Four-year assessment of masticatory function in mandibular overdenture wearers: A randomised clinical trial comparing two to four implants to retain the prosthesis.

BACKGROUND: Limited data exist on the mid- to long-term masticatory capacity of mandibular overdenture (IOD) wearers, particularly regarding the use of posterior implants to retention. OBJECTIVES: To periodically evaluate mastication of IOD wearers, comparing the effectiveness of two to four implants to retain the prosthesis. METHODS: In a randomised controlled clinical trial, 20 complete edentulous patients (14 women), aged 51-84 years (mean age 69.1 ± 9.6), received new bimaxillary complete dentures (CD). After adaptation, baseline measurements of masticatory performance (X50) and swallowing threshold were conducted using the sieving method. Patients were then randomly assigned to groups: control (two intra-foraminal regular implants) and experimental (two intra-foraminal regular implants and two extra-short posterior implants) (n = 10 each). After 4 months, implants were splinted, and a new mandibular IOD was fabricated with bar/clip retention. Mastication was reassessed after 6, 12, and 48 months, and data analysed with repeated measures ANOVA and Sidak's post hoc (α = 0.05). RESULTS: Despite a loss of two patients per group, masticatory performance significantly improved after mandibular IOD installation (p = .031) in both groups (p = .670). A second improvement was observed after 6 months (p = .027), with no subsequent changes (p > .05). Swallowing threshold improvements were noted with IOD, and no discernible differences between groups were observed (p > .05). CONCLUSION: Masticatory function significantly improved after mandibular IOD installation, with the number of implants demonstrating minimal influence. CLINICAL TRIAL REGISTRATION: The present study was not registered in a public database, as mandated. It is important to note that the recommendation for registration was initiated in 2017 by the Committee of Medical Journal Editors, while patient inclusion in the research took place in 2016. Given that the data presented in this manuscript cover a follow-up period of up to 4 years post-surgical intervention, delayed registration was not feasible.

Long-term clinical performance of short 6-mm implants supporting single crowns in the posterior region: A 10-year cohort study.

INTRODUCTION: Long-term clinical success of non-splinted, posterior, and short implants still is unclear. This prospective cohort study reports the 10-year follow-up of 6-mm implants supporting single crowns in the posterior region, and patient-reported outcomes. METHODS: Baseline sample comprised 20 patients treated with 46 screw-retained crowns supported by 6-mm implants with moderately rough implant surface. Participants were recalled for a 10-year clinical follow-up to assess survival rates, biologic and mechanic conditions, quality of life (OHIP-14), and treatment satisfaction. Data were collected with clinical-radiographic exams and analyzed using descriptive and inferential statistics. RESULTS: Fourteen patients with 35 implant-crown units were examined after 127.6 ± 11.8 months. For the entire cohort period, 7/46 implants were lost (survival estimate: 77.7% at 133 months), and mechanic complications occurred in 14/46 units (survival estimate: 66.4% at 116 months). In the Cox models, "maximum occlusal force" had a significant effect for implant loss (p = 0.038) and for prosthetic screw loosening (p = 0.038); "arch" and "bruxism" were not significant. Peri-implant bone loss was 0.4 ± 0.6 mm at 10 years. For peri-implant bone level, "crown-to-implant ratio" (p < 0.001) and "time" (p = 0.001) were significant. Bone levels differed from baseline to 12, 48, and 120 months. Satisfaction VAS was 94.0 ± 7.9 mm and OHIP-14 was 2.3 ± 2.2. CONCLUSION: Single screw-retained crowns supported by 6-mm implants have an acceptable long-term clinical performance, with stable peri-implant bone levels after 10 years of function.

Adhesion to high-performance polymers applied in dentistry: A systematic review.

OBJECTIVE: The aim of this systemic review, conducted in accordance with the PRISMA statement, was to investigate the impact of surface pretreatments on the bonding strength of high performance polymers (HPPs). METHODS: Eight databases were searched through March 2019. Risk of bias was assessed and random effects meta-analyses were applied to analyze mean differences in shear bond strength (SBS) and tensile bond strength (TBS), considering surface pretreatments and bonding agents after 24h and thermocycling. RESULTS: A total of 235 relevant titles and abstracts were found, yielding 11 final selections. Low risk of bias was observed in most studies. For polyetheretherketone (PEEK) specimens, random-effect models showed that, compared to non-treated controls, pretreatments associated with Visio.link® (Bredent, Senden, GE) increased TBS by 26.72MPa (95% confidence interval (CI), 19.69-33.76; p<0.00001) and increased SBS by 4.86MPa (95% CI, 2.61-7.10; p<0.00001). Air abrasion improved SBS by 4.90MPa (95% CI, 3.90-5.90; p<0.00001) (50µm alumina) and 4.51MPa (95% CI, 1.85-7.18; p=0.0009) (silica-coated CoJet). In comparison to non-treated controls, Visio.link® and Signum PEEK Bond® (Heraeus Kulzer, Hanau, GE) increased SBS by 33.76MPa (95% CI, 18.72-48.81; p<0.00001) and 33.28MPa (95% CI, 17.48-49.07; p<0.00001), respectively. No differences were found between Visio.link® and Signum PEEK Bond® or Monobond Plus/Heliobond® (Ivoclar Vivadent, Schaan, LH) (p>0.05). Similar results were observed for polyetherketoneketone (PEKK) specimens. SIGNIFICANCE: This review shows improved HPP bonding following the application of various surface pretreatments, including air abrasion and bonding agents.

Narrow-diameter implants in the anterior region: A meta-analysis.

PURPOSE: Implants in the anterior region are challenging, and literature reporting outcomes of narrow-diameter implants (NDIs) in anterior sites is scarce. This systematic review summarized evidence of functional and esthetic performance of anterior single crowns supported by NDIs. MATERIALS AND METHODS: Ten databases were searched to find studies evaluating anterior single crowns supported by NDIs. Risk of bias was assessed, and random-effects meta-analyses were applied to analyze mean differences in survival, success, and marginal bone level (MBL). The review was registered in the PROSPERO database (CRD42018089886). RESULTS: Twenty-one studies meeting the screening criteria were included for qualitative analysis, and three for meta-analysis. A total of 892 NDIs, placed in 736 patients, were analyzed. Follow-up duration varied from 12 months to 14 years (mean: 40 months), and 16 failures (implant loss) were recorded. Fixed-effect meta-analysis (I2 = 0%) of survival rate revealed a risk difference of 0.02 (95% CI: -0.03 to 0.08), between NDIs and controls (regular-diameter implants), without differences between groups (P = .39). Success rates ranged from 84.2% to 100% (mean: 95.2%). Random-effects meta-analysis (I2 = 56%) of MBL indicated a mean difference of 0.02 mm (95% CI: -0.21 to 0.25), without differences between groups (P = .87). CONCLUSION: Single crowns supported by NDIs are a predictable treatment, since their survival rate and MBL are comparable to those supported by regular-diameter implants. Due to data shortage reporting esthetic outcomes, more studies are needed to evaluate the long-term performance of the single crowns supported by NDIs in the anterior region.

Expression of Cancer Stem Cell Biomarkers in Human Head and Neck Carcinomas: a Systematic Review.

Malignant neoplasms may be composed of several cell groups, including cancer stem cells (CSC). These cells have been related with the capacity of metastasis, relapse and resistance to multiple drugs during chemotherapy. This study aims to identify CSC biomarkers and their expression pattern in human head and neck carcinomas. This study was conducted following the PRISMA checklist. The search for articles was carried out in five databases (PubMed, Scopus, Web of Science, Lilacs and Scielo). The articles found were selected in two phases: 1) reading the titles and / or abstract and 2) reading the full text. At the end, the selected articles were evaluated by QUADAS-2. Most studies evaluated oral neoplastic tissues and, as a control, samples of normal local mucosa. All studies performed immunohistochemistry as a method of immunolocalization and some also applied immunofluorescence. The most commonly used biomarker was CD44. However, other such as Sox2, Oct4, Nestin, Nanog, BMI1, ALDH1, CD133 and CD166 were also found. Several biomarkers were (ALDH1, Sox2, Oct4, ABCB5, AGR2 and TAZ) correlated with clinical characteristics of the tumor, such as staging, tumor size and lymph node metastasis. These data reinforce the CSC theory and favor the use of these biomarkers as possible determinants of prognosis.

The risk of osteonecrosis on alveolar healing after tooth extraction and systemic administration of antiresorptive drugs in rodents: a systematic review.

PURPOSE: There is much concern about the increasing number of patients with medication-related osteonecrosis of the jaw (MRONJ), and many studies have been published in an attempt to understand the pathophysiology of this condition. This study aimed to systematically review the literature on MRONJ arising in rodents under antiresorptive drug therapy after tooth extraction. METHODS: A search of electronic databases, including LILACS, PROQUEST, PubMed, SCOPUS, and the Web of Science. RESULTS: The search resulted in 2319 titles after removing the duplicates, and one paper was identified using the reference list. Ninety-eight full-text papers were then screened for eligibility, resulting in 20 for inclusion in the final qualitative synthesis. The quality of the articles was assessed using the 'ARRIVE' tool. CONCLUSION: Despite the wide heterogeneity of the methodologies used by the authors, the current available evidence suggests that the combination of bisphosphonate and/or denosumab therapy and tooth extraction is associated with osteonecrosis of the jaw in rodents.

Risk factors for single crowns supported by short (6-mm) implants in the posterior region: A prospective clinical and radiographic study.

BACKGROUND: The use of short implants is still not a consensus for challenging clinical situations, such as unfavorable crown-to-implant (C/I) ratio. PURPOSE: This prospective study evaluated the rates of prosthetic complications and implant failure, the mean marginal bone loss of 6-mm dental implants with single crowns in posterior regions and the potential risk factors. MATERIALS AND METHODS: Forty-six dental implants, 6-mm long and 4.1-mm wide, were placed in the posterior region in 20 patients. Patients were clinically and radiographically examined after the restoration with single crowns and on a yearly basis. Potential risk factors (arch, bruxism, maximum bite force, anatomical and clinical C/I ratios, and occlusal table area) were analyzed according to the following outcomes: implant survival, bone loss, and prosthetic complications. RESULTS: The mean follow-up time was 45 ± 9 (16-57) months. There was no early loss of implants. After prosthetic loading, 4 implants were lost (2 in the mandible and 2 in the maxilla; 91.3% survival), and there were 13 prosthetic complications (28.3%), yielding a 65.2% success rate. The frailty term showed a 95% greater chance of loss in the mandible than the maxilla. Mean peri-implant bone loss was of 0.2 ± 0.4 mm, 0.1 ± 0.2 mm, 0.1 ± 0.3 mm, and 0.2 ± 0.4 mm in the first, second, third, and fourth years, respectively, with a mean cumulative loss of 0.3 ± 0.5 mm at 48 months. In the multilevel model, the effects of the clinical C/I ratio and time were significant for bone loss (P < .001). It was estimated that a mean bone loss of 0.1 mm is associated with both a one-unit increase in time (12 months) and a 0.1 increase in the clinical C/I ratio. The other potential risk factors showed no significant relationship with the outcomes. CONCLUSIONS: The 6-mm implants supporting single crowns performed well, but the mandible shows a higher risk of failure. The time and clinical C/I ratio are predictors for bone loss.

Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis.

CONTEXT: Symptoms associated with the primary tooth eruption have been extensively studied but it is still controversial. OBJECTIVE: To assess the occurrence of local and systemic signs and symptoms during primary tooth eruption. DATA SOURCES: Latin American and Caribbean Health Sciences, PubMed, ProQuest, Scopus, and Web of Science were searched. A partial gray literature search was taken by using Google Scholar and the reference lists of the included studies were scanned. STUDY SELECTION: Observational studies assessing the association of eruption of primary teeth with local and systemic signs and symptoms in children aged 0 to 36 months were included. DATA EXTRACTION: Two authors independently collected the information from the selected articles. Information was crosschecked and confirmed for its accuracy. RESULTS: A total of 1179 articles were identified, and after a 2-phase selection, 16 studies were included. Overall prevalence of signs and symptoms occurring during primary tooth eruption in children between 0 and 36 months was 70.5% (total sample = 3506). Gingival irritation (86.81%), irritability (68.19%), and drooling (55.72%) were the most frequent ones. LIMITATIONS: Different general symptoms were considered among studies. Some studies presented lack of confounding factors, no clear definition of the diagnostics methods, use of subjective measures and long intervals between examinations. CONCLUSIONS: There is evidence of the occurrence of signs and symptoms during primary tooth eruption. For body temperature analyses, eruption could lead to a rise in temperature, but it was not characterized as fever.

Diagnostic accuracy of serum biomarkers for head and neck cancer: A systematic review and meta-analysis.

Serum biomarkers could be helpful to characterize head and neck squamous cell carcinoma (HNSCC). Thus, the purpose of this systematic review and meta-analysis was to determine the diagnostic capability of serum biomarkers in the assessment of HNSCC patients. Studies were gathered by searching LILACS, PubMed, Science Direct, Scopus and Web of Science up to April 10th, 2015. Studies that focused on serum biomarkers in the diagnosis of HNSCC compared with controls were considered. Sixty-five studies were identified, and the sample size included 9098 subjects. Combined biomarkers demonstrated improved accuracy than those tested individually. Therefore, 12.8% of single and 34.3% of combined indicated that serum biomarkers discriminate patients with HNSCC from controls. The combined biomarkers with better diagnostic capability included Epidermal growth factor receptor (EGFR)+Cyclin D1 and squamous cell cancer-associated antigen (SCCA)+EGFR+Cyclin D1. Beta2-microglobin may also be a promising single biomarker for future studies. Serum biomarkers can be potentially useful in the diagnosis of HNSCC. However, further research is required to validate these biomarkers.

Correção do plano oclusal antagonista utilizando o rolete de cera / Correction of the antagonistic occlusal plane using the wax rim

Este artigo descreve a técnica de correção de um plano oclusal dentado, antagonista a uma prótese total, utilizando como base o plano de cera convencional. Esse procedimento é indispensável para favorecer a estabilidade das próteses durante os movimentos de desoclusão.

This article describes the alignment technique of a dentate occlusal plane, antagonistic to a complete denture, using wax rim as a reference. This procedure is essential in order to favor the stability of the prosthesis during excursive movements.

Prótese total imediata ­ do planejamento à instalação / Complete immediate denture ­ planning and performing

A confecção de uma Prótese Total Imediata é um procedimento complexo para os profissionais e estressante para o paciente. O presente artigo descreve a sequência clínica do planejamento à realização deste procedimento, com segurança e previsibilidade.

The fabrication of an Immediate Complete Denture is a complex procedure for the practitioners involved and a stressing situation for the patient. This article describes the clinical sequence for planning and performing this procedure with safety and predictability.

Onde se encontra o travamento posterior da maxila de uma prótese total superior? / Where is the postpalatal seal in a complete upper denture?

Na confecção de uma prótese total superior, a delimitação correta do travamento posterior é uma responsabilidade do clínico. Para evidenciá-lo, esse deve basear-se em referências anatômicas e fatores fisiológicos individuais de cada paciente.

During the fabrication of a complete denture the practitioner is responsible for a proper postpalatal seal. Thus it must be based on anatomic structures and physiologic aspects of each patient.

Reabilitação com implantes para mandíbula posterior atrófica: relato de caso clínico / Rehabilitation with implants to the posterior atrophic mandible: case report

Os implantes osseointegrados curtos têm sido utilizados nos últimos anos como uma alternativa confi ável para a reabilitação de rebordos atrésicos em altura. Neste artigo, um caso clínico ilustra a discussão da literatura recente que corrobora o uso de implantes curtos em detrimento a técnicas cirúrgicas reconstrutivas como os enxertos.

Controle do edema: terapia medicamentosa x uso do laser / Control of edema: medical treatment x use of laser

O controle do processo inflamatório é fundamental para o êxito do pós-operatório cirúrgico. Muitos pacientes relatam desconforto, não apenas com a dor, mas também com o edema que determinados procedimentos ocasionam. O objetivo deste trabalho é apresentar uma terapia alternativa às convencionais medicamentos as com a administra­ção de fárrnacos de ação antiinflamatória. Trata-se do uso do laser não ablativo ou soft­laser. Muitos estudos estão sendo realizados nesta área e a eficácia desta terapia, colocada em dúvida por muitos autores e ressaltada com bons resultados por outros. A correta utilização do recurso do laser pode estar determinando estas diferenças. As ações dos fárrnacos também são discutidas, seu uso adequado concomitante com o laser não ablativo, recomendado, e uma comparação entre estas duas terapias, realizada, para assim reunir conhecimento científico e proporcionar um pós-operatório tranqüilo aos pacientes