Systemic Health Characteristics and Self-Reported Xerostomia among Nursing Facility Residents in Iowa-US and Sao Paulo-Brazil / Saúde Sistêmica e Xerostomia Auto-Reporada entre Residentes em Instituições de Longa Permanência em Iowa-EUA e São Paulo-Brasil

Objective: To describe and compare potential differences in systemic health characteristics and xerostomia among residents in American and Brazilian nursing facilities (NF). Material and Methods: This secondary analysis used data from a study in NF located in Iowa-USA (n=81) and Sao Paulo (SP)-Brazil (n=119). Recorded data included demographics, medications, comorbid conditions, and self-reported xerostomia. Results: The Iowa group mean age was 82.1 years (±12.9), 60.5% were females, and 100% were white, whereas the SP group mean age was 76.4 years (±8.7), 47.9% females, most participants identified as either white (42.0%) or as more than one race (45.4%). The median number of comorbid conditions and medications in the Iowa were 9 and 12, respectively, as compared to 2 and 6 in SP. Most common comorbidities in Iowa were hypertension, dementia (including Alzheimer), and depression. In SP, they were hypertension, unspecified diabetes mellitus (including type 2), and Parkinson. Most common prescription medications in Iowa were acetaminophen, acetylsalicylic acid, and magnesium hydroxide, while in SP, they were omeprazole, acetylsalicylic acid, and losartan. Xerostomia was reported by 32.1% (Iowa) and 59.7% (SP) of the participants. There was no association between age and dry mouth sensation in either Iowa (p=0.480) or SP (p=0.130) samples. However, there was an association between total medications and dry mouth sensation in Iowa (p=0.040), but not in SP (p=0.075) Conclusions: Iowans presented with higher numbers of comorbidities and prescription medications, however xerostomia was reported in a greater percentage in SP. Xerostomia was associated to higher number of medications in Iowa, but not in SP.(AU)

Objetivo: Descrever e comparar possíveis diferenças nas características de saúde sistêmica e xerostomia entre residentes em instituições de longa permanência (ILP) americanas e brasileiras. Materiais e Métodos: Esta análise utilizou dados de um estudo em ILPs localizadas em Iowa/EUA (n = 81) e São Paulo/Brasil (n = 119). Os dados avaliados incluíram dados demográficos, medicamentos, comorbidades e xerostomia autoreportada. Resultados: A idade média do grupo de Iowa foi de 82,1 anos (± 12,9), 60,5% eram do sexo feminino e 100% eram brancos, enquanto a idade média do grupo SP foi de 76,4 anos (± 8,7), 47,9% do sexo feminino, a maioria dos participantes identificados como brancos ( 42,0%) ou como mais de uma raça (45,4%). A média do número de comorbidades e medicamentos em Iowa foi de 9 e 12, respectivamente, em comparação com 2 e 6 em SP. Comorbidades mais comuns em Iowa foram hipertensão, demência (incluindo Alzheimer) e depressão. Em SP, foram hipertensão, diabetes mellitus (incluindo o tipo 2) e Parkinson. Os medicamentos de prescrição mais comuns em Iowa eram acetaminofeno, ácido acetilsalicílico e hidróxido de magnésio, enquanto em SP, foram omeprazol, ácido acetilsalicílico e losartana. A xerostomia foi reportada por 32,1% dos participantes em Iowa e 59,7% em SP. Não houve associação entre idade e sensação de boca seca nas amostras de Iowa (p = 0,480) ou SP (p = 0,130). No entanto, houve associação entre o total de medicamentos e a sensação de boca seca em Iowa (p= 0,040), mas não em SP (p = 0,075). Conclusões: Os residentes de Iowa apresentaram maior número de comorbidades e prescrição de medicamentos, porém a xerostomia foi relatada em maior percentual em SP. A xerostomia foi associada ao maior número de medicamentos em Iowa, mas não em SP.(AU)

Dentists' perceptions and barriers to provide oral care for dependent elderly at home, long-term care institutions or hospitals

Aim: The aim of this study was to assess the perceptions and barriers to providing oral health care for the dependent elderly in unconventional settings as reported by dentists in the State of São Paulo, Brazil. The Brazilian elderly population is rapidly growing, and a larger elderly population implies an increasing number of dependent elderly patients. Therefore, investigating the perceptions and barriers reported by dentists for caring for these patients becomes important. Materials and methods: An online survey was sent by e-mail to dentists of a metropolitan area in the State of São Paulo, Brazil. Results: The response rate was 3.65% (n = 125). Only 14.4% of respondents offered home care to the elderly. Lack of experience or training (60.7%) and the small number of home visits (42.9%), were the main reported barriers to providing care for the dependent elderly. Most of the respondents (82.4%) agreed that the age of the patient did not influence their decision to provide care, and 96.8% agreed that delivering care to the elderly could be a rewarding experience. Conclusion: Few respondents offered care to the elderly and some of the most relevant factors considered in the decision to offer care were, experience and training, personal satisfaction and having gerodontology as a stand-alone course during dental school

Sleep bruxism associated with obstructive sleep apnea syndrome in children.

AIMS: Sleep bruxism (SB) and obstructive sleep apnea syndrome (OSAS) are often observed in children and may have several health implications. The aim of this paper is to evaluate their prevalence and to test for possible associations between these two conditions. METHODOLOGY: The sample consisted of 496 children randomly selected among the preschoolers of Taubaté, Brazil; 249 (50·2%) were boys and 247 (49·8%) were girls. Diagnoses of SB and OSAS were made by clinical examinations and questionnaires filled out by the children's parents in a cross-sectional design. Analysis of variance and Chi-square tests were applied to verify possible association among the variables in question. RESULTS: The average age was 4·49 years (SD: ±1·04 years). A total of 25·6% were diagnosed with SB, while 4·83% were diagnosed with OSAS, and only 2·82% presented both conditions. A statistical association was found between SB and OSAS (P<0·001; Chi-square test): 11·03% of subjects with SB also presented with OSAS, and 97·18% of subjects without SB did not present with OSAS. No association was found among children's gender and age and the presence of SB or OSAS. CONCLUSIONS: Within the limits of this study, SB was associated with OSAS.

Patients' Evaluations of Complete Denture Therapy and Their Association with Related Variables: A Pilot Study.

PURPOSE: Patient satisfaction is an important goal in complete denture therapy, and many factors influence this parameter. This study aimed to evaluate expectations before and satisfaction after therapy with complete dentures. As a secondary objective, other variables that may interfere with patient satisfaction were also evaluated. MATERIAL AND METHODS: A representative sample of 99 patients assigned visual analog scale (VAS) scores to their expectations before and satisfaction after therapy regarding chewing, esthetics, comfort, and phonetics. Demographic data and answers to a questionnaire concerning the dentists' conduct were recorded. Multiple linear regression was used to evaluate the association among studied variables and patients' expectation and satisfaction with their dentures. RESULTS: The average VAS scores were high for both expectations and satisfaction, and satisfaction exceeded expectations. Patients' expectations about esthetics and comfort were associated with age and self-reported time of using complete dentures. Patient satisfaction regarding chewing was associated with the number of postdelivery adjustments. Also, patient satisfaction regarding esthetics was associated with gender and esthetic expectations. In regard to phonetic satisfaction, associations were verified among self-reported time of using complete dentures, comfort and phonetics expectations, and dentists' explanations. Comfort satisfaction was associated only with educational level. CONCLUSIONS: Patient satisfaction regarding complete dentures exceeded expectations and an expressive majority of positive evaluations of the dentists was noticed. Many patient-related variables seemed to influence their evaluations of their dentures.

Patients' Expectation Before and Satisfaction After Full-Arch Fixed Implant-Prosthesis Rehabilitation.

This study evaluated patients' expectation before and satisfaction after full-arch fixed implant-prosthesis rehabilitation. Other variables that could influence patient satisfaction with this therapy were also evaluated. Using a visual analog scale (VAS), a sample of 28 patients assigned scores for their expectation before and satisfaction after therapy regarding chewing, esthetics, comfort, and phonetics. They also completed a questionnaire concerning their evaluation of the dentists' conduct. The average VAS scores were high for both expectation prior to treatment and satisfaction after treatment, and there was no statistical difference between them. Women presented higher expectations than men regarding esthetics (P = 0.040), phonetics (P = 0.043) and comfort (P = 0.013). Significant differences were not found between VAS scores with clinical variables (arch, radiographic bone quality, surgical bone quality, and implant inclination), educational level, and patients' evaluation of the dentists' conduct. Considering the results obtained in this study, expectation before implant-supported, full-arch fixed prosthesis therapy were met following treatment, with women having higher expectations than men.

Factors influencing patients’ satisfaction with complete dentures: a qualitative study / Fatores que influenciam a satisfação dos pacientes com prótese totais: estudo qualitativo

Objective: The treatment most used worldwide for edentulism is conventional complete dentures, and the most important factor for the success of denture treatment seems to be patient satisfaction. The present study aims to use a qualitative approach to investigate factors that were previously associated with patient satisfaction with dentures by quantitative techniques (correlational studies). Material & Methods: twenty patients (12 women and 8 men, age 59-87) participated in open and semi-structured interviews, both pre- and post-treatment. All the interviews were recorded, listened to, and transcribed verbatim, after which the content was analyzed thematically. Results: for most respondents, tooth loss represented, first of all, difficulty chewing and eating. Some patients have not accepted the loss of their teeth and felt sadness and shame. Other patients have adapted to their dentures, through acceptance. Regarding expectations, patients expressed very high expectations, especially for the stability and adjustment of dentures, and also for a better appearance. The majority of respondents showed great satisfaction with treatment outcomes; their expectations were met, and the dentures did provide functional benefits. Patients also believed that a trusting relationship between the dentist and the patient plays a fundamental role in treatment outcomes, and they reported that currently dentists are more open to dialogue with their patients. Conclusion: confidence between the dentist and the patient plays a fundamental role in their evaluation of the treatment outcomes.

Objetivo: O tratamento mais utilizado em todo o mundo para o edentulismo são as próteses totais convencionais, e o fator mais imporatante para o sucesso desta terapia parece ser a satisfação do paciente. Este estudo tem como objetivo utilizar uma abordagem qualitativa para investigar os fatores que foram previamente associados (em estudo quantitativos) com a satisfação dos pacientes com as próteses totais. Material e Métodos: vinte pacientes (12 mulheres e 8 homens, entre 59 e 87 anos de idade) participaram em entrevistas abertas e semiestruturadas, tanto antes quanto após o tratamento. Todas as entrevistas foram gravadas, ouvidas e transcritas, e o conteúdo foi analisado tematicamente. Resultados: para a maioria dos indivíduos, a perda dos dentes representa, antes de tudo, dificuldade em mastigar e comer. Alguns pacientes não aceitaram a perda do dentes, e sentiam-se tristes e envergonhados. Outros pacientes adaptaram-se às próteses, por meio da aceitação. Os pacientes expressaram expectativas bastante altas, especialmente quanto à estabilidade e adaptação das próteses e também quanto à aparência. A maioria dos pacientes demonstrou grande satisfação com os resultados do tratamento, suas expectativas foram atendidas e as próteses ofereceram benefícios funcionais. Os pacientes também acreditam que uma relação de confiança com o dentista é de fundamental importância para o resultado do tratamento. Os pacientes reportaram ainda que atualmente os dentistas são mais abertos ao dialógo com os pacientes. Conclusão: a confiança entre o dentista e o paciente tem papel fundamental na avaliação dos pacientes quanto ao resultado da terapia.

Patients' expectation and satisfaction with removable dental prosthesis therapy and correlation with patients' evaluation of the dentists.

OBJECTIVE: Considering that patients' satisfaction is one of the most important goals in conducting removable dental prosthesis (RDP) therapy and the fact that there are many factors which influence this parameter, the present study aims to evaluate the expectation before and satisfaction after therapy with RDP in patients who seek such therapy. As a secondary objective, other variables that may be associated with patient satisfaction are also evaluated, such as gender, age, Kennedy's classification of the arch supporting the RDP, the number of RDP adjustments after delivery and patients' evaluation of the dentists' conduct. MATERIALS AND METHODS: A sample of 44 patients who received RDP therapy were assigned visual analog scale scores for their expectation before and satisfaction after therapy regarding chewing, aesthetics, comfort and phonetics. They also completed a questionnaire concerning the dentists' conduct. RESULTS: There was no statistically significant difference among scores concerning different genders, age, number of post-delivery settings and arch involved in the RDP. Regarding patients' evaluation of the dentists' conduct, there was a predominance of positive evaluations, but only different answers to the statement (i.e. 'The dentist I saw thoroughly explained the recommended treatment before it commenced') present statistically significant different scores for chewing (p = 0.040) and phonetics (p = 0.046). CONCLUSIONS: The average visual analog scale scores were high for both expectation prior to treatment and satisfaction after treatment; however, the scores for expectations were higher than those for satisfaction.

Incidence of sleep bruxism among children in Itanhandu, Brazil.

PURPOSE: Sleep bruxism (SB) in children may be related to headaches and causes extensive damage of primary teeth. This paper evaluates the incidence of SB in children from Itanhandu, MG, Brazil. METHODS: The presence of teeth wear facets was verified through clinical examinations on a sample of children, whose parents answered a questionnaire about their children's behavior and habits. Analysis of variance and chi-square tests (p = 0.05) were applied to identify possible correlations between the presence of SB and the parents' responses to the questionnaire. RESULTS: The sample comprised of 170 children, 51.76% (n = 88) of which were girls, while the average age was 4.37 (±1.69) years. A total of 15.29% (n = 26) had been diagnosed as bruxers, 46.47% displayed restless behavior, and only 10% used medication. The average duration of breastfeeding was 4.4 (±0.25) months. A positive correlation was found between restless behavior and the presence of SB (p < 0.001). No correlation was found between SB and medication (p = 0.573), or between the duration of breastfeeding and restless behavior (p = 0.102), SB (p = 0.565) and medication (p = 0.794). CONCLUSION: Restless behavior was positively correlated with SB, although no correlation was found between SB and medication or duration of breastfeeding.

Establishing a stable centric position using overlays.

The masticatory system's ability to function depends on the distribution of occlusal contacts to promote mandibular stabilization. The patient in this case report was experiencing temporomandibular dysfunction, which was treated by creating an adequate bite plane using indirect composite resin restorations (overlays) made from a wax-up. This therapy made it possible to improve esthetics as well as centric and excursive mandibular occlusion without the need for drilling.

Prótese total implanto-suportada para a maxila: considerações clínicas / Clinical tips: full maxillary bridge supported by implants

A procura por tratamentos reabilitadores com implantes vem crescendo continuamente, visto que as próteses convencionais, principalmente nos casos onde a perda de elementos dentais é maior, não são adequadas quanto a alguns aspectos, como retenção e estabilidade. Fato este que diminui a capacidade mastigatória do paciente, influenciando também o seu convívio social, no qual a falta de retenção das próteses leva os pacientes a não se sentirem seguros para conversar com outras pessoas. Neste trabalho, é relatado um caso de reabilitação com prótese do tipo protocolo sobre seis implantes na maxila, em substituição a uma prótese total mucosuportada, aprimorando aspectos relacionados à estética e função. Porém, ressalta-se a importância de explicar ao paciente as limitações deste tipo de reabilitação para que não haja desgastes posteriores no relacionamento com o profissional.

The demand for oral prothesis using dental implants has been continuously growing, since conventional prothesis, especially in cases where a many teeth are lost, are not adequate in some respects, such as retention and stability. The use of conventional protheses, not only reduces the patient's masticatory capacity, but affects his/hers social environment, since the lack of retention of the prothesis leads patients do feel insecure while talking to other people. This paper describles a case of oral rehabilitation of the upper arch fixed bridge retained by six implants, improving esthetics and function. However, it is important to highlight that patients should be aware of the limitations of this kind of rehabilitation, preventing negative impacts on the patient/professional relationship.

TMD and GOHAI indices of Brazilian institutionalised and community-dwelling elderly.

RATIONALE AND OBJECTIVES: Considering the controversy in the literature regarding several aspects of temporomandibular dysfunction (TMD) in elderly populations and the absence of reliable data on elderly Brazilians in this field, this study consisted of an evaluation of TMD prevalence and the self-perception of oral health among institutionalised and community-dwelling elderly in São José dos Campos, Brazil. METHODS: Two hundred and fifteen community-dwelling and 185 institutionalised elderly people were evaluated by the Helkimo anamnestic (Ai) and clinical dysfunction (Di) indices and answered a questionnaire using the Geriatric Oral Health Assessment Index (GOHAI). RESULTS: The major prevalence of TMD symptoms was for the Ai0 (symptom-free) group (69.5%), while the major prevalence of clinical signs was for the DiI (mild) group (56%). Women presented a higher AiII classification than men (chi(2) test, p = 0.049). Community-dwelling elderly presented a significantly lower Ai0 classification than the institutionalised ones (Two ratios equality test, p < 0.001). There was no relationship between the institutionalised status and the clinical dysfunction index for Di0 and DiIII classification (Two ratios equality test, p = 0.194 and 0.535 respectively). The institutionalised elderly presented greater (One-way ANOVA = 0.005) self-perception of oral health (33.45) than did the community-dwelling group (32.66). There were only weak Pearson's correlations among the anamnestic (-33.0%) or clinical (-14.7%) findings by the TMD and GOHAI indices. Symptom-free (Ai0) institutionalised elderly presented better scores in all GOHAI dimensions and elderly representing an absence of clinical TMD signs (Di0) presented higher GOHAI physical dimension scores in both groups. CONCLUSIONS: The prevalence of TMD symptoms among this sample of elderly individuals was relatively low, self-perception of oral health was reasonable and a weak, inverse correlation was found between TMD signs and symptoms and elderly self-perception of oral health measured by the GOHAI index.

Longitudinal study of removable partial dentures and hygiene habits / Estudo longitudinal de próteses parciais removíveis e hábitos de higiene

The removable partial dentures (RPD) are used to reestablish the phonetics, aesthetics and masticatory function for partially dentate patients, mainly those who compound the Brazilian poorest population, since RPD presents a relatively low cost. The rehabilitation gone to be successfully when besides the planning, the dentist orientate hygiene habits to the patient, and proserve the case. The present paper evaluates hygiene habits and RPD planning among a sample of RPD wearers, in a cross-sectional design. A questionnaire was applied and a clinical examination was performed by two previously calibrated examiners. The sample was composed by 83 patients, and 25 were males. It was verified that 49.4% of the patients brush their teeth three times per day and that 28.9% took approximately 4 minutes for each teeth brushing, 95.2% use other hygiene resources, besides toothbrushing, as dental cream (98.7%), dental floss (79.7%) and mouthrinses (55.7%). However 56.6% showed bacterial plaque and 21.7% presented caries at clinical exam. About the dentures, 74.7% was definitive RPD and 96.4% showed bilateral design. The requisites of stability, retention, occlusion and aesthetics was classified as good, in the majority of the cases; the hygiene was classified as good to regular. In 24% of the dentures, the base was deformed or fractured, 50.6% presented artificial teeth with detritions. Instead of patients’ adequate oral hygiene habits and satisfaction with RPD, more comprehensive explanations about oral care and more frequent follow-ups should be considered to improve plaque index and periodontal health among RPD wearers.

As próteses parciais removíveis (PPR) são usadas para restabelecer fonética, estética e função em pacientesparcialmente dentados, principalmente para aqueles que compõem a população pobre brasileira, visto que asPPR apresentam baixo custo de confecção. Para que a reabilitação seja bem sucedida, além do planejamentocorreto, orientações quanto à higiene bucal, das próteses e proservação do caso se fazem necessárias. O presenteestudo avaliou hábitos de higiene e o planejamento das PPR de uma amostra de portadores de PPR, emestudo transversal. Para tanto foi utilizado questionário e exame clínico realizados por dois examinadorespreviamente calibrados. Foram analisados 83 pacientes, 25 do sexo masculino, verificou-se que 49,4% dospacientes escovavam os dentes três vezes ao dia e que 28,9% levam cerca de 4 minutos para a escovação,95,2% usavam outros meios de higienização, além da escova, como: creme dental (98,7%), fio dental (79,7%)e colutórios (55,7%). Porém, observou-se que 56,6% apresentavam placa bacteriana e 21,7% cárie ao exameclínico. Quanto às próteses 74,7% eram definitivas e 96,4% eram bilaterais. Os requisitos de estabilidade,retenção, oclusão e estética foram classificados como bons, na maioria dos casos; já a higiene teve igualproporção para bom e regular. Em 24% das próteses, a base encontrava-se fraturada ou deformada, 50,6%apresentavam os dentes artificiais com desgaste. Embora a maioria dos pacientes considerasse sua próteseboa, explicações mais completas sobre os cuidados orais e maior freqüência de visitas ao dentista devem serconsiderados para melhorar a saúde periodontal e o controle de placa em usuários de PPR.

General health of elderly institutionalised and community-dwelling Brazilians.

OBJECTIVE: To evaluate the heart rate, blood pressure, blood glucose and other important indicators of the general health of an elderly population of São José dos Campos, Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted among 150 institutionalised and 150 community-dwelling individuals aged 60 years or more. The parameters evaluated were heart rate, blood pressure and blood glucose. The elderly also answered a questionnaire about osteoporosis, falls, physical exercising, participation in social events, type of foods ingested, Alzheimer and Parkinson's diseases and medication. RESULTS: The institutionalised elderly showed an average heart rate of 75.1, while that of the community-dwelling elderly was 76.7. The percentage of systolic hypertension in the institutionalised and community-dwelling groups was 36% and 30% respectively, while diastolic hypertension showed a percentage of 40% and 57%, and diabetes was 32% and 30%. Among the institutionalised and community-dwelling groups, 13.3% and 21.3% respectively, reported osteoporosis, 31.3% and 42.7% falls, 7.3% and 24% exercised regularly, 4% and 69.3% participated regularly in social events, 58.7% and 51.3% reported eating solid foods, and 13.3% and 2%, respectively, suffered from Alzheimer's disease. Parkinson's disease was reported by 2% in both groups. The institutionalised elderly reported taking an average of 3.2 medications, while among community-dwelling elderly this number was 1.8. CONCLUSION: The entire sample presented a high prevalence of hypertension, diabetes and osteoporosis. No significant differences were found in the systemic health of the elderly institutionalised and community-dwelling groups. However, the latter group reported more frequent falls, participation in social events and exercised regularly.

Surgeon heart rate analysis during the dental implant procedure

Dental implant placement is a singular procedure in dentistry, and many variables should influence its success. The operator’s attitudes during surgeries are some of these variables. Considering that, the present paper aims to evaluate surgeon’s stress during different stages of dental implant placement. The heart rates of ten post-graduate students of implantology were evaluated at rest and during various steps of the implant placement procedure, using a Pollar R device. Each surgeon’s heart rate was monitored at different moments (preparation of the surgery; anaesthesia; incising and flapping procedures; bone perforating; implant placement at bone site; suture; end of the surgical procedure) during a single surgical implant insertion procedure (without additional procedures such as expansion, grafting and others). Implantodontic interventions were found to be the most stressful of these procedures, and implant placement in the bone site the most critical. Current procedures for the general practitioner, such as local anaesthesia, induced minor variations in the heart rate and, hence, less stress.

Protetor bucal individualizado confeccionado com silicona acética / Individualized mouthguard made of acetic silicone

O presente trabalho tem por objetivo realizar uma revisão da bibliografia inerente à Odontologia Desportiva, enfatizando a importância da utilização dos protetores bucais para a prevenção de traumatismos dentários em pacientes que apresentam fatores predisponentes e, ainda, naqueles que praticam esportes, principalmente os de contato. Devido às desvantagens e inconvenientes apresentados pelos protetores bucais disponíveis no mercado, os autores propõem uma nova técnica, que utiliza silicona acética para a confecção de protetores bucais individualizados

A utilização da acupuntura em desordens craniomandibulares / Using acupuncture in craniomandibular disorders

Esta revisão da literatura apresenta a acupuntura como uma terapia alternativa para os tratamentos de DCM de pacientes crônicos e refratários à terapia convencional por apresentar características importantes que agem na redução da dor causada por hiperirritabilidade muscular conhecida como «pontos de gatilho¼, apresentados nas dores miofaciais. Com o agulhamento desses pontos, tenta-se desorganizar a região, levando a um aumento na microcirculação que, por sua vez, associado com a estimulação do SNC, atua na liberação de endorfinas e outras substâncias com efeito analgésico, relaxante e antiinflamatório

Técnica laboratorial para utilização de articulador semi-ajustável em prótese total, partindo apenas dos roletes de cera relacionados em relação central / Laboratorial technique using a semi-adjustable articulator for complete denture making when only the orientation planes in centric relation are available

O objetivo deste trabalho é apresentar uma técnica laboratorial para a utilização do articulador semi-ajustável Stratos 200 (Ivoclar), na obtenção de oclusão balanceada durante o processo de confecção de prótesestotais, partindo apenas dos modelos de trabalho relacionados entre si em relação central e na dimensão vertical de oclusão pelos roletes de cera. Para tanto, utiliza-se uma plataforma específica deste articulador para a colocação do modelo inferior, seguindo valores médios, sobre o qual colocam-se os roletes relacionados entre si na relação central que posicionam o modelo superior. Dessa forma, obtém-se um padrão de oclusão balanceada satisfatório a partir apenas dos roletes em relação central. Este procedimento não visa substituir a técnica convencional que utiliza o arco facial, mas é um recurso para o técnico em prótese dentária obter uma oclusão balanceada, quando dispõe somente dos modelos de trabalho articulados em relação central pelos planos de orientação

Prótese fixa livre de metal: uma alternativa estética para o clínico geral / Metal-free fixed bridge: an aesthetic choice for general practice

O presente trabalho tem como objetivo apresentar um caso clínico de resoluçäo estética anterior, utilizando uma prótese fixa adesiva livre de metal, confeccionada com resina composta laboratorial, reforçada com fibras

Prótese parcial removível retida por implantes: relato de caso clínico / Implant retained removable partial denture: a clinical case report

Considerando a crescente utilizaçäo de implantes osseointegrados para reabilitaçäo oral de pacientes parcialmente edêntulos, principalmente nos casos de classe I e II de Kennedy, é objetivo deste trabalho apresentar a resoluçäo de um caso clínico classe II de Kennedy maxilar, no qual optou-se pela confecçäo de uma prótese parcial removível retida por o'rings, fixados a uma barra parafusada sobre dois implantes osseointegrados. mediante a utilizaçäo deste recurso, foi possível restabelecer, de modo adequado, estética e funçäo, sem a necessidade de realizaçäo de cirurgias complementares à colocaçäo dos implantes

Prótese dentária na terceira idade / Dental prosthesis for the elderly

O presente trabalho tem como objetivo ressaltar a importância da prótese dentária no amplo contexto da saúde para indivíduos idosos, cujo grupo populacional vem aumentando significativamente nos últimos ano em todo o mundo. Säo discutidos, mediante uma ampla revisäo da literatura e relato de casos clínicos, a participaçäo da prótese dentária na reintegraçäo social do idoso, as consideraçöes pertinentes à escolha do plano de tratamento, as modificaçöes de cada modalidade de terapia protética e, principalmente, a manutençäo das próteses nos indivíduos de idade avançada, procurando dar-se uma visäo abrangente para o clínico interessado no tema