Prosthetic modalities used to treat cleft palate patients in a university clinic: a 10-year review.

Cleft palate patients are not usually seen in general dental clinics, but this congenital anomaly is one of the most frequent of cases. General dental practitioners are usually unwilling or/and not sufficiently trained to treat such patients for whom rehabilitation and interdisciplinary cooperation is often needed. The aim of this study was to determine the incidence of prosthetic modalities most frequently used by licensed prosthodontists for prosthetic rehabilitation of cleft palate patients. Participants in this study were 56 cleft palate patients (aged 23-66 years) who received prosthetic treatment between 2000 and 2010. Patients' dental status and prosthetic modalities used were noted from patient records archived at Department of Prosthodontics, School of Dental Medicine, University of Zagreb. Data analyses revealed that combined prosthetic constructions (fixed + removable, p < 0.05) were the most frequently used. In a group of molar teeth, the most frequent fixed prosthetic modalities were crowns with rests; in a group of premolar teeth, telescopic crowns; on canines, metal ceramic crowns and telescopic crowns; and in a group of incisors, metal ceramic pontics (p < 0.05). Understanding the distribution of prosthetic modalities for cleft palate patients could serve to guide dental practitioners towards planning adequate prosthetic treatment for their patients since only a well-planned prosthetic therapy will result in satisfactory function and alleviation of the deformities.

Prosthetic rehabilitation of a patient with mandibular resection prosthesis using mini dental implants (MDIs)--case report.

Physical disfigurement and functional impairments associated with facial trauma are a challenge to a prosthodontist, because even novel sophisticated surgical reconstructive techniques fail to provide adequate support for dental resection prosthesis. Therefore, different endosseous implants are often used as prosthesis-supporting elements. Manufacturers of dental implants have recently presented mini dental implants (MDIs) with diameter of only 1.8-2.4 mm. These implants allow very suitable prosthetic solutions within the range of their indications due to good osseointegration success rates, simple surgical technique, and immediate loading possibility. In this report, a case was presented for prosthetic rehabilitation including implantation of two Sendax type (IMTEC, Ardmore, Oklahoma, USA) MDIs in mental region, to obtain better retention and stability of the mandibular resection prosthesis and to improve function, phonation and aesthetics. The use of these implants, among aforementioned preferences, is also very cost-effective, so this implantation possibility should be taken into consideration during prosthetic treatment planning.

Comparative study of condylar inclination settings in two types of semiadjustable articulators.

The purpose of this study was to research the possible influence of difference in construction of mechanical joint in arcon and nonarcon articulators, upon the adjustment of condylar inclination by intraoral protrusive record. The determination of condylar inclination by protrusive record in two types of articulators was performed on 30 examinees, and the adjustment of condylar inclination in each articulator was done for left and right joint. In arcon articulator the measured values for condylar inclination were higher and the mean difference for right joint was 7.4 degrees, and for the left joint 7.2 degrees The found differences are statistically significant for both, left and right joint, at the level of P < 0.001. There is possible influence of difference in construction of mechanical joint upon the adjustment of condylar inclination by intraoral protrusive record. The arcon articulator, due to constant relation between occlusal plane and mechanical fossa, reproduces the movements more accurately.

Comparison of flexural strength between fiber-reinforced polymer and high-impact strength resin.

Fractures of polymer material are one of the most frequent reasons for the repair of removable dental prostheses. Therefore, there is a constant endeavor to strengthen them, and polymer materials with high resistance to fracture are being developed. The aim of this study was to determine the flexural strength of polymer materials and their reinforcements and thus give preference to their clinical use. Specimens with dimensions 18 x 10 x 3 mm were tested after polymerization, immersion in water at a temperature 37 degrees C for 28 days, and thermocycling by using the "short-beam" method to determine the flexural strength. Microscopic examination was performed to determine the quality of bonding between the glass fibers and matrix. Common polymer materials (control group) demonstrated the lowest flexural strength, although, when reinforced with fibers they showed higher flexural strength, matching that of the tested high-impact strength resin. Thermocycled specimens had the highest flexural strength, whereas there was no difference (p > 0.05) between specimens tested after polymerization and immersion in water.

Severe Generalized Periodontitis in a Patient with an Aplastic Anemia: a 5 Year Follow-up Case Report.

Aplastic anemia is a hematological disorder characterized by pancytopenia. This case report presents a young patient with untreated periodontitis associated with hematological disorders, and cyclosporine therapy. During 2 consecutive days, periodontal therapy which consisted of nonsurgical therapy supplemented with an antibiotic treatment and antifibrinolytic therapy was performed. Commercial microbiological PCR tests and periodontitis IL-1 polymorphism risk test were performed. Following the periodontal therapy, the inflammation was resolved and the patient's occlusion was restored by means of removable partial dentures. After the 5 year follow-up, the patient still remained with shallow probing depths although there was inadequate compliance during the maintenance phase. Aplastic anemia increases the risk of onset of severe forms of periodontitis that can be additionally complicated with cyclosporine therapy. In such patients, periodontal therapy must be supplemented with antibiotics.

Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants.

Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation.

Differences in articular-eminence inclination between medieval and contemporary human populations.

The articular-eminence inclination is an important element in the biomechanics of the temporomandibular joint and the entire masticatory system; however, very little is known about this inclination in archaeological human populations. Therefore, the aim of this study was to determine the values of, in addition to the differences between, the articular-eminence inclination in medieval and contemporary human populations. The study was carried out on two dry skull groups. The first group consisted of 14 dry skulls from the medieval culture group Bijelo Brdo (BB) of East Croatia, and the other consisted of 137 recent dry skulls from the osteologic collection of the Institute of Anatomy (IA) in Zagreb. All BB skulls were dentulous, whereas the IA skulls were divided into dentulous and edentulous groups. The articular-eminence inclination was measured in relation to the Frankfurt horizontal plane on digital images of the skull's two lateral views using AutoCAD computer software. The mean value of the articular-eminence inclination in the BB sample group (49.57°) was lower, with a statistical significance (p<0.01), than those of the IA dentulous (61.56°), the IA edentulous (62.54°), and all the combined IA (61.99°) specimens. Because the values of the articular-eminence inclination can vary a lot with reference to the number of specimens and the different methods used for measuring, the obtained values yield only orientational information. Further investigations including a larger number of medieval specimens are needed to confirm the results obtained from this study.