A clinical application study of digital manufacturing simple intraoral Gothic arch-tracing device in determining the centric relation of complete dentures / 北京大学学报(医学版)

OBJECTIVE@#To verify the consistency between the digital manufacturing simple intraoral Gothic arch-tracing device and the traditional intraoral Gothic arch-tracing device in determining the centric relation of complete dentures restoration.@*METHODS@#Ten outpatients with edentulous jaws were selec-ted, and the centric relation of the patients was determined by digital manufacturing of simple intraoral Gothic arch-tracing device (T1) and traditional intraoral Gothic arch-tracing device (T2); the difference of clinical operation time between the two methods was recorded; the upper and lower edentulous jaw plaster models were scanned with two kinds of centric relation, the Standard Triangle Language (STL) files imported into Geomagic studio software to apply the best fitting of multiple points of the both upper jaw models, the fitted STL files imported into the 3 shape viewer software, and the maximum position deviations of the vertical, labial (buccal) and lingual directions of the mandibular midline area and molar areas in T1 and T2 groups measured. During the clinical complete dentures try-in, we observed whether there was midline deviation in the mouth of T1 group and T2 group, and whether the occlusion of posterior teeth was stable or not.@*RESULTS@#The mean time spent on determining the centric relation of T1 and T2 groups was (41.90±2.64) min, (57.50±2.37) min respectively. Paired t test was conducted in the two groups, P < 0.01 with significant statistical difference; The mean maximum position deviation between T1 group and T2 group of the midline mandibular region in labial lingual direction was (0.32±0.14) mm, that was (0.40±0.23) mm in vertical direction; the mean maximum position deviation of molar area in buccal lingual direction was (0.35±0.23) mm and that was (0.33±0.20) mm in vertical direction. In the vertical and horizontal directions, the maximum position deviation of mandibles between group T1 and group T2 was controlled within 0.5 mm. In the process of clinical complete dentures try-in, there was no deviation from the center line of dentures. There was not warping, swinging and other poor stability phenomena in T1 and T2 groups.@*CONCLUSION@#The digital manufacturing of simple intraoral Gothic arch-tracing device can be used to determine the centric relation of complete dentures, which can not only save time of clinical operation, but also ensure the accuracy of the centric relation.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Preparation of ICD and overdenture in patients with Cushing's Syndrome: five-year follow-up / Preparo de PTI e overdenture em pacientes com Síndrome de Cushing: cinco anos de acompanhamento

The aim of this study is to report a clinical case of a patient with Cushing's syndrome, low self-esteem and need for oral rehabilitation. A 50-year-old female patient with hypercortisolism sought care at School of Dentistry of the Federal University of Minas Gerais. During anamnesis, the patient reported painful symptoms and mobility of the upper and lower teeth. On clinical examination, absence of many teeth were observed, periodontal disease and caries lesions. After discussion of the case, the planning involved the extraction of all teeth, and the preparation of Maxillary Immediate Complete Dentures (ICD's) and Immediate Mandibular Implant-retained Overdenture (IMIO). The treatment proposed allowed the restored aesthetics, phonetics and chewing(AU)

O objetivo desse estudo é relatar um caso clínico de uma paciente com síndrome de Cushing, baixa autoestima e necessidade de reabilitação oral. Paciente do sexo feminino, 50 anos de idade e com hipercortisolismo, procurou atendimento na Faculdade de Odontologia da Universidade Federal de Minas Gerais. Durante a anamnese, a paciente relatou sintomas dolorosos e mobilidade dos dentes superiores e inferiores. No exame clínico, foi observada a ausência de muitos dentes, doença periodontal e lesões cariosas. Após a discussão do caso, o planejamento envolveu a extração de todos os dentes, e o preparo de Prótese Total Imediata maxilar (PTI), e Overdenture Implantorretida Imediata mandibular. O tratamento proposto permitiu que restaurasse a estética, fonética e mastigação(AU)

Tecnologia digital em próteses totais: propriedades dos materiais CAD-CAM e desenvolvimento de uma patente de inovação para simplificação do fluxo de trabalho / Digital technology in complete dentures: properties of CAD-CAM materials and development of an innovation patent to simplify the workflow

Recursos digitais, como a manufatura subtrativa (fresagem CAD-CAM) e a manufatura aditiva (impressão 3D) podem promover significativos avanços, reduzindo o tempo e o custo de produção de próteses totais (PTs). Assim, este estudo objetiva investigar as características superficiais (rugosidade e ângulo de contato), propriedades mecânicas (resistência mini-flexural) e a adesão de biofilme sobre polímeros de PMMA pré-polimerizado para fresagem CAD-CAM e sobre resinas para impressão 3D utilizados na fabricação de bases de PTs, bem como propor um fluxo de trabalho inovador para abreviar e simplificar as etapas de confecção de PTs. Para a análise in vitro, foram fabricados um total de 60 discos e 40 barras distribuídas igualmente em quatro grupos: fresagem CAD-CAM (GF), impressão 3D (GI) e PMMA convencional termopolimerizado por ciclo longo (GCL) ou por energia de micro-ondas (GCM). A rugosidade foi determinada pelo valor de Ra; o ângulo de contato foi medido pelo método da gota séssil; o teste de resistência à mini-flexão foi obtido por teste de flexão de três pontos, enquanto o comportamento frente à formação de biofilme foi analisado através da adesão de biofilme de C. albicans. Os dados foram analisados por meio de estatística descritiva e analítica (α = 0,05). Os resultados mostraram que o GI apresentou a maior rugosidade superficial (Ra: 0,317 ± 0,151µm) e os menores valores de resistência à miniflexão (57,23 ± 9,07MPa) e o GF apresentou a menor adesão de biofilme de C. albicans (log UFC/mL: 3,74 ± 0,57) e maior média de resistência à mini-flexão (114,96 ± 16,23 MPa). Não houve diferença estatística entre o GF e os grupos convencionais para rugosidade, ângulo de contato e resistência à mini-flexão. A patente de inovação desenvolvida estabeleceu um novo fluxo de trabalho para confecção de próteses totais através de um protocolo de três consultas em que foram feitas as moldagens anatômicas na 1ª sessão, juntamente com o registro do suporte labial, plano oclusal e linhas de referência para subsidiar a montagem dos dentes superiores. Uma prótese-teste foi confeccionada por meio de procedimentos convencionais ou CAD-CAM e avaliada na 2ª consulta, permitindo observar o resultado estético, executar a moldagem funcional e realizar o registro da relação maxilo-mandibular, fornecendo referências precisas para a confecção da prótese inferior. Com base nos resultados da fase in vitro deste estudo, os corpos-de-prova obtidos a partir de disco para fresagem CAD-CAM apresentaram resistência flexural e propriedades superficiais semelhantes às resinas convencionais e mostraram um comportamento inibidor da adesão de C. albicans, enquanto os espécimes produzidos por impressão 3D exibiram a menor resistência à flexão e a maior rugosidade da superfície. O dispositivo inovador apresentado para a execução das etapas clínicas relacionadas à fabricação de PTs mostrou-se efetivo para abreviar e simplificar as técnicas disponíveis, apresentando confiabilidade e previsibilidade para produção de PTs em número de sessões reduzido (AU).

Digital features like subtractive and additive manufacturing can promote breakthroughs by reducing the time and cost of making complete dentures (CDs). Thus, this study aims to investigate surface characteristics (roughness and contact angle), mechanical properties (mini-flexural strength), and biofilm adhesion on computer-aided design/computer-aided manufacturing (CAD-CAM) PMMA polymer, and threedimensional (3D) printed resin for denture´s base fabrication as well as to propose an innovative workflow. For in vitro analysis, a total of 60 discs and 40 rectangular specimens were fabricated from one CAD-CAM pre-polymerized PMMA disc (GF), one 3D-printed (GI), and two conventional heat-polymerized (GCL and GCM) materials for denture base fabrication. Roughness was determined by the Ra value; the contact angle was measured by the sessile drop method; the mini-flexural strength test was a three-point bending test while the biofilm formation inhibition behavior was analyzed through C. albicans adhesion. The data were analyzed using descriptive and analytical statistics (α = 0.05). Results showed that GI specimens presented the highest surface roughness (Ra: 0.317 ± 0.151 µm) and lowest mini-flexural strength values (57.23 ± 9.07 MPa) and the GF showed the lowest C. albicans adhesion (log CFU/mL: 3.74 ± 0.57) and highest mini-flexural strength mean (114.96 ± 16.23 MPa). There was no statistical difference between GF and conventional groups for roughness, contact angle, and mini-flexural strength. In turn, the presented novel workflow for complete dentures fabrication reached a three appointments protocol in which preliminary impressions were made in the 1st session, all together to maxillary registration of lip support, occlusal plane, and reference lines for teeth arrangement. A trial denture was manufactured and evaluated by the 2nd appointment through conventional or CAD-CAM procedures, allowing esthetics evaluation, final impression, and maxillomandibular relationship record and providing precise references for final dentures fabrication. Based on the findings of this in vitro study, GF presented surface and mechanical properties similar to conventional resins and show improved behavior preventing C. albicans adhesion, while GI specimens exhibited the lowest flexural strength, and highest surface roughness. The proposed device for CD´s fabrication clinical procedures reached feasibility and by simplifying available techniques, this protocol could achieve reliability and predictability to produce complete dentures with reduced working time (AU).

Evaluation of bite force and masticatory performance: complete denture vs mandibular overdenture users

Abstract: This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture (CCD) and implant mandibular overdenture (IMO) users and the correlation between these variables. The BF test was performed bilaterally with an occlusal force device. During the MP test, patients were asked to chew Optocal particles for 40 cycles. The Shapiro Wilk test was employed to verify the normality of the data, the student t test to identify differences between groups, and Pearson's correlation to investigate interrelationships between variables. A multiple linear regression was subsequently performed via the stepwise method. P values ≤0.05 were considered statistically significant. Unlike IMO users, CCD users presented a significant difference (25.6%) in BF between the dominant and non-dominant chewing side (p=0.04). IMO users presented significantly higher BF (p=0.01) without presenting a dominant side (p=0.38), and also performed significantly better for the following MP parameters: MPX50 values decreased by 27.25% in IMO users (p=0.01), MPB decreased by 48.38% (p=0.01), and ME 5.6 decreased by 53.25% (p=0.02), while ME2.8 increased by 151.57% (p=0.01). The BF and MPX50 in the IMO wearers group were negatively correlated (-0.57; p=0.05); this correlation coefficient was the only parameter included in the multivariate regression model. IMO users have higher BF and better masticatory performance than CCD users, especially in terms of chewed particles size reduction. MP is correlated with a higher BF in IMO users through better particle trituration.

Resumo Este estudo observacional transversal com 24 participantes teve como objetivo avaliar as diferenças na força de mordida (FM) e na PM (performance mastigatória) entre usuários de prótese total convencional (PTC) e de overdenture mandibular (OM) e a correlação entre essas variáveis. O teste de FM foi realizado bilateralmente com um dispositivo de força oclusal. Durante o teste de PM, os pacientes foram solicitados a mastigar uma porção padronizada de Optocal por 40 ciclos mastigatórios. O teste de Shapiro Wilk foi empregado para verificar a normalidade dos dados, o teste T de Student para identificar diferenças entre os grupos e os coeficientes de correlação de Pearson para investigar inter-relações entre variáveis. Uma regressão linear múltipla foi realizada pelo método stepwise. Valores de p≤0,05 foram considerados estatisticamente significantes. Diferentemente dos usuários de OM, os usuários de PTC apresentaram uma diferença significativa (34%) na FM entre o lado dominante e o não dominante (p=0,04). Os usuários de OM apresentaram FM significativamente maior (p=0,01) sem apresentar um lado dominante (p=0,38) e obtiveram PM significativamente melhor nos seguintes parâmetros: os valores de PMX50 diminuíram 27,25% (p=0,01), PMB diminuiu em 48,38% (p=0,01), e EM 5.6 diminuiu 53,25% (p=0,02), enquanto EM2.8 aumentou 151,57% (p=0,01). A FM e PMX50 no grupo de usuários da IMO foram negativamente correlacionados (-0,57;p=0,05); esse coeficiente de correlação foi o único parâmetro incluído no modelo de regressão multivariada. Os usuários da OM possuem maior FM e melhor performance mastigatória do que os usuários de PTC, observados principalmente na redução do tamanho das partículas mastigadas. A PM está correlacionada com um maior FM nos usuários da OM através de uma melhor trituração de partículas.

The incisive papilla as a guide to maxillary anterior teeth position for complete dentures

Context: The incisive papilla as a guide for complete dentures. Aims: To evaluate incisive papilla as a guide to maxillary anterior teeth position for complete dentures. Settings and Design: To measure the linear distances from the incisive papilla to the maxillary central incisors in Odia population and compare it to other ethnic groups. Subjects and Methods: The subjects were selected following inclusion & exclusion criteria. The impressions of maxillary & mandibular arches were taken and poured with die stone to produce the cast. The incisive papilla & incisors were marked on casts with a pencil. The photographs of casts were traced on an acetate tracing paper. The anterior-most points of maxillary incisors, anterior, middle & posterior-most points of incisive papillae were marked on the tracing as A, I1,M, I2 respectively. The A to M and A to I2 distances were measured, analysed and compared with Caucasians, Southern Chinese, and Dravidians. Statistical Analysis: Independent sample “t” test and Analysis of Variance followed by the post-hoc Bonferroni test were used. Results: A sample of 100 subjects in the age group of 20 to 40 years with was selected. The A to M measurements of Odia population differed significantly from Caucasians but were similar to Southern Chinese population. The A to I2 measurements of Odia population differed significantly from Caucasians & Dravidians but were similar to Southern Chinese. Conclusion: The linear measurements from incisive papilla to maxillary incisors of the Odia population are similar to that of Southern Chinese but differ significantly from Caucasians and Dravidians.

Evaluation of relationship between nutritional status and oral health related quality of life in complete denture wearers

The prevalence of malnutrition increases with old age, especially in developing countries like India, and it is the most common cause of morbidity and mortality, because of many factors out of which dentate status is one. Aim and Objective: The aim of this study is to evaluate and determine the effect of nutritional status and dietary intake on the oral health-related quality of life (OHRQOL) of elderly edentulous complete denture-wearing patients and to know whether elderly complete denture wearers have a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counseling during prosthodontic rehabilitation of elderly edentulous patients. Materials and Methods: A cross-sectional study was conducted among 200 elderly denture-wearing patients above 60 years of age from Nagpur, Maharashtra. Mini-Nutritional Assessment (MNA) questionnaire was used to assess nutritional status, and Geriatric Oral Health Assessment Index (GOHAI) questionnaire was used to determine the OHRQOL of these patients. Descriptive statistics were used to analyze data using SPSS version 21 (SPSS Inc., Chicago, IL, USA). Results: Among the assessed participants, nearly 95% of them had total scores of GOHAI between 12 and 57 which require “needed dental care.” As per MNA, 10.5% had adequate nutrition, 70% were at risk of malnutrition, and remaining 19.5% of participants were malnourished. There was a significant correlation between GOHAI and MNA scores. Conclusion: Low nutritional status was associated with the poor OHRQOL among the elderly. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL. The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly. Dietary analysis and counseling should be strictly incorporated into geriatric treatment planning during prosthetic rehabilitation.

Utility of facebow in the fabrication of complete dentures, occlusal splints and full arch fixed dental prostheses: A systematic review

The objective of this study is to assess the utility of facebow transfer in the fabrication of occlusal splints, complete dentures and full arch fixed dental prosthesis. Materials and Methods: A systematic review protocol was registered at PROSPERO registry, University of York, UK (CRD42016041919). Following databases were explored: PubMed, CINAHL, Cochrane, and Web of knowledge. The PICO model included participants who received occlusal splint or complete denture or full arch fixed dental prosthesis at the centric relation position. The intervention was the use of facebow transfer. Comparators were prosthesis made without using a facebow. Outcomes were the patient satisfaction of the prosthesis and the need for laboratory adjustments. Only randomized clinical trials were included in the present review. A customized data extraction pro forma was used to extract the data and assess its quality. Results: A total of 505 articles were retrieved. On excluding duplicates, protocols, case reports, case series, narrative reviews, etc., only eight studies were selected for review. Six clinical trials on 249 complete dentures and two clinical trials on 65 occlusal splints were reviewed. No study on full arch crown and bridge work satisfied the inclusion criteria. Conclusions: The use of facebow did not yield a superior fit or comfort of the complete dentures or occlusal splints. Therefore, there is no evidence of the utility facebow transfer for these prostheses. However, no inference could be drawn for its utility in full arch fixed dental prosthesis as there were no studies to draw an inference.

Single Maxillary Complete Denture Opposing Mandibular Natural Dentition

The fracture of complete dentures constitutes a challenge and remains an unresolved problem. A midline fracture of single maxillary complete denture base especially in patients who have retained their natural mandibular teeth is an inevitable problem. Several factors have been attributed for the midline fracture including flexural fatigue resulting from cyclic deformation and those which exacerbate the deformation of the base or alter its stress. The present case report deals with oral rehabilitation of completely edentulous maxillary arch by incorporating metal denture base in place of the conventional Poly Methyl Methacrylate material to improve the longevity of the prosthetic replacement, at the same time prevent resorption of the underlying residual maxillary ridge.

Síndrome da combinação: diagnóstico, prevenção e considerações sobre o tratamento / Combination Syndrome: diagnosis, prevention and treatment considerations

A síndrome da combinação, descrita por Kelly em 1972, apresenta-se a partir de um conjunto de características marcantes que ocorrem quando uma maxila desdentada se opõe a dentes anteriores inferiores naturais. Essa condição clínica é mais comumente encontrada em pacientes que fazem uso de prótese total superior que oclui com dentes naturais anteriores inferiores e prótese parcial removível bilateral inferior. Também conhecida por Síndrome de Kelly, é caracterizada pela perda óssea da região anterior do rebordo superior, extrusão dos dentes naturais anteriores, aumento das tuberosidades maxilares, perda óssea da região posterior do arco inferior sob a base da PPR e hiperplasia papilar da mucosa do palato duro. O correto diagnóstico e tratamento da síndrome são imprescindíveis na obtenção de resultado que, no mínimo, impeça o avanço do quadro. O presente trabalho consiste no relato de caso clínico de uma paciente diagnosticada com Síndrome da Combinação, no qual, além de importantes considerações acerca do diagnóstico, prevenção e tratamento reabilitador dos pacientes portadores dessa síndrome, chama-se atenção para os cuidados cirúrgicos e protéticos específicos que devem estar envolvidos na reabilitação dos pacientes portadores dessa condição.

The combination syndrome, as described by Kelly in 1972, is presented as a set of characteristics that occur when an toothless maxilla is opposed to natural mandibular anterior teeth. This clinical condition is more commonly found in patients who use dentures that occludes with natural lower anterior teeth and bilateral removable partial dentures. Also known as kelly syndrome is characterized by loss of bone anterior region of the upper lip, extrusion of lower natural teeth remaining, increased jaws tuberosities, bone loss of support from the base of removable partial dentures and papillary hyperplasia of the mucosa of the palate hard. Proper diagnosis and treatment of syndrome are essential in achieving a result which at least impedes the progress of the condition. This work is a case report of a patient diagnosed with the combination syndrome, in which, in addition to important considerations about the diagnosis, prevention and rehabilitation treatment of patients with this syndrome, called attention to the specific surgical and prosthetic care that should be involved in the rehabilitation of patients with this condition.

Uso combinado de rhBMP-2, osso bovino particulado, tela de titânio, L-PRF e incisão a distância para reconstrução óssea maxilar extensa / Combined use of rhBMP-2, particulate bovine bone, titanium mesh, L-PRF and remote flap incision for extensive maxillary bone reconstruction ­ case report

O presente trabalho relatou um tratamento com enxerto ósseo, mas sem osso autógeno, de uma maxila atrófica com necessidade de aumento vertical. Foi utilizada uma combinação de rhBMP-2 (Infuse Bone Graft, Medtronic, Minneapolis, EUA), osso bovino particulado (Lumina Bone ­ Large Grain, Criteria, São Carlos, Brasil), tela de titânio (Ti Mesh-Lock, Intra-Lock, São Paulo, Brasil), fibrina rica em plaquetas leucócitos (L-PRF ­ Intra-Lock, São Paulo, Brasil) e incisão de acesso a distância. Após seis meses, as placas de titânio foram removidas e seis implantes foram instalados para suporte de uma prótese total fixa, confeccionada seis meses após a colocação dos implantes. O controle de um ano após instalação da prótese revelou estabilidade do enxerto e dos implantes, sem condições de anormalidade.

This paper describes a treatment with bone graft, but without autogenous bone, in an atrophic maxilla in need of vertical augmentation. A combination of rhBMP-2 (Infuse Bone Graft, Medtronic, Minneapolis, USA), particulate bovine bone (Lumina Bone ­ Large Grain, Criteria, São Carlos, Brazil), titanium mesh (Ti Mesh-Lock, Intra-Lock, São Paulo, Brazil), leukocyte and platelet-rich fibrin (L-PRF ­ Intra-Lock, São Paulo, Brazil) and access with a remote flap incision were used. A discussion on material selection, its advantages, limitations, costs, and treatment time is also presented.

Distribution of traumatic injuries after the installation of complete dentures in adult patients

Aim Describe the location of traumatic lesions of the oral mucosa that develop after the installation of complete dentures, as well as to quantify the number of post-operative controls that are required. A descriptive study was conducted by examining 84 patients who attended the dental center of Universidad de Los Andes, San Bernardo, during the period from July 2012 to July 2013. A sample of 120 edentulous patients was obtained. After the fabrication and installation of the complete dentures, at least 3 post-operative controls were performed and the location of oral lesions was recorded. Documentation of the association between the patient's clinical variables and the appearance of oral lesions during the first 3 controls was performed using a logistic regression. Results For maxillary dentures, 5 post-operative visits were made and 6 controls for mandible dentures. In the upper jaw the anatomical areas of higher incidence of traumatic injuries were: canine fossa (23.9%), average bridle (23.1%), and distobuccal sulcus (20.1%). In the lower jaw, the highest number of lesions were recorded on the anterior lingual flank (16.5%), anterior and posterior lingual flank (13.4%), and distobuccal sulcus (12.8%). A significant association was observed between subjects who reported consumption of cholesterol-lowering medications and the development of traumatic lesions of the oral mucosa (OR: 0.25 and 95% CI: 0.055-0.939). The installation of complete dentures does not determine that the treatment has ended. Post-operative controls are needed to assess areas of erythema and ulceration.

Objetivo Describir la ubicación y frecuencia de las lesiones traumáticas de la mucosa oral que se generan después de la instalación de las prótesis dentales completas, y cuantificar el número de controles postoperatorios necesarios. Se realizó un estudio descriptivo, examinando a 84 pacientes que asistieron al centro dental de la Universidad de Los Andes, durante el período comprendido entre de julio de 2012 y julio del de 2013. Se obtuvo una muestra de 120 pacientes edéntulos. Después de la fabricación e instalación de las dentaduras completas se realizaron por lo menos 3 controles postoperatorios y la localización de las lesiones orales fue registrada. La documentación de la asociación entre las variables clínicas de los pacientes y la aparición de lesiones orales durante los 3 primeros controles fue realizado por medio de una regresión logística. Resultados Para prótesis maxilar 5 visitas de controles postoperatorios fueron realizados y 6 para mandibulares. En el maxilar superior las zonas de mayor incidencia de lesiones traumáticas fueron: fosa canina (23,9%), flanco medio (23,1%) y distovestibular del surco (20,1%). En la mandíbula se registraron mayor frecuencia de las lesiones en el flanco lingual anterior (16,5%), anterior y posterior (13,4%) y distovestibular del surco (12,8%). Una asociación significativa se observó entre los sujetos que reportaron consumo de medicamentos reductores del colesterol y el desarrollo de las lesiones traumáticas de la mucosa oral (o: 0,25 e IC: 0,055-0,939). La instalación de las prótesis dentales completas no determina que el tratamiento haya terminado. Los controles postoperatorios son necesarios para evaluar las áreas de eritema y ulceración.

Prótese híbrida mandibular imediata confeccionada pela técnica do assentamento passivo: cinco anos de acompanhamento clínico e radiográfico / The immediate mandibular hybrid prosthesis fabricated with the passive fit technique: five years of clinical and radiographic follow-up

O objetivo deste artigo foi descrever a técnica do assentamento passivo para confecção da estrutura metálica de próteses híbridas, por meio do relato de um caso clínico com acompanhamento em longo prazo. Paciente do sexo masculino, 44 anos, compareceu à clínica de Implantodontia do Instituto Latino Americano de Pesquisa e Ensino Odontológico (Ilapeo) relatando insatisfação devido à instabilidade da prótese total inferior. Foi planejada e executada a reabilitação do paciente com a instalação de cinco implantes entre os forâmenes mentuais, e uma prótese híbrida no sistema de carga imediata. O procedimento cirúrgico e a instalação da prótese definitiva foram realizados no mesmo dia. A agilidade de entrega da prótese foi possível devido à técnica utilizada para a confecção da estrutura metálica, denominada técnica do assentamento passivo, a qual elimina a necessidade de prova e solda da estrutura. A prótese permanece com a caraterística de reversibilidade, por ser parafusada, mas com a passividade das próteses cimentadas. O paciente foi acompanhado durante cinco anos e oito meses, não apresentou complicação e está totalmente satisfeito com o tratamento. Concluiu-se que a técnica do assentamento passivo reduz o tempo clínico e simplifica as etapas laboratoriais. Além disso, garante um adequado ajuste entre implante e prótese, favorecendo a longevidade da reabilitação.

The aim of this article was to describe the passive fit technique for the framework fabrication of hybrid prostheses through a clinical case presentation. A female, 44 years-old patient was examined at the Ilapeo clinics concerning about the instability of her lower mandibular denture. Five implants were planned and placed between the mental foramina to receive the mandibular hybrid prosthesis under immediate loading. The surgical and prosthodontic procedures were performed in the same day. This quick procedure to fabricate the metallic framework is known as the passive fit technique, which eliminates the try-in and soldering. Its retrievability is maintained, but with the advantage of a passive, cemented prosthesis. The patient has been followed-up for 5 years and 8 months, with no complications identifi ed, being completely satisfi ed with the proposed treatment. Besides, an adequate fit between the dental implants and the prosthesis is warranted, which favors the longevity of this rehabilitation procedure.

Correlation between Academic and Psychomotor Skills Performances of Dental Students in Complete Denture Prosthodontics.

Aims: This study was designed to determine if there is correlation between academic performance of students in complete denture prosthodontics and psychomotor skills for record blocks fabrication/complete denture teeth set up. Study Design: It was a cross-sectional study conducted at the Department of Restorative Dentistry of the University of Port Harcourt between July and October 2015. Methodology: Departmental examination records of all dental students who had done complete denture prosthodontic course and sat for professional examination in the subject since 2011 when the very first was organized were reviewed. The examination involved written, test of psychomotor skills for fabrication of record blocks/complete denture teeth set up and viva. The practical evaluation was conducted by experienced external and internal examiners using already prepared checklist. The checklist includes occlusal vertical dimension, occlusion (inter-digitations, overbite & overjet), setting up on the ridge, adaptation and thickness of the denture base, extension of the flange and finishing. Spearman’s rank test was used to assess the correlation between academic and psychomotor skills performances. Results: Six sets and a total number of 65 students had taken the course and sat for professional examination since the very first was organized in 2011. Spearman’s correlation coefficient was very low (0.237) and the relationship was almost statistically significant (P value was 0.06). Conclusion: There was poor correlation between academic and psychomotor skills performances of dental students as it relates to complete denture prosthodontics. Conscious efforts should be made to recognize candidates who lag behind in psychomotor skills acquisition and to assist them.

Neutral zone approach for rehabilitation of severely atrophic maxillary and mandibular ridges: A case report / 대한치과보철학회지

The neutral zone technique is an alternative approach for the construction of complete dentures on highly atrophic ridges with history of denture instability. This technique achieves two objectives. First, the teeth will not interfere with the normal muscle function, and second, the force exerted by the musculature against the denture is more favorable for stability and retention. In this case of a 78-years-old female patient with severely atrophic ridges who had been using unstable complete dentures, the neutral zone impression technique was used to increase the stability and the retention of dentures. The neutral zone for both arch was located with modeling compound. After the arrangement of artificial teeth within the neutral zone, the external impression was taken to determine the tissue surface. The final dentures showed enhanced stability and retention and the patient was satisfied with the new dentures with respect to functional and esthetic aspects.

Immediate complete denture: a contemporary view

AIM: The objective of this study was to describe the advantages, disadvantages, indications and some limitations of the Immediate Complete Denture (ICD) treatment. MATERIAL AND METHODS: An electronic and manual search was made in SciELO, SCOPUS, MEDLINE/PubMed databases from 1972 to 2015. Publications in Portuguese, Spanish and English were selected to write this narrative review of the literature. CONCLUSION: Despite the limitations of this study it was conclude that treatment with ICD is the best option because of its satisfactory results.

Avaliação eletromiográfica dos músculos masseter e temporal, força de mordida e qualidade de vida em pacientes desdentados antes, durante e após a instalação e adaptação de novas próteses - total maxilar e overdenture mandibular sobre implante / Evaluation of electromyography of masseter and temporalis, bite force and quality of life in edentulous patients during and after the adaptation of new prostheses – complete dentures in the maxilla and mandibular overdentures

Apesar dos avanços da odontologia preventiva mundial, o número de indivíduos desdentados ainda é grande. Muitos pacientes têm dificuldades na utilização das próteses totais convencionais, principalmente, as mandibulares. Uma alternativa de tratamento nessas situações é a instalação de overdentures implanto suportadas. Esse tratamento já é bem estabelecido na literatura, mas ainda não há estudos que comparem o que ocorre com a atividade elétrica, força de mordida e qualidade de vida dos pacientes até o momento da adaptação com as novas dentaduras. Avaliamos a eficiência do tratamento bem como sua evolução em cinco etapas distintas, com as próteses totais antigas (I), após a cirurgia de instalação dos implantes com as próteses mandibulares reembasadas (II), após a instalação dos cicatrizadores (III), no momento da instalação das novas próteses (IV) e após três meses de uso (V). Foram selecionados 12 pacientes completamente desdentados, de acordo com critérios de inclusão e exclusão preestabelecidos, para a instalação de overdentures retidas por dois implantes mandibulares e próteses totais maxilares como antagonistas. Em cada etapa avaliamos os pacientes por meio da eletromiografia de temporal e masseter, da força de mordida e também aplicamos o questionário OHIP edent para avaliar a qualidade de vida desses pacientes. Nos resultados encontramos uma diminuição da atividade elétrica para a mastigação habitual de uvas passas, repouso e movimento de lateralidade, a força de mordida e a qualidade de vida dos pacientes aumentaram progressivamente durante o estudo (p ˂ 0,05). Comprovando que essa reabilitação deveria se tornar padrão para indivíduos desdentados e que seus benefícios já são observados antes mesmo de sua completude.

Despite advances in preventive dentistry in Brazil, the number of edentulous individuals is still great. Many patients present difficulty when using conventional dentures, especially towards the mandibular one. A treatment option for these situations is the installation of implant-retained prostheses. Although this treatment is well established in the literature, there are no studies comparing what happens to muscles and quality of life of patients during the treatment. We selected 12 completely edentulous patients, according to pre-established inclusion and exclusion criteria, to rehabilitate with mandibular overdentures retained by two dental implants and a complete denture as antagonists. We evaluated the efficacy of the treatment and its evolution in five distinct steps, initially with the old complete dentures (I) after the implants placement with the mandibular prosthesis relined (II) after the placement on of the healing abutments (III), after the installation and adaptation of new prostheses (IV) and after three months of its use (V). At each stage, we evaluated patients through the temporal and masseter electromyography (EMG), bite force and the questionnaire OHIP Edent to assess the quality of life of these patients. The results for EMG found a decrease in muscle activity during the mastication of raisins, rest and lateral movements, while the bite force and the quality of life of patients gradually improved during the study (p ˂ 0.05). Proving that this rehabilitation should become standard for edentulous individuals and that the benefits of treatment are observed even before its completion.

Fabrication of complete dentures using treatment dentures for a patient with erratic mandibular movements: A case report / 대한치과보철학회지

Long-term use of ill-fitting dentures may cause irregular movements of the mandible. In such cases, satisfactory outcomes both in terms of function and esthetics could be achieved by accurate registration of mandibular movement and centric relation when fabricating new dentures. In this case, treatment dentures with flat occlusal tables were used to register centric relation and mandibular movements of a patient with erratic mandibular movements

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.