Effect of splinting in accuracy of two implant impression techniques.

Because there is no consensus in the literature about the need for a splint between copings, the aim of this study was to evaluate, in vitro, the accuracy of 2 impression techniques for implant-supported prostheses. A master cast was fabricated with four parallel implant abutment analogs and a passive framework. Two groups with 5 casts each were formed: Group 1 (squared impression copings with no splint: S) and Group 2 (splinted squared impression copings, using metal drill burs and Pattern resin: SS). The impression material used was polyvinyl siloxane with open trays for standard preparation of the casts. For each cast, the framework was positioned, and a titanium screw was tightened with 10 N·cm torque in analog A, after which measurements of the abutment-framework interface gaps were performed at analogs C and D. This process was repeated for analog D. These measurements were analyzed using software. A one-way analysis of variance (ANOVA) with a confidence interval of 95% was used to analyze the data. Significant differences were detected between S and SS in relation to the master cast (P ≤ 0.05). The median values of the abutment-framework interface gaps were as follows: master cast: 39.64 µm; squared impression copings with no splint: 205.86 µm; splinted squared impression copings: 99.19 µm. Under the limitations of this study, the technique presented for Group 2 produces better results compared with the technique used for Group 1.

Eight-year follow-up of a fixed-detachable maxillary prosthesis utilizing an attachment system: clinical protocol for individuals with skeletal class III malocclusions.

The aim of this article is to describe a successful clinical protocol for prosthodontic rehabilitation of a patient with a skeletal Class III malocclusion using a fixed-detachable maxillary prosthesis supported by 6 implants and the MK1 attachment system. The patient was followed up for 8 years. A 46-year-old edentulous woman with a skeletal Class III malocclusion expressed dissatisfaction with her old existing maxillary denture from an esthetic point of view and frustration regarding its function. A fixed-detachable maxillary prosthesis using the MK1 attachment system was made. The patient was followed up clinically and radiographically for 8 years. No bone loss, fracture of prosthetic components, or fracture of the prosthesis was detected in that period. A fixed detachable maxillary prosthesis using the MK1 attachment system is a treatment option for patients with Class III malocclusions who opt not to undergo orthognathic surgery.

The Relationship between Biofilm and Physical-Chemical Properties of Implant Abutment Materials for Successful Dental Implants.

The aim of this review was to investigate the relationship between biofilm and peri-implant disease, with an emphasis on the types of implant abutment surfaces. Individuals with periodontal disease typically have a large amount of pathogenic microorganisms in the periodontal pocket. If the individuals lose their teeth, these microorganisms remain viable inside the mouth and can directly influence peri-implant microbiota. Metal implants offer a suitable solution, but similarly, these remaining bacteria can adhere on abutment implant surfaces, induce peri-implantitis causing potential destruction of the alveolar bone near to the implant threads and cause the subsequent loss of the implant. Studies have demonstrated differences in biofilm formation on dental materials and these variations can be associated with both physical and chemical characteristics of the surfaces. In the case of partially edentulous patients affected by periodontal disease, the ideal type of implant abutments utilized should be one that adheres the least or negligible amounts of periodontopathogenic bacteria. Therefore, it is of clinically relevance to know how the bacteria behave on different types of surfaces in order to develop new materials and/or new types of treatment surfaces, which will reduce or inhibit adhesion of pathogenic microorganisms, and, thus, restrict the use of the abutments with indication propensity for bacterial adhesion.

Implications of Surface and Bulk Properties of Abutment Implants and Their Degradation in the Health of Periodontal Tissue.

The aim of the current review was to investigate the implications of the surface and bulk properties of abutment implants and their degradation in relation to periodontal health. The success of dental implants is no longer a challenge for dentistry. The scientific literature presents several types of implants that are specific for each case. However, in cases of prosthetics components, such as abutments, further research is needed to improve the materials used to avoid bacterial adhesion and enhance contact with epithelial cells. The implanted surfaces of the abutments are composed of chemical elements that may degrade under different temperatures or be damaged by the forces applied onto them. This study showed that the resulting release of such chemical elements could cause inflammation in the periodontal tissue. At the same time, the surface characteristics can be altered, thus favoring biofilm development and further increasing the inflammation. Finally, if not treated, this inflammation can cause the loss of the implant.

Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis: thinking about implants?

Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Implants are commonly used to replace congenitally missing lateral incisors in adolescent orthodontic patients. However, an interdisciplinary approach should be observed during the diagnosis, prognosis, and treatment plan to provide a result with good predictability and meet the esthetic and functional expectations of the patient. The present study describes a case of a young patient with tooth agenesis of maxillary lateral incisors, which was conducted with an integrated planning. After 5-year follow-up of 2 fixed implant-supported prostheses, clinical and radiographic examination showed the treatment to be successful.

Comparison of the accuracy of plastic and metal stock trays for implant impressions.

PURPOSE: This in vitro study evaluated the dimensional accuracy of two impression techniques (tapered and splinted) with two stock trays (plastic and metal) for implant-supported prostheses. MATERIALS AND METHODS: A master cast with four parallel abutment analogs and a passive framework were fabricated. Polyvinyl siloxane impression material was used for all impressions with two metal stock trays and two plastic stock trays (closed and open trays). Four groups (tapered plastic, splinted plastic, tapered metal, and splinted metal) and a control group (master cast) were tested (n = 5 for each group). After the framework was seated on each of the casts, one abutment screw was tightened, and the marginal gap between the abutment and framework on the other side was measured with a stereomicroscope. The measurements were analyzed with the Kruskal-Wallis one-way analysis of variance on ranks test followed by the Dunn method. RESULTS: The mean values (± standard deviations) for the abutment/framework interface gaps were: master cast, 32 ± 2 Μm; tapered metal, 44 ± 10 Μm; splinted metal, 69 ± 28 Μm; tapered plastic, 164 ± 58 Μm; splinted plastic, 128 ± 47 Μm. No significant difference was detected between the master cast, tapered metal, and splinted metal groups or between the tapered and splinted plastic groups. CONCLUSIONS: In this study, the rigidity of the metal stock tray ensured better results than the plastic stock tray for implant impressions with a high-viscosity impression material (putty). Statistically similar results were obtained using tapered impression copings and splinted squared impression copings. The tapered impression copings technique and splinted squared impression copings technique with a metal stock tray produced precise casts with no statistically significant difference in interface gaps compared to the master cast.

Kinesiographic study of deglutition in dentate individuals and complete denture wearers.

Swallowing is used as a clinical method in prosthodontics to determine and record jaw relationships. The aim of this study was to perform a quantitative evaluation, in naturally dentate subjects and complete denture wearers, of three measurements associated with the mandibular position during the act of swallowing water: 1. intermaxillary distance on vertical axis; 2. anteroposterior deviation; and 3. lateral deviation. Two groups were selected: Group I (GI) included 40 subjects with complete dentition (mean age 45.27 yrs) and Group II (GII) included 40 bimaxillary edentate subjects, complete denture wearers (mean age 63.92 yrs). A kinesiographic instrument was used for analysis. Three records were taken for each measurement and a mean value obtained. It was concluded that: 1. intermaxillary distance on vertical axis and horizontal deviation were similar for both groups; 2. there was a significant intermaxillary distance on the vertical axis; and 3. for anteroposterior and lateral axis, results showed moderate deviation in relation to maximal intercuspation (MI).

A variation on split-cast mounting for complete denture construction.

This article describes a variation of the split-cast mounting technique wherein the border of the definitive cast is wrapped with masking tape to form a container for the dental plaster normally used to affix the cast to the articulator. The entire inferior surface of the cast is coated with a thin film of petroleum jelly, and the cast is mounted in the articulator. After the dental plaster has set, the cast is retained by means of the masking tape. The cast is separated from the dental plaster simply by removing the masking tape.