Immediate loaded fixed complete dentures supported by implants in patients with a history of periodontitis: A retrospective cohort study of 2 to 7 years.

STATEMENT OF PROBLEM: The outcome of implant-supported fixed complete dentures in edentulous patients with a history of periodontitis is unclear. PURPOSE: The purpose of this retrospective clinical study was to assess the clinical outcomes of immediate loaded fixed complete dentures in individuals with a history of periodontitis and to analyze risk factors related to implant failure. MATERIAL AND METHODS: A total of 642 implants (146 prostheses) in 119 patients were included. The follow-up period ranged from 2 to 7 years. Implant survival rates, marginal bone loss, mechanical complications, biologic complications, and patient satisfaction were evaluated. The Pearson chi-square test, independent samples t test, and multivariate generalized estimating equation were performed for statistical analysis (α=.05). RESULTS: Eleven implants in 9 patients failed, leading to overall survival rates of 98.3% at the implant level and 92.4% at the patient level. The mean ±standard deviation marginal bone loss was 0.62 ±0.86 mm, and marginal bone loss did not differ significantly between axial and tilted implants (P>.05). Mechanical complications were detected in 55 (37.7%) definitive prostheses; biologic complications were detected in 318 (49.5%) implants. Smokers had a significantly lower survival rate than nonsmokers (odds ratio: 6.880, P=.013). Bruxers had a significantly higher incidence of mechanical complications than nonbruxers (P<.001). CONCLUSIONS: The immediate loaded fixed complete denture supported by implants is a suitable treatment option for edentulous patients with a history of periodontitis, with high survival implant rates. Smoking is a risk factor for implant failure. Bruxism may increase the incidence of mechanical complications with implant-supported fixed complete dentures, and the overall biologic complication incidence is comparatively high.

Preparation of ICD and overdenture in patients with Cushing's Syndrome: five-year follow-up / Preparo de PTI e overdenture em pacientes com Síndrome de Cushing: cinco anos de acompanhamento

The aim of this study is to report a clinical case of a patient with Cushing's syndrome, low self-esteem and need for oral rehabilitation. A 50-year-old female patient with hypercortisolism sought care at School of Dentistry of the Federal University of Minas Gerais. During anamnesis, the patient reported painful symptoms and mobility of the upper and lower teeth. On clinical examination, absence of many teeth were observed, periodontal disease and caries lesions. After discussion of the case, the planning involved the extraction of all teeth, and the preparation of Maxillary Immediate Complete Dentures (ICD's) and Immediate Mandibular Implant-retained Overdenture (IMIO). The treatment proposed allowed the restored aesthetics, phonetics and chewing(AU)

O objetivo desse estudo é relatar um caso clínico de uma paciente com síndrome de Cushing, baixa autoestima e necessidade de reabilitação oral. Paciente do sexo feminino, 50 anos de idade e com hipercortisolismo, procurou atendimento na Faculdade de Odontologia da Universidade Federal de Minas Gerais. Durante a anamnese, a paciente relatou sintomas dolorosos e mobilidade dos dentes superiores e inferiores. No exame clínico, foi observada a ausência de muitos dentes, doença periodontal e lesões cariosas. Após a discussão do caso, o planejamento envolveu a extração de todos os dentes, e o preparo de Prótese Total Imediata maxilar (PTI), e Overdenture Implantorretida Imediata mandibular. O tratamento proposto permitiu que restaurasse a estética, fonética e mastigação(AU)

Qualitative evaluation of immediate rehabilitation: a case report with 5 years of follow-up / Avaliação qualitativa de reabilitação imediata: relato de caso com 5 anos de acompanhamento

Próteses totais imediatas e overdentures mandibulares em carga imediata, são boas alternativas para restaurar a função e a estética. Além disso, proporcionam um fator psicológico positivo, eliminando as consequências emocionais e sociais da perda dos dentes. O objetivo deste estudo foi relatar um caso clínico, com cinco anos de acompanhamento, utilizando parâmetros clínicos e ferramentas qualitativas, para analisar o impacto na qualidade de vida do paciente e no sucesso do tratamento. Este caso clínico foi desenvolvido em um projeto assistencial da Faculdade de Odontologia da Universidade Federal de Minas Gerais, Brasil, que promove a reabilitação oral de pacientes de baixa renda com dentes severamente comprometidos. Paciente do sexo masculino, 57 anos, apresentou-se para tratamento com condição severa de saúde dental e periodontal. O plano de tratamento proposto foi a extração dos dentes remanescentes e confecção de prótese total imediata maxilar e overdenture mandibular, em carga imediata, sobre implantes. O paciente foi acompanhado periodicamente, a cada seis meses, para substituição do o´rings, conforme recomendação do fabricante. Após 5 anos, as próteses foram reembasadas com resina acrílica termopolimerizável e os componentes protéticos da overdenture foram substituídos. Em um acompanhamento qualitativo, a equipe utilizou uma entrevista narrativa, com foco nos impactos do tratamento na qualidade de vida desse paciente. Ele confirmou, em um relato em primeira pessoa, sua satisfação com o tratamento realizado e a melhora nas relações sociais, afetivas e no trabalho, mostrando como a reconquista do sorriso pode transformar a experiência pessoal do indivíduo(AU)

Immediate complete dentures and mandibular immediately loaded overdentures are good alternatives to restore function and aesthetics. Moreover, they provide positive psychological factor, eliminating the emotional and social consequences of tooth loss. The aim of this study was to report a clinical case, with five years of follow-up using clinical parameters and qualitative tools, to analyze the impact on quality of life and the success of treatment. This clinical case was developed in an assistance project of the Dental School of Federal University of Minas Gerais in Brazil, which promotes oral rehabilitation of low-income patients with severely damaged dentitions. A 57-yearold male patient presented for treatment with a severe dental and periodontal health condition. The proposed treatment plan was extraction of the remaining teeth and making maxillary immediate complete denture and mandibular immediately loaded implant-supported overdenture. The patient was monitored periodically, every six months, to replace the polymer ring ball attachment, according to the manufacturer's recommendation. After 5 years, the prostheses were relining with heat-polymerized acrylic resin and overdenture prosthetic components were replaced. In a qualitative follow-up, the team used a narrative interview, focusing on the impacts of treatment in the quality of life of this patient. He confirms, in a firstperson account, his satisfaction with the treatment performed and improvements in social and affective relations and in the work, showing how the reconquest of the smile can transform the personal experience of the individual(AU)

Innovative subtractive production of a digital removable complete denture from start to finish: a JPD Digital video presentation.

This JPD Digital video presentation presents the clinical treatment from start to finish in which a dual-shaded bi-coloured monolithic disk was used for the fabrication of an immediate digital complete denture followed by the delivery of a definitive digital complete denture. The treatment plan included extraction of the remaining maxillary and mandibular teeth followed by an esthetic evaluation with digital smile design. The digital definitive complete dentures were milled from a monolithic dual-shaded disk.

Manejo interdisciplinario para una óptima rehabilitación oral / Interdisciplinary management for optimal oral rehabilitation

Las estrategias para el éxito en la rehabilitación bucal requieren de la interrelación de varias disciplinas que en conjunto logren resultados predecibles y duraderos. La visión individualizada de cada área de especialidad puede conllevar a no ofrecer la mejor alternativa de tratamiento, es por ello que la valoración, el diagnóstico y la planificación del caso clínico debe ser realizada por un equipo interdisciplinario para evitar esta situación y crear una sinergia en donde el «todo sea mayor que la suma de sus partes¼. El objetivo de este trabajo es presentar un caso clínico en el cual intervinieron varias áreas de especialidad: periodoncia, prostodoncia, cirugía oral y patología bucal, logrando devolver la función y la estética a través del manejo interdisciplinario (AU)

The strategies for success in oral rehabilitation require the interrelation of several disciplines, which together, achieve predictable and lasting results. The individualized view of each specialty area may lead to not offering the best treatment alternative, which is why the assessment, diagnosis, and planning of the clinical case must be carried out by an interdisciplinary team to avoid this situation and create a synergy in where the «whole is greater than the sum of its parts¼. The objective of this work is to present a clinical case where several areas of specialty intervened: periodontics, prosthodontics, oral surgery, and oral pathology, thus achieving the return of function and aesthetics through interdisciplinary management (AU)

Digital Immediate Complete Denture for a Patient with Rhabdomyosarcoma: A Clinical Report.

Fabricating an immediate complete denture can be very challenging in some clinical situations. This clinical report describes a digital workflow to fabricate a printed maxillary immediate complete denture for a patient with a severely compromised maxilla. Digital data obtained by using an intraoral scanner was utilized to reconstruct the three-dimensional (3D) image of the jaws at the desirable vertical dimension of occlusion. After performing the virtual teeth extraction and alveoloplasty, the denture base and teeth were designed. The resulting data were exported to a 3D printer for denture fabrication and the 3D printed (additively manufactured) denture was successfully inserted immediately after the surgery. After initial healing and confirmation of good retention and function, a new printed denture was fabricated by digitally duplicating the relined denture maintaining the same teeth positions but adjusting the base to a new intraoral scan of the healed ridge.

A Technique to Fabricate an Interim Implant-Supported Fixed Complete Denture for Immediate Loading.

Converting an acrylic resin removable complete prosthesis into a fixed implant-supported prosthesis to immediately load the implants can be a challenging procedure. Using acrylic resin to secure titanium interim copings intraorally may be a difficult task, and any process to facilitate this procedure may be advantageous for the clinician and the patient. This report describes a technique for facilitating the fabrication of an interim immediately loaded implant-supported fixed complete prosthesis. This technique and the materials used enabled the efficient fabrication and delivery of the prosthesis with an appropriate soft-tissue surface and acrylic resin thickness without irritating newly sutured soft tissues.

Improving digital scans by using a peripheral custom tray: A dental technique.

A digital dental technique is described for registering functional borders of immediate complete dentures, by using an intraoral scanner, a dental computer-aided design software program, and a peripheral custom tray. This article also illustrates how to virtually match the recorded information in order to transform the initial intraoral scan into definitive digital scans.

Reproduction of Esthetic Individuality in Upper Immediate Complete Denture / Reproducción de la Individualidad Estética en Prótesis Completa Inmediata Superior

ABSTRACT: Prosthodontics, in general, aims to rehabilitate the masticatory function of the patient, as well as the stomatognathic system, maintaining his or her individual facial characteristics. The immediate removable complete denture is placed immediately after extraction of the natural teeth and allows adaptation of the patient from the dentate state to the denture, until the definitive denture is placed. When an immediate complete denture is fabricated, esthetics plays a fundamental role and thus the assembly of artificial teeth can be performed maintaining the same position, alignment and arrangement of the remaining anterior teeth, providing a natural and esthetic appearance to the denture, thus the transition from the dentate to the edentulous state is less noticeable. This paper reports the case of a patient who needed oral rehabilitation with an immediate upper complete denture and presented favorable smile esthetics of the anterior teeth, which allowed the preservation of alignment, position and arrangement of natural teeth during the assembly of artificial teeth, maintaining and preserving the esthetic individuality and facial harmonization, meeting the patient's desire and expectations.

RESUMEN: La prostodoncia, en general, tiene como objetivo rehabilitar la función masticatoria del paciente, así como el sistema estomatognático, manteniendo sus características faciales individuales. La dentadura postiza completa removible se coloca inmediatamente después de la extracción de los dientes naturales y permite la adaptación del paciente del estado dentado a la dentadura, hasta que se coloque la dentadura definitiva. Cuando se fabrica una dentadura postiza completa inmediata, la estética juega un papel fundamental y, por lo tanto, el ensamblaje de dientes artificiales se puede realizar manteniendo la misma posición, alineación y disposición de los dientes anteriores restantes, proporcionando un aspecto natural y estético a la dentadura, por lo tanto, la transición desde el estado dentado hasta el estado desdentado es menos notable. Este artículo informa el caso de una paciente que necesitó rehabilitación oral con una dentadura postiza completa superior inmediata y presentó una estética de sonrisa favorable de los dientes anteriores, lo que permitió preservar la alineación, la posición y la disposición de los dientes naturales durante el ensamblaje de los dientes artificiales, manteniendo y preservando la individualidad estética y la armonización facial, satisfaciendo los deseos y expectativas del paciente.

Digitally Fabricated Immediate Complete Dentures: Case Reports of Milled and Printed Dentures.

Milling complete dentures is becoming a popular option for clinicians because subtractive technology can make the fabrication of high-quality dentures faster and easier. Additive technology is one of the newest techniques for making complete dentures, and its primary advantage is that a printer is more financially accessible than a milling machine. Printing and milling technologies as methods for denture fabrication have similar steps and time frames for their processes. The production of immediate complete dentures also follows similar procedures for both systems. The aim of this article is to compare subtractive and additive technologies for the manufacture of immediate complete dentures and to present two case reports.

Digital prosthodontic management of a young patient with Papillon-Lefèvre syndrome: A clinical report.

Papillon-Lefèvre syndrome (PLS) is a rare disorder that leads to symptoms including the early progressive loss of deciduous and permanent teeth. Prosthodontic management of children and adolescents affected by PLS sometimes requires an immediate complete denture. Tooth mobility presents a challenge to the dentist, especially during impression-making. This clinical report describes the management of a 14-year-old boy with PLS by using an intraoral scanner to prevent conventional impressions and a fully digital workflow for the design and fabrication of immediate complete dentures.

Planejamento cirúrgico-protético na confecção de prótese total imediata: relato de caso clínico / Surgical-prosthetic planning in the immediate denture prosthesis placement: a clinical report

A prótese total imediata é um aparelho provisório construído previamente as extrações dos dentes remanescentes, com a finalidade de auxiliar na cicatrização e favorecer o conforto no pós-operatório, devolvendo função, estética e fonética imediatamente após as exodontias. Desta forma, esse relato de caso clínico tem por objetivo apresentar o planejamento cirúrgico-protético da reabilitação oral por meio de uma prótese total imediata maxilar, bem como os resultados obtidos com essa modalidade de tratamento. Paciente gênero masculino, 77 anos de idade, foi submetido a múltiplas extrações dentárias, seguindo da instalação de uma prótese total imediata superior e uma prótese total convencional provisória inferior. Ambas as próteses foram confeccionadas antes da remoção cirúrgica dos elementos dentários remanescentes e inseridas imediatamente após a cirurgia. Assim, através dessa modalidade de tratamento reabilitador, proporcionamos ao paciente autoestima, conforto, estética e função, imediatamente após as extrações dentárias, diminuindo o tempo entre a exodontia completa e a confecção de uma prótese total convencional(AU)

Immediate denture prosthesis is a temporary rehabilitating that is fabricated before all the remaining teeth have been removed, with the purpose of assisting in healing and favoring patient comfort in the postoperative period, returning function, aesthetic and phonetics immediately after the exodontia. Thus, this clinical case report aims to present the surgical-prosthetic planning of the oral rehabilitation through an immediate total maxillary prosthesis, as well as the results obtained with this treatment modality. A 77 years old male patient underwent multiple upper dental extractions, followed by the installation of an immediate superior total prosthesis and lower provisional total conventional prosthesis. Both dentures were made before surgical removal of the remaining dental elements and inserted immediately following the surgery. Like this, through this modality of rehabilitation treatment, we provide the patient with self-esteem, comfort, esthetics and function, immediately after the teeth extractions, reducing the time between the complete extraction and the construction of the conventional denture prosthesis(AU)

A Technique to Correct Anterior-Posterior Tooth Discrepancy for a Maxillary Immediate Complete Denture.

This article describes a chairside technique to correct inappropriate occlusal vertical dimension as well as the inaccurate anterior-posterior tooth set-up of a maxillary immediate complete denture. When fabricating an immediate denture, the inability of a wax-denture trial and the potential for unpredictable complications during surgery, compromised esthetics and function of an immediate complete denture may pose a clinical problem, which needs instant correction. The technique described can provide an alternative method to correct and deliver a definitive immediate complete denture on the day of surgery.

A digital technique for fabricating an interim implant-supported fixed prosthesis immediately after implant placement in patients with complete edentulism.

The conversion of a denture into an interim implant-supported, screw-retained restoration has become the standard method for immediate interim restoration in patients with complete edentulism. The most critical steps of the denture conversion process are the creation of appropriate denture access holes to prevent displacement of the denture by the interim cylinders and removal of the denture flanges to facilitate both good esthetics and accessibility for oral hygiene after the denture is connected to the interim cylinders. This article presents a digital technique for designing and fabricating an interim implant-supported, fixed prosthesis for edentulous patients. The interim prosthesis has cylinder access holes that are digitally prefabricated and a denture flange part that is designed to be easily sectioned. This technique facilitates more straightforward and efficient immediate restoration for edentulous patients after implant placement.

Immediate Postextraction Screw-Retained Partial and Full-Arch Rehabilitation: A 3-Year Follow-up Retrospective Clinical Study.

The aim of this study was to document the performance of a novel technique (OnlyOne), involving immediate restoration of postextraction implants supporting a partial or full-arch restoration. A retrospective analysis of patients with at least 3 years of follow-up was performed. Implants were tilted mesiodistally and vestibulopalatally according to the available bone. Prosthetically guided definitive abutments were connected at surgery and never disconnected. Anorganic bovine bone grafting was done to preserve the buccal bone and the ridge contour. Patients received a screw-retained provisional prosthesis within 24 hours of surgery and a final screw-retained prosthesis within 1 year. Prostheses emerged from natural soft tissue. Clinical and radiographic evaluation was routinely performed. A total of 70 patients received 153 implants in fresh extraction sockets. The mean follow-up was 38.0 ± 3.0 months (range 36 to 51 months). One implant failed at the 3-year follow-up. Implant survival was 99.3%. Marginal bone level change averaged -0.68 ± 1.2 mm at the last radiographic control. Immediate placement and restoration of implants designed for high primary stability with a definitive abutment placed at surgery and final screw-retained prosthesis with no artificial gingiva is a viable procedure with excellent medium-term outcomes.

Fabrication of an implant-supported fixed complete denture using multiple digital technologies for a patient with a perioral burn: A clinical report.

This clinical report describes the prosthetic and surgical management of a patient with a restricted oral orifice due to a perioral burn. Complete oral rehabilitation was achieved with maxillary and mandibular implant-supported fixed prostheses using a combination of digital and conventional impressions, design, and processing techniques.

Importancia estética de la prótesis inmediata / Cosmetic importance of the immediate prosthesis

Se presentan los casos clínicos de 3 adultos con dientes extraídos, atendidos en la consulta de prótesis dental del Policlínico Docente 30 de Noviembre" de Santiago de Cuba, a quienes se les colocó prótesis inmediata como única solución ante el deterioro bucal que presentaban. Con el proceder realizado se logró la recuperación estética de los pacientes, así como la reinserción en las actividades sociales y laborales, evitando así las afectaciones psíquicas que suelen aparecer

The case reports of 3 adults with extracted teeth are presented. They were assisted in the dental prosthesis service of 30 de Noviembre Teaching Polyclinic in Santiago de Cuba to whom immediate prothesis were placed as the only solution due to the oral deterioration that presented. With this procedure the cosmetics of the patients was recovered and their reintegration to the social and labor activities was achieved, with which the psychic disorders that usually appear were avoided

Importancia estética de la prótesis inmediata / Cosmetic importance of the immediate prosthesis

Se presentan los casos clínicos de 3 adultos con dientes extraídos, atendidos en la consulta de prótesis dental del Policlínico Docente 30 de Noviembre de Santiago de Cuba, a quienes se les colocó prótesis inmediata como única solución ante el deterioro bucal que presentaban. Con el proceder realizado se logró la recuperación estética de los pacientes, así como la reinserción en las actividades sociales y laborales, evitando así las afectaciones psíquicas que suelen aparecer(AU)

The case reports of 3 adults with extracted teeth are presented. They were assisted in the dental prosthesis service of 30 de Noviembre Teaching Polyclinic in Santiago de Cuba to whom immediate prothesis were placed as the only solution due to the oral deterioration that presented. With this procedure the cosmetics of the patients was recovered and their reintegration to the social and labor activities was achieved, with which the psychic disorders that usually appear were avoided(AU)

Confecção de prótese imediata do tipo protocolo, utilizando transferentes multifuncionais PEEK / Preparation of immediate prosthesis of protocol type, using PEEK multifunctional transfer devices

A possibilidade de reabilitação oral com implantes dentários tem mostrado avanços surpreendentes. A evolução das técnicas cirúrgicas e os materiais disponíveis para reabilitação viabilizam a confecção de protocolos de único estágio. O relato clínico demonstra a substituição da prótese parcial superior por prótese fixa tipo protocolo imediato, utilizando-se do componente transferente do tipo PEEK, proporcionando maior conforto, estética e eficiência mastigatória.

The possibility of oral rehabilitation with dental implants has been showing surprising advances. The evolution of surgical techniques and the materials available for rehabilitation enable the elaboration of single-stage protocols. The clinical report presents the upper partial prosthesis replacement with immediate protocol fixed prosthesis type, using the PEEKtype transfer component, providing greater comfort, aesthetics and masticatory efficiency.