Short-term safety and effectiveness of the mCLIP partial prosthesis.

PURPOSE: This multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP Partial Prosthesis. METHODS: Patients underwent tympanoplasty with implantation of a mCLIP Partial Prosthesis. Follow-up examination included ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. Thus, the follow-up times of each study center were different, which resulted in different follow-up times for the audiological analysis and for adverse events (AE). RESULTS: 72 (66 adults, 6 children) patients were implanted with the mCLIP Partial Prosthesis. 68 (62 adults, 6 children) patients underwent audiological examination; all 72 patients were examined for adverse events. All patients (N = 68): 72.1% of the patients showed a PTA4 ABG of ≤ 20 dB. Individual post-operative bone conduction (BC) PTA4 thresholds were stable in 67 patients. The mean post-operative follow-up time was 78 ± 46 days. Children (N = 6): 5 out of 6 children showed a PTA4 ABG of ≤ 20 dB. None of the children reported a BC PTA4 deterioration of > 10 dB HL after the implantation. The mean post-operative follow-up time was 101 ± 45 days. Adverse events (all patients, N = 72): 15 (14 adults, 1 child) patients had AEs (27 AEs and 2 Follow-Ups). The mean post-operative follow-up time was 375 days. CONCLUSION: Clinical data show satisfactory audiological parameters after implantation of the mCLIP Partial Prosthesis. The prosthesis is safe and effective for implantation in children and adults. TRIAL REGISTRATION NUMBER: NCT05565339, 09 September 2022, retrospectively registered.

Comparison between Distal Extension Attachment-retained Removable Partial Prostheses with Integrated and Conventional Reciprocation Designs: A Clinical Trial.

AIM: To compare marginal bone level (MBL) around the abutments in integrated and conventional reciprocation designs in attachment-retained removable partial prosthesis (A-RPP). MATERIALS AND METHODS: Around 14 participants were indiscriminately selected and separated into two groups. For every group, an A-RPP with one of the studied reciprocation types was fabricated and assessed. Group I received A-RPP with integrated reciprocation and group II received A-RPP with conventional reciprocation. MBL around the crowned primary and secondary abutments was assessed on the day of A-RPP insertion, at 6 and at 9 months of denture use. RESULTS: Comparison of MBL values at the primary and secondary abutments within each group showed no statistical difference from time of delivery and throughout the study. After using the A-RPP for 6 and 9 months, group I revealed lower mean values of MBL than group II which were statistically significant. CONCLUSION: Distal extension A-RPP with integrated and conventional reciprocation designs were associated with raise in bone loss. Integrated reciprocation design revealed a lesser amount of bone loss than the conventional reciprocation design and therefore, it is considered as more preferable to be used. CLINICAL SIGNIFICANCE: Distal extension A-RPP with integrated reciprocation is superior in terms of periodontium preservation around abutment teeth as compared to distal extension A-RPD with conventional reciprocation.

Uso de prótesis parcial removible con resina acrílica termoplástica: una revisión de literatura

La prótesis parcial removible (PPR) es una alternativa de tratamiento en pacientes que perdieron algunos elementos dentarios, debido al costo relativamente bajo y a la generación de una función masticatoria satisfactoria. Además, es una buena opción cuando hay pérdida de los tejidos óseos, dado que impide la instalación de implantes dentarios. La PPR convencional presenta una estructura metálica que ofrece retención y resistencia a la prótesis, convirtiéndola en poco agradable a los pacientes, por el hecho de dejar a la vista el metal en la cavidad oral. A partir de investigadores que decidieron ir más allá del simple estudio de la función y la estética de las PPR para adentrase en sus diversas formas de presentación, surgió la prótesis parcial flexible (PFlex). La PFlex es una prótesis parcial confeccionada con resina termoplástica, sin metal y con flexibilidad. Si bien, muchos profesionales la emplean como prótesis temporal, otros tantos la han usado como alternativa a la PPR convencional. Así, uno de los frecuentes interrogantes de los clínicos es si realmente es posible utilizar la PFlex como alternativa protética definitiva. Por tanto, el propósito de este trabajo fue realizar una revisión de la literatura para evaluar si el uso de prótesis parciales removibles con resina termoplástica puede ser una alternativa a las prótesis parciales convencionales, exponiendo las ventajas, desventajas, indicaciones, contraindicaciones y las propiedades del material protético.

Removable partial denture (RPP) is an alternative treatment when it comes to patients who have lost some dental elements, as they have the advantages of a relatively low cost and a satisfactory masticatory function. Furthermore, it is a good option when there is bone tissue loss, making dental implants placement unfeasible. Conventional PPR has a metallic frame that provides retention and resistance to the prosthesis, which makes it unpalatable to patients because it leaves the metal in the oral cavity evident. Many researchers, aiming to give back beyond function and aesthetics, are studying forms of presentation of PPR, thus emerging the flexible partial prosthesis (PFlex). PFlex is a partial denture made with thermoplastic, resin metal-free and with flexibility, however its use, for many professionals, is limited only as temporary prostheses, but there are some clinicians who use PFlex as an alternative to conventional PPR. Thus, one of the questions constantly asked by scientists is whether it is possible to use PFlex as a definitive prosthetic alternative. Therefore, the aim of this study was to conduct a literature review to assess whether the use of removable partial dentures with thermoplastic resin can be an alternative to conventional partial dentures, exposing the advantages, disadvantages, indications, contraindications, and the properties of the prosthetic material.

Estudio correlacional de complicaciones técnicas, biológicas, estéticas y nivel de satisfacción en tratamientos realizados en la Cátedra de Prótesis de Coronas y Puentes II de la Facultad de Odontología de la Universidad Nacional de Asunción

El objetivofue determinar la asociación correlacional que pudiera presentarse entre las complicaciones técnicas, biológicas y estéticas y el nivel de satisfacción de los tratamientos realizados en la Cátedra de Prótesis de Coronas y Puentes II de la Facultad de Odontología de la UNA en el 2019. Este fue un estudio observacional descriptivo, analítico, de corte transverso. Se incluyeron pacientes que recibieron tratamientos del 2016 al 2018. Acudieron 59 pacientes para la evaluación clínica y aplicación del cuestionario. Se analizaron los datos según número de tratamientos encontrados en cada sujeto, por lo que se calcularon los resultados según 119 tratamientos. Las complicaciones biológicas pulpares fueron la sensibilidad o molestia al frio o al calor en los pilares en un 20.1%. Se encontró asociación muy significativa de las complicaciones biológicas pulpares (p>001) con estado civil, complicaciones biológicas periodontales, complicaciones estéticas cervicales. Las complicaciones biológicas periodontales fueron en mayor frecuencia la gingivitis alrededor de la restauración en un 40,4%. El nivel de satisfacción con el tratamiento recibido se presentó favorable en un 89,1% y asociación muy significativa (p>001) con grado de instrucción y significativa (p>005) con estado civil.Se encontró asociación muy significativa de las complicaciones estéticas cervicales, las complicaciones estéticas de forma y significativa de las complicaciones biológicas periodontales con el nivel de satisfacción.

The objective was to determine the correlational association that could occur between technical, biological and esthetic complications and level of satisfaction in the treatments performed in the Department of Crown and Bridge Prosthodontics II of the Faculty of Dentistry of the National University of Asuncion in 2019. This was a descriptive, analytical, cross-sectional, observational study. Patients who received treatments from 2016 to 2018 were included. Fifty-nine patients attended for clinical evaluation and application of the questionnaire. The data were analyzed according to the number of treatments found in each subject, by which the results were calculated according to 119 treatments. Pulpal biological complications were sensitivity or discomfort to cold or heat in 20.1% of the abutments. A highly significant association was found between pulpal biological complications (p>001) and marital status, periodontal biological complications and cervical esthetic complications. The most frequent periodontal biological complications were gingivitis around the restoration (40.4%). The level of satisfaction with the treatment received was favorable in 89.1% and there was a very significant association (p>001) with educational level and significant (p>005) with marital status. A highly significant association was found between cervical esthetic complications, esthetic complications of shape and periodontal biological complications and the level of satisfaction.

Effectiveness of implant-supported fixed partial denture in patients with history of periodontitis: A systematic review and meta-analysis.

AIM: This systematic review investigates the effectiveness of implant-supported fixed partial denture (IS-FPD) in patients with history of periodontitis (HP) vs. patients with no history of periodontitis (NHP). METHODS: A literature search was performed on different databases on May 2020. Prospective and retrospective studies assessing survival (primary outcome), success and biological/mechanical complications of IS-FPDs in HP vs. NHP patients at ≥1 year after implant loading were evaluated. Meta-analyses were conducted by estimating hazard ratio (HR), risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) using random effect models. RESULTS: Of the initially identified 4096 articles, 349 underwent a full-text evaluation. Finally, 17 were included. Pooled data analyses showed that overall implant survival was significantly higher in the NHP than the HP group (HR = 2.06; 95% CI = 1.37-3.09; I2  = 0%). This difference was noted when follow-up ≥5 years. The risk of peri-implantitis was higher in HP than NHP patients (RR = 3.3; 95% CI = 1.31-8.3; I2  = 0%), whereas the mean marginal bone level change over time was not different between the groups (SMD = -0.16 mm; 95% CI = -1.04-0.73; I2  = 98%). CONCLUSIONS: In partially edentulous patients receiving IS-FPDs, a history of periodontitis is associated with poorer survival rate and higher risk of peri-implantitis during a 5-10 years period after implant loading.

Consensos referidos a conceptos rehabilitadores en la enseñanza de la odontología. Parte I: conceptos generales y diseño de la prótesis parcial removible / Consensus referring rehabilitative concepts in the teaching of dentistry. Part I: general concepts and design of removable partial prosthesis

En este artículo se desarrolla el consenso alcanzado entre profesores, referido a los conceptos generales, componentes y la secuencia del diseño de la prótesis parcial removible, durante la formación del odontó-logo en el ámbito de la Facultad de Odontología de la Universidad de Buenos Aires (AU)

This article develops the consensus between professors on the general concepts, components, and the sequence of the design of the partial removable prosthesis during the training of the dentist in the field of the Faculty of Dentistry of the University of Buenos Aires (AU)

Peri-Implant Behavior of Tissue Level Dental Implants with a Convergent Neck.

INTRODUCTION: The aim of this retrospective study was to analyze the radiographic peri-implant bone loss of bone level implants and tissue level implants with a convergent neck in screw-retained single crowns and in screw-retained fixed partial prostheses, after two years of functional loading. MATERIALS AND METHODS: The sample was divided into two groups according to their type: Group I: supracrestal implants with convergent transmucosal neck; Group II: crestal implants. In each group we distinguish two subgroups according to the type of prosthetic restoration: single crowns and a three-piece fixed partial prosthesis on two implants. To quantify bone loss, parallelized periapical radiographs were analyzed at the time of implant placement and after two years of functional load. RESULTS: A total of 120 implants were placed in 53 patients. After statistical analysis it was observed that for each type of implant bone loss was 0.97 ± 0.91 mm for bone level and 0.31 ± 0.48 mm for tissue level. No significant differences were found regarding the type of prosthesis and the location (maxilla or mandible) of the implants. CONCLUSIONS: Tissue level implants with a convergent transepithelial neck exhibit less peri-implant bone loss than bone level implants regardless of the type of prosthesis.

Comparative analysis of titanium clip prostheses for partial ossiculoplasty.

OBJECTIVES: The aim of our study was to perform a comparative analysis in our cases with titanium partial clip ossiculoplasty in terms of audiometric outcome and extrusion rates as well as to review the literature for relevant information on this surgical issue. MATERIALS AND METHODS: The records of all patients who had undergone primary partial ossiculoplasty with the implantation of a CliP® Partial Prosthesis Dresden Type (CPPDT, group A) or a CliP Partial FlexiBAL® (CPF, Group B, both Heinz Kurz GmbH, Dusslingen, Germany) between 2012 and 2020 were studied retrospectively. RESULTS: 274 patients made up our study sample (148 men, 126 women, male to female ratio: 1.17). Their mean age at the time of first surgery was 39.6 years (range: 4-79 years). The mean preoperative air-bone gap (ABG) was 22.7dΒ ± 10.5 dB. Mean follow-up was approximately 4 months (1-12 months). The mean postoperative ABG was 15.7 ± 8.1 dB. In total, the postoperative ABG was significantly improved compared to preoperative values (P < 0.001). Surgical success, defined as an ABG ≤ 20 dB, was achieved in the majority of our study patients (210/274, 76.6%). Extrusion of the prosthesis was detected in 3/216 CPF and 5/58 CPPDT cases (p = 0.012). Comparison of both prosthesis groups revealed a significantly better audiological outcome for the patients with ossicular reconstruction using CPF. A significantly better audiological outcome was detected in the cases with a normal aeration of the middle ear. DISCUSSION: Titanium clip partial ossiculoplasty is a reliable component of modern tympanoplasty, allowing a satisfying audiologic outcome. The higher adaptability of the CPF to the changing postoperative circumstances and the frequently defective aeration of the middle ear is reflected in the better audiologic outcome for this prosthesis.

The biological width around implant.

PURPOSE: The concept of biological width has been proposed and widely used in oral implantation. This review aimed to summarize the biological width around implant in detail. STUDY SELECTION: An electronic search of the literature prior to March 2019 was performed to identify all articles related to biological width in periimplant soft tissue. The search was conducted in the MEDLINE (National Library of Medicine) database accessed through PubMed with no date restriction. The following main keywords were used: "implant", "biological width", "soft tissue", "junctional epithelium", "peri-implant epithelium", "connective tissue", "gingiva", "mucosa" (connecting multiple keywords with AND, OR). RESULTS: The identified researches focused on several aspects related to biological width in oral implantation, namely the concept, formation, remodeling, dimension, structure and function. CONCLUSIONS: Based on of the reviewed literature, the concept, formation, remodeling, structure, dimension, and functional significances of periimplant biological width are explored in this narrative review. The formation of biological width around implant is a complex process after several weeks of healing. The biological width around implant is a 3-4mm distance from the top of the peri-implant mucosa to the first bone-to-implant contact or the stabilized top of the adjacent bone, consisting of sulcular epithelium, junctional epithelium and fibrous connective tissue between the epithelium and the first bone-to-implant contact or the stabilized top of the adjacent bone. The biological width forms a biological barrier against the bacteria, influences the remodeling of soft and hard tissue around implant and has implications for clinical aspects of dental implantation.

Survival and complication rates of tooth-implant versus freestanding implant supporting fixed partial prosthesis: a systematic review and meta-analysis.

PURPOSE: This systematic review was performed to compare tooth, implant and prosthesis failures and biological and technical complications in toothimplant vs freestanding implant supported fixed partial prostheses, in order to evaluate the effectiveness and predictability in combining teeth and implants in the same fixed partial prosthesis. STUDY SELECTION: A comprehensive and systematic literature research was conducted, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, to identify human trials, with a minimum sample size of 10 patients, comparing tooth-implant to freestanding implant supported fixed partial prostheses. Four groups of meta-analyses were performed based on the patients treated with toothimplant vs freestanding implant-supported fixed partial prostheses: abutment failures, biological and mechanical complications, prosthesis failures, and prosthetic (technical) complications. RESULTS: The search yielded 749 records, after removal of duplicates. Based on the title assessment, the abstracts reading and the full-texts evaluation, 8 articles, published between 1999 and 2013, fulfilled the inclusion criteria and were included in the meta-analysis. The studies included were: 4 controlled clinical trials, 2 prospective and 2 retrospective cohort studies. The meta-analysis revealed no significant difference between tooth-implant and implant-implant supported fixed in the number of abutment (implant or tooth) failures, biological complications, prosthesis lost, and prosthetic complications. CONCLUSIONS: Within the limitations of the present systematic review, although the freestanding implant supported fixed partial prosthesis remains the first choice, joining teeth and implants to support fixed prosthesis in partially edentulous patients becomes a valid alternative with an acceptable success rate.

Comparison of the Crestal Bone Loss Between Implant-Supported Prosthesis With Sinus Augmentation and Distal Cantilevered Implant-Supported Prosthesis Without Sinus Augmentation.

This study aimed to compare the crestal bone loss between a 2-implant-supported, noncantilevered 3-unit fixed partial prosthesis (TUFPP) with sinus augmentation and a 2-implant-supported, distal cantilevered TUFPP without sinus augmentation in the posterior maxilla having insufficient crestal bone. The study subjects were enrolled in 2 groups. Group 1 included patients with 2 implants: an anterior implant placed in the native bone and a posterior implant inserted with simultaneous sinus augmentation using a xenogenic bone graft to support a TUFPP. Group 2 included patients with 2 implants inserted in the native bone to support a distal cantilevered TUFPP. The crestal bone levels at the distal and mesial aspects of each implant were measured at baseline and 6-, 12-, and 24-month follow-up controls on panoramic radiographs. Fifty-two patients and 104 implants were included. There was a significant difference in distal crestal bone loss between anterior and posterior implants in group 1 at 6 months (P < .05) but not at 12 and 24 months (P > .05). Distal crestal bone loss was significantly increased in group 1 posterior implants compared to the group 2 posterior implants at 6 months (P < .05). There was no significant difference in mesial bone loss between the anterior and posterior implants in both groups at all follow-up controls (P > .05). There was also no significant mesial crestal bone loss in relation to the anterior and posterior implants of both groups at all follow-up controls (P > .05). Noncantilevered 2-implant-supported TUFPP with sinus augmentation may have similar medium-term crestal bone loss when compared to cantilevered 2-implant-supported TUFPP without sinus augmentation. Further prospective studies should be designed to compare the performance of the 2-implant-supported cantilevered TUFPP and 2-implant-supported TUFPP with sinus augmentation.

Extension implants in the atrophic posterior maxilla: 1-year results of a retrospective case-series.

BACKGROUND/PURPOSE: Blade implants account for one of the most debated dental implants design in scientific literature. They have been reconsidered by clinicians since their re-classification by Food and Drug Administration in 2014. MATERIALS AND METHODS: The present study aimed to evaluate the outcome of newly manufactured extension implants in the treatment of moderate atrophic posterior maxillae. All the patients enrolled in the present retrospective case series study showed a moderate bone atrophy in the posterior maxilla with a maximum residual height ranging between 4 mm and 8 mm. Implants were inserted with the aid of an electro-magnetic device, and then they covered with screws and left healing. Three months after, implants were exposed and loaded. RESULTS: Difference between the marginal bone level at the 3-month evaluation (5.57 ±â€¯0.67 mm) and that at baseline (5.67 ±â€¯0.55 mm) appeared to be not significant (p-value = 0.63). At the 12-month evaluation, the marginal bone level (4.95 ±â€¯0.45 mm) underwent significant decrease respect to baseline value as proven by significant change at marginal bone level (-0.62 ±â€¯0.51 mm with a p-value = 0.01). CONCLUSION: The results of the present study suggested a positive 12-month outcome for extension implants in the rehabilitation of the moderate atrophic maxilla, without the need of extensive reconstructive surgeries and grafting procedures.

Quality of models supplied to dental laboratories for the fabrication of partial removable denture framework / Qualidade de modelos enviados aos laboratórios para execução de prótese parcialmente removível

ABSTRACT Objective The aim of this study was to evaluate the models and plannings of metallic framework of removable partial prosthesis sent to dental laboratories in the city of Recife. Methods: The physical and technical conditions of plaster models were sent by the dentists to 4 dental laboratories. All models were examined, photographed and recorded on a form according to the research objective. Results: A total number of 235 models sent by dental surgeons were used to prepare the metallic structure, in which none of the models presented surveying nor the path of insertion. Out of the 235 models, 41 (17.44%) presented serious failures, such as positive and negative bubbles, broken dental elements, direct retainers and damaged edentulous areas. With respect to the planning, only 22 (9.35%) models were presented with the metallic framework planning, but in an unsatisfactory way. Regarding mouth preparation, no model presented a guide plane, and only 6.8% of models had rests seats, but incorrectly prepared. Conclusion: The models evaluated presented poor quality, lack of planning and no mouth preparation. This shows the need for dental surgeons to be aware of the appropriate prosthesis models and plannings in order to ensure a satisfactory and long-term rehabilitation of the patient, as well as preserving the remaining mouth structures.

RESUMO Objetivo Avaliar os modelos e planejamentos das estruturas metálicas das próteses parciais removíveis enviadas aos laboratórios de prótese dentária da cidade do Recife. Métodos Foram avaliadas as condições físicas e técnicas dos modelos de gesso enviados pelos dentistas à 4 laboratórios de prótese dentária. Todos os modelos foram examinados, fotografados e registrados por meio de um formulário de acordo com o objetivo da pesquisa. Avaliou-se 235 modelos enviados pelos cirurgiões dentistas para confecção da estrutura metálica, na qual nenhum dos modelos apresentou delineamento e registro do eixo de inserção. Resultados Dos 235 modelos, 41 (17,44%) apresentaram falhas graves, tais como bolhas positivas, bolhas negativas, elementos dentários quebrados, retentores diretos e áreas edêntulas danificados. Quanto ao planejamento, apenas 22 (9,35%) modelos apresentavam-se com o desenho da estrutura metálica, porém, de maneira insatisfatória. Quanto ao preparo de boca, nenhum modelo apresentou preparo de plano guia, e apenas 6,8% dos modelos possuíam nichos, porém confeccionados de maneira incorreta. Conclusão Os modelos avaliados apresentaram qualidade insatisfatória, ausência de planejamento e realização de preparo de boca. Isto demonstra a necessidade de conscientização dos cirurgiões dentistas para a confecção dos modelos e planejamentos adequados das próteses, a fim de garantir uma reabilitação duradoura e satisfatória ao paciente, assim como proservação das estruturas bucais remanescentes.

Stress distribution of three-unit fixed partial prostheses (conventional and pontic) supported by three or two implants: 3D finite element analysis of ductile materials.

In implantology, when financial or biological feasibility limitations appear, it is necessary to use prostheses with geometries that deviate from the conventional, with a pontic in the absence of an intermediate implant. The aim of this study was analyze and understand the general differences in the stresses generated in implants, components and infrastructures according to the configuration of the prosthesis over three or two implants. Thus, this paper analyzes the von Mises equivalent stresses (VMES) of ductile materials on their external surfaces. The experimental groups: Regular Splinted Conventional Group (RCG), which had conventional infrastructures on 3 regular-length Morse taper implants (4x11 mm); Regular Splinted Pontic Group (RPG), which had infrastructures with intermediate pontics on 2 regular-length Morse taper implants (4x11 mm). The simulations of the groups were created with Ansys Workbench 10.0 software. The results revealed that the RPG presented greater areas of possible fragility due to higher stress concentrations, for example, in the cervical area of the union between the implant and component the top platform of the abutment, as well as greater coverage of the stress by the cervical implant threads. The RPG infrastructure was also more affected by stresses in the connection areas between the prostheses and on the occlusal surface. There is an advantage to using prostheses supported by a greater number of implants (RCG) because this decreases the stress in the analyzed structures and consequently improves stress dissipation to the supporting bone, which would preserve the system.

Stress distribution on short implants with different designs: a photoelastic analysis.

Short dental implants have been used as an attempt to avoid bone grafts surgery, however there are few literature reports that evaluate changes to their design. Therefore, the aim of this study was to assess the effect of different short implant design on stress distribution through photoelastic analysis. Six external hexagon (5 × 5 mm) short dental implants with different design were used. Each group was treated with a single crown and a three element fixed partial dental prosthesis, resulting in a total of 12 photoelastic models. The assembling photoelastic model-implant-prosthesis was set in a circular polariscope where loads of 100N were applied on the occlusal surface with a Universal Test Machine (UTM). The tension fringes were photographed and later assessed qualitatively by a graphic software (Adobe Photoshop). Less high-intensity fringes were observed on the short implants with triangular threads, short external hexagon and flat apical profile. In conclusion, the macrodesign influenced the amount of stress distributed to the bone when short dental implants are placed.

Efeito de uma malha de nylon contendo sílica como reforço em próteses parciais fixas em resina composta indireta / Effect of a nylon mesh containing silica as reinforcement on fixed partial dentures in indirect composite resin

O presente estudo teve como objetivo avaliar as características mecânicas de próteses parciais fixas adesivas, confeccionadas em resina composta de uso indireto, reforçadas por uma malha de nylon. Para a confecção da matriz dos espécimes e estudo das tensões nas estruturas, foi realizada análise qualitativa pregressa análise de elementos finitos (FEA). A pesquisa in vitro simula uma prótese parcial fixa de três elementos com inserção entre os primeiros pré-molares e os primeiros molares superiores (n = 60; 10 por grupo). Três dos seis grupos passaram por ciclagem mecânica. Os grupos experimentais foram: G1-prótese fixa convencional; G2 - prótese convencional ciclada; G3 - prótese com reforço da malha posicionada na vertical; G4 ­ Prótese com reforço da malha posicionada na vertical ciclada; G5 ­ Prótese com reforço da malha posicionada na horizontal; G6 ­ Prótese com reforço da malha posicionada na horizontal ciclada.Todos os grupos passaram por ensaio de carga máxima a fratura (EMIC). Os resultados não apresentaram diferença estatística entre os grupos. Concluiu-se que a utilização da malha nylon proporcionou estabilidade, mesmo após a fratura da peça, pois as partes não se separam, além disso, os resultados obtidos in vitro puderam validar os dados in sílico(AU)

The present study aimed to evaluate the mechanical characteristics of adhesive fixed partial dentures, made from composite resin of indirect use, reinforced by a nylon mesh. A finite element analysis (FEA) was used to compile the specimen matrix and to study the stresses in the structures. In vitro research, simulated a fixed partial denture of three elements with insertion between the first premolars and the major maxillary molars (n = 60; 10 per group). Three of the six groups underwent mechanical cycling. The experimental groups were: G1 - conventional fixed prosthesis; G2 - conventional cyst prosthesis; G3 - prosthesis with reinforcement of the mesh positioned vertically; G4 - Prosthesis with reinforcement of the mesh positioned in the cycled vertical; G5 - Prosthetics with mesh reflux positioned horizontally; G6 - Prosthetics with mesh reinforcement positioned horizontally cycled. All groups underwent maximum fracture loading test (EMIC). The results do not present a statistic between the groups. It was concluded that the use of the nylon mesh provided stability, even after fracture of the part, as parts do not separate, besides, the results obtained in vitro could validate the data in silica(AU)

A prótese parcial removível acrílica na atenção em saúde bucal das unidades básicas de saúde da prefeitura de Belo Horizonte: a visão dos cirurgiões-dentistas / The acrylic removable partial denture in the oral health care of basic health units of Belo Horizonte: the vision of dentists

As diretrizes da Política Nacional de Saúde Bucal orientaram para a inclusão de próteses elementares na atenção primária (APS) dimensionando sua relevância. Pesquisou-se a experiência dos cirurgiões-dentistas (CD) com a Prótese Parcial Removível Acrílica (PPRA), como parte do rol de procedimentos que compõem a atenção em saúde bucal nas Unidades Básicas de Saúde (UBS) no município de Belo Horizonte (11.949, produzidas de agosto de 2010 a setembro de 2016). Visou identificar as dificuldades e facilidades relativas às suas diversas fases de execução, além da satisfação e insucessos dos CD. Fizeram parte da amostra (cálculo amostral por estimativa de proporção, com erro amostral de 7%, prevalência da condição 50% e nível de significância de 95%) 155 cirurgiões-dentistas da rede básica, selecionados entre 359 que a compõem, através de sorteio (amostra aleatória simples). A amostra final foi distribuída proporcionalmente ao número de cirurgiões-dentistas de cada distrito sanitário de Belo Horizonte. Para a coleta de informações, construiu-se um questionário estruturado com 72 questões inerentes à prática diária de execução da PPRA, além de dados sociodemográficos e de trabalho dos CD. Aplicou-se o questionário utilizando-se a plataforma SurveyMonkey, , submetendo os dados obtidos ás análises descritiva e estatística. Realizou-se uma análise fatorial a partir da matriz de correlação policórica para as questões de satisfação, dificuldade e preparação e obtidos escores, por meio do cálculo do coeficiente de correlação de Spearman. A análise das correlações encontradas mostrou que estar mais preparado para realizar a PPRA implicou apresentar menos dificuldades em suas diversas fases. Estar mais satisfeito implicou estar mais preparado para executá-las. Relacionaram-se, posteriormente, os mesmos escores com os insucessos (intercorrências que dificultaram ou impediram a instalação das próteses) nas diversas fases. Quando correlacionados o insucesso e os escores de preparação, verificou-se que quanto mais preparado, maior ausência de insucesso. Com relação à satisfação e insucesso, verificou-se que quanto mais satisfeito, maior ausência de insucesso. Com relação à dificuldade e os escores de insucesso, verificou-se que quanto mais dificuldade, menos insucesso, o inverso do esperado. A partir de uma análise bivariada sociodemográfica e de trabalho dos profissionais com os relatos de insucesso, realizou-se a regressão logística dos resultados mais significativos, obtendo-se que o CD que avaliou negativamente a inclusão da PPRA no rol de procedimentos da APS tem 1,71 vezes mais chances de ter maior insucesso na confecção de PPRA. Para aquele que se graduou em instituição privada existem 4,51 vezes mais chances de ter insucesso comparado ao que se graduou em instituição pública. Quando o paciente participa da prova de dentes, existe 0,19 vezes mais chance de ter insucesso. Quando a experiência com a execução foi negativa existem 3,85 vezes mais chances de ter insucesso. A alta freqüência de confecção da PPRA em vários países, financiada na maioria das vezes por sistemas públicos de saúde, aponta para a necessidade de estudá-la, e de capacitar os profissionais na sua execução, sob pena de se tornar um problema de saúde pública. Por outro lado, não há como desconsiderar seu papel social para significativa parcela da população

The guidelines of the National Oral Health Policies directed to the inclusion of elementary prosthesis in the Primary Care (PC) highlighting their relevance. This research was about the experience of Dental Surgeons (DS) with the Acrylic Partial Denture Partial Prosthesis (APD), as part of the index of procedures which constitute the Basic Health Units (BHU) in the city of Belo Horizonte (11.949 units between August 2010 and September 2016). It aimed at identifying the difficulties regarding inthe various phases of confection of the ARPP, satisfaction of dentists and failures. 155 dental surgeons of the public health system were part of the sampling (sampling calculation via proportion estimate, with a sampling error of 7%, condition prevalence of 50% and significance level of 95%), who were selected amongst the 359 who are part of it, through a random choice (simple random sampling). The final sample was proportionally distributed to the number of dental surgeons within each sanitary district of Belo Horizonte. A structured questionnaire was built, with 72 questionsconcerning the daily practice of performance of the ARPP beyond dentistry sociodemograph and work data, using the platform SurveyMonkey . Both descriptive and statistic analysis of the results were performed. A factorial analysis from the policoric correlation matrix was carried out for the questions about satisfaction, difficulties and preparation and scores were obtained through the correlation coefficient calculation of Spearman. The analysis of the correlations found showed that being better prepared for performing ARPP implied in presenting fewer difficulties in its various stages. Being more satisfied implied in being more prepared to perform it. The same scores related to failures in the various stages were seen later. When correlating the failures and preparation scores, it could be seen that the better prepared, the higher the lack of failures. With regards to satisfaction and failures, it was verified that the higher the satisfaction rate, the higher the lack of failures. As for the scores of difficulties and failures, it could be pinpointed that the greater the difficulty, the fewer failures, the opposite of what had been expected. From a socio-demographic bivariate analysis and the reports of failures of the work of professionals, the logical regression of the most significant results was conducted, realizing that the DS who negatively evaluated the inclusion of ARPP in the index of procedures of the PCs has 1,71 more chances of achieving the highest failure in the making of ARPP. For those who graduated in private institutions there are 4,51 times more chances of having failures in comparison to those who graduated in public institutions. When the experience with the performance was negative there were 3,85 times more chances of failing. The high frequency of confection from PPRA in several countries financed most cases by public health systems points to the need to study it and to train professionals to perfom it, under penalty, otherwise it will become a public health problem. However, there is no how to disregard their social role

Avaliação comparativa dos níveis de desajustes marginais de pilares UCLAS calcináveis assentados sobre a plataforma de implantes e sobre pilar cônico em próteses fixas implantosuportadas / Comparative assessment of the levels of marginal misfits UCLAS calcinable pillars seated on the platform and on implant abutment conical

Este trabalho objetivou avaliar os níveis de desajustes marginais de infraestruturas metálicas em próteses fixas assentadas sobre pilar cônico pré-fabricado (estheticone) e diretamente sobre o hexagonal do implante. Foram obtidas quatro amostras de infraestruturas de próteses fixas fundidas em liga de Níquel-Cromo assentadas sobre análogos de implantes regulares e sobre análogos do pilar cônico. As infraestruturas foram distribuídas em dois grupos (n=2) experimentais. Os desajustes marginais verticais (µm) foram avaliados com o emprego de um microscópio mensurador digital. Cada amostra recebeu quatro marcações diametralmente opostas (mesial, distal, vestibular e lingual) e foram avaliadas três vezes em cada uma dessas superfícies com o parafuso de fixação devidamente adaptado. Para a análise estatística foi utilizado o teste de U Mann Whitney na correlação dos valores das quatro faces diametralmente opostas (mesial, distal, vestibular e lingual) de ambos os grupos. Ainda, utilizou-se o teste Kruskal-Wallis para correlacionar os valores obtidos entre os pilares empregados. Os resultados mostraram que não houve diferença estatisticamente significante no desajuste marginal entre os grupos comparados. Concluiu-se que não houve diferença no desajuste marginal de infraestruturas metálicas de próteses sobre implantes fundidas com ligas de Ni-Cr com UCLA assentados sobre pilar estheticone ou diretamente sobre o hexágono de um implante de plataforma regular (AU).

The objective of this work was to evaluate the levels of marginal mismatches of metallic infrastructures on fixed prostheses seated on the following types of platforms: pre-fabricated conical pillar (estheticone), pillar UCLA, and directly on the hexagonal of the implant. Samples of infrastructures of fixed prostheses made of nickel-chrome alloy and seated on similar regular implants and on similar conical pillar were used. The infrastructures were distributed in two experimental groups (pillar estheticone and direct pillar on the platform). For the evaluation of vertical marginal mismatches (µm), each sample was seated on its platform and observed with the aid of a digital measuring microscope. Each sample received four marks, diametrically opposite to each other (mesial, distal, vestibular, and lingual) and all samples were evaluated three times in each surface with the fixation screw properly adapted. The averages of these evaluations were obtained using U Mann Whitney and Kruskal-Wallis statistical tests. The result of the U Mann Whitney test,did not show significant statistical difference while Kruskal-Wallis test showed difference between the estheticone pillar and the UCLA pillar. The estheticone pillar showed lower mismatches averages than the UCLA pillar and, no significant statistical difference was observed in the comparison with the hexagonal platform of the implant (AU).

Influência da reabilitação protética imediata na saúde periodontal: relato de caso / Influence immediate prosthetic rehabilitation on periodontal health: Case Report

A busca por uma composição agradável no sorriso, tornou-se uma demanda mundial, porém para produzir sorrisos harmoniosos, é essencial uma abordagem multidisciplinar. Paciente sexo masculino, leucoderma, 48 anos, gênero masculino, não fumante, não etilista, queixou-se de ausências de dentes, observou-se doença periodontal crônica agressiva com presença de sangramento, exsudato purulento, halitose, abfrações e lesão periapical. Foram feitas múltiplas raspagens periodontais associadas a terapia periodontal cirúrgica, com consequente avulsão dentária juntamente com protocolo medicamentoso e acompanhamento semanal por um período de 06 meses. Noventa dias após remissão da doença periodontal indicou-se exodontia de múltiplos elementos e iniciou-se tratamento restaurador protético imediato. Paciente encontra-se em proservação já há 12 meses, mantendo níveis ótimos de higiene oral e satisfação funcional e estética. Na diária clínica, a associação de procedimentos periodontais, cirúrgicos e protéticos, bem como a colaborativa do paciente tornam-se de extrema importância, para harmonizar a relação entre os aspectos biológicos e estéticos, a fim de restabelecer a saúde bucal e a composição do sorrisonfluência da reabilitação protética imediata na saúde periodontal: relato de caso (AU)

The search for a pleasant composition in the smile has become a worldwide demand, but to produce harmonious smiles, a multidisciplinary approach is essential. Male patient, leucoderma, 48 years old, male, non-smoker, non-alcoholic, complained of absence of teeth, aggressive chronic periodontal disease with bleeding, purulent exudate, halitosis, periapical lesions and periapical lesions. Multiple periodontal scrapes were associated with periodontal surgical therapy, with consequent dental avulsion along with drug protocol and weekly followup for a period of 06 months. Ninety days after remission of periodontal disease, multiple element extraction was indicated and immediate prosthetic restorative treatment was initiated. Patient has been in proservation for 6 months, maintaining optimal levels of oral hygiene and functional and aesthetic satisfaction. In the clinical daily routine, the association of periodontal, surgical and prosthetic procedures, as well as the patient's collaborative, become extremely important, in order to harmonize the relationship between biological and aesthetic aspects, in order to restore oral health and smile composition .(AU)

Three-Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques.

PURPOSE: The aim of this prospective clinical study was to evaluate the 3-year outcome of fixed partial prostheses supported by implants with immediate provisionalization without occlusal contacts inserted in predominantly soft bone with flap and flapless protocols. MATERIALS AND METHODS: Forty-one patients partially rehabilitated with 72 NobelSpeedy implants (51 maxillary; 21 mandibular) were consecutively included and treated with a flapless surgical protocol (n = 20 patients; 32 implants) and flapped surgical protocol (n = 21 patients; 40 implants). Primary outcome measure was implant survival; secondary outcome measures were marginal bone resorption (comparing the bone levels at 1 and 3 years with baseline) and the incidence of biological, mechanical, and esthetic complications. Survival was computed through life tables; descriptive statistics were applied to the remaining variables of interest. RESULTS: Eight patients with eight implants dropped out of the study. One implant failed in one patient (flapless group) giving an overall cumulative survival rate (CSR) of 98.6%. No failures were noted with the flapped protocol (CSR 100%), while for the implants placed with the flapless surgical technique, a 96.9% CSR was registered. The overall average marginal bone resorption at 3 years was 1.37 mm (SD = 0.94 mm), with 1.14 mm (SD = 0.49 mm) and 1.60 mm (SD = 1.22 mm) for the flap and flapless groups, respectively. Mechanical complications occurred in nine patients (n = 5 patients in the flapless group; n = 4 patients in the flap group). Implant infection was registered in three implants and three patients (flapless group), who exhibited inadequate oral hygiene levels. CONCLUSIONS: Partial edentulism rehabilitation through immediate provisionalization fixed prosthesis supported by dental implants inserted through flap or flapless surgical techniques in areas of predominantly soft bone was viable at 3 years of follow-up. The limitations and risks of the "free-hand" method in flapless surgery should be considered when planning implant-supported fixed prosthetic reconstructions.