Reabilitação oral em paciente acometido por cárie da primeira infância: relato de caso / Oral rehabilitation in a patient with severe early childhood caries: a case report

Objetivo: Apresentar as abordagens adotadas no tratamento estético reabilitador de paciente pediátrico acometido por cárie da primeira infância respeitando as individualidades e buscando a integralidade do paciente infantil. Relato do caso: O caso clínico descreve a reabilitação bucal realizada em uma criança de 4 anos e 6 meses de idade, diagnosticada com cárie da primeira infância. Após anamnese criteriosa, exames físicos e complementares e de posse do diagnóstico, estabeleceu-se um plano de tratamento obedecendo-se a todas as fases terapêuticas, nas quais a fase preparatória englobou abordagem psicológica, fluorterapia, exodontias e selamento dos dentes com cimento de ionômero de vidro. Posteriormente, procedeu-se à fase estético-re-abilitadora por meio de restaurações diretas e indireta, instalação de mantenedor de espaço estético-funcional e confecção e instalação de uma prótese total superior. Após a conclusão do tratamento odontológico, os responsáveis foram orientados quanto à necessidade e importância do tratamento multidisciplinar com o fonoaudiólogo para completa recuperação da saúde do paciente e de visitas periódicas ao cirurgião-dentista para acompanhamento. Conclusão: A reabilitação bucal da criança propiciou o restabelecimento das funções do sistema estomatognático e promoveu a recuperação da sua saúde bucal.

Aim: To present the approaches adopted in the rehabili-tative aesthetic treatment of pediatric patients affected by early childhood caries, respecting individualities and seeking the integrality of the child patient. Case report: The clinical case describes the oral rehabilitation performed in a child aged 4 years and 6 months, diagnosed with early childhood caries. After careful anamnesis, physical and complementary examinations and in possession of the diagnosis, a treatment plan was established, complying with all therapeutic phases, in which the preparatory phase included a psychological approach, fluortherapy, extractions and teeth sealing with glass ionomer cement. Subsequently, the esthetic-rehabilitation phase was carried out through direct and indirect restorations, installation of an esthetic-functional space maintainer and fabri-cation and installation of an upper total denture. After completion of the dental treatment, those responsible were instructed on the need and importance of multi-disciplinary treatment with the speech therapist for the complete recovery of the patient's health and periodic visits to the dentist for follow-up. Conclusion: The child's oral rehabilitation provided the reestablishment of the functions of the stomatognathic system and promoted the recovery of their oral health.

Fotobiomodulação associada à escleroterapia no tratamento de hemangioma em palato duro / Photobiomodulation associated with sclerotherapy for treatment of hemangioma in the hard palate

Resumo As alterações vasculares ocorrem frequentemente em região de cabeça e pescoço, sendo o hemangioma a mais comum. Paciente do sexo feminino, 61 anos, queixou-se de dor intensa em palato duro. Notou-se lesão arroxeada, de 1,5 cm, sensível à palpação e com histórico de hemorragia. A paciente era edêntula total, e a prótese total superior comprimia o local da lesão. Foi realizada a vitropressão, confirmando a origem vascular. A hipótese diagnóstica foi de hemangioma. Na primeira sessão, aplicou-se o laser vermelho (660 nm) em quatro pontos ao redor da lesão, sendo 0,5 J em cada ponto afim de se obter analgesia e iniciar o processo de reparo, além do reembasamento da prótese total superior. Na segunda sessão, foi feita aplicação de 2 mL de oleato de monoetanolamina 5%. Após 14 dias, observou-se regressão total da lesão. Os cirurgiões-dentistas devem estar aptos a reconhecer, diagnosticar e tratar as lesões vasculares em cavidade oral.

Abstract Vascular changes frequently involve the head and neck region and hemagioma is the most common. A 61-year-old female patient complained of severe pain in the hard palate. A purple lesion was found, measuring 1.5 cm, sensitive to palpation, and with a history of hemorrhage. The patient was fully edentulous and her upper denture compressed the lesion site. Diascopy confirmed the lesion's vascular origin. A diagnostic hypothesis of hemangioma was raised. In the first session, red laser light (660nm) was applied at 4 points around the lesion, with 0.5 J at each point, in order to obtain analgesia and trigger the repair process. The upper denture was also relined. In the second session, 2 mL of 5% monoethanolamine oleate was applied. After 14 days, total regression of the lesion was observed. Dental surgeons must be able to recognize, diagnose and treat vascular lesions in the oral cavity.

Reproduction of Esthetic Individuality in Upper Immediate Complete Denture / Reproducción de la Individualidad Estética en Prótesis Completa Inmediata Superior

ABSTRACT: Prosthodontics, in general, aims to rehabilitate the masticatory function of the patient, as well as the stomatognathic system, maintaining his or her individual facial characteristics. The immediate removable complete denture is placed immediately after extraction of the natural teeth and allows adaptation of the patient from the dentate state to the denture, until the definitive denture is placed. When an immediate complete denture is fabricated, esthetics plays a fundamental role and thus the assembly of artificial teeth can be performed maintaining the same position, alignment and arrangement of the remaining anterior teeth, providing a natural and esthetic appearance to the denture, thus the transition from the dentate to the edentulous state is less noticeable. This paper reports the case of a patient who needed oral rehabilitation with an immediate upper complete denture and presented favorable smile esthetics of the anterior teeth, which allowed the preservation of alignment, position and arrangement of natural teeth during the assembly of artificial teeth, maintaining and preserving the esthetic individuality and facial harmonization, meeting the patient's desire and expectations.

RESUMEN: La prostodoncia, en general, tiene como objetivo rehabilitar la función masticatoria del paciente, así como el sistema estomatognático, manteniendo sus características faciales individuales. La dentadura postiza completa removible se coloca inmediatamente después de la extracción de los dientes naturales y permite la adaptación del paciente del estado dentado a la dentadura, hasta que se coloque la dentadura definitiva. Cuando se fabrica una dentadura postiza completa inmediata, la estética juega un papel fundamental y, por lo tanto, el ensamblaje de dientes artificiales se puede realizar manteniendo la misma posición, alineación y disposición de los dientes anteriores restantes, proporcionando un aspecto natural y estético a la dentadura, por lo tanto, la transición desde el estado dentado hasta el estado desdentado es menos notable. Este artículo informa el caso de una paciente que necesitó rehabilitación oral con una dentadura postiza completa superior inmediata y presentó una estética de sonrisa favorable de los dientes anteriores, lo que permitió preservar la alineación, la posición y la disposición de los dientes naturales durante el ensamblaje de los dientes artificiales, manteniendo y preservando la individualidad estética y la armonización facial, satisfaciendo los deseos y expectativas del paciente.

Clinical trial for evaluation of Ricinus communis and sodium hypochlorite as denture cleanser

Abstract The development of opportunistic infections due to poor denture hygiene conditions justified the search for effective hygiene protocols for controlling denture biofilm. Objective This study evaluated Ricinus communis and sodium hypochlorite solutions in terms of biofilm removal ability, remission of candidiasis, antimicrobial activity, and participant satisfaction. Material and Methods It was conducted a controlled clinical trial, randomized, double-blind, and crossover. Sixty-four denture wearers with (n=24) and without candidiasis (n=40) were instructed to brush (3 times/day) and immerse their dentures (20 min/day) in different storage solutions (S1 / S2: 0.25% / 0.5% sodium hypochlorite; S3: 10% R. communis; S4: Saline).The trial period for each solution was seven days and a washout period of seven days was used before starting the use of another solution. The variables were analyzed at baseline and after each trial period. The biofilm of inner surfaces of maxillary dentures was disclosed, photographed, and total and dyed areas were measured (Image Tool software). The percentage of biofilm was calculated. Remission of candidiasis was assessed by visual scale and score were attributed. Antimicrobial activity was assessed by the DNA-Checkerboard hybridization method. Patient satisfaction was measured using a questionnaire. Results S1 (4.41±7.98%) and S2 (2.93±5.23%) were more effective then S3 (6.95±10.93%) in biofilm remotion(P<0.0001). All solutions were different from the control (11.07±11.99%). S3 was the most effective solution in remission of candidiasis (50%), followed by S1 (46%). Concerning antimicrobial action, S1/S2 were similar and resulted in the lowest microorganism mean count (P=0.04), followed by S3. No significant differences were found with patient's satisfaction. Conclusions 10% R. communis and 0.25% sodium hypochlorite were effective in biofilm removal, causing remission of candidiasis and reducing the formation of microbial colonies in denture surfaces. All solutions were approved by patients.

Candida spp. in complete dentures of institutionalized elderly individuals / Candida spp. en prótesis dentales totales de personas mayores institucionalizadas

The objective of this study was to evaluate the prevalence of Candida spp. in complete dentures of institucionalized elderly, aged 60 or more, in a city of northeast of Brazil. A survey was conducted of the health profile and quantification of Candida spp. from isolation in Sabouraud agar. Our results showed that from 181 institutionalized elderlies, only 17 (66-84 years) met the inclusion criteria. 47.1 % were totally dependent, and 58.8 % needed help with hygiene. The most commonly used drugs were antihypertensive. The results showed a high prevalence of Candida spp. (64.5 %) in the dentures of institutionalized elderly and this may be a reflection of poor oral hygiene.

El objetivo fue asociar el uso de prótesis dentales totales y la prevalencia de Candida spp. en ancianos institucionalizados con 60 o más años de edad, en una ciudad del Nordeste de Brasil. Se llevó a cabo un estudio del perfil de salud y cuantificación de Candida spp. por aislamiento con agar Sabouraud. A partir de 181 ancianos institucionalizados, sólo 17 (66­84 años) cumplieron los criterios de inclusión. 47,1 % eran totalmente dependientes y 58,8 % necesitó ayuda con la higiene. Los fármacos más utilizados fueron antihipertensivos. Los resultados mostraron una alta prevalencia de Candida spp. (64,5 %) en las prótesis dentales totales de los ancianos institucionalizados y esto tal vez sea un reflejo de la deficiente higiene oral.

Prótese híbrida mandibular imediata confeccionada pela técnica do assentamento passivo: cinco anos de acompanhamento clínico e radiográfico / The immediate mandibular hybrid prosthesis fabricated with the passive fit technique: five years of clinical and radiographic follow-up

O objetivo deste artigo foi descrever a técnica do assentamento passivo para confecção da estrutura metálica de próteses híbridas, por meio do relato de um caso clínico com acompanhamento em longo prazo. Paciente do sexo masculino, 44 anos, compareceu à clínica de Implantodontia do Instituto Latino Americano de Pesquisa e Ensino Odontológico (Ilapeo) relatando insatisfação devido à instabilidade da prótese total inferior. Foi planejada e executada a reabilitação do paciente com a instalação de cinco implantes entre os forâmenes mentuais, e uma prótese híbrida no sistema de carga imediata. O procedimento cirúrgico e a instalação da prótese definitiva foram realizados no mesmo dia. A agilidade de entrega da prótese foi possível devido à técnica utilizada para a confecção da estrutura metálica, denominada técnica do assentamento passivo, a qual elimina a necessidade de prova e solda da estrutura. A prótese permanece com a caraterística de reversibilidade, por ser parafusada, mas com a passividade das próteses cimentadas. O paciente foi acompanhado durante cinco anos e oito meses, não apresentou complicação e está totalmente satisfeito com o tratamento. Concluiu-se que a técnica do assentamento passivo reduz o tempo clínico e simplifica as etapas laboratoriais. Além disso, garante um adequado ajuste entre implante e prótese, favorecendo a longevidade da reabilitação.

The aim of this article was to describe the passive fit technique for the framework fabrication of hybrid prostheses through a clinical case presentation. A female, 44 years-old patient was examined at the Ilapeo clinics concerning about the instability of her lower mandibular denture. Five implants were planned and placed between the mental foramina to receive the mandibular hybrid prosthesis under immediate loading. The surgical and prosthodontic procedures were performed in the same day. This quick procedure to fabricate the metallic framework is known as the passive fit technique, which eliminates the try-in and soldering. Its retrievability is maintained, but with the advantage of a passive, cemented prosthesis. The patient has been followed-up for 5 years and 8 months, with no complications identifi ed, being completely satisfi ed with the proposed treatment. Besides, an adequate fit between the dental implants and the prosthesis is warranted, which favors the longevity of this rehabilitation procedure.

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.

Elevação bilateral de seio maxilar utilizando cem porcento de biomaterial aloplástico, para posterior reabilitaçãode maxila atrófica. Follow-up tomográfico de cinco anos / Bilateral sinus floor augmentation using one hundred percent alloplastic biomaterial for later rehabilitation of atrophic maxilla. A 5-year tomographic follow-up

A restauração implantossuportada bem-sucedida passa por um planejamento prévio, abordando as variáveis clínicas específicas para cada caso. Maxilas severamente atróficas representam um desafio para reabilitação com próteses fixas, haja vista que o paciente não possui a quantidade mínima necessária de altura óssea na região posterior para a instalação de implantes no local preconizado pelo enceramento diagnóstico. Objetivo: o presente estudo tem como objetivo relatar um caso de reabilitação bucal com prótese total implantossuportada por meio de elevação bilateral de seio maxilar, utilizando 100% de biomaterial aloplástico para posterior instalação de implantes dentários, com cinco anos de follow-up clínico e tomográfico. Métodos: a utilização de um substituto ósseo sintético (fosfato de cálcio bifásico) elimina qualquer risco potencial de transmissão de microrganismos e reduz o número de sítios cirúrgicos, haja vista que dispensa a coleta de osso autógeno para enxertia. Como a altura óssea subantral residual chegava a ser inferior a 1mm, um procedimento de elevação de seio maxilar bilateral, por meio da técnica da janela lateral, foi planejado para oito meses antes da instalação de oito implantes, que serviriam de retenção para uma prótese total implantossuportada, a ser instalada 60 dias após a cirurgia de colocação dos implantes. Conclusão: há evidências, tanto na literatura científica quanto no caso relatado,que de que a utilização de 100% biomaterial aloplástico para aumento vertical de maxila atrófica por meio de levantamento do assoalho do seio maxilar consiste em uma alternativa ao uso do enxerto autógeno, tornando-se uma solução eficiente e de menor morbidade...

Successful implant rehabilitation relies on previous planning that addresses thespecific clinical variables of each case. Fixed-prosthesis rehabilitation of severely atrophic maxilla is a challenge, given that patients do not present with minimal posterior bone height required for implant placement at the site recommended by diagnostic wax-up. Objective: The present study aims at reporting a case of implant-supported complete denture oral rehabilitation performed by means of bilateral maxillary sinus lift with 100% alloplastic biomaterial for subsequent implant placement, with a 5-year clinicaland tomographic follow-up. Methods: The use of synthetic bone substitutes (biphasic calcium phosphate) not only eliminates potential risks of contamination, but also reduces the number of surgical sites, given that it does not require autogenous bone to be harvested for grafting. Subantral residual bone height was less than 1 mm, therefore, bilateral maxillary sinus lift carried out by means of the lateral window approach was planned to be performed eight months before placement of eight implants. These implants would give support to a complete denture installed 60 days after implant placement surgery. Conclusion:Both scientific literature and the case reported herein evince that the use of 100% alloplastic biomaterialfor vertical augmentation of atrophic maxilla by means of maxillary sinus lift is an efficient alternative to replace autograft due to presenting lower morbidity rates...

Reabilitação de maxila edêntula com prótese fixa implantossuportada: relato de caso / Rehabilitation of edentulous maxilla with implant-supported fixed prosthesis: a case report

Introdução: os problemas funcionais, estéticos e psicológicos decorrentes do edentulismo têm levado a uma busca crescente por reabilitação bucal com próteses sobre implantes. Esse tipo de reabilitação necessita de um planejamento meticuloso, especialmente para os casos de maxila edêntula com prótese fixa sobre implantes, em decorrência da anatomia dessa região. Objetivo: o objetivo do presente caso clínico é descrever a reabilitação de uma maxila edêntula com prótese total fixa implantossuportada, cuja infraestrutura recebeu elementos metalocerâmicos cimentados individualmente.

Introduction: Functional, aesthetic and psychological issues arising from edentulism have led to a growing search for oral rehabilitation with implant-supported prostheses. This type of rehabilitation requires detailed planning, especially for treating edentulous maxilla with implantsupported fixed prostheses due to the anatomy of this region. Objective: The aim of this case report is to describe the rehabilitation of an edentulous maxilla with implantsupported full fixed prosthesis of which framework received metal-ceramic elements individually cemented.

The influence of mandibular ridge anatomy on treatment outcome with conventional complete dentures

Since prognostic indicators are likely to take on increasingimportance as a diagnostic tool for selection of patients forimplant provision, this study investigated the influence of theshape and resiliency of the mandibular alveolar ridge on theretention and stability of conventional complete dentures. Ninety-three edentulous patients wearing both maxillary andmandibular conventional complete dentures composed the sample.Data were collected regarding shape and resiliencyof themandibular residual ridge. Dentures were assessed for retentionand stability using an objective and reproducible tool.The associationsbetween the clinical characteristics of the mandibularalveolar ridge and denture retention and stability were analyzedusing chi-square and Fisher exact tests (α = 0.05). A significantassociation between ridge shape and denture stability (p < 0.05)was found, while ridge resiliency was significantly associated todenture retention (p < 0.001). Based on the results, mandibularridge shape and resiliency influenced the retention and stabilityof conventional complete dentures...

Rendimiento masticatorio en pacientes rehabilitados con prótesis total removible v/s prótesis Ad-Modum Branemark / Masticatory performance in patients rehabilitated by means of removable complete dentures vs. Ad-Modum Branemark prostheses

Propósito: el propósito de este estudio fue evaluar y comparar el rendimiento masticatorio de pacientes desdentados totales rehabilitados mediante (prótesistipo Ad-Modum y/o prótesis removibles convencional. Método: Se evaluaron24 pacientes divididos en 3 grupos de ocho pacientes. Grupo Ipacientes rehabilitados con prótesis Ad-Modum bimaxilar, Grupo IIpacientes rehabilitados con prótesis Ad-Modum inferior y prótesis total removible superior, Grupo III pacientes rehabilitados con prótesis total removible bimaxilar. Se solicitó a cadapaciente realizar 20 golpes masticatorios a una pastilla de silicona previamente estandarizada, a la muestra obtenida se le realizó tamizado múltiple y los resultados fueron procesados con la fórmula de obtención de rendimiento masticatorio propuesta por el protocolo de Edlund y Lamm en 1980. Resultados: Lospromedios de rendimiento masticatorio fueron: Grupo I(15,6 por ciento±3,4), Grupo II (4,3 por ciento±4,6), Grupo III (0,3 por ciento±0,7). Mediante test de Tukey se demostró que existendiferencias significativas entre el grupo I y II, pero no entre los Grupos II yIII. Conclusiones: El tratamiento con prótesis Ad-Modum bimaxilar logró elmejor rendimiento masticatorio entre los 3 tratamientos rehabilitadores evaluados, el tratamiento con prótesis total removible superior y Ad-Modum inferior fue más exitoso en términos de rendimiento masticatorio que el grupo rehabilitado con prótesis total removible bimaxilar. Los tratamientos con prótesis removible total convencional, no otorgan al paciente una óptima función masticatoria

Estandarización de las dimensiones de tuberosidad maxilar y la papila retromolar en edéntulos totales / Standardization of the dimensions of the maxilary tuberosity and retromolar pad in completely edentulous

Objetivo: Determinar medidas estandarizadas de la tuberosidad del maxilar y papila retromolar, analizando su longitud, ancho y altura en modelos primarios de pacientes edéntulos totales. Se busca proveer al clínico la estandarización de las medidas de estas estructuras para considerarlas como referente para el llenado de las historias clínicas. Métodos: Se utilizaron modelos superiores e inferiores de 80 pacientes edéntulos totales de la Clínica Dental de la Facultad de Estomatología, Universidad Peruana Cayetano Heredia, cuyas edades oscilaban entre 48 y 90 años de edad. Se analizaron 160 papilas y 160 tuberosidades, realizando un total de 960 mediciones utilizando un calibrador de Vernier digital, niveles adheridos y paralelígrafo. Se realizó un análisis univariado de todas las medidas obtenidas: longitud, ancho y altura y una prueba de normalidad. Para el análisis se utilizó un método de clasificación empleado por Santos y Rojas con ciertas modificaciones. Asimismo, se realizó la prueba de Anova y de Mann Whitney determinando que no existió diferencia significativa de los resultados por lados. Resultados: Los resultados indicaron diferentes parámetros para determinar una tuberosidad y papila pequeña, mediana o grande. Para la tuberosidad las medidas referenciales fueron: altura: 6mm, ancho: 11mm y longitud: 16mm; y para la papila: altura: 5mm, longitud: 15mm y ancho: 9mm.

Objectives: The purpose was to determine standardized measures analyzing height, length and width of the tuberosity and pad in edentulous primary models. The aim is to provide the clinical standardization measures tuberosity and retromolar papilla and consider them as a reference for the purpose of filling the medical records. Methods: 80 edentulous patientsÆ upper and lower models of the School of Dentistry at Universidad Peruana Cayetano Heredia, whose age ranges between 48 and 90 years. 160 pads and 160 tuberosities are analyzed making a total of 960 measurements using a digital Vernier caliper, adhered levels and parallelometer. Univariate analysis was in all measurements obtained: of length, width and height and a normality test. A classification method by Santos and Rojas with certain modifications will be used for the analysis. Moreover, an ANOVA and Mann Whitney test is made determining that there is no significant difference in the results by sides. Results: The results indicated different parameters to determine a tuberosity and pad can be small, medium or large. The reference measures for tuberosity are: height: 6mm length: 16mm, width: 11mm and for papilla are: height: 5 mm, length: 15 mm, width: 9 mm.

Reabilitação de maxila atrófica sem uso de abordagem reconstrutiva: relato de caso / Rehabilitation of atrophic maxilla without a reconstructive approach:a case report

A reabilitação bucal de pacientes edêntulos, por meio do uso de próteses totais fixas, comumente envolve procedimentos reconstrutivos prévios, haja vista que o rebordo ósseo residual não apresenta as dimensões mínimas requeridas para a instalação de implantes de diâmetro regular na região planejada. Fatores como o custo elevado e o medo de procedimentos cirúrgicos adicionais fazem com que alguns idosos, mesmo insatisfeitos com a instabilidade da prótese removível, resistam ao tratamento com implantes dentários. Objetivo: dessa forma, o presente estudo tem como objetivo relatar um caso de reabilitação bucal com prótese total implantossuportada, por meio da instalação de implantes de diâmetro reduzido (3,3mm) em maxila severamente atrófica, sem a utilização de enxertos ou abordagens reconstrutivas. Os 8 implantes, instalados com abordagem palatina nos sítios previamente planejados, permaneceram submersos por 45 dias, quando foi dado o início da adequação gengival e etapas protéticas. A prótese definitiva foi instalada 65 dias após a cirurgia. Nenhuma intercorrência foi registrada durante 6 meses de acompanhamento. Nota-se que os implantes de diâmetro reduzido surgem como uma alternativa simples e rápida à realização de procedimentos de aumento ósseo horizontal, e podem ser utilizados com segurança como forma de retenção para próteses fixas, tornando-se uma solução eficiente e de menor custo para pacientes edêntulos que desejam reduzir os problemas relacionados à instabilidade de próteses totais removíveis...

Oral rehabilitation of edentulous patients using fixed prostheses commonlyinvolves previous reconstructive procedures, since the residual ridge does not have the minimumdimensions required for installation of standard diameter implants in the planned site. Factors suchas high cost and fear of additional surgical procedures make some elderly, even those who are dissatisfiedwith the instability of removable prosthesis, hesitant to treatment with dental implants.Objective: This study aims to report a case of oral rehabilitation with fixed dentures supported byimplants of reduced diameter (3.3 mm) in severely atrophic maxilla without the use of grafts or reconstructiveapproaches. The eight implants, installed with palatal approach at previously plannedsites, remained submerged for 45 days when soft tissue adjustment and prosthetic procedures werestarted. The definitive prosthesis was installed 65 days after surgery. Results: No intercurrence wasregistered after 6 months of follow-up. Small diameter implants appear as a simple and fast alternativefor horizontal bone augmentation procedures. Additionally, they can be safely used for retentionof fixed prosthesis, and prove to be an efficient and low-cost solution for edentulous patientswho wish to minimize problems related to the instability of removable dentures...

Análise comparativa de dois produtos de higienização de prótesestotais na remoção do biofilme / Comparative analysis of two cleaning products for biofilm removalof total prosthesis

Introdução: A higiene das próteses totais é importante na prevenção de doenças cardíacas e pulmonares em pacientes idosos. Objetivo: Comparar a eficácia dos métodos de higienização para próteses totais. Materiais e métodos: Foram selecionados 20 pacientes portadores de próteses totais superiores. As próteses foram coradas com fucsina básica e, posteriormente, divididas em dois grupos de acordo com as soluções de higiene: grupo 1 – Corega Tabs® (CT); grupo 2 – hipoclorito de sódio (HS) 2,5%. No grupo 1, as próteses foram submersas em 250 mL de água destilada + 1 pastilha de Corega Tabs, no Grupo 2, em 250 mL de água destilada + 10 mL de hipoclorito de sódio a 2,5% por 5 minutos. Após a imersão, foi escovada a porção interna das próteses por um minuto. As bases internas das próteses foram coradas e fotografadas. Em seguida, realizaram-se imersão e imersão + escovação, e então, foi avaliada a quantidade de placa bacteriana pelo método da contagem de pontos. Os dados foram analisados pelos testes t de Student, ANOVA e múltiplas comparações de Tukey HSD. Resultados: Foram encontradas diferenças significativas entre a quantidade de placa bacteriana inicial e após imersão + escovação para ambos os grupos (CT, 40,12 ± 22,44 e 10,92 ± 11,39; HS, 40,64 ± 24,12 e 13,06 ± 11,08; p < 0,05). Não foram encontradas diferenças entre os grupos 1 e 2 para nenhuma condição teste (inicial, imersão e imersão + escovação) (p > 0,05). Conclusão: CT e HS não apresentaram diferenças para eficiência na remoção de placa bacteriana. O método de imersão + escovação mostrou-se o mais eficaz na remoção de placa bacteriana em próteses totais superiores.

Introduction: The hygiene of the dentures is important in the prevention of heart and lung disease in old patients. Objective: To compare the effectiveness of methods for cleaning dentures in reducing plaque. Materials and methods: We selected 20 patients with maxillary dentures. The prostheses were stained with basic fucsin Replak (Dentsply) and then divided into two groups according to the hygiene solutions: group 1 – Corega Tabs® (CT), group 2 - 2.5% sodium hypochlorite (HS). In group 1, the dentures were submerged in 250 mL of water + Corega Tabs; and group 2 in 250 mL of water + 10 mL of sodium hypochlorite 2.5% for five minutes. After soaking was done, the inner portion of the prosthesis was brushed for one minute. The foundations of internal prostheses were stained and photographed. After the initial period, immersion and immersion + brushing, and then evaluated the amount of plaque by the method of scoring. Data were analyzed by Student´s t-tests, ANOVA and Turkey HSD multiple comparisons. Results: Significant differences were found between the amount of initial plaque and immersion + brushing for both groups (CT, 40.12 ± 22.44 and 10.92 ± 11.39; HS, 40.64 ± 24.12 and 13.06 ± 11.08, p < 0.05). No differences were found between groups 1 and 2 test for any condition (initial, immersion and immersion + brushing) (p > 0.05). Conclusion: CT and HS showed no differences related to the efficiency in removing plaque. The immersion + brushing method proved to be the most efficient at removing plaque from maxillary denture.

Effect of different curing temperatures on the distortion at the posterior peripheral seal: An in vitro study.

Context: Most of the maxillary complete dentures do not adapt accurately to the cast because of the changes in the resin during polymerization. The amount of heat associated with processing of polymethyl methacrylate has been correlated with the adaptation of the processed denture base to its supporting tissues. Aims: This study conducted to determine the effect of different curing temperatures on the accuracy of fit of a complete maxillary denture and to compare with that of fiber-reinforced acrylic resins. Materials and Methods : An ideal maxillary rubber mould used to make an edentulous cast. Forty-eight stone casts made from the ideal rubber mould. Out of 48 identical stone casts, 44 stone casts with wax adapted processed using simple acrylic resin. The remaining four stone casts were processed using fiber-reinforced acrylic resin. However, processing time for 12 hrs was maintained constant for all the samples. The variable to investigate was the temperature. Therefore, four denture bases processed at each temperature from 60°C to 80°C with two-degree increments for a total of 44 samples using simple acrylic resin. Remaining four samples processed at 70°C using fiber-reinforced acrylic resin. A traveling microscope used to measure the discrepancy between each cast and its denture base. Statistical analysis used: Analyzed with Student's unpaired t test. Results : Minimum distortion was observed at 70°C. Maximum distortion was observed for the denture bases processed at 80°C. Amount of distortion increases as the processing temperature increases which was highly significant. Distortion was significantly high from 60 to 68°C in the decreasing order. Conclusion: This study verified the observation that maxillary complete denture base show the greatest discrepancy at the central portion of the posterior palatal seal region as the processing temperature increases.

Palateless custom bar supported overdenture: A treatment modality to treat patient with severe gag reflex.

Objective: To suggest a custom bar supported overdenture treatment modality for prosthodontic management of patients with severe gag reflex. Background: Some patients have a severe gag reflex and cannot tolerate conventional maxillary complete dentures with maximum palatal coverage and extensions of all borders. The condition further gets complicated in patients suffering from respiratory problems along with severe gag reflex. Severe gagging acts as a barrier to treat such patients with accepted clinical procedures and prevent patients from wearing the prosthesis. By saving some of the remaining natural teeth and fabricating, a horse shoe shape palateless simple tooth or bar supported overdenture can be successfully used for treating such patients. Materials and Methods: The remaining maxillary right and left canines were prepared with the tapered round end diamond bur to receive copings of custom bar after intentional root canal treatment of same teeth. Impression was made with light body and putty of the polyvinyl siloxane elastomer with double step putty wash technique. Impression was poured with die stone. Wax pattern of copings with bar was fabricated with inlay wax which was invested and casted. After retrieving the bar, it was finished and its fit was evaluated. The coping-bar assembly was finally cemented with the glass ionomer cement. Palateless overdenture was fabricated by conventional technique used for the fabrication of complete denture. Conclusion: Palateless custom bar supported overdenture procedure can be successfully used for the management of patients with severe gag reflex with improved denture retention, stability, chewing efficiency and comfort of the patient.

Correlation between intercondylar distance and mandibular intermolar distance for teeth arrangement

The objective of this study was to find out the potential relationship of intercondylar distance with mandibular intermolar distance. It was a cross-sectional comparative study and was carried out from August 2011 to Jan 2012. The present study was carried out on 250 dentate subjects selected from the department of Prosthodontics, Lahore Medical and Dental College, Lahore. The orthodontically treated subjects and those with congenital or acquired orofacial deformities were also excluded. Al the subjects with a history of tempro-mandibulr joint dysfunction and pain were not included in the study. The impression of the maxillary arch was obtained using irreversible hydrocollide. The vernier caliper was used to measure the distance between the mesiobuccal cusp tips of mandibular first molars. The distance between both the condyles was recorded using an arbitary face bow. The intercondylar distance was measured in millimeters with the help of the vernier caliper. For accuracy every distance was measured three times by the same operator and the mean taken. For the statistical analysis the data was recorded on the proforma. The statistical results of the present study showed that the Pearson correlation coefficients [r] for the intercondylar distance and mandibular intermolar are showing positive correlation and significant [r=0.54 p=0.0005]. It was concluded that the Intercondylar distance measurement can be utilized for the arrangement of posterior teeth in edentulous patients

Prótesis híbrida (PH): enfoque actual de la prótesis implantoasistida híbrida (PIAH) / Hybrid prosthesis (HP): a current approach to implant-supported hybrid prosthesis

Oportunamente, en publicaciones dedicadas a la prótesis híbrida (PH), la definimos como la conjunción de dos especies, la prótesis total removible (PTR) y la prótesis parcial fija (PPF). Decíamos en aquella oportunidad, que utilizamos tres tipos de PH, a las que denominamos de baja, media y alta complejidad. Este tipo de prótesis está indicada en rebordes exiguos no reconstruidos parcialmente y con implantes no distribuidos en posición ideal. Antes de realizar nuestro enfoque actual del tema, nos parece oportuno hacer una síntesis de aquellos capítulos en los que desarrollamos las técnicas constructivas de las híbridas de maxilar inferior y cuestionábamos la utilización de las híbridas para el maxilar superior. Finalmente, daremos los motivos por los cuales, en la actualidad, indicamos la PH en el maxilar superior, y desarrollaremos dos nuevos recursos, diseñados por nosotros, para facilitar la eficiencia de la PH: uno para mejorar la fijación de las partes de la clásica PH de alta complejidad y otro para obtener mayor precisión en la fijación de la PH de maxilar superior.

Inflatable hollow obturator prostheses for patients undergoing an extensive maxillectomy: a case report / 国际口腔科学杂志·英文版

The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot be considered. This case report described the use of an air valve in a hollow silicone obturator to manufacture an inflatable obturator that could be extended further into undercut area to retain itself. The inflatable obturator exhibited adequate retention, stability and border sealing, thereby improving the masticatory,pronunciation and swallowing functions of patients. It may be a suitable alternative treatment option to an implant-retained obturator.