Evaluation of Prosthetic Complications with Metal-Acrylic Resin Implant-Fixed Complete Dentures: A Medium- and Long-Term Retrospective Analysis with Up to 13 Years of Follow-up

PURPOSE: To present prosthetic complications observed in the medium and long term in patients treated with metal-acrylic resin implant-supported fixed complete dentures (MAIFCDs). MATERIALS AND METHODS: A total of 87 patients who were treated with MAIFCDs were included. Acrylic resin (denture teeth and base) fracture, screw loosening (prosthetic or abutment), screw (prosthetic or abutment), and framework fracture were analyzed for descriptive statistics. Product-limit survival estimates were used for the cumulative no-complication rate (CNCR) of prostheses. All results were assessed using α = .05. RESULTS: The average observation time was 42.9 months (range: 19 to 153). Of 597 implants, 8 mandibular (44.4%) and 10 maxillary implants (55.6%) failed. In total, 29 patients (33.3%) experienced no complications in an average of 7 years, and 58 patients (66.6%) experienced at least one complication. The average time for the first complication to occur was 23 months (range: 1 to 97 months). The average number of complications was 5.9/patient. Acrylic resin complications were the most frequent, followed by screw loosening, screw fracture, and framework fracture. Of those patients with complications, 9 (16%) had maxillary MAIFCDs with an average of 4 complications. In total, 28 patients (48%) had only mandibular MAIFCDs with an average of 5 complications, and 21 patients (36%) had both arches treated with MAIFCDs with an average of 9 complications. Mandibular MAIFCDPs in women had a higher CNCR compared to maxillary MAIFCDs of both women and men and when both arches of women were treated with MAIFCDs (P < .05). CONCLUSIONS: The CNCR of MAIFCDs differed depending on the arch treated and sex. Mandibular MAIFCDs in women had a lower complication rate than MAIFCDs in other arch-sex pairs. Acrylic resin related complications were commonly observed as well as prosthetic screw loosening.

Osteoma of temporomandibular joint: a rarity.

Osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs in the bones of the craniofacial complex. Only a few cases involving the temporomandibular joint have been reported. An osteoma of the left temporomandibular joint causing limited mouth opening in a 22-year-old man with CT findings revealing the unusual possibility in differential diagnosis of trismus.

Calcifying epithelial odontogenic cyst associated with complex odontome of maxilla.

The term calcifying odontogenic cyst was first introduced by Gorlin in 1962 (Eshghyar et al., Acta Med Iran 44(1):59-62, 2006). The lesion is unusual in that it has some features of a cyst but also has many characteristics of a solid neoplasm (Cysts and tumors of odontogenic origin: textbook of oral pathology, 2006). It is classified into two types-Type I-the cystic variant, Type II-solid tumor variant. This case report present Type I B-odontome producing intraosseous calcifying odontogenic cyst and Type I C-with ameloblastomatous proliferation in a 19 years old male patient in the right maxillary quadrant. The lesion involved an unerupted permanent maxillary central incisor, which was displaced to the infraorbital ridge of right side and the radiograph revealed a calcified mass in the periapical region of right incisor that was later recognized histopathologically as complex composite odontoma. The lesion was removed surgically. This case report emphasizes on the presence of this Type I B and C lesion and the need to keep them in follow up.

Ameloblastoma: an evidence based study.

OBJECTIVE: The purpose of this study is to present a series of 46 cases of ameloblastoma-38 in mandible and 8 in maxilla treated in the Oral and Maxillofacial Surgery Department of Government Dental College and Hospital, Nagpur during 1997-2006 with emphasis on various treatment modalities used in treating different types of ameloblastoma and how to define the safe margin for different clinical and histopathological types of ameloblastoma with their follow-up. METHOD: Confirmation of lesion done by incisional biopsy upon which treatment plan was decided and if resection is done then section was studied for amount of infiltration in adjoining bone histopathologically. RESULT: In a follow-up period of 1-9 years recurrence was observed in six cases, two in patients treated with enucleation and curettage, three in patients treated with segmental resection and one in patient with peripheral ameloblastoma treated with soft tissue resection. CONCLUSION: From this study we conclude that depending upon the histopathological type different amount of adjoining bone is resected to get the safe margin and based upon the result it is recommended to remain a bit aggressive in maxillary lesions.