Evaluation of mandibular implant-supported fixed prosthesis retained by 3 dental implants, 1 straight and 2 angled: A retrospective clinical study.

STATEMENT OF PROBLEM: The minimum number of implants to support fixed complete dentures is still unclear. PURPOSE: The purpose of this retrospective clinical study was to evaluate the survival rate of fixed complete dentures supported by 3 immediately loaded implants opposing maxillary complete dentures. MATERIAL AND METHODS: A retrospective study of edentulous patients rehabilitated with complete dentures opposing mandibular metal-resin implant-supported fixed complete dentures supported by 3 immediately loaded implants was conducted in a 48-hour protocol. Fifty-one machined and 99 rough-surface implants were evaluated from 2.2 up to 8 years. Implant loss, peri-implant outcomes, and mechanical complications were assessed by considering the influence of age, sex, health status, smoking, excessive alcohol consumption, educational level, and socioeconomic status. The presence of comorbidities in relation to the implant surface or the cantilever lengths was also evaluated. RESULTS: Four machined and 6 rough-surface implants failed, a 6.7% failure rate. The cantilever length varied from 3.3 to 22.9 mm. Mechanical complications were abutment screw loosening (3.0%), prosthetic screw loosening (17%), screw fracture (1%), superstructure detachment and fractures (16%), metal framework fracture (2%), maxillary denture fractures (6%), and mandibular prosthesis loss (4%). Peri-implant mucositis was found in 27% of participants. The cumulative implant and mandibular prosthesis survival rates were 93.3% and 96%, respectively. None of the variables evaluated, including demographic data and health status, were found to influence clinical failures and/or mechanical complications. CONCLUSIONS: Mandibular fixed complete dentures supported by 3 implants can be considered a successful treatment with reduced costs compared with those of other fixed options for application in public health.

Does the natural maxillary dentition influence the survival rate of mandibular metal-resin implant-supported fixed complete dentures? A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Consensus is lacking regarding the influence of the maxillary dentition on the survival rate of a mandibular metal-resin implant-supported fixed complete denture (MRISFCD) with distal cantilevers. PURPOSE: The purpose of this systematic review was to identify whether an opposing natural dentition influences the survival rate of mandibular MRISFCDs. MATERIAL AND METHODS: A literature search was performed up to February 2018 from MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, BBO/LILACS databases and also in the non-peer-reviewed literature through Open Grey. Clinical studies regarding natural (ND), removable prostheses (RP), and complete fixed maxillary implant dentitions (ID) with at least a year of follow-up were included. The quality of the included studies was analyzed, and the risk of bias was reported. A meta-analysis comparing the survival rate of ND with RP and ND with ID was performed with a confidence interval (CI) of 95%, and heterogeneity was tested by an I2 index. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of the evidence. RESULTS: From a total of 112 ND, 69 ID, and 204 RP in the maxillary dentition, the overall prevalence of failures was 5.4% (6/112; 95% CI [2.3 to 10.76]) for ND, 13.99% (20/69; 95% CI [0.77 to 39.41]) for ID, and 4.9% (10/204; 95% CI [0.69 to 12.18]) for RP. No statistical differences were detected in the success rates between ND and RP (risk difference = 0.00 [-0.06, 0.06]; P=.93; I2=27%) or between ND and ID (risk difference=0.00 [-0.06, 0.07]; P=.97; I2=0%), both with moderate evidence. CONCLUSION: With a moderate certainty of evidence, it is suggested that natural maxillary dentitions do not affect the survival rate of mandibular MRISFCDs differently from other prosthetic designs.

Prosthetic rehabilitation in a pediatric patient with hypohidrotic ectodermal dysplasia: a case report.

Hypohidrotic ectodermal dysplasia (HED) is a rare ectodermal disease with a systemic expression. Oral abnormalities are common and may include hypodontia and shape irregularities in the primary and permanent dentitions. Rehabilitation of the dental arches in pediatric patients with HED is a challenge because HED is a multifactorial disease that demands a complicated treatment approach and most dentists have limited experience or training in the necessary treatment. In addition, pediatric patients often lack the patience or ability to cooperate with complex prosthetic treatment. This case report describes a simplified technique used to fabricate complete dentures for a 4-year-old HED patient in 4 sessions.

Desenvolvimento de aplicativo móvel para cuidadores sobre higiene bucal em demência e disfagia / Desarrollo de aplicación móvil para cuidadores sobre higiene bucal en demencia y disfagia / Development of a mobile application for caregivers on oral hygiene in dementia and dysphagia

Os autores relatam a experiência do processo de desenvolvimento do protótipo de um aplicativo sobre higiene bucal de idosos com demência, com atenção especial aos que apresentam disfagia, voltado à orientação dos seus cuidadores. Objetivou, também, descrever o papel desta experiência como estratégia de ensino interprofissional e de inovação social a estudantes de Odontologia e Fonoaudiologia. Realizou-se estudo qualitativo do tiporelato de experiência, com informações originadas de narrativas verbais e registro escrito e iconográfico dos autores dessa pesquisa, bem como de relatos escritos de duas revisoras do protótipo do aplicativo ­ambas especialistas em Gerontologia. Para o protótipo, utilizou-se o site SeuApp.com, sem necessidade de programação, gerando formato de aplicativo e site para desktop e celular. O produto foi desenvolvido em três fases, concluído com êxito, e avaliado positivamente pelas pareceristas. Seu conteúdo incluiu informações escritas e iconográficas, estáticas e dinâmicas, referentes à importância e "passo a passo" da higiene bucal, suas relações com saúde e disfagia, e cuidados específicos diante dessa, além de um "Guia do Aplicativo" e "Feedback". A experiência relatada demonstrou que a construção do aplicativo se deu com êxito e avaliação positiva por pareceristas, com contribuição social almejada. Os discentes e docentes de Odontologia e de Fonoaudiologia envolvidos ampliaram suas habilidades na inovação e nas competências interprofissionais. Mais estudos sobre a inovação na graduação em saúde são requeridos, por se tratar de uma área em expansão no mercado, tendo grande contribuição para atualização dos profissionais da saúde (AU).

Los autores relatan la experiencia del proceso de desarrollo del prototipo de una aplicación sobre higiene bucal para personas mayores con demencia, con especial atención a aquellas con disfagia, con el objetivo de orientar a sus cuidadores. También tuvo como objetivo describir el papel de esta experiencia como estrategia de enseñanza interprofesional e innovación social para estudiantes de Odontología y Logopedia. Se realizó un estudio cualitativo del tipo relato de experiencia, con informaciones provenientes de relatos verbales y registros escritos e iconográficos de los autores de esta investigación, así como relatos escritos de dos revisores del prototipo de la aplicación, ambos especialistas en Gerontología. Para el prototipo se utilizó el sitioweb SeuApp.com, sin necesidad de programación, generando un formato de aplicación y sitio web para escritorio y celular. El producto fue desarrollado en tres fases, completado con éxito y evaluado positivamente por los revisores. Su contenido incluía información escrita e iconográfica, estática y dinámica, referente a la importancia y el "paso a paso" de la higiene bucal, sus relaciones con la salud y la disfagia, y los cuidados específicos ante esta, además de una "Guía de Aplicación" y "Comentarios". La experiencia relatada demostró que la construcción de la aplicación fue exitosa y fue evaluada positivamente por los revisores, con la contribución social deseada. Los estudiantes y profesores de Odontología y Logopedia involucrados ampliaron sus habilidades en innovación y competencias interprofesionales. Se requiere más estudios en innovación en la graduación en salud, ya que es un área en expansión en el mercado, con un gran aporte para la actualización de los profesionales de la salud (AU).

The authors report the experience of developing the prototype of an application on oral hygiene for elderly individuals with dementia, with special attention to those with dysphagia, aimed at guiding their caregivers. The purpose was also to describe the role of this experience as a strategy for interprofessional education and social innovation for dentistry and speech-language pathology students. A qualitative study of the experience was conducted, gathering information from verbal narratives and written and iconographic records of the researchers, as well as written reports from two reviewers of the application prototype­both experts in Gerontology. The website SeuApp.com website was used for the prototype, which required no programming, generating an application format and a website for desktop and mobile. The product was developed in three phases, successfully completed, and positively evaluated by the reviewers. Its content included written and iconographic information, static and dynamic, regarding the importance and step-by-step process of oral hygiene, its relationships with health and dysphagia, and specific care in the face of the latter, along with an "App Guide" and "Feedback." The reported experience demonstrated that the application's construction was successful and positively evaluated by reviewers, thus achieving the intended social contribution. Dentistry and speech-language pathology students and faculty involved expanded their skills in innovation and interprofessional competencies. Given itsexpanding presence in the market and significant contribution to the ongoing education of healthcare professionals, further studies on innovation in health education are required (AU).

Is there enough evidence that mouthguards do not affect athletic performance? A systematic literature review.

BACKGROUND: Although there is evidence that mouthguards prevent orofacial trauma occurrence during sport practice, the influence of this device on athletic performance has not been systematically quantified. OBJECTIVES: We aim to systematically review the literature to determine the effect of mouthguards on athletic performance and if the type of mouthguard influences this overcome. MATERIALS AND METHODS: A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Scopus, Web of Science and the Cochrane Library from their inception to February 2017. The publications were grouped based on their outcome: (i) the use of mouthguards; or (ii) the type of mouthguards. We conducted descriptive analyses and quality assessments of the included studies. RESULTS: The search identified 489 citations. After screening the studies, we identified 15 trials comprising a population of 312 athletes. According to the risk of bias evaluation, nine studies were considered 'high' risk of bias, and six 'low' risk of bias. Overall, custom-made mouthguards did not interfere or improve athletes' performance when compared with the control group (without mouthguard). Custom-made mouthguards showed the smallest range of changes in players' performance compared with other types of mouthguards. CONCLUSIONS: This systematic review provides evidence for sports professionals to advocate the use of custom-made mouthguards to prevent injury, and these devices do not impair performance. The scientific evidence should be interpreted carefully because there is a great variability in outcome measures and lack of important methodological details.

On the accuracy of some in vitro models for mechanical studies of maxillary removable partial dentures.

OBJECTIVES: Comparative in vitro/in vivo studies show wide differences in functional strain magnitudes and patterns of functional strain distribution in prosthetic devices. The aim of this study was to evaluate the accuracy of three in vitro models for biomechanical studies of prosthetic devices. METHODS: Strain gages were attached to the test RPDs of six subjects. In vitro maxillary models with simple (model A), intermediate (model B) and advanced (model C) features for the anatomical simulation of supporting structures were manufactured for each subject. The dentures were subjected to two separate series of standardized functional and laboratorial loading tests. The principal maximum strain value (epsilon (1)) obtained for each gage and experiment was used to calculate the intra-experiment variance and inter-experiment variance for the in vivo and in vitro experiments. The integrated strain gage difference value between the in vitro and in vivo data (Sigma(diff)) was calculated for every loading test and compared to the in vivo inter-experiment variance with ANOVA and Scheffés test. RESULTS: The bite forces recorded were similar for each subject and loading position and between the two loading sessions. The inter- and intra-experiment variance was found to be higher for in vivo loadings than for in vitro. Results showed that the (Sigma(diff)) values for model B and model C were significantly different from the in vivo strain inter-experiment variance (p<0.05). SIGNIFICANCE: This study showed that the anatomical simulation of in vitro models is insufficient to allow for accurate mechanical analyses of maxillary RPDs and that only simple verifications of the strain levels in prosthetic appliances can be attained in vitro.

Restauraçäo de amálgama: influência do amalgam joint no seu vedamento / Amalgam restoration: amalgam joint influence

Os autores se dispuseram a avaliar a eficácia do verniz cavitário "Amalgam Joint", que se utiliza de micropartículas de prata em sua composiçäo, como agente de vedamento. De acordo com os resultados obtidos, o "Amalgam Joint" mostrou-se capaz de diminuir o espaço entre as paredes cavitárias e a restauraçäo, porém näo impediu a passagem de líquidos através dessa interface