RESUMO
Edentulism (total tooth loss) can be managed with four possible options: no prosthetic replacement, conventional complete dentures, implant-retained overdentures (removable), or implant-supported bridgework (fixed). Selection of these choices is influenced by social, medical, anatomical, technical, and economic factors. The care team involved in the decision-making process (be it patients, clinicians and occasionally commissioners of services) should be aware of the different treatment options and their potential impact on the patient's quality of life (QoL). The cost effectiveness of this impact can also be evaluated. Knowledge of the life-long sequelae of edentulism will also help practitioners guide patients in their treatment planning decisions when they may be approaching an edentulous state, preparing them for the challenges that may lie ahead. This paper aims to address the impact that edentulism has on QoL and the treatment options, focusing on the patient perspective.
Assuntos
Prótese Dentária Fixada por Implante , Boca Edêntula , Qualidade de Vida , Humanos , Implantes Dentários , Prótese Total , Revestimento de Dentadura , Boca Edêntula/reabilitação , Análise de Custo-EfetividadeRESUMO
OBJECTIVES: This crossover randomized controlled clinical trial (RCT) aimed to evaluate the clinical applicability of three-dimensional printed dentures (CAD-3DPs) by comparing two fabricated complete dentures, CAD-3DPs and conventional complete dentures (CCDs), and assess the non-inferiority of CAD-3DPs. The hypothesis was that CAD-3DPs would be inferior to CCDs in terms of the oral health-related quality of life (OHRQoL) and patient satisfaction. METHODS: This single-blind RCT was conducted at two university hospitals. The participants included adult patients with edentulous maxillary and mandibular arches, who had existing complete dentures and were willing to use new complete dentures. Eighteen participants were assigned to two groups: CCD-CAD-3DP and CAD-3DP-CCD, based on the order of denture delivery. Both sets of maxillary and mandibular CCDs and CAD-3DPs were delivered to all the participants. The OHRQoL using Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) was considered the primary outcome. General satisfaction using a 100-mm visual analog scale was also evaluated as a suboutcome. RESULTS: Based on the non-inferior test on the total score of the OHIP-EDENT and each score of the seven conceptual subdomains, the lower limit of the 95 % confidence interval was < 2.65 in seven domains. Therefore, CAD-3DP was judged to be non-inferior to CCD. Patient satisfaction was not significantly different between the CCD and CAD-3DP groups (p > 0.05). CONCLUSIONS: This RCT revealed that CAD-3DP is comparable to CCD based on the OHIP-JDENT scores and patient satisfaction. CLINICAL SIGNIFICANCE: CAD-3DP is clinically applicable and comparable to CCD in terms of patient-reported outcomes.
Assuntos
Estudos Cross-Over , Planejamento de Dentadura , Prótese Total , Saúde Bucal , Satisfação do Paciente , Impressão Tridimensional , Qualidade de Vida , Humanos , Feminino , Masculino , Prótese Total/psicologia , Idoso , Pessoa de Meia-Idade , Método Simples-Cego , Boca Edêntula/psicologia , Boca Edêntula/reabilitação , Desenho Assistido por ComputadorRESUMO
PURPOSE: To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers. METHODS: Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann-Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test. RESULTS: Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05). CONCLUSIONS: The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected.
Assuntos
Prótese Total , Mastigação , Boca Edêntula , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Qualidade de Vida , Humanos , Mastigação/fisiologia , Feminino , Masculino , Idoso , Boca Edêntula/fisiopatologia , Boca Edêntula/reabilitação , Pessoa de Meia-Idade , Deglutição/fisiologia , Saúde BucalRESUMO
BACKGROUND: Immediate rehabilitation is a considerable therapeutic challenge but is necessary for edentulous patients with oronasal fistulas, especially those with inadequate residual bone and a history of radiotherapy. CASE PRESENTATION: We report a rare case of a 63-year-old patient who was missing the majority of his maxillary teeth and who had a defect due to palatal mucoepidermoid carcinoma resection. The patient also received radiotherapy twice within one year postoperatively. An implant-supported prosthesis with an obturator was fabricated immediately. CONCLUSION: This technique improved patients' oral function, enhanced the aesthetic effect, and increased their confidence.
Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Boca Edêntula , Humanos , Pessoa de Meia-Idade , Masculino , Boca Edêntula/reabilitação , Neoplasias Palatinas/cirurgia , Neoplasias Palatinas/reabilitação , Obturadores Palatinos , Planejamento de DentaduraRESUMO
BACKGROUND: Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. METHODS: Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant's mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. RESULTS: Compared to complete dentures, mandibular implant overdentures showed a significant decrease (P < 0.05) in both anterior hyoid displacement and duration of hyoid maximum anterior excursion (DOHMAE). However, there was a non-significant difference (P > 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. CONCLUSION: Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. TRIAL REGISTRATION: Retrospectively registered (NCT06187181) 02/1/2024.
Assuntos
Deglutição , Revestimento de Dentadura , Osso Hioide , Boca Edêntula , Humanos , Deglutição/fisiologia , Masculino , Feminino , Boca Edêntula/fisiopatologia , Boca Edêntula/reabilitação , Pessoa de Meia-Idade , Idoso , Mandíbula , Fluoroscopia , Prótese Dentária Fixada por Implante , Implantes Dentários , Arcada Edêntula/reabilitação , Arcada Edêntula/fisiopatologiaRESUMO
Background: This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures. Methods: The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA. Results: The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p < 0.001) of the overdenture use compared to the conventional denture. The PrMA insignificantly improved (p = 0.397) after six months of the single implant retained overdenture use. Discussion: The study's findings indicate that using immediate loading single implant-retained mandibular overdentures significantly improved PrMA in completely edentulous patients.
Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Mastigação , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Mastigação/fisiologia , Boca Edêntula/reabilitação , Prótese Total , Mandíbula/cirurgia , Egito , Implantes Dentários para Um Único DenteRESUMO
BACKGROUND: Edentulism remains a major disability worldwide, especially among the elderly population, although the prevalence of complete edentulism has declined over the last decades. In Uganda, the prevalence of edentulism in people aged 20 years and above is 1.8%. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design and computer-aided manufacturing (CADCAM), however, the provision of removable complete dentures continues to be the predominant rehabilitation for edentulous patients. However, no published study has explored the lived experiences with removable complete dentures among the Ugandan population. The aim of the present study was to explore patients' lived experiences on the usage of removable complete dentures among Ugandan edentulous patients attending Makerere University Dental Hospital. METHODS: This was a qualitative study approach using purposive sampling. Fifteen (15) respondents were selected across social demographics. Interviews were recorded and transcribed and themes were generated to draw a deeper meaning to the usage of removable complete dentures. A qualitative statistical package, Atlas Ti software was used to generate themes from the interviews followed by an interpretation of the generated data and the results were presented as text and in a table. RESULTS: The reported key positive experiences due to removable complete denture rehabilitation were the improvement in speech, eating ability, regaining good facial appearance, better oral hygiene management, self-esteem and confidence to smile in public, and a feeling of completeness. However, respondents complained of pain and discomfort due to the looseness of dentures, inability to eat certain foods, and regular cleaning of dentures. The respondents did not go through proper informed consent processes before getting removable complete dentures. CONCLUSION: The study found that patients were satisfied with their removable complete dentures rehabilitation due to the positive experiences registered, such as the ability to eat and talk well, and restoration of self-esteem, all of which improved their quality of life. However, they experience pain and discomfort due to the looseness of dentures.
Assuntos
Prótese Total , Boca Edêntula , Humanos , Uganda , Boca Edêntula/psicologia , Boca Edêntula/reabilitação , Feminino , Masculino , Prótese Total/psicologia , Pessoa de Meia-Idade , Idoso , Pesquisa Qualitativa , Adulto , Qualidade de VidaRESUMO
(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.
Assuntos
Fluxo de Trabalho , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Desenho Assistido por Computador , Idoso , Prótese Dentária Fixada por Implante/métodos , Impressão Tridimensional , Tomografia Computadorizada por Raios X/métodos , Boca Edêntula/reabilitaçãoRESUMO
OBJECTIVES: Total tooth loss is common in the aging population resulting in insufficient chewing function with subsequent weakening of the masticatory muscles. The study aims to evaluate the changes in thicknesses of the masseter and anterior temporal muscle in edentulous patients following the reconstruction of implant-supported fixed prostheses and compare them with the dentate individuals. MATERIALS AND METHODS: The study was designed as a prospective, single-center, controlled clinical trial. A total of 60 participants were included in the present study. The patients were divided into two groups; Group I (Test Group): 30 edentulous patients who received implant-supported fixed prostheses, Group II (Control Group): 30 dentate individuals of an age and sex-matched group. Ultrasonography was used to measure the cross-sectional thickness of the left and right musculus masseter and anterior temporalis immediately after the cementation of the prosthetic rehabilitation (T1), on the 1st (T2) and 6th (T3) months after rehabilitation and at a single time point in the control group. RESULTS: The results showed that there were significant comparison differences in muscle thickness at the baseline measurements between groups while at the end of the 6th month, these differences were not significant. The muscle thicknesses of both the masseter and anterior temporalis muscles increased significantly at T2 and T3 compared to T1 in the test group. The asymmetry index between the left and right muscles in the test group and the asymmetry differences between groups also decreased significantly at the end of the 6th month. CONCLUSION: The implant-supported fixed prostheses significantly increase the thicknesses of the masseter and anterior temporal muscle together with a decrease in the asymmetry between the left and right muscles. At six months, implant-treated patients showed similar muscle thicknesses compared to dentate individuals. CLINICAL RELEVANCE: The findings suggest that implant-supported fixed prostheses can improve the masticatory function and facial symmetry of edentulous patients.
Assuntos
Prótese Dentária Fixada por Implante , Músculo Masseter , Boca Edêntula , Músculo Temporal , Ultrassonografia , Humanos , Masculino , Feminino , Estudos Prospectivos , Músculo Masseter/diagnóstico por imagem , Músculo Temporal/diagnóstico por imagem , Pessoa de Meia-Idade , Boca Edêntula/reabilitação , Boca Edêntula/diagnóstico por imagem , Idoso , Resultado do TratamentoRESUMO
PURPOSE: This systematic review aims to compare clinical outcomes of digital dentures with conventional dentures. MATERIALS AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in Prospero. The formulated population, intervention, comparison, outcome (PICO) question was "What is the clinical outcome of digital versus conventional complete dentures (CDs) in edentulous patients?". The search strategy used three main electronic databases and an additional manual search was completed in August 2023 by following an established search strategy. Initial inclusion was based on titles and abstracts, followed by a detailed review of selected studies, and clinical studies that evaluated the clinical outcome of digital (milled or 3D-printed) versus conventional CDs were included. A qualitative analysis for clinical studies was used to assess the risk of bias. The certainty of the evidence was assessed according to the grading of recommendations, assessment, development, and evaluations (GRADE) system. In addition, a single-arm meta-analysis was performed to evaluate the retention between digital versus conventional CDs. RESULTS: The initial search yielded a total of 947 articles, out of which 19 were selected for a comprehensive review, and six met the eligibility criteria to be included in this systematic review. The computer-aided design and computer-aided manufacturing (CAD-CAM) CDs showed increased retention, no relevant differences in oral health-related quality of life (OHRQoL), and shorter working time compared to conventional dentures. Two studies were eligible for meta-analysis; retention was significantly better among CAD-CAM fabricated dentures (standardized mean difference [SMD] 0.501) than conventional dentures. The heterogeneity between studies was high (95% CI: 0.049-0.952). CONCLUSIONS: Clinically, both the milled and the 3D-printed CD fared better than conventional dentures in terms of retention, reduction in the number of appointments, improved patient comfort, and improved predictable maintenance of the denture. Patients' perceptions and satisfaction were independent of the digital and conventional fabricated dentures.
Assuntos
Desenho Assistido por Computador , Planejamento de Dentadura , Prótese Total , Boca Edêntula , Impressão Tridimensional , Humanos , Planejamento de Dentadura/métodos , Boca Edêntula/reabilitação , Resultado do TratamentoRESUMO
PURPOSE: To evaluate and compare patient satisfaction levels in edentulous patients treated with different configurations of implant-supported prostheses as well as previous prosthesis experiences before implant treatment. MATERIALS AND METHODS: A study population of 142 patients was identified and separated into four treatment groups: group 1 comprised 43 patients treated with an implant-supported overdenture in the mandible and conventional complete denture in the maxilla; group 2 comprised 32 patients treated with implant-supported overdentures in the maxilla and mandible; group 3 comprised 26 patients treated with an implant-supported overdenture in the mandible and a fixed prosthesis in the maxilla; and group 4 comprised 41 patients treated with implant-supported maxillomandibular fixed restorations. Questionnaires asking about masticatory performance, pronunciation, comfort, and social ability were used to evaluate treatment outcomes. RESULTS: The patients in group 4 were significantly more satisfied regarding masticatory performance than other treatment modalities. Visual analog scale (VAS) scores for comfort and social ability were similar in groups 3 and 4 and significantly higher than those in groups 1 and 2. The patients who used a conventional removable prosthesis before implant treatment were more satisfied with their implant-supported prosthesis regarding social ability (P = .03). CONCLUSIONS: The treatment design of an implant-supported fixed prosthesis in the maxilla and implant overdenture in the mandible provided a comparable level of satisfaction with maxillomandibular fixed prosthesis for edentulous patients. This combination served as a practical solution especially for patients with mandibular atrophy who would require extensive surgeries to support maxillomandibular fixed prostheses. In the maxilla, patient satisfaction with an implantsupported overdenture was not superior to that with a conventional prosthesis. Note that previous removable prosthesis experience may influence social comfort for patients.
Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Mastigação , Boca Edêntula , Satisfação do Paciente , Humanos , Prótese Dentária Fixada por Implante/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Mastigação/fisiologia , Boca Edêntula/reabilitação , Boca Edêntula/cirurgia , Boca Edêntula/psicologia , Inquéritos e Questionários , Prótese Total , Resultado do Tratamento , Adulto , Arcada Edêntula/reabilitação , Arcada Edêntula/cirurgia , Idoso de 80 Anos ou maisRESUMO
PURPOSE: To evaluate whether complete dentures (CDs) relined with long-term resilient liners (LTRLs) favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to conventional CDs. MATERIALS AND METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in PROSPERO (the International Prospective Register of Systematic Reviews; CRD42021258700). The population, intervention, comparison, and outcome (PICO) purpose was to determine whether CDs relined with LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs. Searches were performed in the PubMed/MEDLINE, Embase, Scopus, Lilacs, BBO, and OpenGrey databases. Manual searches were also performed to identify additional primary studies. RESULTS: Overall, 3,953 articles were found. After removing duplicates, reading the articles, and applying the inclusion and exclusion criteria, 15 articles were selected for qualitative analysis, totaling 422 patients with follow-up periods ranging from 1 week to 3 years. Among these, 8 studies assessed masticatory function using different methods, 2 assessed satisfaction, 1 assessed quality of life, and 4 assessed more than one outcome. Through qualitative analysis, LTRLs showed satisfactory results in most studies when compared to CDs in relation to masticatory function, satisfaction, and quality of life. CONCLUSIONS: LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to CDs.
Assuntos
Prótese Total , Mastigação , Satisfação do Paciente , Qualidade de Vida , Humanos , Mastigação/fisiologia , Reembasadores de Dentadura , Reembasamento de Dentadura , Boca Edêntula/reabilitação , Boca Edêntula/psicologiaRESUMO
Most edentulous patients prefer fixed restoration or detachable prostheses over conventional complete dentures. The case report aims to address and discuss the clinical and laboratory steps of implant-supported, bar-retained maxillary overdenture and mandibular implant-supported, metal-acrylic resin, screw-retained, fixed complete denture. Impression techniques and laboratory steps are discussed and demonstrated to minimize the postfabrication or insertion complication. It lets you achieve the passive fit of the prosthesis that maintains the osseointegration by reducing stress on implants and the surrounding bone.
Assuntos
Resinas Acrílicas , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Humanos , Retenção de Dentadura/instrumentação , Planejamento de Dentadura , Técnica de Moldagem Odontológica , Boca Edêntula/reabilitação , Boca Edêntula/cirurgia , Mandíbula/cirurgia , Feminino , Maxila/cirurgia , Arcada Edêntula/reabilitação , Masculino , Prótese Total Superior , Implantes DentáriosRESUMO
BACKGROUND: Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials. OBJECTIVES: This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation. METHODS: The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction. RESULTS: Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'. CONCLUSIONS: Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.
Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Mastigação , Satisfação do Paciente , Levantamento do Assoalho do Seio Maxilar , Humanos , Mastigação/fisiologia , Feminino , Masculino , Pessoa de Meia-Idade , Levantamento do Assoalho do Seio Maxilar/métodos , Idoso , Boca Edêntula/reabilitação , Boca Edêntula/cirurgia , Boca Edêntula/fisiopatologia , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the clinical procedures of complete denture set fabrication in three appointments. BACKGROUND: Simplified approaches have proven not to be inferior to conventional ones in terms of quality, patient satisfaction and masticatory ability. MATERIALS AND METHODS: The patient was a 77-year-old edentulous adult with mobility impairment seeking dental rehabilitation in a small number of appointments due to commuting difficulties. RESULTS: A set of complete dentures was delivered within three appointments. The second appointment was dedicated to set-up trial due to the patient's aesthetic demands. CONCLUSION: Under certain circumstances and after a thorough study of each case, dental clinicians may propose the fabrication of complete dentures in a three-appointment protocol incorporating a set-up trial session.
Assuntos
Planejamento de Dentadura , Prótese Total , Humanos , Idoso , Boca Edêntula/reabilitação , Limitação da Mobilidade , Masculino , Feminino , Agendamento de Consultas , Técnica de Moldagem OdontológicaRESUMO
With the life expectancy increasing, there is a growing need for prosthetic dental treatments to restore the oral health, function, and quality of life of edentulous patients. Presently, only a few articles are available describing the oral rehabilitation of patients with severely resorbed ridges with milled complete dentures. This clinical case report provides a straightforward protocol consisting of a combination of analog and digital techniques for the rehabilitation of edentulous patients with severely resorbed ridges with milled fixed and removable complete dentures. This technique permits the minimization of the number of appointments, improves patient comfort, allows for the digital archiving of important clinical data, and permits the manufacture of prostheses with improved mechanical properties. These favorable outcomes were achieved by using the patient's existing PMMA complete denture as a custom tray for a final impression with light-bodied Polyvinylsiloxane. Subsequently, the resulting models were digitized, and a digital complete denture was designed and manufactured in an expedited manner using CAD-CAM techniques. Therefore, this case report highlights the potential of CAD/CAM technology to predictably restabilize oral functions and improve patients' quality of life.
Assuntos
Boca Edêntula , Qualidade de Vida , Humanos , Prótese Total , Boca Edêntula/reabilitação , Desenho Assistido por ComputadorRESUMO
Aims: The aim of this study was to assess the impact of prosthodontic rehabilitation on glycemic and lipid control in functionally and completely edentulous patients with diabetes. Setting and Design: An in vivo study conducted with the intention of studying the potential link between edentulism and impaired masticatory efficiency with the nutritional status in diabetic patients. Materials and Methods: A total of 20 diabetic patients based on the inclusion criteria were selected. They were rehabilitated using a removable prosthesis, and observations were made across three parameters - glycosylated hemoglobin (HbA1C), serum cholesterol (S col), and serum protein (SP) at three stages - baseline, 3 months, and 6 months posttreatment. This was done to gauge the impact of the prosthetic rehabilitation on their health due to an increased masticatory efficiency potentially causing changes in dietary patterns. Statistical Analysis Used: â¢Inter group comparison (>2 groups) was done using one way ANOVA followed by pair wise comparison using post hoc test. â¢Intra group comparison was done using repeated measures ANOVA (for>2 observations) followed by post Hoc test. For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and ß error ati20%, thus giving a power to the study as 80%. Results: Hba1c at the baseline had a mean value of 8.04%, which reduced to 7.87% at the 3-month stage and 7.38% at the 6-month stage. S col at the baseline had a mean of 151.6 mg/dL; at the 3-month follow-up, it was 166.5 mg/dL, and at the 6-month follow-up, it was 173.95 mg/dL. SP had a mean baseline value of 6.38 mg/dL, which progressed to 6.67 mg/dL at the 3-month stage and 6.97 at the 6-month stage. Conclusion: Within the limitations of this study, it can be concluded that after 6 months of prosthetic rehabilitation in edentulous/functionally edentulous patients: There was a reduction in HbA1c (8.04%-7.38%); however, it was found to be statistically insignificant at that stage There was an increase in S col (151.6 mg/dL-173.95 mg/dL); it was found to be statistically significant There was an increase in SP (6.38 mg/dL-6.97 mg/dL); however, it was found to be statistically insignificant at that stage.
Assuntos
Diabetes Mellitus , Boca Edêntula , Humanos , Controle Glicêmico , Hemoglobinas Glicadas , Prótese Total , Boca Edêntula/reabilitação , LipídeosRESUMO
BACKGROUND: Elderly people frequently report tooth loss, affecting their nutritional status. There is a gap in the scientific evidence about the influence of prosthodontic rehabilitation on nutritional status. OBJECTIVE: To investigate the influence of prosthodontic rehabilitation combinates or not with dietary advice on nutritional status in elderly patients. METHODS: A systematic literature search was conducted in three electronic databases to identify randomized clinical trials that evaluated the effect of prosthetic rehabilitation on nutritional status in subjects aged 60 years or older, with a follow-up of at least 1 month after prosthesis rehabilitation. RESULTS: Of the 1517 articles identified in the initial search, 12 were selected for the final review. No significant difference between the types of prosthesis were found regarding the chewing by the elderly population. Although patients who received prosthetic treatment had significant improvement in chewing ability, a consistent pattern of improvement in nutritional status was not observed when they did not receive dietary advice. In addition, the association between the condition of the dentition, the masticatory performance and nutritional change of elderly patients has been found. Studies that evaluated simultaneous complete denture treatment and simple dietary advice showed an improvement of nutrient intake in elderly patients. CONCLUSIONS: Isolated prosthetic rehabilitation may not have the effect of exerting a change in nutritional status of edentulous elderly patients. In general, simultaneous dietary consulting and prosthetic treatment in combination may improve dietary habits, since masticatory capacity and efficiency are not the only factors that influence the nutritional status of a patient.
Assuntos
Boca Edêntula , Estado Nutricional , Humanos , Idoso , Boca Edêntula/reabilitação , Prótese Total , Dieta , AconselhamentoRESUMO
BACKGROUND: Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food. OBJECTIVE: To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses. METHODS: This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches. RESULTS: Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND. CONCLUSIONS: Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Assuntos
Implantes Dentários , Boca Edêntula , Humanos , Prótese Dentária Fixada por Implante , Boca Edêntula/reabilitação , Prótese Total , Mastigação/fisiologia , Músculos , Revestimento de DentaduraRESUMO
Aim: Mastication is an important consideration for patients seeking prosthodontic treatment. Individuals with mastication problems have increased risk of systemic diseases which can negatively affect a person's postural balance control, which in turn increases the risk of falls. This study aims to correlate masticatory efficiency and dynamic postural balance in complete denture patients at 3 and 6 months after denture insertion. Settings and Design: In vivo - observational study. Materials and Methods: Fifty edentulous healthy patients were rehabilitated with conventional complete dentures. The dynamic postural balance was evaluated using the timed up-and-go test. The masticatory efficiency was evaluated using a color-changing chewing-gum and a color scale. The values for both were recorded 3 and 6 months after denture insertion. Statistical Analysis Used: Spearman's correlation. Results: The correlation between the values of dynamic postural balance and the values of masticatory efficiency was negative (values are inversely proportional) at 3 months (-0.379) and at 6 months (-0.246). Conclusions: This study showed that there is a correlation between dynamic postural balance and masticatory efficiency. Prosthodontic rehabilitation of edentulous patients is important for improving postural balance by generating adequate postural reflex through mandibular stability for the prevention of falls in the elderly population and improving masticatory efficiency.