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1.
Int J Prosthodont ; 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33651026

RESUMEN

PURPOSE: To evaluate the effects of overnight storage conditions on the dimensional stability and retention of prostheses, as well as the participant's subjective perception of these interventions. MATERIALS AND METHODS: Subjects with maxillary complete prostheses (CRPs) were randomly assigned to receive two interventions in a crossover design: storing the CRPs overnight in a dry or wet environment with a cleansing tablet. The denture intaglio surface was scanned, and outcome measures were collected before each intervention (BLN), post ntervention (PIS), and after immersion in water for 15 minutes after the intervention (WOC). Dimensional changes were analyzed for the total surface, anterior flange, palate, and tuberosities. Retention force was measured using a dynamometer, and the participants' subjective assessment of comfort, fit, and retention of their CRPs were collected. After verifying normal distribution, paired t and Wilcoxon signed-rank tests were used to check for any statistical significance (α = .05). RESULTS: Ten participants (mean age: 76.5 ± 5.9 y) were recruited in this study. Between BLN and PIS, the dimensional changes after dry intervention were significantly less than when stored wet for total surface (P = .009), anterior flange (P = .028), and the palate (P = .005). No difference was found between the effects of storage or washout interventions on objectively measured CRP retention. However, after WOC following dry storage, participants perceived a lower retention (P = .021), and a more comfortable palate after WOC following the wet intervention (P = .018). CONCLUSION: For dimensional stability, dry overnight storage of removable prostheses can safely be recommended when indicated. Immersion in water for 15 minutes does not seem to add advantages.

2.
Int J Prosthodont ; 34: s46-s62, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33571326

RESUMEN

PURPOSE: To analyze the influence of material selection, attachment type, interarch space, and opposing dentition on the prosthetic outcomes of fixed and removable implant complete prostheses (FCIPs and RCIPs, respectively). MATERIALS AND METHODS: This review was designed as an overview of systematic reviews. An electronic database search was performed to identify scientific literature that reported on FCIPs and RCIPs. The last search was performed in January 2020. The final inclusion of systematic reviews for data extraction was decided by consensus of the authors. The included studies were analyzed qualitatively. RESULTS: A total of 21 systematic reviews (FCIP: n = 11, RCIP: n = 10) out of 5,733 articles initially identified were included for data extraction and interpretation. High overall 5-year and 10-year prosthesis survival rates were shown for FCIPs and RCIPs (93.3% to 100% and 96.9% to 100%, respectively). Chipping/fracture of the veneering material was the most frequent technical complication for FCIPs, and attachment-related complications were the main technical problems for RCIPs. For FCIPs, the effect of prosthetic material was not significant on the technical complications nor the survival rates. No studies were identified that provided direct information on the effect of interarch space in FCIPs and RCIPs. CONCLUSIONS: Both FCIPs and RCIPs obtained high overall survival rates, but technical complications cannot be avoided with either prosthesis type. No prosthetic material can be considered as the material of choice over another. Attachment type has no influence on the overall clinical outcomes of RCIPs. The influence of opposing dentition and the required prosthetic space were not investigated sufficiently.


Asunto(s)
Implantes Dentales , Fracaso de la Restauración Dental , Prótesis Dental de Soporte Implantado , Humanos
3.
J Prosthet Dent ; 2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-33610329

RESUMEN

STATEMENT OF PROBLEM: Scientific data analyzing the clinical outcomes and costs of complete dentures fabricated by using conventional and computer-aided design and computer-aided manufacturing (CAD-CAM) processes are lacking. PURPOSE: The purpose of this retrospective study was to compare the treatment duration, financial costs, and postdelivery adjustments of CAD-CAM and conventional removable complete dentures. MATERIAL AND METHODS: Thirty-two edentulous participants (16 women, 16 men; age 35-85 years) who had received either CAD-CAM (n=16) or conventional (n=16) maxillary and mandibular removable complete dentures provided by prosthodontists with a minimum of 2 years of experience were evaluated. The CAD-CAM denture systems were either DDS-AV (AvaDent Digital Dental Solutions) (n=11) or DD-IV (Wieland Digital Denture) (n=5). The total treatment period (days) was recorded at 3 different time points (T0: preliminary alginate impression; T1: denture delivery; T2: last scheduled postdelivery adjustment). Adjustments during the follow-up (after T2) were noted and included the removal of areas of excessive pressure, relining, or repairs. The costs of the dental treatment and the laboratory fees were calculated. The Wilcoxon rank sum tests were used for statistical analysis (α=.05). RESULTS: No statistically significant difference regarding the treatment duration between digitally and conventionally fabricated removable complete dentures was found: T0-T1 (P=.889); T1-T2 (P=.675); T2- T3 (P=.978). No significant difference was found in the number adjustments for areas of excessive pressure, relines, or repairs (P=.757, P=1.000, P=1.000) during the period. Laboratory costs of CAD-CAM removable complete dentures were significantly lower than those of conventional removable complete dentures (P<.001), but clinical fees were similar between groups (P=.596), resulting in a reduction in the overall total costs for the CAD-CAM removable complete dentures (P=.011). Regarding the number of clinical visits, neither the group (conventional/CAD-CAM (P=.945)/DDS-AV/DD-IV [P=.848]) nor the interaction group (conventional/CAD-CAM and DDS-AV/DD-IV)/period (P=.084/P=.171) showed any significant differences. CONCLUSIONS: CAD-CAM removable complete dentures can be considered a viable alternative to conventional removable complete dentures regarding treatment duration, clinical and follow-up visits, adjustments, and maintenance requirements.

4.
Swiss Dent J ; 131(5)2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33515230

RESUMEN

This systematic review was undertaken to address the PICO question: Is silver diamine fluoride (SDF) effective in preventing and arresting root caries lesions in (RCLs) elders? Systematic literature searches were conducted of electronic databases [PubMed, Embase, and CENTRAL (Cochrane Controlled Register of Trials)] and hand searches were performed to identify studies reporting on the use of SDF in elders to prevent and arrest root caries. Prospective clinical studies were included. Two independent investigators performed the literature search and data extraction. A total of 277 studies were identified; of those 3 randomized controlled clinical trials were included for data extraction and analysis. A meta-analysis, using a fixed-effects model, was performed on the mean active RCLs present after SDF intervention compared to controls at 24 months (3 studies), and 30-36 months (2 studies) post-intervention. The fixed-effects model revealed a significant decrease in the mean new active RCLs post intervention with SDF compared to controls at both 24 months (95%CI: 0.265 - 0.638; I2=0.0%; Overall: Z=4.749, p<0.001), and at 30-36 months (95%CI: 0.329 - 0.812; I2=0.0%; Overall: Z=4.629, p<0.001). A funnel plot ruled out any publication bias and the risk of bias was judged to be low. This systematic review and meta-analysis provides evidence that the application of silver diamine fluoride prevents and arrests root caries in elders.

5.
Gerodontology ; 2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33470436

RESUMEN

BACKGROUND AND OBJECTIVE: Dental care provision in long-term care facilities (LTCFs) is often a problem despite the high demand. LTCF residents would greatly benefit from a concept that provides an onsite dental care. A rational evaluation of the costs to render this service as well as the cost benefits is worth investigating. This study aimed to calculate the costs involved in providing a mobile dental clinic (MDC) service for LTCF residents in Zurich, Switzerland. MATERIALS AND METHODS: Cost models for setting up, executing and maintaining an MDC unit were generated. The costs included personnel, equipment/material, maintenance and running costs. The treatment costs were calculated for the treatment in MDC, university-setting dental clinic (UC) and private practice (PP). Hypothetical cost estimates were generated for the return of the invested capital. Costs incurred for the institutions for accommodating the MDC visit were also calculated. RESULTS: The set-up capital required to start a MDC in Switzerland (for 2020) was approximately around CHF 505'007.90 (Euros 466'576.80) and was around CHF 452'666.48 (Euros 418'218.56) when a dental care professional (DCP) substituted the dentist. The estimated cost savings for an LTCF resident in the MDC were CHF 205.60 (Euros 189.95) when compared to a UC and approximately CHF 226.34 (Euros 209.12) when compared to a PP. With the dentist, the return of the invested capital can be expected by 3 years while it would take around 6 years with the DCP, assuming that the maximum number of patients possible-to-treat are treated every year. The daily running costs for the LTCF for accommodating the MDC visit were approximately CHF 299.04 (Euros 276.28). CONCLUSIONS: Delivery of oral health services for LTCF residents through the use of a MDC service seems to be an effective model for dependent elders with limited access to care. However, the costs of maintaining this service are high with similarly large start-up costs. Future development of this model by utilising dental care professionals may produce cost savings but with a more limited range of services offered.

6.
Swiss Dent J ; 131(2)2021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33496423

RESUMEN

The purpose of this questionnaire-based survey was to evaluate the attitudes of the undergraduate dental students towards elders. The 14-item Geriatric attitudes scale (GAS) questionnaire, along with a 9-item questionnaire with specific questions on the current geriatric dental curriculum, confidence, and preference in treating the elderly patients were administered to the undergraduate dental students (3rd bachelor, 1st master, and 2nd master) in the four Swiss university dental schools. Mean GAS scores were calculated and inter- and intra-group differences were analyzed with ANOVA and post hoc tests (level of significance set at α=0.05). Responses to the 9-item questionnaire were reported descriptively. Further analyses were performed to evaluate the effect of demographic factors on the GAS scores. 305 students (meanage: 25.8±4.0y) participated in this study. The mean overall GAS score of the students was 3.5±0.4. There were no significant differences in the GAS scores between the centers [F(3, 300)=2.266, p=0.081] or between the year of training [F(2, 301)=1.884, p=0.154]. Demographic factors did not influence the GAS scores. Students considered geriatric dentistry as an important part of their dental undergraduate education. The current geriatric curriculum was perceived to be on an adequate level. Hands-on experience in treating geriatric patients in the undergraduate curriculum was positively opinionated, and mobile dental services for elders with limited access to care was considered a good solution. In conclusion, the attitudes of the Swiss undergraduate dental students towards an elderly patient seem acceptable but could still be improved.

7.
Int J Dent Hyg ; 19(2): 176-183, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33382526

RESUMEN

OBJECTIVE: This questionnaire-based survey assessed the attitudes of dental hygiene students towards treating elderly patients. METHODS: The 14-item UCLA 14-item Geriatrics Attitudes Scale (GAS-14) questionnaire was used in this survey. A further set of nine questions evaluated the opinions of the students towards the existing geriatric curriculum in their respective institutions. Students from five dental hygiene schools from three countries (Switzerland, Belgium and Canada) participated in this survey. General demographic information from the participants was collected. Mean GAS-14 scores were calculated; ANOVA and Bonferroni's tests were used for statistical analyses (p < 0.05). RESULTS: Three hundred eighty-five students (Switzerland: n = 157, mean age = 25.38 ± 4.6 years; Belgium: n = 82, mean age = 27.58 ± 12.8 years; Canada: n = 146, mean age = 25.95 ± 12.3 years) completed the survey for a response rate of 86.3%. The overall GAS-14 scores for Switzerland, Belgium and Canada were 3.61 ± 0.42, 3.24 ± 0.37 and 3.32 ± 0.36, respectively. Switzerland scored significantly higher than Belgium and Canada (p < 0.0001). Overall scores revealed a significant effect of progressive training (p = 0.010). The GAS-14 score was influenced by the nationality of the participants (p < 0.0001), but not influenced by sex, age, origin, religion, or marital and accommodation statuses. Majority of the students (75.8%) agreed that geriatric dentistry was an important part of their education. 77.4% agreed that they would like hands on experience in treating the elderly patient during their education. 85.1% of the participants considered mobile dental clinics as a good solution for the provision of dental care to the institutionalized elders. CONCLUSIONS: The general attitudes of DH students towards treating the elderly patients are on an acceptable level and improved as they progressed through their dental hygiene academic programmes.


Asunto(s)
Actitud del Personal de Salud , Higiene Bucal , Adolescente , Adulto , Anciano , Bélgica , Canadá , Curriculum , Higienistas Dentales , Humanos , Estudiantes , Encuestas y Cuestionarios , Adulto Joven
8.
Clin Nutr ; 2020 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-33358024

RESUMEN

BACKGROUND & AIMS: Oral nutritional supplements (ONS) administered to malnourished elders and other patients contain high-levels of carbohydrates that could be a potential risk factor for dental caries. This study aimed to evaluate the cariogenic potentials of ONS using intraoral plaque telemetry. METHODS: Ten ONS were tested on five healthy volunteers (mean age: 76.8 ± 9.15 years). Participants were requested to refrain from performing oral hygiene 3-7 days prior to testing. The pH-value below the dental plaque on the tooth was measured while the ONS was being consumed. After neutralizing the participant's saliva, a control solution (10% sucrose) was administered and telemetry measurements were repeated. Mean relative cariogenicity (RC) was calculated for each ONS. ANOVA and post hoc tests were used for statistical analyses (p < 0.05). RESULTS: All ten ONS were potentially cariogenic on enamel with an overall RC of 0.519 ± 0.35 (Range: Min = 0.31 ± 0.16; Max = 1.00 ± 0.34). RC differed significantly between the ONS (p = 0.002). RC was lower in ONS that contained high-protein (p = 0.018). RC was not influenced by other factors such as readily consumable (p = 0.102), flavor (p = 0.869), consistency (p = 0.126), fiber containing (p = 0.134), style (p = 0.112), and age of plaque (p = 0.339). CONCLUSIONS: The ONS administered to elders and malnourished patients are potentially cariogenic. It is imperative that the administration of ONS must be based on individual needs to potentiate a maximum benefit. Wherever possible, an attempt to limit the use of high-carbohydrate containing ONS must be practiced along with the adoption of suitable preventive measures to arrest the development and progression of caries.

9.
Swiss Dent J ; 130(11): 876-884, 2020 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-33140630

RESUMEN

The objective of this study was to explore the preferred dental services of older people for when they become dependent. It aimed to assess their preferred type of health care professional and location of dental service, and relate their preferences to their willingness to pay (WTP) and willingness to travel (WTT). Older people aged 65 years or older were invited to participate in a questionnaire-based discrete choice experiment (DCE), to measure preferences for dental examinations and treatment, defined by two attributes: type of professional and location of the activity. Hypothetical scenarios based attributes were displayed in a projected visual presentation and participants noted their personal preference using a response sheet. Data was analyzed using a random-effects logit model. Eighty-nine participants (mean age 73.7 ± 6.6 years) attended focus group sessions. Respondents preferred that the family dentist (ß: 0.2596) or an auxiliary (ß: 0.2098) undertake the examination and wanted to avoid a medical doctor (ß: ­0.469). The preferred location for dental examination was at a dental practice (ß: 0.2204). Respondents preferred to avoid treatments at home (ß: ­0.3875); they had a significant preference for treatment at the dental office (ß: 0.2255) or in a specialist setting (ß: 0.1620, ns). However, the type of professional did not have a significant influence on overall preference. Participants with a low WTP preferred examination at home (ß: 0.2151) and wanted to avoid the dental practice (ß: ­0.0235), whereas those with a high WTP preferred the dental office (ß: 0.4535) rather than home (ß: ­0.3029). WTT did not have a significant influence on preference. The study showed that older people generally preferred receiving dental services in a dental practice or specialist setting, and would prefer not to be treated at home. Continuity of dental services provided by the family dentist should therefore be prioritized where possible and further studies should examine the role of domiciliary care at home.


Asunto(s)
Cuidado Dental para Ancianos , Prioridad del Paciente , Anciano , Anciano de 80 o más Años , Humanos , Encuestas y Cuestionarios , Suiza
10.
Gerodontology ; 2020 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-33169864

RESUMEN

OBJECTIVES: To evaluate the impacts of restrictions to the provision of dental services for dependent older patients due to the COVID-19 pandemic. METHODS: Data were gathered on the number of dependent older patients treated, emergency treatment provided and the revenues generated by a specialised clinic for geriatric dentistry during the current pandemic period and compared with the recorded clinical activity from the preceding year. Hypothetical projections were generated for the remainder of the current year based on the assumption that restrictions due to COVID-19 would remain. RESULTS: A significant decrease in the total number of dependent older patients treated was recorded during the periods of January-March 2020 (P = .026) and April-May 2020 (P = .001) when compared to 2019. According to projections, by December 2020 the clinic will be providing 81.14% less clinical activity compared to 2019 (P < .0001), including a complete cessation of domiciliary services. Despite decreases in expenditure, revenues generated by the clinic have decreased significantly due to reduced clinical activity during January-March 2020 (P = .268) and April-May 2020 (P = .010) compared to 2019, and would decline further by 899.61% by December 2020. CONCLUSIONS: The restrictions implemented to prevent the spread of COVID-19 have resulted in a significant reduction in oral healthcare provision for dependent older adults. Within this clinic, dedicated to dependent older adults, clinical activity is projected to reduce by 81% by the end of 2020 with associated reductions in revenue generation. Given the importance of oral healthcare delivery for this patient group, this may have significant and lasting impacts.

11.
Gerodontology ; 2020 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-33073408

RESUMEN

OBJECTIVES: This study aimed to obtain a consensus on oral health policy, access to dental care, oral hygiene measures and training levels. BACKGROUND: Poor oral health is widespread in care-dependent older people, but no consensus for a minimum standard of oral health care exists yet. METHODS: The e-Delphi approach was applied to a selected panel of interdisciplinary experts. Data analysis was based on three measurements: (a) ≥70% of experts' opinion fall into category "agree or strongly agree," (b) median score on the 5-point Likert scale ≥4, (c) interquartile range ≤1. RESULTS: A total of 31 experts from 17 European countries participated in this survey. Agreement was achieved for a compulsory dental examination when an elder is admitted to a long-term care (LTC) facility. Older people should brush their teeth twice/day and regularly clean interproximal spaces and oral mucosa. Dentures should be rinsed after meals and cleaned twice/day. The use of denture cleansing tablets was considered necessary. Dentures should be removed before sleeping and stored dry. A 5000 ppm fluoride toothpaste should be applied daily in elder with high caries risk. A short report on the oral health status of the elder should be included in the geriatric assessment. All experts concluded that the knowledge and the training in oral health care for caregivers and family members of care-dependent older people were imperative. CONCLUSIONS: Using the e-Delphi method, multidisciplinary healthcare professionals from different countries agreed on certain cardinal recommendations for a standard oral health care for care-dependent older people.

12.
Prim Dent J ; 9(3): 29-33, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32940588

RESUMEN

Whilst increasing numbers of older people retain natural teeth, a sizable proportion of older people are still edentate. Replacement of missing teeth is important for function, aesthetics and to facilitate social interactions. The process of providing oral rehabilitation for edentate older adults can be challenging, but clinicians can utilise a number of treatment options including removable or implant retained prostheses. In this article, complete denture construction will be described using both conventional and copy denture techniques. Recent innovations in the process for constructing complete dentures using computer aided design and manufacturing (CAD-CAM) techniques will also be discussed. Dental implants can be used to help retain removable complete prostheses for edentate patients and the use of implant-retained overdentures is presented as a treatment alternative.


Asunto(s)
Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Anciano , Anciano de 80 o más Años , Diseño Asistido por Computadora , Dentadura Completa , Humanos
13.
Clin Oral Implants Res ; 31(12): 1207-1222, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32965052

RESUMEN

OBJECTIVE: This randomized controlled trial (RCT) aimed to demonstrate the non-inferiority of mandibular 2-implant overdentures (IODs) on a CAD-CAM milled bar with long distal extensions (MBDE) against IODs on retentive anchors (RA). METHODS: Forty edentulous participants rehabilitated with a maxillary conventional denture and a mandibular 2-IOD participated in this trial. They were randomized into two groups [Control group (CG): RA + gold matrices; Experimental group (EG): MBDE + gold clip]. The outcomes included implant survival rate (ISR), chewing efficiency [quantitative (VoH) and subjective (SA) assessments], peri-implant marginal bone levels (PI-MBL), maximum bite force (MBF), and patient-reported outcomes [oral health impact profile (OHIP-EDENT), and denture satisfaction index (DSI)]. Outcomes were recorded at baseline (BL), two weeks (T0 ), 6 months (T1 ), and at 1 year (T2 ) after the intervention. Intra- and inter-group analyses were performed using regression models with ⍺=0.05. RESULTS: 38 participants completed the T2 visit (CG: n = 19, age = 74.7 ± 7.8 years; EG: n = 19, age = 70.3 ± 10.7 years). At T2 , there was no implant loss in either of the groups (ISR = 100%). There were no significant differences between the groups for the PI-MBL changes (p = .754). Improvements occurred faster in the EG than in the CG, but over the observation time, there were no differences between the trial groups for VoH, MBF, OHIP-EDENT, and the DSI, except for SA being significantly better in the EG group (p = .022). CONCLUSIONS: The results of this RCT confirm that mandibular 2-IODs with a CAD-CAM milled bar with long distal extensions are not an inferior treatment to the conventional IODs on retentive anchors in the short term (1 year).

14.
J Oral Rehabil ; 47(12): 1496-1502, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32966643

RESUMEN

BACKGROUND: The two-colour mixing test is a quick method to assess chewing function (CF). The use of smartphone cameras for acquiring images may help in further simplifying the process. OBJECTIVE: This study evaluated the reliability of smartphone-camera images of chewing gums to assess CF. METHODS: Five test samples of a bicoloured chewing gum were produced by a single fully dentate adult volunteer. The specimens were flattened to 1-mm thick wafers. The two sides of the wafers were digitised with a conventional flatbed scanner (control) and were photographed 20 times using 8 different smartphones. The images were assessed optoelectronically to obtain the variance of hue (VoH) and subjectively by visual assessment (SA) using a categorical scale (SA1-SA5). Spearman's correlation and regression models were used for statistical analyses. RESULTS: The intra-group variability for SA1-SA3 was <1% for all smartphones, but significantly higher than controls for SA4 and SA5 (smartphone: SA4 = 5.57%; SA5 = 8.76%; control: SA4 = 2.5%; SA5 = 0.79%). VoH was progressively lower from SA1 to SA5 for all imaging devices (r > -.97; P < .001). VoH comparisons between control and smartphone images revealed significant differences for the individual SA categories, and however, the magnitude of differences was small and non-significant when the full range of SA levels were considered. The linear mixed model regression showed significant effects for all the smartphones (P < .001) and SA levels (P < .001) in relation to the flatbed scanner values. CONCLUSIONS: Smartphone cameras may be used to evaluate colour mixture for a bolus-kneading test, however, the precision is lower with higher degrees of colour mixing.


Asunto(s)
Goma de Mascar , Teléfono Inteligente , Adulto , Color , Humanos , Modelos Lineales , Masticación , Reproducibilidad de los Resultados
15.
J Prosthodont ; 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-32864812

RESUMEN

PURPOSE: To evaluate the color stability of CAD/CAM complete denture resins. MATERIALS AND METHODS: A total of 176 resin specimens were manufactured from conventional heat-polymerizing (pink: CONHCP : n = 16; tooth-shade: CONHCT : n = 16), CAD/CAM subtractively manufactured (pink: WIMP : n = 16, AVMP : n = 16, MEMP : n = 16, POMP : n = 16; tooth-shade: AVMT : n = 16, MEMT : n = 16, POMT : n = 16), and additively manufactured (pink: NDRPP : n = 16; tooth-shade: NDRPT : n = 16) denture resins; four different aging processes (thermal cycling, distilled water, red-wine, and coffee) were used. A spectrophotometer evaluated the color change (ΔE) using two modes of measurements (specular component included (ΔESCI ) and specular component excluded (ΔESCE )) recorded at baseline (T0 ) and at day#30 (T30 ). ANOVA and post hoc tests were used for statistical analysis (alpha = 0.05). RESULTS: Additively manufactured resins (NDRPP and NDRPT ) demonstrated significant ΔE in comparison to the other groups in all aging media (p < 0.001). WIMP demonstrated higher ΔESCI in comparison to the other subtractively manufactured groups in distilled water (p < 0.001). In red-wine, AVMT revealed significantly more ΔESCE than POMT (p = 0.039). In coffee, the ΔESCE was higher for CONHCT than MEMT (p = 0.026) and POMT (p = 0.011). Similarly, in coffee the ΔESCE for AVMT was higher than POMT (p = 0.030). CONCLUSION: Additively manufactured denture resins demonstrated the maximum color change compared to conventional heat-polymerized and CAD/CAM subtractively manufactured denture resins. Furthermore, CAD/CAM subtractively manufactured denture resins were not inferior to conventional resins in terms of color stability.

16.
Clin Oral Investig ; 2020 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-32812098

RESUMEN

OBJECTIVES: New generation intraoral scanners are promoted to be suitable for digital scans of long-span edentulous spaces and completely edentulous arches; however, the evidence is lacking. The current study evaluated the accuracy of intraoral scanning (IOS) in partially and completely edentulous arch models and analyzed the influence of operator experience on accuracy. MATERIALS AND METHODS: Four different resin models (completely and partially edentulous maxilla and mandible) were scanned, using a new generation IOS device (n = 20 each). Ten scans of each model were performed by an IOS-experienced and an inexperienced operator. An industrial high-precision scanner was employed to obtain reference scans. IOS files of each model-operator combination, their respective reference scan files (n = 10 each; total = 80), as well as the IOS files from each model generated by the same operator, were superimposed (n = 45; total = 360) to calculate trueness and precision. An ANOVA for mixed models and post hoc t tests for mixed models were used to assess group-wise differences (α = 0.05). RESULTS: The median overall trueness and precision were 24.2 µm (IQR 20.7-27.4 µm) and 18.3 µm (IQR 14.4-22.1 µm), respectively. The scans of the inexperienced operator had significantly higher trueness in the edentulous mandibular model (p = 0.0001) and higher precision in the edentulous maxillary model (p = 0.0004). CONCLUSION: The accuracy of IOS for partially and completely edentulous arches in in vitro settings was high. Experience with IOS had small influence on the accuracy of the scans. CLINICAL RELEVANCE: IOS with the tested new generation intraoral scanner may be suitable for the fabrication of removable dentures regardless of clinician's experience in IOS.

17.
Clin Oral Investig ; 2020 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-32488486

RESUMEN

OBJECTIVES: Despite the complexity of the edentulous anatomy, little evidence exists as to what impression techniques and materials should be employed for an optimal result. The aim of this in silico study was to evaluate the trueness of peripheral and inner seals of different edentulous jaw impressions. MATERIALS AND METHODS: Twelve maxillary edentulous participants (male = 8, female = 4; age 68.5 ± 11.7 years) participated in this study. Four different impression materials and techniques, irreversible hydrocolloid (Alginate; Blueprint X-Crème, Dentsply Sirona, PA, USA), polyvinyl siloxane impression (PVS; Aquasil Ultra+ Medium, Dentsply Sirona, PA, USA), and subsequently modified with ZnOE (PVSM) and an optical impression (Optical; 3Shape A/S, Copenhagen, Denmark), were tested against a control impression: low-fusing impression compound border molding (Kerr Corp., CA, USA) followed by a ZnOE impression (ZnOE; SS White impression paste, S.S. White Group, Gloucester, England). All impressions were scanned and analyzed using a custom-built 3D comparison software analyzing the vertical and horizontal trueness. RESULTS: The vertical discrepancy (peripheral seal) of the impression surface was significantly more true for PVSM than Alginate (p = 0.001), PVS (p = 0.019), and Optical groups (p < 0.001). Where the horizontal discrepancy (inner seal) was compared, the impression surface was more true for PVSM than Alginate (p < 0.001) and Optical (p < 0.001). PVS group was also significantly more true than Optical (p = 0.015). CONCLUSION: Impression techniques and materials may significantly influence the peripheral and inner seal of an edentulous jaw impression. CLINICAL RELEVANCE: When using a polyvinylsiloxane impression material for master edentulous impressions, a selective inner seal reline with a conventional zinc oxide eugenol impression paste can improve the inner seal.

18.
Clin Oral Implants Res ; 31(4): 315-327, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31876004

RESUMEN

OBJECTIVES: This in vitro study aimed to compare changes in retentive force due to cyclic dislodging of three novel un-splinted attachments. MATERIALS AND METHODS: Experimental models simulating a mandibular two-implant overdenture situation, with implants positioned with various interimplant discrepancies (0°, 20°, 40°, and 60°) were fabricated. Three attachment systems were tested, "N": a straight or 15°-angulated stud; "L": a sole straight stud; and "C": a straight or individually angulated stud. All models underwent wet testing and were subjected to 10,000 insertion-removal cycles in a universal testing machine. The mean retentive forces were calculated for cycles 10, 100, 1,000, 5,000, and 10,000. Multiple mixed-effects linear regression models were applied for statistical analyses (⍺ < 0.05). RESULTS: "N" demonstrated an increasing retention until 1,000 cycles, which subsequently diminished back to its initial retention at 10,000 cycles, showing no significant loss during the entire experiment. Statistical models demonstrated no effect of implant angulation on retention, except for 60° after 10,000 cycles (p < .05). "L" showed an early peak at 100 cycles and did not significantly lose retentive force before 5,000 cycles. Angulations of 40° or higher were shown to lead to lower retentive forces (0° vs. 40° cycle 5,000: p < .05; 0° vs. 60° cycle 100: p < .05, ≥cycle 1,000: p < .001). "C" showed stable retentive forces with no significant loss only at 10,000 cycles (all angles: p < .001) or 5,000 cycles (0° vs. 60°: p < .05). CONCLUSIONS: All systems showed retentive forces promising successful clinical use in implant overdentures, even in situations with extremely angulated implants. Specific abutments compensating interimplant angulation maintain retention longer in situations with high axe divergencies.


Asunto(s)
Retención de Dentadura , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Mandíbula
19.
J Prosthet Dent ; 123(1): 27-37, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31079883

RESUMEN

This technical report describes 2 workflows for fabricating computer-aided design and computer-aided manufacturing (CAD-CAM) milled complete dentures (CDs). The first technique illustrates a manufacturer-independent workflow using conventional clinical steps and a novel, custom modified tray to successfully fabricate CAD-CAM milled CDs. The second technique highlights a nearly digital workflow for manufacturing a CAD-CAM milled CD and a milled resin interim removable partial denture.


Asunto(s)
Diseño de Dentadura , Dentadura Completa , Diseño Asistido por Computadora
20.
J Prosthet Dent ; 123(1): 6-14, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31113663

RESUMEN

The functionality of a new overdenture attachment (LOCATOR R-Tx) was described for different clinical situations: a conventional mandibular implant overdenture (IOD) retained by 2 implants, a straightforward chairside maintenance procedure for replacing a worn LOCATOR (Legacy) attachment with the new LOCATOR R-Tx, and a complex clinical situation with nonideal implant positions with compromised parallelism. The LOCATOR R-Tx is an advance on the existing LOCATOR Legacy attachment and has an improved abutment head design with a more durable surface coating to prevent attachment wear and thereby reduce frequency of maintenance.


Asunto(s)
Retención de Dentadura , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Mandíbula
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