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1.
J Prosthet Dent ; 2021 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-33879318

RESUMEN

STATEMENT OF PROBLEM: Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness. PURPOSE: The purpose of this systematic review and meta-analysis was to determine the effectiveness of intraoral stent use and determine whether these prosthetic devices can reduce radiation dosage to nontargeted oral tissues and adverse effects related to head and neck radiation. MATERIAL AND METHODS: Two independent reviewers made a systematic search for articles published from January 2010 to March 2020 in 3 databases, supplemented by a manual search. Studies were included if they were clinical trials (randomized controlled trials, both prospective and retrospective), published in English, and evaluated radiation dose and oral adverse side effects (acute or chronic) induced by radiotherapy of participants with and without intraoral stents. RESULTS: The search strategy identified 201 studies; of which, 9 were included. A total of 251 participants were evaluated; of whom, 168 (77.3%) used intraoral stents and 57 (22.7%) were treated with radiotherapy without a prosthetic device. A statistically significant difference was found regarding the use of intraoral stents for preventing oral mucositis (P<.001), salivary changes (P=.003), and trismus (P<.02). A funnel plot showed asymmetry among the differences of means in all selected studies. CONCLUSIONS: Intraoral stents have a positive effect on preventing oral mucositis. Further clinical trials are needed to address the flaws identified in the present systematic review.

3.
J Prosthet Dent ; 2021 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-33715834

RESUMEN

STATEMENT OF PROBLEM: Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations. PURPOSE: The purpose of this systematic review and meta-analysis was to analyze the evidence regarding the impact of head and neck radiotherapy on the longevity of dental adhesive restorations. MATERIAL AND METHODS: A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November 2020). Data extraction was performed regarding the percentage of restoration failure among dental adhesive materials, including glass ionomer cements, resin-modified glass ionomer cements, and composite resins. Risk of bias was assessed by the meta-analysis of statistics assessment and review instrument (MAStARI). Confidence in cumulative evidence was evaluated by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. RESULTS: Four studies met the inclusion criteria. All included studies were classified as having a moderate risk of bias and reported results regarding class V restorations. Overall, composite resins presented lower failure rates at 2 years (30%) when compared with resin-modified glass ionomer (41%) and glass ionomer cements (57%). Meta-analysis showed that the risk of failure with glass ionomer cements was greater than with resin-modified glass ionomer cements (RR: 1.71, P<.001). Composite resins presented lower risk of failure when compared with glass ionomer (RR: 2.29, P<.001) and resin-modified glass ionomer cements (RR: 1.30, P=.03). Three studies reported results regarding fluoride compliance, which had a negative effect on the survival rates of glass ionomer and resin-modified glass ionomer cements and a positive effect on composite resin restorations. CONCLUSIONS: The results suggest that composite resin restorations associated with fluoride gel compliance seems to be the best alternative for restoring class V lesions in patients after head and neck radiotherapy. However, the results showed moderate certainty of evidence, which justifies the need for more randomized clinical trials regarding this subject.

4.
Support Care Cancer ; 29(1): 11-15, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32856215

RESUMEN

During the current pandemic scenario, maxillofacial rehabilitation specialists involved with supportive care in cancer must transform its practice to cope with COVID-19 and improve protocols that could quickly return the oral function of complex cancer patients who cannot wait for surgical complex rehabilitation. This includes the role of the maxillofacial prosthodontist for the rehabilitation of surgically treated patients with maxillary cancers by the means of filling obturator prostheses that are considered an optimal scientific-based strategy to reduce hospital stay with excellent pain control, oral function (speech, swallowing, mastication, and facial esthetics), psychologic and quality of life outcomes for the patients following intraoral cancer resection. Therefore, the aim of this commentary was to bring new lights to the strategic use of obturator prostheses for the rehabilitation of oral cancer patients during the COVID-19 pandemic as well as to present a protocol for managing such cases.


Asunto(s)
/epidemiología , Vías Clínicas/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Prótesis Maxilofacial , Neoplasias de la Boca/rehabilitación , Obturadores Palatinos , Atención Ambulatoria/métodos , Atención Ambulatoria/organización & administración , Vías Clínicas/normas , Diseño de Prótesis Dental/normas , Estética , Humanos , Reconstrucción Mandibular/instrumentación , Reconstrucción Mandibular/métodos , Reconstrucción Mandibular/normas , Prótesis Maxilofacial/estadística & datos numéricos , Neoplasias de la Boca/cirugía , Ortodoncia/métodos , Ortodoncia/organización & administración , Ortodoncia/normas , Obturadores Palatinos/estadística & datos numéricos , Pandemias , Patología Bucal/organización & administración , Patología Bucal/normas , Calidad de Vida , Flujo de Trabajo
7.
Artículo en Inglés | MEDLINE | ID: mdl-32444333

RESUMEN

OBJECTIVE AND STUDY DESIGN: This narrative review summarizes the current state of art of radiation-related caries (RC), an aggressive disease that affects approximately 30% of post-head and neck radiotherapy (HNRT) patients. RESULTS: RC mainly affects the tooth cervical areas and incisal/cuspal tips and develops 6 to 12 months after HNRT. Early RC signs include black/brownish tooth discoloration and enamel cracks, which progress to enamel delamination, exposing underlying dentin to a highly cariogenic oral environment and rapid tooth destruction/dental crown amputation. As RC advances and renders the tooth nonrestorable, it may lead to osteoradionecrosis spontaneously or upon extraction if the tooth is in a highly irradiated field of the oral cavity. This requires aggressive treatment, which would have a negative impact on a cancer survivor's quality of life and contribute to the incremental cost of cancer care. Chlorhexidine mouth rinses and topical fluoride applications are effective agents used in RC prevention; however, there are no well-established treatment protocols. Once RC progresses, dental restorations should be performed with adhesive materials in association with systematic fluoride application as illustrated in the clinical case presented in this review. Post-HNRT patients should be closely followed up for optimal RC prevention, early diagnosis, and prompt treatment. CONCLUSIONS: Future clinical studies are necessary to establish a contemporary, clinically validated protocol for RC management.


Asunto(s)
Caries Dental , Osteorradionecrosis , Traumatismos por Radiación , Humanos , Pronóstico , Calidad de Vida
8.
Caries Res ; 54(2): 113-126, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31962337

RESUMEN

Radiation-related caries (RRC) is a disease with a high potential for destruction of the dentition, which impairs quality of life in head-and-neck (HN) cancer (HNC) patients who undergo radiotherapy. In light of the recently described "clustering of oral symptoms theory," the present systematic review (PROSPERO CRD42019132709) aims to assess HN and gastrointestinal (GI) symptom clusters among HNC patients and discusses how these indirect effects of cancer therapy play a pivotal role in the pathophysiology of RRC. The search was performed at PubMed, Scopus, and Embase and resulted in 11 studies that met the inclusion criteria. Data extraction was performed with respect to the presence of HN/GI symptom clusters among HNC patients. The methodological data of the studies included were assessed using the MAStARI and GRADE instruments. The most prevalent reported HN symptoms were dysphagia, xerostomia, and pain. Taste alterations and fatigue were also commonly reported by the patients. Loss of appetite and weight loss were regularly reported in the studies, as well as nausea and vomiting. The results of the present study suggest that HNC treatment generates clusters of oral symptoms, leading to dietary changes, impaired oral hygiene, enamel fragility, and a highly cariogenic oral environment, which may impact the risk for RRC. A better understanding of oral symptom clustering could be of considerable clinical significance for the oral health and quality of life of HNC patients. Therefore, contemporary protocols of RRC prevention must take this broader treatment scenario of symptom clusters such as oral side effects into account.


Asunto(s)
Caries Dental , Xerostomía , Análisis por Conglomerados , Caries Dental/etiología , Neoplasias de Cabeza y Cuello , Humanos , Calidad de Vida , Xerostomía/etiología
9.
Support Care Cancer ; 28(7): 3451-3457, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31802252

RESUMEN

PURPOSE: The objectives of this study were to describe the distribution and the clinicopathological features of the most common causes for dental treatment needs during the hospitalization of cancer patients. METHODS: A retrospective cohort study of 2664 hospitalized cancer patients that analyzed the main dental treatment needs and dental procedures performed from January 2010 to December 2017. RESULTS: A total of 2664 medical patients were included in this study. Non-Hodgkin lymphoma (17.2%) was the most common cancer type, followed by leukemia (14.8%), and oral and oropharyngeal squamous cell carcinoma (10.5%). The most common reasons for patients' hospitalization were chemotherapy protocols (18.8%), monitoring head and neck surgeries (9.7%), and febrile neutropenia (9.6%). The main motivation for the medical team to request dental evaluation was oral mucositis (22.8%) followed by oral pain or toothache (10.8%) and fungal, viral oral infections or traumatic oral lesions (9.9%). The dental treatment needs most observed were pain due to oral mucositis (17%), dental treatment prior to radiotherapy (RT), chemotherapy (CT) or bisphosphonate therapy (BP) (10.8%), teeth extractions (6.5%), and prophylactic photobiomodulation therapy (6.3%), whereas the most common dental treatments performed were oral hygiene protocols (30.2%), photobiomodulation therapy (prophylactic and curative) (21.7%), and dental treatment prior to cancer treatment initiation (RT, CT, and BP) (9.5%). CONCLUSION: This study can be considered original in the oncologic context, providing new information about the most frequent dental treatment needs among a large population of hospitalized cancer patients.


Asunto(s)
Atención Odontológica/métodos , Neoplasias/enfermería , Neoplasias/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Instituciones Oncológicas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
10.
J Prosthodont ; 28(1): e18-e20, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29148238

RESUMEN

The purpose of this article was to present an alternative procedure using resin-based provisional material to create the posterior palatal seal (PPS). This method offers more practicality in clinical routine and increased control for addition of material to create the PPS when compared to traditional techniques such as the use of impression wax.


Asunto(s)
Técnica de Impresión Dental , Diseño de Dentadura/métodos , Retención de Dentadura/métodos , Dentadura Completa , Resinas Sintéticas/uso terapéutico , Materiales de Impresión Dental/uso terapéutico , Humanos
11.
J Prosthodont ; 27(8): 784-785, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27880027

RESUMEN

Translucent acrylic templates have been used to indicate implant positions for implant-retained extraoral prostheses; however, this procedure can be challenging, as the acrylic templates have to be positioned onto reflected skin flaps. The fabrication of an acrylic-based colorless template or duplicating an existing prosthesis can facilitate the location of extraoral implants. Spots can be created on templates to indicate the optimal position of the implants. Afterward, punching the skin to the bone with a very thick sharp needle or a small sharp bur will mark the desired implant position on the bone before reflecting the skin.


Asunto(s)
Implantación de Prótesis Maxilofacial/métodos , Prótesis Maxilofacial , Resinas Acrílicas/uso terapéutico , Humanos
12.
J Prosthet Dent ; 119(1): 185-192, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28533010

RESUMEN

STATEMENT OF PROBLEM: Although craniofacial implants have been used for retention of facial prostheses, failures are common. Titanium undergoes corrosion in the oral cavity, but the corrosion of craniofacial implants requires evaluation. PURPOSE: The purpose of this in vitro study was to investigate the corrosion stability of commercially pure titanium (CP Ti) exposed to simulated human perspiration at 2 different pH levels (5.5 and 8). MATERIAL AND METHODS: Fifteen titanium disks were divided into 3 groups (n=5 per group). The control group was subjected to simulated body fluid (SBF) (control). Disks from the 2 experimental groups were immersed in simulated alkaline perspiration (SAKP) and simulated acidic perspiration (SACP). Electrochemical tests, including open circuit potential (3600 seconds), electrochemical impedance spectroscopy, and potentiodynamic tests were performed according to the standardized method of 3-cell electrodes. Data were analyzed by 1-way ANOVA and the Tukey honestly significant difference tests (α=.05). RESULTS: Simulated human perspiration reduced the corrosion stability of CP Ti (P<.05). The SBF group presented the lowest capacitance values (P<.05). SAKP and SACP groups showed increased values of capacitance and showed no statistically significant differences (P>.05) from each other. The increase in capacitance suggests that the acceleration of the ionic exchanges between the CP Ti and the electrolyte leads to a lower corrosion resistance. SAKP reduced the oxide layer resistance of CP Ti (P<.05), and an increased corrosion rate was noted in both simulated human perspiration groups. CONCLUSIONS: Craniofacial implants can corrode when in contact with simulated human perspiration, whereas alkaline perspiration shows a more deleterious effect. Perspiration induces a more corrosive effect than simulated body fluid.


Asunto(s)
Huesos Faciales/cirugía , Prótesis e Implantes , Cráneo/cirugía , Titanio , Corrosión , Ensayo de Materiales , Diseño de Prótesis
13.
J Adhes Dent ; : 525-533, 2017 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-29260804

RESUMEN

PURPOSE: To characterize the surface of glass fiber posts (GFP) after different surface treatments and evaluate which method incorporates higher amounts of silicon (Si) particles, as well as to evaluate the bond strength at the post/ composite-cement interface with four different surface treatments of glass fiber posts luted with composite cement. MATERIALS AND METHODS: Twelve glass fiber posts were obtained from the manufacturer. The posts were randomly distributed into four groups (n = 3): Co (control), no surface treatment; S, 70% alcohol and silane (60 s); HF + S, 10% hydrofluoric acid gel (60 s) and silane (60 s); NTP, nonthermal plasma of hexamethyldisiloxane (HMDSO) associated with argon (30 min). The surface of each GFP was characterized through scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Forty GFPs were randomly divided into 4 groups according the surface treatments (n = 10) and cemented with one composite cement (Rely X U200) into artificial canine teeth. The specimens were placed in a universal testing machine and subjected to tensile testing until failure occurred. Statistical analysis of the atomic percentage and bond strength was performed using ANOVA, followed by the post-hoc Tukey test (p = 0.05). RESULTS: EDS graphics showed that the NTP group had a higher Si atomic percentage (at%) than the other groups (p < 0.001). The HF + S group had a higher Si at% than did the Co and S groups. SEM images illustrated that the surfaces of the GFPs were variously modified after different treatments. The NTP group incorporated higher Si levels on the GFP surface and yielded the highest bond strengths (p < 0.005) compared to the other tested groups. CONCLUSION: Treatment with HMDSO + Ar plasma (NTP) incorporated higher Si levels on the surface of the GFPs without inducing critical defects. NTP treatment promoted better bond strength results when compared to the other tested group when GFPs were cemented with composite cement.

14.
J Craniofac Surg ; 28(8): e737-e738, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28922246

RESUMEN

The aim of the authors was to report a clinical case about immediate implant placement after the removal of complex odontoma. A 35-year-old female patient presented to private service complaining about absence of lower right first premolar. The computed tomographic showed radiopaque attenuation, surrounded by a narrow radiolucency in the area of dental absence, suggesting a mineralized lesion. The surgical removal of lesion was performed by intraoral access with general anesthesia and the implant of 3.75 × 10 mm (Neodent) was placed with the aid of a surgical guide, following the drill sequence established by the manufacturer. No complications were observed after 1 year with the prosthetic rehabilitation.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado/métodos , Odontoma , Procedimientos Quirúrgicos Orales , Adulto , Femenino , Humanos , Odontoma/patología , Odontoma/cirugía , Procedimientos Quirúrgicos Orales/métodos , Procedimientos Quirúrgicos Orales/rehabilitación , Tiempo de Tratamiento , Resultado del Tratamiento
15.
J Prosthet Dent ; 118(2): 235-241, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28159348

RESUMEN

STATEMENT OF PROBLEM: The longevity of silicone facial prostheses is short, and published data concerning this type of rehabilitation are limited. PURPOSE: The purpose of this retrospective study was to identify predictive variables for prosthetic failure and to highlight the results that can be expected after treatment with silicone facial prostheses. MATERIAL AND METHODS: After institutional approval, patient records from a single Brazilian institution for the time period 2004 to 2015 were assessed. A standardized form was used to collect patient data. Frailty survival modeling (simple random effects survival model) was used to test whether age, sex, type of prosthesis, source of defect, number of implants, and type of retention have a direct impact on the prosthetic failure rate (α=.05). RESULTS: Auricular prostheses were the most frequently fabricated prostheses. Eighty-four prostheses were fabricated during the follow-up period. The overall survival rate for facial prostheses was 34.5%. Color alteration was the most common reason for new prostheses (27.38%). The implant success rate was 98.18%. The number of implants approached statistical significance (P=.06) with a reduced risk of failure when the patient had 2 implants compared with patients with zero implants and patients with more than 2 implants. CONCLUSIONS: Patients should be recalled frequently so that retouches can be performed, avoiding the repeated fabrication of new prostheses. Well-designed studies are necessary to identify more relevant complications and factors that lead to prosthetic failure.


Asunto(s)
Cara/cirugía , Complicaciones Posoperatorias/epidemiología , Prótesis e Implantes , Cráneo/cirugía , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Falla de Prótesis , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
16.
Implant Dent ; 26(1): 106-111, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28060024

RESUMEN

PURPOSE: The aim of this study was to assess stress distribution in the bone-implant interface of a mandibular implant-supported prosthesis with different cantilever lengths, aesthetic coating materials, and implant abutments. MATERIALS AND METHODS: A photoelastic model of an edentulous mandible, containing 5 external hexagon implants, was constructed. Experimental models were divided into 6 groups: group 1-UCLA component and metal bar; group 2-UCLA component and acrylic resin coating; group 3-UCLA component and porcelain coating; group 4-abutment and metal bar; group 5-abutment and acrylic resin coating; and group 6-abutment and porcelain coating. Forces were applied to the most anterior implant, the most posterior implant, and different cantilever lengths. RESULTS: The results showed a higher number of high-stress fringes as the cantilever length increased. Fringes were better distributed in groups with prostheses composed of acrylic resin and in groups that contained an abutment. CONCLUSION: The stress distribution in the bone-implant interface is improved when the cantilever is eliminated and when abutments in an acrylic resin prosthesis are used.


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Dentadura Completa , Interfase Hueso-Implante/fisiopatología , Retención de Prótesis Dentales , Prótesis Dental de Soporte Implantado/normas , Análisis del Estrés Dental , Dentadura Completa/normas , Humanos , Técnicas In Vitro , Resinas Sintéticas/uso terapéutico , Soporte de Peso
17.
J Prosthet Dent ; 117(2): 321-326.e2, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27666496

RESUMEN

STATEMENT OF PROBLEM: Currently, which type of suprastructure is preferred when fabricating implant-retained craniofacial prostheses is unknown. PURPOSE: The purpose of this systematic review was to identify the best retention system (bar-clips versus magnets) for implant-retained craniofacial prostheses. MATERIAL AND METHODS: This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of Medline/PubMed and Web of Science databases for clinical trials was conducted on implant-retained craniofacial prostheses published between 2005 and 2015. English-language studies that directly compared different types of retention systems or presented information on implant survival, periimplant soft tissue reactions, and prosthetic complications were included. Nonclinical studies were excluded to eliminate bias. RESULTS: A total to 173 studies were identified, of which 10 satisfied the inclusion criteria. In total, 492 participants were included in these studies. Four selected studies displayed detailed information with regard to the number of implant failures according to the retention system. As reported, 29 (18.2%) of 159 implants with magnets failed, whereas 25 (31.6%) of 79 implants with bars failed. Overall auricular superstructures showed the highest survival (99.08%). In addition, 55.4% of all participants in the selected studies showed grade 0 of periimplant soft tissue reactions. CONCLUSIONS: A systematic search for clinical studies resulted in few studies with a short-term follow-up and small number of participants. The limited data collected indicated that magnets show fewer complications than bar superstructures; however, no hard conclusions could be drawn. Further research, preferably in the form of clinical trials, is needed to validate these findings.


Asunto(s)
Prótesis Dental de Soporte Implantado/instrumentación , Prótesis Maxilofacial , Retención de la Prótesis/instrumentación , Prótesis Dental de Soporte Implantado/métodos , Humanos , Imanes , Retención de la Prótesis/métodos
18.
Mater Sci Eng C Mater Biol Appl ; 72: 284-292, 2017 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-28024588

RESUMEN

There is no established protocol for bonding zirconia (Y-TZP) with resin cements. Non-thermal plasma (NTP) may be an alternative for the clinical problems related to adhesion. The purpose of the present study was to characterize the surface of Y-TZP exposed to methane (CH4) NTP or coated with a layer of primer for metal alloys and the association between the two methods and to evaluate the effect of NTP treatment on bond strength between Y-TZP and two resin cements. A total of 235 Y-TZP discs (8×2mm) were distributed into five groups: Co (no surface treatment), Pr (primer), NTP (methane plasma), Pr+NTP and NTP+Pr. The effect of the treatment type on the surface free energy, morphology, topography and chemical composition of the Y-TZP discs was investigated. The discs were cemented to composite resin substrates using Panavia F2.0 or RelyX U200. Shear bond strength (n=10) analyses were performed (1mm/min) before and after thermocycling (5-55°C, 2000cycles) on the bonded specimens. The data were analyzed with one and three-way ANOVAs and Bonferroni tests (α=0.05). NTP reduced the surface energy and roughness of the Y-TZP discs. SEM-EDS and XPS analyses showed the presence of the organic thin film, which significantly improved the bond strength results when Rely X U200 was used, whereas the primer treatment was more effective with Panavia F2.0. Thermocycling significantly reduced the bond strength results of the NTP and Pr+NTP groups cemented with Rely X U200 and the Pr and NTP+Pr groups cemented with Panavia F2.0. Nonthermal plasma improves the bond strength between Rely X U200 and Y-TZP and also seems to have water-resistant behavior, whereas Panavia F2.0 showed better results when associated with primer.


Asunto(s)
Aleaciones/química , Gases em Plasma/química , Cementos de Resina/química , Circonio/química , Metano/química , Microscopía Electrónica de Rastreo , Espectroscopía de Fotoelectrones , Resistencia al Corte , Espectrometría por Rayos X , Propiedades de Superficie
19.
Contemp Clin Dent ; 7(3): 307-11, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27630492

RESUMEN

OBJECTIVES: This study aimed to evaluate the influence of the incorporation of pigments on surface hardness of four acrylic resins subjected to thermocycling and analyze their elemental composition using energy dispersive X-ray spectroscopy (EDS). MATERIALS AND METHODS: Twenty-one discs of each resin were fabricated, whereas seven had no additive, seven had 3% of nanoscale pigments and last seven had 10% of them. The percentage was obtained by measuring the total weight of each resin disc. Besides, seven discs composed by only nanoscale pigments were also fabricated, totalizing 91 discs. The pigment was weighed by using an analytical balance (BEL Analytical Equipment, SP, Brazil). The surface hardness was measured through a hardness tester machine before and after thermocycling (5-55°C, for 2000 cycles). Data were analyzed by ANOVA and Tukey's test (P < 0.05). The chemical composition of the discs composed only by nanoscale pigments was analyzed with EDS test. RESULTS: Hardness of all resins decreased after thermocycling. The lowest values were observed on the discs with 3% of nanoscale pigments and discs fabricated only with them. EDS showed the presence of titanium dioxide. CONCLUSION: Discs with 7% of pigments (after thermocycling) showed higher hardness values.

20.
J Craniofac Surg ; 27(7): e620-e622, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27513785

RESUMEN

This article reports a case of oral rehabilitation with two-implant-retained mandibular overdenture using bar/clip and ball attachment bilaterally on the distal side. A patient aged 69 years, fully edentulous, presented herself to private practice complaining about the instability of mandibular denture. Several possibilities of rehabilitation with advantages and disadvantages were explained to the patient, based in the clinical and radiograph examinations, and patient desire, in which she opted by conventional maxillary complete denture and two-implant-retained mandibular overdenture. Two external hexagon implants of 3.75 × 10 mm were placed in anterior area of mandible. The fabrication of the metal framework with bar/clip and ball attachment bilaterally on the distal side was planned based on prior arrangement of the artificial teeth. Internal adaptation and occlusal adjustments were performed in the day of insertion of finalized denture and instructions about maintenance and sanitation. The patient showed satisfaction with the final result of her treatment, and no complications were observed during this period. The association of bar/clip with ball system may be viable as option of retention for mandibular implant-retained complete overdenture; however, further randomized controlled trials are necessary to obtain detailed knowledge about the topic.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Retención de Dentadura/instrumentación , Dentadura Completa Inferior , Prótesis de Recubrimiento , Procedimientos Quirúrgicos Orales/métodos , Anciano , Femenino , Humanos , Procedimientos Quirúrgicos Orales/instrumentación
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