Risk factors for mandibular bone resorption in complete denture wearers.

This study aimed to evaluate the impact of factors related to the patient (age, sex, bruxism, and general health) or prosthesis (use of old dentures, duration of denture wear, and nocturnal wear) on the mandibular ridge resorption rate (RRR) of complete denture (CD) wearers. This retrospective cohort study was composed of edentulous patients who sought prosthodontic treatment for maxillary and mandibular CDs. The mandibular RRR was estimated based on panoramic radiographs (n = 120) obtained at the time of the clinical examination. The total height of the alveolar process was considered to be 3 times the distance from the inferior border of the mandible to the lower border of the mental foramen. Radiographic measurements were performed by 1 calibrated examiner. Data were collected from dental records related to the patient or prosthesis. Data were evaluated by 1-way analysis of variance or Student t test at a significance level of 5%. Of the factors evaluated, age (P ∼ 0.000), previous use of CDs (P ∼ 0.000), and bruxism history (P = 0.003) were statistically significant for the mandibular RRR. The RRR was greater among patients older than 60 years, those who had been wearing old CDs, and those who reported bruxism. Thus, the study results showed the negative influence of advanced age, use of old dentures, and bruxism on mandibular RRR.

Teaching Complete Denture Procedures to Dental Students by Conventional or Simplified Methods: A Randomized Clinical Trial.

With populations aging around the world, the need for complete dentures is likely to increase in Brazil and other developing countries, as well among low-income populations globally, making the teaching of cost-efficient techniques to dental students essential. The aim of this study was to evaluate the effectiveness of complete dentures fabricated by the simplified method in comparison to the conventional method regarding patients' oral health-related quality of life (OHRQoL) and satisfaction, dentures' functional quality, and masticatory performance of patients who were rehabilitated by dental students. From February 2016 to April 2017, final-year dental students at the Federal University of Alfenas, Brazil, were instructed to fabricate new complete dentures for 36 edentulous patients, who were randomly divided into two groups according to denture manufacturing method: simplified method or conventional method. Patients' OHRQoL and satisfaction and the prostheses quality were evaluated at one, three, and six months. Masticatory performance was evaluated at three months. The results showed there was no significant difference between the two methods regarding OHRQoL, patient satisfaction, prostheses quality, or masticatory performance (p>0.05). All aspects evaluated also remained constant for the same group (simplified method or conventional method) in all periods of evaluation (p>0.05). The study concluded that the simplified method for complete denture fabrication was able to produce protheses with functional quality and patient satisfaction comparable to those produced with the conventional method, even when made by dental students.

The Influence of Age, Gender, Mandibular Bone Height, Previous Experience with Prostheses, and Fabrication Methods on Masticatory Performance of Complete Denture Wearers.

PURPOSE: To evaluate the influence of age, gender, mandibular bone height, previous experience with prostheses, and methods for denture fabrication on masticatory performance of complete denture (CD) wearers. MATERIALS AND METHODS: For this study, 29 individuals treated with CDs fabricated by simplified or conventional methods had their masticatory performance assessed 4 weeks after the prostheses' adjustment and control, using the sieve method and almonds as a natural food test. Experimental variables related to age, gender, and previous use of complete dentures were collected from dental records. Panoramic digital radiographs were used to determine mandibular bone height according to the criteria described by the American College of Prosthodontists. Data on masticatory performance were assessed using t-test for independent samples to make comparison between simplified and conventional methods, and a multiple linear regression analysis was performed to evaluate the influence of age, gender, previous experience with CDs, and mandibular bone height on masticatory performance using SPSS software with a significance level of 5%. RESULTS: There was no significant influence regarding the method for CD fabrication (p = 0.92), age (p = 0.36), mandibular bone height (p = 0.37), and previous experience with prostheses (p = 0.15) on masticatory performance of CD wearers. Female patients presented lower masticatory performance than male (p = 0.04) patients did. CONCLUSIONS: Considering the limitations of this study, it was concluded that gender might be considered a risk factor for masticatory performance of CD wearers. Female patients demonstrated reduced masticatory performance in comparison to male patients.

A Randomized Clinical Trial of Oral Health-Related Quality of Life, Peri-Implant and Kinesiograph Parameters in Wearers of One-or Two-Implant Mandibular Overdentures.

PURPOSE: The present randomized clinical trial compared the oral health-related quality of life (OHRQoL), peri-implant parameters, mandible movements, and maxillary complete denture movement during chewing between wearers of single- (1-IOD) and wearers of two-implant overdentures (2-IODs) for a period of 12 months. MATERIALS AND METHODS: Twenty-one complete denture wearers were randomly allocated into two parallel groups: 1-IOD (n = 11) or 2-IODs (n = 10). The validated Brazilian version of the OHIP-EDENT was used to evaluate the OHRQoL. A kinesiograph recorded maxillary complete denture movement during chewing of hard food testing (polysulphide impression material) and soft food testing (bread). Peri-implant parameters were also recorded: plaque index (PI), bleeding on probing (BOP), and probing depth (PD). The Friedman test was used to compare the OHRQoL data and peri-implant parameters among periods; the Mann-Whitney test was performed to compare the groups (1- and 2-IODs). One-way ANOVA and the Bonferroni test were used to compare mandible movement during chewing among periods, and the t-test for independent samples was used to compare the groups. Maxillary complete denture movement was analyzed using three-way ANOVA followed by the Bonferroni test. All statistical analyses were performed at α = 0.05. RESULTS: Both treatments led to better general OHRQoL in comparison to conventional complete dentures (p < 0.001). Better OHRQoL was observed among 2-IOD patients at the 12-month follow up (p = 0.034). Peri-implant parameters were similar irrespective of the group and follow-up period. Vertical opening was significantly higher among 1-IOD patients at 3 months (p = 0.038). Decreased maxillary denture vertical intrusions were observed with complete dentures in comparison with overdentures (p = 0.006), regardless of the food test (p = 0.251); however, vertical intrusion was significantly higher among 1-IOD patients (p = 0.043). CONCLUSIONS: This study suggested that 1-IOD can improve patient OHRQoL and may be similar to 2-IODs in preservation of both peri-implant parameters and masticatory movements.

Retention Force and Wear Characteristics of three Attachment Systems after Dislodging Cycles.

Several attachment systems for mandibular implant-supported overdentures are currently available and studies are required to understand their mechanical properties. The objective of this study was to evaluate the retention force and wear characteristics of three attachment systems in a simulation of the cyclic dislodging of implant-supported overdentures. Thirty samples were fabricated and divided into 3 groups: 1-O-ring; 2-Mini Ball; and 3-Equator. A mechanical fatigue test was applied to the specimens using a servo-hydraulic universal testing machine performing 5500 insertion/removal cycles (f=0.8 Hz), immersed in artificial saliva. Retention force values ​​were obtained before and after 1500, 3000, and 5500 cycles using a speed of 1 mm/min and a load cell of 1 kN. One specimen from each group was randomly selected and analyzed by scanning electron microscopy. Two-way repeated measures ANOVA and the Bonferroni post hoc test were used for statistical analyses (α=0.05). The O-ring system remained stable during all periods tested and exhibited significantly lower retention force values than the Mini Ball and Equator systems. The Mini Ball system exhibited a significant increase in retention force after the mechanical test (baseline=21.04±3.29N; 5500 cycles=24.01±3.30N).The Equator system exhibited a significant decrease in retention force after each period tested, but the values were higher than the other systems. The type of attachment was found to influence retention force in different ways after mechanical tests. The Equator system exhibited the highest retention force values. The Mini Ball and Equator matrices produced deformation and wear on the surfaces without breakage of the polyamide rings.

Retention force and wear characteristics of three attachment systems after dislodging cycles

Abstract Several attachment systems for mandibular implant-supported overdentures are currently available and studies are required to understand their mechanical properties. The objective of this study was to evaluate the retention force and wear characteristics of three attachment systems in a simulation of the cyclic dislodging of implant-supported overdentures. Thirty samples were fabricated and divided into 3 groups: 1-O-ring; 2-Mini Ball; and 3-Equator. A mechanical fatigue test was applied to the specimens using a servo-hydraulic universal testing machine performing 5500 insertion/removal cycles (f=0.8 Hz), immersed in artificial saliva. Retention force values ​​were obtained before and after 1500, 3000, and 5500 cycles using a speed of 1 mm/min and a load cell of 1 kN. One specimen from each group was randomly selected and analyzed by scanning electron microscopy. Two-way repeated measures ANOVA and the Bonferroni post hoc test were used for statistical analyses (α=0.05). The O-ring system remained stable during all periods tested and exhibited significantly lower retention force values than the Mini Ball and Equator systems. The Mini Ball system exhibited a significant increase in retention force after the mechanical test (baseline=21.04±3.29N; 5500 cycles=24.01±3.30N).The Equator system exhibited a significant decrease in retention force after each period tested, but the values were higher than the other systems. The type of attachment was found to influence retention force in different ways after mechanical tests. The Equator system exhibited the highest retention force values. The Mini Ball and Equator matrices produced deformation and wear on the surfaces without breakage of the polyamide rings.

Resumo Vários sistemas de encaixe para sobredentaduras mandibulares implantossuportadas estão atualmente disponíveis e estudos são necessários para entender as suas propriedades mecânicas. O objetivo deste estudo foi avaliar a força de retenção e as características de desgaste de três sistemas de encaixe por meio de uma simulação de deslocamento cíclico de sobredentaduras implantossuportadas. Trinta amostras foram fabricadas e divididas em 3 grupos: 1-O-ring; 2-Mini Ball; e 3-Equador. Um teste de fadiga mecânica foi aplicado aos espécimes utilizando uma máquina de teste universal servo-hidráulica com 5500 ciclos de inserção/remoção (f = 0,8 Hz), imersos em saliva artificial. Os valores da força de retenção foram obtidos antes e após 1500, 3000 e 5500 ciclos utilizando uma velocidade de 1 mm/min e uma célula de carga de 1 kN. Um espécime de cada grupo foi selecionado aleatoriamente e analisado por microscopia eletrônica de varredura. O teste de Análise de Variância a dois fatores para medidas repetidas e o teste de comparações múltiplas de Bonferroni foram utilizados para análises estatísticas (α = 0,05). O sistema de O-ring permaneceu estável durante todos os períodos testados e apresentou valores de força de retenção significativamente menores do que os sistemas Mini Ball e Equator. O sistema Mini Ball apresentou um aumento significativo na força de retenção após o teste mecânico (controle = 21,04 ± 3,29N; 5500 ciclos = 24,01 ± 3,30N). O sistema Equator apresentou uma diminuição significativa na força de retenção após cada período testado, mas os valores eram maiores do que os outros sistemas. O tipo de sistema de encaixe influenciou na força de retenção de diferentes maneiras após testes mecânicos. O sistema do Equador exibiu os maiores valores de força de retenção. As matrizes dos sistemas Mini Ball e Equator produziram deformação e desgaste nas superfícies sem ruptura dos anéis de poliamida.

One-year prospective clinical study comparing patient satisfaction and masticatory performance of mandibular overdentures supported by one versus two implants.

OBJECTIVE: There is a lack of clinical evidence on mandibular overdentures (MOD) supported by a single implant. To compare patient satisfaction and masticatory performance in MOD supported by one versus two implants in a two-group parallel randomized clinical trial. MATERIAL AND METHODS: Twenty-one patients wearing new maxillary and mandibular complete dentures (CDs) were randomly divided to receive one (GI, n = 11) or two (GII, n = 10) implants in the mandibular arch. Four months after implant placement, o-ring abutments were installed in the implants, and matrix attachments were placed in the lower complete dentures. Patient satisfaction with their dentures and masticatory performance were compared at baseline, 3, 6, and 12 months after the procedure. Data on patient satisfaction were analyzed using the Friedman test and the Mann-Whitney U test. Data on masticatory performance were analyzed using one-way repeated measures analysis of variance (ANOVA) and Student's t test (α=0.05). RESULTS: Both groups exhibited a significant increase in overall patient satisfaction in all periods evaluated (p<0.05), except for GI after 12 months, which had values similar to baseline (p=0.74). Satisfaction levels of GI and GII were similar at baseline, 3 and 6 months, but GII showed higher satisfaction levels (p=0.01) than GI at 12 months. GI and GII exhibited a significant increase (p<0.05) in masticatory performance for all periods relative to baseline. However, GII had higher masticatory performance with dentures than GI, regardless of the period (p<0.05). CONCLUSION: MOD supported by two implants demonstrated better patient satisfaction in the follow-up at 12 months and better masticatory performance than MOD supported by one implant.

In Vitro Assessment of the Abrasion Resistance of Two Types of Artificial Teeth Submitted to Brushing.

PURPOSE: To assess the effect of brushing with different solutions on the abrasion resistance of two types of acrylic resin teeth. MATERIALS AND METHODS: Maxillary premolars from two types of acrylic teeth (Biotone and Biotone IPN) were divided into six groups (n = 12), according to the solution used during brushing: distilled water (control), coconut soap, or dentifrice. A mechanical brushing machine was used to simulate approximately 1 year of brushing (11,000 strokes). The weight loss (WL) of teeth was obtained from the difference between the initial (IW) and final weight (FW) of each specimen, and the mean of percentage of weight loss (PWL) was calculated for each group. Data were analyzed using the Kruskal-Wallis test, followed by Bonferroni's post-test comparison (α = 0.05). RESULTS: A statistically significant difference was found for the factor solution (p < 0.001). Brushing using dentifrice caused the highest values of weight loss (-0.50%), in comparison with the groups brushed with coconut soap (0.00%) or distilled water (0.00%). CONCLUSIONS: For both types of artificial teeth, brushing with dentifrice produced higher abrasion than brushing with coconut soap or water.

Antimicrobial activity of a tissue conditioner combined with a biocide polymer.

BACKGROUND: The characteristics of tissue conditioners support microorganism development that can threaten the health of the dentures user. PURPOSE: The object of this study was to evaluate the effect on antimicrobial activity, roughness and wettability surface of a tissue conditioners material combined with the antimicrobial polymer poly (2-tert-butilaminoethyl) methacrylate (PTBAEMA). MATERIALS AND METHODS: Specimens of tissue conditioner (Coe Soft(®)) were divided into three groups, according to the concentration of PTBAEMA incorporated (0, 10 and 25%). Antimicrobial activity was assessed by adherence assay of one of the microorganisms, Staphylococcus aureus, Streptococcus mutans and Candida albicans. Roughness measurements were made using a Mitutoyo SJ-400, and the mean arithmetic roughness values (Ra) obtained were used for the comparisons. The wettability properties were determined by contact angle measurements. RESULTS: The group containing 25% of PTBAEMA inhibited totally the S. aureus and S. mutans biofilm formation. A significant reduc tion in the S. aureus (Kruskal-Wallis, p = 0,001) and S. mutans (Kruscal-Wallis, p = 0,001) count for 10% PTBAEMA group compared with respective control group. No significant difference was found for C. albicans among PTBAEMA groups and control group (ANOVA, p > 0,05). Incorporating 10 and 25% PTBAEMA increased surface roughness and decreased contact angles (ANOVA and Tukey's post hoc tests, α = 5%). CONCLUSION: Incorporating 10% PTBAEMA into tissue conditioner increases wettability and roughness of tissue conditioner surface; and decreases the adhesion of S. mutans and S. aureus on material surface, but did not exhibit antimicrobial effect against C. albicans. SIGNIFICANCE: The PTBAEMA incorporated into tissue conditioner could prevent biofilm formation on elderly patient.

An alternative technique for fabrication of frameworks in an immediate loading implant fixed mandibular prosthesis.

The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time.

Split-Framework in Mandibular Implant-Supported Prosthesis.

During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient's discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities.

Effect of a denture adhesive on the satisfaction and kinesiographic parameters of complete denture wearers: a cross-over randomized clinical trial.

The aim of the present study was to assess the effect of a denture adhesive (DA) on patient satisfaction and kinesiographic parameters of complete denture wearers by a cross-over study. Fifty edentulous patients received a set of new complete dentures. After an adaptation period, the participants were enrolled in the trial and randomized to receive a sequence of treatment protocols: Protocol 1- DA use during the first 15 days, followed by no DA for the next 15 days; Protocol 2- no DA during the first 15 days, followed by use of DA for the next 15 days. Outcomes were assessed after 15 days of each sequence of treatment. A questionnaire was used to assess the patients' satisfaction. A kinesiograph was used to record mandible movements and patterns of maxillary complete denture movement during chewing. The Wilcoxon test (α=0.05) and a paired sample t-test (α=0.05) were used to compare satisfaction levels and kinesiographic data, respectively. Use of DA improved the overall level of patient satisfaction (p<0.001). The kinesiographic recordings revealed a significant increase (1.7 mm) in vertical mandible movements (p<0.001) during chewing and a lower (0.3 mm) vertical intrusion of the maxillary complete dentures (p=0.002) during chewing after using the DA. Use of DA in complete denture wearers improved the patients' satisfaction and altered mandible movements, with increases in vertical movements during chewing and less intrusion of maxillary complete dentures.

Oclusão em pr¢teses implantossuportadas – uma revisÆo de literatura / Occlusion on implant-supported prosthesis – a literature review

Embora a pr¢tese sobre implantes e a pr¢tese sobre dentes naturais compartilhem diversas caracter¡sticas devido ao diferente comportamento biomecƒnico entre os implantes e os dentes, alguns princ¡pios devem ser diferenciados, dentre eles a oclusÆo, pois esta ‚ um dos principais fatores respons veis pelo sucesso da osseointegra‡Æo. Considerando a quantidade de tratamentos poss¡veis de serem realizados com implantes e tendo em vista que ainda nÆo h  um consenso sobre o padrÆo oclusal ideal para essas pr¢teses, o objetivo deste trabalho foi realizar uma revisÆo de literatura, procurando abordar os aspectos oclusais relevantes para o sucesso do tratamento com pr¢teses sobre implantes.

Although implant-supported prosthesis and prosthesis over natural teeth share several characteristics some aspects should be distinguished due to the different biomechanical behavior between implants and teeth. Occlusion is one of these aspects and is one of the main factors responsible for the success of osseointegration. Considering the diversity of treatments that can be performed with implants and aware that there is still no consensus on the ideal occlusal pattern for these prostheses, the objective of the study was to conduct a literature review seeking to address the occlusal aspects relevant to the success of treatment with prosthetic implants.

Impact of replacing conventional complete dentures with implant-supported fixed complete dentures.

The aim of this study was to assess the impact of replacing conventional mandibular complete dentures with implant-supported fixed complete dentures (ISFDs) on the oral health-related quality of life (OHQOL) of edentulous patients and on the associated kinesiographic parameters. The patients had their complete dentures replaced by ISFDs and were assessed after 1, 2, 3, 6, and 12 months. An improvement of general OHQOL was observed 2 months after treatment with ISFDs. Kinesiographic recordings revealed significant mandibular vertical and horizontal opening increases and a greater vertical intrusion of the maxillary complete dentures during clenching after the treatment with ISFD.

Repair technique for fractured implant-supported metal-ceramic restorations: a clinical report.

The fracture of porcelain structures have been related in either natural dentition or implant-supported restorations. Techniques using a composite resin or indirect methods can be used. This article presents a porcelain fracture on implant-supported metal-ceramic restoration. IPS Empress e.max laminate veneer restoration was used to repair the fracture. With this technique, it was possible to restore aesthetics and function, combined with low cost and patient satisfaction.

Effect of a Denture Adhesive on the Satisfaction and Kinesiographic Parameters of Complete Denture Wearers: A Cross-Over Randomized Clinical Trial

The aim of the present study was to assess the effect of a denture adhesive (DA) on patient satisfaction and kinesiographic parameters of complete denture wearers by a cross-over study. Fifty edentulous patients received a set of new complete dentures. After an adaptation period, the participants were enrolled in the trial and randomized to receive a sequence of treatment protocols: Protocol 1- DA use during the first 15 days, followed by no DA for the next 15 days; Protocol 2- no DA during the first 15 days, followed by use of DA for the next 15 days. Outcomes were assessed after 15 days of each sequence of treatment. A questionnaire was used to assess the patients´ satisfaction. A kinesiograph was used to record mandible movements and patterns of maxillary complete denture movement during chewing. The Wilcoxon test (α=0.05) and a paired sample t-test (α=0.05) were used to compare satisfaction levels and kinesiographic data, respectively. Use of DA improved the overall level of patient satisfaction (p<0.001). The kinesiographic recordings revealed a significant increase (1.7 mm) in vertical mandible movements (p<0.001) during chewing and a lower (0.3 mm) vertical intrusion of the maxillary complete dentures (p=0.002) during chewing after using the DA. Use of DA in complete denture wearers improved the patients´ satisfaction and altered mandible movements, with increases in vertical movements during chewing and less intrusion of maxillary complete dentures.

O objetivo deste estudo foi avaliar o efeito da utilização de um adesivo para prótese na satisfação e nos parâmetros cinesiográficos em usuários de próteses totais por meio de um estudo "cross-over". Cinquenta pacientes desdentados receberam novas próteses totais bimaxilares. Após um período de adaptação, os participantes incluídos no estudo receberam uma sequência de tratamento: Protocolo 1- utilização do adesivo para prótese durante os primeiros 15 dias, seguida por não utilização do adesivo os próximos 15 dias; Protocolo 2- não utilização do adesivo durante os primeiros 15 dias; seguida por utilização do adesivo nos próximos 15 dias. Os resultados foram avaliados após 15 dias de cada sequência de tratamento. Um questionário para avaliar a satisfação dos pacientes e um cinesiógrafo para registrar os movimentos mandibulares e o padrão de movimento da prótese total maxilar durante mastigação foram utilizados. O teste de "Wilcoxon" (α=0,05) e o "t-test" de Student para amostras pareadas (α=0,05) foram utilizados para comparar o grau de satisfação dos pacientes e os dados cinesiográficos, respectivamente. O adesivo para prótese melhorou significativamente a satisfação geral dos participantes (p<0,001). Os registros cinesiográficos mostraram um aumento significativo (1,7 mm) no movimento mandibular vertical (p<0,001) e uma menor intrusão (0,3 mm) da prótese total superior (p=0,002) durante a mastigação após o uso de adesivo. O uso de adesivo para prótese melhorou a satisfação dos usuários de próteses totais e gerou um aumento no movimento mandibular vertical e uma menor intrusão da prótese total maxilar durante a mastigação.

Masticatory performance of complete denture wearers after using two adhesives: a crossover randomized clinical trial.

STATEMENT OF PROBLEM: Masticatory performance analysis of conventional complete denture wearers who use denture adhesives is scarce in the dental literature. PURPOSE: The purpose of this study was to assess the effect of the use of 2 denture adhesives on the masticatory performance of conventional complete denture wearers by means of a crossover study. MATERIAL AND METHODS: Forty individuals who were edentulous received new maxillary and mandibular complete dentures, and, after an adaptation period, were submitted to masticatory performance analysis without denture adhesive (control). The participants were randomly divided and assigned to 2 protocols: protocol 1, denture adhesive 1 (Ultra Corega cream tasteless) use during the first 15 days, followed by no use of denture adhesive over the next 15 days (washout), and then use of denture adhesive 2 (Ultra Corega powder tasteless) for 15 days; protocol 2, denture adhesive 2 (Ultra Corega powder tasteless) use during the first 15 days, followed by no use of denture adhesive during the next 15 days (washout), and then use of denture adhesive 1 (Ultra Corega cream tasteless) for 15 days. The masticatory performance was assessed immediately after the use of denture adhesive by means of the sieve method, in which participants were instructed to deliberately chew 5 almonds for 20 chewing strokes. Masticatory performance was calculated by the weight of comminuted material that passed through the sieves. Data were analyzed by a 1-way ANOVA for paired samples and the multiple comparison of means by using the Bonferroni test (α=.05). RESULTS: A significant increase in masticatory performance was noted after using the Ultra Corega cream (mean, 32.6%) and Ultra Corega powder (mean, 31.2%) when compared with the control group (mean, 19.8%) (P<.001). No significant difference was found between the 2 denture adhesives evaluated. CONCLUSION: The use of denture adhesive improved the masticatory performance of conventional complete denture wearers. No difference was found in masticatory performance with the use of cream or powder denture adhesive.

Reabilitação oral de paciente com Síndrome da Combinacão: relato de caso / Oral rehabilitation of a patient with combination syndrome: a case report

A Síndrome da Combinação representa uma importante condição patológica do sistema mastigatório que precisa de um tratamento reabilitador complexo. A presença de mucosa flácida é uma das caraterísticas mais comuns quando ocorre a reabsorção óssea anterior da pre-maxila ocasionada pela hiperfunção anterior dos dentes inferiores sobre a prótese total superior, onde a incidência de cargas nessa região resulta na movimentação da pró tese em direção ao rebordo, resultando no aumento da reabsorção do rebordo residual, na desadaptação interna da prótese e na perda de retenção da prótese. A presença de mucosa flácida, nesses casos, acarreta ainda problemas de suporte e estabilidade da prótese total superior, que podem ser tratados com redução cirúrgica da espessura do tecido ou usando técnicas específicas de confecção das próteses. Este artigo descreve a reabilitação oral de um paciente com Síndrome da Combinação onde a redução cirúrgica da mucosa flácida não foi realizada, utilizando uma técnica modificada de moldagem funcional em duas etapas, com o objetivo de gerar menos forças e distorções na fibromucosa flácida durante a moldagem funcional.

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and 1055 of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Fragment reattachment after atypical crown fracture in maxillary central incisor.

Background. Fracture by trauma is one of the most common types of dental injury in the permanent dentition among children and teenagers. Aim. The aim of this study was to report the treatment performed to an atypical dental trauma case in a maxillary central incisor of a young patient by means of reattachment of the tooth fragment. Case Description. A 12-year-old male patient suffered a vertical crown fracture to the maxillary right central incisor. After clinical and radiographic examinations, a conservative restorative treatment which consisted in the reattachment of the tooth fragment with flow resin was performed in order to preserve the dental element and to obtain maximum aesthetics. Conclusion. The reattachment of fractured fragment is a fast and easy technique that can be used successfully as an option to restore dental element which suffered trauma. Clinical Significance. This technique restores the aesthetics and function of the dental element with minimal discomfort to the patient.

Prótese metalocerâmica associada à prótese metaloplástica implantossuportada em paciente desdentado total / Full maxillary, metal-ceramic implant-supported prosthesis against a complete, mandibular, acrylic implant-supported prosthesis: a case report

A utilização de diferentes métodos e materiais deve ser considerada durante o planejamento de próteses implantossuportadas. Complicações, como fraturas da base de resina acrílica, desgaste e fratura dos dentes, podem ocorrer com frequência, gerando a necessidade de um planejamento cuidadoso para cada paciente, o que pode tornar a seleção do tipo de tratamento mais complexa. Diante disso, este artigo descreve a reabilitação oral de um paciente totalmente edêntulo, portador de prótese tipo protocolo bimaxilar, que apresentava queixa estética, perda de dimensão vertical e fratura em dentes de resina acrílica do arco superior. Após o restabelecimento da dimensão vertical, realizou-se a substituição de suas próteses antigas por uma nova prótese tipo protocolo bimaxilar, sendo que a cerâmica foi utilizada como material de cobertura para o arco superior, e resina como material de cobertura para o arco inferior. Ao final do tratamento, o paciente recebeu placas oclusais lisas bimaxilares para proteger os dentes e implantes de possíveis hábitos parafuncionais. A forma como o tratamento foi conduzido permitiu uma resolução rápida e eficaz, com resultado estético e funcional muito favorável para o paciente.

The use of different methods and materials should be considered during the planning of implant-supported prostheses. Complications such as fractures of the acrylic resin base, wear and fracture of teeth can occur frequently, creating the need for careful planning for each patient, which can make the selection of the type of treatment more complex. Thus, this article describes the oral rehabilitation of a completely edentulous patient with bimaxillary fixed implant-supported prosthesis, with complaints on aesthetics, loss of vertical dimension and fracture of acrylic resin teeth of the upper arch. After the restoration of vertical dimension, his dentures were replaced with new bimaxillary implant-supported fixed prostheses, ceramic and acrylic resin were used as veneering material for maxilla and mandible, respectively. At the end of the treatment, the patient received bimaxillary flat occlusal splints to protect the teeth and implants of possible parafunctional habits. The approach for the treatment allowed a quick and effective resolution, with aesthetic and functional outcomes very favorable for the patient.