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1.
J Esthet Restor Dent ; 36(2): 270-277, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37615345

RESUMEN

OBJECTIVE: Immediate implants and immediate alveolar sealing have been a widely utilized treatment with high predictability and biological advantages. The improvement in technology has made it possible to simplify clinical processes. The aim of the present report was to describe the complete digital workflow of the Biologically oriented preparation technique for immediate posterior implant, immediate provisionalization and fabrication of definitive implant crowns. CLINICAL CONSIDERATIONS: The surgical process and prosthetic management to preserve the gingival contours of the extracted natural tooth during immediate implant placement and provisionalization are described. Additionally, during the same clinical intervention, the definitive intraoral digital implant scans for capturing the implant position, peri-implant tissue contours, adjacent and antagonist dentition, and profile emergence of the interim implant crown are captured for the fabrication of the definitive crown. CONCLUSIONS: Based on the technique described, the immediate implant placement and provisionalization in the posterior area provides biological and clinical advantages, reducing the number of abutment-implant disconnections and the number of clinical appointments, as well as increases patient comfort. CLINICAL SIGNIFICANCE: The present article describes a technique for an immediate implant placement and provisionalization in the posterior region for maintaining the gingival architecture of the extracted tooth. During the same appointment, the implant position, peri-implant tissue contours, and adjacent and antagonist dentition, and profile emergence of the interim implant crown are captured by using an intraoral scanner and used for the fabrication of the definitive crown. This technique aims to reduce the number of abutment-implant disconnections and clinical appointments.


Asunto(s)
Implantes Dentales de Diente Único , Humanos , Flujo de Trabajo , Coronas , Corona del Diente , Implantación Dental Endoósea/métodos
2.
J Prosthodont ; 33(1): 77-85, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36704924

RESUMEN

PURPOSE: To measure the wear at the implant interface between the Grade 4 titanium (Ti) of the implant and frameworks fabricated using two additively manufactured alloys (Ti alloy and cobalt-chromium [Co-Cr]) pre- and post-artificial aging. MATERIAL AND METHODS: Three-unit frameworks supported by two implants were additively manufactured (Atlantis; Dentsply Sirona) using Ti and Co-Cr dental alloys. Two implants (OsseoSpeed EV, Astra Tech; Dentsply Sirona) were torqued on each non-engaging framework. The assembled implant-frameworks were secured into polyurethane foam blocks. Groups were created based on the material and surface assessed: framework (Ti-framework and Co-Cr-framework groups) and implant (Ti-implant group). Two subgroups were created depending on the location: premolar (PM) and molar (M). Computed tomography images were obtained pre- (as manufactured) and post-simulated mastication procedures. The pre- and post-simulated mastication files of each specimen were aligned using the best-fit algorithm using a metrology program. Wear was measured by calculating the volumetric discrepancies at the implant interface on 64 measurement points per area analyzed. Three-way ANOVA and Tukey tests were used to analyze the data (α = 0.05). RESULTS: The mean volumetric discrepancy values ranged from 0.8 to 3.1 µm among all the subgroups tested. The group (framework vs. implant) (p < 0.001) and tooth location (p < 0.001) were significant factors of the mean volumetric discrepancy values obtained. The framework group presented with significantly lower volumetric discrepancy mean values (1 µm) compared with the implant group (3 µm), whereas the premolar area obtained significantly lower mean volumetric discrepancy values (1.9 µm) compared with the molar location (2.3 µm). CONCLUSIONS: Volumetric discrepancies were found at the implant-framework interface tested between the pre- and post-artificial aging measurements ranging from 1 to 3 µm after 1,200,000 cyclic loading that simulated approximately 12 months of function.


Asunto(s)
Implantes Dentales , Polimetil Metacrilato , Titanio , Cobalto , Cromo , Prótesis Dental de Soporte Implantado , Aleaciones de Cromo , Diseño Asistido por Computadora
3.
Medicina (Kaunas) ; 60(9)2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39336504

RESUMEN

Background and Objectives: This study uses finite element analysis to evaluate the impact of abutment angulation, types, and framework materials on the stress distribution and fatigue performance of dental implant systems. Materials and Methods: Three-dimensional models of maxillary three-unit fixed implant-supported prostheses were analyzed. Abutments with different angles and types were used. Two different framework materials were used. Conducted on implants, a force of 150 N was applied obliquely, directed from the palatal to the buccal aspect, at a specific angle of 30 degrees. The distribution of stress and fatigue performance were then assessed, considering the types of restoration frameworks used and the angles of the abutments in three distinct locations. The simulation aspect of the research was carried out utilizing Abaqus Software (ABAQUS 2020, Dassault Systems Simulation Corp., Johnston, RT, USA). Results: In all models, fatigue strengths in the premolar region were higher than in the molar region. Maximum stress levels were seen in models with angled implants. In almost all models with the zirconia framework, fatigue performance was slightly lower. Conclusions: According to the findings of this study, it was concluded that the use of metal-framework multi-unit restorations with minimum angulation has significant positive effects on the biomechanics and long-term success of implant treatments.


Asunto(s)
Implantes Dentales , Análisis de Elementos Finitos , Humanos , Implantes Dentales/normas , Pilares Dentales , Análisis del Estrés Dental/métodos , Diseño de Implante Dental-Pilar/métodos
4.
Medicina (Kaunas) ; 59(2)2023 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-36837500

RESUMEN

Background and Objectives: Implant rehabilitation of complete edentulous arches has become more and more popular because of the increased access of the population to this type of treatment. Furthermore, the development of new rehabilitation procedures can be applied in most clinical cases, including in those with severe atrophy. Hence, this study aimed to assess the functional changes that can occur in the stomatognathic system after implant rehabilitation procedures. Materials and Methods: A total of 63 patients were accepted in the study. They were divided into a first control (dentate) group (CG) and a second study group (edentulous, SG). For the latter, 30 patients received 204 two-stage implants immediately loaded with provisional prostheses. Surface electromyography (EMG) was assessed at the time of prostheses fixation, while for some patients it was applied six months after the fixation of the fixed prostheses, as well. These supplemental investigated patients formed a third, follow-up study group (FSG). All assessments were performed during the processes of clenching and mastication. The obtained data of the two study groups, SG and FSG, were compared with those of the control group, CG. Results: No statistical differences were found in the electrical muscular activity between the study and control groups during both clenching and mastication (p > 0.05). In addition, there were no differences within the same study group, both initially and after 6 months. The only changes were noticed between static and dynamic values for the right masseter muscle in the follow-up group FSG (p = 0.008). Deviations of the overlapping coefficients were similar for all groups (p = 0.086): for CG, 20.5%, median 11.1 (min. 0, max. 104); for SG, 21.4%, median 12.2 (min. 0, max. 103); for FSG, 36.1%, median 26.9 (min. 0, max. 160). This revealed no neuromuscular adaption to the prostheses. Conclusions: Implant-prosthetic rehabilitation led to an EMG activity that was similar to that of dentate patients immediately after the placement of the fixed implant-supported prostheses. Moreover, the measured values did not change after six months of functioning for all evaluated parameters. This may point to an immediate restoration of the muscle contraction capacity, without the necessity of adaptation over time. The study serves as an argument for the application and reliability of the immediate fixed implant-supported prostheses from the perspective of muscle adaptation and functioning.


Asunto(s)
Músculo Masetero , Boca Edéntula , Humanos , Estudios de Seguimiento , Reproducibilidad de los Resultados , Boca Edéntula/rehabilitación , Prótesis e Implantes , Resultado del Tratamiento
5.
J Evid Based Dent Pract ; 23(1): 101799, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36914295

RESUMEN

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Delucchi, F.; De Giovanni, E.; Pesce, P.; Bagnasco, F.; Pera, F.; Baldi, D.; Menini, M. Framework Materials for Full-Arch Implant-Supported Rehabilitations: A Systematic Review of Clinical Studies. Materials 2021, 14, 3251. https:// doi.org/10.3390/ma14123251 SOURCE OF FUNDING: This research received no funding. TYPE OF STUDY/DESIGN: Systematic Review (SR).


Asunto(s)
Implantes Dentales , Humanos , Prótesis Dental de Soporte Implantado , Circonio
6.
Eur J Oral Sci ; 129(2): e12762, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33501688

RESUMEN

This study determined the shear bond strength (SBS) between an indirect gingival composite resin and glazed gingival porcelain after various surface treatments. A total of 176 porcelain disks with natural glazing were used and assigned to one of four groups: no surface treatment, airborne-particle abrasion, hydrofluoric acid etching, or a combination of airborne-particle abrasion followed by hydrofluoric acid etching. Each group was divided into two subgroups: one subgroup was unprimed, and the other was silanized. An indirect composite resin was then bonded to the porcelain disks. Half of the specimens in each group (n = 11) were exposed to 5000 thermocycles. SBSs were measured, and data were analyzed with the Kruskal-Wallis and Steel-Dwass tests. Among silanized specimens, those treated with the combination of airborne-particle abrasion and hydrofluoric acid etching exhibited the highest bond strengths both before and after thermocycling. However, the SBS values of the silanized and unprimed hydrofluoric acid etched specimens did not differ significantly. Airborne-particle abrasion followed by hydrofluoric acid etching with silane application yielded stronger, more durable bonds between the indirect gingival composite resin and glazed gingival porcelain.


Asunto(s)
Recubrimiento Dental Adhesivo , Implantes Dentales , Grabado Ácido Dental , Resinas Compuestas , Porcelana Dental , Análisis del Estrés Dental , Ensayo de Materiales , Cementos de Resina , Resistencia al Corte , Propiedades de Superficie , Circonio
7.
J Prosthodont ; 30(8): 645-650, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33938077

RESUMEN

The failing dentition of partially edentulous individuals may be used as an initial reference for stackable restrictive surgical guides during full-arch immediate implant placement. The stackable guide option derived from a digital workflow increases the predictability of the performance of bone reduction, immediate implant placement, and immediate loading of provisional implant-supported fixed dental prostheses. The present paper aims to report a practical approach to design and produce a metal framework with occlusal rests to facilitate the use of a tooth-supported surgical guide when full-arch immediate implant placement is indicated in patients with failing dentition.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Humanos , Tecnología , Flujo de Trabajo
8.
Clin Oral Implants Res ; 29(4): 396-403, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29484710

RESUMEN

OBJECTIVES: The purpose of this in vitro study was to evaluate fracture loads of implant-supported zirconia-based prostheses fabricated with different veneer materials (resin-based material and lithium disilicate ceramics). MATERIAL AND METHODS: Forty-four zirconia-based molar prostheses were fabricated on dental implants and divided into four groups (n = 11): zirconia-based prostheses veneered with feldspathic porcelain (ZVF), zirconia-based prostheses bonded with the lithium disilicate glass-ceramic veneer (ZBD), zirconia-based prostheses veneered with indirect composite resin (ZVC), and zirconia-based prostheses bonded with composite materials fabricated from a CAD/CAM resin block (ZBC). The zirconia-based prostheses and abutments were adhesively bonded with a dual-polymerized resin-based luting material. Fracture load was determined using compression load to the prostheses with a universal testing machine. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey's HSD test (α = .05). RESULTS: The mean fracture load was significantly higher in the ZBC group (3.95 kN) than in the ZVC group (3.28 kN). No significant difference in fracture load was found among the ZVF (3.52 kN), ZBD (3.48 kN), and ZVC groups. CONCLUSIONS: The adhesively bonded veneering technique enhances fracture resistance of implant-supported zirconia-based prostheses fabricated with a resin-based material. All implant-supported zirconia-based restorations tested should resist physiologic masticatory forces in the oral environment.


Asunto(s)
Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Coronas con Frente Estético , Circonio , Diseño de Prótesis Dental , Ensayo de Materiales
9.
J Contemp Dent Pract ; 18(10): 927-932, 2017 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-28989132

RESUMEN

AIM: The aim of this prospective cohort study was to evaluate the postinsertion posterior single-implant occlusion changes at 3- and 6-month intervals using T-Scan computerized occlusal analysis. MATERIALS AND METHODS: A total of 21 patients received single implant, opposed by natural dentition, in posterior regions of the maxilla or mandible (13 premolar, 8 molar) and were finally restored with cemented-retained metal-ceramic crowns. The occlusal contacts were equilibrated according to the implant-protective occlusion concept to develop light contact with heavy occlusion and no contact with light occlusion in maximum inter-cuspation. The percentage of force applied to the implant crowns (POFI) and contralateral teeth (POFT) was evaluated using T-Scan computerized occlusal analysis at prosthesis insertion, 3- and 6-month follow-up appointments. The data were statistically analyzed using Friedman test and Wilcoxon post hoc test (α = 0.05). RESULTS: The POFI values at the 6- and 3-month follow-up appointments were significantly higher than those at prostheses insertion (p = 0.001 and p = 0.005 respectively). In addition, there were significant differences between the POFI at 3- and 6-month follow-up (p = 0.020). However, the POFT values at 3- and 6-month follow-up appointments were significantly lower than those at baseline (p < 0.001). CONCLUSION: The intensity of occlusal contacts of implant-supported prostheses opposed by natural dentition gradually increased after prosthesis insertion. Placement of single posterior implant-supported restoration decreased the percentage of occlusal force applied to contralateral arch. CLINICAL SIGNIFICANCE: A periodic occlusal adjustment of implant-supported prostheses is necessary to prevent potential overloading from the movement of opposing natural dentition.


Asunto(s)
Implantes Dentales de Diente Único , Prótesis Dental de Soporte Implantado , Fuerza de la Mordida , Coronas , Implantación Dental/métodos , Oclusión Dental , Fracaso de la Restauración Dental , Restauración Dental Permanente , Humanos , Estudios Prospectivos
10.
Clin Oral Implants Res ; 27(2): e31-7, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25346286

RESUMEN

OBJECTIVES: The purpose of this study was to compare patient satisfaction and oral health-related quality of life (OHRQoL) among fully edentulous patients treated with either fixed implant-supported prostheses (FP), removable implant-supported prostheses (RP), or complete dentures (CD). MATERIAL AND METHODS: Eighty-six patients - 29 FP, 27 RP, and 30 CD patients - participated in this study. The survey was conducted using face-to-face interviews with a questionnaire that included a patient satisfaction scale and Oral Health Impact Profile (OHIP-14). We measured patient satisfaction after prosthetic treatments and OHRQoL before and after the treatments. RESULTS: After prosthetic treatments, OHRQoL increased in all three groups (P < 0.05). The FP and RP groups showed no significant difference in patient satisfaction and OHRQoL, and both groups showed greater improvement compared with the CD group. Specifically, the OHRQoL dimensions of functional limitation, physical pain, psychological discomfort, and psychological disability in the FP group, and functional limitation in the RP group, improved greatly in comparison with the CD group (P < 0.05). CONCLUSIONS: Although further research is still needed, prosthetic treatments may provide superior OHRQoL for fully edentulous patients. In particular, both the FP and RP treatments provided significantly greater improvement of OHRQoL and patient satisfaction than the CD treatment. Reliable information of OHRQoL and patient satisfaction helps experts and patients choose the best prosthetic treatment option.


Asunto(s)
Prótesis Dental de Soporte Implantado , Dentadura Completa , Prótesis de Recubrimiento , Arcada Edéntula/rehabilitación , Salud Bucal , Satisfacción del Paciente , Calidad de Vida , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Resultado del Tratamiento
11.
Clin Oral Implants Res ; 27(4): 473-80, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25655618

RESUMEN

OBJECTIVES: Appropriate sensory information from periodontal mechanoreceptors (PMRs) is important for optimizing the positioning of food and adjustment of force vectors during precision biting. This study was designed to describe motor behavior during the first cycle of a natural chewing task and to evaluate the role of such sensory input in this behavior. MATERIAL AND METHODS: While 10 subjects with natural dentition, 11 with bimaxillary fixed tooth-supported prostheses (TSP) and 10 with bimaxillary fixed implant-supported prostheses (ISP) (mean age 69 [range 61-83]) chewed a total of five hazelnuts, their vertical and lateral jaw movements were recorded. Data obtained during the first chewing cycle of each hazelnut were analyzed. RESULTS: The amplitude of vertical and lateral mandibular movement and duration of jaw opening did not differ between the groups, indicating similar behavior during this part of the chewing cycle. However, only 30% of the subjects in the natural dentate group, but 82% of those in the TSP and 70% in the ISP group exhibited slippage of the hazelnut during jaw closure in at least one of five trials. The TSP and ISP groups also exhibited more irregular and narrower patterns of motion (total lateral/vertical movement = 0.15 and 0.19, respectively, compared to 0.27 for the natural group). CONCLUSIONS: Subjects with fixed tooth- or implant-supported prostheses in both jaws show altered behavior, including inadequate control of the hazelnut, during the first chewing cycle. We propose that these differences are due to impairment or absence of sensory signaling from PMRs in these individuals.


Asunto(s)
Prótesis Dental de Soporte Implantado , Mandíbula/fisiología , Masticación , Mecanorreceptores/fisiología , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad
12.
J Oral Implantol ; 41 Spec No: 352-9, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24779915

RESUMEN

Due to the brittleness and limited tensile strength of the veneering glass-ceramic materials, the methods that combine strong core material (as zirconia or alumina) are still under debate. The present study aims to evaluate the fracture strength and the mechanism of failure through fractographic analysis of single all-ceramic crowns supported by implants. Forty premolar cores were fabricated with CAD/CAM technology using alumina (n = 20) and zirconia (n = 20). The specimens were veneered with glass-ceramic, cemented on titanium abutments, and subjected to loading test until fracture. SEM fractographic analysis was also performed. The fracture load was 1165 (±509) N for alumina and 1638 (±662) N for zirconia with a statistically significant difference between the two groups (P = 0.026). Fractographic analysis of alumina-glass-ceramic crowns, showed the presence of catastrophic cracks through the entire thickness of the alumina core; for the zirconia-glass-ceramic crowns, the cracks involved mainly the thickness of the ceramic veneering layer. The sandblast procedure of the zirconia core influenced crack path deflection. Few samples (n = 3) showed limited microcracks of the zirconia core. Zirconia showed a significantly higher fracture strength value in implant-supported restorations, indicating the role played by the high resistant cores for premolar crowns.


Asunto(s)
Óxido de Aluminio/química , Cerámica/química , Coronas , Materiales Dentales/química , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Circonio/química , Cementación/métodos , Diseño Asistido por Computadora , Pilares Dentales , Porcelana Dental/química , Diseño de Prótesis Dental , Análisis del Estrés Dental/instrumentación , Coronas con Frente Estético , Humanos , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Cementos de Resina/química , Estrés Mecánico , Propiedades de Superficie , Titanio/química , Itrio/química
13.
J Prosthodont ; 24(2): 168-71, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24990286

RESUMEN

In the event of the loss of an implant and to take advantage of the preexisting structures, a rescue procedure that allows continuous use of the original fixed restoration during the restoration of the tripod support at the implant level can be used. When nonphysiological occlusion forces are avoided, the success rate of this rescue procedure is very similar to any other rehabilitation made following a conventional protocol. Furthermore, the fact that the patient has already adapted to the prosthesis position and its vertical dimension results in easier functional adaptation in the postoperative period and, consequently, greater comfort.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Dentadura Parcial Fija , Anciano , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Mandíbula/cirugía , Maxilar/cirugía
14.
J Pharm Bioallied Sci ; 16(Suppl 3): S2730-S2732, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39346340

RESUMEN

Objective: This retrospective research was directed to investigate the longevity and maintenance requirements of implant-supported prostheses in subjects treated at a tertiary care center. Methods: Patient records of individuals who received implant-supported prostheses between January 2018 and December 2020 were retrospectively analyzed. Demographic information, implant type, prosthetic design, and follow-up data were collected. The primary outcomes assessed were prosthetic survival rates and the incidence of complications requiring maintenance interventions. Statistical analysis was performed to identify associations between demographic and clinical variables and the observed outcomes. Results: The research included 150 subjects with an average follow-up duration of 3 years. The overall survival rate of implant-supported prostheses was 90%, with 20% requiring maintenance interventions. Common complications included peri-implantitis (10%), prosthetic fracture (6%), and screw loosening (4%). Significant associations were found between smoking status and peri-implantitis (P < 0.05) and between prosthetic design and prosthetic fracture (P < 0.01). Conclusion: Implant-supported prostheses demonstrated a high overall longevity rate, with a subset of subjects requiring maintenance interventions due to complications. Peri-implantitis, prosthetic fracture, and screw loosening were the most prevalent complications, emphasizing the importance of tailored patient care and risk stratification.

15.
Int J Surg Case Rep ; 119: 109707, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38677251

RESUMEN

INTRODUCTION AND IMPORTANCE: Aliments such as congenital conditions, pathological, and iatrogenic circumstances may result in mandibular defects that can severely disturb the patients' oral health, functions (mastication, speech), aesthetics, and quality of life and present a rehabilitating challenge. CASE PRESENTATION: we present a multidisciplinary treatment approach for three cases presented with mandibular resection as a consequence of cystic, benign, and malignant tumour eradication that were rehabilitated with immediately loaded fixed corticobasal implant-supported prostheses and a follow-up period of 5,5 and 4 years. The reported cases present with excellent implant survival, along with healthy peri-implant tissues, stable prostheses, enhanced speech, chewing ability, aesthetics, superior patient satisfaction, and improved overall self-esteem. CLINICAL DISCUSSION: A multidisciplinary oral and maxillofacial team is mandatory for the successful rehabilitation of patients with mandibular resection and to restore soft and hard tissue loss. The reported treatment modality offers the patient immediate fixed implant-supported prostheses omitting the need for a bone grafting procedure, with optimum peri-implant tissue health, excellent biomechanical and prosthetic results, and significant improvement in function and satisfaction. CONCLUSION: Corticobasal fixed implant-supported prostheses can be a reliable treatment modality for mandibular resection, resulting in notable enhancements in the patients' oral health, appearance, mastication, speech, and self-esteem.

16.
Healthcare (Basel) ; 11(11)2023 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-37297717

RESUMEN

Edentulous patients' quality of life can be greatly diminished by the use of a badly fitting removable prosthesis, as many aspects of social life become notably impaired. The object of this study was to evaluate if treating these patients with a two implants mandibular overdenture could improve their quality of life as measured with the Italian version of the OHIP-14 (Oral Health Impact Profile). Edentulous patients, in good clinical condition, were selected. Two implants were placed following the recommended guidelines and three months after new mandibular dentures were manufactured, implants were uncovered and connected to the prosthesis using LOCATOR abutments. OHIP-14 was measured at baseline, one month after delivery and one year after delivery. An improvement was observed even after one month (with a mean reduction of 17 points in OHIP) and that improvement appeared to be stable at the one-year follow-up. Mandibular overdentures can improve a patient's quality of life when compared to a tissue-supported removable complete denture, as long as the patient is subjected to an appropriate follow-up as the retentive rings of the attachment can deteriorate even after two years and lose a great deal of retentive capabilities.

17.
Materials (Basel) ; 16(11)2023 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-37297310

RESUMEN

Obtaining accurate models and well-fitting prostheses during the fabrication of complete implant-supported prostheses has been a significant challenge. Conventional impression methods involve multiple clinical and laboratory steps that can lead to distortions, potentially resulting in inaccurate prostheses. In contrast, digital impressions may eliminate some of these steps, leading to better-fitting prostheses. Therefore, it is important to compare conventional and digital impressions for producing implant-supported prostheses. This study aimed to compare the quality of digital intraoral and conventional impressions by measuring the vertical misfit of implant-supported complete bars obtained using both types of techniques. Five digital impressions using an intraoral scanner and five impressions using elastomer were made in a four-implant master model. The plaster models produced with conventional impressions were scanned in a laboratory scanner to obtain virtual models. Screw-retained bars (n = five) were designed on the models and milled in zirconia. The bars fabricated using digital (DI) and conventional (CI) impressions were screwed to the master model, initially with one screw (DI1 and CI1) and later with four screws (DI4 and CI4), and were analyzed under a SEM to measure the misfit. ANOVA was used to compare the results (p < 0.05). There were no statistically significant differences in the misfit between the bars fabricated using digital and conventional impressions when screwed with one (DI1 = 94.45 µm vs. CI1 = 101.90 µm: F = 0.096; p = 0.761) or four screws (DI4 = 59.43 µm vs. CI4 = 75.62 µm: F = 2.655; p = 0.139). Further, there were no differences when the bars were compared within the same group screwed with one or four screws (DI1 = 94.45 µm vs. DI4 = 59.43 µm: F = 2.926; p = 0.123; CI1 = 101.90 µm vs. CI4 = 75.62 µm: F = 0.013; p = 0.907). It was concluded that both impression techniques produced bars with a satisfactory fit, regardless of whether they were screwed with one or four screws.

18.
Int J Prosthodont ; 0(0)2023 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-37824117

RESUMEN

Traditionally, metal-ceramics, metal-reinforced acrylics, and more recently full-contour or layered zirconia have been the materials of choice for definitive fixed implant-supported rehabilitations. Polymethyl Methacrylate (PMMA) is commonly used in implant dentistry for the fabrication of implant-supported interim prostheses and as milled or 3D printed prototypes. This article describes a novel protocol to prosthetically restore a completely edentulous patient following a digital workflow, with fixed, screw-retained, implant-supported prostheses fabricated from CAD/CAM milled polymethyl methacrylate (PMMA), with no metal substructure. After two years follow up in terms of esthetics, phonetics, function and biological tissue response, the outcome remains functional and free of mechanical, biomechanical or biological complications. The aim of this article is to illustrate the feasibility of using milled PMMA as viable definitive prosthetic material for the fixed implant rehabilitation of edentulous patients.

19.
Healthcare (Basel) ; 11(22)2023 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-37998459

RESUMEN

"Combination syndrome", defined by Kelly in 1972, is a challenging condition observed in a patient with an edentulous maxilla and a partially edentulous mandible with only mandibular anterior teeth. "Anterior hyperfunction syndrome" is regarded as a synonym of combination syndrome and was first described in 1994. Although these terms have been well known, the definition of "anterior hyperfunction" has not been described yet. This narrative review focused on anterior hyperfunction and discussed the etiology and the clinical managements. An electronic bibliographic search for this literature review was conducted in addition to the review of our clinical cases. The previous reports indicated that combination syndrome with all five features was rarely observed. The patients with anterior hyperfunction generally showed the loss of posterior occlusal supports and the loss of vertical dimension of occlusion. To manage anterior hyperfunction, these conditions should be improved using conventional removable prostheses and implant-supported prostheses. Anterior hyperfunction is attributed to mandibular anterior teeth and some interventions for mandibular anterior teeth are required in many cases. Additionally, it must be noted that implant-supported prostheses may lead to anterior hyperfunction. In conclusion, comprehensive approaches for the remaining teeth and the prostheses will be required to manage this complex condition.

20.
Biomedicines ; 11(11)2023 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-38002036

RESUMEN

The roughness of the intra-oral surfaces significantly influences the initial adhesion and the retention of microorganisms. The aim of this study was to analyze the surface texture of four different CAD-CAM materials (two high-performance polymers and two fifth-generation zirconia) used for complete-arch implant-supported prostheses (CAISPs), and to investigate the effect of artificial aging on their roughness. A total of 40 milled prostheses were divided into 4 groups (n = 10) according to their framework material, bio.HPP (B), bio.HPP Plus (BP), zirconia Luxor Z Frame (ZF), and Luxor Z True Nature (ZM). The areal surface roughness "Sa" and the maximum height "Sz" of each specimen was measured on the same site after laboratory fabrication (lab as-received specimen) and after thermocycling (5-55 °C, 10,000 cycles) by using a noncontact optical profilometer. Data were analyzed using SPSS version 28.0.1. One-way ANOVA with multiple comparison tests (p = 0.05) and repeated measures ANOVA were used. After thermocycling, all materials maintained "Sa" values at the laboratory as-received specimen level (p = 0.24). "Sz" increased only for the zirconia groups (p = 0.01). B-BP exhibited results equal/slightly better than ZM-ZF. This study provides more realistic surface texture values of new metal-free materials used in real anatomical CAISPs after the manufacturing and aging processes and establishes a detailed and reproducible measurement workflow.

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