Evaluation of mandibular implant-supported fixed prosthesis retained by 3 dental implants, 1 straight and 2 angled: A retrospective clinical study.

STATEMENT OF PROBLEM: The minimum number of implants to support fixed complete dentures is still unclear. PURPOSE: The purpose of this retrospective clinical study was to evaluate the survival rate of fixed complete dentures supported by 3 immediately loaded implants opposing maxillary complete dentures. MATERIAL AND METHODS: A retrospective study of edentulous patients rehabilitated with complete dentures opposing mandibular metal-resin implant-supported fixed complete dentures supported by 3 immediately loaded implants was conducted in a 48-hour protocol. Fifty-one machined and 99 rough-surface implants were evaluated from 2.2 up to 8 years. Implant loss, peri-implant outcomes, and mechanical complications were assessed by considering the influence of age, sex, health status, smoking, excessive alcohol consumption, educational level, and socioeconomic status. The presence of comorbidities in relation to the implant surface or the cantilever lengths was also evaluated. RESULTS: Four machined and 6 rough-surface implants failed, a 6.7% failure rate. The cantilever length varied from 3.3 to 22.9 mm. Mechanical complications were abutment screw loosening (3.0%), prosthetic screw loosening (17%), screw fracture (1%), superstructure detachment and fractures (16%), metal framework fracture (2%), maxillary denture fractures (6%), and mandibular prosthesis loss (4%). Peri-implant mucositis was found in 27% of participants. The cumulative implant and mandibular prosthesis survival rates were 93.3% and 96%, respectively. None of the variables evaluated, including demographic data and health status, were found to influence clinical failures and/or mechanical complications. CONCLUSIONS: Mandibular fixed complete dentures supported by 3 implants can be considered a successful treatment with reduced costs compared with those of other fixed options for application in public health.

Does the natural maxillary dentition influence the survival rate of mandibular metal-resin implant-supported fixed complete dentures? A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Consensus is lacking regarding the influence of the maxillary dentition on the survival rate of a mandibular metal-resin implant-supported fixed complete denture (MRISFCD) with distal cantilevers. PURPOSE: The purpose of this systematic review was to identify whether an opposing natural dentition influences the survival rate of mandibular MRISFCDs. MATERIAL AND METHODS: A literature search was performed up to February 2018 from MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, BBO/LILACS databases and also in the non-peer-reviewed literature through Open Grey. Clinical studies regarding natural (ND), removable prostheses (RP), and complete fixed maxillary implant dentitions (ID) with at least a year of follow-up were included. The quality of the included studies was analyzed, and the risk of bias was reported. A meta-analysis comparing the survival rate of ND with RP and ND with ID was performed with a confidence interval (CI) of 95%, and heterogeneity was tested by an I2 index. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of the evidence. RESULTS: From a total of 112 ND, 69 ID, and 204 RP in the maxillary dentition, the overall prevalence of failures was 5.4% (6/112; 95% CI [2.3 to 10.76]) for ND, 13.99% (20/69; 95% CI [0.77 to 39.41]) for ID, and 4.9% (10/204; 95% CI [0.69 to 12.18]) for RP. No statistical differences were detected in the success rates between ND and RP (risk difference = 0.00 [-0.06, 0.06]; P=.93; I2=27%) or between ND and ID (risk difference=0.00 [-0.06, 0.07]; P=.97; I2=0%), both with moderate evidence. CONCLUSION: With a moderate certainty of evidence, it is suggested that natural maxillary dentitions do not affect the survival rate of mandibular MRISFCDs differently from other prosthetic designs.

Prosthetic rehabilitation in a pediatric patient with hypohidrotic ectodermal dysplasia: a case report.

Hypohidrotic ectodermal dysplasia (HED) is a rare ectodermal disease with a systemic expression. Oral abnormalities are common and may include hypodontia and shape irregularities in the primary and permanent dentitions. Rehabilitation of the dental arches in pediatric patients with HED is a challenge because HED is a multifactorial disease that demands a complicated treatment approach and most dentists have limited experience or training in the necessary treatment. In addition, pediatric patients often lack the patience or ability to cooperate with complex prosthetic treatment. This case report describes a simplified technique used to fabricate complete dentures for a 4-year-old HED patient in 4 sessions.

The effect of titanium topography features on mesenchymal human stromal cells' adhesion.

OBJECTIVE: The aim of this study was to evaluate the effect of two kinds of dental implants surfaces with their own characteristics on human marrow stromal cells' adhesion. MATERIAL AND METHODS: Fifty-six titanium discs (28 machined and 28 acid etched) were used. Machined (MS) and acid-etched surfaces (ES) were analyzed using a scanning electron microscope, energy dispersing spectroscopy (EDS), contact angle analysis and human marrow stromal cells' culture. RESULTS: Significant differences were observed in the topography and wetability of the tested surfaces. However, etched surfaces presented a high level of wetability when compared with machined surfaces. Contact angles showed considerable differences between etched and machined surfaces (Friedman test P<0.05). EDS analysis showed the same composition on both the surfaces tested. Counting of adhered cells on both types of surfaces showed that there is no statistical significance in human marrow stromal cells' adhesion after 18 h (Mann-Whitney test P>0.05). CONCLUSION: The present study concludes that modifications on the titanium implant surfaces roughness may promote differences in the morphology of bone marrow stromal cells. Nevertheless, in this microenvironment, no interference in the adhesion phenomenon was noted.