ABSTRACT
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...
Subject(s)
Humans , Female , Middle Aged , Cleft Palate/rehabilitation , Dental Implantation/instrumentation , Denture, Partial, Removable , Mouth RehabilitationABSTRACT
A lot of the research paper was reported about the result of influence of IMC (Intramobile connector)in the IMZ implant placed solely in the alveolar bone, but reports about the effect of IMC on functional load at state of connecting with natural teeth were rare. The major purpose of this study was find the mechanical character of IMC itself by using the finite element analysis program after simulated variance of condition connected with the natural teeth and implant on functional load. When first and second premolar was lost, IMZ implant was placed with a diameter of 3.3 mm and a length of 13mm with IMC in second premolar area. Rigid connection was done and the non-figid connection was located on the female part of the canine abutment and the implant respectively and then both the infraocclusion of 30um and the non-infraocclusion under the load of 40kg applied to the portion of the natural teeth, the pontic and the implant. The displacement and the stress of it was estimated and analyzed IMC itself of the rigid connection and the non-rigid connection was grouped. The following results were obtainded. 1. In all groups, the displacement of Y-axis was greater than that of X-axis and the aspect of displacement showed that IMC was displaced downward and to the center. 2. There was no differences in the displacement of IMC regardless of the connection type. 3. In the displacement of IMC, I 4 was the least, I 1 and I 3 are similar and I 2 was the greatest. 4. There was no differences in the peak value of miximal stress of IMC regardless of the connection type. 5. In the peak value of maximal stress of IMC, I 4 was the least, I 1 and I 3 ere similar, and I 2 was the largest.