RESUMEN
Implant-supported complete dentures are a common procedure for patients with mandibular edentulism problems. This article documents the protocol for immediate functional loading of fixed transient mandibular prostheses with fully moldable attachments and distal extensions to prevent fractures. A 56-year-old female patient was referred to the Oral Rehabilitation and Implantology Service due to periodontal problems, difficulty in chewing capacity and aesthetic compromise. The patient was treated in a single surgical procedure with dental extractions, guided regularization of the alveolar process and guided placement of five interforaminal implants and placement of functional fixed mandibular prostheses with immediate loading with personalized UCLA'S, distal extensions and short arc occlusal scheme. At 3 months postoperatively, the definitive placement of fixed mandibular metal acrylic prostheses and conventional upper prostheses was performed. The functional and aesthetic integrity of the fixed mandibular prosthesis implant preserved with UCLA'S documents that implant placement in the interforaminal zone with an immediate loading protocol is a viable treatment option for prosthetic rehabilitation of the fully edentulous mandibular arch and that design with distal extensions in the posterior sector of the mandibular arch is an effective option to avoid fracture of the prostheses, presenting a survival of the five mandibular implants of 100% at 1 year postoperatively.
RESUMEN
Prosthetic biomaterials can affect the composition of the subgingival microbiota and consequently the production of proinflammatory cytokines, causing damage to the periodontium. A total of 40 patients were divided into two groups: 20 with monolithic zirconia (MZ) prostheses and 20 with porcelain fused to metal (PFM) with nickel-chromium (Ni-Cr) alloy prostheses. Subgingival plaque and gingival crevicular fluid samples were taken. The Checkerboard technique for DNA-DNA hybridization and the enzyme-linked immunosorbent assay technique were performed. Teeth with MZ presented a lower percentage of bleeding on probing and tooth mobility compared to teeth with PFM with Ni-Cr alloy. Prosthodontic teeth harbored higher total levels of the 18 bacterial species than non-prosthodontic teeth. There was a higher prevalence of S. gordonii and V. parvula species in PFM with Ni-Cr alloy compared to MZ. There was an increase in IL-1ß, TNF-α and CX3CL1 levels in PFM with Ni-Cr alloy compared to MZ. MZ is a candidate biomaterial with fewer negative effects on the periodontium, allowing for longer prostheses longevity in the mouth.
