A Combined Digital Technique for Manufacturing Functional Fixed Implant Prosthesis Prototypes Using a CAD/CAM Software.

The manufacture of complete-arch fixed implant prostheses requires many technical steps to ensure a successful outcome. With the use of monolithic materials such as zirconia, the design of the prosthesis is crucial for a superior result. The aim of this article is to outline a combined technique using a CAD/CAM software for the manufacture of fixed implant prosthesis prototypes for complete-arch implant rehabilitations, which can be done in-house with minimal equipment. This makes it accessible and feasible for those who wish to be involved in the design phase of such prostheses. The method involves collecting several 3D data files including the patient's current prosthesis, the definitive cast, occlusal records and photographs. The technique is described using a patient case that has been provided with digitally designed and in-house manufactured prototypes.

Management of Biotechnical Complications Associated with a Full-Arch Implant Restoration Using Digital and Conventional Workflows: A Clinical Report.

Full-arch implant-supported restorations using a metal-acrylic resin design have had a high success rate but are also associated with frequent technical complications including framework misfit due to casting errors, debonding of denture teeth, and fracture of the acrylic from the metal framework. This clinical report describes a case of maxillary and mandibular full-arch implant-supported rehabilitation associated with technical and biological complications and use of digital technology for fabricating monolithic restorations. The use of a bio-functional try-in and its subsequent use as a conversion prosthesis for fabricating a master cast is described. The use of the patient's existing metal bar to fabricate a retread type prosthesis is also described along with using digital technology for fabricating a new metal bar and a monolithic type of restoration. The integration of digital and conventional workflows to obtain an increased level of accuracy and simplicity is also discussed.

Salese to buffer saliva in elderly patients with xerostomia: a pilot study.

PURPOSE: The objective of this study was to compare the pH of saliva from xerostomic patients before and after the use of Salese lozenges (Nuvora Inc., Santa Clara, CA). MATERIALS AND METHODS: After IRB approval, ten subjects were selected to participate in this pilot study to evaluate the efficacy of Salese. The inclusion criteria were patients on multiple medications who demonstrated xerostomia and acidic salivary pH. Saliva was collected from the patients at baseline and after the use of Salese at selected intervals up to 120 minutes. The pH of the collected saliva was measured, and the data were analyzed using an ANOVA. RESULTS: Use of Salese lozenges showed a shift toward a more neutral pH in the first half hour. The pH remained at the same level after the primary shift for at least 2 hours. CONCLUSIONS: This pilot study indicates that patients suffering with xerostomia can use Salese lozenges for at least 10-30 minutes to induce a salivary pH shift to a more neutral level. More research should be performed to investigate the buffering capacity of Salese lozenges.

Decision Process in Treatment of Reduced Periodontium: A Case Report.

The relationship between attachment loss and occlusal trauma has been debated for many years. When a patient presents with advanced periodontal disease, a decision has to be made on whether the teeth can be saved or extracted. In this treatment example, the decision process in therapeutic planning for a patient with stage IV periodontal disease is discussed. The main dilemma is whether the patient should receive a prosthodontic reconstruction supported by osseointegrated implants or by periodontally compromised natural teeth. It is assumed that implants do better than teeth over the long term based on firm documentation in the literature, but this article describes why a periodontal prosthesis is still a viable treatment option.