ABSTRACT
AIM: To describe a technique for performing an adhesive oral rehabilitation based on a digital workflow and focused on the integration between esthetic and occlusal aspects in a young patient with a worn dentition. MATERIALS AND METHODS: An adhesive oral rehabilitation with severe loss of dental structure in a 40-year-old male patient is described. The treatment was based on a fully digital workflow (including facial scanning), esthetic and occlusal virtual planning, guided implant surgeries, an adhesive resin prototype, and ceramic restorations. The technique integrates both esthetic and occlusal factors, splitting the dental arches into four sectors and following a stepped sequence with specific objectives for each one. The loss of dental structure was initially rebuilt by an adhesive composite resin full-mouth prototype rehabilitation. This step also helped to confirm the esthetic and occlusal digital planning. After 4 months, lithium disilicate restorations were delivered following the same order, sector by sector, to reduce possible errors when transferring the previously approved anatomy to the final ceramic oral rehabilitation. Lastly, an acrylic nightguard was installed and a 6-month recall program established. RESULTS: An accurate integration between esthetic and occlusal aspects was achieved during digital planning, which was also corroborated by the adhesive resin prototype. The final ceramic restorations fulfilled the patient's esthetic expectations and recovered the occlusal anatomy. CONCLUSIONS: The proposed esthetically guided and occlusally protected (EGOP) technique seems to be a reliable approach to treat patients with worn dentition. Further clinical research and additional proposals are necessary to assess the possible benefits associated with these procedures.
Subject(s)
Dental Cements , Esthetics, Dental , Male , Humans , Adult , Composite Resins/chemistry , CeramicsABSTRACT
PURPOSE: To describe a digitally designed device for improving esthetic and occlusal planning for full-arch implant-supported rehabilitations. MATERIALS AND METHODS: A step-by-step clinical and technical protocol is described to obtain an esthetic rim. Alternatives in terms of design and case requirements and the clinical use of the device are also described. RESULTS/CONCLUSION: An integral approach based on esthetic and functional needs is mandatory in full-arch restorations. The proposed device can improve teamwork and communication, minimizing possible errors. Future proposals are needed to achieve a fully digital protocol in the fabrication of these rehabilitations.
Subject(s)
Dental Implants , Dental Prosthesis, Implant-Supported , Esthetics , Esthetics, Dental , HumansABSTRACT
Objetivos: Realizar una revisión de la literatura sobre métodos de rehabilitación mínimamente invasivos, y presentar un caso clínico acerca de un nuevo procedimiento denominado sistematización adhesiva temporaria (SAT), destinado a pacientes que presentan pérdida de sustancia dentaria y que se caracteriza como un abordaje terapéutico predecible para transferir el proyecto rehabilitador (encerado) a la boca del paciente mediante 3 pasos bien definidos y con objetivos específicos. Caso clínico: Un paciente adulto joven de sexo masculino con desgastes severos por bruxismo es rehabilitado temporalmente con resinas compuestas (SAT) para devolver la anatomía perdida en forma adhesiva y conservadora, siguiendo un protocolo de abordaje terapéutico predecible denominado EGOP (estéticamente guiado y oclusalmente protegido). Este procedimiento, que es considerado muchas veces de transición previo a las restauraciones finales, nos permite evaluar la estética, la oclusión y mejorar la comunicación entre el equipo de trabajo para poder realizar el cambio por restauraciones cerámicas en forma gradual. En aquellos pacientes que necesitan rehabilitaciones totales producto del desgaste dentario severo, la SAT puede ser una herramienta que facilite al odontólogo la posibilidad de restablecer los patrones oclusales y estéticos perdidos sin la necesidad de realizar desgastes dentarios y provisionales como se hacía clásicamente (AU)
Aims: To carry out a literature review on minimally-invasive rehabilitation methods and to present a clinical case on a new procedure called Temporary Adhesive Systemization (TAS), intended for patients that show a considerable loss of dental substance, characterized by a predictable therapeutic approach to transfer the rehabilitation diagnosis wax-up through 3 well defined steps and with specific objectives to the patient´s dentition. Clinical case: A young adult male patient with severe wear due to bruxism is temporarily rehabilitated with composite resins (TAS) to return the lost anatomy in a conservative way, following a predictable therapeutic approach protocol called EGOP (aesthetically guided and occlusally protected). This procedure, which is often considered transitional prior to final restorations, allows us to evaluate aesthetics, occlusion, improve communication between the working team and to be able to gradually change for ceramic restorations. In patients that need full rehabilitation due to severe dental erosion, TAS is a predictable procedure that helps the dentist to re-establish the loss of aesthetical and occlusal patterns, without the need of preparing the teeth for the classic provisional restorations (AU)
Subject(s)
Humans , Male , Middle Aged , Tooth Erosion/therapy , Bruxism/rehabilitation , Dental Restoration, Temporary , Esthetics, Dental , Tooth Wear/therapy , Conservative Treatment , Ceramics , Dental Bonding , Lithium Compounds , Composite Resins , Dental OcclusionABSTRACT
OBJECTIVES: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs. conventional impressions and assessing the accuracy of static computer-aided implant surgery (s-CAIS) and patient-related outcome measurements when using s-CAIS were addressed. MATERIALS AND METHODS: The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted. RESULTS: Static computer-aided surgery (s-CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s-CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent. CONCLUSIONS: Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s-CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s-CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care.
Subject(s)
Computer-Aided Design , Cone-Beam Computed Tomography/methods , Imaging, Three-Dimensional/methods , Surgery, Computer-Assisted/methods , Consensus , Databases, Factual , Dental Implantation, Endosseous , Dental Impression Technique , Dental Prosthesis, Implant-Supported , Humans , Mouth, Edentulous/surgery , Patient Care Planning , Patient Reported Outcome Measures , Reproducibility of Results , SoftwareABSTRACT
O presente artigo apresenta o relato de dois casos clínicos onde através de uma técnica alternativa de incisão vertical foram removidos tecidos ósseos da região de sínfise mentual para aumento de volume ósseo em outra região para posterior reabilitação com implante osseo integrado. No primeiro relato em um paciente de 40 anos foi removido osso autógeno em bloco da sínfise mentual com a técnica da incisão vertical para aumento vertical na região da pré-maxila associado com biomaterial e posteriormente instalados dois implantes cilíndricos na região dos 12 e 22. O segundo relato, em paciente com 72 anos, removeu osso particulado da região de sínfise mentual e procedeu-se a enxertia do seio maxilar através da técnica da janela lateral e ambas as áreas utilizaram a técnica da incisão vertical.Constatou-se em ambos os casos minimização de edemas e sintomatologia dolorosa pós-operatórias e nenhum paciente relatou parestesia na região doadora, algo comum em casos com a remoção pela técnica tradicional.
This paper presents a report of two cases where using an alternative technique of vertical incision were removed bone tissue of the symphysis chin region to increase bone volume in another region for later rehabilitation with osseointegrated implant. The first report on a 40 year old patient was removed autogenous bone in the chin symphysis block with the vertical incision technique for vertical increase in pre maxilla associated with biomaterial and then installed two cylindrical implants in the region of 12 and 22. The second account in patients with 72 years removed particulate bone symphysis chin region and decided to graft the maxillarysinus through the lateral window technique and both areas have used the technique of vertical incision. It was found in both cases minimizing swelling and postoperative painful symptoms and no patients reported numbness in the donor area, something common in cases with removing the traditional technique.
Subject(s)
Humans , Male , Female , Adult , Aged , Bone Transplantation , Dental Implantation , Dental Implantation/adverse effects , Dental Implantation/methods , Dental Implantation , Transplantation, Autologous/adverse effects , Transplantation, Autologous/methods , Transplantation, Autologous/trends , Transplantation, AutologousABSTRACT
A carga imediata de implantes no maxilar inferior está certificada por numerosos estudos demonstrando previsibilidade e taxa de êxito similares ou ainda maiores que na carga convencional. O propósito deste artigo foi reportar uma técnica protocolar de colocação de quatro a seis implantes com tratamento de superfície no maxilar inferior, mediante a utilização de um guia de transferência translúcido (GTT). A utilização deste dispositivo simplifica a localização dos implantes, sua transferência e a realização de registros estéticos e intermaxilares. A prótese parafusada é feita no laboratório e os implantes são carregados dentro de 72 horas. No presente artigo, descreveu-se as etapas pré-operatórias, cirúrgico protéticas, de elaboração da prótese, instalação e controles posteriores. Um total de 20 pacientes (111 implantes) foi tratado com este protocolo e controlado durante 18 meses (+/- três meses). A taxa de sobrevida dos implantes foi de 100% e das próteses foi de 95%...
Immediate implant loading in the lower jaw is supported by numerous studies demonstrating predictability and a success rate similar or even greater than conventional loading. The purpose of this article is to report a protocol technique placing four to six rough-surface implants in the mandible by means of a Translucent Transference Guide (T.T.G.). The use of this device simplifi es implant location, transferring, as well as aesthetic and intermaxillary records. A screwed prosthesis was made by the dental technician and the implants were loaded within 72 hours. This article describes the pre-surgical, surgical prosthetic steps, prosthesis fabrication, delivery, and subsequent tests. A total of 20 patients (111 implants) were rehabilitated with this protocol and controlled for 18 months (+-3 months). The implant survival rate was 100% and the prosthetic success rate was 95%...
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Dental Implants , Immediate Dental Implant Loading , Mandible , Prostheses and ImplantsABSTRACT
En el presente artículo se reveen los conceptos que tratan la problemática del trauma periodontal por oclusión (TPO) desde su comienzo hasta la actualidad. Se describen las consecuencias de las fuerzas oclusales en el periodonto cuanto éste pierde la capacidad de adaptación ante las mismas o cuando éstas exceden la capacidad de adaptación del periodonto. Luego, los factores que puedenproducir un desequilibrio biomecánico en el sistema gnático necesarios para generar TPO. Por último, se propone un enfoque de tratamiento multidisciplinario para cada uno de los tipos de TPO, ilustrando cada uno de ellos con casos clínicos
Subject(s)
Periodontal Diseases/etiology , Periodontal Diseases/therapy , Dental Occlusion, Traumatic/pathology , Patient Care Team , Biomechanical Phenomena , Bruxism/physiopathology , Periodontium/physiopathology , Alveolar Process/physiopathology , Stomatognathic System/physiopathologyABSTRACT
En el presente artículo se reveen los conceptos que tratan la problemática del trauma periodontal por oclusión (TPO) desde su comienzo hasta la actualidad. Se describen las consecuencias de las fuerzas oclusales en el periodonto cuanto éste pierde la capacidad de adaptación ante las mismas o cuando éstas exceden la capacidad de adaptación del periodonto. Luego, los factores que puedenproducir un desequilibrio biomecánico en el sistema gnático necesarios para generar TPO. Por último, se propone un enfoque de tratamiento multidisciplinario para cada uno de los tipos de TPO, ilustrando cada uno de ellos con casos clínicos (AU)
Subject(s)
Periodontal Diseases/etiology , Periodontal Diseases/therapy , Dental Occlusion, Traumatic/pathology , Patient Care Team , Bruxism/physiopathology , Periodontium/physiopathology , Alveolar Process/physiopathology , Biomechanical Phenomena , Stomatognathic System/physiopathologyABSTRACT
Prólogo, Alberto Bustamante. Prefacio, Alberto Horacio Bechelli. Carga inmediata en implantología oral. La implantología oseointegrada y los grandes cambios. Biología aplicada a la implantología con carga inmediata. Carga inmediata introducción al diagnóstico. Técnicas actuales en diagnóstico por imágenes en cirugía implantológica. Planificación en implantología con carga inmediata. Carga inmediata: primera parte protocolo diagnóstico. Segunda parte: protocolo quirúrgico-protético. Prótesis implantoasistida y carga inmediata. Oclusión en implantología con carga inmediata. Segunda parte: Casos clínicos con carga inmediata. Carga temprana e inmediata en un desdentado parcial. Carga inmediata en un desdentado total
Subject(s)
Dental ImplantsABSTRACT
Prólogo, Alberto Bustamante. Prefacio, Alberto Horacio Bechelli. Carga inmediata en implantología oral. La implantología oseointegrada y los grandes cambios. Biología aplicada a la implantología con carga inmediata. Carga inmediata introducción al diagnóstico. Técnicas actuales en diagnóstico por imágenes en cirugía implantológica. Planificación en implantología con carga inmediata. Carga inmediata: primera parte protocolo diagnóstico. Segunda parte: protocolo quirúrgico-protético. Prótesis implantoasistida y carga inmediata. Oclusión en implantología con carga inmediata. Segunda parte: Casos clínicos con carga inmediata. Carga temprana e inmediata en un desdentado parcial. Carga inmediata en un desdentado total
