Esquema oclusal em prótese total / Occlusal scheme in complete dentures

O objetivo foi revisar a literatura e discutir os conceitos oclusais em reabilitações orais com próteses totais, enfatizando as vantagens e as necessidades de cada esquema oclusal. Realizou-se uma busca nas bases de dados PubMed, SciELO, Google Scholar e em li-vros didáticos com as palavras-chave "Oclusão Dentária", "Oclusão Dentária Balanceada", "Orientação de Canino", "Planejamento de Dentadura", "Planejamento de Prótese Dentá-ria" e "Prótese Total" e com os operadores booleanos AND (E), OR (OU), NOT (MENOS). Dentro dos esquemas oclusais disponíveis para o planejamento protético, a oclusão balan-ceada bilateral (OBB) e a oclusão guiada pelo canino (OGC) foram as mais estudadas e discutidas na desoclusão de próteses totais. Os estudos indicam que o tipo de oclusão pode interferir na atividade muscular do sistema estomatognático, na eficiência mastigatória, na reabsorção óssea, na retenção e estabilidade das próteses removíveis e na satisfação do pa-ciente. Na literatura examinada, foi perceptível a recomendação da OGC como o esquema oclusal de preferência no planejamento das próteses totais, pois os resultados dos estudos indicam menor atividade muscular durante a mastigação, melhor retenção e estabilidade da prótese total. A OGC é o esquema oclusal mais simples e fácil de ser obtido comparada à OBB, beneficia a fonética, é esteticamente preferida pelos pacientes e, em termos de qua-lidade de vida, autopercepção da força mastigatória e oclusal, tem se mostrado satisfatória. Conclui-se que a OGC pode ser recomendada como um esquema oclusal favorável para as reabilitações orais com próteses totais.Descritores: Oclusão Dentária. Oclusão Dentária Balanceada. Orientação de canino. Pró-tese Total. Planejamento de Prótese Dentária.

The aim was to review the literature and discuss the occlusal concepts in oral rehabilitation with complete dentures, emphasizing the advantages and needs of each occlusal scheme. A search was carried out on the databases PubMed, SciELO, Google Scholar and in textbooks, using "Dental Occlusion"; "Dental Occlusion Balanced"; "Canino guidance"; "Denture complete"; and "Denture design" as keywords and the Boolean operators AND, OR, and NOT. Among the occlusal schemes available for prosthetic planning, the bilateral balanced occlusion (BBO) and the canine guided occlusion (CGO) were the most studied and discussed in the disocclusion of complete dentures. Studies indicate the type of occlusion can interfere with muscle activity of the stomatognathic system, masticatory efficiency, bone resorption, retention and stability of removable dentures, and patient satisfaction. In the literature examined, the recommendation of the CGO as the preferred occlusal scheme in the planning of complete dentures was noticeable. The results of the studies indicate less muscle activity during mastication, better retention, and stability of the total denture. It is simpler and easier to obtain this occlusal scheme than the BBO. CGO benefits phonetics; it is aesthetically preferred by patients; and, in terms of quality of life, self-perception of masticatory and occlusal strength, has shown to be satisfactory. We conclude that CGO can be recommended as a favorable occlusal scheme for oral rehabilitation with complete dentures.

Complete denture of a skeletal class III patient with occlusal scheme in consideration: A case report / 대한치과보철학회지

Occlusal disharmony is frequently observed among edentulous patients. When artificial teeth come into contact, the unfavorable displacing force may lead to the discomfort, mucosal trauma, or even neuromuscular alterations and emotional disturbances. An optimal occlusal scheme is a critical factor for successful complete dentures. For this case, an edentulous patient with significant interarch size discrepancy due to mandibular prognathism contributing to inadequate function of dentures was treated with complete dentures. The posterior cross-bite tooth setup for compensating the abnormal jaw relations provided a stable and retentive complete denture prosthesis, which was considered adequate by both patient and dentist.

CAD-CAM en prótesis total. Reporte de caso / CAD-CAM in complete dentures. Case report

Antecedentes: En los últimos 15 años, la robótica ha incursionado en el campo de la prostodoncia total a través de la cual se han desarrollo técnicas clínicas y de laboratorio para elaborar dentaduras. Objetivo: Rehabilitar un paciente desdentado total con una técnica actual que utiliza la robótica y acrílicos industrializados. Descripción del caso: El tratamiento prostodóntico de un paciente desdentado total superior e inferior se realizó mediante tecnología de diseño y manufacturación asistidas por computador (CAD-CAM). Resultado: Se emplearon impresiones digitales y acrílicos industriales de alto rendimiento, así como escáner, programa de computador y fresadora. El caso fue exitoso en cuanto a estabilidad, retención y soporte del tratamiento efectuado.

Background: In the last 15 years, robotics has started to be used in the field of complete denture prosthodontics through the development of clinical and laboratory techniques to elaborate dentures. Purpose: To rehabilitate an edentulous patient with an innovative technique using robotics and industrialized acrylics. Description of the case: Prosthodontic treatment of a completely edentulous patient was performed using computer-assisted design and manufacturing (CAD-CAM) technology. Results: Digital impressions and industrial acrylics, as well as scanner, software, and dental milling machine. The case was successful regarding stability, retention, and support of the treatment carried out.

Prótese total imediata ­ do planejamento à instalação / Complete immediate denture ­ planning and performing

A confecção de uma Prótese Total Imediata é um procedimento complexo para os profissionais e estressante para o paciente. O presente artigo descreve a sequência clínica do planejamento à realização deste procedimento, com segurança e previsibilidade.

The fabrication of an Immediate Complete Denture is a complex procedure for the practitioners involved and a stressing situation for the patient. This article describes the clinical sequence for planning and performing this procedure with safety and predictability.

Onde se encontra o travamento posterior da maxila de uma prótese total superior? / Where is the postpalatal seal in a complete upper denture?

Na confecção de uma prótese total superior, a delimitação correta do travamento posterior é uma responsabilidade do clínico. Para evidenciá-lo, esse deve basear-se em referências anatômicas e fatores fisiológicos individuais de cada paciente.

During the fabrication of a complete denture the practitioner is responsible for a proper postpalatal seal. Thus it must be based on anatomic structures and physiologic aspects of each patient.

Immediate fixed partial denture after tooth extraction in patients with systemic diseases: A clinical report

For patients with systemic diseases who face difficulties visiting dental clinics, wearing fixed partial denture in the anterior region on the same day of tooth extraction can reduce the total period of treatment and the number of visits, as well as post-treatment psychological effect on the patient.

Mapping of tooth loss profiles and the variety of removable partial denture designs fitted to patients in a University dental school clinic in Trinidad.

Background: Clinicians are continually challenged to improve the standard of treatment. Careful measurements and designs, based on knowledge of tooth loss patterns and biomechanical principles, will determine the overall quality of removable prostheses. Objectives: This study maps the pattern of tooth loss in a sample of patients and the most efficient designs employed for their cobalt-chrome removable prosthesis. Material and methods: Data was collected from gypsum casts, metal castings, and prescriptions sent to dental technicians. The sample included both men (44) and women (109). Information was obtained on their Kennedy classification, number of missing teeth in the maxilla and the mandible, the type of major connector fitted, and when additional indirect retainers with clasps were incorporated into the frame. The significance of the association between pairs of these categorical variables was tested by a Chi Square test. Results: Patients with maxilla loss (82%) had mostly (54%) 6 to 10 missing teeth and were assessed principally (78%) as exhibiting Kennedy Class II or III patterns. Most (77%) of those missing teeth in their mandible (66%) were assessed as either Class I or Class II. The Anterior-Posterior (70%) in the maxilla and the Lingual Bar (74%) in the mandible were the most common fitted connectors. Indirect retainers were used for patients with maxilla (78%) or mandible (96%) tooth loss to provide extra stability. Conclusion: Additional components incorporated in the Cobalt-Chrome frame increased the biomechanical efficiency of the appliance by reducing destructive forces, caused by the torque on the abutment teeth.

Treatment of geriatric odontoptosis with removable partial denture:framework design and fabrication / 解放军医学杂志

Objective To summarize and analyze the clinical experiences of treatment of complicated geriatric odontoptosis for the purpose of establishing a better technique to cope with such situation.Method The data of 542 outpatients with geriatric odontoptosis,from 1998 till the present treated in the Department of Outpatient,General Hospital of PLA,were summarized and analyzed according to the type and location of odontoptosis,with complications such as severe attrition,periodontitis,food impaction and detective occlusion.The special prosthetic designs on certain cases were also summarized.Some cases were followed-up.Results Removable partial dentares(RPD)with cast framework were prescribed to the geriatric odontoptosis patients.According to the site and type of odontoptosis,four special designed frameworks include casting fence-wall enforced artificial tooth prosthesis for lower clearance cases,metal strengthened plastic occlusive pad or metal occlusive pad for severe attrition cases,casting splint prosthesis for periodontal and food impaction with impaction preventive denture.36 cases were followed up for two years with satisfactory result in 31 cases,but in four cases the clasp was broken.In the cases with failure the dentures were redesigned and fabricated with cast framework,and better results were accomplished.Generally,the patients were accustomed to the new RPD quickly and revisit times were less frequent.The strength of prosthesis was enhanced.It was proved that custom designed framework could solve the clinical dilemma of severe dentition attrition,food impaction and periodontitis,and the odontoptosis was repaired.Conclusion The designed fence-wall prosthesis,metal strengthened plastic occlusal pad and metal occlusal pad,casting splint prosthesis and casting food impaction stop are effective prosthetic procedure for certain cases.