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1.
J Prosthet Dent ; 125(1): 138.e1-138.e8, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33393474

RESUMEN

STATEMENT OF PROBLEM: Mini implants (<3 mm in diameter) are being used as an alternative to standard implants for implant-retained mandibular overdentures; however, they may exhibit higher stresses at the crestal level. PURPOSE: The purpose of this finite element analysis study was to evaluate the biomechanical behavior (stress distribution pattern) in the mandibular overdenture, mucosa, bone, and implants when retained with 2 standard implants or 2 mini implants under unilateral or bilateral loading conditions. MATERIAL AND METHODS: A patient with edentulous mandible and his denture was scanned with cone beam computed tomography (CBCT), and a 3D mandibular model was created in the Mimics software program by using the CBCT digital imaging and communications in medicine (DICOM) images. The model was transferred to the 3Matics software program to form a 2-mm-thick mucosal layer and to assemble the denture DICOM file. A 12-mm-long standard implant (Ø3.5 mm) and a mini dental implant (Ø2.5 mm) along with the LOCATOR male attachments (height 4 mm) were designed by using the SOLIDWORKS software program. Two standard or 2 mini implants in the canine region were embedded separately in the 3D assembled model. The base of the mandible was fixed, and vertical compressive loads of 100 N were applied unilaterally and bilaterally in the first molar region. The material properties for acrylic resin (denture), titanium (implants), mucosa (tissue), and bone (mandible) were allocated. Maximum von Mises stress and strain values were obtained and analyzed. RESULTS: Maximum stresses of 9.78 MPa (bilaterally) and 11.98 MPa (unilaterally) were observed in 2 mini implants as compared with 3.12 MPa (bilaterally) and 3.81 MPa (unilaterally) in 2 standard implants. The stress values in the mandible were observed to be almost double the mini implants as compared with the standard implants. The stresses in the denture were in the range of 3.21 MPa and 3.83 MPa and in the mucosa of 0.68 MPa and 0.7 MPa for 2 implants under unilateral and bilateral loading conditions. The strain values shown similar trends with both implant types under bilateral and unilateral loading. CONCLUSIONS: Two mini implants generated an average of 68.15% more stress than standard implants. The 2 standard implant-retained overdenture showed less stress concentration in and around implants than mini implant-retained overdentures.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Retención de Dentadura , Análisis de Elementos Finitos , Humanos , Mandíbula/diagnóstico por imagen , Estándares de Referencia , Estrés Mecánico
2.
Medicina (Kaunas) ; 56(12)2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33255716

RESUMEN

Background and Objectives: The aims of this systematic review were to identify additional infection control measures implemented in dental practice globally to prevent cross-infection and evaluate the psychological impacts of the pandemic among dental professionals. Materials and Methods: A sequential systematic literature search was conducted from December 2019 to 30 April 2020 through PubMed, CINAHL, Scopus, Google Scholar, Embase, and Web of Science databases. The search yielded the following results: "COVID-19" (n = 12,137), "Novel corona virus" (n = 63), "COVID-19 and dentistry" (n = 46), "COVID-19 and oral health" (n = 41), "Novel Corona virus and Dentistry" (n = 0), "dental health and Novel Coronavirus" (n = 26), and "dental practice and Novel Coronavirus" (n = 6). Results: After a careful review and eliminating articles based on inclusion and exclusion criteria, the final review included 13 articles. Management of infection control is discussed extensively in the literature and remains the main theme of many Coronavirus Disease 2019 (COVID-19) articles on dentistry. Telephone triage using a questionnaire, hand hygiene, personal protective equipment (PPE) for clinical and nonclinical staff, a preprocedural mouth rinse, and aerosol management have been discussed and implemented in few countries. Three studies recommended that elective treatments for patients with a temperature of >100.4 F or 38 °C should be postponed or performed in an airborne infection isolation room (AIIR) or negative-pressure room. Limiting the number of patients in the waiting area, the removal of shared objects, proper ventilation, and physical distancing were highly recommended. Psychological distress among dental professionals in relation to existing medical conditions and self-efficacy has been discussed. Conclusions: Although the COVID-19 pandemic has had a substantial impact on the dental profession worldwide, our review highlights many practice management approaches to adopt the new norm. More research highlighting evidence-based safety practices and multisectoral collaboration is required to help dental professionals make informed decisions and make the profession safe, both for the patient and dental professionals.

3.
J Oral Sci ; 2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33239486

RESUMEN

During the current coronavirus disease 2019 (COVID-19) pandemic, dental education and training requiring face-to-face interaction must prioritize infection prevention and the safety of students, staff, and patients. In July 2020, the Association for Dental Education, Asia Pacific (ADEAP) published safety guidelines for safe dental education during the COVID-19 pandemic. These guidelines summarize ADEAP recommendations for classroom-based courses, reopening of simulated training courses and dental clinics, and provision of clinical skills training courses in dentistry during the COIVID-19 pandemic. They have been formulated to ensure the safety of students and teaching staff, dental auxiliary staff, and patients. However, the present guidelines are considered appropriate only when the number of COVID-19 epidemic cases has been significantly reduced, i.e. when the epidemiological curve has flattened in the area concerned. The criteria for lifting restrictions on activities should be consistent with relevant jurisdictional guidelines.

4.
J Prosthet Dent ; 123(5): 710-716, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31558274

RESUMEN

STATEMENT OF PROBLEM: Single-implant-retained overdentures are an alternative treatment option for an edentulous mandible. However, evaluation of their clinical performance with an immediate loading protocol is lacking. PURPOSE: The purpose of this prospective randomized controlled clinical study was to evaluate crest bone-level changes and patient satisfaction with mandibular overdentures retained by 1 or 2 titanium-zirconium (Ti-Zr) implants with immediate loading protocols after 1 year. MATERIAL AND METHODS: Thirty-six Ti-Zr implants were placed in 24 participants (single central implant in 12 participants and 2 interforaminal implants in 11 participants) by a single operator. LOCATOR attachments were used to retain the mandibular overdentures with an immediate loading protocol, and observations were made at 1 month and 1 year. Changes to the crestal bone level were evaluated with digital periapical radiographs. A 100-mm visual analog scale (VAS) was used to evaluate patient satisfaction. The Mann-Whitney U test was used to analyze the data. RESULTS: At 1 month, the mean crestal bone loss was 0.23 mm in the 2-implant group (n=22) and 0.39 mm (P=.181) in the single-implant group (n=11). At 1 year, the bone loss was 0.67 mm in the 2-implant group and 0.88 mm (P=.248) in the single-implant group. The mean VAS score for patient satisfaction level increased from 38.3% to 49.7% for single-implant participants and from 40.5% to 54.8% for 2-implant participants 1 month after implant placement (P=.250) and from 38.3% to 54.5% for single-implant participants and from 40.5% to 58.9% for 2-implant participants after 1 year (P=.341). CONCLUSIONS: Single-implant-retained mandibular overdentures with an immediate loading protocol may represent a viable treatment option considering crestal bone-level changes and patient satisfaction compared with 2-implant-retained mandibular overdentures after 1 year of follow-up.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Carga Inmediata del Implante Dental , Arcada Edéntula , Estudios de Seguimiento , Humanos , Mandíbula , Satisfacción del Paciente , Estudios Prospectivos
5.
Med Teach ; : 1-6, 2019 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-31854254

RESUMEN

Background: There is a continuing concern about how graduate work readiness (WR) reflects on the success of universities meeting the requirements of employment. This study is to establish a valid and reliable instrument measuring WR in health professions (HP) graduates of medicine, pharmacy and dentistry.Methods: The study from March 2016 to April 2017 was conducted to validate the 'Work Readiness Scale' (WRS; Deakin University) using Principal Component Analysis and Cronbach - α for internal consistency. It was modified to a four-item even-point scale and distributed as an online survey to 335 final year students of the three programs.Results: A reduction from 64 to 53 items provided good internal consistency in all factors: WC 0.85, OA 0.88, SI 0.88 and PC 0.71. The PC domain had the greatest item reduction from 22 to 6, whilst the SI domain increased in items from 8 to 19. These changes may be associated with difference in understanding or interpretation of the items in the SI domain.Conclusion: The modified WRS can be used to evaluate job readiness in HP graduates. However, it needs further refinement and validation in specific educational and employment contexts.

6.
Singapore Dent J ; 38: 45-54, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-29229074

RESUMEN

BACKGROUND: To quantify participation in dental research activities in Malaysia, and investigate its association with socio-demographic and professional characteristics, and perceptions of research and development (R&D) culture. MATERIALS AND METHODS: Dental academics in Malaysian dental schools were invited to complete a questionnaire by email and post. The survey comprised questions on research activities in the past 12 months, socio-demographic and professional characteristics, and the R&D Culture Index. Principal components factor analysis was carried out to confirm the factor structure of the R&D Culture Index. Chi-square test was used to identify association of research activities with R&D culture, and socio-demographic and professional characteristics. Binary logistic regression was carried to identify predicators of research activities. RESULTS: Of 256 potential participants contacted, 128 (50%) useable responses were returned. Three R&D Culture factors accounting for 57.4% of variance were extracted. More positive perception of R&D Support was associated with Malaysians (0.025) and those employed in Government schools (0.017). R&D Skills and Aptitude were associated with older respondents (0.050), PhD qualification (0.014) and more years in academia (0.014). R&D Intention was associated with any of the socio-demographic characteristics. Thirty (23.4%) respondents reported a peer-review research publication in the past 12 months, which was associated with having a PhD (OR 12.79, CI 1.28-127.96), after adjustment in regression analyses. DISCUSSION: Postgraduate research training should be encouraged to promote participation in research activities. R&D culture did not appear to impact on research productivity. Other factors such as individual attitudinal interests should be studied.


Asunto(s)
Actitud del Personal de Salud , Investigación Dental , Docentes de Odontología/psicología , Cultura Organizacional , Facultades de Odontología/organización & administración , Adulto , Competencia Clínica , Estudios Transversales , Eficiencia , Femenino , Humanos , Intención , Malasia , Masculino , Percepción , Apoyo a la Investigación como Asunto , Encuestas y Cuestionarios
7.
J Dent ; 43(1): 126-32, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25448436

RESUMEN

OBJECTIVES: The aim of this study was to investigate the recovery of cuspal stiffness and fracture resistance in endodontically treated maxillary premolars restored with bonded ceramic inlays and onlays of various designs. METHODS: Seventy intact premolars were selected for this study; six cavity designs were investigated: (i) mesio-occlusal-distal (MOD) inlay (I), (ii) MOD inlay with palatal cusp coverage (IPC), (iii) MOD onlay (O), (iv) MOD inlay with pulp chamber extension (IPE), (v) MOD inlay with palatal cusp coverage and pulp chamber extension (IPCPE), and (vi) MOD onlay with pulp chamber extension (OPE). Intact teeth acted as control. Strain gauges were attached to the buccal and palatal surfaces of the teeth to measure cuspal stiffness under static loading. All specimens were eventually subjected to compressive load to failure. Cuspal stiffness and fracture resistance data were analyzed using ANOVA and Tukey test. RESULTS: The I and IPE restorations restored cuspal stiffness to 75% of the sound tooth value. The O and OPE restored teeth had stiffness values greater than that of a sound tooth. The I, IPC, O, IPE, IPCPE and OPE restored teeth demonstrated fracture strength values of 938N±113 N (s.d.), 1073N±176 N and 1317N±219 N, 893N±129 N, 1062N±153 N and 1347N±191 N respectively. CONCLUSIONS: Within the limitations of this study, it was concluded that the all-ceramic onlay or inlay with palatal cusp coverage provided best biomechanical advantage in restoring an endodontically treated maxillary premolar tooth. CLINICAL SIGNIFICANCE: The onlay approach which is more conservative compared to full coverage restoration is considered an appropriate approach to the restoration of endodontically treated maxillary premolars. The addition of a pulpal extension to the all-ceramic restorations, apart from being technically challenging, was not found to offer any biomechanical advantage to the restored teeth.


Asunto(s)
Diente Premolar/cirugía , Restauración Dental Permanente , Recubrimientos Dentinarios/uso terapéutico , Fracturas de los Dientes/cirugía , Diente Premolar/fisiología , Cerámica/uso terapéutico , Preparación de la Cavidad Dental , Porcelana Dental/uso terapéutico , Humanos , Incrustaciones/métodos , Tratamiento del Conducto Radicular , Corona del Diente/cirugía , Fracturas de los Dientes/patología , Diente no Vital/patología , Diente no Vital/cirugía
8.
Am J Dent ; 21(5): 331-6, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19024261

RESUMEN

PURPOSE: To investigate the level and distribution of stresses in endodontically treated maxillary premolar teeth restored using various cavity designs of bonded all-ceramic restorations. The hypothesis tested was that the various all-ceramic approaches, including incorporating a pulp chamber extension in the restoration, had no influence on the stresses in the restored tooth unit. METHODS: Finite element packages Patran and Abaqus were used for the stress analysis. The cavity designs investigated include: (1) inlay (I); (2) inlay with palatal cusp coverage (IPC); (3) onlay (O); (4) inlay with pulp chamber extension (IPE); (5) inlay with palatal cusp coverage and pulp chamber extension (IPCPE); and (6) onlay with pulp chamber extension (OPE). RESULTS: In each case, tensile stresses were found to be concentrated subjacent to the occlusal fossa. Peak tensile stress and peak shear stress values along the tooth/restoration interface for IPC, O IPCPE and OPE cavity designs were found to be associated with the axiogingival line angle. Overall, the order of the various forms of restoration investigated in terms of the maximum principal stress (from greatest to lowest) was as follows: IPE > IPCPE > OPE > I > IPC > O.


Asunto(s)
Porcelana Dental , Análisis del Estrés Dental/métodos , Incrustaciones/métodos , Diente no Vital , Adhesivos , Diente Premolar , Módulo de Elasticidad , Análisis de Elementos Finitos , Humanos , Resistencia al Corte , Resistencia a la Tracción
9.
Eur J Prosthodont Restor Dent ; 13(2): 57-64, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16011232

RESUMEN

Existing literature suggests a relationship between the amount of remaining tooth structure and the fracture resistance of the restored endodontically treated tooth. This study investigated the amount of tooth structure remaining following various tooth preparations used in the restoration of the endodontically treated maxillary second premolar. Illustrations of the maxillary second premolar in buccopalatal, mesiodistal and occlusal sections were drawn to scale. Outlines of various intra- and extracoronal preparations were superim-posed on the illustrations to reveal the amount of tooth tissue remaining in each case. Preparations for a ceramic inlay, inlay with palatal cusp coverage and onlay left 2.0-2.5mm of tooth structure buccally and palatally. Following preparation for a metal-ceramic crown, approximately 1.0mm of tooth structure remained buccally, and between 1.6mm-1.8mm palatally. Preparation for an all-ceramic crown was observed to leave 1.0mm-1.2mm of tooth structure surrounding what remained of the endodontic access cavity. It was concluded that decisions as to the type of definitive restoration to restore the endodontically treated maxillary second premolar may be influenced, amongst other factors, by information on the amount of tooth tissue remaining following preparation.


Asunto(s)
Diente Premolar/patología , Diseño de Prótesis Dental , Preparación del Diente/métodos , Diente no Vital/terapia , Cerámica , Coronas , Esmalte Dental/patología , Cavidad Pulpar/patología , Dentina/patología , Humanos , Incrustaciones , Maxilar , Aleaciones de Cerámica y Metal , Modelos Anatómicos , Técnica de Perno Muñón , Preparación del Conducto Radicular , Fracturas de los Dientes/prevención & control , Preparación Protodóncica del Diente/métodos , Diente no Vital/patología
10.
Prim Dent Care ; 10(3): 87-92, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12929337

RESUMEN

AIM: The purpose of this study was to obtain data on current approaches for the restoration of endodontically treated teeth among general dental practitioners (GDPs) in Manchester, United Kingdom. METHOD: A questionnaire containing 19 single-answer, multiple-choice type questions was mailed to 503 GDPs practising in the Greater Manchester area in January 2002. An explanatory covering letter and a stamped addressed return envelope were enclosed. The data obtained were processed using SPSS statistical software. RESULTS: Three hundred and fifty-one (70%) of the practitioners responded to the questionnaire. The restoration of root-filled teeth was normally undertaken within 1-2 weeks of completing root canal therapy by 63% of the practitioners. Only 35% of the GDPs used posts routinely in the restoration of root-filled anterior teeth; the corresponding figure for posterior teeth was 15%. While a cast, precious metal post was the preferred choice in the restoration of anterior teeth, the use of prefabricated posts and related techniques predominated in the restoration of posterior teeth. Composite resin was the most popular choice of material for core build-up procedures in anterior teeth. Amalgam tended to be favoured for core build-ups in posterior teeth. The majority of the practitioners (56%) routinely restored root-filled anterior teeth by means of porcelain-fused-to-metal crowns. Seventy-three per cent of the GDPs preferred to restore root-filled posterior teeth by means of a full veneer crown. CONCLUSIONS: The results of this study suggest that the practitioners surveyed had a sound understanding of the principles involved in the restoration of endodontically treated teeth, with the possible exception of the need to establish a durable coronal seal as soon as possible after the placement of a root filling.


Asunto(s)
Odontología General/estadística & datos numéricos , Técnica de Perno Muñón/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , Diente no Vital , Inglaterra , Odontología General/educación , Humanos , Encuestas y Cuestionarios
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