Gnathology in implant-supported fixed restoration in edentulous mandible / 华西口腔医学杂志

OBJECTIVE@#This study aims to investigate the occlusal and myoelectric characteristics of implant-supported fixed denture in the mandibular region and provide reference for the design of fixed restoration.@*METHODS@#Sixty edentulous patients with implant-supported fixed denture were selected and divided into three groups: group A, 20 cases with implant-supported fixed restoration in the maxillary region; group B, 20 cases with natural dentition, and group C, 20 cases with removable partial denture. The T-scan 8.0 digital occlusion analysis system was used to evaluate the occlusal characteristics of patients in the three groups at intercuspal, protrusion, and left and right lateral positions. Electromyography was used to analyze the myoelectric amplitude and bilateral asymmetry index of the anterior temporalis and masseter of the three groups in different states such as resting and clenching. The relationship between occlusion and myoelectricity was also investigated.@*RESULTS@#In the occlusion analysis by T-scan, the occlusion time, the balance of left and right bite force, the left and right asymmetry of the occlusion center, the trajectory of central occlusion force, and the disclusion time were higher in group C than in groups A and B (P<0.05). No significant differences were observed in the anterior and posterior asymmetry of the occlusion center and percentage of bite force at anterior region among the three groups. In the analysis of myoelectricity, the myoelectric amplitude at resting state and the asymmetry index of masticatory muscles in group C were higher than those in groups A and B (P<0.05). The myoelectric amplitude during clenching in groups A and B groups was higher than that in group C (P<0.05).@*CONCLUSIONS@#In implant-supported fixed restoration at edentulous mandibular, when maxillary includes the removable partial denture, degree of occlusal instability and left and right asymmetry of occlusion center are greater than those with the natural dentition and implant-supported fixed denture at maxillary. The myoelectricity is closely related to occlusion. The removable partial denture can increase the myoelectric activity and reduce the potential of the masticatory muscle. The asymmetry of bilateral myoelectricity is related to the occlusion imbalance.

Maxillary complete denture and mandibular All-on-4 implant restoration considering maintenance: a case report

In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.

Full mouth rehabilitation of mandibular edentulous patient using implant hybrid prosthesis / 대한치과보철학회지

In edentulous patients, the advantages of prosthodontic therapy using oral implants include both stability and comfort. Advantages suggested for this approach include the prevention of mandibular bone resorption and increased masticatory function. Implant hybrid prostheses place 4 to 6 implants between the mental foramens, and cantilevers are used to replace the posterior teeth at both ends. The 85

A case of full mouth rehabilitation in patient with loss of vertical dimension and deep bite due to tooth wear / 대한치과보철학회지

The collapse of the posterior occlusion destroys the normal occlusal plane and causes excessive wear reducing the vertical dimension. Reduced vertical dimension of occlusion causes not only aesthetic and functional problems but also overloading on the temporomandibular joints and abnormalities of muscle nerve system. In order to improve the collapsed occlusal relationship, it is necessary to consider the change of the vertical dimension. It is necessary to make a precise diagnosis and analysis before the treatment and to evaluate the adaption of patient to the new vertical dimension of occlusion. A patient with excessive overbite often has occlusal problems of tooth wear and tooth eruption. Considering these considerations, overall prosthodontic restoration is required to solve the problem. A patient of 68 year old man in this case who suffered major tooth wear and maxillary posterior teeth loss was treated with elevation of vertical dimension of occlusion by maxillary removable dental prosthesis and mandibular fixed prosthesis.

Full mouth rehabilitation of fully edentulous patient with implant-supported fixed prosthesis preceding bone graft: A case report / 대한치과보철학회지

Prosthetic treatment using implants in fully edentulous patients includes implant-supported fixed prosthesis, implant hybrid prosthesis, implant retained- or supported-overdenture and implant supported fixed prosthesis has advantages such as psychological stability, pronunciation. If an implant supported fixed prosthesis is planned, the implants should be placed in consideration of pronunciation, esthetics, and oral hygiene. For this, clinical and radiological diagnosis is indispensable. When placing the prosthetic driven implant at the site determined from the diagnosis, a sufficient amount of alveolar bone and soft tissue support are required. If these requirements found to be insufficient, a wide range of bone grafting should be performed in advance. In this case, a fully edentulous patient with severe alveolar bone resorption due to periodontal disease was treated with a full mouth rehabilitation using implant-supported fixed prosthesis preceding maxillary sinus graft and alveolar bone augmentation. We report this patient were satisfied with esthetic and function.

Application of digital implant system on implant treatment with “all-on-4” concept / 대한치과보철학회지

Recently, digital implant systems are expanding its influence in dental area. Due to technical improvement, they jumped over their limits nowadays. We can use these newest systems to treat edentulous patient, from implant surgery to fabrication of prosthesis. In this case, The patient was a fifty years old female. She had a full edentulous ridge on mandible and wanted to reconstruct occlusion with using implants. We planned to use digital implant system with “all-on-4” concept on mandible and produced surgical guide for flapless implant surgery. After the surgery, we tried to fabricate full arch prosthesis just using a digital devices and confirmed satisfying result.

Occlusal analysis of implant-supported fixed denture in edentulous patients / 华西口腔医学杂志

OBJECTIVE@#This study aims to evaluate the occlusal characteristics of full edentulous patients with implant-supported prostheses and to provide a reference with the occlusal situation for clinicians.@*METHODS@#A Teetester occlusal analysis system was used with 30 full edentulous patients of implant-supported fixed denture (test group) in comparison with 30 natural dentition (control group). The percentage of occlusal force distribution were measured, as well as the occlusal time at the intercuspal, protrusion, and left and right lateral positions.@*RESULTS@#Compared with control group, the occlusion time, maximum occlusal force in intercuspal of test group significantly reduced (P<0.05); while control group was obviously superior to test group in the left and right bit force degree. Disclusion time in protrusion, occlusion times in lateral positions of test group also significantly reduced (P<0.05). There were no significant differences in average occlusion force, percentage of total force in anterior teeth, and lateral occlusion between test group and control group.@*CONCLUSIONS@#The maximum occlusal force in intercuspal of full edentulous patients with implant-supported prostheses reduce. The occlusal force in protrusive occlusion is concentrated in the front teeth, and the group function occlusion is the main lateral occlusal pattern.

Zirconia ceramic fixed dental prosthesis with all-on-4 concept implants for irradiated maxilla: A case report / 대한치과보철학회지

The implant-supported fixed dental prosthesis in irradiated maxilla needs meticulous treatment planning due to low bone healing capacity. All-on-4 concept implantation can reduce the number of implants to be placed avoiding bone grafting procedure. Conventionally, prefabricated angled abutments for tilted implants have been used. However, in this case, it was replaced with computer-aided design and computer-aided manufacturing (CAD/CAM) abutment. This case report described all-on-4 concept implantation and fabrication of CAD/CAM zirconia fixed dental prostheses using CAD/CAM titanium abutments.

Complete denture rehabilitation of fully edentulous patient with severe bone resorption and class II jaw relation using piezography / 대한치과보철학회지

Piezography, prosthetic space recorded by pronunciation, can be used as a reference for arrangement of artificial teeth and polishing surface of a denture. In this case, a 67 year old female patient was presented for new dentures. Old dentures had class II relationship and poor retention. For fabrication of stable dentures, using piezography and lingualized occlusion was planned. After taking impressions with conventional method, conventional denture bases with wax rim were fabricated. Then, additional mandibular denture base was fabricated for piezography. With fast setting silicon impression material, piezography was recorded by using six pronunciations, 'si', 'so', 'me', 'te', 'de', and 'mu'. According to the piezographic space, mandibular artificial teeth were arranged and modified for lingualized occlusion. As a result, the patient was satisfied with new dentures functionally and esthetically.

Full mouth rehabilitation of fully edentulous patient using implant hybrid prosthesis / 대한치과보철학회지

Loss of teeth may not only imply impaired oral function and loss of alveolar bone but is also often accompanied by reduced self-confidence. This results in a larger problem with the fully edentulous patient. The patient introduced in this study showed multiple missing teeth and mobility of remaining teeth and wanted to have fixed dental prosthesis using implants. Remaining teeth were extracted because of periodontally bad prognosis. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using implant hybrid prosthesis in fully edentulous patient.

Evaluation of dental panoramic radiographic findings in edentulous jaws: A retrospective study of 743 patients "Radiographic features in edentulous jaws"

PURPOSE: The aim of this study was to determine the frequency of significant panoramic radiographic findings and eventual treatment requirements before conventional or implant supported prosthetic treatment in asymptomatic edentulous patients. MATERIALS AND METHODS: A total of 743 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system. We analyzed the radiographic findings, including impacted teeth, retained root fragments, foreign bodies, severe atrophy of the posterior maxillary alveolar bone, mucous retention cysts, soft tissue calcifications and radiopaque-radiolucent conditions. RESULTS: Four-hundred-eighty-seven (65.6%) patients had no radiographic finding. A total of 331 radiographic findings were detected in 256 (34%) patients. In 52.9% (n=175) of these conditions, surgical treatment was required before application of implant-supported fixed prosthesis. However, before application of conventional removable prosthesis surgical treatment was required for 6% (n=20) of these conditions. CONCLUSION: The edentulous patients who will have implant placement for implant-supported fixed prosthesis can frequently require additional surgical procedures to eliminate pathological conditions.

Complete denture rehabilitation of edentulous patient using mandibular suction denture: a clinical report / 대한치과보철학회지

Suction dentures enhance retention and support by forming negative pressure temporarily at the internal surface of denture base at times of swallowing and chewing because the areas surrounding the denture flanges are sealed by mobile mucosa. In this case, an 81-year-old male visited for new dentures. Considering the high expectations for retention and masticatory efficiency of dentures, fabricating complete dentures with suction dentures was planned. Preliminary impression was taken without applying pressure on retromolar pad area and diagnostic cast was fabricated. Afterwards, individual tray was made and final impression was taken, at the same time, gothic arch tracing was done to acquire centric relation and vertical dimension. Then, anatomic teeth were placed on maxilla and non-anatomic teeth were placed on mandible forming lingualized occlusion. Consequently, restoring a complete edentulous patient with complete dentures using mandibular suction denture resulted in recovering satisfying retention and function.

Full mouth implant rehabilitation with double scanning of provisional restoration / 대한치과보철학회지

It is important to produce a provisional restoration reflecting the patient's jaw relation, occlusal plane, lip support, shape of teeth, and occlusion type for fully edentulous patients before making a definite prosthesis. The patient introduced in this study showed bad prognosis of remained tooth after severe periodontal diseases. Therefore, remaining teeth were extracted and replaced with dental implants. Provisional restorations were fabricated and the the patient's vertical and horizontal jaw relationship, occlusal plane, amount of overjet and overbite, size of teeth, and length of anterior tooth were recorded. Provisional restorations were scanned and CAD/CAM techniques were used to fabricate a monolithic zirconia bridge, which contour is identical with the provisional restorations. The patient was satisfied with the treatment results on functional, esthetic aspects and the prosthesis retained stable during the four-month clinical observation period.

The Implant Retained Overdenture by Locator Attachments on the Edentulous Mandible: A Case Report

Over the past decades, conventional complete dentures were used for various patients although they have incomplete function. Overdenture using dental implants could help the improvement of denture function. In this case, a fully edentulous patient was treated with a conventional complete denture on the maxilla and implant retained overdenture retained by 2 freestanding implants placed in the anterior region of the mandible, following recommendations from the 2002 McGill. Locator attachments were used for retention of the mandibular overdenture. Patient was satisfied with the final maxillary full denture and mandibular implant retained overdenture in esthetic and functional aspect.

Prótese parcial removível overlay: fundamentos clínicos e relatos de casos / Overlay removable partial denture: underluing principles and cases reports

A prótese parcial removível (PPR) de recobrimento oclusal, também conhecida como PPR overlay, se caracteriza por recobrir a face oclusal de um ou mais dentes, podendo até mesmo recobrir as oclusais de todos os dentes posteriores e as incisais dos dentes anteriores para apoio ou sustentação. O presente trabalho teve como objetivo revisar os princípios envolvidos na sua indicação clínica, planejamento e execução, com o objetivo de discutir a viabilidade clínica e efetividade deste tipo de tratamento, identificando suas indicações, vantagens e desvantagens através da apresentação de casos clínicos. Concluiu-se que a PPR overlay pode ser indicada como alternativa de tratamento para situações especiais de arcadas parcialmente desdentadas, em pacientes com necessidade de alteração da dimensão vertical e/ou realinhamento do plano oclusal, podendo ser empregada como tratamento temporário ou definitivo. Apresenta como vantagens principais a maior simplicidade do tratamento, reversibilidade e custo relativamente baixo. No entanto, estudos adicionais são necessários para assegurar a viabilidade clínica e efetividade deste tipo de tratamento.

Overlay removable partial denture (RPD) is a prosthesis that recovers and uses for support, the occlusal surface of teeth, or even the occlusal of all posterior teeth and incisal edge of the anterior teeth. This review presents and discusses clinical and technical aspects involved in treatment with overlay partial dentures. It was concluded that overlay RPD can be indicated as an alternative treatment for partially edentulous patients who present reduced vertical dimension and changes of the occlusal plan. Treatment may be a definitive or temporary solution. The main advantages of overlay RPD are technical simplicity, reversibility and relative low cost. However, additional studies are needed to assure clinical viability and effectiveness of this treatment.

A comparison of the masticatory function between two different types of implant supported prostheses and complete denture for fully edentulous patients / 대한치과보철학회지

STATEMENT OF PROBLEM: The improvement in oral function and comfort from the dental implant appears to depend on the particular type of implant support used with the denture. The number and positioning of implants have an influence on the force transfer and subsequent stress distribution around implants. Nevertheless, a quantitative comparison has not been made between the types of implant prosthesis used with different materials compared to conventional complete denture. PURPOSE: The objective of this study is to assess the masticatory performance, bite force and impact of two different type of implant supported prostheses on oral health-related quality of life compared to conventional complete denture with GOHAI, validated oral-specific health status measures, the sieving method, and the Prescale Dental System. MATERIAL AND METHODS: From the years 1999 to 2006, a total of 30 completely edentulous patients in a single arch were selected from the Yonsei University Dental Hospital, Department of Prosthodontics and Implant Clinic in Seoul, S. Korea. Patients were divided into 3 groups of 10 each. Group HR was restored with fixed-detachable hybrid prostheses with resin teeth. Group FP had fixed dentures with porcelain teeth while Group CD had a complete denture. The masticatory performance was compared between 3 groups. RESULTS: The results showed a significant improvement in oral health-related quality of life with dental implants compared to a conventional denture in GOHAI comparison. Overall, implant prostheses showed a higher masticatory performance (S50) and maximum bite force compared with conventional dentures (P .05). CONCLUSION: Within the limitation of this study, the numbers of implant and material of implant prostheses does not appear to impact patient satisfaction, masticatory performance or bite force.