Does the Use of Surface Electromyography Could Improve Quality of Life among Patients Rehabilitated by Mandibular Overdentures on Different Attachments?

Abstract Objective: To analyze and compare changes of quality of life parameter among dental patients rehabilitated by the implant-supported overdentures with different attachment systems. Material and Methods: Forty-eight patients were recruited as a study cohort. The implant placement procedure was based on the results obtained by CBCT scanning and individualized surgical templates manufactured for correct implant placement. Each individual received two k3Pro Implants (Sure Type with 4.0 or 4.5 mm in diameter) at the intraforaminal area due to standard protocol of implantation provided by the manufacturer under local anesthesia. All patients were distributed between two groups based on the fact of using either Locator- or ball-attachments. Rank correlation was measured using Spearman correlation coefficient, while linear correlation was evaluated by Pearson correlation coefficient. Results: No statistically meaningful differences were noted regarding patients' distribution among groups considering age (p>0.05) and gender (p>0.05). Provided patient-level analysis demonstrated that increase of conventional full denture service time was positively correlated with escalation of OHIP-EDENT scores. The most prominent inter-correspondences were noted specifically between longevity of denture service and elevation of scores within "Functional limitation" (r=0.61; p<0.05), "Physical pain" (r=0.51; p<0.05) and "Physical disability" (r=0.57; p<0.05) subdomains. No statistically argumented regressions were noted between increase tendency of OHIP-EDENT scores and gender (p>0.05) or age (p>0.05) parameters. Conclusion: Significant improvements of quality of life measured with OHIP-EDENT were noted for both types of attachments compared to the pre-treatment situation independently of additionally provided surface electromyography-based alignment.

Utilização de implante estreito na reposição de incisivo lateral superior com espa‡o m‚sio-distal restrito – relato de caso / Use of narrow implant in replacement of the upper lateral incisor with space distal mesio restricted – case report

A reposição de incisivos laterais superiores utilizando implantes dentários ‚ um desafio para o implantodontista. Diversas são as causas da falta destes incisivos, dentre elas, traumas dentários, cáries ou agenesia dental que consiste em uma anomalia comum de desenvolvimento, gerando a ausência de elementos dentários. Frequentemente os incisivos laterais superiores apresentam dimensão mésio-distal reduzida, inferiores a 6 mm. Nestas situações, diversos fatores devem ser levados em consideração no momento do planejamento, dentre eles, o diâmetro do implante a ser utilizado, tipo de coneção protética do implante e tratamento de superfície do implante a fim de permitir uma ótima condição e estabilidade dos tecidos moles e duros peri-implantares. Sendo assim, o objetivo deste artigo ‚ apresentar um relato de caso clínico para substituição de um incisivo lateral superior com pouco espaço mésio-distal, em que se utilizou um novo sistema de implante AxiomTM (Anthogyr) com 2,8 mm de diâmetro e um sistema de conexão do tipo cone morse com provisionalização imediata. Os resultados estéticos e funcionais avaliando o ideal perfil de emergência, a qualidade dos tecidos peri-implantares e a distância intra-óssea foram excelentes. Tanto do ponto de vista clínico quanto biológico, o implante Anthogyr AxiomTM de 2,8 mm de diâmetro mostrou-se uma excelente alternativa para solucionar a ausência de incisivos laterais superiores com espaço mésio-distal restrito

The replacement of upper lateral incisors using dental implants is a challenge for implantologists. There are several causes of the lack of incisors teeth, among them, dental trauma, cavities or dental agenesis (a common abnormality of development resulting on the absence of teeth). It is common to observe upper lateral incisors with reduced mesio- -distal dimension (less than 6 mm). In these cases, several factors must be considered while planning the treatment: the diameter of the implant; abutment connection type; treatment of the implant surface treatment to enable stability of and peri-implant soft and hard tissue. Thus, the aim of this paper was to present a clinical case of replacement of a maxillary lateral incisor with reduced mesio-distal space, using a new implant system AxiomTM (Anthogyr) with 2.8 mm diameter and a cone morse connection system with provisional restoration. Ideal emergence profile, peri-implant tissue quality and intraosseous distance were evaluated and excellent results were observed. The Anthogyr AxiomTM implant of 2.8 mm diameter proved to be an excellent solution for the absence of maxillary lateral incisors with reduced mesio-distal space

Análise biomecânica de próteses implantossuportadas parafusadas e cimentadas por meio do método dos elementos finitos / Biomechanical analysis of screw and cement-retained implant-supported prostheses via the finite element method

As próteses implantossuportadas podem ser retidas por parafusos ou por meio de cimento. Um fator relevante que pode influenciar a opção por um dos dois tipos de retenção é o comportamento biomecânico supostamente distinto entre eles. Por meio do método dos elementos finitos 3D, foram comparadas as tensões e deslocamentos nos parafusos, implantes, abutments e no tecido ósseo periimplantar de próteses implantossuportadas parafusadas e cimentadas. Foram construídos dos modelos distintos, consistindo em uma prótese fixa metalocerãmica implantossuportada de três elementos, parafusada (PFP) ou cimentada (PFC) Inicialmente, os parafusos de retenção das próteses foram torqueados para se obter o valor da pré-carga. Em seguida, com o parafuso ainda tensionado, cargas verticais(100 N) e oblíquas (100N) foram aplicadas nos modelos...

A new portable vibrator for plaster pouring: effect on the marginal fit at cylinder-abutment

OBJECTIVE: The aim of this study was to test a new portable vibrator for plaster pouring (developed for this purpose), comparing the effect of its use on the accuracy of working cast of implant-supported restorations to the conventional vibrator. MATERIAL AND METHODS: From a master cast with 2 implants, 30 transfer moldings were made randomly and divided into three groups: Group I (GI): pouring performed in an outsourced dental laboratory with conventional plaster vibrator (10 casts), Group II (GII): pouring performed in the laboratory of the Federal University of Santa Catarina (UFSC) with conventional plaster vibrator (10 casts) and Group III (GIII): pouring performed with the portable vibrator fabricated for this study (10 casts). The position of the analogue and marginal adaptation of the infrastructure were verified by testing the single screw on the master model and on the working model. The measurement of misfit was blindly performed with a precision microscope and analyzing unit, Quadra-Check 200. The data were statistically analyzed by analysis of variance (ANOVA) and the Holm-Sidak test (α=0.05). RESULTS: Means±standard deviations were as follows: GI: 19.19±4.73 µm; GII: 21.72±5.41 µm; GIII: 13.5±2.39 µm (P<0.05), with GIII significantly lower as compared to the other groups. CONCLUSION: Within the limitations of this study, it was concluded that a greater accuracy of working cast was achieved when a portable vibrator was used for casting molds.

Intraoral framework pick-up technique to improve fit of a metal-resin implant prosthesis.

The achievement of passive fit is an important prerequisite for the prevention of complications in full-arch screw-retained implant prosthesis. With cemented prosthesis, the cementation compensates for the discrepancies in the cast framework, but the lack of retrievability seems undesirable. The aim of this paper is to propose a modified screw-retained prosthesis design for complete arch implant fixed rehabilitation. A technique for the fabrication of a full-arch metal-resin implant-supported screw-retained prosthesis is described. Cementation of the framework to the abutments intraorally improves the passivity of fit of the prosthesis on the implants. Maintenance of screw-access channels in the final prosthesis ensures retrievability. The metal-resin design allows for easy repair and maintenance. The prosthesis is cost-effective compared to conventional options and can be employed as a viable treatment alternative when considering metal-acrylic resin complete arch fixed prosthesis.

Porcelain application and simulation of firing cycle: effect on marginal misfit of implant-supported frameworks

Aim: Success of implant-supported prostheses is related to the frameworks’ passive fit, henceinaccuracies can generate stress, leading to bone resorption and rehabilitation failure. This study evaluated misfit levels of implant-supported frameworks after different coverage treatments.Methods: Twenty commercially pure titanium (CP Ti) frameworks were manufactured with 5Branemark type multi-unit abutments. Frameworks were distributed in two groups as follows: G1- porcelain application (n=10); G2 - porcelain firing cycle simulation (n=10). Using a traveling microscope, marginal misfit was measured before and after undertaking the techniques, following the single-screw test protocol. All data were submitted to ANOVA and Tukey’s test (p<0.05).Results: Initial marginal misfit values were not significantly different, but both groups presented significantly higher misfit values after treatment: G1: 233.99 ìm (p=0.0003); G2: 119.75 ìm(p<0.0001). In addition, G1 presented higher misfit than G2 (p<0.0001). Conclusions: Porcelain application promoted significantly higher increase of misfit, which indicates that such procedure should be considered on misfit analysis of implant-supported prostheses.

Abutment cerâmico para prótese individual metalfree sobre implante: parafusada ou cimentada - demonstração laboratorial e clínica / Ceramic abutment for metalfree individual protesis supported implant: screw or cement - demonstration laboratory and clinical

A crescente exigência estética por parte dos pacientes tem levado ao desenvolvimento de novos materiais e técnicas restauradoras. Dentro desses novos conceitos e recursos protéticos, os pilares cerâmicos vêm ganhando popularidade por possibilitarem a elaboração de próteses implantossuportadas livres de metal e assim viabilizarem uma situação estética mais favorável, principalmente quando comparados aos abutments metálicos. Suas propriedades mecânicas são confiáveis, e sua biocompatibilidade com os tecidos também, o que os tornam uma alternativa viável nas reabilitações protéticas em regiões onde a estética é fundamental. Sendo assim, o presente trabalho apresenta um novo abutment cerâmico com características que possibilitam a realização de próteses cimentadas ou parafusadas livres de metal, com a demonstração de uma sequência laboratorial e clínica de uma restauração implanto-suportada confeccionada sobre o pilar cerâmico Ceraprep®.

The increasing demand of aesthetic by the patients, has led to the development of new materials and restorative techniques. Within these new concepts and features prosthetic ceramic pillars are gaining popularity because they allow for the development of implant-supported prostheses free of metal and thus continue to permit a more favorable aesthetic situation, especially when compared to metal abutments. Their mechanical properties are reliable, and its biocompatibility with the tissues as well, which makes it a viable alternative in prosthetic rehabilitation in areas where aesthetics are critical. Therefore, this paper presents a new ceramic abutment with features that enable the use of bolted or cemented prostheses free of metal, with the demonstration of a sequence of clinical laboratory and an implant-supported restoration fabricated on the ceramic abutment Ceraprep®.

A six-year study of hydroxyapatite-coated root-form dental implants / Un estudio de seis años sobre implantes dentales de raíz con recubrimiento de hidroxiapatita

BACKGROUND: The effect of hydroxyapatite coating of dental implants is controversial. The long-term fate of hydroxyapatite-coated implants has been the subject of some criticism. PURPOSE: The aim of this retrospective study was to assess the clinical outcome of hydroxyapatite-coated cylindrical root-form endosseous Impladent dental implants (LASAK Ltd, Prague, Czech Republic) during a six-year course. METHODS: Three-hundred and ninety-one consecutively placed implants were used in 169 patients and followed for four to six years. Interval and cumulative success of implants and prostheses survival was tabulated. Marginal bone loss was measured RESULTS: Of the total number of implants, 98.5achieved initial osseointegration. The cumulative success was 98.3after one year, 97.0after three years, 92.8after five years and 90.4after six years. The prostheses survival at the end of the study was 100for fixed bridges totally supported by implants, 96.5for fixed bridges with combined implant and tooth support, 94.2for single crowns, 90.9for mandibular overdentures and 81.3for maxillary overdentures. Marginal bone loss averaged 2.4 +/- 0.8 mm at the end of five years. CONCLUSION: The success rate of the investigated hydroxyapatite-coated implants was comparable with the data presented in the literature and with the results of the similar implants without hydroxyapatite-coating. However, the marginal bone loss was of interest. Longer monitoring of the implants is necessary.

ANTECEDENTES: El efecto del recubrimiento de los implantes dentales con hidroxiapatita es un asunto controversial. El destino a largo plazo de los implantes recubiertos con hidroxiapatita ha sido objeto de críticas. PROPÓSITO: El objetivo de este estudio retrospectivo fue evaluar los resultados clínicos de los implantes dentales endo-óseos de raíz con recubrimiento de hidroxiapatita de la marca Impladent (LASAK Ltd., Praga, República Checa), durante el transcurso de seis años. MÉTODOS: Un número de 391 implantes colocados consecutivamente, fueron usados en 169 pacientes, y sujetos a seguimiento por un período de 4 a 6 años. Se tabuló el éxito de lo implantes – por intervalos y de forma cumulativa – así como la supervivencia de las prótesis. Se midió la pérdida de hueso marginal. RESULTADOS: El 98.5% de los implantes alcanzó óseo-integración en la fase inicial. El éxito cumulativo fue de 98.3% después de un año, 97.0% después de tres años, 92.8% luego de cinco años, y 90.4% tras seis años. La supervivencia de las prótesis al final del estudio fue de 100% para puentes fijos soportados totalmente por implantes, 96.5% para puentes fijos con combinación de soporte sobre dientes e implantes, 94.2% para coronas solas, 90.9% para sobredentaduras mandibulares, y 81.3% para sobredentaduras maxilares. La pérdida marginal de hueso tuvo un promedio de 2.4 ± 0.8 mm al final de los cinco años.CONCLUSIÓN: La tasa de éxito de los implantes recubiertos con HA investigados, resultó comparable a los datos presentados en la literatura, y a los resultados de implantes similares sin revestimiento de HA. Sin embargo, la pérdida marginal de hueso fue una alerta: se necesita monitorear los implantes por un período más largo de tiempo.