Comparación de prótesis removibles parciales y totales entregadas según sus características clínicas en el servicio de odontología del hospital nacional de geriatría y gerontología, en el período de tiempo comprendido del 1 de enero 2005 al 31 de diciembre del 2008 / Comparison of partial and total removable prosthesis delivered according to their clinical characteristics in the dentistry service of the national hospital of geriatry and gerontology, in the period under january 1 of 2005 to december 31 of 2008

RESUMEN Objetivo: Comparar la cantidad y características de las prótesis dentales removibles parciales y totales, en el servicio de odontología del Hospital Nacional de Geriatría y Gerontología, en el periodo de tiempo comprendido del 1 de enero 2005 al 31 de diciembre 2008, equivalentes a 326 expedientes. Se tomó la base de datos del servicio de odontología de consulta externa especializada de los pacientes atendidos de los años 2005 al 2008, en los cuales se entregaron un total de 2786 prótesis dentales removibles. Materiales y métodos: Con base en el dato anterior se seleccionó la muestra no aleatoria a conveniencia hasta alcanzar el tamaño de 599 prótesis entregadas, examinando 326 expedientes del periodo de enero del 2005 a diciembre del 2008, con un nivel de confianza de 99% y un error de muestreo de 0.0466. La recolección de datos se realizó por medio del programa Microsoft Excel donde se utilizó una tabla en la que se anotó el número de expediente, fecha de inicio y conclusión de prótesis, tipo de prótesis, cantidad y color de prótesis, edad, género y domicilio del paciente por distrito, cantón y provincia. El procesamiento se realizó por medio de estadística descriptiva utilizando cuadros y gráficos. Resultados: Se determinó que el mayor porcentaje de rango de edad de personas que solicitaron prótesis removibles fue de 62 a 65 años, independiente si eran prótesis totales o parciales, los pacientes que requirieron dos prótesis fueron 273 de 326, en su mayoría los pacientes solicitaron prótesis totales para un total de 372 de 599 prótesis entregadas. De la guía de color utilizada en el HRBC los colores más requeridos fueron los tonos claros blanco amarillentos que corresponde al número 62 y 65; de los expedientes analizados la mayoría de los pacientes residían en San José con un total de 200 pacientes. Se concluye que el mayor porcentaje de edentulismo que se presento es el edentulismo total con un 62%, la prótesis más utilizada es la prótesis total superior removible y en su mayoría los pacientes requieren dos prótesis, con respecto al color no es concluyente para este estudio debido a los datos no disponibles en los expedientes analizados.

ABSTRACT Objective: Compare the quantity and characteristics of partial and total removable dental prostheses, in the dentistry service of the National Hospital of Geriatrics and Gerontology, in the period from January 1, 2005 to December 31, 2008. The database of the specialized outpatient dentistry service of the patients treated from 2005 to 2008 was taken, in which a total of 2786 removable dentures were delivered. Materials and methods: Based on the previous data, the non-random sample was selected for convenience until reaching the size of 599 protheses of 326 files, with a confidence level of 99% and a sampling error of 0.0466. Data collection was carried out through the Microsoft Excel program where a table was used in which the file number, date of start and conclusion of the prosthesis, type of prosthesis, amount and color of prosthesis, age, gender and address were used of the patient by district, canton and province. The processing was carried out by means of descriptive statistics using tables and graphs. Results: It was determined that the highest percentage of the age range of people who requested removable prostheses was 62 to 65 years, the patients that required two prostheses were 273 of 326. In their majority, the patients requested total prostheses for a total of 372 of 599 prostheses delivered. Of the color guide used in the HRBC, the most requested colors were the light yellowish-white tones corresponding to the number 62 and 65; of the files analyzed, most of the patients resided in San José with a total of 200 patients. Conclusion: It is concluded that the highest percentage of edentulism that is presented is total edentulism with 62%, the most commonly used prosthesis is the removable upper total prosthesis and for the most part patients require two prostheses, with respect to color it is inconclusive for this study due to data not available in the analyzed files.

Rehabilitación implanto protésica en paciente con injerto mandibular de larga data / Implant-prosthetic rehabilitation in a patient with a longstanding mandibular graft / Reabilitação protética com implantes em pacientes com enxerto mandibular de longa data

En la actualidad es cada vez más frecuente la consulta de pacientes que siendo sometidos en edades tempranas a cirugías de extirpación tumoral y posterior reconstrucción con injertos presentan problemas tanto funcionales como estéticos, el uso de prótesis implantosoportadas mejora la calidad de vida, pero al mismo tiempo representan un desafío por la baja disponibilidad ósea. Se presenta un caso clínico de rehabilitación protésica implantosoportada en una paciente con gran déficit óseo mandibular como consecuencia de le extirpación de una neoplasia y posterior injerto de costilla. Se colocaron 2 implantes osteointegrados en hueso remanente y rehabilitación con prótesis removible sostenida a una barra colada. Por ser un tratamiento poco invasivo y conservador fue aceptado fácilmente por la paciente y la mejora tanto en la estética como en la función fue notoria.

Nowadays, it is becoming more and more frequent to see patients who underwent surgery for tumor removal and subsequent reconstruction with grafts at an early age, presenting both functional and esthetic problems. The use of implant-supported prostheses improves the quality of life, but at the same time represents a challenge due to the low availability of bone. A clinical case of implant-supported prosthetic rehabilitation is presented in a patient with a great mandibular bone deficit as a consequence of the removal of a neoplasm and subsequent rib graft. Two osseointegrated implants were placed in the remaining bone and rehabilitation with a removable prosthesis supported by a cast bar. Being a minimally invasive and conservative treatment, it was easily accepted by the patient and the improvement in both esthetics and function was notorious.

Atualmente, são cada vez mais frequentes os pacientes submetidos à cirurgia de remoção de tumores e posterior reconstrução com enxertos em idade precoce que apresentam problemas funcionais e estéticos. O uso de próteses implanto-suportadas melhora a qualidade de vida, mas, ao mesmo tempo, representa um desafio devido à baixa disponibilidade de osso. Apresentamos um caso clínico de reabilitação protética implanto-suportada em um paciente com grande déficit ósseo mandibular em consequência da remoção de uma neoplasia e posterior enxerto de costela. Dois implantes osseointegrados foram colocados no osso remanescente e a reabilitação foi feita com uma prótese removível suportada por uma barra de gesso. Por se tratar de um tratamento minimamente invasivo e conservador, foi facilmente aceito pelo paciente e a melhora na estética e na função foi perceptível.

Reabilitação oral com próteses parciais removíveis após restabelecimento de dimensão vertical de oclusão e tratamento multidisciplinar: relato de caso / Oral rehabilitation with removable partial dentures after restoration of the vertical dimension of occlusion and multidisciplinary treatment: case report

As próteses parciais removíveis (PPRs) são uma alternativa de tratamento viável na prática clínica para reabilitar arcos parcialmente desdentados. Entretanto, o planejamento dessas próteses e preparo bucal prévio são frequentemente negligenciados. O presente artigo tem como objetivo relatar o caso clínico de uma reabilitação oral com PPRs superior e inferior após abordagem multidisciplinar, de modo a enfatizar as fases de um planejamento criterioso e de preparo prévio dos dentes pilares, visando o sucesso e a longevidade da reabilitação. Paciente do sexo masculino de 57 anos de idade compareceu à clínica da Faculdade de Odontologia de Bauru, Universidade de São Paulo, queixando-se da estética de seu sorriso e de algumas ausências dentárias. O indivíduo utilizava uma PPR provisória inferior insatisfatória e apresentava perda de dimensão vertical de oclusão (DVO). Após o exame clínico, radiográfico e estudo do caso em articulador semi-ajustável, realizou-se o planejamento com abordagens restauradoras, endodônticas, periodontais e protéticas. Após tratamento periodontal, foi realizada endodontia dos elementos 12, 15 e 47, confecção de núcleos e coroas nos dentes 12 e 15, restauração a nível gengival para apoio residual no dente 47, restaurações nos dentes 11, 13, 22, 24 e 44 e, por fim, a confecção das PPRs superior e inferior. A abordagem multidisciplinar utilizada neste caso clínico viabilizou o restabelecimento da DVO e possibilitou o sucesso da reabilitação protética(AU)

Removable partial dentures (RPDs) are a viable treatment alternative in clinical practice to rehabilitate partially edentulous arches. However, the planning of these dentures and prior oral preparation are often neglected. This article aims to report the clinical case of an oral rehabilitation with upper and lower RPDs after a multidisciplinary approach, to emphasize the phases of careful planning and prior preparation of the abutment teeth, aiming at the success and longevity of the rehabilitation. A 57-year-old male patient came to the clinic of the Bauru School of Dentistry, University of São Paulo, complaining about the esthetics of his smile and some missing teeth. The subject was using an unsatisfactory lower provisional prosthesis and had a loss of vertical dimension of occlusion (OVD). After the clinical and radiographic examination and the case study in a semi-adjustable articulator, planning was carried out with restorative, endodontic, periodontal and prosthetic approaches. After periodontal treatment, endodontics were performed on elements 12, 15 and 47, creation of cores and crowns on teeth 12 and 15, restoration at the gingival level for residual support on tooth 47, restorations on teeth 11, 13, 22, 24 and 44 and, finally, the making of the upper and lower PPRs. The multidisciplinary approach used in this clinical case enabled the restoration of the OVD and enabled the success of the oral rehabilitation(AU)

The effect of different framework's material on strain induced in distal abutment in mandibular Kennedy's class II: an in-vitro study / O efeito de diferentes materiais de estrutura na deformação induzida na distal do pilar da classe II de Kennedy mandibular: um estudo in vitro

Objective: This study aims to compare the strain induced in the supporting structures of unilateral mandibular removable partial denture frameworks retained by extra-coronal attachments fabricated with three different materials. Material and Methods: Three mandibular class II digitally designed and printed acrylic models with detachable abutments were used to fabricate three removable partial denture framework with extra coronal attachments from three different materials. A total of 33 models were prepared for strain testing (n=11). Models were divided into three groups according to framework's material: porcelain fused to cobalt chromium (PFM), polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) group. Unilateral load of 60 N was applied in the three groups and strains were measured around the main abutment and saddle area using strain gauge. Results: Statistical analysis was performed using Shapiro-Wilk's test and by checking data distribution. Data were found to be non-parametric and were analysed using Kruskal-Wallis test followed by Dunn's post hoc test with Bonferroni correction. PFM group showed significantly the highest strain values around abutment, slot 1 (1mm distal to the socket of the last abutment) and slot 2 (1 cm away from slot 1) respectively (843.00±23.08, 91.00±6.52 and 1274.00±65.71) than the other tested groups (p<0.05) at same tested sites respectively followed by PEKK group (384.00±37.48, 81.00±2.24 and 135.00±0.00) and PEEK group (29.00±4.18, 63.00±4.47 and 52.00±5.70). Conclusions: PEEK and PEKK for partial denture framework with extra coronal attachments are adequate alternative to PFM due to their good mechanical response applying less strain on supportive structures in free-end cases. PEEK induces lower strain magnitude on the supporting structures when compared to PEKK. (AU)

Objetivo: Este estudo tem como objetivo comparar a tensão induzida nas estruturas de suporte de estruturas de próteses parciais removíveis mandibulares unilateraisretidas por encaixes extracoronários fabricados com três materiais diferentes. Material e Métodos: Três modelos mandibulares de classe II digitalmente projetados e impressos em acrílico com pilares destacáveis foram usados para fabricar três estruturas de próteses parciais removíveis com encaixes extracoronários de três materiais diferentes. Um total de 33 modelos foram preparados para testes de deformação (n=11). Os modelos foram divididos em três grupos de acordo com o material da estrutura: porcelana fundida com cobalto-cromo (PFM), poliétercetonacetona (PEKK) e polieteretercetona (PEEK). Carga unilateral de 60 N foi aplicada nos três grupos e as deformações foram medidas em torno do pilar principal e área de sela usando medido de tensão. Resultados: A análise estatística foi realizada por meio do teste de Shapiro-Wilk e com a verificação da distribuição dos dados. Os dados mostraram-se não paramétricos e foram analisados pelo teste de Kruskal-Wallis seguido pelo de Dunn com correção de Bonferroni. O grupo PFM mostrou significativamente os maiores valores de tensão ao redor do pilar, slot 1 (1mm distal do último pilar) e slot 2 (1 cm de distância do slot 1) respectivamente (843,00±23,08, 91,00±6,52 e 1274,00±65,71) do que os outros grupos testados (p<0,05) nos mesmos locais testados, respectivamente, seguido pelo grupo PEKK (384,00±37,48, 81,00±2,24 e 135,00±0,00) e grupo PEEK (29,00±4,18, 63,00±4,47 e 52,00±5,70). Conclusão: PEEK e PEKK para estrutura de prótese parcial com encaixes extracoronários são alternativas adequadas ao PFM devido à sua boa resposta mecânica aplicando menos tensão nas estruturas de suporte em casos de extremidade livre. O PEEK induz menor magnitude de deformação nas estruturas de suporte quando comparado ao PEKK (AU)

Restauration prothétique amovible partielle et implantologie dans la qualité de vie orale des patients: revue narrative / Restoration of partial removable prosthetic and implantology in oral quality of life of patients: narrative review

L'association des implants aux prothèses amovibles partielles (PAP) ne sont pas bien perçues contrairement à la prothèse amovible complète. Cet article examine les connaissances actuelles sur la qualité de vie orale des patients porteurs de Prothèses amovibles partielles supra implantaires (PAPSI), en prenant en compte les performances cliniques, la comparaison des PAP versus les PAPSI et le taux de survie des implants. Les édentements mandibulaires en extension sont les plus concernés par les PAPSI avec une utilisation prépondérante de piliers axiaux. Le passage de la PAP à la PAPSI augmente de manière significative la satisfaction du patient. Le taux de survie des implants varie de 91.6% à 100% sur une durée de 2.5 à 7 ans. Au total, l'utilisation des PAP associée à des implants améliore la qualité de vie orale des patients. Des études cliniques prospectives sont davantage nécessaires pour évaluer cette approche.

The association of implants with partial removable prostheses (RPPs) is not well perceived in contrast to complete removable prostheses. This article reviews the current knowledge on the oral quality of life of patients with supra-implant removable partial dentures (SIRPDs), considering clinical performance, comparison of RPPs versus SIRPDs and implant survival. Extended mandibular edentulous teeth are the most concerned by PAPSI with a preponderance of axial abutments used. The switch from RPDs to SIRDs significantly increases patient satisfaction. The survival rate of the implants varies from 91.6% to 100% over a period of 2.5 to 7 years. Overall, the use of RPPs in combination with implants improves the oral quality of life of patients. More prospective clinical studies are needed to evaluate this approach.

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.

X-linked hypohidrotic ectodermal dysplasia management with removable prosthesis in a pediatric patient: case report / Manejo de displasia ectodérmica hipohidrótica ligada al cromosoma X con prótesis removible en un paciente pediátrico: reporte de caso

Introduction: Ectodermal dysplasia is a rare genetic disorder that affects structures derived from ectoderm such as teeth, hair, nails, and sweat glands. Oligodontia is a common finding that affects the chewing, smiling and self- esteem of these pediatric patients. Case Report: We present a case report of a 7-years-old pediatric patient who consulted with his mother, showing the same condition. The intervention consisted of a removable prosthesis with satisfactory results. Conclusion: The X-linked hypohidrotic ectodermal dysplasia represents a challenge for a pediatric dentist who offers rehabilitation to the patient according to craniofacial development, age, socioeconomic status, and the number of missing teeth.

Introducción: La oligodoncia es un hallazgo común que afecta la masticación, la sonrisa y la autoestima de estos pacientes pediátricos. Case Report: Presentamos un reporte de caso de un paciente pediátrico de 7 años que consultó con su madre presentando la misma condición. La intervención consistió en una prótesis de remoción con resultados satisfactorios. Conclusión: La displasia ectodérmica hipohidrótica ligada al cromosoma X representa un desafío para un odontopediatra que ofrece rehabilitación al paciente de acuerdo con el desarrollo craneofacial, la edad, el nivel socioeconómico y el número de dientes faltantes.

Does the level of knowledge of denture hygiene affect their maintenance? / ¿El nivel de conocimiento de higiene protésica afecta el mantenimiento de estas prótesis?

Introduction: The lack of knowledge about denture hygiene can negatively affect their maintenance. On the other hand, good oral hygiene can reduce the chances of plaque accumulation. Objetive: To determine if there is a relationship between knowledge of hygiene and denture maintenance. Material and Methods: A questionnaire was applied to 67 patients who wore partial and/or total removable prostheses daily to evaluate their knowledge of denture hygiene. For the evaluation of denture maintenance, clinical inspection of the removable prosthesis was carried out using the Vigild criterion to observe the amount of plaque that was adhered to it. Data were statistically processed with Spearman's correlation test to determine the relationship between hygiene knowledge and denture maintenance. Results: The patients presented a medium (37.3%) and low (56.7%) denture hygiene knowledge; and fair (68.7%) and poor (11.9%) maintenance of their prosthesis. There is a statistically significant relationship between hygiene knowledge and denture maintenance (p<0.001). Conclusion: There is little knowledge of denture hygiene. This level of knowledge has a statistically significant relationship with the maintenance of the prostheses.

Introducción: El desconocimiento sobre la higiene de prótesis, de los pacientes portadores de estas, puede afectar negativamente en el mantenimiento protésico, una correcta higiene puede disminuir las probabilidades de acúmulo de placa. Objetivo: Determinar si existe relación entre el conocimiento de higiene y el mantenimiento protésico. Material y Métodos: Para la evaluación del conocimiento en higiene protésica se aplicó un cuestionario a 67 pacientes que utilizaban diariamente prótesis removibles parciales y/o totales; y para la valoración del mantenimiento protésico se realizó la inspección clínica de la prótesis removible mediante el criterio de Vigild, observando la cantidad de placa que se encontraba adherida. Se procesaron los datos estadísticamente con la prueba de correlación de Spearman para determinar la relación entre el conocimiento de higiene y el mantenimiento protésico. Resultados: Los pacientes presentaron un conocimiento de higiene protésica medio (37,3%) y bajo (56,7%); y un mantenimiento de la prótesis de forma regular (68,7%) y malo (11,9%). Existiendo relación estadísticamente significativa entre el conocimiento de higiene y el mantenimiento protésico (p<0, 0 01). Conclusión: Existe un bajo conocimiento de higiene protésica, teniendo este nivel de conocimiento una relación estadísticamente significativa con el mantenimiento que evidenciaban las prótesis.

Reabilitação oral utilizando prótese parcial removível associada a implantes osseointegrados: relato de caso / Oral rehabilitation using removable partial prosthesis associated with osseointegrated implants: case report

Introdução: As próteses parciais removíveis são alternativas amplamente utilizadas na reabilitação oral de pacientes parcialmente desdentados. Na atualidade os implantes dentais têm sido indicados para tratamento de pacientes edêntulos em associação com próteses parciais removíveis convencionais. Objetivo: Relatar um caso clínico utilizando uma prótese parcial removível convencional associada a implantes osseointegrados em paciente portador de Classe I de Kennedy. Relato de Caso: Paciente N.A.A.S., sexo feminino, 65 anos, procurou atendimento clínico no Instituto de Estudos da Saúde (IES) para reabilitação protética das arcadas dentais superior e inferior. A sua queixa principal era "dificuldade de mastigação". A paciente apresentava prótese total removível insatisfatória na maxila e não utilizava nenhum tipo de prótese dentária na mandíbula, que se apresentava parcialmente edêntula. O tratamento realizado foi a confecção de uma prótese total na arcada superior. Na arcada inferior foram inseridos dois implantes de hexágono externo nas regiões correspondentes às áreas dos dentes 34 e 44, após quatro meses a prótese parcial removível convencional foi confeccionada e incorporada aos implantes osseointegrados utilizando o sistema de retenção do tipo attachments Equator. Conclusão: Os resultados revelaram que a técnica de associação da prótese parcial removível convencional aos implantes osseointegrados demonstrou ser uma opção viável de tratamento com capacidade de devolver a função, a estética e manter a integridade dos dentes e tecidos periodontais(AU)

Introduction: Removable partial dentures are alternatives widely used in the oral rehabilitation of partially edentulous patients. Currently, dental implants have been indicated for the treatment of edentulous patients in association with conventional removable partial dentures. Objective: To report a clinical case using a conventional removable partial denture associated with osseointegrated implants in a patient with Kennedy Class I. Case Report: Patient N.A.A.S., female, 65 years old, sought clinical care at the Institute of Health Studies (HEI) for prosthetic rehabilitation of the upper and lower dental arches. His main complaint was "chewing difficulty". The patient had unsatisfactory removable total prosthesis in the maxilla and did not use any type of dental prosthesis in the mandible, which was partially edentulous. The treatment performed was the manufacture of a total prosthesis in the upper arch. In the lower arch, two external hexagon implants were inserted in the regions corresponding to the tooth areas 34 and 44, after four months the conventional removable partial denture was made and incorporated into the osseointegrated implants using the equator attachments retention system. Conclusion: The results revealed that the technique of associating conventional removable partial dentures with osseointegrated implants proved to be a viable treatment option with the ability to restore function, aesthetics and maintain the integrity of teeth and periodontal tissues(AU)

Restabelecimento da Dimensão Vertical de Oclusão com JIG estético modificado e Prótese Parcial Removível Overlay: relato de caso / Reestablishment of occlusal vertical dimension with a modified aesthetic JIG and an overlay removable partial denture: a case report

A reabilitação de pacientes parcialmente edêntulos com desgaste dentário severo e dimensão vertical de oclusão reduzida é desafiadora e complexa. Objetivo: Descrever o restabelecimento da dimensão vertical de oclusão e parâmetros estéticos com uma prótese parcial removível do tipo overlay (PPRO) com auxílio de um JIG estético modificado. Relato de caso: Paciente do sexo masculino, 58 anos de idade, procurou serviço odontológico queixando-se de insatisfação com a estética do sorriso e perda dos dentes posteriores. Ao exame clínico, foram observados desgaste dentário excessivo e edentulismo parcial nas arcadas superior e inferior. Então, foi proposto tratamento em 2 etapas (provisória e definitiva) com PPRO em maxila. O JIG estético foi usado como guia de referência para incrementos em resina composta fotopolimerizável e o restabelecimento da dimensão vertical de oclusão foi determinado a partir de métodos métrico, fonético e estético. Os dentes desgastados foram aumentados e os dentes ausentes substituídos por dentes artificiais a partir de uma PPRO provisória. Após 2 meses de adaptação, a reabilitação final com PPRO definitiva foi conduzida baseando-se na reabilitação com a PPRO provisória. Conclusão: O paciente relatou satisfação com a estética e desempenho funcional com o tratamento. Portanto, o JIG estético beneficia o planejamento e o tratamento para restabelecer a dimensão vertical de oclusão. Além disso, a PPRO é uma alternativa reversível, de baixo custo, para reabilitar a estética e a função de pacientes com desgaste severo e perda parcial dos dentes.

The rehabilitation of partially edentulous patients with severe tooth wear and reduced occlusal vertical dimension is challenging and complex. Objective: To describe the reestablishment of occlusal vertical dimension and aesthetic parameters with an overlay re-movable partial denture (ORPD) with the aid of a modified aesthetic JIG. Case report: A 58-year-old man sought dental service complaining of dissatisfaction with the aesthetics of his smile and a loss of posterior teeth. At clinical examination, excessive tooth wear and partially edentulism in the lower and upper arches were observed. A two-step treatment (interim and definitive) with an ORPD in the upper arch was proposed. The aesthetic JIG was used as a reference guide for the increments in light-curing resin composite, and the reestablishmentthe occlusal vertical dimension was determined using aesthetic, phonetic, and metric methods. The worn teeth were increased, and the missing natural teeth were replaced by artificial teeth using a temporary ORPD. After two months of adaptation, de-finitive rehabilitation with a definitive ORPD was performed based on the interim ORPD. Conclusion: The patient reported satisfaction with the esthetic and functional performance of this treatment. Therefore, the aesthetic JIG benefits the planning and treatment of reduced vertical dimension. Moreover, the ORPD is a reversible and lower-cost alternative to rehabilitate the aesthetics and function of patients with severe teeth wear and partial teeth loss.

Finite element analyses of retention of removable partial denture circumferential clasps manufactured by selective laser melting / 北京大学学报(医学版)

OBJECTIVE@#To compare the retentions of different designs of cobalt-chromium (Co-Cr), pure titanium (CP Ti), and titanium alloy (Ti-6Al-4V) removable partial denture (RPD) circumferential clasps manufactured by selective laser melting (SLM) and to analyze the stress distribution of these clasps during the removal from abutment teeth.@*METHODS@#Clasps with clasp arm size A (1.9 mm width/1.1 mm thickness at the body and 0.8-taper) or B (1.2 times A) and 0.25 mm or 0.50 mm undercut engagement were modeled on a prepared first premolar die, named as designs A1, A2, A3, and A4, respectively. The density and elastic modulus of SLM-built Co-Cr, CP Ti, and Ti-6Al-4V were measured and given to different groups of clasps. The density, elastic modulus, and Poisson ' s ratio of enamel were given to the die. The control group was the cast Co-Cr clasp with design A1, to which the density and elastic modulus of cast Co-Cr alloy were given. The Poisson's ratio of all metals was 0.33. The initial 5 N dislodging force was applied, and the maximum displacement of the clasp along the insertion path was computed. The load was reapplied with an increment of 5 N than in the last simulation until the clasp was completely dislodged. The retentive force range of different groups of clasps was obtained. The retentive forces of the SLM-built Co-Cr, CP Ti, and Ti-6Al-4V clasps with equivalent computed retentive force range to the control group were validated through the insertion/removal experiment. The von Mises stress distributions of these three groups of SLM-built clasps under 15 N loads were analyzed.@*RESULTS@#SLM-built Co-Cr, CP Ti, and Ti-6Al-4V clasps with designs B1 or B2, and Co-Cr clasps with design A2 had higher retentive forces than those of the control group. SLM-built CP Ti and Ti-6Al-4V clasps with design A1 had lower retentive forces than those of the control group. SLM-built Co-Cr clasp with design A1 and SLM-built CP Ti and Ti-6Al-4V clasps with design A2 had equivalent retentive forces to those of the control group. The insertion/removal experiment showed that the measured retentive forces of these three groups of SLM-built clasps were (21.57±5.41) N, (19.75±4.47) N, and (19.32±2.04) N, respectively. No statistically significant measured retentive force difference was found among these three groups of SLM-built clasps (P>0.05). The maximum von Mises stress of these three groups of SLM-built clasps exceeded their responding yield strength except for the Ti-6Al-4V one.@*CONCLUSION@#SLM-built Co-Cr circumferential clasps had higher retention than CP Ti and Ti-6Al-4V ones with the same clasp arm size and undercut engagement. The retention of SLM-built circumferential clasps could be adjusted by changing the undercut engagement and clasp arm size. If SLM-built circumferential clasps are used in clinical practice, the Ti-6Al-4V clasp with clasp arm size A and 0.50 mm undercut engagement is recommended considering the long-term use of RPD in the patient's mouth.

Consensos referidos a conceptos rehabilitadores en la enseñanza de la odontología. Parte I: conceptos generales y diseño de la prótesis parcial removible / Consensus referring rehabilitative concepts in the teaching of dentistry. Part I: general concepts and design of removable partial prosthesis

En este artículo se desarrolla el consenso alcanzado entre profesores, referido a los conceptos generales, componentes y la secuencia del diseño de la prótesis parcial removible, durante la formación del odontó-logo en el ámbito de la Facultad de Odontología de la Universidad de Buenos Aires (AU)

This article develops the consensus between professors on the general concepts, components, and the sequence of the design of the partial removable prosthesis during the training of the dentist in the field of the Faculty of Dentistry of the University of Buenos Aires (AU)

Reabilitação Oral com Prótese Obturadora em Comunicação Buconasal após Ocorrência de Carcinoma de Células Escamosas: Relato de Caso / Oral Rehabilitation with Filling Prosthesis in Bucconasal Communication after the Occurrence of Squamous Cell Carcinoma: Case Report / Rehabilitación Oral con Prótesis Obturatriz en Comunicación Oral tras la Aparición de Carcinoma Epidermoide: Reporte de Caso

Introdução: O tratamento de neoplasia maligna pode consistir em ampla excisão cirúrgica. Em alguns casos, em razão do tratamento agressivo na remoção do tumor, há grande comprometimento das estruturas intrabucais. Assim, próteses são utilizadas para a obturação da cavidade maxilar, possibilitando a reconstrução da região afetada, juntamente com a reabilitação oral. Relato do caso: Paciente de 53 anos de idade, sexo feminino, ex-tabagista e ex-etilista, apresentou diagnóstico de carcinoma de células escamosas na região de palato mole, sendo necessária cirurgia de ressecção transoral associada à radioterapia. Após aproximadamente um ano, a paciente retornou com nova lesão em palato, que novamente evidenciou carcinoma de células escamosas, sendo necessária nova cirurgia de ressecção transoral. Após dois anos, a paciente retornou ao Departamento de Odontologia a fim de receber o tratamento reabilitador, pois a prótese parcial removível superior era provisória, não substituía todos os dentes ausentes e não obtinha adaptação adequada à comunicação buconasal. Foi realizado tratamento reabilitador definitivo com prótese parcial removível superior e com prótese total no rebordo residual inferior. Conclusão: A necessidade do acompanhamento odontológico nos casos de ocorrência de carcinoma de células escamosas oral bem como a importância do tratamento reabilitador e suas técnicas contribuem para a autoestima e a qualidade de vida do paciente

Introduction: The treatment of malignant neoplasm may consist in extensive surgical excision. In some cases, due to aggressive treatment in the removal of the tumor, intraoral structures are strongly compromised. Thus, prostheses are used to fill the maxillary cavity, allowing reconstruction of the affected region, together with oral rehabilitation. Case report: A 53-year-old female patient, ex-smoker and ex-alcoholic was diagnosed with squamous cell carcinoma in the soft palate region, requiring transoral resection surgery associated with radiotherapy. After approximately one year, the patient returned with a new palatal lesion, also diagnosed as squamous cell carcinoma, requiring further transoral resection surgery. After two years, the patient returned to the Dentistry Department to receive the rehabilitative treatment, as she had only a temporary removable upper partial denture, where all the missing teeth were not replaced and there was poor adaptation to bucconasal communication. A final rehabilitative treatment was performed with upper partial removable denture and total prosthesis in the inferior residual ridge. Conclusion: The need for dental follow-up in cases of oral squamous cell carcinoma as well as the importance of rehabilitation treatment and its techniques contribute for the patient's self-esteem and quality of life

Introducción: El tratamiento de las neoplasias malignas puede consistir en una exéresis quirúrgica extensa. En algunos casos, debido a un tratamiento agresivo para extirpar el tumor, existe un gran compromiso de las estructuras intraorales. Así, las prótesis se utilizan para rellenar la cavidad maxilar, permitiendo la reconstrucción de la región afectada, junto con la rehabilitación oral. Relato del caso: Paciente femenina de 53 años, exfumadora y exalcohólica, que presentó el diagnóstico de carcinoma epidermoide en la región del paladar blando, que requirió cirugía de resección transoral asociada a radioterapia. Después de aproximadamente un año, la paciente regresó con una nueva lesión en el paladar, en la que también se le diagnosticó un carcinoma epidermoide, requiriendo una nueva cirugía de resección transoral. A los dos años, la paciente volvió al Departamento de Odontología para recibir tratamiento rehabilitador, ya que la prótesis parcial superior removible era temporal, no reponía todos los dientes faltantes y no obtenía una adecuada adaptación a la comunicación bucconasal. El tratamiento de rehabilitación definitivo se realizó con una dentadura postiza parcial removible superior y una dentadura total en el reborde residual inferior. Conclusión: La necesidad de seguimiento odontológico en los casos de carcinoma epidermoide oral así como la importancia del tratamiento rehabilitador y sus técnicas contribuyen a la autoestima y calidad de vida del paciente

Patients' Management Patterns for Restorative Treatment Procedures: A 4-Year Overview at the Restorative Clinic of a Tertiary Hospital in Nigeria

Abstract Objective: To determine the patients' management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients' management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.

Tooth Loss, Sociodemographic Conditions and Oral Health-Related Quality of Life in the Elderly

Abstract Objective: To verify the association between impacts produced by tooth loss and sociodemographic variables in the oral health-related quality of life (OHRQoL) in the elderly. Material and Methods: This is an analytical cross-sectional study carried out in the municipality of Vitória/ES, Brazil, which sample was composed of 402 older adults. The Oral Health Impact Profile (OHIP-14) was used to measure the individuals' OHRQoL. For data analysis, descriptive and bivariate analyses were performed using the Fisher's exact test and the Mantel-Haenzsel test to assess the effects of combined dimensions. The significance level adopted was 5%. To assess the strength of association between independent variables and dimensions, Odds-Ratio (OR) with 95% confidence interval (CI) was calculated. Results: The prevalence of negative impact on OHRQoL in the elderly was 32.6%. The greatest impact perception was found in individuals with up to 10 years of schooling (p=0.021 and OR=1.602), with need for removable partial dentures (p=0.000 and OR=2.873) and those who did not accept the loss of dental elements (p=0.000 and OR=3.064). Conclusion: Older female adults with socioeconomic class C/D-E, with up to 10 years of schooling, who lost 11 or more teeth, who declared the need for removable partial dentures, suffered greater impacts caused by tooth loss on OHRQoL.

Atención odontológica humanizada a un paciente con neurofibromatosis tipo 1 atendido en una clínica de odontología de especialización infantil: reporte de Caso / Humanized dental care for a patient with type 1 neurofibromatosis attended in a specialized children's dentistry clinic: case report / Atendimento odontológico humanizado a paciente com neurofibromatose tipo 1 atendido em ambulatório especializado de odontologia infantil: relato de caso

Este trabajo tiene como objetivo relatar el abordaje individualizado, inclusivo y humanizado de un niño de 4 años y tres meses, con diagnóstico de neurofibromatosis tipo 1, atendido en la Carrera de Especialización en Odontopediatría de la Escuela de Graduados, Facultad de Odontología, Universidad de la Repú blica, Montevideo, Uruguay. En el examen clínico se pudo observar cicatrices derivadas del tratamiento quirúrgico del neurofibroma plexiforme en la zona cervical y la presencia de hipotonicidad muscular oral. Al examen clínico intraoral, se observaron amplias zonas desdentadas a consecuencia de exodoncias de quince dientes deciduos. Presentaba lesiones activas de caries en los dientes remanentes, acompañado de biopelícula generalizada y sangrado gingival provocado. Se realizó un abordaje integral del paciente y la terapia rehabilitadora mediante el uso de prótesis parcial removible superior e inferior. Concluímos que el tratamiento odontológico educativo, preventivo, restaurador y rehabilitador fue satisfactorio y la empatía, como proceso dinámico, involucró mecanismos cognitivos, afectivos y conductuales, y fue reconocida por sus efectos positivos en la promoción de la salud bucal del paciente.

Este trabalho tem como objetivo relatar uma abordagem odontológica individualizada, inclusiva e humanizada, enfatizando a importância do tratamento de uma criança de 4 anos e três meses, com diagnóstico de neurofibromatose tipo 1, que foi encaminhada e tratada en la clínica de la Carrera de Especialización en Odontopediatria de la Escuela de Graduados, Facultad de Odontología, Universidad de la República. O exame clínico revelou cicatrizes decorrentes do tratamento cirúrgico do neurofibroma plexiforme que acometia o pescoço da criança e hipotonicidade muscular oral. Ao exame clínico intraoral, quinze dentes decíduos estavam ausentes e cinco com lesões de cárie na primeira infância, além de presença generalizada de biofilme microbiano nas superfícies dentais e sangramento gengival provocado. Foi realizado tratamento odontológico necessário ao paciente, com os devidos cuidados e terapia reabilitadora com prótese parcial removível superior e inferior. Concluímos que o tratamento odontológico educacional, preventivo, restaurador e reabilitador foi satisfatório e a empatia, como processo dinâmico, envolveu mecanismos cognitivos, afetivos e comportamentais e foi reconhecida por seus efeitos positivos na promoção da saúde bucal do paciente.

This paper aims to report an individualized, inclusive, and humanized dental approach, emphasizing the importance of treating a child aged four years and three months with neurofibromatosis type 1. The patient was referred and treated at the Clinic of the Specialization Course in Pediatric Dentistry of the Graduate School, School of Dentistry, Universidad de la República, Montevideo, Uruguay. The clinical examination revealed scars from the surgical treatment of the plexiform neurofibroma and neck and oral muscle hypotonicity. The intraoral clinical examination showed large edentulous areas as 15 deciduous teeth were missing. The patient had active carious lesions, generalized microbial biofilm on the tooth surfaces, and gingival bleeding. A comprehensive treatment was provided, as well as restorative therapy with upper and lower removable partial dentures. We conclude that the dental educational, preventive, restorative, and rehabilitation treatment was satisfactory. Furthermore, empathy, as a dynamic process, involved cognitive, affective, and behavioral mechanisms. It also helped enhance the patient's oral health.

Lesiones paraprotésicas en pacientes geriátricos portadores de prótesis removibles / Paraprosthetic lesions in geriatric patients with removable prostheses / Lesões paraprotéticas em pacientes geriátricos com próteses removíveis

RESUMEN Introducción: Los pacientes geriátricos portadores de prótesis removible con frecuencia presentan lesiones paraprotésicas que repercuten en su calidad de vida. Objetivo: Identificar los tipos de lesiones paraprotésicas en pacientes geriátricos portadores de prótesis removibles. Método: Se realizó un estudio observacional y descriptivo en 97 pacientes de cualquier sexo, mayores de 60 años, portadores de prótesis removible, que acudieron a la Clínica Estomatológica Docente Provincial "Dr. Justo Ortelio Pestana Lorenzo" de Sancti Spíritus, por presentar algún tipo de lesión en la mucosa bucal, desde enero de 2019 hasta febrero de 2020. Se utilizaron métodos del nivel teórico, empírico y estadístico-matemático para el estudio de las variables: edad, sexo, tipo de lesión. Resultados: El 49,5 % del universo correspondió a pacientes de 60 a 69 años y el 66 % del sexo femenino. Las lesiones paraprotésicas más frecuentes fueron la estomatitis subprótesis (55,6 %) y las úlceras traumáticas (31,9 %). Conclusiones: Las lesiones de la mucosa bucal asociadas al uso de prótesis removible fueron más frecuentes en las mujeres. La estomatitis subprótesis fue la lesión paraprotésica que predominó, seguida de la úlcera traumática y épulis fisurado.

ABSTRACT Introduction: Geriatric patients with removable prostheses often present paraprosthetic lesions that have an unfavorable impact on their quality of life. Objective: To identify the type of paraprosthetic lesions in geriatric patients with removable prostheses. Method: An observational and descriptive study in a total of 97 patients with removable prostheses, no specific sex, and over 60 years of age, was carried out. All patients studied were presented to the Clínica Estomatológica Docente Provincial "Dr. Justo Ortelio Pestana Lorenzo" in Sancti Spíritus, from January 2019 throughout February 2020, with any type of oral lesions. Theoretical, empirical and statistical-mathematical methods were used to study the following variables: age, sex, type of lesions. Results: The 49.5% of the total of patients studied were 60 to 69 years old and 66% were female. Most common paraprosthetic lesions found were the subprosthetic stomatitis (55.6%) and traumatic ulcers (31.9%). Conclusions: The oral lesions related to removable prostheses were most common in females. The subprosthetic stomatitis was the most predominant followed by the traumatic ulcer and fissured epulis.

RESUMO Introdução: Pacientes geriátricos com próteses removíveis freqüentemente apresentam lesões paraprotéticas que afetam sua qualidade de vida. Objetivo: Identificar os tipos de lesões paraprotéticas em pacientes geriátricos com próteses removíveis. Método: Foi realizado um estudo observacional e descritivo em 97 pacientes de ambos os sexos, maiores de 60 anos, com próteses removíveis, atendidos na Clínica Provincial de Ensino de Estomatologia "Dr. Justo Ortelio Pestana Lorenzo "de Sancti Spíritus, por apresentar algum tipo de lesão na mucosa oral, de janeiro de 2019 a fevereiro de 2020. Foram utilizados métodos de nível teórico, empírico e estatístico-matemático para estudar as variáveis: idade, sexo, tipo de lesão. Resultados: 49,5% do universo corresponderam a pacientes de 60 a 69 anos e 66% ao sexo feminino. As lesões paraprotéticas mais frequentes foram estomatite subprotética (55,6%) e úlceras traumáticas (31,9%). Conclusões: As lesões da mucosa oral associadas ao uso de próteses removíveis foram mais frequentes nas mulheres. A estomatite subprotética foi a lesão paraprotética predominante, seguida por úlcera traumática e epúlide fissurada.

Reabilitação prótetica convencional após remoção cirúrgica de hiperplasia fibrosa: relato de caso / Conventional prosthetic rehabilitation after surgical removal of fibrous hyperplasia: case report

O uso de próteses mal adaptadas pode ocasionar o surgimento de processos proliferativos não neoplásicos. A hiperplasia fibrosa inflamatória (HFI) é uma lesão benigna, proveniente de reação hiperplásica do tecido conjuntivo fibroso em resposta às injúrias crônicas de baixa intensidade. O objetivo do presente trabalho é relatar um caso clínico sobre remoção cirúrgica de HFI, seguida de reabilitação oral com próteses removíveis. Paciente de 75 anos do sexo masculino relatou que gostaria de fazer a troca da sua prótese, pois a mesma estava fraturada. Ao exame clínico intra-oral constatou-se que suas próteses possuíam higienização precária, e, a superior, possuía uma borda cortante que causou uma lesão hiperplásica na região de fundo de vestíbulo anterior. Quanto ao aspecto clínico, apresentava-se com consistência fibrosa e firme à palpação, de coloração semelhante a mucosa e assintomática. O plano de tratamento proposto foi reembasamento da prótese antiga com resina Soft Confort (Dencril, Brasil) eliminando as áreas que traumatizavam a mucosa, cirurgia pré-protética para a remoção da HFI, exame histopatológico e a confecção de novas próteses, sendo a superior prótese total convencional e a inferior prótese parcial removível. Observa-se a importância no cuidado do planejamento reabilitador protético dos pacientes, pois, como foi descrito neste caso, em algumas situações pode haver necessidade de lançarmos mão de diversas modalidades de tratamento prévias à reabilitação(AU)

The use of poorly adapted prostheses can lead to the emergence of non-neoplastic proliferative processes. Inflammatory fibrous hyperplasia (HFI) is a benign lesion, resulting from a hyperplastic reaction of fibrous connective tissue in response to low-intensity chronic injuries. The aim of the present study is to report a clinical case about surgical removal of HFI, followed by oral rehabilitation with removable prostheses. A 75-year-old male patient reported that he would like to change his prosthesis, because it was fractured. On intra-oral clinical examination, it was found that his prostheses had poor hygiene, and the upper one had a cutting edge that caused a hyperplastic lesion in the deep region of the anterior vestibule. As for the clinical aspect, it was fibrous and firm on palpation, mucosa-like and asymptomatic. The proposed treatment plan was to repurpose the old prosthesis with Soft Confort resin (Dencril, Brazil), eliminating the areas that traumatized the mucosa, pre-prosthetic surgery for the removal of HFI, histopathological examination and the making of new prostheses, the upper prosthesis being conventional total and the lower partial removable prosthesis. It is observed the importance in the care of the prosthetic rehabilitation planning of the patients, because, as it was described in this case, in some situations it may be necessary to resort to different treatment modalities prior to the rehabilitation(AU)

Effects of 3 kinds of processing techniques on the fitness of metal clasp / 中南大学学报(医学版)

OBJECTIVES@#At present, removable partial denture is still one of the main restoration methods for dentition defects. However, the trend for digital partial denture is becoming more and more obvious in the field of oral repair. However, there are relatively few studies on digital removable partial denture. The aim of this study is to investigate the effects of 3 processing technologies (precision casting, digital cutting, and 3D printing) on the fitness for the clasps of cobalt chromium alloy and pure titanium removable partial denture, and to provide a theoretical basis for the clinical application of digital removable partial denture.@*METHODS@#Clasps of Co-Cr alloy and pure titanium were produced by 3 different processing technologies (precision casting, digital cutting, and 3D printing). There are 6 groups, including a casting pure titanium group, a casting cobalt chromium group, a cutting pure titanium group, a cutting cobalt chromium group, a printing pure titanium group, and a printing cobalt chromium group (@*RESULTS@#There was no statistical difference in fitness between the casting pure titanium group and the casting cobalt chromium group (@*CONCLUSIONS@#The cobalt chromium alloy and pure titanium clasps made by precision casting, digital cutting, and 3D printing have good fitness. Under the same process, there is no significant difference between cobalt chromium alloy and pure titanium clasps. The 3D printing pure titanium clasps have better fitness than casting pure titanium and cutting pure titanium clasps, which meet the needs of clinical application.