Cambios en parámetros masticatorios con prótesis parcial removible para dientes posteriores perdidos / Changes in masticatory parameters with removable partial dentures for missing posterior teeth

Introducción: el reemplazo de dientes perdidos aspira a mejorar la función masticatoria. Aunque hay diferentes opciones para ello, la conveniencia de la prótesis parcial removible (PPR) es su bajo costo. Objetivo: comparar el desempeño masticatorio (DM) después de 20 ciclos masticatorios y al umbral de la deglución (UD) en adultos de 50 a 70 años con dientes posteriores perdidos (DPP), con/sin PPR; y los ciclos hasta la deglución. Material y métodos: estudio transversal en 35 adultos con dientes anteriores y PPR bien ajustadas y utilizadas para comer. El lado de prueba fue el lado con más DPP. El DM se evaluó después de 20 ciclos y al UD utilizando un alimento prueba artificial (Optosil Comfort®) con/sin la PPR en orden aleatorizado. Las partículas se tamizaron para determinar el tamaño medio de partícula (TMP) como medida del DM. Los ciclos se contaron visualmente. Estadística descriptiva y comparaciones con SPSS-v23. Resultados: hubo diferencias significativas (p ≤ 0.05) al masticar con/sin PPR. El TMP fue más pequeño (mejor DM) con la PPR después de 20 ciclos y al UD (3.9 vs 4.4 mm y 3.2 vs 4.2 mm). Los ciclos para llegar al UD disminuyeron con la PPR (40 vs 47). Conclusión: a pesar de una mejora limitada de la función masticatoria, las PPR ayudan a preparar los alimentos en partículas más pequeñas antes de deglutirlas. La mejoría en DM con PPR es de 24% al UD, realizando menos ciclos antes de deglutir sus alimentos (AU)

Introduction: replacement of missing teeth should improve masticatory function. Although there are different options removable partial dentures (RPD) are used due to their lower cost. Objective: to compare masticatory performance (MP) after 20 chewing-cycles and swallowing-threshold (ST) in 50-70 year-old adults with missing posterior teeth (MPT) with and without their cast-metal RPD; chewing cycles until swallowing were also compared. Material and methods: 35 adults participated in this cross-sectional study. Subjects with anterior teeth and welladjusted RPDs, used for eating were included. The side with more MPT was selected as the test side. MP was evaluated after 20 cycles and ST using an artificial test-food (Optosil Comfort®) with/without the RPD (subject-own-control) (randomized order). Chewed particles were sieved to determine medium-particle-size (MPS) as a measure of MP. Chewing cycles were visually counted. Descriptive statistics and comparisons were run with SPSS v23. Results: there were significant differences (p ≤ 0.05) for all parameters when chewing with/without the RPD. MPS was smaller (better MP) with the RPD (3.9 vs 4.4 mm and 3.2 vs 4.2 mm) after 20 cycles and ST respectively. Cycles required to reach ST were less when chewing with the denture (40 vs 47). Conclusion: despite a limited improvement of masticatory function RPDs help patients prepare their food into smaller particles before swallowing. Improvement in MP with RPDs for patients with MPT is 24% at ST and they perform fewer chewing cycles before swallowing food (AU)

Traditional versus simplified impression methods for complete dentures: critical appraisal of evidence / Método tradicional versus simplificado en impresiones para prótesis total removible: evaluación crítica de la evidencia Método tradicional versus simplificado

Abstract Introduction: Inspite of the great advances in dentistry, aging populations imply that there are still significant numbers of edentulous people worldwide. In most cases, implant-assisted prosthetic rehabilitation is the best solution. However, economic issues constrain access to this therapeutic approach, meaning that conventional removable prosthetics continue to be the most frequent treatment. In the removable denture making process, the so-called traditional method has been widely taught and used. It involves taking two impressions: a preliminary one followed by a definitive one (or functional). The simplified method constructs the prosthesis directly from the first impression obtained with a stock tray, without the need of a second impression. Purpose: To review the scientific evidence comparing both methods in terms of patient satisfaction, clinical quality, and masticatory performance and capacity. Results: No advantages have been found in favor of the traditional method regarding the four variables selected. Conclusions: According to the available information, the traditional method of taking impressions for complete removable dental prostheses does not provide significantly superior clinical results when compared to those obtained using the simplified method in terms of clinical quality, patient satisfaction, performance and masticatory capacity.

Resumen Introducción: Pese a los avances de la odontología, el fenómeno del envejecimiento de la población ha generado que la cantidad de personas desdentadas totales aún represente una cifra significativa. Los artificios protésicos implanto-asistidos constituyen, en la mayoría de los casos, la mejor alternativa rehabilitadora. Sin embargo, la variable económica surge como el principal impedimento para que los pacientes accedan a este recurso, y por este motivo, mantienen la prótesis total removible como una opción terapéutica. Para su confección, el método tradicional indica la necesidad de tomar dos impresiones: una preliminar y una definitiva o funcional. El método simplificado, confecciona la prótesis a partir de la primera impresión, obtenida con cubeta de stock. Objetivo: Revisar evidencia científica que compara ambos métodos en cuanto a las variables de: satisfacción del paciente, calidad clínica, rendimiento y capacidad masticatoria. Resultados: No se verifican ventajas a favor del método tradicional en relación a las variables estudiadas. Conclusiones: En concordancia con la información recabada, los resultados clínicos obtenidos mediante el método tradicional de toma de impresiones para prótesis totales no son significativamente superiores a los del método simplificado en relación a calidad clínica, satisfacción del paciente, rendimiento y capacidad masticatoria.

Evaluation of two interforaminal implants and implant-assisted removable dentures on stress distribution: an in vitro study

OBJECTIVES: In mandibular edentulism, the treatment option with a two-interforaminal implant-retained bridge and a removable partial denture is rarely evaluated in literature. The aim of this in vitro study was to evaluate the stress distribution of this treatment option by comparing it with traditional treatment options with interforaminal implants in the edentulous mandible. MATERIALS AND METHODS: Two interforaminal implants were placed in a formalin-fixed cadaver mandible, and overdentures with three different types of attachments were fabricated: (1) two ball attachments and an overdenture, (2) a Dolder bar and an overdenture, and (3) screw-retained two-implant inter-canine porcelain fused to a metal bridge and an implant-assisted removable denture (IARD) with precision attachments. Three biting conditions were generated for each denture type, and the strains were documented under vertical loading of 100 N. RESULTS: The calculated strain values from measured strains in all measurement sites and loading conditions for the screw-retained two-implant inter-canine porcelain fused to a metal bridge and a cast framework partial denture with precision attachments situation were lower than in the other scenarios (P<0.05). CONCLUSION: Within the limitations of the present study, it can be concluded that an IARD may be a reasonable and valuable alternative to ball attachments or a bar in two interforaminal implants, especially when the patients prefer to be able to show their teeth even when they take out their removable dentures.

Implant-assisted removable partial denture for severely atrophied mandible / 대한치과보철학회지

Mandible with severe alveolar bone atrophy poses a significant challenge in terms of reproducing clinically acceptable anatomy for a removable prosthesis. To overcome this potential complication, altered cast impression technique is often recommended to capture accurate and functional gingiva tissues. It becomes possible to get proper anchors functional impression by placing 2 implants crowns which were impossible in previous implant overdenture impression technique. In this case, an 80-year old female patient with severe mandibular ridge atrophy was treated with an implant-assisted removable partial denture with two implant crowns on the canine area. An altered cast impression was taken with an individual tray on a metal framework of removable partial denture on both posterior edentulous areas. The patient was satisfied with the final prosthesis after failure of 2 previous prostheses. Clinician had a difficult time to manage disabled patient and patient were suffered with ill-fitting denture due to inaccurate impression in conventional overdenture condition. The oral rehabilitation was completed with placing 2 implants as proper anchor.

Prosthetic treatment for patient with congenital bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture / 대한치과보철학회지

Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.

Rehabilitación oral en paciente con alteración de la dimensión vertical oclusal aplicando un enfoque multidisciplinario / Oral rehabilitation in patient with alteration of vertical dimension occlusal applying a multidisciplinary approach

El objetivo de éste caso clínico fue restaurar las funciones del sistema estomatognático mediante confección de prótesis convencional combinada, restableciendo de esta manera la dimensión vertical alterada. Caso clínico: Paciente de sexo masculino, 64 años de edad, edéntulo parcial superior clase II de Kennedy modificación 1 e inferior clase II de Kennedy, el motivo de consulta fue la atrición de las piezas dentarias antero superiores e inferiores evidenciando disminución de la dimensión vertical, se realizó tratamiento de conductos con fines protésicos; confección de espigos muñones y se restableció una dimensión vertical terapéutica a través de prótesis superior e inferior; para posteriormente lograr una rehabilitación definitiva mediante prótesis fija y prótesis parcial removible convencional. Las prótesis combinadas definitivas son los dispositivos protéticos que mantienen la dimensión vertical en el tiempo.

The aim in the present case report was re-establish stomatology system functions by conventional mixed dental prosthesis for recovering altered vertical dimension. Clinical case: A 64 years old male patient with upper partial edentulism, Kennedy class II-1 and also lower partial edentulism but Kennedy class II. Patient's chief complaint was dental wearing and an evident oclusal vertical dimension loss. Endodontic treatment was done focusing it in dental prosthetic rehabilitation. Thus therapeutic vertical dimension was reestablished with fixed and removal dental prosthesis. Later, definitive dental therapeutic rehabilitation was attained with fixed and conventional removable dental prosthesis. That mixed dental rehabilitation is an alternative which recovers and maintains oclusal vertical dimension through the time.

Traditional versus simplified impression methods for complete dentures: critical appraisal of evidence

Introduction: Inspite of the great advances in dentistry, aging populations imply that there are still significant numbers of edentulous people worldwide. In most cases, implant-assisted prosthetic rehabilitation is the best solution. However, economic issues constrain access to this therapeutic approach, meaning that conventional removable prosthetics continue to be the most frequent treatment. In the removable denture making process, the so-called traditional method has been widely taught and used. It involves taking two impressions: a preliminary one followed by a definitive one (or functional). The simplified method constructs the prosthesis directly from the first impression obtained with a stock tray, without the need of a second impression. Purpose: To review the scientific evidence comparing both methods in terms of patient satisfaction, clinical quality, and masticatory performance and capacity. Results: No advantages have been found in favor of the traditional method regarding the four variables selected. Conclusions: According to the available information, the traditional method of taking impressions for complete removable dental prostheses does not provide significantly superior clinical results when compared to those obtained using the simplified method in terms of clinical quality, patient satisfaction, performance and masticatory capacity.

Introducción: Pese a los avances de la odontología, el fenómeno del envejecimiento de la población ha generado que la cantidad de personas desdentadas totales aún represente una cifra significativa. Los artificios protésicos implanto-asistidos constituyen, en la mayoría de los casos, la mejor alternativa rehabilitadora. Sin embargo, la variable económica surge como el principal impedimento para que los pacientes accedan a este recurso, y por este motivo, mantienen la prótesis total removible como una opción terapéutica. Para su confección, el método tradicional indica la necesidad de tomar dos impresiones: una preliminar y una definitiva o funcional. El método simplificado, confecciona la prótesis a partir de la primera impresión, obtenida con cubeta de stock. Objetivo: Revisar evidencia científica que compara ambos métodos en cuanto a las variables de: satisfacción del paciente, calidad clínica, rendimiento y capacidad masticatoria. Resultados: No se verifican ventajas a favor del método tradicional en relación a las variables estudiadas. Conclusiones: En concordancia con la información recabada, los resultados clínicos obtenidos mediante el método tradicional de toma de impresiones para prótesis totales no son significativamente superiores a los del método simplificado en relación a calidad clínica, satisfacción del paciente, rendimiento y capacidad masticatoria.

Management of HIV/Aids Patients in Prosthodontics- A Current Prospective.

Human immunodeficiency virus (HIV) has been recognized as one of the most devastating infectious diseases of the century. Because of repeated exposure to the microorganisms present in blood and saliva, the incidence of certain infectious diseases has been significantly higher among dental professionals. HIV, Hepatitis B, Tuberculosis and Herpes simplex virus infections are well recognized and indicate the need for increased understanding of modes of disease transmission and infection control procedures. The purpose of this review is to provide brief awareness and understanding of the treatment options for the HIV (Human Immunodeficiency Virus) patient. Significant regulations and recommendations have been generated to lessen the chances of viral exposure during prosthetic procedures.

Associação entre implantes odontológicos e próteses parciais removíveis: revisão de literatura / Association between implants and removable partial dentures: review of the literature

Introdução: A prótese parcial removível de extremidade livre unilateral ou bilateral apresenta complexa biomecânica. Seus movimentos em diversas direções, juntamente com a forma do rebordo alveolar e a resiliência da fibromucosa, podem levar a forças danosas sobre as estruturas de suporte. A associação entre implantes e prótese parcial removível visa proporcionar melhores propriedades mecânico-biológicas ao sistema estomatognático. Objetivo: Realizar uma revisão de literatura e discussão quanto ao uso dessa alternativa de reabilitação. Revisão de literatura e conclusão: Estudos têm evidenciado que essa associação oferece maior suporte, retenção e estabilidade às próteses, limitando seu movimento de aproximação em direção aos tecidos de suporte e propiciando conforto funcional e psicológico aos pacientes.

Introduction: Unilateral or bilateral distal-extension removable partial dentures present complex biomechanics. The movements in different directions, associated with the alveolar ridge shape and soft tissue resilience can lead to damaging forces on the supporting structures. The association between implants / removable partial denture aims to provide better mechanical and biological properties to the stomatognathic system. Objective: The aim of this paper was to review the articles about the effect of implant support on distal extension removable partial dentures. Literature review and conclusion: Studies have shown that this combination provides greater support, retention and stability to the prosthesis, thus limiting their approach movement toward supporting tissues and providing functional and psychological comfort to patients.

A clinical study of improved occlusal reconstructions to partial denture arches with seriously interlaced occlusion / 中国基层医药

Objective To investigate the effective and inexpensive therapy to partial denture arches with seriously interlaced occlusion. Methods Occlusal reconstructions with fixed and removable prosthesis were taken to cure partial denture arches with seriously interlaced occlusion. Masticatory efficiency was measured and X-rays of Schillers position were taken before and after therapy. Results After therapy masticatory efficiency was raised. And the function of TMJ was better. Conclusion Occlusal reconstruction with fixed and removable prosthesis is an effective way to cure partial denture arches with seriously interlaced occlusion.

Dealing with dental implant failures

An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician’s efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

Occlusal reconstruction using casting occlusal splint removable denture 3 years clinical observation / 重庆医科大学学报

Objective:To analyze the reasons of the occlusal disorder after the loss of posterior teeth,trauma and serious wearing of teeth, and to observe the masticatory efficiency and the clinical changes of temporomandibular disorders after occlusal reconstruction using casting occlusal splint removable denture.Methods:The reasons of occlusal disorder were analyzed according to the case history and clinical examination of 73 patients.The casting occlusal splint removable denture was used to reconstruct the occlusal relationship.Masticatory efficiency was measured with the method of ATP particle capsule absorbing ultrasonic light before reconstruction,three months and five years after reconstruction.Results:Statistical analysis showed the significant difference before and after occlusal reconstruction with casting occlusal splint removable denture(P