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1.
Comput Biol Med ; 175: 108550, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38701590

RESUMO

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.


Assuntos
Prótese Total , Humanos , Planejamento de Dentadura/métodos , Redes Neurais de Computação , Desenho Assistido por Computador
2.
BMC Oral Health ; 24(1): 473, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38641783

RESUMO

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.


Assuntos
Prótese Total Superior , Boca Edêntula , Humanos , Estudos Cross-Over , Planejamento de Dentadura/métodos , Prótese Total , Retenção de Dentadura , Satisfação do Paciente
3.
Int J Prosthodont ; 37(2): 157-165, 2024 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-38648164

RESUMO

PURPOSE: To generate data on the long-term survival of metal-ceramic resin-bonded fixed partial dentures (RBFPDs). MATERIALS AND METHODS: A total of 89 patients received 94 RBFPDs, 5 of whom (women n = 1; men n = 4) received 2 RBFPDs each. All RBFPDs were fabricated as two-retainer end-abutment metal-ceramic restorations. Clinical follow-ups were performed 6 months after cementation and then annually thereafter. The mean observation time was 7.5 years. Cox regression was performed to test the effects of the variables: gender, location, arch, design, use of rubber dam, and adhesive luting system. Survival and success were calculated using Kaplan-Meier curves. As a secondary objective, patient and dentist satisfaction with the esthetics and function of the RBFPDs was evaluated. The significance level was set at α = .05 for all calculations. RESULTS: Estimated Kaplan-Meier failure-free survival was 97.5% (standard error [SE] 1.7) after 5 years and 83.3% (SE 5.3) after 10 years. Calculated intervention-free survival (success) was 90.1% (SE 3.4) after 5 years and 65.5% (SE 6.7) after 10 years. Debonding-free survival was 92.6% (SE 2.9) after 5 years and 80.6% (SE 5.4) after 10 years. Cox regression revealed that none of the four tested variables had a significant effect on the incidence of complications in RBFPDs. Patient and dentist satisfaction with RBFPD esthetics and function was consistently high throughout the observation period. CONCLUSIONS: Within the limitations of an observational study, RBFPDs achieved clinically successful outcomes over a mean observational period of 7.5 years.


Assuntos
Prótese Adesiva , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Falha de Restauração Dentária , Ligas Metalo-Cerâmicas/química , Adulto , Planejamento de Dentadura , Satisfação do Paciente , Idoso , Estética Dentária
4.
Int J Prosthodont ; 37(2): 173-180, 2024 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-38648165

RESUMO

PURPOSE: To evaluate the marginal integrity of three inlay-retained fixed dental prosthesis (IRFDP) designs fabricated using monolithic zirconia. MATERIALS AND METHODS: In total, 30 IRFDPs were fabricated using 4-YTZP monolithic zirconia and randomly divided into three groups according to the cavity design. Groups ID2 and ID1.5 received an inlay cavity preparation, which includes a proximal box and an occlusal extension with a depth of 2 mm or 1.5 mm, respectively. Group PB received a proximal box cavity preparation without an occlusal extension. The restorations were fabricated and cemented using a dual-cure resin cement (Panavia V5) and subjected to an equivalent of 5 years of aging. The specimens were evaluated under an SEM to measure marginal continuity before and after the aging process. RESULTS: During the whole 5-year aging process, no specimens showed signs of cracking, fracture, or loss of retention in any restorations. In the SEM analysis, most marginal defects observed in the restorations were areas of microgaps at the tooth/cement interface (TC) or zirconia/cement interface (ZC), resulting in loss of adaptation. There was a significant difference between the groups after the aging process at both the TC (F = 4.762, P < .05) and ZC (F = 6.975, P < .05), with Group ID2 presenting the best performance. There was a significant difference between TC and ZC in all groups (P < .05), with ZC presenting more gaps in all groups. CONCLUSIONS: Inlay cavity designs including a proximal box and an occlusal extension exhibited better marginal stability than a proximal box without occlusal extension.


Assuntos
Restaurações Intracoronárias , Zircônio , Zircônio/química , Humanos , Técnicas In Vitro , Adaptação Marginal Dentária , Planejamento de Prótese Dentária , Planejamento de Dentadura , Prótese Parcial Fixa , Materiais Dentários/química
5.
J Prosthet Dent ; 131(5): 933.e1-933.e7, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38429151

RESUMO

STATEMENT OF PROBLEM: The connector height and retainer occlusal thickness of fixed partial dentures (FPDs) may affect restoration longevity. PURPOSE: The purpose of this in vitro study was to determine and compare the fracture resistance of 4-unit monolithic 5% yttria tetragonal zirconia polycrystal (5Y-TZP) FPDs made with different connector heights and retainer occlusal thicknesses after thermomechanical aging. MATERIAL AND METHODS: Forty test metal dies were duplicated from a master metal die containing 2 anatomic abutment preparations of the mandibular right first premolar and second molar for a 4-unit FPD. The dies were divided into 2 groups of 20 each for the fabrication of 4-unit FPDs, with 2-mm and 4-mm uniform connector heights at all 3 connectors, resulting in 6.3-mm2 and 12.6-mm2 connector areas. Each of these groups was further divided into 2 subgroups based on the occlusal thickness of the 2 retainers of 1 mm and 2 mm (n=10). Polyvinyl siloxane impressions of the test metal dies were made and poured in Type V dental stone. Laboratory scans were performed on all the stone dies, and 40 5Y-TZP FPDs (Ceramill Zolid FX) were designed and fabricated. Subsequently, all the FPDs were luted on to the metal dies with a self-adhesive resin cement. The FPDs were preloaded (400 000 mechanical cycles; 4000 thermocycles) using a mastication simulator and tested for axial compressive strength. Two-way analysis of variance (ANOVA) was used to examine the effect of connector and occlusal thicknesses on the fracture load (α=.05). The data were further assessed using the post hoc Tukey HSD multiple comparison test (α=.05). RESULTS: The mean fracture load values were between 737 N and 1563 N. Significant differences in the mean fracture load were found between the connector heights (601 N; P<.001) and occlusal thicknesses (225 N; P=.002), but the interaction of the 2 factors was not significant (P=.132) The Tukey post hoc analysis showed significant differences between the connector thicknesses groups (P<.01), but the occlusal thicknesses were found to be similar for the same connector height (P=.609) CONCLUSIONS: Connector height and occlusal retainer thickness influenced the fracture load of 4-unit monolithic 5Y-TZP FPDs after thermomechanical aging.


Assuntos
Análise do Estresse Dentário , Planejamento de Dentadura , Prótese Parcial Fixa , Ítrio , Zircônio , Zircônio/química , Ítrio/química , Falha de Restauração Dentária , Humanos , Teste de Materiais , Técnicas In Vitro , Materiais Dentários/química , Dente Suporte
7.
J Prosthodont Res ; 68(1): 78-84, 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36990752

RESUMO

Purpose To evaluate and compare the survival, success rates, and biological and technical complications of three-unit posterior monolithic and veneered zirconia and metal-ceramic (MC) posterior fixed partial dentures (FPDs) fabricated using a digital workflow and computer-aided design and computer-aided manufacturing (CAD/CAM) over a 5-year follow-up.Methods Ninety patients in need of three-unit posterior FPDs were randomized to receive monolithic zirconia (MZ), veneered zirconia (VZ), and MC restorations (n = 30 each). Teeth preparations were scanned using an intraoral scanner, and restorations were milled and cemented with resin cement. Clinical performance and periodontal parameters were assessed at baseline and yearly up to 5 years after insertion. Data analysis was performed using the Kaplan-Meier method, Friedman test, and Wilcoxon signed-rank test with Bonferroni correction and Mann-Whitney U test.Results The 5-year survival rates of the MZ, VZ, and MC FPDs were 87%, 97%, and 100%, respectively (P = 0.04). Most complications were biological in nature. Only one MZ FPD fractured 58 months after placement. All the restorations were assessed as satisfactory at each recall. Differences were found in the gingival index score over time in the VZ and MC groups. The margin index remained stable throughout the follow-up period in both zirconia groups.Conclusions The results of this study suggest that using a digital workflow to fabricate posterior FPDs is an adequate treatment option and that monolithic zirconia could be a viable alternative to metal-ceramic or veneered zirconia. However, further long-term studies are necessary to provide stronger evidence in patients with bruxism.


Assuntos
Falha de Restauração Dentária , Planejamento de Dentadura , Humanos , Estudos Prospectivos , Fluxo de Trabalho , Cerâmica , Zircônio , Prótese Parcial Fixa , Desenho Assistido por Computador , Porcelana Dentária
8.
Spec Care Dentist ; 44(1): 124-129, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37013961

RESUMO

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.


Assuntos
Doença de Parkinson , Humanos , Idoso de 80 Anos ou mais , Doença de Parkinson/complicações , Planejamento de Dentadura/métodos , Retenção de Dentadura/métodos , Prótese Total , Satisfação do Paciente
9.
J Prosthodont ; 33(4): 367-373, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37004216

RESUMO

PURPOSE: The aim of this study was to analyze the stress distribution of fiber-reinforced composite provisional fixed partial denture utilizing a finite element analysis model. MATERIAL AND METHODS: Three anterior teeth were collected: upper right central, left central, and right lateral incisors. A fiber-reinforced composite strip was applied to the palatal surfaces of the teeth. Micro-computed tomographic scans were acquired of the models in order to generate three-dimensional geometrical replicas. Finite element analysis was used to assess the stress distribution of fiber-reinforced composite provisional fixed partial denture using different pontic types under static applied forces that were 100, 30, and 0 N. RESULTS: The maximum stress values were found on the unprepared natural pontic. Stress values ranged from 92.2 to 909.8, 116.4 to 646.7, and 93.8 to 393.5 MPa for composite, naturally prepared, and natural unprepared pontic, respectively. CONCLUSIONS: Using unprepared natural tooth pontic in anterior provisional fixed partial denture to replace missing central incisors is considered superior to other types in terms of stress distribution.


Assuntos
Resinas Compostas , Planejamento de Dentadura , Análise de Elementos Finitos , Prótese Parcial Fixa , Análise do Estresse Dentário/métodos , Estresse Mecânico
10.
J Esthet Restor Dent ; 36(1): 37-46, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38084818

RESUMO

AIM: When young patients are congenitally missing anterior teeth, different treatment modalities can be used to complement the dental arch. This article proposes a new treatment modality for the replacement of anterior teeth, the cantilever contact-point resin bonded bridge (CCP-RBB). MATERIALS AND METHODS: In this proof of principle study, CCP-RBB's delivered by one operator were clinically assessed. Patients who were missing maxillary incisors and had suitable intra-oral conditions for a contact-point cantilever RBB were included. Three cases are presented to describe all adhesive steps. This proof of principle clinical study is presented with up to 60 months follow-up of the cantilever contact resin bonded bridges. RESULTS: A total of 19 CCP-RBB's were evaluated after a mean period of 29.8 months. None of the restorations exhibited failure, carious lesions or fractures during the follow-up periods, demonstrating an absence of restoration debonding or the need for repair. CONCLUSION: The new cantilever contact-point resin bonded bridge exhibited an excellent treatment modality without failure or debonding up to 5 years. More and extended duration in vivo studies are needed to evaluate this new treatment modality. CLINICAL SIGNIFICANCE: In this proof of principle the new cantilever contact-point resin bonded bridge obtained excellent results up to 5 years of clinical follow-up.


Assuntos
Prótese Adesiva , Humanos , Falha de Restauração Dentária , Planejamento de Dentadura , Incisivo
11.
J Prosthodont ; 33(3): 239-245, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36815435

RESUMO

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.


Assuntos
Planejamento de Dentadura , Boca Edêntula , Humanos , Dimensão Vertical , Planejamento de Dentadura/métodos , Prótese Total , Desenho Assistido por Computador
13.
J Prosthodont ; 33(4): 307-312, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37927117

RESUMO

Microstomia presents a challenge for the patient and dental provider. This report describes a partial digital workflow for the fabrication of a mandibular complete denture for a patient with microstomia. Computer-aided design and computer-aided manufacturing technology was utilized to 3D print a sectional custom tray with a unique design. The sectional custom tray was used to make a conventional border molded impression of the edentulous arch to fabricate a flexible complete mandibular denture for a 58-year-old female patient with scleroderma and microstomia. This treatment resulted in a successful prosthetic outcome and high patient satisfaction.


Assuntos
Microstomia , Boca Edêntula , Feminino , Humanos , Pessoa de Meia-Idade , Planejamento de Dentadura , Microstomia/complicações , Técnica de Moldagem Odontológica , Prótese Total , Desenho Assistido por Computador
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 58(12): 1243-1248, 2023 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-38061866

RESUMO

Objective: To evaluate the clinical survival rates and influence factors of different types of resin-bonded fixed partial dentures (RBFPD) used in anterior missing teeth restoration. Methods: Ninety-three RBFPD were delivered to 92 patients [92 patients,43 males and 49 females, average age (46.1±12.8) years] who visited Peking University School and Hospital of Stomatology from January 2006 to December 2021 for restoration of 1 or 2 anterior missing teeth. Altogether 32 cases of glass fiber reinforced RBFPD, 39 cases of glass-based ceramic RBFPD and 22 cases of porcelain-fused-to-metal RBFPD were retrospectively analyzed. The complete survival rate, functional survival rate, patients' satisfaction and color matching of the restorations were recorded and evaluated every year since the replacement with RBFPD. The Kaplan-Meier survival curve method was used for survival analysis, and the Log-rank analysis was used to compare the effect of the number of missing teeth, position (maxillary or mandibular), cantilever or non-cantilever and gender on the survival rate of the restorations. Results: The overall survival time for the 93 RBFPD was 13.7 years (95%CI: 12.3-15.1 years). There was a decreasing trend in complete survival and functional survival for all three material RBFPD from year to year, but complete and functional survival rates exceeded 90% at year 5 and exceeded 80% at year 10. The complete survival rate of the glass-ceramic RBFPD was higher than the other two during the follow-up period, with a complete survival rate of 90% (35/39) at year 15. The porcelain-fused-to-metal RBFPD had a higher functional survival rate in years 1-8, but the complete and functional survival rates showed a substantial decrease after year 9. The single-factor Log-rank analysis showed that the success rate of porcelain-fused-to-metal RBFPD was significantly higher than that of glass fiber reinforced RBFPD (χ²=7.33, P=0.007), and the success rate of RBFPD with 1 missing tooth restored was significantly higher than that of RBFPD with 2 missing teeth restored (χ²=3.23, P=0.072). The differences in success rates between different restoration positions (maxillary and mandibular), cantilever or non-cantilever, and gender factors were not statistically significant (χ²=2.26, P=0.133; χ²=0.68, P=0.411; χ²=1.07, P=0.300). Conclusions: For the restoration of individual missing anterior teeth, both porcelain-fused-to-metal RBFPD and glass-based ceramic RBFPD achieve a high long-term clinical success rate, with glass-based ceramic RBFPD being more able to ensure long-term restorative result.


Assuntos
Prótese Adesiva , Perda de Dente , Masculino , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Porcelana Dentária , Estudos Retrospectivos , Planejamento de Dentadura , Falha de Restauração Dentária , Prótese Parcial Fixa
16.
Swiss Dent J ; 133(11): 737-743, 2023 11 06.
Artigo em Francês | MEDLINE | ID: mdl-37927040

RESUMO

The recording of the maxillo-mandibular relationship (MMR) is an essential and unavoidable step that occurs at different stages of treatment during a prosthetic rehabilitation. Tissue duality is a major problem in metal partial dentures (MPD), especially in complete and large edentulisms, and is responsible for occlusal inaccuracies resulting in restorations that are not integrated with the patient's manducatory system. In order to perform this step, the practitioner must choose the right material, make the appropriate support, and adopt a reliable and reproducible technique that is adapted to the clinical situation and the prosthetic step. The objective of this work is to suggest a simple and codified approach, which guarantees a reliable recording of the maxillo-mandibular relationship, adapted to the particularities of the supporting structures and taking into consideration the clinical sequence for an optimal occlusal-functional integration of the future metallic partial denture.


Assuntos
Prótese Parcial Removível , Planejamento de Dentadura
17.
Br Dent J ; 235(7): 503-509, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37828183

RESUMO

Resin-bonded bridges are one of the main options for replacing missing teeth for hypodontia patients. This technique offers several advantages for these patients, who are often young, have unrestored abutment teeth, and have had tooth positions optimised by orthodontic treatment. However, the replacement of missing teeth can be challenging due to tooth positions and anomalies of abutment tooth shape and size.These patients are often young adults at the time of restoration, making the minimally invasive nature and predictable long-term success of resin-bonded bridges advantageous over other treatment methods.This paper in the hypodontia themed issue discusses the importance of case selection and gives practical advice for the design and provision of resin-bonded bridges.


Assuntos
Anodontia , Prótese Adesiva , Adulto Jovem , Humanos , Anodontia/terapia , Planejamento de Dentadura
18.
J Prosthet Dent ; 130(2): 238.e1-238.e7, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37419711

RESUMO

STATEMENT OF PROBLEM: Successful outcomes with cast removable partial dentures (RPDs) are dependent on adequate fabrication and adjustments at the delivery appointment. Evaluation of the number and frequency of postinsertion follow-up appointments helps determine whether the prosthesis continues to fit comfortably and whether function and esthetics continue to be satisfactory. Reports on the number of appointments and frequency and type of adjustments required for RPDs following insertion are sparse. PURPOSE: The purpose of this university-based population study was to determine the number of appointments and type of adjustments following RPD insertion and their association with patient demographics, type of RPD, and denture survival. MATERIAL AND METHODS: This retrospective clinical study examined the records of 257 patients at the University of Toronto, Faculty Dentistry, wearing 308 RPDs inserted between 2013 and 2014 with a 5-year follow-up. The outcome measures investigated included postinsertion appointments, type of adjustments, and denture survival. RESULTS: A total of 48.1% of the dentures (19.5% tissue supported; and 28.6% tooth supported) were maxillary, and 51.9% (34.7% tissue supported; and 17.2% tooth supported) mandibular. Most patients (68.9%) had 1 to 3 postinsertion appointments, with 78.6% having no major adjustments. Twenty-six dentures failed (failure rate 8.4%), with the failure-free time estimated at 4.58 years (95% confidence interval (CI) 4.42-4.73 years, Kaplan-Meier survival analysis). Failed dentures were significantly associated with more minor adjustments (Mean (M)=4.12, SD=3.90, Kruskal-Wallis (K-W) P=.027; OR=1.18; 95% CI 1.05-1.32, P=.006). More minor adjustments were needed for mandibular dentures (multivariable Poisson regression (MPR) P=.003) compared with maxillary dentures. More major adjustments were needed for maxillary dentures (MPR P=.030) compared with mandibular dentures. More minor and major adjustments were needed for dentures that were remade from within 5 years to beyond 10 years compared with first time denture wearers (MPR P<.001). Patients with musculoskeletal disorders required a significantly higher number of minor adjustments (M=3.67, MPR P<.001) and appointments (M=3.87, MPR P<.001) than those without these disorders. CONCLUSIONS: The 5-year survival of RPDs following insertion was estimated at 91.6%. Most patients required 1 to 3 appointments after insertion. Mandibular RPDs required significantly more minor adjustments, and maxillary RPDs more major adjustments. More minor and major adjustments were needed for dentures that were remade at any time previously compared with first time denture wearers.


Assuntos
Prótese Parcial Removível , Dente , Humanos , Planejamento de Dentadura , Estudos Retrospectivos , Estética Dentária
19.
IEEE J Biomed Health Inform ; 27(10): 4950-4960, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37471183

RESUMO

The ever-growing aging population has led to an increasing need for removable partial dentures (RPDs) since they are typically the least expensive treatment options for partial edentulism. However, the digital design of RPDs remains challenging for dental technicians due to the variety of partially edentulous scenarios and complex combinations of denture components. To accelerate the design of RPDs, we propose a U-shape network incorporated with Transformer blocks to automatically generate RPD clasps, one of the most frequently used RPD components. Unlike existing dental restoration design algorithms, we introduce the voxel-based truncated signed distance field (TSDF) as an intermediate representation, which reduces the sensitivity of the network to resolution and contributes to more smooth reconstruction. Besides, a selective insertion scheme is proposed for solving the memory issue caused by Transformer blocks and enables the algorithm to work well in scenarios with insufficient data. We further design two weighted loss functions to filter out the noisy signals generated from the zero-gradient areas in TSDF. Ablation and comparison studies demonstrate that our algorithm outperforms state-of-the-art reconstruction methods by a large margin and can serve as an intelligent auxiliary in denture design.


Assuntos
Prótese Parcial Removível , Arcada Parcialmente Edêntula , Humanos , Idoso , Planejamento de Dentadura
20.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 41(3): 315-322, 2023 Jun 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-37277798

RESUMO

OBJECTIVES: The objectives of this study were to assess the quality of prosthetic prescriptions of removable partial dentures (RPDs) and to analyze the current situation of the communication and information delivery between clinicians and technicians. METHODS: All RPD prosthetic prescriptions received by a major dental laboratory in 4 weeks were involved in a quality audit, and the prescriptions were divided into three groups in accordance with the grades of clients. The filling of prosthetic prescriptions was recorded. The items in the prescriptions for audit included the general information of the patient, the general information of the clinician, the design diagram information, other detailed information, and the return date. The prescriptions were categorized into four levels on the basis of their quality by two quality inspectors who have been working for more than 10 years. RESULTS: A total of 916 prescriptions were collected and assessed. The names in the general information of the patient and the clinician were filled out best, both at the rate of 97.6% (n=894). The return date was filled out worst, only at the rate of 6.4% (n=59). Of those prescriptions, 86.8% (n=795) exhibited inadequate design diagram information. The results of the quality assessment demonstrated that 74.2% of prescriptions were assessed as noncompliant ones and failed to meet the acceptable clinical quality standard. CONCLUSIONS: At present, the overall quality of RPD prosthetic prescriptions is poor. The responsibilities of clinicians and technicians are unclear, and the communication between them is not ideal.


Assuntos
Planejamento de Dentadura , Prótese Parcial Removível , Humanos , Prescrições
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