Expected and perceived burdens in patients receiving mandibular overdentures retained by one or two implants.

PURPOSE: This study aimed to assess patients' expected burdens before treatment and their perceived burdens after the surgical and prosthodontic procedures of mandibular overdenture treatment and to evaluate factors influencing patients' perceptions. METHODS: Data were collected from 47 participants enrolled in a randomized clinical trial comparing mandibular overdentures retained by one or two implants. A 20-item questionnaire measured on a four-point Likert scale covering the surgical and prosthetic treatment procedures was used to assess the patients' perception of the procedural burdens before (expected burdens) and immediately after (experienced burdens) each procedure. Operators' perceptions of intercurrences associated with the procedures were also assessed as an independent variable. RESULTS: Low levels of perceived burdens were observed both before and after treatment. The mean overall scores of 1.65 ± 0.46 and 1.53 ± 0.33 for expected and experienced burdens, respectively, indicated that most items ranged between "not burdensome at all" and "somewhat burdensome." Significant differences between expected and experienced burdens were found for eight items (P < 0.001). Considering the treatment stages, expected burdens scored higher in the pre-surgical, surgical, and prosthetic stages and lower in the post-surgical phase than experienced burdens. Overall, the experienced burdens were significantly affected by the expected burdens (P < 0.001) and operator's perceived burdens(P = 0.045). CONCLUSIONS: Treatments were associated with low levels of perceived burdens related to surgical and prosthodontic procedures and were highly correlated with the expected burdens before treatment. However, patients tend to overestimate the expected burdens before treatment, especially for surgical procedures.

Prosthetic maintenance assessment for implant fixed complete dentures and implant overdentures: a randomized clinical trial / Avaliação da manutenção protética para próteses totais fixas suportadas por implantes e Overdentures: um ensaio clínico randomizado

Objective: The rehabilitation choice for the edentulous patients usually lies between the fixed and removable prosthetic options. The treatment decisions are affected by many factors where complications and maintenance needs are both considered crucial factors, in addition to the cost effectiveness of the chosen treatment. Material and Methods: This study was applied on 44 edentulous patients, where 22 patient for each group were enrolled in the outpatient clinic of prosthodontics, Cairo University as per a set of eligibility criteria. Four inter-foraminal implants were installed for all eligible participants. Three months later, healing abutments were used for soft tissue preparation prior to the fabrication of the final prosthesis. A prosthetic treatment option was then randomly allocated to obtain two equal groups via computer generated randomization program; Group. A received telescopic implant overdentures, and Group. B received screw retained dentures. All Complications (Screw loosening or fracture, tooth or denture base fracture and mucositis) were reported after overdenture insertion along the follow up period (1, 6, 9 and 12 months respectively). Results: The frequency of the screw loosening for hybrid overdentures where (59.1%) compared to (27.3%) of telescopic prosthesis at 12 months follow up period (p=0.035), mucositis reporting at 6m interval had shown the highest frequency in both groups (Group A (54.5%), Group B (81.8%), (p=0.045), all other reported complications that lack statistical significance either within the same group or between both groups at different time intervals. Conclusion: Both treatment modalities; telescopic implant overdenture and hybrid fixed screw-retained are reliable for restoring the completely edentulous arches, the decision whether to make a fixed or removable implant denture shall be guided with the patient preference together with the dentist assessment in relation (AU)

Objetivo: A escolha da reabilitação para pacientes edêntulos geralmente recai entre próteses fixas e removíveis. As decisões de tratamento são afetadas por muitos fatores onde as complicações e as necessidades de manutenção são consideradas critérios cruciais, além do custo-efetividade do tratamento escolhido. Material e Métodos: Este estudo foi aplicado em 44 pacientes edêntulos, onde 22 pacientes para cada grupo foram matriculados no ambulatório de prótese dentária da Universidade do Cairo de acordo com um conjunto de critérios de elegibilidade. Quatro implantes interforaminais foram instalados para todos os participantes elegíveis. Três meses depois, pilares de cicatrização foram utilizados para preparação dos tecidos moles antes da fabricação da prótese final. Uma opção de tratamento protético foi então alocada aleatoriamente para obter dois grupos iguais por meio de andomização gerada através programa de computador. O Grupo A recebeu overdentures de implantes telescópicos e o Grupo B recebeu dentaduras fixas parafusadas sobre os implantes. Todas as complicações (afrouxamento ou fratura do parafuso, fratura da base do dente ou da prótese e mucosite) foram relatadas após a inserção da overdentures ao longo do período de acompanhamento (1, 6, 9 e 12 meses, respectivamente). Resultados: A frequência do afrouxamento do parafuso para Overdentures híbridas (59,1%) em comparação com (27,3%) da prótese telescópica no período de acompanhamento de 12 meses (p=0,035), o relato de mucosite no intervalo de 6 meses mostrou a maior frequência em ambos os grupos (Grupo A (54,5%), Grupo B (81,8%), p=0,045, todas as outras complicações relatadas foram sem significância estatística dentro do mesmo grupo ou entre os dois grupos em intervalos de tempo diferentes. Conclusão: Ambas as modalidades de tratamento; overdentures sobre implantes telescópicos e próteses híbridas fixas parafusadas são confiáveis para reabilitar as arcadas completamente edêntulas. A decisão de fazer uma prótese fixa ou removível sobre implantes deve ser guiada pela preferência do paciente juntamente com a avaliação do dentista em relação ao estado geral do paciente e sua saúde bucal. (AU)

A systematic review and meta-analysis of the clinical performance of implant-supported overdentures retained by CAD-CAM bars

Abstract Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars. Objective: To evaluate the performance of IODs involving CAD-CAM bars. Methodology: A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: "How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?" The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI). Results: Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies. Conclusion: Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used.

Prosthetic rehabilitation with removable dentures positively influences quality of life in older patients: a systematic review / A reabilitação protética com próteses removíveis influencia positivamente a qualidade de vida de pacientes idosos: uma revisão sistemática

OBJECTIVE: This systematic review assessed the effects of prosthetic rehabilitation with removable dentures on oral health-related quality of life (OHRQoL) in older adults. METHODS: A comprehensive electronic search was conducted in the PubMed/MEDLINE, Web of Science, and Cochrane databases to identify randomized clinical trials and prospective clinical studies. The included studies evaluated the effects of prosthetic rehabilitation on OHRQoL in patients whose mean age was > 60 years. The interventions included complete dentures, implant-retained overdentures, and removable partial prostheses, with a minimum follow-up period of 1 month after prosthetic rehabilitation. Patient-reported outcome measures, specifically OHRQoL, were the primary outcome. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized clinical trials and the ROBINS-I tool for prospective clinical studies. RESULTS: Eleven articles were considered eligible for the systematic review. The findings indicated that removable dentures improved various OHRQoL domains, mainly functional limitations and physical and psychological disabilities. Retention, stability, comfort, speech, and masticatory efficiency were significantly better with implant overdentures than complete dentures, leading to higher patient satisfaction and OHRQoL. CONCLUSIONS: This systematic review suggests that prosthetic rehabilitation with removable dentures has a positive influence on OHRQoL in older patients. The findings highlight the beneficial impact of implant overdentures and fixed adhesive prostheses for enhancing functional outcomes and patient satisfaction.

OBJETIVO: Esta revisão sistemática avaliou os efeitos da reabilitação protética com próteses removíveis na qualidade de vida relacionada à saúde bucal (QVRSB) em pacientes idosos. METODOLOGIA: Foi realizada uma pesquisa eletrônica abrangente nas bases de dados United States National Library of Medicine/ Medical Literature Analysis and Retrieval System Online ­ PubMed/MEDLINE, Web of Science e Cochrane para identificar ensaios clínicos randomizados (ECR) e estudos clínicos prospectivos. Os artigos selecionados tiveram como foco avaliar o efeito da reabilitação protética na QVRSB em indivíduos com média de idade superior a 60 anos. As intervenções descritas incluíram próteses totais, overdentures suportadas por implantes e próteses parciais removíveis, com acompanhamento mínimo de um mês após a reabilitação protética. As medidas de resultados relatadas pelos pacientes, especificamente QVRSB, foram o desfecho primário. O risco de viés foi avaliado com a ferramenta Cochrane RoB 2 pare ensaios clínicos randomizados e a ferramenta ROBINS-I para estudos clínicos prospectivos. RESULTADOS: Os resultados mostraram que as próteses dentárias removíveis melhoraram vários domínios da QVRSB, principalmente limitações funcionais e físicas e deficiências psicológicas. A retenção, estabilidade, conforto, fala e eficiência mastigatória foram significativamente melhores com overdentures sobre implantes do que com próteses totais, levando a maior satisfação do paciente e QVRSB. CONCLUSÕES: Esta revisão sistemática sugere uma influência positiva da reabilitação protética com próteses removíveis na QVRSB em pacientes idosos. As descobertas destacam o impacto benéfico das overdentures sobre implantes e das próteses adesivas fixas para melhorar os resultados funcionais e a satisfação do paciente

Mandibular Overdenture Retained by Telescopic Crowns and Ball Attachments on Semierupted Premolars.

This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth with a 5-year follow-up. A female patient used an old complete denture in the maxilla and was willing to extract her remaining mandibular teeth to have new dentures. The treatment included preservation of semierupted premolars because of the high surgical risk for mandibular fracture and paresthesia, a new maxillary complete denture, and a mandibular overdenture supported by combined telescopic crowns and ball attachments. The prosthetic rehabilitation restored function and esthetics with high patient satisfaction after 5 years in function.

Restabelecimento da Dimensão Vertical de Oclusão com JIG estético modificado e Prótese Parcial Removível Overlay: relato de caso / Reestablishment of occlusal vertical dimension with a modified aesthetic JIG and an overlay removable partial denture: a case report

A reabilitação de pacientes parcialmente edêntulos com desgaste dentário severo e dimensão vertical de oclusão reduzida é desafiadora e complexa. Objetivo: Descrever o restabelecimento da dimensão vertical de oclusão e parâmetros estéticos com uma prótese parcial removível do tipo overlay (PPRO) com auxílio de um JIG estético modificado. Relato de caso: Paciente do sexo masculino, 58 anos de idade, procurou serviço odontológico queixando-se de insatisfação com a estética do sorriso e perda dos dentes posteriores. Ao exame clínico, foram observados desgaste dentário excessivo e edentulismo parcial nas arcadas superior e inferior. Então, foi proposto tratamento em 2 etapas (provisória e definitiva) com PPRO em maxila. O JIG estético foi usado como guia de referência para incrementos em resina composta fotopolimerizável e o restabelecimento da dimensão vertical de oclusão foi determinado a partir de métodos métrico, fonético e estético. Os dentes desgastados foram aumentados e os dentes ausentes substituídos por dentes artificiais a partir de uma PPRO provisória. Após 2 meses de adaptação, a reabilitação final com PPRO definitiva foi conduzida baseando-se na reabilitação com a PPRO provisória. Conclusão: O paciente relatou satisfação com a estética e desempenho funcional com o tratamento. Portanto, o JIG estético beneficia o planejamento e o tratamento para restabelecer a dimensão vertical de oclusão. Além disso, a PPRO é uma alternativa reversível, de baixo custo, para reabilitar a estética e a função de pacientes com desgaste severo e perda parcial dos dentes.

The rehabilitation of partially edentulous patients with severe tooth wear and reduced occlusal vertical dimension is challenging and complex. Objective: To describe the reestablishment of occlusal vertical dimension and aesthetic parameters with an overlay re-movable partial denture (ORPD) with the aid of a modified aesthetic JIG. Case report: A 58-year-old man sought dental service complaining of dissatisfaction with the aesthetics of his smile and a loss of posterior teeth. At clinical examination, excessive tooth wear and partially edentulism in the lower and upper arches were observed. A two-step treatment (interim and definitive) with an ORPD in the upper arch was proposed. The aesthetic JIG was used as a reference guide for the increments in light-curing resin composite, and the reestablishmentthe occlusal vertical dimension was determined using aesthetic, phonetic, and metric methods. The worn teeth were increased, and the missing natural teeth were replaced by artificial teeth using a temporary ORPD. After two months of adaptation, de-finitive rehabilitation with a definitive ORPD was performed based on the interim ORPD. Conclusion: The patient reported satisfaction with the esthetic and functional performance of this treatment. Therefore, the aesthetic JIG benefits the planning and treatment of reduced vertical dimension. Moreover, the ORPD is a reversible and lower-cost alternative to rehabilitate the aesthetics and function of patients with severe teeth wear and partial teeth loss.

Speech and the swallowing threshold in single implant overdenture wearers: A paired control study.

BACKGROUND: Single implant mandibular overdentures (SIMOs) can improve mastication in edentulous elderly people. However, little attention has been paid to their effects on articulation disorders and the swallowing threshold relative to those of conventional complete dentures (CDs). OBJECTIVE: To compare the effects of new conventional CD set and SIMOs on articulation disorders, mandibular movements during speech and swallowing threshold using a paired study design. METHODS: Twenty-two edentulous Brazilian Portuguese-speaking elderly people (mean age 66.7 ± 4.6 years) were first evaluated whilst wearing their old conventional CDs. Articulation disorders were analysed by audio and video recordings, mandibular movements during speech were measured by kinesiography, and the swallowing threshold was assessed by masticatory cycle counting and medium particle size (X50 ) calculation. Participants then received new conventional CDs, and evaluations were repeated 2 months later. Subsequently, single implants were installed in the midlines of subjects' mandibles, and the conventional CDs were converted to SIMOs. After 2 months of SIMOs use, the evaluations were repeated. Data were submitted to the Cochran-Mantel-Haenszel and ANOVA. RESULTS: No difference in articulation disorders was found between new conventional CD and SIMO use. The frequency of anterior lisp during /s/ and /z/ phoneme pronunciation was reduced with new conventional CD use relative to old conventional CD use (p < .05). The X50 decreased progressively with new conventional CD and SIMO use (both p < .05). CONCLUSION: SIMOs do not alter speech relative to new well-fitted conventional CDs, but improved the swallowing threshold, in edentulous elderly people.

Patient satisfaction with ball and Equator attachments for single-implant mandibular overdentures: A short-term randomised crossover clinical trial.

BACKGROUND: Retention and stabilisation of a single-implant mandibular overdenture (SIMO) are influenced by the biomechanical properties and clinical performance of the attachment system. PURPOSE: To compare clinical and patient-reported outcomes following the use of two retention systems, a ball and a stud-type Equator attachment used for SIMO. MATERIAL AND METHODS: Eighteen fully edentulous participants were treated with a SIMO opposing to a maxillary complete denture. They received two retentive attachments (ball and Equator) in alternate periods (sequences A-B and B-A) and outcomes were assessed after the 1 week (initial) and 3 months (final) periods. In the final assessment, patients were also asked about their preferred retention system. RESULTS: Compared with baseline, there was an improvement in patient satisfaction using both attachments, whilst no difference was observed between initial and final periods. Similarly, no significant differences were observed when comparing the ball and Equator at the initial (P = .330) and final (P = .08) periods. The multilevel mixed-model analysis revealed that the patients' satisfaction was predicted only by their satisfaction with dentures before implant placement. Although no significant difference was found between attachments regarding patient preference, this may be biased by the sequence of attachment use, which suggests that a learning effect might be present in this crossover study design. CONCLUSION: The use of a single midline implant to retain a mandibular overdenture significantly improves patient satisfaction irrespective of the attachment used, but patients' preference for the second treatment suggested a learning effect in this study.

Surgical and nonsurgical treatment of papillary hyperplasia: A case report / Tratamiento quirúrgico y no quirúrgico de la hiperplasia papilar inflamatoria: Reporte de Caso

Dentures with dental plaque predispose recurrent hyperplasia on the palatal mucosa. Surgical procedures for the treatment of inflammatory papillary hyperplasia involve postsurgical discomfort and morbidity. This repot describes clinical and histologic aspects of a patient with severe akantolitic inflammatory papillary hyperplasia. The palatal mucosa was treated with a surgical bur with a low-speed handpiece. A new removable denture was performed and adapted. A follow-up of 4 years showed staility of health at palatal mucosa. Patient referred low discomfort and morbidity when using bur technique. Control of removable denture was critical for long-term healing and soft tissue stability.

Las prótesis dentales con placa bacteriana predisponen a la hiperplasia recurrente en la mucosa palatina. Los procedimientos quirúrgicos para el tratamiento de la hiperplasia papilar inflamatoria implican molestias y morbilidad posquirúrgicas. Este reporte describe los aspectos clínicos e histológicos de un paciente con hiperplasia papilar inflamatoria acantolítica severa. La mucosa palatina fue tratada con una fresa quirúrgica con una pieza de mano de baja velocidad. Se realizó y adaptó una nueva prótesis parcial removible. Después de un seguimiento de 4 años, se encontró estabilidad de la salud de la mucosa palatina. El paciente se refirió a la baja incomodidad y morbilidad al usar la técnica de la fresa. El control de la prótesis parcial removible fue crítico para la cicatrización a largo plazo y la estabilidad de los tejidos blandos, evitando la recidiva de la hiperplasia papilar inflamatoria.

Biomechanical behavior of overdentures supported by different implant position and angulation using Micro ERA® system: a finite element analysis study

Aim: The aim of this study was to investigate the biomechanical behavior of implant-retained mandibular overdentures using Micro ERA® system with different implant position and angulation by finite element analysis (FEA). Methods: Four 3D finite element models of simplified mandibular overdentures were constructed, using one Bränemark implant with a Micro ERA® attachment. The implant was positioned on the canine or lateral incisor area with an angulation of either 0º (C-0º; LI-0º) or 17º (C-17º, LI-17º) to the vertical axis. A 100 N axial load was applied in one side simultaneously, from first premolar to second molar. In all models it was analyzed the overdenture displacement, compressive/tensile stress in the bone-implant interface, and also the von Mises equivalent stress for the nylon component of the housing. The stresses were obtained (numerically and color-coded) for further comparison among all the groups. Results: The displacement on the overdenture was higher at the posterior surface for all groups, especially in the C-17º group. When comparing the compressive/tensile stress in the bone-implant interface, the lateral-incisor groups (LI-0º and LI-17º) had the highest compressive and lowest tensile stress compared to the canine groups (C-0º and C-17º). The von Mises stress on the nylon component generated higher stress value for the LI-0º among all groups. Conclusions: The inclination and positioning of the implant in mandibular overdenture interferes directly in the stress distribution. The results showed that angulated implants had the highest displacement. While the implants placed in the lateral incisor position presented lower compressive and higher tensile stress respectively. For the attachment the canine groups had the lowest stress

Flood susceptibility in rural settlements in remote zones: The case of a mountainous basin in the Sierra-Costa region of Michoacán, Mexico.

Maps of natural hazards are essential for the prevention or mitigation of disasters. The Nexpa River mountainous basin is in the Sierra-Costa region of the state of Michoacán, Mexico. The dispersed rural settlements in the basin, accessed through a network of mainly minor roads and tracks, are highly vulnerable in cases of catastrophic hydrometeorological events. Our study aimed to map flood zones and assess flood susceptibility in the basin on the basis of geopedology, topography, land cover and land use, to assess the vulnerability of local rural settlements and their network of roads and tracks. The land morphology was mapped and the weighted overlay technique was applied in a geographic information system to generate maps of susceptibility to flooding. Our results showed that 13% of settlements and 7% of the communication network are within flood zones. Maps based on environmental factors showed low to medium susceptibility to flooding. These methods are useful and effective for zones with little or no hydrometeorological information, and they can provide a robust source of information for decision makers regarding land planning to mitigate flood vulnerability.

Clinical and Radiographic Evaluation of Rehabilitated Implants with Overdenture with Two Ball Abutments in the Mandible and Submitted to Immediate Load: One Year of Observation / Evaluación Clínica y Radiográfica de Implantes Rehabilitados con Sobredentadura con dos Pilares de Bola en la Mandíbula y Sometidos a Carga Inmediata: Un Año de Observación

ABSTRACT: The purpose of this prospective clinical study was to evaluate the clinical and radiographic survival of two non-splinted implants immediately loaded with ball abutments for supporting mandibular overdentures. Thirty edentulous patients using full dentures (22 women and 8 men) with a mean age of 64 years were included in this study. Each patient received two inter-foraminal implants in the mandible, near the canine, with an insertion torque greater than 45 Ncm. Nonsplinted ball abutments were connected to the implants, and the overdenture was immediately loaded. The success of the implants was clinically and radiographically evaluated; along with the satisfaction level of the patients, after the first year of having placed the implants. One patient withdrew from the study. After 12 months the implants were loaded, the survival rate was of 98.27 %, one implant failed. The average bone loss was of 0.34 mm. No surgical complications were observed, minor prosthetic maintenance appointments were required. The satisfaction of the patients was of 89.3 %. The immediate loading of two non-splinted implants in the inter-foraminal area of the mandible retaining an overdenture by means of ball abutments is a predictable treatment, with a high success rate of survival and a favorable response of the peri-implant tissues. The patients showed good satisfaction with this treatment modality.

RESUMEN: El propósito de este estudio clínico prospectivo fue evaluar la supervivencia de manera clínica y radiográfica de dos implantes no ferulizados cargados inmediatamente con pilares tipo bola para soportar sobredentaduras mandibulares.Treinta pacientes desdentados totales usuarios de prótesis total (22 mujeres y 8 hombres) con una edad promedio de 64 años se incluyeron en este estudio. Cada paciente recibió dos implantes interforaminales en la mandíbula aproximadamente en posición de canino con un torque mayor a los 45 Ncm. Pilares no ferulizados tipo bola se conectaron a los implantes y se cargó inmediatamente la sobredentadura. El éxito de los implantes se evaluó clínica y radiográficamente; así como el nivel de satisfacción de los pacientes al año de haber sido colocados los implantes. Una paciente se retiró del estudio. Después de 12 meses de cargados los implantes la tasa de supervivencia fue del 98,27 %, un implante fracasó. El promedio de pérdida ósea fue de 0.34 mm. No se observaron complicaciones quirúrgicas, se requirieron citas de mantenimiento protésicas menores. La satisfacción de los pacientes fue del 89,3 %. La carga inmediata de dos implantes no ferulizados en el área interforaminal de la mandíbula reteniendo una sobredentadura a través de pilares en bola es un tratamiento predecible, con un alta tasa de éxito de supervivencia, y respuesta favorable de los tejidos periimplantares. Los pacientes muestran una buena satisfacción ante ésta modalidad de tratamiento.

Reabilitação oral de paciente com redução de dimensão vertical de oclusão utilizando prótese parcial removível overlay: relato de caso / Oral rehabilitation of patient with reduced vertical dimension of occlusion using overlay removable partial denture: case report

A reabilitação oclusal de pacientes parcialmente desdentados com redução da dimensão vertical de oclusão (DVO) representa um grande desafio para o cirurgião-dentista. Normalmente envolve procedimentos complexos, demorados e de elevado custo. A prótese parcial removível (PPR) do tipo overlay representa uma alternativa reabilitadora que pode ser utilizada para esta finalidade. Por meio do relato de um caso clínico, este trabalho teve por objetivo descrever a técnica de utilização da PPR overlay, bem como discutir a viabilidade clínica e efetividade desta modalidade de tratamento. No caso em questão, diagnosticada a redução da DVO, inicialmente a reabilitação oral foi feita de forma provisória, utilizando PPR overlay provisória no arco superior e PPR provisória convencional no arco inferior. O restabelecimento das posições mandibulares possibilitou a reconstrução dos dentes anteriores desgastados com resina composta e a confecção de PPR overlay com recobrimento metálico como tratamento "definitivo". As PPRs de recobrimento (overlays) representam uma excelente e eficiente alternativa no restabelecimento das relações maxilomandibulares. São procedimentos menos onerosos que os procedimentos fixos convencionais, normalmente utilizados na reabilitação de pacientes com diminuição da DVO, mais conservadores e bem indicados para pacientes que tiveram desgastes em função de hábitos parafuncionais.

The occlusal rehabilitation of partially edentulous patients with reduced vertical dimension of occlusion (VDO) represents a great challenge for the dentist. Normally, involving complex, time-consuming and expensive procedures. The removable partial denture (RPD) overlay type represents a rehabilitative alternative that can be used for this purpose. Through the report of a case, this study aimed to describe the use of the RPD overlay technique as well as discuss the clinical feasibility and effectiveness of this treatment modality. In this case, diagnosed the VDO reduction, initially, the oral rehabilitation was made provisionally, using provisory overlay RPD on the upper arch and conventional provisory RPD in the lower arch. The restoration of mandibular positions made possible the reconstruction of the worn anterior teeth with composite resin and the production of the overlay RPD with metallic covering as the "definitive" treatment. The covering RPDs (overlays) are an excellent and efficient alternative on the restoration of the maxillomandibular relations. They are less costly procedures than conventional fixed procedures, normally used in the rehabilitation of patients with decreased VDO, more conservative and well suited for patients who had wear due parafunctions habits.

Short-term quality of life change perceived by patients after transition to mandibular overdentures

The aim of this longitudinal observational study was to evaluate the oral health-related quality of life (OHRQoL) following patient rehabilitation with implant-retained mandibular overdentures (IMO) and to identify the contribution of the different domains to OHRQoL. The Oral Health Impact Profile (OHIP-EDENT), Dental Impact on Daily Living (DIDL), and Geriatric Oral Health Assessment Index (GOHAI) questionnaires were completed twice by 25 patients: after 3 months of rehabilitation with complete dentures (CD) and after 3 months of IMO loading using stud abutments. The evaluation after IMO rehabilitation showed significant improvement in three DIDL domains: appearance (p = 0.011), eating and chewing (p = 0.003), and general performance (p = 0.003). The GOHAI results showed significant differences in two domains: psychosocial (p = 0.005) and pain and discomfort (p = 0.0004). The OHIP-EDENT outcomes showed significant improvements in five domains: functional limitation (p = 0.0001), physical pain (p = 0.0002), physical disability (p = 0.0010), and psychological disability and handicap (p = 0.032). The largest observed effect sizes were close to one standard deviation and were observed in the eating and chewing domain (0.93) of the DIDL; the pain and discomfort domain (0.83) of the GOHAI, and the functional limitation (0.89), physical pain (1.02), physical disability (0.84) domains of the OHIP-EDENT. The percentage of satisfied patients increased in all domains. Self-reported OHRQoL of CD wearers was significantly improved after 3 months of treatment with IMO, especially concerning the functional and pain-related aspects.

Short-term quality of life change perceived by patients after transition to mandibular overdentures

Abstract The aim of this longitudinal observational study was to evaluate the oral health-related quality of life (OHRQoL) following patient rehabilitation with implant-retained mandibular overdentures (IMO) and to identify the contribution of the different domains to OHRQoL. The Oral Health Impact Profile (OHIP-EDENT), Dental Impact on Daily Living (DIDL), and Geriatric Oral Health Assessment Index (GOHAI) questionnaires were completed twice by 25 patients: after 3 months of rehabilitation with complete dentures (CD) and after 3 months of IMO loading using stud abutments. The evaluation after IMO rehabilitation showed significant improvement in three DIDL domains: appearance (p = 0.011), eating and chewing (p = 0.003), and general performance (p = 0.003). The GOHAI results showed significant differences in two domains: psychosocial (p = 0.005) and pain and discomfort (p = 0.0004). The OHIP-EDENT outcomes showed significant improvements in five domains: functional limitation (p = 0.0001), physical pain (p = 0.0002), physical disability (p = 0.0010), and psychological disability and handicap (p = 0.032). The largest observed effect sizes were close to one standard deviation and were observed in the eating and chewing domain (0.93) of the DIDL; the pain and discomfort domain (0.83) of the GOHAI, and the functional limitation (0.89), physical pain (1.02), physical disability (0.84) domains of the OHIP-EDENT. The percentage of satisfied patients increased in all domains. Self-reported OHRQoL of CD wearers was significantly improved after 3 months of treatment with IMO, especially concerning the functional and pain-related aspects.

Comparação dos sistemas de retenção para overdenture / Comparison of different attachment systems for overdenture

As próteses totais convencionais inferiores são as mais difíceis de adaptar, devido à perda óssea ser maior e consequentemente à baixa estabilidade e pouca retenção. Entretanto, com o aparecimento dos implantes osse-ointegráveis surgiram os tratamentos com próteses do tipo overdenture, as quais oferecem melhor estabilidade e retenção. O objetivo deste trabalho foi comparar os três principais tipos de sistemas de retenção para a pró¬tese overdenture encontrada na literatura. Para isso, foram realizadas pesquisas com os termos "overdenture"; "attachment", "implant-supported", "dental prosthesis", "denture" e "oral rehabilitation" nas bases de dados PubMed, Science Direct e Scielo. Os sistemas barra-clipe e esférico apresentaram semelhanças estatísticas quanto à retenção e estabilidade. Já o sistema magnético apresentou pouca retenção e baixa estabilidade

The conventional lower total prosthesis is the most difficult dental prosthesis to adapt in the patients mouth, due to bone loss be greater in this region, which consequently decreases stability and retention of the prosthe¬sis. However, the appearance of osseointegrated implants gave rise to treatments with overdenture prostheses, which offer better stability and retention to the prostheses. The aim of this study was to compare the three main types of overdenture prosthesis restraint systems found in the literature. For this research, we used the terms: "overdenture"; "attachment", "implant-supported", "dental prosthesis", "denture" and "oral rehabilitation" in the databases of PubMed, Science Direct and Scielo. The clip bar and spherical systems presented statistical similarities regarding retention and stability. Already, the magnetic system presented little retention and low stability

Reabilitação funcional e estética em dentes anteriores e posteriores: relato de caso / Functional and aesthetic rehabilitation in anterior and posterior teeth: a case report

Hoje há uma relevante busca por parte dos pacientes por alternativas de tratamentos a fim de melhorar ou alterar a aparência do sorriso. Isso ocorre devido à grande valorização atual por um sorriso com uma estética agradável. No entanto, a busca não está restrita somente aos elementos anteriores. Muitos pacientes demonstram a preocupação em melhorar a estética e a função também dos elementos posteriores. Com base nisso, o objetivo deste trabalho foi relatar um caso clínico sobre reabilitação funcional e estética utilizando lentes de contato, facetas, coroas e overlay de cerâmica(AU)

Currently, there is a search for alternative treatments to improve or change the appearance of the smile by the patients. This occurs due to the currently high appreciation for a smile with a pleasing aesthetic. However, the search is not restricted only to the anterior elements, since many patients show the desire to improve the aesthetics as well as the function of the posterior elements. Based on this, the aim of this study was to presente a case report of functional and esthetic rehabilitation using ceramic veneers, crowns and overlay restorations(AU)

ODEF ­ oral design para estética e função oclusal: o planejamento responsável estético e oclusal nas reabilitações orais / ODEF ­ oral design for aesthetic and oclusal function: responsible aesthetic and occlusal planning in oral rehabilitation

O desgaste dentário quando excessivo ou patológico pode levar a uma alteração da dimensão vertical de oclusão, gerando prejuízos na estética, função e fonética do paciente. O restabelecimento da dimensão vertical de oclusão perdida através da reabilitação é complexa e trabalhosa para o cirurgião-dentista. Necessita-se primeiramente determinar se houve a perda dessa dimensão vertical e o quanto ela ocorreu. Para isso, é preciso avaliar se houve perda de suporte posterior através da distância interoclusal, aparência facial e fonética. Se for detectada a perda da dimensão vertical de oclusão, o tratamento de eleição para restabelecê-la é a confecção de uma placa acrílica provisória, denominada ODEF (Oral Designpara Estética e Função Oclusal). Essa terapêutica apresenta reversibilidade, baixo custo e tempo operacional reduzido, quando comparada a outros tratamentos reabilitadores. Neste trabalho mostra-se que além dessas vantagens o ODEF pode apresentar um novo design que recobre não só a oclusal dos dentes remanescentes, mas também faz o recobrimento de toda a face vestibular desses dentes até a cervical, fazendo desaparecer a linha de união dente-placa até então existente nas placas overlay provisórias de diagnóstico de dimensão vertical de oclusão, o que comprometia a estética (AU).

Dental wear when excessive or pathological can lead to an alteration of vertical dimension of occlusion, resulting in patient bad aesthetics, function and phonetics. The re-establishment of the lost vertical dimension of occlusion is complex and laborious for the dentist. First, it is necessary to determine if there was loss of this vertical dimension and how it occurred. To determine it, it is necessary to evaluate if there was loss of posterior support through the interocclusal distance, facial appearance and phonetics. If loss of vertical dimension of occlusion is detected, treatment chosen to restore it is overlay splint called ODEF (Oral Design for Aesthetic and Occlusal Function). This therapeutic presents reversibility, low cost and reduced operating time compared to other rehabilitating treatments. This paper shows that in addition to these advantages, ODEF can present a new design that covers not only the occlusal of the remaining teeth, but also covers the entire vestibular surface of these teeth until the cervical, disappearing the line of union tooth-plate, which would compromise the aesthetic (AU).

Clinical aspects in the treatment planning for rehabilitation with overdenture and protocol-type prosthesis / Aspectos clínicos utilizados no planejamento de prótese overdenture e protocolo

Objective: The aim of this study was to criticaly review the published literature regarding the clinical aspects involved in the rehabilitation of edentulous patients using Branemark protocol and overdenture prostheses.Methods: An active search was conducted in the LILACS, MEDLINE, PubMed, and SciELO databases using the descriptors: "Coating for dentures" (Overlay Prosthesis and Overdenture) and "Implant-supported fixed dental prosthesis" (Protesis dental de suporte implantado, Dental prosthesis, and Implant Supported Prosthesis) in Portuguese, English, and Spanish between January 2000 and October 2014.Results: The following parameters should be considered when selecting between Branemark protocol and overdenture prostheses: bone support, lip support, lip-line, upper lip length, oral mucosa conditions and size, alveolar ridge contour, crown-bone ratio, interarch space, and speaking space. Overdenture rehabilitation can provide many benefits to patients, such as prosthetic retention, stability, comfort, and improved aesthetics.Conclusions: This study highlights the need for a thorough individualized treatment planning to ensure that fixed prostheses and overdentures have an excellent prognosis when used appropriately in suitable patients at the appropriate time.

Objetivo: Verificar por meio de revisão crítica da literatura os aspectos clínicos durante o planejamento de pacientes edêntulos frente à utilização de próteses tipo protocolo de Branemark e overdenture.Métodos: Busca ativa nas bases de dados LILACS, MEDLINE, PubMed e SciELO por meio dos descritores: "Revestimento de dentadura" (Prótese de Recobrimento e Overdenture) e "Prótese dentária fixada por implante" (Protesis dental de suporte implantado e Dental prosthesis, implant supported) entre janeiro de 2000 até outubro de 2014 nas línguas Portuguesa, Inglesa e Espanhola.Resultados: Deve-se levar em consideração para indicar as próteses overdentures e protocolo o suporte ósseo, suporte labial, linha do sorriso, comprimento do lábio superior, qualidade e quantidade da mucosa, contorno do rebordo alveolar, relação coroa/osso, espaço interarcos e zona fonética. A reabilitação com overdenture pode trazer muitos benefícios ao paciente, tais como retenção, estabilidade, conforto, e a estética.Conclusões: Evidencia-se a necessidade de um planejamento individualizado, para que se chegue a um correto plano de tratamento, no qual as próteses fixas e overdentures possam ter um excelente prognóstico, desde que utilizadas no momento apropriado e no paciente indicado.

La rehabilitación protésica implantomucosoportada en el desdentado total / Removable prosthetic rehabilitation in the total toothless patient

Introducción: la rehabilitación sobre implantes con sobredentaduras mejora la calidad de vida de los pacientes y las técnicas para la rehabilitación son simples y preserva mayor cantidad de tejido dentario. Objetivo: caracterizar el comportamiento de la rehabilitación protésica implantomucosoportada en el desdentado total. Material y método: se realizó un estudio descriptivo, longitudinal y retrospectivo en los pacientes rehabilitados con sobredentaduras implantomucosoportadas en la Clínica Estomatológica "Antonio Briones Montoto" de Pinar del Río, en el período comprendido entre el año 2013 y 2014. El universo estuvo constituido por 28 pacientes, coincidente con la muestra. La información se recopiló a través de datos obtenidos en la historia clínica. Resultados: se encontró la mayor cantidad de implantes en la mandíbula. Se comprobó que la mayoría de los pacientes con mucositis perimplantaria el 14,3%, presentaban una higiene bucal regular o mala. Existió una dependencia estadísticamente significativa entre los períodos de tiempo en que les fue necesario el cambio de la cápsula de teflón. Conclusiones: se caracterizó el comportamiento de la rehabilitación protésica implantomucosoportada en el desdentado total.

Introduction: overlay dentures rehabilitation improves the quality of life of patients, while the rehabilitation techniques are simple and more dental tissue is preserved. Objective: to characterize the behavior of removable prosthetic rehabilitation in the total toothless patient. Material and method: a descriptive, longitudinal and retrospective study was performed in patients rehabilitated with overlay dentures in Antonio Briones Montoto Dental Clinic of Pinar del Río, in the time between the years 2013 and 2014. The target group consisted of 28 patients and coincided with the sample. Data was compiled from the clinical records. Results: most dentures were localized in the mandible. The majority of the patients with peri-implant mucositis (14.3%) practiced fair or bad oral hygiene. A statistically significant dependency existed between the two periods of time when changing the Teflon capsule was required. Conclusions: the behavior of removable prosthetic rehabilitation in the total toothless patient was characterized.