RESUMEN
The latest generation of intraoral scanners can record the prosthetic field with relative ease, high accuracy and comfort for the patient, and have enabled fully digital protocols for designing and manufacturing complete dentures. The present study aims to examine the intaglio surface trueness of 3D printed maxillary dentures produced by fully digital workflow in comparison with dentures produced by analogue clinical and laboratory prosthetic workflow. The edentulous maxillary arch of 15 patients was scanned with an intraoral scanner as well as the intaglio of the delivered conventional denture. The scan of the edentulous arch was imported into a dental design software to produce the denture base which was then 3D printed. The intaglio surface of the finished 3D printed denture bases was digitized and used to assess the trueness of the printed denture bases compared to the intaglio surface of the conventional dentures as well as performing a trueness comparison in relation to the scanned edentulous arches. The dataset (n = 30) was subjected to Kruskal-Wallis test analysis, the significance level being established at α = 0.05. The results of the study showed that the printed group displayed better trueness values with a median of 176.9 µm while the analogue group showed a median of 342 µm. Employing a fully digital workflow to produce 3D-printed denture bases yields a consistent and precise manufacturing method when accounting for the intaglio surface of the denture.
Asunto(s)
Bases para Dentadura , Diseño de Dentadura , Impresión Tridimensional , Flujo de Trabajo , Humanos , Diseño de Dentadura/métodos , Diseño Asistido por Computadora , Femenino , Arcada Edéntula , Dentadura Completa SuperiorRESUMEN
STATEMENT OF PROBLEM: The success of a removable partial denture depends on its fit, and, with conventional casting, the framework is more distorted in patients with a deep palatal vault. Questions remain about whether the three-dimensional (3D) printing technique for fabricating a framework can improve the accuracy of fit for these patients. PURPOSE: The purpose of this in vitro study was to compare the trueness of metal frameworks fabricated by selective laser melting, 3D printing pattern casting, and conventional casting for different palatal vault depths. MATERIAL AND METHODS: A total of 30 partially edentulous maxillary casts were custom-made in 15 medium and 15 deep palatal vaults. All stone casts were scanned as reference models in digital files. For the medium palatal vault casts, Co-Cr frameworks of the conventional casting (CON) group (n=5) were fabricated with the lost wax technique. For the 3D printing pattern casting (PPC) group (n=5), wax patterns of the framework were printed, followed by metal casting. The frameworks created for the selective laser melting (SLM) group (n=5) were printed directly by using the SLM machine. The same procedures were followed for the deep palatal vault group. All the metal frameworks were scanned and superimposed with the reference casts by using the Geomagic Control X software program. Discrepancies were measured as mean ±standard deviation (trueness), and the data were statistically analyzed with a 2-way ANOVA test to evaluate the interaction of 2 independent factors (fabrication techniques and palatal vault depths) on a trueness outcome (α=.05). RESULTS: The lowest mean ±standard deviation value was 0.092 ±0.023 mm, found from the SLM framework with deep palatal vault group, while the highest value was 0.194 ±0.017 mm, found from the CON framework with deep palatal vault group. Different fabrication techniques interacted with different palatal vault depths in terms of trueness (P<.05); however, no significant differences were observed in the medium palatal vault groups (P>.05). Additionally, color mapping demonstrated the gaps of metal frameworks among the 6 groups. CONCLUSIONS: With the conventional casting technique, the accuracy of the metal framework was affected by the depth of the palate. For medium palatal vaults, all fabricated frameworks had clinically acceptable fit. For deep palatal vaults, the SLM frameworks showed the lowest discrepancy. As a result, the SLM technique is advised for fabricating a better-fitting metal framework for patients with a deep palatal vault.
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Técnica de Colado Dental , Diseño de Dentadura , Dentadura Parcial Removible , Impresión Tridimensional , Humanos , Diseño de Dentadura/métodos , Técnicas In Vitro , Diseño Asistido por Computadora , Modelos DentalesRESUMEN
OBJECTIVES: The purpose of this scoping review was to identify different methods employed for recording the maxillomandibular relationship (MMR) for computer-aided designed and manufactured (CAD-CAM) complete dentures (CDs). MATERIALS AND METHODS: This scoping review followed the PRISMA-ScR guidelines and was developed according to Arksey and O'Malley and The Joanna Briggs Institute protocol. The methods were registered on the Open Science Framework (< osf.io/rf4xm> ). The focus question was: "What are the different techniques for recording the maxillomandibular relationship in the digital workflow used in CECDs?" Two investigators searched 3 online databases [MEDLINE (PubMed), Scopus, and Science Direct] independently. The inclusion criteria were clinical studies and reviews that assessed techniques for recording MMR using digital workflow for manufacturing of CECDs. A descriptive analysis was performed considering the study design, manufacturing system, clinical steps, and tools for the determination of MMR, and the difficulty level of procedures. RESULTS: 4779 articles were identified in the electronic search and 10 studies were included for data analysis. The review identified 4 commercially available CAD-CAM denture systems and 3 innovative methods suitable for abbreviating the number of appointments (2 to 4 visits). The trial denture is inherent to the procedure for the Baltic System and 3 innovative techniques. Three techniques (2 innovative and WholeYouNexteeth) demonstrated lower difficulty levels for performing the clinical procedures, regardless of the professional skills. CONCLUSIONS: The commercially available and innovative techniques for the recording of MMR may provide predictability of the treatment. The techniques are effective, however, rely on the learning curve and the patient's clinical condition. CLINICAL RELEVANCE: Recording of the maxillomandibular relationship is paramount for the manufacturing and functionality of complete dentures. Clinicians should be aware of the different tools and techniques described for registering the jaw relationship.
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Diseño Asistido por Computadora , Diseño de Dentadura , Dentadura Completa , Humanos , Diseño de Dentadura/métodos , Registro de la Relación Maxilomandibular/métodosRESUMEN
BACKGROUND AND OBJECTIVE: Complete denture is a common restorative treatment in dental patients and the design of the core components (major connector and retentive mesh) of complete denture metal base (CDMB) is the basis of successful restoration. However, the automated design process of CDMB has become a challenging task primarily due to the complexity of manual interaction, low personalization, and low design accuracy. METHODS: To solve the existing problems, we develop a computer-aided Segmentation Network-driven CDMB design framework, called CDMB-SegNet, to automatically generate personalized digital design boundaries for complete dentures of edentulous patients. Specifically, CDMB-SegNet consists of a novel upright-orientation adjustment module (UO-AM), a dental feature-driven segmentation network, and a specific boundary-optimization design module (BO-DM). UO-AM automatically identifies key points for locating spatial attitude of the three-dimensional dental model with arbitrary posture, while BO-DM can result in smoother and more personalized designs for complete denture. In addition, to achieve efficient and accurate feature extraction and segmentation of 3D edentulous models with irregular gingival tissues, the light-weight backbone network is also incorporated into CDMB-SegNet. RESULTS: Experimental results on a large clinical dataset showed that CDMB-SegNet can achieve superior performance over the state-of-the-art methods. Quantitative evaluation (major connector/retentive mesh) showed improved Accuracy (98.54 ± 0.58 %/97.73 ± 0.92 %) and IoU (87.42 ± 5.48 %/70.42 ± 7.95 %), and reduced Maximum Symmetric Surface Distance (4.54 ± 2.06 mm/4.62 ± 1.68 mm), Average Symmetric Surface Distance (1.45 ± 0.63mm/1.28 ± 0.54 mm), Roughness Rate (6.17 ± 1.40 %/6.80 ± 1.23 %) and Vertices Number (23.22 ± 1.85/43.15 ± 2.72). Moreover, CDMB-SegNet shortened the overall design time to around 4 min, which is one tenth of the comparison methods. CONCLUSIONS: CDMB-SegNet is the first intelligent neural network for automatic CDMB design driven by oral big data and dental features. The designed CDMB is able to couple with patient's personalized dental anatomical morphology, providing higher clinical applicability compared with the state-of-the-art methods.
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Dentadura Completa , Humanos , Diseño de Dentadura/métodos , Redes Neurales de la Computación , Diseño Asistido por ComputadoraRESUMEN
STATEMENT OF PROBLEM: Computer-aided design and manufacturing (CAD/CAM) have been increasingly used to enhance the patient and clinician experiences with removable complete dentures (CDs). Yet, evidence from systematic reviews is lacking to validate the clinical significance of these digital prostheses. PURPOSE: The purpose of this systematic review was to compare CAD/CAM CDs with the traditional ones in terms of patient and clinician-reported outcomes, post-insertion adjustment visits and costs. MATERIALS AND METHODS: An electronic search of four databases [Medline (Ovid), Embase, Scopus and Cochrane CENTRAL; last update: May 2022] was performed to retrieve clinical studies comparing CAD/CAM and traditional CDs. Two independent reviewers screened the articles, extracted data (methods and outcomes) and assessed risk of bias of the included studies. The following outcomes underwent meta-analysis (random-effects model): overall patient and clinician satisfaction, oral health-related quality of life (OHRQoL), number of post-insertion adjustment visits, as well as laboratory and total costs. RESULTS: This review included 11 studies. Meta-analysis revealed that CAD/CAM CDs are comparable to the traditional CDs in terms of overall patient satisfaction and OHRQoL. Clinician-reported data depended on the manufacturing technique: whereas milled CDs performed better than traditional CDs in terms of clinician satisfaction and number of adjustments, 3D printed and traditional CDs were similar. Fabrication of CAD/CAM CDs required significantly less laboratory and overall costs than the traditional CDs. CONCLUSIONS: There is some evidence showing that CAD/CAM CDs are at least comparable to traditional CDs. Further well-designed randomized clinical trials are needed to evaluate the performance of specific CAD/CAM approaches for manufacturing CDs, however.
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Diseño Asistido por Computadora , Diseño de Dentadura , Dentadura Completa , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Calidad de Vida , Humanos , Dentadura Completa/economía , Diseño de Dentadura/economía , Diseño de Dentadura/métodosRESUMEN
BACKGROUND: The establishment of good facial esthetics is one of the main objectives of complete denture construction. Unfortunately, it may be the caused issue for patients having a prominent premaxilla due to excessive lip support by the labial flange of the maxillary denture. Open-face dentures (OFD) may suggest suitable prosthetic management for these patients. However, clinical evidence regarding the efficiency of OFD is scarce. METHODS: A total of 38 completely edentulous participants having prominent premaxilla and skeletal class I Angle's classification were enrolled in this study. Each participant received a mandibular complete denture and 2 opposing maxillary dentures; conventional (CD) and open-face (OFD). On the day of denture insertion, the participants were divided into 2 groups; CD-OFD and OFD-CD where CD-OFD group was instructed to use the mandibular denture and the maxillary CD for 3 months and then to use the maxillary OFD for another 3 months after a wash-out period of 2 weeks. While group OFD-CD was instructed to use the mandibular denture and the maxillary OFD for 3 months then to use the maxillary CD for another 3 months after a wash-out period of 2 weeks. The dislodging force of the maxillary dentures was evaluated using the universal testing machine and the patient perception of retention, esthetics, and comfort was evaluated using the Visual Analogue Scale (VAS). Evaluation was carried out 1 day, 1 month, and 3 months after denture insertion. The Student t-test was used to compare the 2 maxillary dentures and the intervals for each denture were compared by using the ANOVA test with repeated measures followed by a Post Hoc test (adjusted Bonferroni) for pairwise comparison. RESULTS: The significance of the obtained results was judged at the 5% level (P value). The dislodging force and patient perception of retention did not show significant differences between the 2 dentures, while the perception of esthetics showed significant differences throughout the follow-up period. Perception of comfort showed an insignificant difference only at the 3-month interval. CONCLUSIONS: Open-face maxillary dentures can be a suitable alternative for patients with prominent premaxilla to achieve satisfactory retention, aesthetics, and comfort.
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Dentadura Completa Superior , Boca Edéntula , Humanos , Estudios Cruzados , Diseño de Dentadura/métodos , Dentadura Completa , Retención de Dentadura , Satisfacción del PacienteRESUMEN
PURPOSE: This study aimed to investigate the retentive force and deformation of double Akers' polyetherketoneketone (PEKK) clasps on removable partial dentures (RPDs) with varying designs and undercut depths. METHODS: Thirty double Akers' PEKK clasps with two different widths and heights (Groups I and II) were fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM). Each design was further subdivided (n = 5) into three undercut depths (0.25, 0.50, and 0.75 mm). The retentive force of the clasps was measured after 10 years of clinical use (15,000 insertion/removal cycles), and the deformation of the clasp tips was analyzed before and after cycling. RESULTS: Clasps with 0.50-mm and 0.75-mm undercut depths exhibited greater initial retentive forces (3.15-3.51 N) compared to those in the 0.25-mm undercut group (2.40-2.80 N). Group I maintained consistent retentive forces over the cycles (P = 0.345), whereas Group II showed declining forces after the initial use (P < 0.003). In both groups, the 0.50-mm undercut exhibited a greater retentive force than the 0.25-mm (P < 0.001 and P < 0.004, respectively), with no significant differences between the 0.50-mm and 0.75-mm undercut depths. Despite a lower initial retentive force, the 0.25-mm undercut showed less deformation and clasp tip wear. CONCLUSIONS: The PEKK clasps did not exhibit significantly reduced retentive forces or permanent deformations after 15,000 fatigue cycles. These results suggest that the PEKK polymer displays superior mechanical properties as an esthetic clasp material, and clasps with 0.50-mm and 0.75-mm undercut depths are recommended for long-term clinical use.
Asunto(s)
Diseño Asistido por Computadora , Abrazadera Dental , Diseño de Dentadura , Dentadura Parcial Removible , Cetonas , Diseño de Dentadura/métodos , Polímeros , Retención de Dentadura , Benzofenonas , Ensayo de Materiales , Técnicas In Vitro , Análisis del Estrés DentalRESUMEN
PURPOSE: There are different methods to transfer occlusal vertical dimension (OVD) when fabricating complete dentures, but it is not clear which method yields the most accurate transfer. This study investigated the accuracy of transferring the OVD of the maxillary/mandibular relationship when designing and fabricating digital dentures by evaluating two commonly used workflows: duplicate dentures (DDs) and occlusion rims (ORs). MATERIALS AND METHODS: Mounted edentulous casts were used to simulate a completely edentulous patient. These casts were used in two workflows: (1) DD workflow where complete dentures were fabricated and relined (n = 15), and (2) OR where final impressions and ORs were constructed (n = 15). Relined dentures and ORs with fiduciary markers were then scanned and virtually articulated, then exported as STL files. A scan of the articulated casts (simulated patients) with fiduciary markers embedded was also exported as an STL file and used as a control. STL files for each workflow were superimposed over the control and analyzed in 3D inspection software (Geomagic Control X, 3D Systems, NC) for deviations (mm) at three different locations. Average 3D deviations were compared among the groups using a two-way ANOVA (α-0.05). RESULTS: The average deviation for OR was significantly larger than DD at all locations of measurement [F = 46.00, p < 0.0001]. The majority of the measurements (98.9%) had a positive deviation value, indicating increased OVD. The overall deviation for the OR group from the control was 0.72 ± 0.13 mm versus 0.45 ± 0.23 mm for the DD group. There was no difference in deviation between the points of measurement and no interaction between the location and method [F = 0.02, p < 0.98]. CONCLUSIONS: The DD workflow exhibited less deviation in the transfer of OVD than the OR workflow. However, the deviation was small and may not be clinically significant.
Asunto(s)
Diseño de Dentadura , Boca Edéntula , Humanos , Dimensión Vertical , Diseño de Dentadura/métodos , Dentadura Completa , Diseño Asistido por ComputadoraRESUMEN
OBJECTIVE: To present clinical strategies for prosthetic rehabilitation with complete dentures (CDs) of a Parkinson's disease patient. CASE REPORT: An 82-year-old patient sought the Department of Dentistry at UFRN, reporting retention dissatisfaction and hamper to the mandibular CD adaptation. Patient-reported a dry mouth sensation, and exhibited disordered mandibular movements, tremors, and resorbed mandibular ridge. Aiming retention and stability, double molding with zinc enolic oxide impression paste, neutral zone technique, and non-anatomic teeth were proposed as clinical strategies. At delivery, identification and relief in the supercompression areas were performed to facilitate the acceptance and use of the new dentures. CONCLUSION: The strategies promoted patient satisfaction regarding retention, stability, and comfort. This treatment may be considered for the rehabilitation of Parkinson's disease patients, favoring the adaptation process.
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Enfermedad de Parkinson , Humanos , Anciano de 80 o más Años , Enfermedad de Parkinson/complicaciones , Diseño de Dentadura/métodos , Retención de Dentadura/métodos , Dentadura Completa , Satisfacción del PacienteRESUMEN
OBJECTIVE: This technique aims to construct a virtual, well-adapted maxillary denture from an existing, ill-fitting denture in completely edentulous patients. CLINICAL CONSIDERATIONS: A functional impression is made using the loose maxillary denture, and a cone beam computed tomography (CBCT) of the entire old denture is carried out. The obtained digital imaging and communication in medicine (DICOM) file was segmented using an image computing platform software (3D slicer). The resultant Standard Tessellation Language (STL) file was 3D printed in porcelain white-like resin, then colored and characterized. CONCLUSIONS: The technique introduces a high-quality digital denture replicate with good retention, that can replace the traditional duplication technique. It can also be used as a relining method for old dentures. This proposed digital technique reduces the number of clinical appointments while also providing a digital library for future denture manufacture. CLINICAL SIGNIFICANCE: The proposed technique offers a high-quality digital denture replicate that can replace the traditional duplication technique. This digital technique also reduces the number of clinical appointments required for denture duplication.
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Diseño de Dentadura , Boca Edéntula , Humanos , Diseño de Dentadura/métodos , Diseño Asistido por Computadora , Dentadura Completa , Porcelana DentalRESUMEN
The purpose of this clinical report was to describe the use of a piezographic impression associated with computer-aided design and computer-aided manufacturing (CAD-CAM) for teeth setup and of digital tools for neuro-musculo-kinetic analyses. An edentulous patient with hemiglossectomy and heavily resorbed mandible consulted for complete denture rehabilitation to improve their masticatory function and speech. Master casts, wax rims, and piezographic impression were scanned for digital prosthetic work. Two digital try-ins were performed to respect the neutral zone: try-in 1 with posterior crossbite and try-in 2 without crossbite. Muscle activity and mandibular kinetics were performed for each try-in following the MAC2 protocol (six criteria): muscular tone, contraction synchrony, contraction efficiency, interocclusal rest distance, amplitude of mandibular movement, and velocity. Try-in 2 showed better data than try-in 1 in all criteria: muscle tone (respectively 71% vs. 59%), contraction synchrony (79% vs. 75%), contraction efficiency (85% vs. 77%), an increase in range of motion of 3.3 mm, and a better velocity (0.35 ± 0.12 s vs. 0.57 ± 0.14 s, p = 0.008). The piezographic impression, in combination with CAD-CAM, allowed the comparison of two prosthetic designs and the selection of the try-in with the best neuro-musculo-kinetic results.
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Maloclusión , Boca Edéntula , Humanos , Glosectomía , Diseño de Dentadura/métodos , Boca Edéntula/cirugía , Dentadura Completa , Diseño Asistido por ComputadoraRESUMEN
STATEMENT OF PROBLEM: Research evaluating the accuracy of anterior tooth mold templates to computer-aided design and computer-aided manufacture (CAD-CAM) fabricated complete removable dental prostheses (CRDPs) is limited. PURPOSE: The purpose of this in vitro study was to investigate the accuracy of the anterior denture tooth arrangement on CAD-CAM complete removable dental prostheses made with the anterior tooth mold template. MATERIAL AND METHODS: A maxillary and mandibular edentulous model was mounted on a semiadjustable articulator to simulate a patient's maxillary arch. Definitive impressions and jaw relation records were made as per the manufacturer's protocol. A maxillary and mandibular anatomic measuring device was completely seated onto the edentulous models, centered on the edentulous model midline, and horizontally positioned parallel to the mandibular ridge. A medium-size anterior tooth mold template sticker was attached on the anatomic measuring device to identify the maxillary dental midline and incisal edge position and was sent to the manufacturer as the proposed tooth arrangement reference for the definitive complete removable dental prostheses. A total of 10 milled complete removable dental prostheses were generated for 2 groups by using 2 different tooth arrangement techniques. One group (n=5) used the monobloc milling technique without bonding of denture teeth, while the other group (n=5) used the bonding system for denture teeth on the milled denture base. For comparison, a camera mounted on a tripod was used for photographic documentation. Reference markers placed on the edentulous model were used to orient and measure the difference of 4 aspects of the anterior tooth arrangement: average incisal edge position, intercanine distance, midline, and clinical crown length of the left central incisor. The difference values between the tooth mold template and definitive complete removable dental prostheses were statistically analyzed by multivariate ANOVA (α=.05) and 1-sample t tests (adjusted α=.0125). RESULTS: Overall, statistically significant differences were found between the tooth mold template (control) and definitive complete removable dental prostheses at all measuring aspects except for the midline of the midline of the milled arrangement technique (P<.0125). In terms of the midline value, the value of the milled group did not show a significant difference compared with tooth mold template (-0.19 mm). However, the value of the bonded group indicated a significant difference of midline (0.44 mm toward to the left of the tooth mold template midline). When the complete removable dental prosthesis milled denture tooth and complete removable dental prosthesis bonded denture tooth techniques were compared, there was no difference in the tested variables between the milled and the bonded groups (P>.0125). CONCLUSIONS: The tooth mold template did not represent an accurate position for definitive complete removable dental prostheses for either the milled or bonded techniques. The largest differences were found at the average incisal edge of the anterior teeth and the intercanine distance for both groups. However, there was overall no clinical difference between the 2 groups (milled and bonded) of CAD-CAM complete removable dental prostheses.
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Diseño de Dentadura , Boca Edéntula , Humanos , Diseño de Dentadura/métodos , Diseño Asistido por Computadora , Dentadura Completa , Registro de la Relación MaxilomandibularRESUMEN
STATEMENT OF PROBLEM: The introduction of computer-aided design and computer-aided manufacturing (CAD-CAM) technology for complete denture fabrication may have improved clinical outcomes compared with conventional techniques. However, systematic reviews comparing these techniques are lacking. PURPOSE: The purpose of this systematic review was to identify, compare, and synthesize the outcomes of published clinical studies related to complete denture fabrication, with respect to the differences between CAD-CAM technology and conventional techniques. MATERIAL AND METHODS: A comprehensive search of studies published up to March 16, 2020, was conducted by using the PubMed/MEDLINE, Web of Science, Cochrane Library, SciELO, and Embase databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement criteria and was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID 42020202614). The population, intervention, comparison, and outcome (PICO) question was: Do CAD-CAM complete dentures have a similar functional performance to those fabricated by conventional techniques? The quality of publications was appraised by using the Critical Appraisal Skills Program (CASP) checklists. RESULTS: Of the 1232 titles, 6 articles were selected. The studies reported better retention of digitally manufactured complete dentures without denture adhesives than that of conventional complete dentures with or without denture adhesives. Other studies reported that dentures manufactured with digital systems were better adapted to tissue surfaces, required less clinical time, were lower in cost, and provided better experience and satisfaction to patients. CONCLUSIONS: The assessment of CAD-CAM planning and manufacturing through clinical studies is ongoing. However, preliminary results indicate better clinical performance and lower overall costs of digital complete dentures than conventional dentures.
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Diseño de Dentadura , Dentadura Completa , Humanos , Diseño de Dentadura/métodos , Diseño Asistido por Computadora , TecnologíaRESUMEN
This technique report presents a novel method of digitally replicating a treatment denture and converting it into a definitive denture. The procedure accurately duplicates the appearance of the mucosal surface and border of the treatment dentures, mounts the jaw relation on a virtual articulator to arrange artificial teeth, and optimizes the occlusion based on recorded mandibular motion tracks. This technique uses personalized jaw relation transfer and dynamic occlusal adjustment to establish balanced occlusion, which accomplishes the digital duplication of the treatment denture with high accuracy and minimal effort.
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Dentadura Completa , Ajuste Oclusal , Flujo de Trabajo , Diseño de Dentadura/métodos , Oclusión Dental , Articuladores Dentales , Registro de la Relación Maxilomandibular/métodosRESUMEN
BACKGROUND AND OBJECTIVE: Parkinson's disease is a neurological disorder that affects 1% of individuals aged 60 years and older. The associated symptoms can impose limitations on the available dental treatment options. CASE DESCRIPTION: This case report follows the CARE guidelines and presents an adapted and simplified technique to fabricate complete dentures for a 74-year-old male edentulous patient with Parkinson's disease. This modified technique enabled the fabrication of complete dentures in 4 clinical sessions of approximately 40 minutes. The first session involved manufacturing a preliminary impression with fast-setting alginate. The base plates and occlusal rims were then adjusted for artificial teeth arrangement during the second session. The final prosthesis was completed in the third session, which involved a teeth try-in and fabrication of a functional impression with low-melting thermoplastic material and polyether. Finally, denture installation was performed in the fourth session and follow-up consisted of 3 weekly sessions. DISCUSSION: Considering that the treatment provided satisfactory aesthetics and function, mastication and socialization benefits, and improved the self-esteem and well-being of the older patient with Parkinson's disease, the authors suggest this adapted and simplified technique for fabricating complete dentures. (AU)
JUSTIFICATIVA E OBJETIVO: A doença de Parkinson é uma desordem neurológica que afeta 1% dos indivíduos com 60 anos ou mais. Os sintomas associados podem impor limitações nas opções de tratamento odontológico disponíveis. DESCRIÇÃO DO CASO: Este relato de caso segue o protocolo CARE e apresenta uma adaptação da técnica simplificada para confecção de novas próteses totais, para um paciente edêntulo, do sexo masculino, de 74 anos com doença de Parkinson. Essa técnica modificada possibilita a confecção de próteses totais em quatro sessões clínicas de aproximadamente 40 minutos. A primeira sessão envolveu uma moldagem preliminar com alginato de presa rápida. As placas articulares com rodetes de cera foram ajustadas para montagem dos dentes artificiais durante a segunda sessão. A prótese definitiva foi concluída na terceira sessão, que envolveu a prova dos dentes e moldagem funcional com material termoplástico de baixa fusão e poliéter. Por fim, a instalação da prótese foi realizada na quarta sessão e o acompanhamento consistiu em três sessões semanais. DISCUSSÃO: Considerando que o tratamento proporcionou estética e função satisfatórias, benefícios mastigatórios e de socialização, melhora da autoestima e bem-estar do idoso com doença de Parkinson, os autores sugerem o uso da adaptação da técnica simplificada para confecção de prótese total. (AU)
Asunto(s)
Humanos , Masculino , Anciano , Enfermedad de Parkinson , Diseño de Dentadura/métodos , Boca Edéntula/rehabilitaciónRESUMEN
OBJECTIVE: This review will evaluate patient-reported outcome measures of treatment with digitally fabricated versus conventionally manufactured removable dental prostheses in partially or completely edentate adults. INTRODUCTION: Compared with conventionally manufactured dental prostheses, digitally fabricated prostheses may simplify and reduce the number of clinical steps and minimize errors in the production of prostheses without compromising occlusal accuracy and fit. This may, in turn, improve patient satisfaction, ability to speak, esthetics, stability, and oral health status. Determining evidence of patient-reported outcomes will assist the dental practitioner when communicating patient expectations. INCLUSION CRITERIA: This review will consider experimental and quasi-experimental study designs, including randomized and non-randomized controlled trials, comparative clinical studies, prospective or retrospective trials, longitudinal clinical studies, clinical reports, and technique articles. The review will include patient-reported outcome measures from fully or partially edentulous adult participants who received either conventionally or digitally fabricated dental prostheses. METHODS: The following databases will be searched for scientific, peer-reviewed literature: Academic Search Complete, CINAHL, Dentistry and Oral Sciences (all via EBSCO), MEDLINE (PubMed), ScienceDirect, and Cochrane Central Register of Controlled Trials. The search strategy will include terms relevant to the intervention, which will be adapted for each bibliographic database, in combination with database-specific filters, where available. The language restriction will be English and Dutch. All included studies will be critically appraised and data will be extracted for synthesis. If possible, a meta-analysis will be conducted. The Grading of Recommendations, Assessment, Development and Evaluation approach will be followed to evaluate the certainty of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018094357.
Asunto(s)
Diseño de Dentadura , Dentadura Parcial , Medición de Resultados Informados por el Paciente , Revisiones Sistemáticas como Asunto , Adulto , Ensayos Clínicos como Asunto , Odontólogos , Diseño de Dentadura/métodos , Humanos , Metaanálisis como Asunto , Estudios Prospectivos , Estudios Retrospectivos , Revisiones Sistemáticas como Asunto/métodosRESUMEN
OBJECTIVE: Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional techniques. MATERIALS AND METHODS: The present systematic review was carried out according to PRISMA guidelines. The search was carried out on PubMed/MEDLINE, Cochrane collaboration, Science direct, and Scopus scientific engines using selected MeSH keywords. The articles fulfilling the predefined selection criteria based on the fit and accuracy of removable partial denture (RPD) frameworks constructed from digital workflow (CAD/CAM; rapid prototyping) and conventional techniques were included. RESULTS: Nine full-text articles comprising 6 in vitro and 3 in vivo studies were included in this review. The digital RPDs were fabricated in all articles by CAD/CAM selective laser sintering and selective laser melting techniques. The articles that have used CAD/CAM and rapid prototyping technique demonstrated better fit and accuracy as compared to the RPDs fabricated through conventional techniques. The least gaps between the framework and cast (41.677 ± 15.546 µm) were found in RPDs constructed through digital CAD/CAM systems. CONCLUSION: A better accuracy was achieved using CAD/CAM and rapid prototyping techniques. The RPD frameworks fabricated by CAD/CAM and rapid prototyping techniques had clinically acceptable fit, superior precision, and better accuracy than conventionally fabricated RPD frameworks.
Asunto(s)
Diseño de Dentadura/métodos , Diseño de Dentadura/tendencias , Dentadura Parcial Removible/tendencias , Diseño Asistido por Computadora/tendencias , Dentadura Parcial/tendencias , Humanos , Rayos Láser , Flujo de TrabajoRESUMEN
The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.
Asunto(s)
Pilares Dentales/normas , Implantes Dentales/normas , Diseño de Dentadura/métodos , Dentadura Parcial Removible/normas , Algoritmos , Fenómenos Biomecánicos , Análisis de Elementos Finitos , Humanos , Estrés MecánicoRESUMEN
Xerostomia is a subjective symptom of dry mouth. It can occur as a part of the systemic disease, drug-induced side effect, or following therapeutic radiation therapy to the head-and-neck region. The primary complication faced by these xerostomic patients is the difficulty in retention of removable dentures. It is important to recognize that the prosthodontic management of these patients requires special attention and care. In an attempt to overcome the presence of xerostomia, several techniques of introducing reservoirs into the dentures containing salivary substitutes have been proposed. This case report presents a simplified approach for the construction of a reservoir in the maxillary denture, specifically in patients where other treatment modalities have failed. This technique provided excellent lubrication to oral tissues, hygienic for the patient, and utilized routine denture base material.
Asunto(s)
Diseño de Dentadura/métodos , Retención de Dentadura/métodos , Dentadura Completa Superior/normas , Neoplasias de Cabeza y Cuello/radioterapia , Traumatismos por Radiación/terapia , Xerostomía/terapia , Anciano , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Pronóstico , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Xerostomía/etiologíaRESUMEN
Nowadays, a lot of people need in reconstruction of the teeth in connection with their loss. Before prosthetics or any other manipulations, a person wants to quickly see the aesthetic appearance of his future tooth. At the moment, many dentists use the option of verbal explanation to the patient, what will look like a smile or a front row of teeth after treatment, but the visual representation of the person remains aside. But now this can be achieved with the help of "Digital smile design", which shows the person the final result of the dentition. This technology has a number of advantages. Some of them are the rapid creation of a prototype model and high accuracy in the manufacture of work. Thanks to these technologies, communication between the specialist and the patient has been facilitated. The digital smile design has simplified the doctor's work process and reduced patient data processing time. From now on, achieving aesthetic results in the reconstruction of teeth for the dentist is not a problem.