Résumé
Objective@#To explore an accurate method to obtain an intraoral model of patients with specific limited mouth opening (microstomia) due to systemic scleroderma.@*Methods@#This study followed medical ethics, and informed consent has been obtained from patients. A case of Ken's Type I mandibular dentition defect scleroderma with limited mouth opening was addressed with digital technology as the leading method combined with the traditional impression method of segmental impression. Individual trays were made based on the patient's left and right mandibular dentition, and segmented molds were obtained. Simultaneously, intraoral scanning was performed to obtain the morphological data of both the soft and hard tissues of the upper and lower mandibles. After each part of the model was obtained, the mandibular model was scanned and digitally aligned to form the final denture model, and the final removable partial denture was designed and made by computer aided design/computer aided manufacturing (CAD/CAM) technology. At the same time, combined with the literature, the diagnosis and treatment of removable partial denture in patients with limited mouth opening were retrospectively analyzed.@*Results@#The denture was well retained and achieved a good repair effect. The patients expressed satisfaction with the mastication efficiency and other functions of the denture. The findings of the literature review show that the integration of digital technology with the traditional impression method, along with computer fitting, can accurately obtain the patient's oral model and facilitate successful follow-up repairs. However, when the anterior mandibular dentition of the patient is absent, the margin of error is increased in this procedure, which deserves further exploration.@*Conclusion@#Utilizing digital technology as the leading method, combined with the traditional impression method of segmental impression, for the repair of dental defects in patients with limited mouth opening, has proven to be effective. Thus, patients report a positive medical experience with high satisfaction, indicating that this approach is worthy of clinical promotion.
Résumé
Objective@# To explore the application of digital technology in the restoration of partial edentulous patients with microstomia. @*Methods@# A patient with microstomia was presented and seeking for the restoration of her full edentulous in the upper jaw and partial edentulous in the lower jaw (Kennedy Ⅲ). A digital intraoral scanning was used to obtain digital impressions of soft and hard tissues in the oral cavity. Computer aided design and 3D printing technology were used to design and fabricate the metal framework. @* Results @#The patient had no difficulty to wear or take off the dentures. The maxillary and mandibular dentures showed good retention, stability, mastication function and articulation. There was no tenderness in the one week and one month′s follow-up. And the chewing efficiency was satisfactory@*Conclusion@#This case report successfully designed and fabricated mandibular removable partial dentures for patients with microstomia through intraoral scanning and 3D printing technology. Thus, this work provides a new method and idea for treating partial edentulous dentition with microstomia
Résumé
Introduction: Edentulism is an irreversible chronic condition that seriously affects the stomatognathic system. Consequently, determining its prevalence may contribute to prioritize preventive and rehabilitative oral health interventions. Objective: To determine the prevalence of partial edentulism according to the Kennedy and Applegate classification in patients attending the Dental Clinic at Universidad San Martín de Porres - Lambayeque Campus, Peru, in the years 2016 and 2017. Materials and methods: A descriptive, retrospective and cross-sectional study was designed. The study comprised 321 clinical records that previously underwent a quality control stage, which included a calibration process (k=0.86). The criteria and rules proposed by Kennedy and Applegate were applied to estimate the prevalence of edentulism in each jaw according to sex; tables of frequency distribution containing percentage results were used. Results: The highest prevalence of partial edentulism in the upper jaw corresponded to Class III (42.4%), followed by Class I (34.6%), and Class II (16.5%). In the lower jaw, the most prevalent were Class I (42.4%), Class III (36.4%), and Class II (15.6%). According to sex, Class III and Class I were the most prevalent in both females and males. Conclusion: Class III and I were the most prevalent in the upper jaw in both females and males; while in the lower jaw, Classes I and III were the most prevalent for both sexes.
El edentulismo se presenta como una alteración irreversible y crónica, que genera consecuencias en el sistema estomatognático, por lo cual es necesario conocer su prevalencia para priorizar intervenciones de salud bucal preventivas y de rehabilitación. Objetivo: Determinar la prevalencia de edentulismo parcial según la clasificación de Kennedy y Applegate en pacientes atendidos en la Clínica Odontológica de la Universidad San Martín de Porres - Filial Lambayeque, en los años 2016 y 2017. Material y Método: Se diseñó un estudio descriptivo, retrospectivo y transversal, con 321 historias clínicas que pasaron previamente por un control de calidad que incluyó un proceso de calibración (k=0.86). Para estimar la prevalencia de edentulismo en cada maxilar y de acuerdo al género, fueron aplicados los criterios y reglas de kennedy y Applegate, utilizando tablas de distribución de frecuencias con resultados porcentuales. Resultados: La mayor prevalencia de edentulismo parcial para maxilar superior corresponde a la Clase III con 42,4%, siguiendo en orden descendente la Clase I con 34.6% y la Clase II con 16.5%. En el maxilar inferior, la más prevalente fue la Clase I con 42,4%, continuando la Clase III con 36.4% y la Clase II con 15.6%. De acuerdo a género, resultaron más prevalentes la Clase III y la Clase I tanto para mujeres como para hombres. Conclusiones: Las clases III y I fueron las más prevalentes en el maxilar superior, tanto para género masculino como femenino; mientras que en el maxilar inferior, fueron las clases I y III las más prevalentes también para ambos géneros.
Sujets)
Humains , Mâle , Femelle , Mâchoire partiellement édentée/prévention et contrôle , Mâchoire partiellement édentée/rééducation et réadaptation , Pérou/épidémiologie , Santé buccodentaire , Épidémiologie Descriptive , Prévalence , Mâchoire édentée/prévention et contrôle , Mâchoire édentée/rééducation et réadaptationRésumé
ABSTRACT Rehabilitation of the partially edentulous anterior maxilla is considered one of the most difficult challenges for the restorative dentist due to the esthetic, functional and psychological implications. Implant-supported restorations provide an appealing treatment alternative that responds to today's patient expectations. The gold standard for this scenario has been the use of an implant-supported fixed partial denture with pontics that masks the soft tissue deficiencies, with acceptable esthetic results. However, nowadays patients are looking for individual single crowns since they believe that this type of restorations resemble the natural dentition, are easy to clean and floss. From the dentist perspective, they are easy to maintain and in case of prosthetic complications they can be repaired or changed without compromising the adjacent restorations. Three parameters have been identified that could guide the decision-making process when multiple adjacent implant supported restorations (MAISR) are selected as the treatment of choice: 1) Smile line 2) Inter-implant distance and tooth-implant distance 3) Patient's expectations and ability to clean.
RESUMEN La rehabilitación del maxilar anterior parcialmente edéntulo se considera uno de los retos más difíciles para el dentista restaurador debido a las implicaciones estéticas, funcionales y psicológicas. Las restauraciones apoyadas por implantes proporcionan una alternativa de tratamiento atractiva que responde a las expectativas actuales de los pacientes. El patrón de referencia en este contexto ha sido el uso de una prótesis parcial fija con implantes con pónticos para enmascarar las deficiencias de tejido blando, el cual ha tenido resultados estéticos aceptables. Sin embargo, hoy en día los pacientes están buscando coronas individuales ya que creen que este tipo de restauraciones se asemejan a la dentición natural y son fáciles de limpiar con cepillado e hilo dental. Desde la perspectiva del dentista, son fáciles de mantener y en caso de complicaciones protésicas pueden ser reparadas o cambiadas sin comprometer las restauraciones adyacentes. Se han identificado tres parámetros que podrían guiar el proceso de toma de decisiones cuando se seleccionan varias restauraciones compatibles con implantes adyacentes como el tratamiento de elección: 1) Línea de sonrisa 2) Distancia entre implantes y distancia de implante dental 3) Las expectativas del paciente y la facilidad de limpieza.
Sujets)
Rééducation buccale , Implants dentairesRésumé
Treatment options for partially edentulous patients are fixed partial denture, removable partial denture and implant supported fixed partial denture. In case of a patient with a few remaining teeth, removable partial denture and implant supported fixed prosthesis are available. For implant fixed prothesis, enough implant fixtures are required and the patient's general condition, local factors and economic status must be considered. When the condition of the abutments and the residual ridge is favorable and the prosthesis is well designed, removable partial denture can be an option. In removable partial denture, the bilateral support is important. If the teeth remain unilateral, harmful stress is put on the abutments by the fulcrum line. In this situation, strategic implantation and implant-retained or assisted removable partial denture is beneficial to the retention and support of the denture. And this can be cost-effective, functional and esthetic choice of treatment. This article describes the prosthodontic rehabilitation of Maxillary Kennedy class I partially edentulous patients. In these two cases, the patients had a small number of teeth and they were restored by the combination of a removable partial denture and dental implants.
Sujets)
Humains , Implants dentaires , Prothèse partielle fixe , Prothèse dentaire partielle amovible , Appareils de prothèse dentaire , Prothèses et implants , Prosthodontie , Réadaptation , DentRésumé
Os sistemas de classificação podem melhorar a comunicação entre os profissionais e facilitar a elaboraçãodo planejamento e prognóstico. Assim, o objetivo desse estudo foi de verificar topograficamente a prevalênciade espaços protéticos em arcadas parcialmente desdentadas, registradas em prontuários clínicos daFaculdade de Odontologia da Universidade Federal de Goiás no período de 1994 a 2004. Os resultadosevidenciaram um total de 1684 pacientes durante o período de avaliação, sendo 67,2% do sexo femininoe 32,8% do sexo masculino. A localização das arcadas parcialmente desdentadas foi de 55,3% na regiãoinferior e 44,7% na região superior. Houve uma prevalência de 58,1% de arcadas do tipo classe III, 21,3%de classe II, 18,5% de classe I e apenas 2,1% de arcadas desdentados do tipo classe IV.
Abstract: Classification systems for partial edentulism can improve the communication between cliniciansand facilitate the prognosis, diagnosis and selection of treatment. Thus, the aim of this study was to investigatethe prevalence of various classes of partially edentulous arches in patients attended at the Goias FederalUniversity, School of Dentistry, from 1994 to 2004. A total of 1684 clinical forms were reviewed. The resultsindicated that 67.2% were females and 32.8% were males. It was observed that 55.3% of the partially edentulousarches were in the lower jaw and 44.7% in the upper jaw.? There was a prevalence of 58.1% class IIIarches, 21.3% of class II, 18.5% of class I and only 2.1% of edentulous class IV arches.