Cambios en parámetros masticatorios con prótesis parcial removible para dientes posteriores perdidos / Changes in masticatory parameters with removable partial dentures for missing posterior teeth

Introducción: el reemplazo de dientes perdidos aspira a mejorar la función masticatoria. Aunque hay diferentes opciones para ello, la conveniencia de la prótesis parcial removible (PPR) es su bajo costo. Objetivo: comparar el desempeño masticatorio (DM) después de 20 ciclos masticatorios y al umbral de la deglución (UD) en adultos de 50 a 70 años con dientes posteriores perdidos (DPP), con/sin PPR; y los ciclos hasta la deglución. Material y métodos: estudio transversal en 35 adultos con dientes anteriores y PPR bien ajustadas y utilizadas para comer. El lado de prueba fue el lado con más DPP. El DM se evaluó después de 20 ciclos y al UD utilizando un alimento prueba artificial (Optosil Comfort®) con/sin la PPR en orden aleatorizado. Las partículas se tamizaron para determinar el tamaño medio de partícula (TMP) como medida del DM. Los ciclos se contaron visualmente. Estadística descriptiva y comparaciones con SPSS-v23. Resultados: hubo diferencias significativas (p ≤ 0.05) al masticar con/sin PPR. El TMP fue más pequeño (mejor DM) con la PPR después de 20 ciclos y al UD (3.9 vs 4.4 mm y 3.2 vs 4.2 mm). Los ciclos para llegar al UD disminuyeron con la PPR (40 vs 47). Conclusión: a pesar de una mejora limitada de la función masticatoria, las PPR ayudan a preparar los alimentos en partículas más pequeñas antes de deglutirlas. La mejoría en DM con PPR es de 24% al UD, realizando menos ciclos antes de deglutir sus alimentos (AU)

Introduction: replacement of missing teeth should improve masticatory function. Although there are different options removable partial dentures (RPD) are used due to their lower cost. Objective: to compare masticatory performance (MP) after 20 chewing-cycles and swallowing-threshold (ST) in 50-70 year-old adults with missing posterior teeth (MPT) with and without their cast-metal RPD; chewing cycles until swallowing were also compared. Material and methods: 35 adults participated in this cross-sectional study. Subjects with anterior teeth and welladjusted RPDs, used for eating were included. The side with more MPT was selected as the test side. MP was evaluated after 20 cycles and ST using an artificial test-food (Optosil Comfort®) with/without the RPD (subject-own-control) (randomized order). Chewed particles were sieved to determine medium-particle-size (MPS) as a measure of MP. Chewing cycles were visually counted. Descriptive statistics and comparisons were run with SPSS v23. Results: there were significant differences (p ≤ 0.05) for all parameters when chewing with/without the RPD. MPS was smaller (better MP) with the RPD (3.9 vs 4.4 mm and 3.2 vs 4.2 mm) after 20 cycles and ST respectively. Cycles required to reach ST were less when chewing with the denture (40 vs 47). Conclusion: despite a limited improvement of masticatory function RPDs help patients prepare their food into smaller particles before swallowing. Improvement in MP with RPDs for patients with MPT is 24% at ST and they perform fewer chewing cycles before swallowing food (AU)

Rehabilitación oral en paciente con alteración de la dimensión vertical oclusal aplicando un enfoque multidisciplinario / Oral rehabilitation in patient with alteration of vertical dimension occlusal applying a multidisciplinary approach

El objetivo de éste caso clínico fue restaurar las funciones del sistema estomatognático mediante confección de prótesis convencional combinada, restableciendo de esta manera la dimensión vertical alterada. Caso clínico: Paciente de sexo masculino, 64 años de edad, edéntulo parcial superior clase II de Kennedy modificación 1 e inferior clase II de Kennedy, el motivo de consulta fue la atrición de las piezas dentarias antero superiores e inferiores evidenciando disminución de la dimensión vertical, se realizó tratamiento de conductos con fines protésicos; confección de espigos muñones y se restableció una dimensión vertical terapéutica a través de prótesis superior e inferior; para posteriormente lograr una rehabilitación definitiva mediante prótesis fija y prótesis parcial removible convencional. Las prótesis combinadas definitivas son los dispositivos protéticos que mantienen la dimensión vertical en el tiempo.

The aim in the present case report was re-establish stomatology system functions by conventional mixed dental prosthesis for recovering altered vertical dimension. Clinical case: A 64 years old male patient with upper partial edentulism, Kennedy class II-1 and also lower partial edentulism but Kennedy class II. Patient's chief complaint was dental wearing and an evident oclusal vertical dimension loss. Endodontic treatment was done focusing it in dental prosthetic rehabilitation. Thus therapeutic vertical dimension was reestablished with fixed and removal dental prosthesis. Later, definitive dental therapeutic rehabilitation was attained with fixed and conventional removable dental prosthesis. That mixed dental rehabilitation is an alternative which recovers and maintains oclusal vertical dimension through the time.

Associação entre implantes odontológicos e próteses parciais removíveis: revisão de literatura / Association between implants and removable partial dentures: review of the literature

Introdução: A prótese parcial removível de extremidade livre unilateral ou bilateral apresenta complexa biomecânica. Seus movimentos em diversas direções, juntamente com a forma do rebordo alveolar e a resiliência da fibromucosa, podem levar a forças danosas sobre as estruturas de suporte. A associação entre implantes e prótese parcial removível visa proporcionar melhores propriedades mecânico-biológicas ao sistema estomatognático. Objetivo: Realizar uma revisão de literatura e discussão quanto ao uso dessa alternativa de reabilitação. Revisão de literatura e conclusão: Estudos têm evidenciado que essa associação oferece maior suporte, retenção e estabilidade às próteses, limitando seu movimento de aproximação em direção aos tecidos de suporte e propiciando conforto funcional e psicológico aos pacientes.

Introduction: Unilateral or bilateral distal-extension removable partial dentures present complex biomechanics. The movements in different directions, associated with the alveolar ridge shape and soft tissue resilience can lead to damaging forces on the supporting structures. The association between implants / removable partial denture aims to provide better mechanical and biological properties to the stomatognathic system. Objective: The aim of this paper was to review the articles about the effect of implant support on distal extension removable partial dentures. Literature review and conclusion: Studies have shown that this combination provides greater support, retention and stability to the prosthesis, thus limiting their approach movement toward supporting tissues and providing functional and psychological comfort to patients.