Phantom eye syndrome: a review of the literature.

The purpose of this literature review was to describe the main features of phantom eye syndrome in relation to their possible causes, symptoms, treatments, and influence of eye amputation on quality of life of anophthalmic patients. For this, a bibliographical research was performed in Pubmed database using the following terms: "eye amputation," "eye trauma," "phantom eye syndrome," "phantom pain," and "quality of life," associated or not. Thirteen studies were selected, besides some relevant references contained in the selected manuscripts and other studies hallowed in the literature. Thus, 56 articles were included in this review. The phantom eye syndrome is defined as any sensation reported by the patient with anophthalmia, originated anophthalmic cavity. In phantom eye syndrome, at least one of these three symptoms has to be present: phantom vision, phantom pain, and phantom sensations. This syndrome has a direct influence on the quality of life of the patients, and psychological support is recommended before and after the amputation of the eyeball as well as aid in the treatment of the syndrome. Therefore, it is suggested that, for more effective treatment of phantom eye syndrome, drug therapy should be associated with psychological approach.

Esthetics in implant-supported prostheses: a literature review.

Esthetics is important for success of implant-supported prostheses. This study aimed to review esthetics concepts for implant treatment. Research in the PubMed database included studies published from 1995 to 2010 with the keywords implant esthetics, implant-supported prostheses, and esthetics. Forty-five studies were evaluated regarding the presurgical planning, surgical phase, and temporary and final restoration phases. It was concluded that esthetics in implant-supported prostheses results from a multidisciplinary approach from planning until insertion of the final restoration.

Influence of different base thicknesses on maxillary complete denture processing: linear and angular graphic analysis on the movement of artificial teeth.

OBJECTIVE: The purpose of this study was to compare the dental movement that occurs during the processing of maxillary complete dentures with 3 different base thicknesses, using 2 investment methods, and microwave polymerization. METHODS: A sample of 42 denture models was randomly divided into 6 groups (n = 7), with base thicknesses of 1.25, 2.50, and 3.75 mm and gypsum or silicone flask investment. Points were demarcated on the distal surface of the second molars and on the back of the gypsum cast at the alveolar ridge level to allow linear and angular measurement using AutoCAD software. The data were subjected to analysis of variance with double factor, Tukey test and Fisher (post hoc). RESULTS: Angular analysis of the varying methods and their interactions generated a statistical difference (P = 0.023) when the magnitudes of molar inclination were compared. Tooth movement was greater for thin-based prostheses, 1.25 mm (-0.234), versus thick 3.75 mm (0.2395), with antagonistic behavior. Prosthesis investment with silicone (0.053) showed greater vertical change compared with the gypsum investment (0.032). There was a difference between the point of analysis, demonstrating that the changes were not symmetric. CONCLUSIONS: All groups evaluated showed change in the position of artificial teeth after processing. The complete denture with a thin base (1.25 mm) and silicone investment showed the worst results, whereas intermediate thickness (2.50 mm) was demonstrated to be ideal for the denture base.

Passivity in implant-supported prosthesis.

Because of the widespread use of implant-supported restorations and that the success of this treatment depends on the passivity of the different component systems of implant-prosthesis, a literature review was performed to highlight issues related to passivity in framework of implant-supported fixed prosthesis. A search of English-language peer-review literature was completed using MEDLINE database (PubMed) focusing on acceptable levels of passivity, misfit classification, problems related to misfit, methods to evaluate misfit, general factors that affect the passivity, and the biologic tolerance in the presence of misfit. The information obtained in the present review suggested that even if it is hard to obtain an implant-supported prosthesis with complete passivity, the professional should use the technological resources to offer better conditions for their patients. An acceptable clinical level of passivity that does not cause any problem to the biologic, aesthetic, and functional parameters of the patient should be sought.

Factors to achieve aesthetics in all-ceramic restorations.

The demand for aesthetic restorations has increased during the last years. Dental ceramics are a successful alternative for some cases because of aesthetics and biocompatibility. Therefore, the aim of this literature review was to present the factors necessary to fabricate all-ceramic restorations with aesthetics similar to natural dentition. A search of English-language peer-review literature was completed using MEDLINE database from 1975 to 2009 including the keywords "aesthetic," "metal-free crown," "all-ceramic," and "color." It was observed that several factors influence aesthetics of all-ceramic restorations. Color scale, light source during color evaluation, characteristic of core material, color of supporting tooth, presence of root post, and type of cement are clinical factors that may influence color of the restorations. Laboratorial factors as technique for ceramic condensation, thickness, temperature, and number of firing cycles also influence the result of these crowns. Although several clinical and laboratorial factors influence aesthetics of all-ceramic restorations, the aesthetic success and longevity of these restorations depend on the integration with surrounding periodontal tissue.

Evaluation of different retention systems on a distal extension removable partial denture associated with an osseointegrated implant.

The aim of this study was to evaluate the biomechanical behavior of a mandibular distal extension removable partial denture (DERPD) associated with an implant and different retention system, by bidimensional finite element method. Five hemimandible models with a canine and external hexagon implant at second molar region associated with DERPD were simulated: model A, hemimandible with a canine and a DERPD; model B, hemimandible with a canine and implant with a healing abutment associated to a DERPD; model C, hemimandible with a canine and implant with an ERA attachment associated to a DERPD; model D, hemimandible with a canine and implant with an O'ring attachment associated to a DERPD; and model E, hemimandible with a canine and implant-supported prosthesis associated to a DERPD. Cusp tips were loaded with 50 N of axial or oblique force (45 degrees). Finite element analysis was performed in ANSYS 9.0. model E showed the higher displacement and overload in the supporting tissues; the patterns of stress distribution around the dental apex of models B, C, and D were similar. The association between a DERPD and an osseointegrated implant using the ERA or O'ring systems shows lower stress values. Oblique forces showed higher stress values and displacement. Oblique forces increased the displacement and stress levels in all models; model C displayed the best stress distribution in the supporting structures; healing abutment, ERA, and O'ring systems were viable with RPD, but DERPD association with a single implant-supported prosthesis was nonviable.

Photoelastic analysis of stress distribution in oral rehabilitation.

The purpose of this study was to present a literature review about photoelasticity, a laboratory method for evaluation of implants prosthesis behavior. Fixed or removable prostheses function as levers on supporting teeth, allowing forces to cause tooth movement if not carefully planned. Hence, during treatment planning, the dentist must be aware of the biomechanics involved and prevent movement of supporting teeth, decreasing lever-type forces generated by these prosthesis. Photoelastic analysis has great applicability in restorative dentistry as it allows prediction and minimization of biomechanical critical points through modifications in treatment planning.

Effect of different repair techniques on the accuracy of repositioning the fractured denture base.

OBJECTIVE: This study investigated the efficacy of different techniques for the union of fragments of a denture before repair and on the accuracy of the reposition. MATERIALS AND METHODS: For this study, 20 maxillary dentures made with Lucitone 550 heat-cured resin were used. Points were determined with a scanner on the cusp of the teeth, as a measurement of the segments. After digitisation, each model was exported to the AUTOCAD R 14 program and two-dimensional measurements of the distances between the marked points were made. After the initial analysis, the dentures were fractured into two segments using an impact test machine. For the repair, maxillary dentures were divided into two groups; in the first, the repair was carried out using Kerr's sticky wax and in the second group, Super Bonder was used to join the fragments, with subsequent inclusion of DENTSPLY Repair Material resin. After the repair, the points of the maxillary dentures were measured again. The numerical values obtained were tabulated to compare the measurements before fracture and after the repair. For statistical analysis, analysis of variance was employed, using a single factor and double factor, followed by the Tukey test with a reliability of 95%. RESULTS: The results demonstrated a statistically significant difference between the materials used to join the dentures for repair, where the dentures were joined with sticky wax presented a larger variation in the distances between the points. CONCLUSION: The variation in distances between the points is influenced by the agent of repair.

Effect of flasking and polymerization techniques on tooth movement in complete denture processing.

PURPOSE: The purpose of this study was to compare the artificial tooth positional changes following the flasking and polymerization of complete dentures by a combination of two flasking methods and two polymerization techniques using computer graphic measurements. MATERIALS AND METHODS: Four groups of waxed complete dentures (n = 10) were invested and polymerized using the following techniques: (1) adding a second investment layer of gypsum and conventional water bath polymerization (Control), (2) adding a second investment layer of gypsum and polymerization with microwave energy (Gypmicro), (3) adding a second investment layer of silicone (Zetalabor) and conventional polymerization (Silwater), and (4) adding a second investment layer of silicone and polymerization with microwave energy (Silmicro). For each specimen, six segments of interdental distances (A to F) were measured to determine the artificial tooth positions in the waxed and polymerized stages using software program AutoCad R14. The mean values of the changes were statistically compared by univariate ANOVA with Tukey post-hoc test at 5% significance. RESULTS: There were no significant differences among the four groups, except for segment D of the Silmicro group (-0.004 +/- 0.032 cm) in relation to the Gypwater group (0.044 +/- 0.031 cm) (p < 0.05), which presented, respectively, expansion and shrinkage after polymerization. CONCLUSIONS: Within the limitations of this study, it was concluded that although the differences were not statistically significant, the use of a silicone investment layer when flasking complete dentures resulted in the least positional changes of the artificial teeth regardless of the polymerization technique.

Influence of investment, disinfection, and storage on the microhardness of ocular resins.

PURPOSE: The longevity of an ocular prosthesis is directly related to the resistance to erosion of its material. The purpose of this study was to evaluate the effects of chemical disinfection and the method of investment on the microhardness of ocular prosthesis acrylic resin. MATERIALS AND METHODS: Thirty-two test specimen investments were obtained in two silicones. A segment was cut in each test specimen, and each specimen was fixed in an acrylic disk. The specimens were then polished and submitted to the first microhardness test before immersion in distilled water and incubation for 2 months. During this 2-month period, the specimens were immersed in a water bath at 37 degrees C and were disinfected daily; half were disinfected with neutral soap and the other half were disinfected with 4% chlorhexidine gluconate. After the storage phase and disinfection, a second microhardness test was performed. The surface microhardness values for the acrylic resins were submitted to ANOVA, followed by the Tukey test. RESULTS: The disinfection and the period of storage did not statistically influence the surface microhardness of the acrylic resin, independent of the method of investment of the specimens (Zetalabor or Vipi Sil). The investment of specimens with Zetalabor silicone presented a greater surface hardness, independent of the type of disinfection and the period of storage. CONCLUSIONS: Based on these results, we suggest that the microhardness of the resin evaluated was not influenced by the method of disinfection or the time of storage used and was affected only by the investment material.

A modified method of immediate occlusal loading using a reinforced framework denture: a case report.

The technique presented in this article presents a protocol for treatment that reduces the time required for the fabrication and placement of an implant supported prosthesis. It also offers improved patient comfort at a lower cost when compared to conventional technology.

A comparison of profilometer and AutoCAD software techniques in evaluation of implant angulation in vitro.

PURPOSE: The aim of this study was to compare 2 different methods of assessment of implants at different inclinations (90 degrees and 65 degrees)--with a profilometer and AutoCAD software. MATERIALS AND METHODS: Impressions (n = 5) of a metal matrix containing 2 implants, 1 at 90 degrees to the surface and 1 at 65 degrees to the surface, were obtained with square impression copings joined together with dental floss splinting covered with autopolymerizing acrylic resin, an open custom tray, and vinyl polysiloxane impression material. Measurement of the angles (in degrees) of the implant analogs were assessed by the same blinded operator with a profilometer and through analysis of digitized images by AutoCAD software. For each implant analog, 3 readings were performed with each method. The results were subjected to a nonparametric Kruskal-Wallis test, with P < or = .05 considered significant. RESULTS: For implants perpendicular to the horizontal surface of the specimen (90 degrees), there were no significant differences between the mean measurements obtained with the profilometer (90.04 degrees) and AutoCAD (89.95 degrees; P = .9142). In the analyses of the angled implants at 65 degrees in relation to the horizontal surface of the specimen, significant differences were observed (P = .0472) between the mean readings with the profilometer (65.73 degrees) and AutoCAD (66.25 degrees). CONCLUSIONS: The degrees of accuracy of implant angulation recording vary among the techniques available and may vary depending on the angle of the implant. Further investigation is needed to determine the best test conditions and the best measuring technique for determination of the angle of the implant in vitro.

Stress distribution in implant-supported prostheses using different connection systems and cantilever lengths: digital photoelasticity.

Photoelastic analysis was used to evaluate the biomechanical behaviour of implant-supported, double-screwed crowns with different connection systems and cantilever lengths. Three models were made in PL-2 photoelastic resin and divided into six groups, on the basis of the implant connection system (external hexagon [EH] or Morse taper [MT]), type of abutment (Mini Pilar [Neodent, Curitiba, Paraná, Brazil] or "UCLA") and number of crowns in the cantilever (one or two). The implant-prosthesis unit was placed in a circular polariscope. Occlusal surfaces of the crowns were subjected to 100-N loads in the axial and oblique (45°) directions in a universal testing machine (EMIC). Generated stresses were recorded and analysed qualitatively in a graphics program (Adobe Photoshop). Under axial loading, all of the groups had similar numbers of fringes, which were increased when the crowns were subjected to oblique loading. The highest number of fringes was found during oblique loading in the EH + Mini Pilar group. In conclusion, although the type of implant connection system did not have a direct influence on the stress distribution for axial loading, the cantilever length did have a direct influence on stress distribution. Models with two crowns in the cantilever showed more stress, with a greater concentration of force on the cervical part of the implant.

Effect of smoking on the survival of dental implants.

BACKGROUND: Although the long-term success of implant treatment has been well- established, failures can still occur and the smoking habit has been reported as a risk factor for implant loss. A literature review on the effects of smoking on the survival of dental implants was undertaken. METHODS AND RESULTS: Medline database was used to carry out the review with the keywords "osseointegration", "smoking" and "bone healing". The cigarette has more than 4,000 bioactive chemical components with potential toxic effects to human tissues including bone. Nicotine is the main component of the cigarette and it is frequently associated with bone healing failures. Since smoking negatively affects the osseointegration of dental implants, the main target is to quit the consumption of cigarettes. CONCLUSION: Nevertheless, the smoking habit should not be an absolute contraindication for implant treatment, but, patients should be advised that they are at a greater risk of implant failure.

Dental implant fractures - aetiology, treatment and case report.

PURPOSE: This study aimed to investigate the etiology, clinical manifestations, and treatment options of dental implants fractures through a literature review and to relate a clinical report. METHODS: A literature review was performed using the Medline database and this paper describes a case demonstrating the management of implant fracture. Twenty two articles were selected in the present literature review. RESULTS: Nowadays the use of dental implants to rehabilitate completely and partially edentulous patients became the best treatment option; however, this treatment is suitable to failure. The fracture of implant body is a possible complication. The fracture of implant body is a late complication and is related to the failure in implant design or material, non-passive fitting of the prosthetic crown and overloading. Clinically, prosthesis instability and spontaneous bleeding are observed. Three options of treatment have been indicated: complete removal of implant fragment, maintenance of implant fragment, and surface preparation of the fragment with insertion of a new abutment. CONCLUSION: The literature indicates the complete removal of the fragment as the best treatment option.

Implant-retained finger prosthesis with modified retention system.

BACKGROUND: Amputations affect both the physical and the psychological aspects of an individual, causing significant impact on self-esteem. The main causes of finger amputations are work-related accidents with dangerous machinery, road traffic accidents, and animal bites, as well as systemic diseases such as diabetes. This report aims to describe a simple technique for fabrication of implant-retained finger prosthesis with a modified base of the retention system. CASE DESCRIPTION AND METHODS: The O-Ring retention system was used with a modified hexagon-shaped base and a metallic capsule adapted to the acrylic resin to attach the prosthesis to the implant. FINDINGS AND OUTCOMES: The prosthesis was made with silicone, and after osseointegration, it was installed without complications, leading to a patient satisfied with the end result and encouraged to return to social life. CLINICAL RELEVANCE: Restoring self-esteem in the patient and static and functional rehabilitation.

Diagnóstico diferencial de limitação de abertura bucal / Differential diagnosis of limited mouth opening

O objetivo do presente estudo é apresentar uma revisão de literatura exemplificando alguns dos possíveis fatores etiológicos de limitação de abertura bucal e ilustrar o caso de um paciente diagnosticado com hiperplasia do processo coronoide. Foi realizada uma busca nas bases de dados PUBMED/MEDLINE, Scielo, Bireme e Google Acadêmico utilizando-se inicialmente o termo "limited mouth opening" e "limitação de abertura bucal" no mês de novembro de 2016. Além disso, foi realizada busca manual em periódicos e nas bases de dados com novas palavras-chave como disfunção temporomandibular, tétano, traumas, doenças genéticas e imitação de abertura bucal e hiperplasia do processo coronóide. Foram incluídos estudos clínicos, revisões de literatura, revisões sistemáticas e relatos de caso publicados em idioma inglês ou português. Foram descritos os aspectos relevantes sobre desordens na articulação temporomandibular, tétano, traumas e fraturas, lesões orais, neoplasias e efeito colateral de radio e quimioterapia, desordens genéticas, hiperplasia do processo coronóide. O diagnóstico da limitação de abertura bucal é complexo devido ao grande número de fatores que podem provocar o problema. Diante disso, é de suma importância que seja realizada correta anamnese e investigação minuciosa do histórico do paciente, além da realização de exames complementares, permitindo assim, que a causa do problema seja detectada e que o tratamento correto seja aplicado, por meio de abordagem multidisciplinar, melhorando a qualidade de vida e devolvendo saúde ao paciente(AU)

The objective of this study is to present a review of literature exemplifying some of the possible etiological factors of oral opening limitation and to illustrate the case of a patient diagnosed with coronoid hyperplasia. A searched was made on PUBMED / MEDLINE, Scielo, Bireme and Google Scholar databases initially using the term "limited mouth opening" and "limitação de abertura bucal" in the month of November 2016. In addition, a manual search was carried out in journals and with new keywords like temporomanbidular disorders, tetanus, traumas, genetic disorders and limited open mouth and coronoid process hiperplasia. Clinical studies, literature reviews, systematic reviews and case reports published in English or Portuguese were included in the review. Relevant aspects of temporomandibular joint disorders, tetanus, trauma and fractures, oral lesions, neoplasys and side effects of radiotherapy and chemotherapy, genetic disorders, and coronoid process hyperplasia were described. The diagnosis of oral opening limitation is complex because of the many causes of the problem. Therefore, it is very important that a correct anamnesis and detailed investigation of the patient's history be performed, in addition to performing complementary tests, thus allowing the cause of the problem to be detected and treated correctly, through a multidisciplinary approach, improving the quality of life and healing the patient(AU)

Precisão dimensional de modelos obtidos de moldes de alginato pelos métodos invertido e não invertido / Dimensional accuracy of models obtained from pouring molds by inverted and non-inverted methods

Este é um estudo cuja finalidade foi demonstrar as possíveis deformações que podem ocorrer nos modelos obtidos de moldes de alginato, dependentes da forma de vazamento. Foram obtidos 20 moldes de alginato da marca Hydrogum 5 (Zhermack, Badia Polesine, Italy), através de um modelo de resina acrílica previamente preparado, divididos em dois grupos de 10: com vazamento invertido e não invertido. Os modelos foram analisados por fotografias, mensurados por um programa de computação (Corel Draw X3 Graphics Suíte (Corel Corporation ­ USA) e comparados com o modelo padrão. Os resultados mostraram que os vazamentos invertidos e não invertidos apresentaram valores clínicos diferentes do modelo padrão, mas que na comparação entre as técnicas, dos quatro segmentos analisados, apenas um apresentou diferença estatística significante(AU)

This is a study whose purpose was to demonstrate the possible deformations that may occur in the models obtained from alginate molds, depending on the form of flow. 20 alginate molds of Hydrogum 5 (Zhermack, Badia Polesine, Italy) were obtained through a previously prepared acrylic resin model, divided into two groups of 10: with inverted and non inverted casting. The models were analyzed by photographs, measured by a computer program (Corel Draw X3 Graphics Suite (Corel Corporation - USA) and compared with the standard model.The results showed that inverted and non inverted flow presented clinical values different from the standard model, But that in the comparison between the techniques, of the four analyzed segments, only one presented significant statistical difference(AU)

Evaluation of the color stability of two techniques for reproducing artificial irides after microwave polymerization.

UNLABELLED: The use of ocular prostheses for ophthalmic patients aims to rebuild facial aesthetics and provide an artificial substitute to the visual organ. Natural intemperate conditions promote discoloration of artificial irides and many studies have attempted to produce irides with greater chromatic paint durability using different paint materials. OBJECTIVES: The present study evaluated the color stability of artificial irides obtained with two techniques (oil painting and digital image) and submitted to microwave polymerization. MATERIAL AND METHODS: Forty samples were fabricated simulating ocular prostheses. each sample was constituted by one disc of acrylic resin N1 and one disc of colorless acrylic resin with the iris interposed between the discs. The irides in brown and blue color were obtained by oil painting or digital image. The color stability was determined by a reflection spectrophotometer and measurements were taken before and after microwave polymerization. Statistical analysis of the techniques for reproducing artificial irides was performed by applying the normal data distribution test followed by 2-way ANOVA and Tukey HSD test (α=.05). RESULTS: Chromatic alterations occurred in all specimens and statistically significant differences were observed between the oil-painted samples and those obtained by digital imaging. There was no statistical difference between the brown and blue colors. Independently of technique, all samples suffered color alterations after microwave polymerization. CONCLUSION: The digital imaging technique for reproducing irides presented better color stability after microwave polymerization.