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1.
Gen Dent ; 68(1): 50-55, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31859663

RESUMEN

The edentulous population is increasing globally regardless of the advancement in dental materials and technology. Computer-engineered complete dentures can significantly reduce clinical time, provide better patient satisfaction, and enable digital record archiving. A patient's existing denture provides useful information for the fabrication of new dentures. An examination checklist can be used to ensure a methodical evaluation of the patient's oral conditions and existing dentures and guide the clinician in deciding whether to continue treatment or refer the patient to a specialist. Once the decision is made to continue treatment, the clinician can duplicate the patient's existing dentures and make necessary corrections. The corrected duplicates can then be used as custom trays and record bases and sent to a laboratory for digital design and fabrication of new dentures. This case report describes the replacement of 30-year-old, ill-fitting dentures with digitally designed and milled prostheses that restored the vertical dimension of occlusion, masticatory function, and esthetics. In addition, an examination checklist to aid in treatment planning is offered.


Asunto(s)
Diseño Asistido por Computadora , Diseño de Dentadura , Boca Edéntula , Adulto , Diseño de Dentadura/métodos , Dentadura Completa , Estética Dental , Humanos , Boca Edéntula/rehabilitación , Satisfacción del Paciente
2.
Cien Saude Colet ; 24(9): 3345-3356, 2019 Sep 09.
Artículo en Portugués | MEDLINE | ID: mdl-31508755

RESUMEN

Oral rehabilitation with dental prosthesis was mandated by national oral health policy in Brazil, due to the high prevalence of total teeth loss and low use of dental prosthesis among the elderly. There is a pressing need to assess the impact of this rehabilitation policy. An attempt was therefore made to investigate if the dental service used was one of the factors associated with the use of total dental prosthesis among the elderly. To achieve this, a cross-sectional study using a probabilistic sample of elderly (60 years and above) urban-area residents of a small city was conducted by qualified examiners. Descriptive, bivariate and multiple (logistic regression/odds ratio - OR) analyses were conducted on 287 elderly people, of which 186 (64.8%) used dental prosthesis. The use of total dental prosthesis was associated with a higher probability of being attended by private dental services (OR = 4.19; p < 0.001) and the presence of lesions on the palate (OR = 7.52; p = 0.002). Conversely, it was associated with lower probability in ages greater than or equal to 73 years (OR = 0.52; p = 0.023) and among those with impairment of OHIP-14 (OR = 0.20; p = 0.002) in the physical disability dimension. The use of total dental prosthesis was associated with the type of dental service used by the elderly, it being greater among private service users.


Asunto(s)
Servicios de Salud Dental/estadística & datos numéricos , Dentaduras/estadística & datos numéricos , Boca Edéntula/rehabilitación , Salud Bucal/estadística & datos numéricos , Factores de Edad , Anciano , Anciano de 80 o más Años , Brasil , Estudios Transversales , Femenino , Política de Salud , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/epidemiología , Población Urbana/estadística & datos numéricos
3.
Ciênc. Saúde Colet ; 24(9): 3345-3356, set. 2019. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1019660

RESUMEN

Resumo A reabilitação protética foi prevista pela política nacional de saúde bucal em função da alta prevalência de perda de todos os dentes e do baixo uso de prótese dentária entre idosos. Há necessidade de se avaliar o impacto dessa política de reabilitação. Portanto, objetivou-se investigar se o tipo de serviço odontológico utilizado foi um dos fatores associados ao uso de prótese dentária total entre idosos. Trata-se de um estudo transversal conduzido em uma amostra probabilística de idosos (60 anos ou mais) residentes na zona urbana de um município brasileiro de pequeno porte populacional por examinadores calibrados. Realizaram-se análises descritiva, bivariada e múltipla (Regressão logística - odds ratio - OR). Participaram 287 idosos, destes, 186 (64,8%) faziam uso de prótese dentária total. O uso de prótese dentária total foi associado a maiores chances de uso de serviços odontológicos supletivos ou particulares (OR = 4,19; p < 0,001) e a presença de lesão no palato (OR = 7,52; p = 0,002) e, também, a menores chances em idades maiores ou iguais a 73 anos (OR = 0,52; p = 0,023) e entre os com comprometimento na dimensão incapacidade física do OHIP-14 (OR = 0,20; p = 0,002). O uso de prótese dentária total foi associado ao tipo de serviço odontológico entre idosos, sendo maior o uso entre usuários dos serviços supletivos ou particulares.


Abstract Oral rehabilitation with dental prosthesis was mandated by national oral health policy in Brazil, due to the high prevalence of total teeth loss and low use of dental prosthesis among the elderly. There is a pressing need to assess the impact of this rehabilitation policy. An attempt was therefore made to investigate if the dental service used was one of the factors associated with the use of total dental prosthesis among the elderly. To achieve this, a cross-sectional study using a probabilistic sample of elderly (60 years and above) urban-area residents of a small city was conducted by qualified examiners. Descriptive, bivariate and multiple (logistic regression/odds ratio - OR) analyses were conducted on 287 elderly people, of which 186 (64.8%) used dental prosthesis. The use of total dental prosthesis was associated with a higher probability of being attended by private dental services (OR = 4.19; p < 0.001) and the presence of lesions on the palate (OR = 7.52; p = 0.002). Conversely, it was associated with lower probability in ages greater than or equal to 73 years (OR = 0.52; p = 0.023) and among those with impairment of OHIP-14 (OR = 0.20; p = 0.002) in the physical disability dimension. The use of total dental prosthesis was associated with the type of dental service used by the elderly, it being greater among private service users.


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Salud Bucal/estadística & datos numéricos , Dentaduras/estadística & datos numéricos , Boca Edéntula/rehabilitación , Servicios de Salud Dental/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Brasil , Estudios Transversales , Factores de Edad , Boca Edéntula/epidemiología , Política de Salud , Persona de Mediana Edad
4.
Rev Saude Publica ; 532019 Aug 19.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31432931

RESUMEN

OBJECTIVE: To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis). METHODS: A Markov model was developed to capture long-term clinical and economic outcomes. The model's population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost - in BRL, and effectiveness - measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years. RESULTS: Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY). CONCLUSIONS: The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.


Asunto(s)
Prótesis Dental de Soporte Implantado/economía , Dentadura Parcial Fija/economía , Boca Edéntula/economía , Brasil , Análisis Costo-Beneficio , Implantes Dentales/economía , Prótesis Dental de Soporte Implantado/métodos , Humanos , Persona de Mediana Edad , Boca Edéntula/rehabilitación , Programas Nacionales de Salud
5.
Aust Dent J ; 64 Suppl 1: S63-S70, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31144322

RESUMEN

As our population ages, dentists face challenges in maintaining compromised teeth in aging patients. For the most part, elderly patients (i.e., over 65 years of age) prefer to keep their natural teeth and in some cases, avoid removable dentures altogether. Ideally, patients should not be rendered edentate late in life, as they are unlikely to successfully adapt to the limitations of complete replacement dentures. However, this is not always possible and care should ideally be planned to avoid edentulism, or at least, to carefully manage the transition to the edentate state. In the course of planning care, the dentist needs to recognise the need for age appropriate care, factoring in the impact of the elderly patient's health status and social circumstances. For elderly patients with a compromised dentition, the dentist should try to provide care which is minimally invasive and with as low a burden of maintenance as possible. In this paper, principles of pragmatic care for elderly patients with a compromised dentition will be outlined using clinical cases. Three pathways will be outlined: (i) maintenance of a functional natural dentition using adhesive restorative techniques; (ii) use of overlay prostheses and complete replacement overdentures to manage toothwear and toothloss, complete replacement overdentures, and; (iii) staging a transition to the edentate state using transitional removable partial dentures.


Asunto(s)
Cuidado Dental para Ancianos/métodos , Arcada Parcialmente Edéntula , Boca Edéntula , Anciano , Prótesis Dental de Soporte Implantado , Dentición , Prótesis de Recubrimiento , Dentadura Parcial Removible , Humanos , Arcada Parcialmente Edéntula/prevención & control , Arcada Parcialmente Edéntula/rehabilitación , Boca Edéntula/prevención & control , Boca Edéntula/rehabilitación
6.
Int J Oral Maxillofac Implants ; 34(2): 343-356, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883617

RESUMEN

PURPOSE: To evaluate the survival rate of mini implants used to retain mandibular overdentures. MATERIALS AND METHODS: An electronic search, supplemented by hand searching of the references, was conducted with no time or language restriction in October 2016 and updated in October 2017. The results were reviewed independently by the two authors. All randomized controlled trials, clinical trials, observational studies, and case series were included. The primary outcome measure was implant survival (months). RESULTS: The search retrieved a combined total of 391 articles. Following screening, 17 articles were included. A total of 1,715 mini implants were assessed in 475 patients. Follow-up periods ranged from 6 to 84 months (mean: 28.24 months). There were 75 failures in total. The overall survival rate was 95.63%. The majority of patients received four implants to retain their prostheses. Most studies used a flapless surgical technique, but there were vast differences in loading protocols and retention methods. Formal meta-analysis was not conducted due to the heterogeneity between studies. CONCLUSION: Based on the findings of this systematic review, mini dental implants exhibit excellent survival rates in the short to medium term. They appear to be a reasonable alternative treatment modality to retain mandibular complete overdentures from the available evidence.


Asunto(s)
Implantes Dentales/normas , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Boca Edéntula/rehabilitación , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Mandíbula , Ajuste de Prótesis
7.
Int J Oral Maxillofac Implants ; 34(2): 390-396, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883618

RESUMEN

PURPOSE: The aim of this study was to evaluate the responses of human gingival fibroblast (HGF-1) in contact with provisional materials with various chemical compositions and fabricated using different methods. MATERIALS AND METHODS: A total of 210 specimens in eight experimental groups were used. Groups were divided by chemical compositions (poly[ethyl methacrylate], poly[methyl methacrylate], bis-acryl, and hybrid ceramic) and fabricating methods (direct, indirect, and computer-aided design/computer-aided manufacturing [CAD/CAM]). To evaluate the surface characteristics of each group, roughness, water contact angle, and degree of conversion were measured. The responses of HGF-1 to provisional materials were evaluated with cytotoxicity and cell attachment assay. The roughness, surface energy, degree of conversion, level of cytotoxicity, and cell attachment were compared between groups using one-way analysis of variance (ANOVA) and Tukey's multiple comparison (α = .05). RESULTS: The poly(ethyl methacrylate)-direct/indirect and poly(methyl methacrylate)-direct/indirect groups showed higher roughness than the bis-acryl-direct/indirect, poly(methyl methacrylate)-CAD/CAM, and hybrid ceramic-CAD/CAM groups with statistical significance (P < .05). The poly(ethyl methacrylate)-direct group showed the significantly highest water contact angle, and the hybrid ceramic-CAD/CAM group showed the lowest water contact angle (P < .05). The groups that used indirect fabrication methods showed a higher degree of conversion than those that used direct fabrication methods, regardless of chemical composition (P < .05). The poly(ethyl methacrylate) groups showed significantly lower cell viability than the other groups regardless of fabricating methods (P < .05). The poly(ethyl methacrylate)-direct method group showed the lowest cell attachment, and the hybrid ceramic-CAD/CAM method group showed the highest cell attachment (P < .05). CONCLUSION: Poly(methyl methacrylate) and bis-acryl have lower cytotoxicity to HGF-1 than poly(ethyl methacrylate). Indirect fabrication and CAD/CAM are recommended to prevent residual monomer and achieve high cell attachment. To use direct fabrication methods, the auto-mix system is beneficial for the favorable cell response, as it derives a smooth surface.


Asunto(s)
Adhesión Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Materiales Dentales , Fibroblastos/efectos de los fármacos , Análisis de Varianza , Cerámica/farmacología , Cerámica/toxicidad , Diseño Asistido por Computadora , Materiales Dentales/química , Materiales Dentales/toxicidad , Humanos , Ensayo de Materiales , Metilmetacrilatos/farmacología , Metilmetacrilatos/toxicidad , Boca Edéntula/rehabilitación , Polimetil Metacrilato/farmacología , Polimetil Metacrilato/toxicidad , Propiedades de Superficie
8.
J Prosthodont Res ; 63(2): 245-249, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30692048

RESUMEN

PURPOSE: To clarify the effect of denture treatment on masticatory movement in patients with complete dentures. METHODS: Forty eight patients who required new complete dentures and 20 patients who were satisfied with their original complete dentures (control: C group) participated in this study. Subjects were asked to chew a gummy jelly on their habitual chewing side. The movement of mandibular incisal point was recorded using a mandibular kinesiograph. First, average path and overlap of the movement path were displayed for the ten cycles between the fifth cycle and the fourteenth cycle. The movement path was classified into one of seven patterns and the frequency of each pattern was calculated and investigated the relationship between treatment and masticatory path pattern. Next, opening distance and masticatory width (spatial parameter) and cycle time (temporal parameter) were calculated and compared between the before treatment group (BT group) and after treatment group (AT group), and between the AT and C groups. RESULTS: The BT group showed various patterns of masticatory path, whereas the majority of subjects in the AT and C groups showed path patterns that were representative of healthy dentate subjects. The opening distance and masticatory width increased, and the cycle time was shortened after wearing new complete denture, and there were no statistically significant differences between AT group and C group. CONCLUSIONS: From these results it was suggested that the masticatory movement of patients with complete dentures improved greatly after wearing new denture.


Asunto(s)
Dentadura Completa , Mandíbula/fisiopatología , Masticación/fisiología , Boca Edéntula/fisiopatología , Boca Edéntula/rehabilitación , Movimiento , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino
9.
J Prosthet Dent ; 121(1): 59-68.e3, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30006220

RESUMEN

STATEMENT OF PROBLEM: Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated. PURPOSE: The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments. MATERIAL AND METHODS: Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals). RESULTS: Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases. CONCLUSIONS: TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.


Asunto(s)
Dentadura Parcial Fija , Dentadura Parcial Removible , Boca Edéntula/psicología , Boca Edéntula/terapia , Salud Bucal , Calidad de Vida , Bases de Datos Factuales , Implantes Dentales , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Boca Edéntula/rehabilitación , Resultado del Tratamiento
10.
Int J Oral Maxillofac Implants ; 34(1): 47­60, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30282090

RESUMEN

PURPOSE: The purpose of this systematic review was to evaluate the outcome of dental implant treatment in fully edentulous patients who underwent Le Fort I osteotomy as a preprosthetic surgical technique. MATERIALS AND METHODS: A search was conducted of the PubMed (MEDLINE), EMBASE, Scopus, and Cochrane databases to identify records published from 1995 to 2017 dealing with Le Fort I osteotomy procedures for implant placement purposes. The primary outcomes of interest were the survival and success rates. The secondary outcomes consisted of the analysis of intra- and postsurgical complications and the surgical and prosthetic loading protocols. RESULTS: Overall, 20 articles were selected for data analysis. A total of 483 patients accounting for 3,596 implants were analyzed. The cumulative survival rate was 90.22% ± 0.8% at 10 years (mean: 59.20 ± 32.31 months). The cumulative success rate was 89.07% ± 1.3% at 10 years (mean: 62.82 ± 25 months). Higher survival rates were found for implants with a rough surface (P < .001) and for implants loaded with a delayed protocol (P < .001). The fracture of the palatine bone during the downfracture procedure was the main intrasurgical drawback, while sinus pathology and graft resorption were commonly observed during the postoperative healing. Surgical and prosthetic loading protocols were heterogenous. CONCLUSION: Based on this review, Le Fort I osteotomy might be considered a viable technique to recreate favorable conditions for implant-supported rehabilitations. Caution has to be taken when using machined implants, particularly in the case of a simultaneous approach.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Boca Edéntula/rehabilitación , Osteotomía Le Fort/métodos , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Humanos , Fracturas Maxilomandibulares/etiología , Maxilar/cirugía , Complicaciones Posoperatorias
11.
Clin Oral Implants Res ; 30(1): 79-89, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30520155

RESUMEN

OBJECTIVE: This study aimed to explore the perceptions and long-term experiences of edentulous patients rehabilitated with single-implant mandibular overdentures (SIMO). METHODS: Thirteen participants, mean age 65.7 years, 69.2% women, who had had their treatment completed for at least 1 year, were invited and included in the study. Focus groups including four to five participants each were conducted, audio and video recorded and transcribed verbatim. Subsequently, the transcripts were analysed according to the principles of thematic analysis. RESULTS: Four major themes emerged as follows: before decision to undergo treatment with SIMO, implant surgery experience, perception of treatment outcomes and impressions about the care received. Lack of information, cost, comorbidities, older age and fear were initial barriers to the decision for treatment. Dissatisfaction with previous treatment and a sense of opportunity motivated the decision. There were ambivalent reports of absence of pain during surgery and discomfort during anaesthesia. Post-surgical recovery exceeded the pre-surgical negative expectations in most cases. There was a tendency for a positive impact of SIMO on the patients' quality of life, comprising improved ability to chew and communicate, dietary diversification, greater comfort and safety, increased self-confidence and social interaction. Few minor inconveniences were reported such as the feeling of insecurity after an episode of denture fracture and the need to use adhesive paste. Satisfaction with the care received and the trust in the dentist and dental team were evident. CONCLUSION: In general, participants presented positive perceptions and rewarding experiences after rehabilitation with SIMO.


Asunto(s)
Prótesis de Recubrimiento , Arcada Edéntula/rehabilitación , Boca Edéntula/rehabilitación , Prótesis e Implantes , Anciano , Ingestión de Alimentos , Estética Dental , Femenino , Humanos , Relaciones Interpersonales , Arcada Edéntula/psicología , Arcada Edéntula/cirugía , Masculino , Mandíbula , Boca Edéntula/psicología , Higiene Bucal , Pacientes/psicología , Percepción , Resultado del Tratamiento
12.
Clin Oral Implants Res ; 30(1): 68-78, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30521106

RESUMEN

OBJECTIVES: To evaluate the performance of two types of zirconia frameworks. MATERIAL AND METHODS: From 2014 to 2016, in a prospective clinical trial, 150 patients were rehabilitated with 83 and 110 implant-supported, screw-retained, full-arch ceramic-veneered zirconia (PVZ) rehabilitations and monolithic zirconia with porcelain veneering limited to buccal (MZ) rehabilitations, respectively. Patients were consecutively enlisted according to pre-defined inclusion criteria and evaluated on 4 months intervals. A Kaplan-Meier estimator was adopted, and the log-rank test and Wilcoxon test used to test differences in survival and successful function in the two different groups. RESULTS: The average follow-up time (±SD) and implant success rate was 608.80 ± 172.52 days with 99.53% implant success for the PVZ group and 552.63 ± 197.57 days with 99.83% success for the MZ group. According to the Kaplan-Meier estimator, the mean cumulative survival rate at the 2-year follow-up for framework fracture, major chipping, minor chipping, or any of the former combined to occur was 0.99, 0.95, 0.93 and 0.85 for the PVZ group (n = 18) and 0.99, 0.95, 0.95 and 0.89 for the MZ group (n = 15). No significant differences were found between the two groups. CONCLUSIONS: Results suggest zirconia as a suitable material for frameworks in full-arch implant-supported rehabilitations. Both groups presented a low incidence of technical complications. When comparing the two different designs, the MZ group presented a lower technical complication rate, thus presenting itself as a viable alternative for full-arch implant-supported rehabilitations. Further clinical studies with longer follow-ups (5 years) should be performed to evaluate the long-term stability of such rehabilitations.


Asunto(s)
Porcelana Dental , Prótesis Dental de Soporte Implantado , Boca Edéntula/rehabilitación , Circonio , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Falla de Prótesis , Resultado del Tratamiento
13.
Artículo en Inglés | MEDLINE | ID: mdl-30543725

RESUMEN

The computer-assisted design/computer-assisted manufactured compound prosthesis involves designing and milling a cement-retained prosthesis over milled titanium bars. In the presented clinical case report, a diagnostic wax pattern was made to assess esthetics, contours, and occlusion. A total of eight maxillary root-form implants were restored by following the combined prosthesis design concept. The mandibular arch was restored with a screw-retained implant-supported zirconia fixed prosthesis. A milled polymethyl methacrylate (PMMA) maxillary interim prosthesis was fabricated to intraorally confirm the diagnostic wax pattern. The interim PMMA prosthesis was then scanned, and three screw-retained titanium milled bars were designed that provided the substructure of the definitive restoration. A cement-retained milled zirconia prosthesis was then designed and fabricated. The zirconia prosthesis provided the superstructure of the definitive complete-arch restoration. After confirming esthetics, phonetics, occlusion, and accessibility for oral hygiene, the superstructure was cemented with temporary cement to enable retrievability.


Asunto(s)
Tornillos Óseos , Diseño Asistido por Computadora , Implantes Dentales , Prótesis Dental de Soporte Implantado , Diseño de Dentadura , Dentadura Completa , Cementación , Estética Dental , Humanos , Masculino , Maxilar , Persona de Mediana Edad , Boca Edéntula/rehabilitación , Titanio/química , Circonio/química
14.
Community Dent Oral Epidemiol ; 47(2): 171-176, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30549063

RESUMEN

OBJECTIVES: To explore the sociocultural context in which patients and dentists in urban and rural communities in Southern Brazil interpret dental problems. METHOD: Beliefs and experiences related to dental problems were explored in eight focus groups involving a total of 41 older patients, and in direct interviews with two dentists and two dental assistants. The interactions were audio recorded and transcribed for thematic analysis. RESULTS: The beliefs and experiences of the participants focused on four main themes: cultural beliefs; dental services; decisions to extract teeth; and expectations for change. A culture of pre-nuptial tooth loss and complete dentures was considered beneficial to young women. Although dental services at the time were scarce in the region, demands for relief of pain were extensive despite the fear and anxiety of the participants. Extraction of teeth and fabrication of complete dentures were the usual dental treatments available, although some participants felt that dentists withheld other treatment options. Participants were hopeful that dental services would improve for their children. CONCLUSIONS: Patients and dental professionals in urban and rural communities of Southern Brazil managed dental problems within a culture of limited access and availability of services that favoured dental extractions and complete dentures.


Asunto(s)
Cuidado Dental para Ancianos/métodos , Cuidado Dental para Ancianos/normas , Dentadura Completa , Boca Edéntula , Extracción Dental , Anciano , Anciano de 80 o más Años , Brasil , Odontólogos , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Boca Edéntula/rehabilitación , Salud Bucal , Pérdida de Diente/epidemiología
15.
J Oral Rehabil ; 46(2): 127-133, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30307639

RESUMEN

BACKGROUND: Edentulism can reduce mastication, leading to changes in food pattern, with possible consequences to masticatory muscle thickness. OBJECTIVES: This study verified masticatory function and oral perception in subjects who did not use lower CDs, and whether the insertion of new upper and lower CDs would improve such variables. METHODS: Fifteen edentulous elderly who wore only the upper CD were selected and received new upper and lower CD. Volunteers were evaluated at baseline and after 1, 3 and 6 months of new prosthesis use. Masticatory performance (MP) was assessed by the sieving method (X50 values). Masseter thickness (MT) was evaluated by ultrasonography. Oral sensorial ability (OSA) was assessed by oral stereognosis test and maximum tongue pressure (MTP) was verified by pressure sensors. Data were submitted to repeated measures ANOVA and Tukey-Kramer posthoc tests (α = 0.05). Correlation between OSA and MTP was verified by Person's correlation. RESULTS: X50 and MTP decreased (P < 0.05) after 1 month and remained stable (P > 0.05) for next assessments. After 3 months, MT in rest position was increased (P < 0.05), while during maximum voluntary contraction 1 month was enough to increase MT (P < 0.05). There were no differences for OSA (P > 0.05) and no correlation between OSA and MTP. CONCLUSION: Masticatory performance and masseter thickness of elderly who did not use the lower dentures were improved after 2 months using new upper and lower CDs. However, new CDs in both dental arch decreased MTP. Brazilian Registry of Clinical Trials (ReBEC #RBR-37gdst).


Asunto(s)
Dentadura Completa Inferior , Músculo Masetero/fisiología , Masticación/fisiología , Boca Edéntula/rehabilitación , Anciano , Análisis de Varianza , Fuerza de la Mordida , Femenino , Humanos , Estudios Longitudinales , Masculino , Estudios Prospectivos , Resultado del Tratamiento
16.
J Prosthodont ; 28(5): 526-535, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29573048

RESUMEN

PURPOSE: It has been shown that tooth loss is associated with an increased risk of early mortality, and that prosthetic rehabilitation of edentulism improves quality of life and reduces morbidity. This review examines association between prosthetic rehabilitation of the edentulous state with a complete denture and mortality. METHODS: A systematic search using combinations of related keywords for "complete denture" and "mortality" was performed on PubMed, Web of Science, and Google Scholar. A reference search of included articles and author contacts was also performed. RESULTS: None of the studies reported results for association between mortality and wearing complete dentures among edentulous individuals; however, based on the published methods and results, a total of 15 studies were found to be eligible for author contacts to obtain relevant data. Overall, 5 eligible studies were included and critically evaluated to summarize their findings. The follow-up period in these studies ranged from 3 to 24 years, and the age group of included samples ranging from 52 to 105 years. The proportion of individuals not wearing dentures ranged from 3.0% to 13.3%. Four of the included studies showed fewer individuals without complete dentures surviving over the follow-up years as compared to the group wearing complete dentures. One of two studies that could adjust for certain confounders found no significant difference in mortality after adjusting, but another study found a 42% reduced risk of dying among those wearing complete dentures, as compared to those not wearing complete dentures after adjusting for age, sex, educational level, smoking, alcohol drinking, body mass index, time spent walking daily, medical history, psychological distress score, energy intake, and protein intake. Due to the small sample size of nondenture wearers, it was not possible to analyze with statistical rigor the comparative risk of dying associated with wearing or not wearing complete dentures. CONCLUSION: Most of the included studies indicated a higher proportion of deceased edentulous patients not using dentures as compared to denture wearers. Nevertheless, small sample size prevents a definite conclusion being drawn regarding a relationship between prosthetic rehabilitation and mortality among edentulous individuals.


Asunto(s)
Boca Edéntula , Pérdida de Diente , Anciano , Anciano de 80 o más Años , Dentadura Completa , Humanos , Persona de Mediana Edad , Boca Edéntula/mortalidad , Boca Edéntula/rehabilitación , Calidad de Vida
17.
J Prosthodont Res ; 63(1): 125-129, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30455114

RESUMEN

PURPOSE: This report was written to introduce an attempt at clinical application of our newly developed digital workflow to reproduce the morphology of the subgingival contour and the emergence profile of the provisional restoration within the final bone-anchored fixed restoration, using a bounded unilateral edentulous case. METHODS: This digital workflow involves superimposition of the composite images of two specific types of working casts onto the working cast for the provisional restoration namely, a split cast screwed with a titanium base and a split cast screwed with a provisional restoration and integrating these with the whole intraoral surface image, in which the provisional restoration was present. The final restoration fabricated using this technique could be installed without any clinical problems. The results of in silico analysis revealed that the cubic volume ratio of the total discrepancy between the provisional and the final restorations was only 2.4%. Further, sufficient oral hygiene was maintained and the patient was satisfied with the outcome of the treatment. CONCLUSIONS: This technical report suggests that our newly developed digital workflow provided clinical applicability and may enable accurate transfer of the morphology of the subgingival contour and emergence profile of the provisional to the final bone-anchored fixed restoration.


Asunto(s)
Técnica de Impresión Dental , Diseño de Prótesis Dental/métodos , Restauración Dental Permanente/métodos , Encía/anatomía & histología , Boca Edéntula/rehabilitación , Simulación por Computador , Diseño Asistido por Computadora , Implantes Dentales , Femenino , Humanos , Persona de Mediana Edad , Titanio , Resultado del Tratamiento
18.
J Prosthodont ; 28(1): e1-e5, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28122401

RESUMEN

Prosthetic rehabilitation of a completely edentulous patient should never be restricted to the replacement of missing teeth. The ultimate aim of complete denture treatment should be restoration of the full range of oral functions and esthetics. Slumped cheeks are always a concern for esthetically demanding complete denture patients. This article describes a simple, scientific, cost-effective technique to improve facial esthetics in a completely edentulous patient with the help of a cheek plumper. The technique used here implements the concept of neutral zone to precisely determine the amount of space available for the cheek plumper. The simple friction lock attachments that retained the cheek plumpers on the prosthesis were also fabricated after determining the space available in the appropriate areas. Thus an effort was made to keep the cheek plumpers unobtrusive yet effective to ensure complete integration of the prosthesis into the stomatognathic system.


Asunto(s)
Mejilla , Retención de Dentadura/instrumentación , Dentadura Completa , Estética Dental , Boca Edéntula/rehabilitación , Mejilla/anatomía & histología , Técnica de Colado Dental , Diseño de Dentadura/instrumentación , Diseño de Dentadura/métodos , Retención de Dentadura/métodos , Humanos , Masculino , Persona de Mediana Edad
19.
Braz Oral Res ; 32: e113, 2018 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-30517426

RESUMEN

The impact of oral rehabilitation on masticatory function and oral health-related quality of life (OHRQoL) may vary with the experience of the individual with tissue loss. Our hypothesis is that patient-centered outcomes vary among adults who have experienced large defects in the maxilla due to congenital or acquired conditions even after oral rehabilitation to restore aesthetics and function. This study compared OHRQoL, perceived masticatory ability, maximum bite force (MBF), and symptoms of pain and depression among subjects with acquired (edentulous maxilla) and congenital (cleft lip and palate) loss of oral tissues in the maxilla after dental treatment. A gender-matched sample (n = 60) of cleft lip and palate (CLP), maxillary denture wearers (DENT) and controls (CONT) was recruited. OHRQoL was assessed using OHIP-14. Chewing was evaluated through a masticatory ability questionnaire and by MBF. The RDC/TMD Axis II questionnaire was used to assess symptoms of pain and depression. Data were analyzed by Fisher's test, Kruskal Wallis test, and Spearman correlation coefficients. CLP showed higher OHIP-14 and depression scores than DENT and CONT (p < 0.05). Sub-analysis by OHIP-14 items (%FOVO) showed higher prevalence of psychological impact for CLP and of functional impacts for DENT. The number of foods difficult to chew, of food textures difficult to chew, and avoided foods were similar between CLP and DENT. OHIP-14, MBF, and depression scores showed significant correlation (p < 0.05). The results suggest that adults with treated CLP or maxillary DENT have chewing impairment and lower MBF than healthy subjects, with different psychological and functional impacts.


Asunto(s)
Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Dentaduras , Masticación/fisiología , Calidad de Vida , Adulto , Anciano , Fuerza de la Mordida , Estudios de Casos y Controles , Dolor Crónico/fisiopatología , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Estudios Transversales , Depresión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/rehabilitación , Salud Bucal , Valores de Referencia , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Adulto Joven
20.
Braz Oral Res ; 32: e111, 2018 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-30379235

RESUMEN

Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients' wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach's alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated "Physical Impact", "Psychological Impact" and "Social Impact". In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the "Physical Impact", "Psychological Impact", and "Social Impact" of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.


Asunto(s)
Dentadura Completa/psicología , Salud Bucal , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Anciano , Evaluación de la Discapacidad , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/psicología , Boca Edéntula/rehabilitación , Medición de Resultados Informados por el Paciente , Reproducibilidad de los Resultados , Perfil de Impacto de Enfermedad
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