Historia Clínica empleada por ambos centros, se estudiaron 701 pacientes entre masculinos y femeninos que acudieron a solicitar tratamiento odontológico al ambulatorio urbano tipo III Centro de Especiales Médico Odontológicas (C.E.M.O.) y el ambulatorio urbano tipo II Asociación Damas Salesianas (ADS) durante el período agosto-noviembre 2010. Se elaboró una matriz de datos en el programa Excel para la organización de los datos. 72% de la muestra eran mujeres y 28% eran hombres. La edad más afectada fue entre 21 y 30 años (28%). De acuerdo a las necesidades protésicas el 71% requiere una o más prótesis fija, 26% requerían prótesis parciales removibles tanto dento-soportadas como dento-muco-soportadas y 3% requería de prótesis totales. Se ratifica la importancia de este estudio para proveer información a las entidades del Estado encargados de brindar los recursos para rehabilitar a nivel bucal a esta población.

The partial or complete loss of the natural dentition is the most frequent result of dental caries or periodontal disease. There from the early extraction of teeth permanent bringing as a result the need for rehabilitation tothose affected individual. To determine the population of Río Chico- Miranda State, Venezuela, patients prosthetic needs. descriptive and transversal study. The data collection instrument was the clinical history, used by bothenters, 701 patients of both sexes who came to seek dental treatment to urban ambulatory type III special medical dental (C.E.M.O.) Centre and urban ambulatory type II partnership Damas Salesianas (ADS) during the period August-November 2010. Developed an array of data inthe Excel program for the Organization of the data 72% 28% to the masculine and feminine gender. The most affected age was between 21 and 30 years (28%). Needs prosthetic : 71% requires one or more fixed prosthesis, 26% require removable dento-supported both dento-muco-supported partial dentures and dentures requires 3%. Confirms the importance of this study to provide information to State entities responsible for providing resources to rehabilitate oral level to this population.

Manejo de impresiones en prótesis parciales removibles en la práctica odontológica en tres laboratorios dentales / Management wrapped removable partial dentures in dental practice dental laboratories in three

Se estudió el manejo de impresiones en prótesis parciales removibles en la práctica odontológica a través del análisis de los patrones de frecuencias en relación a la clasificación de Kennedy, tipos de impresión, técnica utilizada, material de impresión y forma de envío; para tal fin se realizaron encuestas en tres laboratorios de la ciudad de Caracas, Venezuela. Se evidenció que en la práctica privada existe una falla en el manejo impresiones enviadas al laboratorio; el tipo de impresión enviada con mayor frecuencia es la anatómica aún en casos a extensión distal. Finalmente, se ratifica la importancia de estudios de este tipo de impresiones para proveer información a los programas de pregrado, postgrado y educación continua...

Impression techniques in removable partial dentures in private practice were studied. The frequency patterns related to Kennedy classification, types of impression, techniques, impression materials and referral form to laboratory technicians were analyzed. The results showed a poor handling of impression procedures. Anatomical impression was the most often impression sent even in distal extension cases. Finally, it confirms the importance of such studies to provide information to undergraduate programs, graduate and continuing education...

Visualización del plano oclusal y guía anterior en desdentados parciales en la telerradiografía lateral: descripción de la técnica a través de casos clínicos / Occlusal plane and anterior guidance visualization in lateral cephalometric radiographs in partially edentulous patients: technique description through case reports

El uso de la telerradiografía lateral ha tomado gran importancia en Rehabilitación Oral ayudando al clínico en el diagnóstico y planificación del tratamiento a través de la identificación del biotipo facial del paciente, la inclinación del plano oclusal, la relación anteroposterior entre maxilar y mandíbula, inclinación de los ejes dentarios y como ayuda complementaria en casos de alteraciones de la Dimensión Vertical. El problema surge cuando estamos frente a pacientes desdentados que han perdido puntos de referencia cefalométricos necesarios para el análisis. El presente trabajo muestra una técnica para poder visualizar radiográficamente el plano oclusal y la guía anterior utilizando láminas de plomo.

The use of lateral cephalometric radiographs has become very important in Oral Rehabilitation, helping the clinician in the diagnosis and treatment planning through the identification of facial biotype, occlusal plane inclination, sagittal relationship between maxilla and mandible, inclination of the dental axes, and a valuable help in assessing alterations of the vertical dimension of occlusion. The problem arises when treating partially edentulous patients who have lost their cephalometric reference points necessary for the analysis. This paper shows a technique to visualize the occlusal plane and anterior guidance in partially edentulous patients who have lost these anatomical landmarks in a lateral cephalometric radiograph, using lead sheets.

Impacto de las prótesis removibles en la posición lingual, patrón de deglución y calibre sagital de la vía aérea orofaríngea / The impact of removable prosthesis on the position of the tongue during resting and swallowing states, and on the sagittal size of the oropharyngeal airway

Introducción: las prótesis dentales removibles y su influencia en las praxis linguales, no han sido analizadas clínica y radiográficamente. El objetivo fue determinar si las prótesis removibles causan modificaciones clínicas en la posición lingual y en el patrón de deglución; y cambios radiográficos en el calibre sagital de la vía aérea orofaríngea en pacientes con pérdida de mesa molar. Métodos: mediante un diseño preexperimental preprueba posprueba en un solo grupo, se evaluaron 15 pacientes en tres tiempos distintos: pretratamiento (T1), inmediatamente al insertar las prótesis (T2) y a los 6 meses posteriores (T3). La posición lingual se evaluó según Kotsiomiti. El patrón de deglución se evaluó según Bossart. Se hizo el análisis cefalométrico basado en Delaire y Argandoña para medir la vía área orofaríngea. Los datos clínicos fueron analizados estadísticamente con la prueba de Friedman, para la cefalometría se usó el análisis de varianza (ANOVA) y la prueba de Duncan. (p > 0,05) Resultados: se encontraron diferencias altamente significativas en la posición lingual, variando desde la posición anormal superior a la normal inferior. En el patrón de deglución se encontraron diferencias significativas, variando del linguo-mandibular al linguo-dentario. El calibre sagital de la vía aérea orofaríngea disminuyó significativamente entre T1 y T2. Conclusiones: línicamente ocurren cambios positivos en la posición lingual en reposo y en el patrón de deglución. Los cambios negativos que ocurren en la vía aérea orofaríngea al insertar las prótesis tienden a revertirse a los 6 meses de uso, producto de la acomodación estructural y funcional del macizo lingual.

Introduction: removable dentures and their influence on lingual position have not been clinically and radiographically tested. The objective of this study was to determine whether dentures cause clinical changes in tongue position and swallowing patterns, as well as radiographic changes in the sagittal caliber of the oropharyngeal airway in patients with molar table loss. Methods: by means of a pretest-posttest preexperimental design in a single group, 15 patients were evaluated at three different times: pretreatment (T1), immediately after inserting the prosthesis (T2) and 6 months afterwards (T3). Lingual position was evaluated according to Kotsiomiti. Swallowing patterns were assessed according to Bossart. The cephalometric analysis by Delaire and Argandoña was conducted in order to measure the oropharyngeal airway. The clinical data were statistically analyzed by using the Friedman test, and for cephalometry both the variance analysis test (ANOVA) and Duncan test were used (p > 0.05). Results: highly significant differences were found in tongue position, ranging from upper abnormal position to lower normal position. In terms of swallowing pattern, significant differences were found, ranging from lingual-mandibular to lingual-dental. The sagittal caliber of oropharyngeal airway significantly decreased between T1 and T2. Conclusions: clinically, positive changes occur in tongue position at rest and in swallowing pattern. Negative changes in the oropharyngeal airway after inserting dentures tend to revert within 6 months of use as a consequence of the structural and functional accommodation of the tongue mass.

Evaluación de la condición periodontal en individuos tratados con prótesis parciales removibles y su relación con el diseño aplicado / Assessment of periodontal status in individuals treated with removable partial dentures and its relationship to the applied design

El propósito de este estudio fue determinar la condición periodontal de individuos tratados con Prótesis Parcial Removible (PPR) y su relación con el diseño empleado. Metodología: La población estudiada consistió en 34 individuos rehabilitados con PPR en el pregrado de la Facultad de Odontología de la UCV que aceptaron ser evaluados de acuerdo a Consentimiento Informado aprobado por la Comisión de Bioética de la Facultad de Odontología y que su plan de tratamiento incluía la instalación de una PPR Clase I o II de Kennedy mandibular. Los parámetros periodontales evaluados en los dientes pilares y no pilares fueron: Índice de Placa (IP), Índice Gingival (IG), profundidad de surco gingival (PSG) (promedio en mm) y movilidad dental con el método Periotest (VPT). En relación al diseño se consideró el tipo de retenedor directo y conector mayor empleado. Las variables, fueron comparadas aplicando la prueba de Chi-cuadrado, considerando un nivel de significancia de p < 0,05. Resultados: El IP, PSG y VPT de los dientes pilares fueron mayores a lo observado en los dientes no pilares con diferencias estadísticamente significativas. Conclusiones: La condición periodontal según los parámetros observados no es la ideal y los dientes pilares tienen un grado de afectación mayor; la aplicación del retenedor combinado colado-forjado está supeditada a la condición periodontal observada, mientras que la condición periodontal parece no haber influenciado la selección del conector mayor

Periodontal condition evaluation of individuals treated with removable partial dentures and association to prosthesis design.The purpose of this study was to analyze the periodontal condition of individuals treated with removable partial dentures (RPD) and the relationship with prosthesis design. Methodology: 34 individuals rehabilitated with RPD, by undergraduate dental students, were included in the study after approval of ethical consent. As inclusion criteria, all RPD consisted in mandibular Class I or II of Kennedy. Periodontal parameters evaluated in abutment and non-abutment teeth were as follow: Plaque index (PI), gingival index (GI), depth of gingival sulcus (DGS) (mean of values expressed in mm) and tooth mobility using the Periotest method (VPT). Regarding to prosthesis design, type of major connector and direct retainer were considered. Variables were compared using Chi2 test, and p values <0,05 were considered statistically significant. Results: PI, DGS and VPT in abutment teeth were higher tham non abutment teeth and this values were statistical difference. Conclusions: periodontal status analyzed by parameters is not ideal, and abutment teeth are more affected, the use of wire wrought clasp is related with periodontal status. Additionally, selection of major connector in the design was not influence by periodontal status

Masticatory muscle activity evaluation by electromyography in removable partial denture users / Avaliação da atividade dos músculos da mastigação por eletromiografia em usuários de prótese parcial removível

Objectives: The aim of this study was to evaluate by electromyography the activity of the temporalis and masseter muscles in removable partial dentures (RPDs) users, before and after new RPDs installation. Material and Methods: Ten patients were selected for this study. All subjects were edentulous in the posterior mandibular region (Kennedy class I or II), fully dentate in the antagonist arch, and dental prosthesis users, which needed to be replaced. The electromyographic activity (EMG) recorded the superficial masseter and temporalis muscles, during the maximum voluntary bite force and the rest position. Maximum mouth opening was also verified. The measurements were recorded at four specific times: using the old prosthesis (T0), right after the new prosthesis installation (T1), two weeks (T2) and four weeks (T4) after installing the new prosthesis. All the RPDs were made by an experienced dentist and the same laboratory. Data were statistically analyzed by ANOVA and Tukey tests (α = 0.05). Results: EMG values had high standard deviation at the time T0. Generally, the mean values decreased after new prosthesis installation, especially after two weeks from the installation (T2). During the rest position, the left masseter and left temporalis muscles showed statistically significant gradual decrease in their activities over time. Conclusion: New prostheses have positive effect on the patient’s muscular activity. However, an adaptation period of the muscle fibers to the new prosthesis is needed

Objetivo: O objetivo deste estudo foi avaliar, através de eletromiografia, a atividade dos músculos masseter e temporal em usuários de próteses parciais removíveis (PPR), antes e depois da instalação da nova prótese. Materiais e Métodos: Dez pacientes foram selecionados para este estudo. Todos os indivíduos eram edêntulos na região mandibular posterior (Classes I e II de Kennedy), totalmente dentados no arco antagonista, e usuários de próteses removíveis, com necessidade de substituição. A atividade eletromiográfica (EMG) dos músculos masseter superficial e temporal foi verificada, durante as posições de contração máxima voluntária e repouso. A abertura bucal máxima também foi mensurada. As mensurações foram efetuadas em quatro momentos: durante a utilização da prótese antiga (T0), logo após a instalação da nova prótese (T1), duas semanas (T2) e quatro semanas (T4) após a instalação da nova prótese. Todas as próteses foram fabricadas por um único dentista com experiência e no mesmo laboratório. Os dados foram analisados estatisticamente pelos testes de ANOVA e Tukey (α = 0,05). Resultados: Os valores de EMG tiveram um alto desvio padrão no momento T0. Em geral, a atividade dos músculos mastigatórios sofreu uma diminuição após a instalação da prótese, especialmente após duas semanas da instalação (T2). Durante a posição de repouso, os músculos masseter e temporal esquerdos demonstraram um decréscimo gradual estatisticamente significativo em suas atividades ao longo do tempo. Conclusão: Novas próteses desempenham efeito positivo sobre a atividade muscular dos pacientes. Ainda, um período de adaptação das fibras musculares com a nova prótese se faz necessário.

Reestablishment of occlusion through overlay removable partial dentures: a case report

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia’s jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.

A perda de dentes posteriores pode provocar o desequilíbrio do sistema estomatognático. As próteses parciais removíveis terapêuticas atuam como terapia reversível e não dispendiosa para os pacientes com desgastes dentais severos. Este trabalho apresenta um tratamento com as próteses parciais removíveis terapêuticas (overlay) em um paciente de 55 anos, do gênero masculino que apresentava atrição severa nos dentes superiores e inferiores, dor na articulação temporomandibular e dimensão vertical de oclusão reduzida. O tratamento consistiu em restabelecer a dimensão vertical de oclusão utilizando o Jig de Lucia, próteses parciais removíveis com reconstrução dos dentes desgastados e sem preparos. Esta terapia pode ser utilizada como uma alternativa de tratamento para a obtenção de estética, função e estabilidade oclusal em pacientes com desgastes dentais severos.