Assessment of Satisfaction Level of Edentulous Patients Rehabilitated with Implant-Supported Prostheses.

PURPOSE: Edentulism usually leads to esthetic, functional, and emotional discomfort resulting in a loss of self-esteem and a decrease of the patient's quality of life. Dental implants provide new possibilities to ensure the comfort and efficacy of prosthetic rehabilitation. The aim of this study was to evaluate the satisfaction level of patients rehabilitated using the Brånemark protocol or overdenture implant-supported prostheses. MATERIALS AND METHODS: Fifty-two patients were rehabilitated using the Brånemark protocol and 23 using overdenture prostheses. Then, an adapted oral health-related quality of life questionnaire was administered in addition to a clinical exam to determine the condition of the dental implants and prostheses. The results for treatment expectation, understanding of the type of treatment, phonetic function, chewing comfort, pain, and self-esteem improvement were analyzed with Fisher exact test (P ≤ .05). RESULTS: Both treatments presented satisfaction of above 87%, with no statistical difference between them. Eighty-two percent of patients treated with overdenture prostheses and 80.8% of those treated with the Brånemark protocol had no complaint of pain (P = .087). CONCLUSION: The treatments analyzed in this study were highly satisfactory with regard to functional and esthetic factors, resulting in an increase in self-esteem and quality of life. The psychological factor is a complex variable in patient satisfaction that directly influences quality of life. Considering the desires of patients in choosing the type of prosthesis is critical to treatment success.

Aluminum Oxide Sandblasting of Hexagonal Coping and Abutment: Influence on Retention and Marginal Leakage Using Temporary Cements.

PURPOSE: To compare the tensile strength and marginal leakage of prefabricated abutments/copings, with or without surface sandblasting with aluminum oxide, luted with a calcium hydroxide-based temporary cement (CH, Dycal; Dentsply, Petrópolis, RJ, Brazil) or a noneugenol zinc oxide cement (ZO, Temp Bond NE; Kerr, Orange, CA). MATERIALS AND METHODS: A total of 48 CeraOne abutment analogs and respective copings were divided into 6 groups (n = 8) according to the component that was sandblasted: the coping only, coping + abutment or no sandblasting and the temporary cement used: CH or ZO. After cementation, the samples underwent 500 thermal cycles (5°C ± 2°C and 55°C ± 2°C) and were subsequently immersed in an aqueous solution of 0.5% basic fuchsine dye for 24 hours. Next, the tensile test was performed, and microleakage was assessed qualitatively. Data were analyzed using Mann-Whitney, Kruskal-Wallis tests, followed by the Student-Newman-Keuls test (α = 0.05). RESULTS: CH cement showed a tensile strength (245.6 N) significantly higher than that of the ZO (18.1 N). Sandblasting both abutment and coping increased tensile strength by 1.7 times. Marginal leakage was not influenced by sandblasting; however, CH presented less microleakage. CONCLUSION: Aluminum oxide sandblasting of the coping and abutment favored the tensile strength of temporary cements and the CH showed a higher tensile strength and less microleakage than did the ZO cement.

Finite element analysis of provisional structures of implant-supported complete prostheses.

The use of provisional resin implant-supported complete dentures is a fast and safe procedure to restore mastication and esthetics of patients soon after surgery and during the adaptation phase to the new denture. This study assessed stress distribution of provisional implant-supported fixed dentures and the all-on-4 concept using self-curing acrylic resin (Tempron) and bis-acrylic resin (Luxatemp) to simulate functional loads through the three-dimensional finite element method. Solidworks software was used to build three-dimensional models using acrylic resin (Tempron, model A) and bis-acrylic resin (Luxatemp, model B) for denture captions. Two loading patterns were applied on each model: (1) right unilateral axial loading of 150 N on the occlusal surfaces of posterior teeth and (2) oblique loading vector of 150 N at 45°. The results showed that higher stress was found on the bone crest below oblique load application with a maximum value of 187.57 MPa on model A and 167.45 MPa on model B. It was concluded that model B improved stress distribution on the denture compared with model A.

Computed tomographic evaluation of alterations of the buccolingual width of the alveolar ridge after immediate implant placement associated with the use of a synthetic bone substitute.

PURPOSE: To evaluate the alterations of the buccolingual width of the alveolar ridge after immediate implant placement using a fully synthetic biphasic calcium phosphate (BCP) consisting of a mixture of 60% hydroxyapatite and 40% ?-tricalcium phosphate in esthetic regions. MATERIALS AND METHODS: The buccolingual widths of the alveolar ridge in 20 extraction sites in 20 patients were assessed using computed tomography. Measurements were performed before and 6 months after extractions and immediate implant placement. In group 1 (11 patients), BCP was in the space between the buccal wall of the alveolar ridge and implant. In group 2 (9 patients), the same evaluations and procedures were performed but without using BCP. RESULTS: The buccolingual dimensions of the alveolar ridge in group 1 (BCP) showed no significant preoperative differences (8.49 ± 1.1 mm) during the 6-month period after surgery (8.82 ± 0.9 mm) (P = .14). In group 2, the differences in buccolingual dimensions of the alveolar ridge were statistically significant (P = .01) with reduction in dimensions from 8.12 ± 0.7 mm during the preoperative period to 7.01 ± 0.4 mm 6-months after surgery. CONCLUSION: The use of BCP was effective in preserving buccolingual dimensions of alveolar ridges in immediate implant surgeries.

Influence of mouthguards on the physical performance of soccer players.

AIM: To evaluate the influence of different types of mouthguard (MG) on physical performance of female soccer players. MATERIAL AND METHODS: The sample was composed of 25 female soccer players from 'Guarani Futebol Clube', age range 18-22 years. For data collection, two tests were performed: agility test (shuttle run) and aerobic capacity and VO2 (Cooper test), in addition to application of a perception questionnaire after wearing mouthguards during the tests. RESULTS: Data analysis showed that mouthguard type III presented better results in the VO2 and aerobic capacity tests (P < 0.05). In relation to difficulties experienced when wearing MGs, there were no reports of pain, discomfort, or nausea. However, 100% of athletes affirmed that it was not possible to speak with MG type I, 80% (n = 20) with type II, and no athlete found difficulty in speaking when wearing MG type III. Distractions were reported by 35% (n = 6) only when athletes wore MG types I and II. CONCLUSIONS: Among the three types evaluated, the customized MG (type III) presented better results in the athletes' physical performance evaluation, even taking into account physical tests performed without the use of mouthguards.

Mechanical evaluation of the influence of low-level laser therapy in secondary stability of implants in mice shinbones.

The present work evaluates mechanically the bone-implant attachment submitted or not to low-level laser therapy, with wavelength of 795 nm, in a continuous way, with power of 120 mW. The implant was placed in one of the shinbones of 24 mice, randomly distributed into two groups. The experimental group was submitted to six laser applications, divided into four points previously established, two lateral and two longitudinal, six times 8 J/cm2 with an interval of 2 days, totaling the dose of 48 J/cm2. The control group did not receive laser therapy. The interval between applications was 48 h and the irradiations began immediately after the end of the implant surgeries. The two groups were killed on the 14th day and a bone block of the area was removed where the implant was inserted. A torque machine was used to measure the torque needed for loosening the implants. A statistically significant difference was observed between the two groups. The experimental group presented larger difficulty for breaking up the implant interface with the bone block than the control group. It can be concluded that with the animal model and the protocol of irradiation present in this study, the laser therapy demonstrated capacity to increase the attachment bone implant.

Association between vitamin D receptor gene polymorphisms and susceptibility to chronic kidney disease and periodontitis.

BACKGROUND/AIMS: Chronic kidney disease (CKD) and periodontitis (PD) are serious public-health concerns. Vitamin D is a fat-soluble steroid hormone that interacts with its nuclear receptor (VDR) to regulate a variety of biological processes, such as bone metabolism, immune response modulation and transcription of several genes involved in CKD and PD disease mechanisms. The aim of this work was to investigate the association between polymorphisms in the VDR gene and end-stage renal disease (ESRD) and PD. METHODS: 222 subjects with and without ESRD (in hemodialysis) were divided into groups with and without PD. Polymorphisms TaqI and BsmI in the VDR gene were analyzed by PCR restriction fragment length polymorphism. The significance of differences in allele, genotype and haplotype frequencies between groups was assessed by the chi2 test (p value <0.05) and odds ratio (OR). RESULTS: Allele G was associated with protection against ESRD: groups without versus with ESRD (GG) x (GA+AA): OR = 2.5, 95% CI = 1.4-4.6, p = 0.00; (G x A): OR = 1.5, 95% CI = 1.0-2.3, p = 0.02; (TG + CG) x (TA + CA): OR = 1.5, 95% CI = 1.0-2.3, p = 0.02. No association was observed between the study polymorphisms and susceptibility to or protection against PD. CONCLUSION: Allele G of the VDR BsmI polymorphism was associated with protection against ESRD.