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Alerta (San Salvador) ; 4(3): 125-119, jul. 29, 2021. ilus
Article in Spanish | LILACS, BISSAL | ID: biblio-1282982


La caries de la temprana infancia puede afectar severamente la dentición primaria que requiere tratamientos complejos y en ocasiones la extracción del diente afectado. Se presenta informe de caso sobre la rehabilitación dental integral de un paciente de 6 años, la evolución de su comportamiento y la mejora en su calidad de vida, autoestima e interacción social. El plan de tratamiento incluyó una fase de adaptación a la consulta odontológica, eliminación de caries, restauración dental, exodoncias y elaboración de dos prótesis removibles. Al inicio del tratamiento presentó temor y rechazo al tratamiento, pero con el avance del proceso rehabilitador odontológico y la evidencia de los resultados, el comportamiento del niño fue de aceptación y colaboración. Su evolución positiva de comportamiento se presentó también en sus relaciones sociales, aumentó la interacción con otras personas y su participación en juegos con otros niños. La rehabilitación protésica contribuyó a recuperar las funciones de masticación y fonación. La renovación de la estética dental produjo un significativo cambio de conducta, mejora en su autoestima con un impacto psicológico positivo en su calidad de vida

Early childhood caries can severely affect the primary dentition requiring complex treatments and sometimes the extraction of the affected tooth. A case report is presented on the comprehensive dental rehabilitation of a 6-year-old patient, the evolution of his behavior and the improvement in his quality of life, self-esteem and social interaction. The treatment plan included a phase of adaptation to the dental consultation, elimination of cavities, dental restoration, extractions and elaboration of two removable prostheses. At the beginning of the treatment, he presented fear and rejection of the treatment, but with the progress of the dental rehabilitation process and the evidence of the results, the child's behavior was one of acceptance and collaboration. Their positive behavior evolution was also present in their social relationships, increased interaction with other people and their participation in games with other children. Prosthetic rehabilitation contributed to recovering the functions of chewing and phonation. The renovation of dental aesthetics produced a significant change in behavior, an improvement in their self-esteem with a positive psychological impact on their quality of life

Child , Child Behavior , Pediatric Dentistry , Prosthodontics , Mouth Rehabilitation
Article in English | WPRIM | ID: wpr-887749


The correct implant site design and placement are the basic clinical techniques that must be known for implant restoration. For a long time, most implants have been placed by free hands, and the choice of site is mostly dependent on the accumulation of long-term experience of the surgeon. The selection of implant site guided by this experience analogy logic is often based on the surgeon's level of experience,which often makes it very easy to produce complications related to the implant restoration of the incorrect site. In contrast, a clinical program using digital guidance and real-time measurable verification has emerged based on the restoration-oriented implantation concept, which marks the formation of an accurate, measurable and verifiable whole-process digital implant prototype. Furthermore, from the perspective of surveying, the numerical requirements that digital implant restoration relies on are actually incomplete to the four elements of measurement, which leading to the doubts about its authenticity. This article will question the numbers in implant restoration, and conduct a preliminary demonstration, and propose a new reliable actual measurement and verification method of the correct location and the numerical requirements of the restoration space and a new clinical program that relies on numbers from the perspective of the evolution of digital restoration, guided implantology and actual measurement technology. And this article further discusses the current mainstream implant restoration technology based on experience analogy which cannot effectively support the whole process of digital implant restoration and provides a new logical cognitive basis for the final realization of the entire process of digital implant restoration.

Computer-Aided Design , Dental Implantation, Endosseous , Dental Implants , Humans , Prosthodontics
Chinese Journal of Stomatology ; (12): 318-323, 2021.
Article in Chinese | WPRIM | ID: wpr-879317


Tooth preparation is the primary and core operation technique for prosthodontics. Microscopic tooth preparation can improve the accuracy and efficiency of the operation. Experts from Society of Prosthodontics, Chinese Stomatological Association formulated the standard operating procedure for microscopic tooth preparation, so as to standardize its design points and operating procedures, highlight the difference between this novel technique and the traditional naked eye tooth preparation and promote the application of microscopic tooth preparation.

Asian Continental Ancestry Group , Humans , Oral Medicine , Prosthodontics , Reference Standards , Tooth Preparation
Article in English | WPRIM | ID: wpr-878448


OBJECTIVES@#To analyze the clinical performance of the intraoral digital impression (IDI) in the fixed prosthodontics.@*METHODS@#Databases of Medline (Ovid), EMBASE, Cochrane Central Register of Controlled Trials, and CNKI were searched for randomized controlled trial (RCT) on the use of IDI in fixed prosthodontics until May 2020. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. A Meta-analysis was conducted when available.@*RESULTS@#Eleven RCTs involving 618 patients were included in this study. A total of 2 and 3 studies had low and high risks of bias, respectively, and other included studies had a medium risk of bias. Results illustrated that the IDI group could shorten the impression-taken time [SMD=-5.63, 95%CI (-11.25, -0.01), @*CONCLUSIONS@#Evidence indicated a good clinical performance of IDI for fixed prosthodontics. Notably, high-quality studies are expected to further support the conclusion.

Dental Care , Humans , Prosthodontics
Article in English | WPRIM | ID: wpr-878403


Tooth preparation is a common operation in dental clinical practice. This procedure is irreversible and invasive from the point of view of tooth preservation. Conditions of the abutment tooth, treatment methods, and restoration materials for target restoration affect tooth preparation. To achieve the goals of tooth tissue preservation, dental pulp protection, and periodontal health, dentistry professionals agreed on the importance of minimizing the amount of tooth reduction. The foundations for realizing this consensus are as follows. First, the available restoration materials with improved comprehensive performance need less target restoration space. Next, teeth can be prepared under a digital guide, and the real-time measurement of restoration space can be verified due to the invention of digital technologies for the analysis of the quantity and shape of the prepared tooth and tooth measurement. Moreover, guiding methods for preparation have been developed from freehand operation under the naked eye based on accumulated personal experience to digital-guidance jointing microscope. These innovations indicate the creation of a prototype of guided prosthodontics that is precise and applies real-time measurement throughout the process of tooth preparation. From the perspective of the evolution of digital, guided, and micro prosthodontics, this article raised seven questions about the numerical value and quantitative data transfer of tooth preparation and evaluated the authenticity of existing numerical requirements from the perspective of the four elements of measurement. Identifying unified measuring methods and developing measuring tools with a precision of hundred or ten microns will be the key to solving the problem about the authenticity of numerical measurement. Furthermore, this paper summarizes the methods of how to control tooth reduction and explains in depth why the currently dominant tooth preparation technology, which is based on empiricism, cannot effectively achieve the goals in digital prosthodontics. Therefore, we strongly call for rebuilding the digital foundation of prosthodontic treatment immediately.

Prosthodontics , Tooth , Tooth Preparation
Braz. dent. sci ; 24(4): 1-10, 2021. tab, ilus, graf
Article in English | LILACS, BBO | ID: biblio-1293129


Objective: The purpose of this in vitro study is to evaluate the effect of four finish line configurations and two cement types on the fracture resistance of zirconia copings. Material and Methods: Forty yttrium tetragonal zirconia polycrystals copings were manufactured on epoxy resin dies with four preparation designs: knife edge, chamfer, deep chamfer 0.5, 1 mm and shoulder 1 mm. The copings were cemented with two cement types (glass ionomer and resin cement); (n = 5). Two strain gauges were attached on each coping before they were vertically loaded till fracture with a universal testing machine. Data were analyzed by 2-way analysis of variance ANOVA (p < .05). Fractured specimens were examined for mode of failure with digital microscope. Results: Knife edge showed the highest mean fracture resistance (987.04 ± 94.18) followed by Chamfer (883.28 ± 205.42) followed by Shoulder (828.64 ± 227.79) and finally Deep chamfer finish line (767.66 ± 207.09) with no statistically significant difference. Resin cemented copings had higher mean Fracture resistance (911.76 ± 167.95) than glass ionomer cemented copings (821.55 ± 224.24) with no statistically significant difference. Knife edge had the highest strain mean values on the buccal (374.04 ± 195.43) and lingual (235.80 ± 103.46) surface. Shoulder finish line showed the lowest mean strain values on the buccal (127.47 ± 40.32) and lingual (68.35 ± 80.68) with no statistically significant difference. Resin cemented copings had higher buccal (295.05 ± 167.92) and lingual (197.38 ± 99.85) mean strain values than glass ionomer copings (149.14 ± 60.94) and (90.27 ± 55.62) with no statistically significant difference. Conclusion: Vertical knife edge finish line is a promising alternative and either adhesive or conventional cementation can be used with zirconia copings (AU)

Objetivo: O objetivo deste estudo in vitro é avaliar o efeito de quatro configurações de términos cervicais e dois tipos de cimentos na resistência à fratura de copings de zircônia. Material e Métodos: Quarenta copings de zircônia tetragonal policristalina estabilizada por ítrio foram confeccionados em matrizes de resina epóxi com quatro tipos de términos cervicais: lâmina de faca, chanfro, chanfro largo 0,5, 1 mm e ombro 1 mm. Os copings foram cimentados com dois tipos de cimento (ionômero de vidro e cimento resinoso); (n = 5). Dois extensômetros foram fixados em cada coping antes de serem carregados verticalmente até a fratura com uma máquina de teste universal. Os dados foram analisados por análise de variância ANOVA 2 fatores (p < 0,05). Os espécimes fraturados foram examinados quanto ao modo de falha com microscópio digital. Resultados: A Lâmina de faca apresentou a maior média de resistência à fratura (987,04 ± 94,18) seguida pelo Chanfro (883,28 ± 205,42), pelo Ombro (828,64 ± 227,79) e finalmente o Chanfro largo (767,66 ± 207,09), sem diferença estatisticamente significativa. Os copings cimentados com cimento resinoso apresentaram maior média de resistência à fratura (911,76 ± 167,95) em relação aos copings cimentados com ionômero de vidro (821,55 ± 224,24), sem diferença estatisticamente significativa. A lâmina de faca apresentou os maiores valores médios de deformação na superfície vestibular (374,04 ± 195,43) e lingual (235,80 ± 103,46). O término em ombro apresentou os menores valores médios de deformação na superfície vestibular (127,47 ± 40,32) e lingual (68,35 ± 80,68), sem diferença estatisticamente significativa. Os copings cimentados com resina apresentaram maiores valores médios de deformação na superfície vestibular (295,05 ± 167,92) e lingual (197,38 ± 99,85) do que os copings cimentados com ionômero de vidro (149,14 ± 60,94) e (90,27 ± 55,62), sem diferença estatisticamente significativa. Conclusão: O término cervical em lâmina de faca é uma alternativa promissora e a cimentação adesiva ou convencional pode ser usada na cimentação de copings de zircônia. (AU)

Prosthodontics , Zirconium , Cementation , Tooth Preparation , Flexural Strength
Braz. oral res. (Online) ; 35: e049, 2021.
Article in English | LILACS, BBO | ID: biblio-1153616


Abstract: The objective of this review is to identify preventive measures for COVID-19 to safeguard dental professionals providing prosthodontic dental care. Electronic searches were performed in PubMed, Scopus, and Cochrane databases using the following descriptors and/or words: "COVID-19," "SARS-CoV-2," "Dental practice," "Prosthodontics," and "Dental infection control." Prosthodontists are at high risk for exposure to the novel coronavirus through aerosols and possibly contaminated surfaces and indirect contact with dental laboratories and dental technicians through impressions, dental stone casts, and fixed and removable prosthetic appliances. Therefore, preventive measures should be implemented, including performing emergency treatments only, rescheduling patients with suspected disease, disinfecting surfaces and prosthodontic materials with biocidal substances, and using protective equipment such as N95 masks, disposable gowns, and face-shields.

Humans , Pandemics/prevention & control , COVID-19 , Prosthodontics , Dentists , SARS-CoV-2
J. oral res. (Impresa) ; 9(1): 63-71, feb. 28, 2020. graf, tab
Article in English | LILACS | ID: biblio-1151505


Optimal flexural strength is a critical prerequisite for prosthetic frameworks. This study aimed to assess the flexural strength of polyether ether ketone (PEEK) polymer compared to a base metal alloy and high-strength Zirconia ceramic commonly used in prosthodontic treatments. Materials and Methods: In this in vitro, experimental study, 10 bar-shaped samples measuring 18×5×2mm were fabricated of each the PEEK polymer, nickel-chromium base metal alloy and zirconia ceramic. Half of the samples in each group were subjected to 5000 thermal cycles between 5°C - 55°C with 20 seconds of dwell time and 20 seconds of transfer time to simulate oral conditions. All samples then underwent three-point bending test. Two-way ANOVA followed by Tukey's test were applied to compare the mean flexural strength of the groups with and without thermocycling at 0.05 level of significance. Results: The flexural strength of base metal alloy, Zirconia and PEEK was 1387.70±45.50 MPa, 895.13±13.99 MPa and 192.10±5.37 MPa, respectively. The difference was significant among the groups (p<0.001). Thermocycling had no significant effect on the flexural strength of samples in any group (p=0.306). Conclusion: PEEK high-performance polymer had a lower flexural strength than base metal alloy and Zirconia ceramic, and its flexural strength was not affected by thermocycling. PEEK seems to be able to resist masticatory forces in the oral cavity pending further in vitro and clinical studies.

La resistencia a la flexión óptima es un requisito previo crítico para los marcos protésicos. Este estudio tuvo como objetivo evaluar la resistencia a la flexión del polímero de poliéter éter cetona (PEEK) en comparación con una aleación de metal base y cerámica de Zirconia de alta resistencia comúnmente utilizada en tratamientos de prostodoncia. Materiales and Métodos: En este estudio experimentalin vitro, se fabricaron 10 muestras en forma de barra de 18 × 5 × 2mm de cada polímero PEEK, aleación de metal base de níquel-cromo y cerámica de circonio. La mitad de las muestras en cada grupo fueron sometidas a 5000 ciclos térmicos entre 5°C - 55°C con 20 segundos de tiempo de permanencia y 20 segundos de tiempo de transferencia para simular condiciones orales. Todas las muestras se sometieron a una prueba de flexión de tres puntos. Se aplicó ANOVA bidireccional seguido de la prueba de Tukey para comparar la resistencia a la flexión media de los grupos con y sin termociclado a un nivel de significancia de 0.05. Resultados: La resistencia a la flexión de la aleación de metal base, Zirconia y PEEK fue de 1387,70 ± 45,50 MPa; 895,13 ± 13,99 MPa y 192.10 ± 5,37 MPa, respectivamente. La diferencia fue significativa entre los grupos (p<0,001). El termociclado no tuvo un efecto significativo sobre la resistencia a la flexión de las muestras en ningún grupo (p=0,306).Conclusión:El polímero de alto rendimiento PEEK tiene una resistencia a la flexión más baja que la aleación de metal base y la cerámica de circonio, y su resistencia a la flexión no se vio afectada por el termociclado. PEEK parece ser capaz de resistir las fuerzas masticatorias en la cavidad oral, con la necesidad de más estudios in vitroy clínicos.

Humans , Prosthodontics/methods , Zirconium/chemistry , Flexural Strength , Biocompatible Materials , In Vitro Techniques , Composite Resins , Dental Materials , Dental Stress Analysis
Braz. j. oral sci ; 19: e209191, jan.-dez. 2020. tab
Article in English | LILACS, BBO | ID: biblio-1177426


Aim: To analyze the stress distribution at the peri-implant bone tissue of mandible in full-arch implant-supported rehabilitation using a different number of implants as support. Methods: Three-dimensional finite element models of full-arch prosthesis with 3, 4 and 5 implants and those respective mandibular bone, screws and structure were built. ANSYS Workbench software was used to analyze the maximum and minimum principal stresses (quantitative analysis) and modified von Mises stress (qualitative analysis) in peri-implant bone tissue after vertical and oblique forces (100N) applied to the structure at the cantilever site (region of the first molars). Results: The peak of tensile stress values were at the bone tissue around to the distal implant in all models. The model with 3 implants presented the maximum principal stress, in the surrounding bone tissue, higher (~14%) than the other models. The difference of maximum principal stress for model with 4 and 5 implants was not relevant (~1%). The first medial implant of the model with 5 implants presented the lower (17%) stress values in bone than model with 3 implants. It was also not different from model with 4 implants. Conclusion: Three regular implants might present a slight higher chance of failure than rehabilitations with four or five implants. The use of four implants showed to be an adequate alternative to the use of classical five implants

Prosthodontics , Dental Implants , Finite Element Analysis , Mouth Rehabilitation
Rev. Cient. CRO-RJ (Online) ; 4(1): 107-113, Jan.-Apr. 2019.
Article in English | LILACS, BBO | ID: biblio-1024347


Introduction: Alveolar bone loss in posterior regions of the mandible is a serious limiting factor for the installation of osseointegrated dental implants. New surgical procedures are needed to circumvent the lack of vertical bone. Objective: The objective of this study was to present an alternative technique for dental implants in the lateral posterior region of the mandible in patients with severe vertical ridge atrophy Case Reports: Four patients with the specific anatomical characteristics that met the requirements of the technique were selected. Six implants were inserted buccally to the mandibular canal and were restored after at least two months of healing time. The mean follow up period of the implants was 3 years. No implant was lost during this time. All of them remained in excellent clinical condition and met the aesthetic criteria and functional demands of occlusion. Conclusion: The technique presented here proved to be minimally invasive, safe, conservative and effective as an alternative treatment option for dental rehabilitation in mandibular posterior regions with severe bone atrophy. However, it requires experience, preparation and skill of the professional in order not to damage the inferior alveolar nerve and at the same time install the implant in the correct position, thus allowing its functional and aesthetic rehabilitation.

Introdução: A perda óssea alveolar severa em região posterior de mandíbula é um sério fator limitante para instalação de implantes dentários osseointegráveis. Novas técnicas cirúrgicas são necessárias visando contornar a falta de osso vertical. Objetivo: O objetivo deste estudo foi apresentar uma técnica alternativa de inserção de implante dentário na região posterior lateral da mandíbula em pacientes com atrofia vertical severa de rebordo alveolar. Relatos de casos : Foram selecionados 4 pacientes com características anatômicas específicas que atendiam aos requisitos da técnica. Seis implantes foram instalados lateralmente ao canal mandibular por vestibular e foram restaurados após o tempo de cicatrização de pelo menos dois meses. A média da avaliação de seguimento do implante foi de 3 anos. Nenhum implante foi perdido e todos eles atenderam às exigências estéticas e funcionais da oclusão, estando em ótimas condições clínicas. Conclusão: A técnica mostrou-se minimamente invasiva, segura, conservadora e eficaz como alternativa de tratamento para reabilitação dentária em regiões posteriores de mandíbula com atrofia óssea severa. Entretanto, ela requer experiência, preparo e habilidade do profissional que visa não lesionar o nervo alveolar inferior e, ao mesmo tempo, instalar corretamente o implante em uma posição que permita sua restauração funcional e estética.

Prosthodontics , Dental Implants , Alveolar Bone Loss , Dental Implantation, Endosseous , Alveolar Process , Mandible
Braz. j. oral sci ; 18: e191573, jan.-dez. 2019. ilus
Article in English | LILACS, BBO | ID: biblio-1095166


Aim: This study evaluated the mechanical behavior of implant-supported crowns obtained by different fabrication technique after thermomechanical cycling. Methods: Thirty-two external hexagon dental implants were divided into four groups (n=10): CC ­ conventional casting with torch; EI ­ electromagnetic induction casting; PL ­ plasma casting; and CAD-CAM ­ milling through computer-aided design and computer-aided manufacturing. Vickers microhardness of the specimens were made before and after the thermomechanical cycling, and then subjected to fracture load. Fracture pattern was evaluated. Results: No significant difference was observed comparing the microhardness before and after thermomechanical cycling. CAD-CAM group presented significant lower microhardness than the other groups. No significant statistical difference was showed on fracture load between the groups. The CAD-CAM and PL presented lower number of failure by plastic deformation. Conclusion: The manufacturing techniques affected the mechanical behavior and the failure pattern of implant-supported crowns tested

Prosthodontics , Dental Implants , Computer-Aided Design
Article in English | LILACS, BBO | ID: biblio-1052030


Introdution: Immediate implants placement has shown contradictory results inthe posterior region. Objective: The aim of the study was to compare the successrate and predictability of the short-term treatment using immediate implants inanterior and posterior regions. Methods: A total of 1000 dental charts wereanalyzed, of which 43 were included in the study: anterior (n=20) and posterior(n=23). The inclusion criteria were: tooth extraction indication, immediate single-tooth implant placement and at least twelve months of follow-up with functionalimplant. The success rates were based on the criteria I. and II. from the healthscale for dental implants proposed at the International Congress of Oral ImplantDentistry: no pain; no mobility, until 4 mm of bone loss, no exudate. P-value <0.05was considered significant. Results: The total success rate of immediate implantswas 97.7% for immediate implants in function for at least 12 months. The use ofbiomaterial (p=0.03) and temporary prosthesis (p<0.0001) were significantly higherin the anterior group. There was no significant difference in implant failure betweengroups (p=0.47). There was no statistical difference between the groups, consideringage, sex, extraction reason, initial torque immediately following implantplacement, treatment time and implant platform type (p> 0.05). Conclusion: Itmay be concluded that the anterior and posterior regions present a high short-term success rate when the immediate implant technique was used.

Introdução: A utilização de implante imediato em regiões posteriores temapresentado resultados contraditórios. Objetivo: O objetivo deste estudo foicomparar o índice de sucesso e previsibilidade à curto prazo de implantes imediatosinstalados em regiões anterior e posterior. Métodos: Um total de 1000 prontuáriosforam analisados, dos quais 43 foram incluídos neste estudo: Anterior (n=20) eposterior (n=23). Os critérios de inclusão foram: Indicação de extração dentária,instalação de implantes imediatos unitários, no mínimo doze meses de segmentocom implante funcional. Os critérios de sucesso foram baseados na escala desaúde dos implantes dentários do Congresso Internacional de Implantologia Oral,eixo I. e II.: ausência de dor, ausência de mobilidade, ausência de exudato e perdaóssea de até 4 mm. Valor de p<0.05 foi considerado estatisticamente significante.Resultados: O índice de sucesso dos implantes imediatos foi de 97,7% paraimplantes em função por pelo menos 12 meses. O uso de biomaterial (p=0,03) eprótese provisória (p<0,0001) foi significantemente maior em região anterior.Não foi encontrado diferença significante quanto a falha dos implantescomparando os dois grupos (p=0,47). Não houve diferença estatisticamentesignificante entre os grupos, considerando a idade, gênero, motivo da extração,torque inicial, tempo de tratamento e tipo de plataforma do implante (p>0,05).Conclusão: Pode-se concluir que as regiões anterior e posterior apresentaramalta taxa de sucesso a curto prazo quanto a técnica de implante imediato.

Prosthodontics , Dental Implants , Dental Implantation
Article in English | WPRIM | ID: wpr-764385


BACKGROUND: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. METHODS: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). RESULTS: For all groups, the duration of dental treatments was 43 ± 18 minutes, total sedation time was 73 ± 23 minutes, and total BIS values was 57 ± 12. The propofol maintenance dosage values for each group were: mental retardation, 3 ± 0.5 (2–4) µg/ml; autism, 3.1 ± 0.7 (2–5) µg/ml; brain lesion, 2.8 ± 0.7 (1.5–5) µg/ml; genetic disease, 2.9 ± 0.9 (1–4) µg/ml; and dementia 2.3 ± 0.7 (1–3.4) µg/ml. CONCLUSIONS: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.

Anesthesia, General , Autistic Disorder , Brain , Consciousness , Deep Sedation , Dementia , Dental Clinics , Hemodynamics , Humans , Intellectual Disability , Methods , Minor Surgical Procedures , Periodontics , Propofol , Prosthodontics , Retrospective Studies , Seoul
Article in English | WPRIM | ID: wpr-764382


The effectiveness of dental implants in patients with disability, who are non-compliant during treatment, is controversial because of their poor oral health. Thus, oral health-care and management in such patients is concerning. Moreover, limited information is available on prognosis after implant placement. Herein, we describe a patient with schizophrenia who underwent dental implantation under multiple inductions of general anesthesia (5 times) and required conservative treatment and tooth extraction for multiple dental caries and retained roots because of inadequate oral health-care. Postoperatively, fracture of the prosthodontics and progression of dental caries were observed, and with 3 additional inductions of general anesthesia, conservative treatment, implant surgery, and prosthesis implantation were conducted. Postoperative 12-month follow-up since the last prosthesis implantation showed successful results. For patients with schizophrenia, multiple implantation can reduce horizontal bone loss and achieve aesthetic results compared to treatment with removable prosthodontics and could serve as an alternative treatment modality.

Anesthesia, General , Dental Caries , Dental Implantation , Dental Implants , Follow-Up Studies , Humans , Oral Health , Prognosis , Prosthesis Implantation , Prosthodontics , Schizophrenia , Tooth Extraction
Article in Korean | WPRIM | ID: wpr-761459


PURPOSE: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. MATERIALS AND METHODS: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The Kaplan-Meier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. RESULTS: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. CONCLUSION: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications

Dentists , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Medical Records , Methods , Mucositis , Proportional Hazards Models , Prostheses and Implants , Prosthodontics , Retrospective Studies , Risk Factors , Survival Rate , Tooth
Article in English | WPRIM | ID: wpr-761423


PURPOSE: To evaluate the effect of periodontal and prosthodontic therapy on glycated hemoglobin A(HbA1c) level in patients with diabetes. MATERIALS AND METHODS: This is a retrospective study of 70 patients suffering from diabetes who visited the Kyungpook National University Hospital between January 2016 and May 2018. Patients underwent medical evaluation for their routine check-up, which includes laboratory test for HbA1c levels. Among the 70 patients, 35 patients also visited Kyungpook National University Dental Hospital during the same period to receive periodontal and prosthodontic therapy, while the other 35 patients did not receive such therapy. The HbA1c levels were compared before and after periodontal and prosthodontic therapy. Comparisons between groups and within groups were performed using independent t-test. RESULTS: The HbA1c levels in the group who have received periodontal and prosthodontic therapy decreased from 7.2 to 6.7 (P=.001). The HbA1c levels in the control group decreased from 7.2 to 7.1 (P=.580). The difference in changes between the two patient groups was statistically significant (P=.011). CONCLUSION: Periodontal and prosthodontic therapy can be effective on glycemic control in patients with diabetes.

Diabetes Mellitus , Glycated Hemoglobin A , Humans , Periodontal Diseases , Prosthodontics , Retrospective Studies
Article in Korean | WPRIM | ID: wpr-742097


At the department of prosthodontics, the elderly patients with severely atrophied alveolar ridge who have been wearing complete dentures for a long period frequently visit the clinic. In general, the open-mouth impression technique for manufacturing a mandibular complete denture to secure primary support on buccal shelf area has been prevalent. In addition, for securing retention and stability of mandibular denture, we should consider diagnosis, oral function, denture border, occlusal plane, teeth arrangement, and patient training, etc.. But in edentulous patients with severe alveolar bone atrophy, it may hardly secure retention and stability of mandibular complete denture. To promote these, some of clinicians are making an attempt manufacturing the mandibular complete dentures using closed-mouth impression technique based on several reports that compare various impression techniques including open-mouth and closed-mouth impression technique. This case report suggests closed-mouth impression technique may promote retention and stability of mandibular complete denture and compares between the two impression techniques clinically.

Aged , Alveolar Bone Loss , Alveolar Process , Dental Occlusion , Denture, Complete , Dentures , Diagnosis, Oral , Humans , Jaw, Edentulous , Prosthodontics , Tooth
Biosci. j. (Online) ; 34(6): 1796-1804, nov.-dec. 2018. ilus
Article in English | LILACS | ID: biblio-968979


The increase in life expectancy occurred along an increase in the demand of edentulous patients for a type of rehabilitation that provides higher masticatory efficiency. Thus, implant overdentures using the ball/o-ring and bar-clip attachment systems represent a muco-supported and implant-retained prosthetic type that allows greater security, stability, and aesthetics, besides presenting a lower cost and easier hygiene. The present study aims to report a clinical case of overdenture with the o-ring retention system. In this case, the patient complained of difficulties during mastication due to instability of the mandibular complete denture, sensitivity from the superficialization of the mental foramina, dissatisfaction with aesthetics, and successive dislocations of the mandibular condyle. After clinical and radiographic evaluation, the treatment proposed was the installation of two osseointegrated implants between the mental foramina and the o-ring attachment overdenture. This prosthetic rehabilitation presents a successful clinical follow-up of 24 months, confirming the effectiveness of the treatment applied. The patient was satisfied because the implant-retained prosthesis provided benefits related to aesthetics, comfort, phonation, and mastication. It is noted that the rehabilitation performed has solved the patient's initial complaints. After the clinical case and literature review, it is concluded that overdentures using the o-ring retention system are viable alternatives and provide adequate function and aesthetics, presenting integration with the stomatognathic system.

Com o aumento da expectativa de vida, houve também o aumento da procura dos pacientes edêntulos por uma forma reabilitadora que lhes proporcione maior eficiência mastigatória. Sendo assim, as sobredentaduras sobre implantes utilizando sistemas de encaixe bola/o'ring e barra-clip representam modalidade protética mucossuportada e implantorretida que possibilita maior segurança, estabilidade e estética, além de apresentarem menor custo e facilidade para higienização. O presente trabalho tem por objetivo relatar um caso clínico de overdenture que utiliza o sistema de retenção o'ring. Neste caso, a paciente queixava-se de dificuldades durante a mastigação devido à instabilidade da prótese total inferior, sensibilidade pela superficialização dos forames mentuais, insatisfação com a estética, além de sucessivas luxações do côndilo mandibular. Após avaliação clínica e radiográfica, o tratamento proposto foi a instalação de dois implantes osseointegráveis entre os forames mentuais e overdenture com encaixes do tipo o'ring. A reabilitação protética em questão apresenta um acompanhamento clínico bem sucedido de 24 meses, comprovando a eficácia do tratamento instituído. A paciente demonstrou estar satisfeita, pois a prótese implanto-retida possibilitou benefícios relacionados à estética, conforto, fonação e mastigação. Nota-se que a reabilitação realizada atendeu às queixas iniciais da paciente. Após a realização do caso clínico e revisão de literatura, conclui-se que overdentures que utilizam o sistema de retenção o'ring são alternativas viáveis e que promovem função e estética adequadas, integrando-se ao sistema estomatognático.

Prosthodontics , Dental Implants , Dental Prosthesis , Denture, Overlay , Denture Precision Attachment
Biosci. j. (Online) ; 34(6): 1824-1834, nov.-dec. 2018. ilus, graf
Article in English | LILACS | ID: biblio-968982


One of greatest challenges of dentists is the rehabilitation of free-end Kennedy class I and class II patients due to the improper occurrence of stress around the supporting structures of conventional removable dentures during mastication. This work aimed to compare the stress distribution in different prosthetic solutions. For this analysis, four photoelastic models (PM) were produced simulating a Kennedy class I arch with the remaining teeth 34 through 44. In all models, teeth 33, 34, 43, and 44 received metal crowns. In addition to the crowns, the A model (PMA) received a conventional removable partial denture (RPD), the B model (PMB) received a RPD associated with a semi-rigid attachment, the C model (PMC) received a RPD associated with a rigid attachment, and the D model (PMD) received a RPD associated with implant and rigid attachment. Evenly distributed loads were applied on the last artificial tooth of the prostheses. Based on the results of the distributed load, the conventional prosthesis presented the best results for all regions (averages ranging from 25.70 to 17.80), followed by the prosthesis associated with the implant, the prosthesis associated with the rigid attachment, and lastly, the prosthesis associated with the semi-rigid attachment. The same result can be observed in the localized load, where the conventional prosthesis presented superior results in all regions (averages ranging from 47.35 to 8.30), followed by the prosthesis associated with the implant, the prosthesis associated with the rigid attachment and, with the prosthesis associated with the semi-rigid attachment. Based on the data obtained, it may be concluded that the conventional RPD presented a balanced stress distribution in the three regions analyzed, and when associated with the semi-rigid attachment, it presented a more favorable behavior than that associated with the rigid attachment.

Um dos maiores desafios para os cirurgiões-dentistas consiste na reabilitação de pacientes com extremidade livre classe I e classe II de Kennedy, devido à ocorrência inadequada de tensão em torno das estruturas de suporte das próteses removíveis convencionais durante o processo da mastigação. O objetivo deste trabalho foi analisar comparativamente a distribuição de tensão em diferentes soluções protéticas. Para essa análise, foram confeccionados quatro Modelos Fotoelásticos (MF) simulando um arco classe I de Kennedy, e tendo como dentes remanescentes do dente 34 ao 44. Em todos os modelos, os dentes 33, 34, 43 e 44 receberam coroas metálicas. Além das coroas, o modelo A (MFA) recebeu uma Prótese Parcial Removível (PPR) convencional, o modelo B (MFB) recebeu uma PPR associada a encaixe semirrígido, o modelo C (MFC) recebeu uma PPR associada a encaixe rígido e o modelo D (MFD) recebeu uma PPR associada a implante e encaixe rígido. Foram aplicadas cargas uniformemente distribuídas e localizadas no último dente artificial das próteses. Baseado nos resultados da carga distribuída, a prótese convencional apresentou os melhores resultados para todas as regiões (médias variando entre 25,70 e 17,80), seguida da prótese associada ao implante, a prótese associada ao encaixe rígido e, finalmente, com a prótese associada ao encaixe semirrígido. O mesmo resultado pode ser observado na carga localizada, onde a prótese convencional apresentou resultados superiores em todas as regiões (médias variando entre 47,35 e 8,30), seguida da prótese associada ao implante, a prótese associada ao encaixe rígido e, finalmente, com a prótese associada ao encaixe semirrígido. Baseado nos dados obtidos pôde-se concluir que a PPR convencional apresentou uma distribuição equilibrada de tensões nas três regiões analisadas e, quando associado à fixação semi-rígida, apresentou um comportamento mais favorável do que aquele associado à fixação rígida.

Denture, Partial, Removable , Prosthodontics , Tooth, Artificial , Dental Implants , Dentures , Dental Prosthesis