Assessment of iatrogenic damage to adjacent teeth during crown and bridge preparation.

INTRODUCTION: Iatrogenic damage to the adjacent tooth during crown preparation is a frequent disastrous effect. The aim of the study was, therefore, to determine the frequency of different types, degree and location of iatrogenic damage to the adjacent tooth during crown and bridge preparations in a tertiary care setting that lead towards the morbidity of tooth. MATERIALS AND METHODS: A prospective study was conducted in Aga Khan University dental laboratory in two months period in which a total of 150 dental casts fulfilling the inclusion criteria were analyzed using non-probability convenient sampling technique. The casts were examined using 3.5x magnifying loupes for the location, degree and type of damage to the proximal surface adjacent to the prepared tooth using Moonpar and Faulkner criteria. Data were analyzed by using SPSS version 22. Chi square test was used to assess the association between the experience of practitioner and degree of damage to adjacent tooth. It was also used to determine the association between location of tooth and degree of damage to adjacent tooth. Inter-examiner reliability was assessed by using kappa statistics. RESULTS: A high prevalence of damage to the proximal surface of adjacent teeth (78% on mesial tooth and 60.6% on distal tooth) was observed, with the majority (32.6%) belonging to the mild categories. There were statistically significant associations between the experience of practitioner and the damage to the surface mesial to the preparation. However, more severe damages occurred in mandibular teeth preparations as compared to maxillary teeth preparations. CONCLUSIONS: A high frequency of iatrogenic damage to the adjacent teeth had been found during crown and bridge work with the middle of the tooth as the most susceptible site. However, the majority of damages were of milder type including only abrasions.

The effectiveness of adhesives on the retention of mandibular free end saddle partial dentures: An in vitro study.

OBJECTIVES: Existing in vitro methods for testing denture adhesives do not fully replicate the complex oral geometries and environment; and in vivo methods are qualitative, prone to bias and not easily reproducible. The purpose of this study was to develop a novel, quantitative and more accurate model to test the effect of adhesives on the retentive force of mandibular free end saddle partial dentures. METHODS: An in vitro model was developed based on an anatomically accurate cast of a clinical case. Experimentally, the amount of adhesive was varied (0.2g-1g) and the tensile force required for displacement was measured. Different commercially available adhesives were then tested at the optimum volume using the in vitro model. A 3D finite element model of the denture was used to assess how the forces to induce denture displacement varied according to the position of the force along the saddle length. RESULTS: The mass of adhesive was found to significantly alter retention forces, with 0.4-0.7g being the optimum range for this particular scenario. Use of adhesives significantly improved mandibular free end saddle partial denture retention with the worst performing adhesive increasing retention nine-fold whilst the best performing adhesive increased retention twenty three-fold. The finite element model revealed that 77% more force was required to displace the denture by positioning forces towards the mesial end of the saddle compared to the distal end. CONCLUSIONS: An in vitro denture adhesive model was developed, which demonstrated that mass of adhesive plays a significant role in enhancing denture retention and supported the design principle of placing as few teeth as clinically necessary on the distal end of the free end saddles. CLINICAL SIGNIFICANCE: Limiting the position of teeth on free end saddles to the mesial and mid portion of the saddle will reduce displacements caused by mastication. The movement of mandibular free end saddle partial dentures can be restricted with the use of denture adhesives. Altering the mass of adhesive used can further improve the retention of mandibular free end saddle partial dentures for patients.

Implante transalveolar en sustitución de una corona espiga de pronóstico dudoso / Transalveolar implant to replace a pin crown of doubtful prognosis

La sustitución de los dientes perdidos en la región estética presenta un complejo desafío debido a la dificultad en la reforma de la apariencia natural y de la anatomía papilar. Se Presenta un caso clínico donde se sustituyó un diente con corona espiga de pronóstico dudoso, por un implante inmediato Avanza. Se trata de una paciente de 24 años de edad atendida en la consulta multidisciplinaria de Implantología de la Clínica Docente de Prótesis de Marianao. Tenía una corona espiga en el incisivo central superior derecho, con cambio de coloración que le afectaba su estética. Además se le caía constantemente y estaba ligeramente inflamada por vestibular, lo cual le producía dolor. Después de una evaluación multidisciplinaria y el consentimiento de la paciente, se procede a la retirada de la corona espiga y exodoncia de la raíz del 11 mediante la técnica de colgajo. Inmediatamente se colocó el implante Avanza y se rehabilitó con una prótesis parcial acrílica removible por razones estéticas. Con este tratamiento, la paciente mantuvo el contorno de los tejidos blandos y la altura ósea de la zona intervenida, necesarios para alcanzar excelentes resultados estéticos(AU)

Replacement of missing teeth from the esthetic region poses a complex challenge to dental specialists due to the difficulties involved in reforming natural appearance and papillary anatomy. A clinical case is presented in which a tooth with a pin crown of doubtful prognosis was replaced with an immediate Avanza implant. A 24-year-old female patient presented at the implantology multidisciplinary service of Marianao Prosthetics University Clinic. The patient had a discoloring pin crown in the upper right central incisor that affected her esthetic appearance. Furthermore, the crown constantly fell out and there was slight vestibular swelling, which caused pain. After multidisciplinary evaluation and having obtained the patients consent, the pin crown was removed and root 11 extracted by flap technique. An Avanza implant was immediately placed and rehabilitated with a removable acrylic partial denture for esthetic reasons. With this treatment, the patient maintained the soft tissue contour and bone height required to achieve appropriate esthetic results(AU)

Implante transalveolar en sustitución de una corona espiga de pronóstico dudoso* / Transalveolar implant to replace a pin crown of doubtful prognosis

La sustitución de los dientes perdidos en la región estética presenta un complejo desafío debido a la dificultad en la reforma de la apariencia natural y de la anatomía papilar. Se Presenta un caso clínico donde se sustituyó un diente con corona espiga de pronóstico dudoso, por un implante inmediato Avanza. Se trata de una paciente de 24 años de edad atendida en la consulta multidisciplinaria de Implantología de la Clínica Docente de Prótesis de Marianao. Tenía una corona espiga en el incisivo central superior derecho, con cambio de coloración que le afectaba su estética. Además se le caía constantemente y estaba ligeramente inflamada por vestibular, lo cual le producía dolor. Después de una evaluación multidisciplinaria y el consentimiento de la paciente, se procede a la retirada de la corona espiga y exodoncia de la raíz del 11 mediante la técnica de colgajo. Inmediatamente se colocó el implante Avanza y se rehabilitó con una prótesis parcial acrílica removible por razones estéticas. Con este tratamiento, la paciente mantuvo el contorno de los tejidos blandos y la altura ósea de la zona intervenida, necesarios para alcanzar excelentes resultados estéticos(AU)

Replacement of missing teeth from the esthetic region poses a complex challenge to dental specialists due to the difficulties involved in reforming natural appearance and papillary anatomy. A clinical case is presented in which a tooth with a pin crown of doubtful prognosis was replaced with an immediate Avanza implant. A 24-year-old female patient presented at the implantology multidisciplinary service of Marianao Prosthetics University Clinic. The patient had a discoloring pin crown in the upper right central incisor that affected her esthetic appearance. Furthermore, the crown constantly fell out and there was slight vestibular swelling, which caused pain. After multidisciplinary evaluation and having obtained the patients consent, the pin crown was removed and root 11 extracted by flap technique. An Avanza implant was immediately placed and rehabilitated with a removable acrylic partial denture for esthetic reasons. With this treatment, the patient maintained the soft tissue contour and bone(AU)

Four-year incidence and predictors of coronal caries in south Brazilian elderly.

OBJECTIVES: To determine the incidence and predictors of coronal caries among community-dwelling elderly in a southern Brazilian city. METHODS: A cohort study was conducted using a simple random sample of persons aged 60 years or older in Carlos Barbosa city, southern Brazil. Interviews and oral examinations were conducted among 388 dentate individuals at baseline and among 273 at 4-year follow-up. The incidence of coronal caries was modeled by means of negative binomial regression. RESULTS: Some 184 (76.7%) participants presented with new coronal caries lesions or restorations, whose mean number was 2.2 ± 2.1, whereas the 4-year mean coronal caries incidence rate was 0.28 ± 0.29. In the multivariate model that controlled for baseline predictors, older age, male gender, living in a rural area, current smoking, and negative self-perception of oral health were associated with coronal caries incidence. Among clinical variables, the use of partial dentures was a predictor, whereas higher saliva flow rate was a protective factor for the outcome. CONCLUSIONS: Demographic factors, primary determinants of health, behavioral, and clinical variables were predictors of the incidence of coronal caries. As people enter old age, even stronger emphasis should be put on preventive strategies.

Gingival overgrowth as secondary effect of calcium channel blockers administration. A case report.

Gingival overgrowth is, among other things, a side effect of the administration of dihydropyridine antihypertensives, generally associated with irritant factors of marginal periodontium. This case refers to a patient, female, who developed a large gingival enlargement that has a combined etiology: the systemic medication with lercanidipina and the presence of dental bridges, which are incorrectly adjusted to the dental cervix. The treatment for this case, involved a complex local treatment (antimicrobial, surgical, endodontic and prosthetic) and the collaboration with a specialist cardiologist. Maintaining the normal gingival parameters in time depends on the possibility of changing the antihypertensive medication, the accuracy of the new dental bridges and the periodic monitoring of the patient.

Dislocated dental bridge covering the larynx: usefulness of tracheal tube guides under video-assisted laryngoscopy for induction of general anesthesia, thus avoiding tracheostomy.

BACKGROUND: To describe a case with dislodgement of dental bridge with clasps covering the vocal cords, in a patient who was successfully intubated using tube exchanger under video-assisted laryngoscopy. STUDY DESIGN, METHODS: Clinical case record with a video clip. SETTING: University hospital. CASE PRESENTATION: A 83-year-old woman presented with dislodgement of her dental bridge whilst eating. Laryngoscopy revealed a foreign body almost entirely covering the vocal cords, with the clasps of the dislodged partial denture piercing the pharyngeal wall. Before induction of general anesthesia, a tracheal tube introducer combined with video-assisted laryngoscopy was introduced into the trachea in the awake condition, followed by successful endotracheal intubation. Thereafter, the dislodged denture was extracted via the oral cavity. CONCLUSIONS: Tracheal tube introducers combined with video-assisted laryngoscopy appear to be useful for airway management, decreasing the number of avoidable tracheostomies performed.

[Clinical reasoning of impact of contemporary partial dentures constructions on the condition of periodontal tissues of patients with generalized periodontitis of I-II severity].

The aim of the study was the evaluation of the effectiveness of using partial dentures made of thermoplastic materials for patients with generalized periodontitis of I-II degree of severity based on the results of clinical research. The effect of partial dentures made of acrylic, metal and thermoplastic materials with and without splinting elements of fixation on the state of periodontal tissues in patients with generalized periodontitis was studied. The results of clinical studies of patients periodontal tissues condition ,who have had dental defects on the background I-II severity of GP using partial splinting elements of fixation showed a significant improvement in oral hygiene, positive change in activity indicators current of generalized periodontitis. The group of patients for whom were made orthopedic constructions of thermoplastic masses, noticed reducing of the depth of periodontal pockets, tooth mobility, bleeding and inflammation of the interdental papillae and the gingival margin.

Clinics in diagnostic imaging (142). Cervical oesophagus impacted partial denture.

A 58-year-old man presented to the emergency department with sudden pain and odynophagia after drinking water. The patient thought that part of his lower denture may have fallen into his throat. There was moderate tenderness over the lower anterior neck. Radiographs of the neck were normal. Computed tomography showed an impacted partial denture in the upper oesophagus, which was removed by rigid endoscopy. Recheck endoscopy showed a superficial mucosal laceration at 18 cm. Ingestion of dental prostheses is common among the elderly population. The role of imaging in the early detection of ingested foreign bodies, particularly nonradio-opaque ones, is discussed.

Oral complaints of denture-wearing elderly people living in two nursing homes in Istanbul, Turkey.

AIM: The aim of this study was to observe and determine oral complaints of people aged 55 years or older, living in two nursing homes in Istanbul, Turkey, and their satisfaction with their complete or partial dentures by means of a simple questionnaire. METHODS: Two old people's homes (one public and one private) in the district of Uskudar in Istanbul agreed to take part in this study. All residents who were available were invited to answer a piloted nine-point questionnaire with questions on age, gender, physical problems, eating, and communication, aesthetic denture wearing and psychological problems. The questions were asked in person by one investigator. The resulting data were entered into SPSS version 15. RESULTS: Out of a total of 210 residents, 130 (61.9%) took part in the study, of whom 53% (n=71) of residents were living in the private nursing home and 60% (n=81) were female. One hundred and five (80%) were denture wearers. More than half of the residents (59%, n=79) were over 75 years old. Problems were mostly seen in older ages, especially those over 75 years old, over 60% of whom reported problems for all the variables listed in the questionnaire. Women were more aware of halitosis than men. CONCLUSIONS: The results of this study confirm those of previous studies and suggest that elderly people with dentures, and particularly complete dentures, frequently complain of a wide range of problems including: eating, social interaction and communication and these problems have a detrimental influence on their quality of life.

Partial denture-- an ENT surgeon's nightmare.

Foreign body oesophagus is one among the common otorhinolaryngology emergencies that we come across. Artificial partial denture impaction in the oesophagus is often an ENT surgeon's nightmare. This study was done in the department of otorhinolaryngology, Government Medical College Kozhikode for a period of 2 years. All patients presented with history of accidental swallowing of partial denture followed by dysphagia. Radiological evaluation was done and subsequently oesophagoscopy and removal of the denture was done. In failed cases exploration and removal of foreign body was required. Complications were found in partial denture with metal wire clasps. It is better to avoid using malfitting dentures with small base, those with metal wire clasps and be cautious of using dentures in alcoholics and unconscious patients.