Reabilitação oral de paciente com fissura palatina e ausência de pré-maxila / Oral rehabilitation of a cleft palate patient without premaxillary bone ­ a clinical report

As fissuras labiopalatais são malformações faciais com sequelas funcionais e estéticas que causam grande impacto na qualidade de vida dos pacientes. O tratamento desses indivíduos requer uma abordagem multidisciplinar, incluindo tratamento plástico cirúrgico, fonoaudiológico e psicológico, além das intervenções odontológicas, ortodônticas e protéticas. Este relato de caso apresentou a reabilitação protética de uma paciente de 57 anos com fissura palatina anterior, com remoção da pré-maxila. Após vários tratamentos, a paciente ainda não havia sido reabilitada, apresentando deformidades provenientes dos tratamentos anteriores incompletos. Uma prótese parcial removível retida por dentes e implantes osseointegrados foi executada, promovendo a melhora na aparência facial, na função mastigatória, na fala e, consequentemente, na qualidade de vida da paciente.

Cleft lip and palate, which is a facial malformation with both functional and aesthetic characteristics, may have a large impact on the lives of those affected. Its correction requires an interdisciplinary approach, which includes surgical, orthodontic and prosthetic treatments. This clinical report presents the prosthetic rehabilitation of a 57-year-old woman with an anterior cleft palate defect that had not been closed completely with surgical repair. In this way, an implant-supported, retained removable partial prosthesis was delivered to improve the patient's facial aspect, masticatory function, speech, and her quality of life.

Satisfaction level and masticatory capacity in edentulous patients with conventional dentures and implant-retained overdentures

The difficulty of totally edentulous individual in performing the basic oral functions in a satisfactory and pleasant way directs the investigations for improvement of the rehabilitation techniques. This study aimed to perform an intra-patient analysis of the satisfaction level and masticatory capacity during the phases of the rehabilitation treatment with osseointegrated implants. Twelve edentulous patients (mean age: 61 years) participated. Satisfaction level and masticatory capacity were analyzed based on specific questionnaires for edentulous patients and by a verbal rating scale from 0 to 10, at three moments: with the old dentures, with conventional new ones after they had been received two osseointegrated implants in the mandible (after 60 days of use). After 5 months of the first surgical phase, gold cap ball attachments were adapted and the last evaluation was performed with the upper denture and the lower overdenture, after 30 days of use. The Friedman test was applied. The rehabilitation with implants produced a significant improvement in the satisfaction level (95.83%) and the masticatory capacity (94.07%). The new full dentures produced a better satisfaction and masticatory capacity than the old dentures. Besides, lower overdenture supported by two osseointegrated implants and a new upper conventional denture produced a higher scores than the conventional new dentures.