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1.
J Oral Implantol ; 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38549253

RESUMO

Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CD) or Implant Retained-Overdentures (IOD), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CD and IOD are the two leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the [redacted for peer review] from 2014 to 2016 with at least one year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IOD had lower physical pain, limitations, and concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IOD and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.

2.
J Oral Implantol ; 49(5): 485-494, 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37776245

RESUMO

This case report presents a literature review and a case report of a full-mouth implant rehabilitation for a 65-year-old woman with a history of Bruxism. The patient's oral condition showed dentition with severe occlusal wear, extensive dental work, and missing teeth replaced with bridges and implants. The existing dental work was failing due to recurrent caries and the mechanical failure of long-span bridges. The unique aspect of the treatment presented in this report is the management of existing osseointegrated implants of different systems with different platform designs, which adds to the treatment's complexity. The existing implants were incorporated into the planned treatment, and other implants were added to support maxillary zirconia and mandibular hybrid full-arch prostheses. After 2 years of function, extensive wear was evident on the milled acrylic, even though an occlusal guard was used. New acrylic teeth were processed using the same milled titanium bar of the mandibular hybrid prosthesis, and the occlusal surfaces of the acrylic teeth were protected with gold onlays. The patient is seen regularly for maintenance every 6 months with no further complications. Careful evaluation, planning, and treatment execution are paramount in managing patients with a history of bruxism. Patients should be prepared and informed about possible mechanical failure and seen regularly for maintenance.


Assuntos
Bruxismo , Implantes Dentários , Feminino , Humanos , Idoso , Bruxismo/complicações , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária
3.
Gen Dent ; 71(2): 48-57, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36825974

RESUMO

The purposes of this case report are to describe the course of treatment for a 29-year-old woman with a chief complaint of spaces in her dentition and to review relevant clinical topics in the literature. The primary etiology of the spacing in this case was a congenitally missing maxillary right lateral incisor and a peg-shaped maxillary left lateral incisor. The clinical diagnosis included skeletal and dental discrepancies in all 3 planes of space; a skeletal and dental open bite; a high and asymmetric smile line with a skeletal occlusal cant; a Class II dental occlusion; a Class III skeletal tendency; and insufficient space for standard-size restoration of the maxillary lateral incisors. A history of poor oral hygiene, multiple restorations, and tooth wear were added challenges. The patient initially requested minimal esthetic procedures. However, during the course of treatment, she changed her treatment goals to achieve optimal esthetics. The case required a multidisciplinary planning approach. This report highlights treatment options, outcomes, and avoidable mistakes for this type of complex case involving high esthetic demands. Additionally, key factors are identified to achieve successful treatment and patient satisfaction.


Assuntos
Anodontia , Mordida Aberta , Humanos , Adulto , Feminino , Estética Dentária , Satisfação do Paciente , Maxila
4.
J Oral Implantol ; 48(6): 533-540, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-35881827

RESUMO

This report describes the predoctoral comprehensive digital implant dentistry program at the University of Kentucky, College of Dentistry (UKCD). UKCD has implemented a digital dentistry workflow in the dental curriculum for predoctoral and graduate programs since 2018. Digital implant dentistry education involves using cone beam computed tomography (CBCT) for diagnosis and treatment planning, intraoral scanner for digital impression, and treatment planning software to plan for single implant-supported restorations and implant-retained mandibular overdenture cases. The laboratory components include virtual designing of a surgical guide and using three-dimensional printing to fabricate a fully guided surgical template for implant placement procedures for the patient. In the last 3 years, including the COVID year, a total of 294 implants have been placed by dental students. Unfortunately, 6 implants failed in the early healing time due to infection, with an overall success rate of 98%. These treatment outcomes are very favorable compared with published literature.


Assuntos
COVID-19 , Implantes Dentários , Humanos , Implantação Dentária/educação , Educação em Odontologia/métodos , Currículo , Tomografia Computadorizada de Feixe Cônico , Desenho Assistido por Computador
5.
J Oral Implantol ; 47(5): 385-393, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33031520

RESUMO

Alveolar ridge preservation maintains ridge dimensions and bone quality for implant placement. The aim of this randomized controlled clinical study is to compare the use of a human amnion-chorion membrane to a collagen membrane in an exposed-barrier ridge preservation technique. Furthermore, this study will determine if intentional membrane exposure compromises ridge dimensions and bone vitality. Forty-three patients requiring extraction and delayed implant placement were randomly assigned into either the experimental or control group. Twenty-one participants received human amnion-chorion membrane (test) during ridge preservation while 22 participants received the collagen membrane (control). In both groups, demineralized freeze-dried bone allografts were used to graft the socket and primary closure was not achieved. The patients underwent implant placement after an average healing period of 19.5 weeks, and 2.7 × 8-mm core bone specimens were obtained for histomorphometric analyses. The clinical ridge dimensions were measured after extraction and at the time of delayed implant placement. No significant difference was observed in the mean vital bone formation between the experimental (51.72 ± 8.46%) and control (49.96 ± 8.31%; P > .05) groups. The bone height and width did not differ, as determined by clinical measurements (P > .05). Using either a human amnion-chorion membrane or type 1 bovine collagen as the open barrier did not change healing, compromise ridge dimensions, or affect bone vitality between the 2 groups.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Processo Alveolar , Âmnio , Animais , Transplante Ósseo , Bovinos , Córion , Colágeno , Colágeno Tipo I , Humanos , Membranas Artificiais , Extração Dentária , Alvéolo Dental/cirurgia
6.
J Oral Implantol ; 46(2): 115-121, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31910068

RESUMO

The purpose of this case report is to present implant-retained maxillary and mandibular complete overdentures in a patient with Marfan syndrome. The patient initially presented with generalized periodontitis (stage IV, grade C). Due to the progressive nature of periodontal disease, the patient elected to have implant-retained maxillary and mandibular complete dentures. Bilateral maxillary sinus augmentation was performed 6 months before full-mouth extraction, alveoloplasty, and immediate implant placement. Maxillary and mandibular immediate overdentures were delivered. After 4 months of healing, the final overdenture was fabricated. The patient was seen regularly throughout the healing process for peri-implant maintenance. Soft-tissue grafts were completed to increase the thickness of the mucosa around the implants. The patient has been followed for 2 years and is functioning well without major complications. For patients with Marfan syndrome, implant-retained prostheses are a viable treatment option in the presence of a failing dentition.


Assuntos
Implantes Dentários , Síndrome de Marfan , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Humanos , Mandíbula , Reabilitação Bucal
7.
Implant Dent ; 28(1): 20-27, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30461439

RESUMO

PURPOSE: To evaluate the effectiveness of collagen matrix (CM) grafts as an alternative to free gingival grafts (FGGs) in increasing the zone of keratinized tissue (KT) around dental implants. METHODS: Thirty subjects with 2 contralateral implants were recruited. The test group (n = 30) received CM grafts. The control group (n = 30) received FGGs. Clinical variables were plaque index, gingival index, probing depths, bleeding on probing (BOP), and mucosal recession (MR). Subjects were followed at 1 and 2 weeks and 1, 3, and 6 months. RESULTS: FGGs resulted in mean gains (3.73 ± 1.93 mm) in KT for 28 of 30 implants (93% success rate). CM grafts resulted in mean gains (3.23 ± 1.52 mm) in KT for 29 of the 30 implants (97% success rate). Mean change in pocket depth around implants grafted with FGG was -0.24 ± 1.02 mm and with CM was -0.25 ± 0.80 mm. Mean change in BOP around implants grafted with FGG was 0.03 ± 0.49 and with CM was 0.13 ± 0.57. CONCLUSION: CM grafts achieved results comparable to those of FGGs in augmented tissue. They do not negatively affect probing depths, MR, or bleeding on probing.


Assuntos
Colágeno/uso terapêutico , Implantação Dentária Endóssea/métodos , Implantes Dentários , Gengiva/transplante , Mucosa Bucal/cirurgia , Adulto , Idoso , Feminino , Humanos , Kentucky , Queratinas , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Resultado do Tratamento
8.
J Oral Implantol ; 45(5): 378-389, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31389755

RESUMO

This clinical study aimed to clinically and radiographically compare the implant survival rate and peri-implant tissue response between immediate and delayed loading protocols for unsplinted implant retained mandibular overdentures. Twenty patients were enrolled to participate in this study. Each subject was randomly assigned to 1 of 2 treatment groups: test group patients' implants (n = 10), which were immediately loaded, and control group patients' implants (n = 10), which were conventionally loaded. Locator abutments were torqued to 15 Ncm at delivery. Attachments were picked up intraorally immediately after implant placement for the test group and at 3 months for the control group, and 3-lb retention inserts were placed. Marginal bone levels based on cone beam computed tomography fixed reference points were recorded at baseline and 12 months. Modified plaque index, gingival index, and implant stability quotients were recorded at baseline, 3 months, and 12 months. After 12 months, implant survival rate was 100% in both groups. Marginal bone levels, keratinized mucosa, modified plaque index, and gingival index were significantly different among the groups at 3- and 12-month intervals, whereas no significant differences were found in implant stability quotients between the groups. The fact that implant survival rate was 100% in both treatment groups suggests that, within the limitations of this study, immediate loading protocol for unsplinted implant retained mandibular complete overdenture is as predictable, safe, and successful as the delayed loading protocol. Implementing the immediate loading protocol for mandibular implant retained overdentures could shorten treatment time, which could lead to better patient's satisfaction.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Arcada Edêntula , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Seguimentos , Humanos , Mandíbula , Resultado do Tratamento
9.
J Int Acad Periodontol ; 17(2): 58-64, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26242012

RESUMO

OBJECTIVE: The main aim of this study was to develop a simplified quantitative denture plaque index that could help dentists to motivate denture patients to maintain optimal oral hygiene. The secondary aim was to assess specific areas of dentures more prone to accumulate plaque and subjects' oral hygiene habits related to their dentures. METHODS: One hundred subjects who wore maxillary and/or mandibular complete dentures for at least one year were included in the study as a powered sample. Fifteen females and 85 males, age range 45-75 years, were recruited. The study was carried out at King Saud University (KSU), College of Dentistry. A plaque disclosing solution was used to assess the plaque covered areas of denture. A quantitative percentage (10 x 10%) score index was developed by assessing plaque scores from digital images of intaglio surfaces of the dentures. The weighted kappa method was used to assess inter-examiner agreement in the main study. RESULTS: The new denture plaque index was identified as ASKD-DPI (Almas, Salameh, Kutkut, and Doubali-Denture Plaque Index). It ranged from 0 - 100%, and reflected the percentage of the intaglio surfaces of maxillary and mandibular complete dentures that contained plaque. It also classified quantitative percentages: 30 subjects ranged from 0 - 30% (low DPI), 50 subjects ranged from 31 - 70% (moderate DPI), and 20 subjects ranged from 71 - 100% (high DPI) denture plaque score. CONCLUSIONS: A simplified denture plaque index (ASKD-DPI) technique was developed and tested in this study. ASKD-DPI may be used for evaluating denture plaque scores, monitoring denture hygiene, and measuring compliance of patients regarding plaque control for complete dentures.


Assuntos
Índice de Placa Dentária , Bases de Dentadura , Prótese Total , Idoso , Corantes , Placa Dentária/classificação , Prótese Total Inferior , Prótese Total Superior , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Fotografação/métodos , Propriedades de Superfície
10.
J Int Acad Periodontol ; 17(2): 34-41, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26242009

RESUMO

OBJECTIVE: The purpose of this case report is to present the clinical course of full mouth rehabilitation in an 1 8-year-old female patient with ectodermal dysplasia who was treated with implant-supported fixed partial dentures for the mandible and the maxilla. CASE REPORT: Fourteen dental implants (8 in the maxilla and 6 in the mandible) were placed simultaneously after full mouth extraction and alveoloplasty surgery. After 6 months of healing, prosthetic rehabilitation was started for screw-retained fixed partial dentures. The patient was followed for one year and a peri-implant maintenance regime established for six-month recalls. The patient was satisfied with the prosthesis both esthetically and functionally. Furthermore, the patient reported significant improvements in oral function and psychosocial activities. CONCLUSION: The use of dental implants to support full mouth prosthetic rehabilitation for adolescents with ectodermal dysplasia may provide a considerable improvement in function and esthetic compared to conventional removable prosthetic options. This has the potential to enhance the quality of life for these patients.


Assuntos
Prótese Dentária Fixada por Implante , Prótese Parcial Fixa , Displasia Ectodérmica/complicações , Reabilitação Bucal , Adolescente , Alveoloplastia/métodos , Anodontia/reabilitação , Implantação Dentária Endóssea/métodos , Planejamento de Dentadura , Estética Dentária , Feminino , Seguimentos , Humanos , Mandíbula/cirurgia , Maxila/cirurgia , Osseointegração/fisiologia , Planejamento de Assistência ao Paciente , Satisfação do Paciente , Extração Dentária/métodos , Resultado do Tratamento
11.
J Oral Implantol ; 50(3): 266-276, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38839070

RESUMO

Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.


Assuntos
Prótese Dentária Fixada por Implante , Prótese Total , Revestimento de Dentadura , Satisfação do Paciente , Qualidade de Vida , Faculdades de Odontologia , Humanos , Masculino , Feminino , Prótese Dentária Fixada por Implante/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Idoso , Clínicas Odontológicas , Adulto , Arcada Edêntula/reabilitação
12.
J Oral Implantol ; 50(5): 474-480, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39069796

RESUMO

This study examined the association between a dental implant and changes in adjacent teeth over time. Electronic health records of 1818 patients who received a dental implant were retrospectively evaluated over 14 years (2005-2019) in a university setting. The status of the adjacent tooth and vertical and horizontal distance from the implant platform to adjacent teeth were determined using digital intraoral radiographs taken at baseline and the last follow-up visit (1-14 years, median 4 years). In total, 1085 dental implants were evaluated. There were 234 instances of a change in the adjacent tooth. Decay was observed in 83 (7.6%) of adjacent teeth; the mean time to development was 4 years (range 1-14 years). Approximately 9% of adjacent teeth received direct restorations, 4.8% received indirect restorations, 1% received endodontic root canal treatment, and 5.6% were extracted. The mean horizontal distance between the implant platform and the adjacent teeth was 3.56 mm; the mean vertical distance from the contact point to the alveolar crest on the tooth side was 6.2 mm at the first time of the reported decay on X ray. These distances did not significantly influence the occurrence of caries. The prevalence of interproximal contact loss was higher on the mesial of the implant crown at 63% compared with 20% on the distal side. This large retrospective analysis identified that teeth adjacent to a dental implant were at risk of decay and changes in their condition. In addition, the implant-to-tooth distance and inadequate emergence profile may contribute as caries risk factors in addition to hygiene and a high sugar level diet. These findings appear essential for clinicians when making treatment decisions and discussing outcomes with patients.


Assuntos
Cárie Dentária , Implantes Dentários , Humanos , Estudos Retrospectivos , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/epidemiologia , Feminino , Prevalência , Masculino , Implantes Dentários/efeitos adversos , Pessoa de Meia-Idade , Adulto , Idoso , Radiografia Dentária , Adulto Jovem , Restauração Dentária Permanente/efeitos adversos , Adolescente
13.
J Int Acad Periodontol ; 15(4): 113-24, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24364175

RESUMO

OBJECTIVE: The aim of this report was to clinically and radiographically evaluate changes to the hard and soft tissues around implants placed in extraction sockets grafted with medical grade calcium sulfate hemihydrate (MGCSH) mixed with platelet-rich plasma (PRP) and a collagen resorbable plug after one year of function. METHODS: This evaluation was part of a previous study conducted to evaluate extraction socket grafts. Fourteen subjects out of 16 were evaluated. After tooth extraction, eight subjects received MGCSH mixed with PRP in the extraction sockets (test group), and six subjects received collagen resorbable plug dressing material (control group). After three months of bone healing, dental implants were placed. Three months after implant installation, provisional restorations were placed and implants were loaded in function for one month followed by definitive restorations. Follow-up examinations and intraoral digital radiographs were made at baseline and one year after definitive restorations to evaluate the marginal bone level in each subject. RESULTS: At the one-year follow-up, the survival and success rate was 100% for all implants. There was no statistically significant difference in the amount of vertical bone loss between groups after 1 year (p > 0.05). For the test group, there was a mean mesial bone loss of -0.8 +/- 0.6mm and a mean distal bone loss of -0.5 +/- 0.4mm. For the control group, there was a mean mesial bone loss of -1.1 +/- 0.7mm and a mean distal bone loss of -0.6 +/- 0.6mm. CONCLUSIONS: At the one-year follow-up, the implant placement in grafted sockets was not affected by the type of the graft material. Implants placed in sockets grafted with MGCSH mixed with PRP showed less marginal bone loss after one year in comparison to those with collagen resorbable grafts.


Assuntos
Sulfato de Cálcio/uso terapêutico , Implantes Dentários para Um Único Dente , Plasma Rico em Plaquetas , Alvéolo Dental/cirurgia , Adulto , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Regeneração Óssea , Substitutos Ósseos , Transplante Ósseo , Colágeno/uso terapêutico , Dente Suporte , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Dentária Digital , Alvéolo Dental/diagnóstico por imagem , Adulto Jovem
14.
J Int Acad Periodontol ; 15(3): 91-8, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24079101

RESUMO

PURPOSE: The purpose of this study was to histologically evaluate newly generated vital bone using porous granules of bioactive and resorbable silica-calcium phosphate nanocomposite (SCPC) in extraction sockets. MATERIAL AND METHODS: Six patients with a non-restorable maxillary central incisor requiring extraction followed by implant placement participated in the study. Extraction sockets were grafted with granules of SCPC. After 6 months, a bone core sample was retrieved from the center of the healed socket for histologic analysis, and dental implants were placed. Alveolar bone width was clinically assessed immediately after tooth extraction and 6 months after bone grafting, at the time of implant placement. Alveolar bone height was radiographically assessed immediately after tooth extraction and 6 months after extraction. RESULTS: Histomorphometric analyses of sockets grafted with SCPC for 6 months revealed 46.8% +/- 14% new vital bone and 2.5% +/- 1.5% graft material remnants. In these sockets, the mean bone height resorption over the 6-month period of healing was 1.6 mm +/- 1.5 mm. The mean bone width resorption of 2 mm +/- 0.7 mm was found at the bone crest. CONCLUSION: The results of this study suggest that SCPC graft material reduces the amount of change in alveolar ridge dimensions after tooth extraction and facilitates the regeneration of new vital bone.


Assuntos
Implantes Absorvíveis , Aumento do Rebordo Alveolar/métodos , Substitutos Ósseos/uso terapêutico , Fosfatos de Cálcio/química , Silicatos/química , Alvéolo Dental/patologia , Adulto , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/patologia , Biópsia , Regeneração Óssea/fisiologia , Reabsorção Óssea/patologia , Substitutos Ósseos/química , Capilares/patologia , Implantação Dentária Endóssea , Seguimentos , Ósteon/patologia , Humanos , Incisivo/cirurgia , Maxila/diagnóstico por imagem , Maxila/patologia , Osteoblastos/patologia , Osteócitos/patologia , Osteogênese/fisiologia , Porosidade , Radiografia , Extração Dentária/métodos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Cicatrização/fisiologia , Adulto Jovem
15.
Dent J (Basel) ; 11(3)2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-36975578

RESUMO

Complete denture fabrication requires multiple clinical and laboratory steps. One of the most critical clinical steps is establishing an anatomical occlusal plane based on hard and soft tissue references. The aim of this study was to determine whether age or gender affects the level of the Ala-Tragus plane to establish which reference point on the Tragus should be used when fabricating the occlusal plane in edentulous patients. Clinical photographs and lateral cephalometric radiographs with complete dentitions were taken from 58 volunteers at the DMD clinic at the University of Kentucky. Each photograph was superimposed over its corresponding cephalometric image. An analysis was conducted to establish the angle of the occlusal plane relative to the Ala-Tragus landmarks; this data was then grouped according to age and gender. The analysis shows that age and gender did not significantly affect where the Camper's plane should be approximated for complete denture treatment. However, it was found that the most parallel line to the occlusal plane was Ala's inferior border to the 'Tragus's inferior border. It should be noted that the volunteers' skeletal classification was significantly related to a Cl III malocclusion tendency. Still, with this new information, functionality and esthetics can be more adequately addressed for patients undergoing complete denture treatment. Given our results, we suggest redefining the 'Camper's plane with a line extending from 'Ala's inferior border to the 'Tragus's inferior border instead of the superior border. Further consideration should be taken if the patient is a skeletal CL III malocclusion.

16.
J Int Acad Periodontol ; 14(3): 62-8, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22908535

RESUMO

OBJECTIVE: The aim of this one-year, re-entry case series was to evaluate clinically the amount of bone regeneration following the placement of immediate implants in fresh extraction sockets where bone allograft has been used to treat horizontal gaps and buccal-bone dehiscence defects in periodontally compromised patients. METHODS: Sixteen patients consented to participate, each having one immediate implant with > 3 mm buccal dehiscence bone defects and > or = 2 mm horizontal defects between the implant and socket wall. Peri-implant defects were treated using a demineralized freeze-dried bone allograft and a bioresorbable collagen membrane. Measurements of the vertical and horizontal bone defects were performed at 4 sites: buccally, mesially, distally and lingually, and were done at baseline and at 1-year follow-up. RESULTS: The mean reduction in vertical defects between baseline and re-entry for all sites was 2.42 mm (p = 0.0005). Compared to lingual sites, the buccal sites showed the greatest resolution in vertical defects dimension (6.37 mm), followed by proximal sites (0.78 mm). The overall mean reduction in horizontal defects was 1.59 mm (p < 0.0001). Compared to lingual sites, the buccal sites showed the greatest resolution in horizontal gap dimension (3.2 mm), followed by proximal sites (0.8 mm). Age, defect location in the mouth and implant length did not show significant effectson the reduction in defect dimension during the first year. CONCLUSIONS: A partially missing buccal plate was not a critical factor for implant success and bone regeneration of immediate implants in patients with a history of periodontal disease regardless of the time of implant loading (immediate/conventional).


Assuntos
Perda do Osso Alveolar/cirurgia , Matriz Óssea/transplante , Regeneração Óssea , Implantação Dentária Endóssea/métodos , Regeneração Tecidual Guiada Periodontal/métodos , Carga Imediata em Implante Dentário , Cirurgia de Second-Look , Alvéolo Dental/cirurgia , Implantes Absorvíveis , Adulto , Idoso , Colágeno , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Funções Verossimilhança , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Tempo
17.
Gen Dent ; 60(6): e398-403, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23220319

RESUMO

An esthetic restoration supported by dental implant rehabilitation is a major challenge to restorative dentists. The ultimate goal of a dental implant is to restore missing or extracted teeth by placing implants in anatomically, esthetically, and long-term functional restorations. Alveolar ridge preservation and site enhancement following tooth extraction has a major impact on the hard and soft tissue volume. Extraction socket preservation is technique sensitive, not 100% successful, and at times unpredictable. Current techniques may delay surgical implant placement for a few months, and the quality of new bone regeneration is questionable. The aim of this report was to describe a minimally traumatic extraction socket preservation technique using different types of bone graft as a preserver prior to implant placement applied for 80 consecutive cases.


Assuntos
Aumento do Rebordo Alveolar/métodos , Implantes Dentários , Estética Dentária , Alvéolo Dental/cirurgia , Implantes Absorvíveis , Processo Alveolar/patologia , Regeneração Óssea/fisiologia , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Implantação Dentária Endóssea/métodos , Seguimentos , Regeneração Tecidual Guiada Periodontal/métodos , Humanos , Membranas Artificiais , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Osteogênese/fisiologia , Extração Dentária/métodos , Resultado do Tratamento
18.
Implant Dent ; 20(6): 413-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22071496

RESUMO

PURPOSE: To propose a clinical recommendation based on anatomy of maxillary sinus before sinus augmentation procedure using presurgical computerized axial tomography (CAT) scan images. MATERIALS AND METHODS: CAT scan images were randomly selected from previous completed implant cases. Proposed area for the lateral window osteotomy was outlined on the panorex image of the CAT scan. Sagittal section on the CAT scan that was in the center of the outlined window was selected for sinus measurement analysis. On CAT scan, 2 lines were drawn to measure the dimensions of sinus. One line measured the horizontal width and the other line measured the vertical height. RESULTS: Based on the measurement data, a classification of the maxillary sinus anatomy was proposed. Narrow sinus cavity indicates favorable type anatomy in terms of bone regeneration healing and wide sinus cavity as less favorable anatomy for patient treatment planning. CONCLUSION: A narrow sinus and greater exposure to the blood supply should require shorter healing times after grafting. Conversely, wider sinus cavities and less exposure to the blood supply would require a longer healing time before implant placement.


Assuntos
Seio Maxilar/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Levantamento do Assoalho do Seio Maxilar/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Regeneração Óssea/fisiologia , Cefalometria/métodos , Classificação , Implantação Dentária Endóssea/métodos , Humanos , Seio Maxilar/irrigação sanguínea , Pessoa de Meia-Idade , Osteotomia/métodos , Cuidados Pré-Operatórios , Radiografia Panorâmica/métodos , Fatores de Tempo , Cicatrização/fisiologia
19.
J Long Term Eff Med Implants ; 20(4): 295-301, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21488822

RESUMO

Medical-grade calcium sulfate has been successfully used for several decades as a bone filler and as a carrier with medications or bone growth factors for the treatment of bone defects. The present review illustrates the biological behavior and clinical outcomes of this material when used in clinical implant dentistry. Furthermore, the review illustrates the different indications specifically related to implant dentistry when medical-grade calcium sulfate has been used alone or in combination with bone grafting materials. The histological published evidence is reviewed together with successful clinical results. This material, well known since the 1800's, continues to be used by clinicians and researchers worldwide, and the latest scientific evidence clearly indicates that medical-grade calcium sulfate can be used alone or in combination with biologically active proteins in applications such as socket preservation, ridge augmentation, and sinus lift procedures.


Assuntos
Sulfato de Cálcio/uso terapêutico , Implantação Dentária/métodos , Materiais Dentários/uso terapêutico , Regeneração Óssea , Substitutos Ósseos/uso terapêutico , Sistemas de Liberação de Medicamentos , Humanos
20.
Int J Implant Dent ; 6(1): 25, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32596764

RESUMO

PURPOSE: This study aimed to evaluate the quality and quantity of newly generated bone in the maxillary sinus grafted with stem cell-based allograft material. METHODS: This study was a single site, prospective, blinded, randomized, and controlled clinical trial. Eleven subjects with 18 edentulous posterior maxillary sites requiring sinus augmentation for delayed implant placement using a lateral window approach were enrolled. At the time of sinus augmentation, test sinus was grafted with stem cell-based allograft (Osteocel Plus; NuVasive Therapeutics), while the control sinus was grafted with conventional cortico-cancellous allograft (alloOss; ACE Surgical). Cone beam computer tomography (CBCT) scan was taken before and 14 weeks post-sinus augmentation procedure, i.e., 2 weeks before implant placement. Thirty-six trephined core bone biopsies were harvested from the anterior and posterior grafted lateral-window osteotomy sites at the time of implant placement. RESULTS: The results showed a statistically significant difference in the vital bone percentage between the test and the control groups at the posterior grafted sites (p = 0.03). There was no significant difference in the percentage of vital bone between the anterior and posterior grafted sites within the test and control groups (p > .05). The CBCT analysis showed that the maxillary sinuses at the posterior grafted sites were statistically wider than those at the anterior grafted sites in both groups (p < .05). CONCLUSIONS: Different allograft bone materials can be used in the maxillary sinus augmentation procedures. Stem cell allograft has more osteogenic potential with a better outcome in the wide posterior sinus.

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