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1.
Rev. Odontol. Araçatuba (Impr.) ; 41(3): 33-39, set./dez. 2020. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1121742

RESUMEN

Este relato de caso clínico tem como objetivo descrever a utilização de osso alógeno na reconstrução de maxila atrófica para posterior reabilitação com prótese fixa metalocerâmica sobre implantes, fazer uma análise histológica do tecido ósseo enxertado e descrever o acompanhamento clínico e radiográfico por 8 anos. Uma paciente de 54 anos, com edentulismo parcial e atrofia moderada-a-severa na maxila, apresentou-se para tratamento demonstrando muito interesse em receber prótese sobre implantes. Após exame clínico e radiográfico, foi realizada montagem dos modelos de estudo em ASA para enceramento diagnóstico e obtenção de um guia multifuncional (tomográfico/ cirúrgico). A tomografia indicou a necessidade de reconstrução óssea maxilar. Procedeuse então à aposição de blocos de osso alógeno para aumento horizontal nas regiões anterior e posterior da maxila. Um dos blocos foi triturado e utilizado para levantamento do assoalho do seio maxilar no lado esquerdo. Dez meses depois, uma nova tomografia foi solicitada, utilizando o mesmo guia inicial, e os implantes instalados, utilizando o guia multifuncional como guia cirúrgico. Neste momento, material ósseo foi coletado na interface osso enxertado/osso nativo com uma broca trefina. Os resultados histológicos demonstraram viabilidade das células ósseas no enxerto, além da presença de vasos sanguíneos. Após o tempo necessário para osseointegração, procedeu-se com tratamento protético. Nenhuma complicação foi relatada até oito anos de controle. A sequência de tratamento proposta forneceu bons resultados estéticos e funcionais. Concluiu-se, então, que o emprego de osso alógeno é uma alternativa viável para a reconstrução de rebordos alveolares severamente reabsorvidos(AU)


This clinical case report aims to describe the use of allogeneic bone in the atrophic maxilla reconstruction for subsequent rehabilitation with a fixed metal-ceramic prosthesis on implants; to perform a histological analysis of the grafted bone tissue; and to describe the clinical and radiographic monitoring for 8 years. A 54-year-old patient, with partial edentulism and moderate-to-severe atrophy in the maxilla showed great interest in receiving implant prostheses. After c linical and radiographic examination, the ASA study models were assembled for diagnostic waxing and a multifunctional guide (tomographic / surgical) was obtained. Tomography indicated the need for maxillary bone reconstruction. Allogeneic bone blocks were then placed for horizontal enlargement in the anterior and posterior regions of the maxilla. One of the blocks was crushed and used to lift the floor of the maxillary sinus on the left side. Ten months later, a new tomography was requested, using the same initial guide, and the implants installed, using the multifunctional guide as a surgical guide. At this time, bone material was collected at the grafted bone / native bone interface with a trephine drill. Histological results demonstrated viability of bone cells in the graft, besides the presence of blood vessels. After the necessary time for osseointegration, a prosthetic treatment was performed. No complications were reported up to eight years of control. The propose treatment sequence provided good aesthetic and functional results. It was concluded, then, that the use of allogeneic bone is a viable alternative for the reconstruction of severely reabsorbed alveolar edges(AU)


Asunto(s)
Trasplante Óseo , Prótesis Dental de Soporte Implantado , Diseño de Prótesis Dental , Elevación del Piso del Seno Maxilar
2.
Orthod Fr ; 91(1-2): 93-99, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33146138

RESUMEN

Our relationship to digital technologies will be a determining factor in building our identity as 21st century orthodontists. The digital workflow used in orthodontics can be summarized in four successive phases: diagnosis, treatment planning, computer Aid Manufacturing, therapeutic follow-up. According to Professor Stanislas Dehaene, cognitive neuroscience has identified four criteria on which learning success depends. Attention, active engagement, feedback and consolidation. Our article demonstrates that a good organization of the digital workflow, thought upstream and coherent, allows the practitioner to strengthen his learning from each treated clinical case by potentiating the four criteria of learning. This design which is a real challenge is part of an increase strategy.


Asunto(s)
Diseño Asistido por Computadora , Diseño de Prótesis Dental , Flujo de Trabajo
3.
Int J Periodontics Restorative Dent ; 40(6): e235-e240, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33151196

RESUMEN

This case report describes the rehabilitation of an extremely atrophic posterior mandible using 4-mm ultrashort implants and reports clinical and radiographic outcomes 7 years after loading. The patient refused to undergo any other treatment, from the removable prosthesis to the reconstructive surgery, and asked for a fixed, minimally invasive solution in the shortest possible time. The residual bone height above the alveolar nerve was an average of about 5 mm, so it was decided to treat the patient with four 4-mm ultrashort implants. Within the limitations of this case report, this procedure appears successful at 7 years after loading in this specific case and could reduce invasiveness, rehabilitative times, and costs. However, longer follow-ups on a large number of patients coming from randomized controlled clinical trials are necessary before making more reliable recommendations.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Resultado del Tratamiento
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 891-896, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171564

RESUMEN

Objective: To evaluate the clinical outcomes of digital technique-aided occlusal rehabilitation based on implant-supported fixed prostheses (ISFP), and to provide some information for clinical application of digital technique. Methods: Retrospectively reviewed the cases which had used neuromuscular system and condylar movement tracing device to reconstruct occlusion in one or double jaw fully edentulous ISFP from January, 2013 to January, 2020. A total of 6 eligible patients were enrolled in the present study with 56 implants and 8 ISFP, including 4 male patients and 2 female patients, aged from 43 to 74 years. The clinical outcomes were evaluated in four aspects, including implant survival rate, implants success rate, marginal bone loss and the occurrence of prosthesis complications. Results: The follow-up time was (4.0±2.2) years (1-7 years). The implant survival rate was 100% (56/56) and the implant success rate was 98% (55/56), with an average missal and distal marginal bone loss of (0.04±0.11) mm/year. Veneer chipping occurred at incisal edge of 2 adjacent incisors in only one prosthesis 3 years after rehabilitation. Conclusions: Combination of digital techniques of neuromuscular system and condylar movement tracing device to assist occlusal rehabilitation based on ISFP showed a high implant success rate. The complication seldom happened. Long and stable occlusion has been observed. The clinical outcomes were favorable.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Boca Edéntula , Adulto , Anciano , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
5.
Int J Esthet Dent ; 15(4): 402-426, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33089257

RESUMEN

This article outlines the prosthetic concepts in the management of implants in the esthetic zone with a view to achieving optimal long-term esthetics and stability. The emphasis is on the understanding and application of the biologic factors and dental technology that influence treatment outcomes. The authors examine the exciting new world of digitalization of dental procedures that has transformed esthetic dentistry, dental technology, and surgery. The digital workflow makes it possible to attain excellence in many kinds of dental restorations, providing high quality while maintaining a very natural-looking appearance. The newest developments in the field of digital systems allow for greater predictability and precision of results as well as more accuracy, which in turn allows for better design quality. The duration of dental treatment and dental technology has also been reduced due to digitalization. Transitioning from an analog to a digital workflow requires a paradigm shift. The techniques to improve the daily workflow in practice and in the dental laboratory integrate advanced CAD/CAM technologies, combining 3D-printed models and high-end esthetic dental restorations in ceramics. An interdisciplinary approach, detailed in this article, is key to optimal case management.


Asunto(s)
Diente , Flujo de Trabajo , Diseño Asistido por Computadora , Diseño de Prótesis Dental , Estética
6.
Shanghai Kou Qiang Yi Xue ; 29(4): 355-358, 2020 Aug.
Artículo en Chino | MEDLINE | ID: mdl-33089281

RESUMEN

PURPOSE: To compare the stress distribution of dental implants with different body shapes after maxillary sinus augmentation. MRTHODS: Three different implant models varying in implant shape were investigated in D3-type maxilla. All materials were assumed to be linear elastic, homogenous and isotropic. An oblique force of 150 N was applied to the implant. Maximal equivalent von-Mises of supporting bone around implants were measured. All of the models were measured by Ansys Workbench 14.5. Statistical analysis was performed using SPSS 17.0 software package. RESULTS: Highest stress of supporting bone emerged on the crestal cortical site around the implant neck. There was no significant difference in the maximum EQV of supporting cortical bone between different groups; the maximum EQV of supporting trabecular bone in the tapered implant group was much higher than other groups; application of grafts reduced the maximum EQV of both cortical and trabecular bone in all groups. CONCLUSIONS: Tampered implant can induce elevated stress distribution of the upper trabecular bone, which may promote marginal bone loss. Application of grafts after maxillary sinus augmentation could favors in reducing the stress loading of dental implants.


Asunto(s)
Implantes Dentales , Maxilar , Diseño de Prótesis Dental , Análisis de Elementos Finitos , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Estrés Mecánico
7.
J Am Dent Assoc ; 151(11): 863-869, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33121608

RESUMEN

BACKGROUND AND OVERVIEW: Patients seropositive HIV and AIDS represent a group of patients who experience longer longevity at the expense of effective therapies for infection control and related opportunistic diseases. However, the prolonged use of these drugs is often associated with adverse events, which theoretically may influence dental management and the long-term stability of dental implants. The objective of this study was to prospectively evaluate a group of HIV-positive people from a previous study who had received dental implants for 12 years after oral rehabilitation and functional loading. CASE DESCRIPTION: Nine patients with a total of 18 implants participated in this study. Viral load was undetectable in 8 patients, with 1 who had 48 copies/milliliter. The cluster of differentiation 4 T lymphocyte count ranged from 227 through 1,000 cells/cubic millimeter, mean (standard deviation [SD]) 564 (271.13) cells/mm3. Five of the 9 (55.5%) patients had visible plaque, and 5 (55.5%) had bleeding on probing with no implant mobility. Radiographs obtained at 6 months, 12 months, and 12 years of functional loading showed mean (SD) marginal bone losses of 0.32 (0.23) mm, 0.37 (0.23) mm, and 2.43 (1.48), respectively. CONCLUSION AND PRACTICAL IMPLICATIONS: These results suggest that dental implant treatment in HIV-positive patients achieved long-term survival, with a success rate comparable with that observed in healthy patients, indicating that implant rehabilitation is not a contraindication for HIV-positive patients.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Infecciones por VIH , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Resultado del Tratamiento
8.
Med Oral Patol Oral Cir Bucal ; 25(6): e784-e790, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-33037809

RESUMEN

BACKGROUND: This study investigated the causes of dental implant removal due to complications, and examined whether patients who had dental implant removal desired re-implant prosthesis treatments. MATERIAL AND METHODS: A retrospective case-control study was conducted on patients who had their dental implants removed. We investigated whether the removed dental implant was replaced with other implant prostheses. Age, sex, diabetes, smoking, implant site distribution, reason for implant removal, and blade and root-form implants were categorized as predictive variables. The outcome variable was desire for re-implantation or use of other prosthetic methods after implant removal. A logistic regression model was created to identify patient factors that could predict the re-implantation of dental prostheses after implant removal. RESULTS: A total of 215 dental implants were removed from 143 patients. The most common reason for implant removal was peri-implantitis that was identified in 165 implants. After implant removal, re-implantation was performed in 98 implants (45.6%). Bivariate analyses showed that age, diabetes, implant type, and reason for implant removal were associated with the desire for re-implanted prostheses. The multiple regression model revealed that age, implant type, and reason for implant removal were associated with an increased desire for re-implant prostheses after implant removal. CONCLUSIONS: Re-implantation of prostheses after the removal of dental implants was desired by patients who were younger, had implants placed in the root form, and had implants removed due to prosthetic-related complications.


Asunto(s)
Implantes Dentales , Estudios de Casos y Controles , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Estudios Retrospectivos
9.
Niger J Clin Pract ; 23(9): 1328-1331, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32913176

RESUMEN

It is possible to rehabilitate fully edentulous patients with implantsupported fixed or removable prostheses; however, implantsupported fixed prostheses are the gold standard for patients who not prefer to use removable dentures. This case report, prosthetic rehabilitation of a completely edentulous young patient with an implantsupported fixed hybrid prosthesis using the "Malo Bridge" technique is described. A 18 years old male patient was referred to the clinic with complaints of tooth loss, aesthetics, function, and phonetic. A total of 5 implants were placed in both the jaws. Considering that screw holes may cause aesthetic problems due to the Class III occlusion, these problems have been solved with the implant-supported hybrid prosthesis called Malo bridge. With the Malo Bridge design, the patient's aesthetic, functional and phonetic loss was eliminated, patient comfort and quality of life were improved, and patient expectations were met. It is a viable treatment option to rehabilitate completely edentulous jaws with a cross relationship and increase interarch distance using Malo Bridge to support a fixed prosthesis.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Arcada Edéntula/rehabilitación , Maxilar/cirugía , Calidad de Vida , Pérdida de Diente/psicología , Adolescente , Diseño de Prótesis Dental , Retención de Dentadura/instrumentación , Humanos , Arcada Edéntula/cirugía , Masculino , Fonética , Radiografía Panorámica , Resultado del Tratamiento
10.
Chin J Dent Res ; 23(3): 215-220, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32974622

RESUMEN

The main goal of this report was to solve a clinical case of a 73-year-old man with diabetes, partial edentulism and a pathological occlusion with biocorrosion using conservative and adhesive techniques. A complete rehabilitative treatment was performed, increasing the vertical dimension of occlusion using indirect restorations with composite resins on teeth and resin crowns on implants and returning function using mutually protected occlusion. A 6-month posttreatment clinical and radiographic follow-up was performed.


Asunto(s)
Fracaso de la Restauración Dental , Estética Dental , Anciano , Resinas Compuestas , Coronas , Diseño de Prótesis Dental , Humanos , Masculino , Dimensión Vertical
11.
Artículo en Inglés | MEDLINE | ID: mdl-32925991

RESUMEN

The purpose of this retrospective study was to evaluate bone level stability around 441 mandibular and 350 maxillary molar implants, placed using an immediate implant protocol, that had been in function from 2 to 17 years postrestoration (mean: 9.9 years). Independent radiographic measurements using the known distance between threads on the specific implant that was used indicated a mean bone loss of 0.27 ± 0.68 mm around maxillary implants and 0.27 ± 0.67 mm around mandibular implants. Maxillary implants showed a statistically significant (SS) difference in bone loss on the mesial (0.20 mm) compared to the distal side (0.34 mm). In the mandibular group, there was an SS difference in bone loss around implants with wide (≥ 5 mm) and regular (< 5 mm) diameters. There was also an SS difference in bone loss in patients 50 years and older (0.28 mm) compared to patients younger than 50 (0.18 mm). In both groups, there were no SS differences in bone loss between machined- and rough-surface implants, men and women, single and splinted implants, nonsmokers and light/heavy smokers, or in patients with a penicillin allergy who were prescribed azithromycin as an alternate prophylactic antibiotic. All SS differences found in variables evaluated in the study were < 1.0 mm and therefore were considered clinically insignificant.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Femenino , Humanos , Masculino , Mandíbula/cirugía , Diente Molar , Estudios Retrospectivos
12.
Int J Periodontics Restorative Dent ; 40(5): e189-e196, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32925993

RESUMEN

Dental implants are intended to provide long-term reliable dental restorations. Limited data exist on the comparison between different implant surfaces. This study aims to clarify whether there is a difference between airborne particle- abraded and acid-etched (SLA implants) and only acid-etched surfaces (Osseotite) in healthy and periodontally compromised patients. After comprehensive evaluation of all 109 patients, including nonsurgical and surgical therapy for the treatment of periodontal disease, 109 implants were placed according to the manufacturer's guidelines. Each treatment site was examined radiographically 3 to 6 months after the final coronal restorations were placed. Patients were enrolled in the follow-up maintenance program, and radiologic evaluations were carried out at 5 and 10 years. Data recorded from 91 patients who completed the final 10-year follow-up were included in the analysis (SLA: n = 50; Osseotite: n = 41). At 10 years, the difference between bone-to-implant distances (DIBs) for SLA and Osseotite was significantly different (P = .001; 95% confidence interval: 0.55, 1.89 mm). Mean ± SD DIB for SLA implants was 2.1 ± 1.1 mm and 0.9 ± 2.1 mm for Osseotite implants. The overall survival rates of SLA and Osseotite implant surfaces were high during the observation period. History of previous periodontal disease plays an important role in the incidence of complications, regardless of the surface type.


Asunto(s)
Implantes Dentales , Implantación Dental Endoósea , Diseño de Prótesis Dental , Fracaso de la Restauración Dental , Humanos , Oseointegración , Estudios Prospectivos , Propiedades de Superficie , Titanio
13.
Artículo en Inglés | MEDLINE | ID: mdl-32925994

RESUMEN

The goal of the present study was to evaluate human histologic healing of dental implants with a unique triangular neck design that is narrower than the implant body. Four patients in need of full-mouth reconstruction were recruited and received several implants to support a full-arch prosthesis. In each patient, two additional customized reduced-diameter implants were placed, designated to be harvested after 6 months of submerged healing. The eight harvested implants were all placed in healed edentulous maxillary or mandibular ridges. These implants were Ø 3.5 × 8 mm in size, and the final osteotomy drill allowed for the creation of a gap up to 0.2 mm in size between the coronal aspect of the triangular implant neck and the surrounding bone. At the end of the healing period, the implants were retrieved with the surrounding bone. Microcomputed tomography (µCT) was performed before processing the biopsy samples for undecalcified histologic exampination. Bone-to-implant contact (BIC) was measured from the µCT data and from buccolingual/buccopalatal and mesiodistal central histologic sections. All implant gaps were filled by mature remodeled bone. The mean BICs of the BL/BP and MD sections were 64.45% ± 6.86% and 65.39% ± 10.44%, respectively, with no statistically significant difference. The mean 360-degree 3D BIC measured all over the implant surface was 68.58% ± 3.76%. The difference between the BIC measured on the µCT and on the histologic sections was not statistically significant. The positive histologic results of the study confirmed the efficacy of this uniquely designed dental implant.


Asunto(s)
Implantes Dentales , Oseointegración , Implantación Dental Endoósea , Diseño de Prótesis Dental , Humanos , Mandíbula/cirugía , Microtomografía por Rayos X
14.
Braz Dent J ; 31(4): 368-373, 2020 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-32901711

RESUMEN

The aim of this study was to clinically and radiographically compare extra short and standards implants. Forty-two implants were installed in 10 selected patients. They received prosthetic loading only after the conventional waiting time for osseointegration and the prostheses were made ferulized. Radiographic shots were performed to evaluate vertical and horizontal bone losses at times T1 (prosthetic installation), T2 (6 months follow-up) and T3 (12 months follow-up). Biological parameters such as bone level around the implants (CBL) were evaluated, CBL alteration (CBLC), total crown length (TCL) and implant/crown ratio (ICR) were digitally calculated. All implants included in the study were submitted to the analysis of the implant stability quotient (ISQ) at the time of implant installation (T0) and at 12 months of prosthetic function (T3). Data were statistically tested. The ICR was higher in the test group than in the control group (p<0.0001). The CBL measurements at the beginning of the study were 0.21±0.19 mm and 0.32±0.38 mm and at 12 months 0.65±0.24 mm and 0.87±0.34 mm, respectively in the test and control groups. CBLCs and CBL were similar at all times (p>0.05). No correlation was found between CBLC and ICR parameters, as well as between ISQ and implant length. We may conclude that standards and extra short implants can provide similar clinical results in prosthetic rehabilitation of the atrophic jaw over 12 months of follow-up.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Coronas , Diseño de Prótesis Dental , Humanos , Oseointegración
16.
J Oral Sci ; 62(4): 430-434, 2020 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-32863318

RESUMEN

Perception of tooth shades is subjective and not rated exactly the same by different individuals. In terms of dental esthetics, chairside individualization of dental restorations might help to improve patient satisfaction. This investigation aimed to validate the practicability of a chairside approach for staining resin-based composite restorations. Thirteen inexperienced and 13 experienced participants were recruited to first individualize two CAD/CAM resin-based composite crowns in randomized order with light-curing characterization material using two reference crowns as templates. They then evaluated the characterization procedure. The processing times were recorded, and the clinical quality of the individualized crowns was evaluated by two blinded master dental technicians. Of the 52 crowns examined, 90.4% were assessed as suitable for insertion; there was no difference in quality attributable to the different degrees of experience of the operators. The average time required for characterization of the second crown was significantly shorter than for the first crown (30.9/43.0 min), indicating that the procedure can be implemented using a chairside approach. Among the operators, 80.8% said they would use the individualization technique and staining material again. Chairside staining of CAD/CAM resin-based composite restorations with light-curing characterization materials is practicable and can be recommended for both experienced and inexperienced users.


Asunto(s)
Porcelana Dental , Diseño de Prótesis Dental , Cerámica , Resinas Compuestas , Diseño Asistido por Computadora , Coronas , Materiales Dentales , Humanos
17.
J Am Dent Assoc ; 151(10): 790-795, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32979958

RESUMEN

BACKGROUND: Historically, anterior-posterior (AP) spread assessments were often used to determine the length that a distal cantilever could be extended off an implant-supported fixed full-arch prosthesis. TYPES OF STUDIES REVIEWED: The authors searched the literature for articles that used AP spread to calculate cantilever size to be constructed off implants bearing a fixed implant-supported full-arch rehabilitation. RESULTS: The data indicate that the relationship between AP spread and cantilever length is not linear and many influences (such as beam theory, cantilever size differences in the mandible versus maxilla, number and distribution of placed implants, prosthetic materials, and framework design) need to be considered when computing cantilever length with respect to fixed implant-supported prostheses. PRACTICAL IMPLICATIONS: Recommendations using AP spread assessments to compute cantilever lengths have not been validated by means of prospective scientific evaluations. Therefore, AP spread evaluation is just one of many issues that need to be considered when determining distal cantilever length associated with a fixed full-arch implant-bearing prosthesis.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Diseño de Prótesis Dental , Humanos , Mandíbula/cirugía , Maxilar , Estudios Prospectivos
18.
Int J Esthet Dent ; 15(3): 242-262, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760922

RESUMEN

The proliferation of digital technology is progressively changing dentistry. Thanks to continual improvements in CAD/CAM devices and dental materials, it is possible nowadays to carry out a treatment plan for oral rehabilitations with fully digital approaches and noninvasive concepts. The availability of digital resources allows clinicians to increase the predictability of enhanced esthetics and good functional results. There is an increasing number of patients today who are affected by excessive tooth wear and may benefit from these kinds of treatments. This article provides a step-by-step documentation of a full-mouth rehabilitation performed with a digital approach and additive CAD/CAM composite resin restorations. An innovative functional evaluation is also documented and discussed. The initial situation was assessed and compared with the rehabilitation project through a snap-on device. After the intraoral adjustment and validation, the final rehabilitation was performed according to the information obtained in the provisional phase and digitally transmitted to the laboratory.


Asunto(s)
Rehabilitación Bucal , Desgaste de los Dientes , Resinas Compuestas , Diseño Asistido por Computadora , Diseño de Prótesis Dental , Estética Dental , Humanos
19.
Eur J Prosthodont Restor Dent ; 28(3): 128-141, 2020 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-32750237

RESUMEN

PURPOSE: To present the results obtained with the "Continuous Scan Strategy" (CSS), a direct intraoral scanning technique based on the connection of the implant scan bodies (SBs) with thermoplastic resin. METHODS: 40 patients were restored with 45 long-span monolithic implant-supported zirconia restorations (10 partial prostheses [PP] and 35 full arches [FA]) fabricated via a full-digital workflow after the capture of an intraoral impression (Trios3®) using the CSS technique. The primary outcomes were the marginal adaptation and passive fit of the superstructures, checked at T0 (intraoral try-in of polyurethane or metal replica of the final prosthesis) and T1 (delivery of the final zirconia restoration). The secondary outcomes, registered at T2 (2 years after the delivery of the final prosthesis), were implant survival, prosthetic success, and complications. A throughout statistical analysis was performed. RESULTS: At T0, 40/45 replicas demonstrated a perfect passive fit and adaptation. At T1, one prosthesis had fractured, and at T2, an additional prosthesis had fractured and one had chipped. The implant survival rate was 100%. The prosthetic success was 93.3%. CONCLUSIONS: CSS seems to represent a viable option for capturing accurate intraoral digital impressions for the fabrication of precise long-span implant-supported restorations.


Asunto(s)
Diseño Asistido por Computadora , Prótesis Dental de Soporte Implantado , Técnica de Impresión Dental , Diseño de Prótesis Dental , Humanos , Flujo de Trabajo
20.
Int J Comput Dent ; 23(3): 269-279, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32789314

RESUMEN

The utilization of digital 3D surface images (STL format) for planning cases of computer-guided implant surgery is very useful in partially edentulous cases. In fully edentulous cases, however, the absence of teeth makes it necessary to add reference markers. The proposed protocol demonstrates a simple procedure that allows for the superimposition of STL and radiologic data (DICOM format). In the presented patient case, the tissue-bearing area of the prosthesis was relined with a polysulfide impression material and sent to the laboratory. A master cast was produced. The prosthesis was relined to improve intraoral stability and was provided with at least three radiopaque 3D markers. An STL copy of the prosthesis and the model was generated through a laboratory scanner. The patient wore the prosthesis with the attached markers during the 3D radiologic examination. In the planning software (CoDiagnostiX; Dental Wings), the prosthesis markers on the STL were matched to the corresponding markers visible on the DICOM data. Then, the STL of the model was matched to that of the prosthesis. Once the STL of the mucosa and the prosthesis were imported into the software, new possibilities arose, ie, the option to add other digital or traditional tooth setups to the same radiologic data or to design a surgical guide based on the actual mucosa of the patient.


Asunto(s)
Implantes Dentales , Tomografía Computarizada de Haz Cónico Espiral , Diseño Asistido por Computadora , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Humanos , Imagenología Tridimensional , Flujo de Trabajo
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