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OBJECTIVE: Digitally-designed removable complete dentures are typically composed of a resin denture base without a metal framework. However, metal denture bases are preferable as resin bases are more susceptible to fracture. Therefore, this article introduces a unique technique that integrates computer-aided design (CAD) and conventional resin processing for the fabrication of removable complete dentures with a metal framework. CLINICAL CONSIDERATIONS: A maxillary complete denture with a metal base and a mandibular implant-retained overdenture reinforced with a metal framework were fabricated. The dentures were designed using CAD software and a tooth library. The denture bases were milled from wax disks, and artificial teeth were placed to complete the wax dentures. The metal frameworks were also designed using CAD software and produced via casting of printed resin patterns. Finally, conventional denture processing techniques were applied to obtain dentures with metal frameworks. CONCLUSIONS: A digitally designed, removable complete denture with a metal base can be successfully fabricated using the described technique, which merges digital design and conventional methods. This article demonstrates the feasibility and potential advantages of this innovative approach in denture fabrication. CLINICAL SIGNIFICANCE: The presented technique provides the following advantages: digital design features, precise space above implant overdenture attachments for a metal framework, convenience of esthetic evaluation with printed trial dentures, long-term data storage and duplication, reliable bond between the artificial teeth and denture base, and enhanced strength of the removable complete denture due to the metal reinforcement.
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Desenho Assistido por Computador , Prótese Total , Mandíbula , Maxila , HumanosRESUMO
STATEMENT OF PROBLEM: Scan bodies play a crucial role in the accuracy of digital implant scans by serving as implant-positioning transfer devices. Previous literature has demonstrated the effects of scan body characteristics on the accuracy of digital implant scans. However, the optimal application methods of scan bodies to enhance scanning accuracy remain unclear. PURPOSE: The purpose of this systematic review was to determine the optimal application methods of scan bodies to enhance the accuracy of digital implant scans. MATERIAL AND METHODS: An electronic search was conducted by using the PubMed (MEDLINE), Web of Science, Cochrane Library, and Embase databases from November 2018 to 2023. Relevant references from the included studies were further screened manually for eligibility. Following the population, intervention, comparison, and outcome (PICO) criteria, a research question focused on identifying the optimal application method for effectively using scan bodies to enhance scanning accuracy was developed. Specific inclusion criteria involved in vitro and in vivo studies. The Checklist for Reporting In Vitro Studies (CRIS) guidelines were followed and the assessment of the risk of bias in the included studies was conducted. RESULTS: Sixteen articles that met the eligibility criteria were included in this systematic review. Two studies investigated the effect of scan body bevel orientation on the accuracy of digital implant scans, and 3 examined the impact of tightening torque on scan bodies. Among the studies focusing on completely edentulous arches, 5 recommended the use of auxiliary geometric devices on the dental arch to enhance scanning accuracy. However, 2 studies reported no improvements in accuracy after splinting scan bodies with thread. CONCLUSIONS: Different techniques for applying scan bodies, such as configuring bevel orientation, adjusting tightening torque, and attaching auxiliary geometric devices, influence the accuracy of digital implant scans. For scanning completely edentulous arches, attaching auxiliary devices to scan bodies to cover the edentulous ridge effectively enhances scanning accuracy.
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OBJECTIVES: To evaluate the association between different vertical levels of the abutment margin and residual cement prevalence in cement-retained implant restorations with customized abutments. METHODS: One hundred and nine single-unit cement-retained implant restorations with a screw-access channel were included. The crowns were intraorally cemented on the abutments, and excess cement was removed. The abutment-crown complex was unscrewed, and the abutment-crown complex and peri-implant tissue were photographed. Residual cement presence was recorded by dividing the abutment-crown complex and peri-implant tissue into four quadrants: mesial, distal, buccal, and lingual. The prevalence of residual cement was compared according to the height of the custom abutment margin of the corresponding quadrant. A multilevel model was used for statistical analysis (α = .05). RESULTS: Cement remnants were discovered on 72.48% of the dental implants. When the restoration quadrants were compared, cement remnants were present on 51.38%, 39.45%, 20.18%, and 17.43% of the mesial, distal, buccal, and lingual surfaces, respectively (p < .01). Regarding the abutment margin level, cement residues were found in 60.22% and 61.4% of the 0.5 mm subgingival and ≥1 mm subgingival margin groups, respectively, which were significantly more than those in the supragingival (23.65%) and equigingival (26.59%) margin groups (p < .01). After adjustment for confounding factors, the adjusted odds ratio (with 95% confidence interval) for residual cement in the subgingival margin groups was 3.664 (1.71, 7.852) when compared to the supragingival and equigingival margin groups. CONCLUSIONS: The risk of residual cement occurrence was 3.66-fold higher with a subgingival abutment margin than with supragingival and equigingival abutment margins.
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Cimentação , Implantes Dentários , Dente Suporte , Prótese Dentária Fixada por Implante , Cimentos Dentários , Cimentos de Ionômeros de Vidro/química , CoroasRESUMO
STATEMENT OF PROBLEM: Interim restorations are often used along with mouth rinses during the healing period following surgical procedures. However, evidence regarding the color and surface properties of digitally fabricated interim restorations after oral rinsing is lacking. PURPOSE: The purpose of this in vitro study was to evaluate whether different mouth rinses could affect the color and surface roughness of milled and printed interim restorations after simulated oral rinsing. MATERIAL AND METHODS: Disk-shaped specimens (Ø15×2 mm; N=180) were fabricated by using conventional (Jet Tooth Shade), milled (Yamahachi PMMA Disk), and printed (NextDent C&B) resin materials. All resin specimens were divided into 3 different groups according to the rinsing material: distilled water, whitening mouth rinse (Listerine Healthy White), and conventional mouth rinse (Listerine Cool Mint). The specimens were further allocated into short- and long-term subgroups, and oral rinsing simulation was performed (n=10). Short-term rinsing simulated the conditions in a usual interim restoration period, and long-term rinsing was performed to evaluate the properties of the interim materials. The color differences (CIEDE2000, ΔE00) between the baseline and each time point were determined by using a spectrophotometer. The surface roughness of the tested specimens was measured by using a confocal laser scanning microscope. Kruskal-Wallis and Friedman tests with nonparametric pairwise comparisons were used to analyze the data (α=.05). RESULTS: On simulation of a 6-month use of the mouth rinse, the color change in the milled resin did not differ from that in the conventional resin (P>.334), but the printed resin showed a significantly greater color change than the other resins (P<.007). The greatest color change with the printed resin was observed when a conventional mouth rinse was used. However, all color changes were below a perceptible threshold of 1.30. When daily rinsing for 14 years was simulated, all resin groups showed a perceptible color change when conventional mouth rinse was used, and the printed resin showed the greatest median ±interquartile range ΔE00 (2.24 ±0.2). In both short- and long-term simulations, the printed resin rinsed with the conventional mouth rinse showed significantly greater roughness than that rinsed with distilled water (P<.009). CONCLUSIONS: The printed resin showed higher stainability than the conventional resin, and the color change was greatest with the conventional mouth rinse. However, in 6 months of daily mouth rinse simulation, all the tested resin materials exhibited imperceptible color change and clinically acceptable surface roughness.
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Antissépticos Bucais , Dente , Materiais Dentários , Água , Teste de Materiais , Propriedades de Superfície , CorRESUMO
Nanoparticles with multifunctionality and high colloidal stability are essential for biomedical applications. However, their use is often hindered by the formation of thick coating shells and/or nanoparticle agglomeration. Herein, we report a single nanoparticle coating strategy to form 1 nm polymeric shells with a variety of chemical functional groups and surface charges. Under exposure to alternating magnetic field, nanosecond thermal energy pulses trigger a polymerization in the region only a few nanometers from the magnetic nanoparticle (MNP) surface. Modular coatings containing functional groups, according to the respective choice of monomers, are possible. In addition, the surface charge can be tuned from negative through neutral to positive. We adopted a coating method for use in biomedical targeting studies where obtaining compact nanoparticles with the desired surface charge is critical. A single MNP with a zwitterionic charge can provide excellent colloidal stability and cell-specific targeting.
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Nanopartículas , Magnetismo , Polimerização , PolímerosRESUMO
Flexibile biosensors have a lot of applications in measuring the concentration of target bioanalytes. In combination with its flexibility, electrochemical sensors containing 2D materials have particular advantages such as enlarged area compatibility, transparency, and high scalability. A flexible biosensor was fabricated by direct synthesis of molybdenum disulfide (MoS2) on a polyimide (PI) substrate, which can be used as the working electrode in electrochemistry platforms. The direct formation of 2D-MoS2 on the PI was achieved using plasma-enhanced chemical vapor deposition (PE-CVD). Since the MoS2 provides higher electrical conductivity, the MoS2-Au-PI flexible sensor is able to provide highly sensitive detection of target proteins with a relatively fast response via cyclic voltammetry. To evaluate the high performance of the fabricated sensor, we selected the endocrine-related hormones parathyroid hormone (PTH), triiodothyronine (T3), and thyroxine (T4) as analytes because they are one of the most important markers for the determination of endocrinopathy, however, they are very difficult to quantify. The newly developed biosensor achieved highly sensitive detection of the hormones and could determine their location with high accuracy. In addition, we performed electrochemical measurements of hormones obtained from 30 clinical patients' sera with confirmed agreement and compared with the measurements performed with standard immunoassay equipment (E 170, Roche Diagnostics, Germany).
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Técnicas Biossensoriais/métodos , Dissulfetos/química , Molibdênio/química , Hormônio Paratireóideo/análise , Resinas Sintéticas/química , Tiroxina/análise , Tri-Iodotironina/análise , Técnicas Eletroquímicas , Eletrodos , Ouro/química , Humanos , Hormônio Paratireóideo/sangue , Tiroxina/sangue , Tri-Iodotironina/sangueRESUMO
High-translucency restorative materials are commonly used in the restoration of anterior teeth where aesthetics is a critical factor. In this in vitro study, the impact of mouthwash on the colour stability and surface characteristics of high-translucency computer-aided design and computer-aided manufacturing (CAD-CAM) dental restorative materials was evaluated. Two-hundred specimens were fabricated from five high-translucency CAD-CAM materials: a resin nano ceramic; a polymer-infiltrated ceramic network; a feldspathic ceramic; a lithium disilicate glass ceramic; and high-translucency zirconia. Each group of ceramic specimens was then divided into four subgroups: conventional mouthwash (LISTERINE); whitening mouthwash (LISTERINE Healthy White); chlorhexidine gluconate; and distilled water. Oral rinsing was simulated at 100 rpm for 180 h, representing 15 yr of clinical simulation. The specimens were then evaluated for colour, translucency, gloss, roughness, and surface morphology. Two-way ANOVA and linear mixed models were used for intergroup comparisons (α = 0.05). The polymer-infiltrated ceramic network and feldspathic ceramic became brighter, more opaque, less glossy, and rougher after rinsing with the whitening mouthwash. The long-term use of specific mouthwashes can cause deterioration of the optical and surface properties of high-translucency CAD-CAM dental restorations.
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Propriedades de Superfície , Cerâmica , Cor , Desenho Assistido por Computador , Porcelana Dentária , Estética Dentária , Teste de MateriaisRESUMO
Multifunctional magnetic nanoparticles have shown great promise as next-generation imaging and perturbation probes for deciphering molecular and cellular processes. As a consequence of multicomponent integration into a single nanosystem, pre-existing nanoprobes are typically large and show limited access to biological targets present in a crowded microenvironment. Here, we apply organic-phase surface PEGylation, click chemistry, and charge-based valency discrimination principles to develop compact, modular, and monovalent magnetofluorescent nanoparticles (MFNs). We show that MFNs exhibit highly efficient labeling to target receptors present in cells with a dense and thick glycocalyx layer. We use these MFNs to interrogate the E-cadherin-mediated adherens junction formation and F-actin polymerization in a three-dimensional space, demonstrating the utility as modular and versatile mechanogenetic probes in the most demanding single-cell perturbation applications.
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Actinas/análise , Caderinas/análise , Corantes Fluorescentes/química , Nanopartículas de Magnetita/química , Nanopartículas/química , Polietilenoglicóis/química , Junções Aderentes/ultraestrutura , Linhagem Celular Tumoral , Microambiente Celular , Química Click , Humanos , Micromanipulação , Imagem ÓpticaRESUMO
Objective: This cross-sectional study investigated the relationship between handgrip strength and oral health behaviours among Koreans.Methods: The data of 7589 individuals (3384 men and 4205 women) aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2015 were analyzed. Oral health behaviour was assessed based on the number of daily toothbrushing sessions and the use of secondary oral-care products. The association between oral-health behaviour and handgrip strength was investigated adjusting for confounders. Multivariable logistic regression analysis was performed (α = 0.05).Results: The proportion of participants diagnosed with sarcopenia was significantly higher in the group with poor oral-health behaviours. After adjusting for confounders including age, the adjusted odds ratios and 95% confidence intervals of female participants with low handgrip strength in groups toothbrushing thrice or more per day, twice per day, and once or less per day were 1 (reference), 1.18 (0.99-1.4), and 1.24 (0.89-1.71), respectively. There were significantly more participants with low handgrip strength in the group that did not use secondary oral products for both sexes.Conclusions: Oral health behaviour is associated with handgrip strength among adults. Poor oral self-care habits may constitute a risk indicator for low muscle strength.
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Força da Mão , Inquéritos Nutricionais , Adulto , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , República da CoreiaRESUMO
BACKGROUND: A balanced nutrient intake is important for patients with diabetes. Even if individuals have the same number of residual natural teeth, there are large differences in the masticatory performance between edentulous sites restored with a fixed dental prosthesis, including dental implants, and those restored with a removable dental prosthesis. This study assessed whether the prevalence and control of diabetes differed based on the use of removable dental prostheses through an analysis of nationally representative data. METHODS: Overall, 8,155 individuals (3,525 men and 4,630 women) aged ≥ 50 years were included in this study and were classified into the following 3 groups: group 1, did not use any removable dental prostheses (NF); group 2, used removable partial dentures (RPD); and group 3, used removable complete dentures on at least 1 jaw (CD). The characterization of diabetic patients and glycemic control were analyzed and compared among groups. To determine the relationship between diabetes and the use of dental prostheses, multivariable logistic regression analysis was performed (P < 0.05). RESULTS: The adjusted odds ratios and 95% confidence intervals for diabetes in men participants in groups NF, RPD, and CD were 1 (reference), 1.165 (0.878-1.544), and 1.491 (1.034-2.151), respectively, after adjusting for confounding factors. Diabetes and glycemic control were significantly associated with the use of removable dental prostheses among men. CONCLUSION: The use of removable dental prostheses is a potential risk indicator for uncontrolled diabetes in Korean men adults, suggesting the need for a comprehensive approach to minimize the complications of diabetes mellitus.
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Prótese Parcial Removível/estatística & dados numéricos , Diabetes Mellitus/patologia , Idoso , Glicemia/análise , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , República da Coreia/epidemiologiaRESUMO
This study aimed to investigate the effects of the luting methods on the amount of cement remnants in implant restorations and to determine the restoration surface with the maximum amount of residual cement. Forty abutments and crowns were divided into 4 groups as follows: TB group, luting with zinc oxide-eugenol cement; TBV group, luting with zinc oxide-eugenol cement after application of a separating agent over the transmucosal area of the abutment; PI group, luting with methacrylate cement; and PIV group, luting with methacrylate cement after application of a separating agent. After cementation, all the quadrants of the specimens were photographed, and the amount and location of the cement remnants were statistically analyzed (P ≤ .05). The amount of cement remnants was significantly smaller in the groups with a separating agent. The type of luting material did not significantly affect the results. Cement remnants were more abundant on the mesial and distal sides than on the buccal and lingual sides of the restoration.
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Dente Suporte , Cimentos Dentários , Cimentação , Coroas , Prótese Dentária Fixada por ImplanteRESUMO
BACKGROUND: Silica nanoparticles (SNPs) can easily enter in respiratory system via inhalation because of their low molecular weight and ease of dispersion. Toxicity and adverse effects of SNPs vary according to the physical characteristics of the particle. METHODS: To evaluate the toxic and adjuvant effects of 3 types of SNPs in the airway system, six-week-old female BALB/c mice were intranasally administered 3 types of SNPs (spherical [S-SNP], mesoporous [M-SNP], and polyethylene glycol-conjugated [P-SNP]) alone or SNPs/ovalbumin (OVA), three times weekly for 2 weeks. Airway hyper-responsiveness (AHR), bronchoalveolar lavage fluid (BALF), cytokine levels, and histology of the lungs were analyzed. RESULTS: The S-SNPs/OVA group and M-SNPs/OVA group showed significant AHR, compared to the control group. Among all SNP-treated groups, the group administered SNPs/OVA showed greater inflammatory cell infiltration in BALF, extensive pathological changes, and higher cytokine levels (IL-5, IL-13, IL-1ß, and IFN-γ) than those administered SNPs alone or saline/OVA. CONCLUSION: Exposure to SNPs alone and SNPs/OVA induced toxicity in the respiratory system. SNPs alone showed significant toxic effects on the airway system. Meanwhile, SNPs/OVA exerted adjuvant effects to OVA of inducing allergic airway inflammation. In particular, M-SNPs showed the most severe airway inflammation in both direct toxicity and adjuvant effect assays. P-SNPs induced less inflammation than the other types of SNPs in both models.
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Pulmão/efeitos dos fármacos , Nanopartículas/toxicidade , Ovalbumina , Pneumonia/induzido quimicamente , Dióxido de Silício/toxicidade , Animais , Hiper-Reatividade Brônquica/induzido quimicamente , Hiper-Reatividade Brônquica/fisiopatologia , Líquido da Lavagem Broncoalveolar/química , Broncoconstrição/efeitos dos fármacos , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Mediadores da Inflamação/metabolismo , Exposição por Inalação , Pulmão/imunologia , Pulmão/metabolismo , Pulmão/fisiopatologia , Camundongos Endogâmicos BALB C , Nanopartículas/química , Pneumonia/imunologia , Pneumonia/metabolismo , Pneumonia/fisiopatologia , Polietilenoglicóis/toxicidade , Porosidade , Dióxido de Silício/químicaRESUMO
Highly conductive poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) ( PEDOT: PSS) films as transparent electrodes for organic light-emitting diodes (OLEDs) are doped with a new solvent 1,3-dimethyl-2-imidazolidinone (DMI) and are optimized using solvent post-treatment. The DMI doped PEDOT: PSS films show significantly enhanced conductivities up to 812.1 S cm(-1) . The sheet resistance of the PEDOT: PSS films doped with DMI is further reduced by various solvent post-treatment. The effect of solvent post-treatment on DMI doped PEDOT: PSS films is investigated and is shown to reduce insulating PSS in the conductive films. The solvent posttreated PEDOT: PSS films are successfully employed as transparent electrodes in white OLEDs. It is shown that the efficiency of OLEDs with the optimized DMI doped PEDOT: PSS films is higher than that of reference OLEDs doped with a conventional solvent (ethylene glycol). The results present that the optimized PEDOT: PSS films with the new solvent of DMI can be a promising transparent electrode for low-cost, efficient ITO-free white OLEDs.
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Compostos Bicíclicos Heterocíclicos com Pontes/química , Imidazóis/química , Luz , Polímeros/química , Poliestirenos/química , Condutividade Elétrica , Eletrodos , Estrutura Molecular , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
This study aimed to investigate the effects of sandblasting on the physical properties and bond strength of two types of translucent zirconia: niobium-oxide-containing yttria-stabilized tetragonal zirconia polycrystals ((Y, Nb)-TZP) and 5 mol% yttria-partially stabilized zirconia (5Y-PSZ). Fully sintered disc specimens were either sandblasted with 125 µm alumina particles or left as-sintered. Surface roughness, crystal phase compositions, and surface morphology were explored. Biaxial flexural strength (n=10) and shear bond strength (SBS) (n=12) were evaluated, including thermocycling conditions. Results indicated a decrease in flexural strength of 5Y-PSZ from 601 to 303 MPa upon sandblasting, while (Y, Nb)-TZP improved from 458 to 544 MPa. Both materials significantly increased SBS after sandblasting (p<0.001). After thermocycling, (Y, Nb)-TZP maintained superior SBS (14.3 MPa) compared to 5Y-PSZ (11.3 MPa) (p<0.001). The study concludes that (Y, Nb)-TZP is preferable for sandblasting applications, particularly for achieving durable bonding without compromising flexural strength.
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Materiais Dentários , Nióbio , Óxidos , Materiais Dentários/química , Teste de Materiais , Propriedades de Superfície , Zircônio/química , Ítrio/química , Óxido de Alumínio , Resistência ao CisalhamentoRESUMO
OBJECTIVES: Natural teeth and dental restorations present with various shades and levels of translucency. This study aimed to determine whether these variations in ceramic crowns and scan powder application affect the trueness of intraoral scanners. METHODS: Eight identical premade resin typodonts, each prepared for a crown on the maxillary right second molar, were used. Eight lithium disilicate crowns, distinguished by two levels of translucency (high and low) and four shades (BL1, A2, A3, and A4), were fabricated to an identical design and cemented onto each typodont, providing eight distinct experimental groups (2 levels of translucency × 4 shades). Reference scans were acquired using a desktop scanner. Test scans were performed ten times for each experimental group using two different intraoral scanners (Medit i700 and CEREC Primescan AC), with and without the application of scan powder (n = 10). Three-dimensional metrology software was used to assess the trueness of the intraoral scan datasets. Statistical analysis involved the Kruskal-Wallis H test, Mann-Whitney U test, and independent t-test (α=0.05). RESULTS: For powder-free intraoral scan datasets, the crown shade did not significantly affect trueness within each translucency group (P = 1.000). For both intraoral scanners, compared with low translucency groups, higher marked deviations were exhibited by high translucency groups (P<.001). Scan powder use largely mitigated these differences (P>.05) and enhanced the trueness of the intraoral scan (P<.01). CONCLUSIONS: Shade did not significantly influence the trueness of intraoral scans. High-translucency crowns were scanned with less accuracy than were low-translucency crowns. CLINICAL SIGNIFICANCE: Unlike tooth shade, translucency significantly affected the accuracy of intraoral scans. Therefore, considering the use of scan powder when scanning objects with high translucency may be beneficial.
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Desenho Assistido por Computador , Coroas , Porcelana Dentária , Planejamento de Prótese Dentária , Pós , Humanos , Porcelana Dentária/química , Cor , Pigmentação em Prótese , Imageamento Tridimensional/métodos , Cerâmica , Dente Molar/diagnóstico por imagem , Dente Molar/anatomia & histologia , Processamento de Imagem Assistida por Computador/métodosRESUMO
Obstructive sleep apnea (OSA) may be linked with oral health issues. This study evaluated the associations between OSA, dental pain, and chewing discomfort. Big data from a nationwide survey involving 6984 participants aged ≥ 40 years were analyzed. The STOP-Bang questionnaire was used to assess the OSA risk, categorizing the participants into low-, intermediate-, and high-risk groups. The associations of OSA risk with dental pain and chewing discomfort were evaluated using multivariate logistic regression analyses (α = 0.05). Results revealed that 50.33%, 37.50%, and 12.17% of the population belonged to the low-, intermediate-, and high-risk groups, respectively. After adjusting for covariates, a significant association emerged between OSA risk and dental pain, with adjusted odds ratios (95% confidence intervals) of 1 (reference), 1.208 (1.003-1.455), and 1.472 (1.131-1.916) for the low-, intermediate-, and high-risk groups, respectively (p = 0.0156). The adjusted odds ratio for chewing discomfort in the high-risk OSA group was 1.307 (0.977-1.748), although not significantly different from that of the low-risk group (p > 0.05). A high risk of OSA was associated with 1.472-fold increased risk of dental pain compared to those at low risk, implicating OSA as a potential risk indicator of poor oral health.
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Mastigação , Apneia Obstrutiva do Sono , Adulto , Humanos , Estudos Transversais , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/epidemiologia , Inquéritos e Questionários , República da Coreia/epidemiologia , Dor/complicaçõesRESUMO
Cerebral air embolism (CAE) occurs in various clinical situations such as surgery, angiography, and hemodialysis; most are iatrogenic. Here we report the case of a 57-year-old man who developed CAE immediately after air-powder abrasive treatment, which is commonly used in dentistry. The patient underwent air-powder abrasive treatment for peri-implantitis, and immediately after the treatment, cardiac arrest occurred and cardio- pulmonary resuscitation was performed. After resuscitation, brain computed tomography performed in the emergency room showed scattered dark density presumed to be air. The day after admission, the patient showed right hemiplegia and a multifocal cerebral infarction was observed on brain magnetic resonance imaging. Therefore, CAE was strongly suspected. After hyperbaric oxygen treatment (HBOT), which started 4 days after the incident, the patient regained consciousness and showed improvement in cognitive impairment, and only grade 4 muscle weakness was observed in the right lower extremity on the manual muscle test. This case highlights the importance of considering CAE as a possible cause of neurological symptoms occurring during clinical procedures involving air, and adds to the accumulation of evidence of therapeutic effects of delayed HBOT.
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OBJECTIVES: Both resin-modified glass ionomer cement (RMGIC) and self-adhesive resin cement (SAC) may be suitable for cementation of full-coverage zirconia restorations. This retrospective study aimed to investigate the clinical outcomes of zirconia-based restorations cemented with RMGIC and compare them with those cemented with SAC. METHODS: Cases of full-coverage zirconia-based restorations cemented with either RMGIC or SAC between March 2016 and February 2019 were evaluated in this study. The clinical outcomes of the restorations were analyzed according to the type of cement used. In addition, cumulative success and survival rates were evaluated according to the cement and abutment types. Non-inferiority, Kaplan-Meier, and Cox hazard tests were conducted (α=.05). RESULTS: A total of 288 full-coverage zirconia-based restorations (natural teeth, 157; implant restorations, 131) were analyzed. Loss of retention occurred in only one case; a single-unit implant crown cemented with RMGIC, which decemented 4.25 years post-restoration. RMGIC was non-inferior to SAC in terms of loss of retention (<5%). For single-unit natural tooth restorations, the four-year success rates in the RMGIC and SAC groups were 100% and 95.65%, respectively (p=.122). For single-unit implant restorations, the four-year success rates in the RMGIC and SAC groups were 95.66% and 100%, respectively (p=.365). The hazard ratios of all the predictor variables, including cement type, were not significant (p>.05). CONCLUSIONS: Cementation of full-coverage zirconia restorations of both natural teeth and implants using RMGIC and SAC yields satisfactory clinical outcomes. Furthermore, RMGIC is non-inferior to SAC in terms of cementation success. CLINICAL SIGNIFICANCE: Cementation with RMGIC or SAC for full-coverage zirconia restorations has favorable clinical outcomes in both natural teeth and implants. Both RMGIC and SAC have advantages in the cementation of full-coverage zirconia restorations to abutments with favorable geometries.
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Cimentação , Cimentos Dentários , Cimentos de Resina , Estudos Retrospectivos , Cimentos de Ionômeros de Vidro , Zircônio , CoroasRESUMO
Purpose Completely edentulous arches can be restored using various prosthetic modalities, and the treatment outcome may include masticatory and speech discomforts. This study aimed to investigate the current status of prosthetic restoration modalities used for completely edentulous patients and investigate the association between prosthetic restoration modalities and subjective discomfort in mastication and speech by analyzing nationwide big data.Methods Of 97,622 individuals, data from 1,576 adults aged ≥40 years with no natural teeth and no requirement for additional prosthetic treatments were included. Oral examination data were analyzed, and the prostheses of the edentulous arches were categorized as follows: CD, removable complete denture; OD, implant-retained overdenture; and IF, implant-supported fixed dental prosthesis. Discomforts in mastication and speech according to the prosthetic restorative modality groups was statistically analyzed using analysis of covariance (α = 0.05).Results The maxillary/mandibular prosthetic restorative modality most commonly used was CD/CD, followed by CD/OD, IF/IF, OD/OD, and CD/IF, with weighted percentages of 93.23%, 2.48%, 1.83%, 1.46%, and 0.84%, respectively. Even after adjusting for various covariates, masticatory discomfort in the CD/CD group was significantly greater than that in the OD/OD (P = 0.0004) and IF/IF (P = 0.0002). The CD/CD group also had significantly greater discomfort in speech than did the IF/IF group (P = 0.0119).Conclusions Most completely edentulous patients were rehabilitated with bimaxillary removable complete dentures; however, the discomforts in mastication and speech were the lowest when both arches were restored with implant-supported fixed restorations.