ABSTRACT
BACKGROUND: The prosthetic treatment in cleft patients is challenging. Based on this, the aim of this study was to evaluate the longevity of prosthetic rehabilitation treatment with implant-supported overdenture (IOD) and implant-supported fixed denture (IFD) in cleft lip and palate patients in a period of 22 years. MATERIALS AND METHODS: The medical records of 72 patients were analyzed (29 males and 43 females), and the survival rate of the implants was evaluated. Moreover, the prostheses' time of use and the reason for the changing of these were also evaluated. RESULTS: Four-hundred-seventeen implants were installed, and 370 implants survive today. The mean survival time of the implants was 7.6 years. Regarding the 97 prostheses made, the time of average use was 3.28 for the IFDs and 3.92 for IODs. The reasons for the replacements of the prostheses were mainly: fracture of the acrylic base (29.6%) and loss of vertical dimension of occlusion (VDO) (18.5%) in the IFDs. Moreover, in IODs, these were accounted for the loss of VDO due to teeth damage (17.2%) and implant loss (14.6%). CONCLUSIONS: The maintenance of the prostheses was challenging because the patients had difficulties returning for periodic control, but this fact did not result in the decrease of the success rate of the implants. The longevity of implants and prostheses was satisfactory; however, the prostheses showed repetitions mainly due to the wear of the teeth, with decreased vertical dimension and fracture of acrylic base.
ABSTRACT
O objetivo deste trabalho foi relatar a taxa de sucesso de implantes unitários sob carga imediata em pacientes portadores de fissura labiopalatina no Hospital de Reabilitação de Anomalias Craniofaciais/USP, e as prováveis causas de falhas. Foram selecionados 21 pacientes que receberam implantes unitários com prótese provisória imediata entre os anos de 2005 e 2015, totalizando 23 implantes avaliados. Exame clínico foi realizado, associado a um exame radiográfico da área e preenchimento de ficha clínica individual com informações importantes para classificação dos implantes em bem-sucedidos ou malsucedidos. Para análise dos resultados, os dados foram submetidos à estatística descritiva. Três implantes foram perdidos, portanto, a taxa de sobrevivência foi de 86,95%. A taxa de sucesso foi de 82,6%, pois, além dos implantes perdidos, um apresentou alteração em um dos critérios de sucesso adotados no estudo (perda óssea maior que dois milímetros). Nos demais casos o sucesso foi alcançado. Concluiu-se que alguns fatores devem ser observados antes de submeter implantes unitários à carga imediata, como o comprimento do implante utilizado, o torque de inserção e seleção rigorosa do paciente. Quando o planejamento é bem realizado, o tratamento com implantes unitários sob carga imediata é uma opção eficaz que apresenta segurança e previsibilidade em pacientes com fissura labiopalatina (AU).
The aim of this study was to evaluate the survival and success rates of implants under immediate loading, installed in patients with cleft lip and palate in Hospital for Rehabilitation of Craniofacial Anomalies/USP. We have selected 21 patients who received single implants with immediate prosthesis between the years 2005 and 2015, totaling 23 implants evaluated. Clinical and radiographic examinations were performed, and an individual medical record was filled with information regarding the success or failure of the treatment. Data were submitted to descriptive statistics for analysis. Three implants were lost, and therefore the survival rate was 86.95%. The success rate was 82.6% because one implant had bone loss superior than two millimeters. All other cases the success was reached. We concluded that some factors must be observed before submitting single implants to immediate loading, such as the length of the implant; the ideal insertion torque; and rigorous patient selection. When the planning is well done, the treatment with single implants under immediate loading is an effective option for patients with cleft lip and palate (AU).
Subject(s)
Humans , Male , Female , Cleft Lip , Dental Implants, Single-Tooth , Dental Prosthesis Design/methods , Immediate Dental Implant Loading , Brazil , Evaluation Study , Radiography, Dental/instrumentationABSTRACT
Pacientes portadores de fissura labiopalatina possuem alterações anatômicas que dificultam o planejamento e a execução de tratamentos reabilitadores protéticos extensos. As próteses do tipooverdentures são indicadas principalmente diante de casos mais extremos de perdas ósseas, associados a relações maxilomandibulares bastante desfavoráveis. Essas próteses totais implantossuportadas confeccionadas para pacientes portadores de fissura labiopalatina podem possuir algumas alterações e apresentar dificuldades. O objetivo deste artigo é relatar alternativas para a confecção de próteses implantossuportadas no que diz respeito principalmente ao desenho da barra e posicionamento dos componentes de retenção (AU).
Patients with cleft lip and palate have anatomic discrepancies that may impair the appropriate planning and execution of extensive prosthetic treatments. Overdentures are indicated mainly for cases of severe bone resorption, associated with unfavorable antero-posterior maxillary relations. These total implant-supported prostheses for patients with clefts may need some alterations and present some difficulties. The aim of this paper is to report different ways to produce overdentures, specially related to the design of the bars and positioning of the retention components (AU).
Subject(s)
Humans , Male , Cleft Lip/pathology , Dental Prosthesis Design/methods , Dental Prosthesis/statistics & numerical data , Mouth Rehabilitation , Brazil , Radiography, Dental/instrumentationABSTRACT
A perda dos primeiros molares inferiores é um problema muito frequente, assim como a procura por tratamento ortodôntico com a intenção de se fechar os espaços dos dentes ausentes. Este trabalho tem como objetivo apresentar um caso clínico em que foi realizada a verticalização e mesialização de molares inferiores com ancoragem absoluta por meio de mini-implante associado à braços de força feitos com fios de TMA e elástico corrente. Foi demonstrado que é possível realizar o fechamento dos espaços desde que o paciente apresente condições biológicas favoráveis, eliminando assim, a necessidade de reabilitações protéticas.
Mandibular first molars loss is a very common problem, as the demand for orthodontic treatment with the intention of closing the spaces of missing teeth. This paper aimed at presenting a clinical case in which it was performed the verticalization and mesialization of the molars with absolute anchorage, using mini-implant associated with TMA cantilevers and elastic chain. It has been shown that it is possible to perform the space closure, since the patient presents favorable biological conditions, thereby eliminating the need for prosthetic rehabilitation.
Subject(s)
Humans , Female , Adult , Cephalometry , Molar , Orthodontic Anchorage ProceduresABSTRACT
The aim of this study was to evaluate halitosis parameters and sialometry in patients subjectedto head and neck radiotherapy compared to patients with periodontal disease, establishing arelationship between oral concentration of volatile sulfur compounds (VSCs) and tongue coatingpresence, salivary flow rate and BANATM test. Methods: Thirty-eight patients were examinedand divided into 2 groups: group I: patients with chronic generalized periodontal disease previouslydiagnosed and not treated; group II: patients subjected to head and neck radiotherapy. All volunteerswere subjected to halitosis measurements through a sulphide monitor, evaluation of tongue coatingweight, stimulated and non-stimulated sialometry and BANATM test. Results: The results wereanalyzed by analysis of the variance, Pearsons correlation coefficient and Students t-test, showingthat both groups presented halitosis. There was also a relationship between tongue coatingpresence and VSC levels in both groups and the irradiated patients showed lower salivary flowrates. Conclusions: Under the tested conditions, it may be concluded that halitosis can beconsidered as an adverse effect of radiotherapy, associated with low salivary flow and poor oralhealth, which seems to be the main contribution to bad breath, since patients with periodontaldisease also showed halitosis.
Subject(s)
Halitosis , Head and Neck Neoplasms , Periodontitis , RadiotherapyABSTRACT
The purposes of this study were to evaluate the rate of success of immediate or early loaded implants placed in congenital cleft alveolus in a reference Brazilian Public Service, and to investigate the probable causes of failures. All the immediately restoredosseointegrated implants installed from 1991 to 2010 at the Hospital for Rehabilitation of Craniofacial Anomalies (Bauru, SP, Brazil) were investigated. This search resulted in 281 patients, in whom 573 implants were installed. Only 10 fulfilled the following criteria: 1) single implants installed at the cleft alveolus (grafted or not) at least two years before the beginning of the study; 2) implants that had undergone to immediate or early load. Data about the patients and implants were collected from records of the patients and presented as percentage of well succeeded and failed implants. None of the implants failed. The implants have been in function for at least 58 months. Nine implants are in function for at least 5 years and one, for at least 10 years. It was concluded that rough surfaced titanium implants with proper dimensions installed in low density bone at the cleft region can receive immediate nonfunctional provisional restoration with satisfactory prognosis at medium and long-term as long as strict criteria is followed for case selection.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Cleft Palate , Dental Implants , Dental Prosthesis , PeriodonticsABSTRACT
OBJECTIVES: The aim of this study was to investigate the parameters of halitosis and sialometry in patients who had undergone head and neck radiotherapy, correlating oral concentration of volatile sulfur compounds (VSC) with the presence of tongue coating, salivary flow rate and BANA test. MATERIAL AND METHODS: 35 patients allocated in two groups were examined: group I (control)--patients with systemic and oral health; group II--patients submitted to head and neck radiotherapy. All volunteers were submitted to halitosis measurements through a sulphide monitor, evaluation of tongue coating weight, non-stimulated sialometry and BANA test. RESULTS: The results were analyzed through analysis of variance, Pearson®s correlation and Student's t-test, showing that there was statistically significant difference in halimetry between the groups, where the irradiated patients showed halitosis. There was a relation between the presence of tongue coating and the levels of VSCs in both groups and it was also noted that the irradiated patients showed a decreased salivary flow rate compared to healthy patients. CONCLUSION: On the conditions of the present research, it was concluded that halitosis can be considered an adverse effect of radiotherapy, connected to hiposalivation and poor oral health.
Subject(s)
Halitosis/etiology , Head and Neck Neoplasms/radiotherapy , Xerostomia/etiology , Humans , Radiotherapy/adverse effectsABSTRACT
Hereditary ectodermal dysplasia is an inherited disorder characterized by aplasia or dysplasia of ectodermal tissues, such as hair, nails, teeth, and skin, that occurs in approximately 1 in every 100,000 live births. Dental abnormalities and abnormal facial appearance are of major concern in childhood and adolescence, since they can restrict the individual socially and affect his or her self-confidence. Oral rehabilitation in the early stages of the patient's life may provide functional and esthetic restoration as well as safeguard psychologic health. This report presents the clinical procedures involved in the rehabilitation of a 10-year-old female patient with complete bilateral cleft lip and palate and ectodermal dysplasia.
