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1.
Int J Oral Maxillofac Implants ; 36(1): 94-102, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600528

RESUMEN

PURPOSE: To examine the effect of the attachment features (abutment height, retention, and freedom of rotation) of implant overdentures on the bending strain around implants under an overdenture. MATERIALS AND METHODS: Mandibular and maxillary edentulous models were fabricated and covered with silicone rubber. Strain gauges were attached to the four sides of each implant. Two implants (tissue-level implant, 4.1-mm diameter, 10-mm length) were placed bilaterally in the area between the mandibular canines and lateral incisors. A maxillary conventional denture and a mandibular overdenture were made to fit the edentulous models. Three levels of peri-implant bone resorption were created sequentially: no bone resorption, 0.8 mm, and 1.5 mm. Three kinds of attachments (magnetic, stud, and ball attachments) were used. Bending strains generated from a 98-N occlusal load through the maxillary denture were measured using a sensor interface, and the data were analyzed using the Kruskal-Wallis and Bonferroni tests. Multiple regression analysis was used to find the relationship between independent variables (peri-implant bone resorption level, abutment height, retention, and freedom of rotation) and the dependent variable (bending strain). RESULTS: For all attachment types, the bending strains were smallest with no bone resorption and largest with 1.5-mm bone resorption (P < .05). Multiple regression analysis showed that abutment height had the greatest impact on the reduction of bending strain (beta = .413), followed by freedom of rotation (beta = -.349), and retention (beta = .107). CONCLUSION: Low abutment height, large freedom of rotation, and low retention can minimize bending strain around implants.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Mandíbula/cirugía
2.
Int J Prosthodont ; 34(1): 7-12, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33570514

RESUMEN

PURPOSE: To determine whether the use of implant-supported overdentures (IODs) with different attachments influences the Mini Nutritional Assessment (MNA) and Geriatric Oral Health Assessment Index (GOHAI) scores in edentulous patients > 65 years of age. MATERIALS AND METHODS: The MNA and GOHAI were administered to 54 edentulous patients > 65 years of age (mean age = 68.35 ± 4.1 years) before treatment (A) and 6 months after treatment (B): 10 with maxillary + mandibular conventional complete dentures (CDs); 10 with a maxillary conventional CD + mandibular magnetic-retained IOD; 12 with a maxillary conventional CD + mandibular ball-retained IOD; 12 with a maxillary conventional CD + mandibular Locator-retained IOD; and 10 with a maxillary conventional CD + mandibular bar-retained IOD. Statistical differences between treatment types were evaluated using one-way analysis of variance and paired-sample t tests. The correlation between MNA and GOHAI scores was determined using Pearson correlation analysis (α = .05). RESULTS: The difference between mean GOHAI-A and GOHAI-B scores was statistically significant for each type of denture (P < .005). The difference between the mean MNA-A and MNA-B scores was statistically significant for all types of denture except for conventional CDs (P < .05). There was a statistically significant positive correlation between MNA and GOHAI scores (P < .01). CONCLUSION: Regardless of the type of denture used, treatment of edentulous geriatric patients is important for improving nutritional status and self-rated oral health.


Asunto(s)
Implantes Dentales , Calidad de Vida , Anciano , Preescolar , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa , Dentadura Completa Inferior , Prótesis de Recubrimiento , Humanos , Estado Nutricional , Satisfacción del Paciente
3.
Clin Implant Dent Relat Res ; 23(1): 131-139, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33592676

RESUMEN

BACKGROUND: There is lack of reliable predictors for success of conventional complete denture (CCD) therapy, which in turn might affect the effectiveness of subsequent implant-retained overdenture (IOD) therapy. PURPOSE: To investigate relationships between digitally obtained geometrical mandibular residual ridge measures and perceived CCD-stability. MATERIALS AND METHODS: 30 CCD wearing patients (67.9 ± 7.0 years) for whom a new set of CCDs was advised, were treated with new CCDs. Digitalized mandibular gypsum models were measured using the Geomagic Studio 2013 software. Data were obtained for (1) height, width, and cross-section surface area of the residual ridge at different locations (midline, premolar, and anterior edge of retromolar pad) and (2) denture base surface area. Scatter plots and multivariate regression analyses were used to investigate associations between the geometric data and denture base surface area, and correlated with denture stability scores (Spearman rank test). RESULTS: Scatter plots showed that best model fit for denture base surface area was mean ridge height (R2 = 0.906). Multivariate regression showed that height at premolar location (p = 0.001) had largest effect on denture base surface area (R2 = 0.796). Ridge morphology variables, except width at midline location, were significantly correlated with CCD-stability (p-values <0.05). CCD-stability was significantly correlated with denture base surface area (p ≤ 0.001). CONCLUSION: Residual ridge height at premolar location was most predictive for denture base surface area and perceived CCD-stability.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa , Dentadura Completa Inferior , Humanos , Mandíbula
4.
Clin Implant Dent Relat Res ; 23(1): 140-148, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33592681

RESUMEN

BACKGROUND: The significance of mandibular residual ridge height and satisfaction with conventional complete dentures (CCD) as predictors for the added value of implant-overdenture (IOD) therapy is unknown. PURPOSE: To investigate the predictive value of thresholds for (1) residual ridge height at premolar location (PRH), and (2) satisfaction with CCD-stability for the added value of two intraforaminal implants supporting the mandibular CCD. METHODS: Thirty CCD wearing patients (67.9 ± 7.0 years) for whom a new CCD was advised, received a new CCD. Mandibular gypsum models were digitally measured. After 3 months free of complaints (T1), perceived CCD-stability was evaluated, and participants received two intraforaminal implants. At T1 and T2 (3 months free of complaints after IOD therapy) participants completed OHIP14-CN, and denture satisfaction (VAS) questionnaires, and performed mixing ability tests. Participants were grouped according to PRH of ≥6.15 mm versus < 6.15 mm, and perceived CCD-stability satisfied vs. dissatisfied. Scores at T2 were compared to T1 (paired t-tests). Predictive values of PRH and CCD-stability were analyzed with logistic multivariate regression models. RESULTS: At T2, only participants with PRH of <6.15 mm or dissatisfied with CCD-stability had significant lower OHIP-total and domain scores for 'physical pain' and 'physical disability' and significantly higher VAS scores for perceived chewing function, denture retention and oral comfort. Regression analyses showed that participants with PRH of <6.15 mm, or dissatisfied with CCD-stability had significantly higher chance for lower OHIP-total and domain scores 'physical pain' and 'physical disability', and for higher VAS scores for perceived chewing function, denture retention and oral comfort at T2. Masticatory performance improved significantly after IOD therapy, but independent of PRH and CCD-stability. CONCLUSION: PRH and satisfaction with CCD-stability were adequate prognostic indicators for improvement of oral health-related quality of life and denture satisfaction by mandibular IOD therapy.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa , Dentadura Completa Inferior , Humanos , Mandíbula , Masticación , Satisfacción del Paciente , Calidad de Vida
5.
J Prosthet Dent ; 125(1): 138.e1-138.e8, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33393474

RESUMEN

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


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Retención de Dentadura , Análisis de Elementos Finitos , Humanos , Mandíbula/diagnóstico por imagen , Estándares de Referencia , Estrés Mecánico
6.
Quintessence Int ; 0(0): 0, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33491387

RESUMEN

Objective: To analyze the loss of abutment teeth for double crown-retained removable partial dentures (DC-RPDs) compared to clasp-retained removable partial dentures (C-RPDs). Method and materials: A search was conducted in the Ovid MEDLINE, Embase, Web of Science databases, and a manual search. The search was conducted based on the PICO framework with inclusion and exclusion criteria. After extracting the data of selected studies, a meta-analysis was performed to estimate abutment loss with 95% confidence interval (CI). The statistical significance was defined as P < .05, and the heterogeneity of the data was assessed based on the chi-squared test and I2 statistics. Risk of bias assessment was conducted using Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. Results: A total of 4,692 records were identified from electronic databases and 38 studies were included for quantitative synthesis of 3,393 subjects with 13,552 abutment teeth. A total of 1,226 abutment teeth were lost with > 4,016 RPDs. Seven studies were compounded for > 668 C-RPDs (mean follow-up time ≤ 5 years) and six studies for 893 C-RPDs (mean follow-up time < 5 years), where the estimates of abutment loss were 5% (95% CI 2% to 8%) and 8% (95% CI 5% to 13%), respectively. The data were not significantly different (P = .1), and were heterogenous between the studies (τ2 ≥ 0.34, I2 ≥ 87.38%). Thirteen studies were compounded for 1,223 DC-RPDs (mean follow-up time ≤ 5 years) and eight studies for 1,033 DC-RPDs (mean follow-up time > 5 years), where the estimates of abutment loss were 6% (95% CI 5% to 8%) and 12% (95% CI 8% to 18%), respectively. The data were heterogenous (τ2 ≥ 0.17, I2 ≥ 75.86%), and were significantly different between the studies (P = .005). Overall, C-RPDs were not significantly different from DC-RPDs in abutment loss (P ≥ .3). A significant predictor for abutment loss was follow-up time with DC-RPDs (P = .005), where the risk of abutment loss per year was 18% (P = .0001). In contrast, follow-up time was not a significant factor for C-RPDs (P = .1). None of the included studies were at high risk of bias. Conclusion: Within the limitations of the current systematic review and meta-analysis, abutment loss was not significantly different between C-RPDs and DC-RPDs. A significant predictor was follow-up time for DC-RPDs, whereas this factor was not significant for C-RPDs. Further research is needed to investigate critical factors for abutment loss with RPDs.


Asunto(s)
Dentadura Parcial Removible , Coronas , Pilares Dentales , Retención de Dentadura , Estudios de Seguimiento , Humanos
7.
Braz Dent J ; 31(6): 657-663, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33237238

RESUMEN

The aim of this study was to evaluate the effect of cleaning solutions on the retention force of o-ring-type overdenture attachments. The effect of four solutions on nitrile rings were evaluated: Cepacol (C), Cepacol with fluoride (CF), Listerine (L) and 0.05% sodium hypochlorite (SH); deionized water (DW) was used as a control. Matrices containing two implants and abutments and acrylic specimens with the metal capsules were obtained and divided into the groups. A simulation of 90 overnight immersions (8 h) was performed, and the tensile strength value was obtained at the beginning (T0) and in every 30 days (T1, T2 and T3) (n=6). In order to analyze o-ring surface damage after the immersions, a scanning electron microscopy (SEM) was used (n=1). For statistical analysis of the results, analysis of variance (ANOVA) and multiple comparisons with Bonferroni adjustment (test power=1.000; a=0.05) were used. There was a significant difference for the factors time (p<0.001), solution (p<0.001) and for the interaction time × solution (p<0.001). Considering the times of each solution, only for DW there was no significant loss of retention over time. Comparing the solutions in each moment, there was no difference among the solutions in T0. From T1, CF and SH provided less retention than DW (p<0.005). Through SEM it was possible to observe changes in the surface of the CF and SH nitrile o-rings. CF and SH should be avoided due to deleterious action in o-rings.


Asunto(s)
Prótesis de Recubrimiento , Hipoclorito de Sodio , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Retención de Dentadura , Ensayo de Materiales , Resistencia a la Tracción
8.
Int J Prosthodont ; 33(5): 572-575, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32956439

RESUMEN

A 54-year-old woman presented with severe maxillary resorption, which resulted in an unstable maxillary removable denture. Due to poor anatomical conditions, the prosthodontic solution posed for the patient was an implant-supported maxillary overdenture based on four implants. This report presents the detailed workflow for CAD/CAM-fabricated, individually milled zirconia bars and an electroplated superstructure framework for an implant-supported removable overdenture, which enabled good retention and an optimal esthetic result. A critical element in the present case was the production of electroplated secondary elements, which are highly precise, with a homogenous layer of gold. No retention loss was observed after 12 months in use.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Estética Dental , Femenino , Oro , Humanos , Persona de Mediana Edad , Circonio
9.
Int J Prosthodont ; 33(5): 576-581, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32956440

RESUMEN

A new-generation mini-implant system offers a polyether ether ketone matrix and a new-generation surface technology on its patrix. This clinical report describes the treatment of a patient with a new-generation mini-implant-retained maxillary overdenture.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Humanos , Maxilar
10.
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
11.
Indian J Dent Res ; 31(3): 414-419, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32769276

RESUMEN

Objectives: To evaluate the impact of implants number and attachments type on the peri-implant stresses and retention of maxillary palateless implant-supported overdenture. Materials and Methods: Four edentulous maxillary educational acrylic resin models were used. According to the implants number and type of attachment used, four groups were compared: Group I, 2-locator attachments in the canine area; Group II, 2- OT equator attachments in the canine area; Group III, 4-locator attachments in the canine, second premolar area and Group IV, 4-OT equator attachments in the canine, second premolar area. Implants retained palateless overdenture was constructed on each model. Four self-protected linear strain gauges were cemented on each implant. A digital loading device was used to apply compressive loads to measure the resulting peri-implant stresses. Forcemeter and Universal testing machines were used to test the retention of palateless overdenture. Results: A significant difference between the same implant number and distribution with different attachments was found (P = 0.003, P = 0.020), respectively. Least stresses amount was found around the 4-implant locator palateless overdenture, while the highest was found around the 2-implant OT equator palateless overdenture. Nevertheless; the result was that 2-implant locator palateless overdenture recorded insignificant higher retentive forces than the 4-implant OT equator one. Conclusions: It can be concluded that the implant-retained palateless overdenture with four locator attachments is considered a promising treatment option regarding stress distribution. Using locator attachments, for implant-retained palateless overdenture with either two or four implants considering their superior retentive properties, is advantageous when compared to OT equator attachments.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Retención de Dentadura , Maxilar
12.
J Oral Sci ; 62(4): 397-401, 2020 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-32848099

RESUMEN

The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Humanos , Mandíbula , Estudios Retrospectivos , Instrumentos Quirúrgicos
13.
J Cancer Res Ther ; 16(3): 693-696, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32719295

RESUMEN

Xerostomia is a subjective symptom of dry mouth. It can occur as a part of the systemic disease, drug-induced side effect, or following therapeutic radiation therapy to the head-and-neck region. The primary complication faced by these xerostomic patients is the difficulty in retention of removable dentures. It is important to recognize that the prosthodontic management of these patients requires special attention and care. In an attempt to overcome the presence of xerostomia, several techniques of introducing reservoirs into the dentures containing salivary substitutes have been proposed. This case report presents a simplified approach for the construction of a reservoir in the maxillary denture, specifically in patients where other treatment modalities have failed. This technique provided excellent lubrication to oral tissues, hygienic for the patient, and utilized routine denture base material.


Asunto(s)
Diseño de Dentadura/métodos , Retención de Dentadura/métodos , Dentadura Completa Superior/normas , Neoplasias de Cabeza y Cuello/radioterapia , Traumatismos por Radiación/terapia , Xerostomía/terapia , Anciano , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Pronóstico , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Xerostomía/etiología
14.
BMC Oral Health ; 20(1): 194, 2020 07 08.
Artículo en Inglés | MEDLINE | ID: mdl-32641033

RESUMEN

BACKGROUND: An increase in the number of elderly edentulous patients likely leads to a greater demand for dentures and denture adhesives. As denture adhesives have both positive and negative features, dentists need to know the types of denture adhesive users to be able to provide instruction to denture wearers on how to use denture adhesives effectively. This study aims to examine the utilization of denture adhesives and associated factors. METHODS: Seven closed-ended questionnaires were developed for a web-based survey. After that, Fisher's exact tests were performed to determine the difference in the denture adhesive usage rate by gender, type of denture, last dental visit, and smoking status. A multivariate-adjusted logistic regression analysis was performed with denture adhesive use or non-use as the dependent variable and the other items as independent variables. Next, Fisher's exact tests and a multivariate-adjusted logistic regression analysis were performed with the type of denture adhesives as the dependent variable in the same way. Statistical analyses were performed for all denture wearers, complete denture wearers, and partial denture wearers. The level of statistical significance was set at p = 0.05. RESULTS: A total of 1470 denture wearers in Japan participated in this study. Of these, 318 used denture adhesives, while 212 (66.7%) used cream; 74 (23.3%) used home liner; 25 (7.9%) used powder; four (1.3%) used sheets; and three (0.9%) used several types. The Fisher's exact tests revealed that the ratios of using denture adhesives were significantly higher for complete denture wearers (p < 0.001), last dental visit over 1 year (p = 0.005), and smokers (p = 0.005). For partial denture wearers, the ratio was significantly higher in smokers (p = 0.262). The multivariate adjusted logistic regression revealed that denture adhesive use or non-use were significantly associated with the type of denture and smoking status in all denture wearers, and just smoking status in partial denture wearers. There were no significant results about the type of denture adhesive selection. CONCLUSIONS: From all denture wearers, complete denture wearers and smokers are more likely to use denture adhesives. In addition, smokers significantly use denture adhesives if they are partial denture wearers.


Asunto(s)
Adhesivos/uso terapéutico , Cementos Dentales , Retención de Dentadura/estadística & datos numéricos , Dentadura Completa , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Salud Bucal , Calidad de Vida , Encuestas y Cuestionarios
15.
Clin Oral Implants Res ; 31(8): 747-767, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32497274

RESUMEN

OBJECTIVES: The aim of this prospective study was to evaluate the implant, prosthesis, and patient-reported outcomes of maxillary removable prostheses retained by 4 implant-supported study abutments after a follow-up period of 1 year in patients with natural teeth or a fixed rehabilitation in the mandible. MATERIALS AND METHODS: A total of 30 patients were included, and all received 4 implants in the upper maxilla. After 12 weeks, the prostheses were connected to the implant with unsplinted attachments. The implant and prosthodontics outcomes were assessed over a follow-up period of 1 year. Patient-reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP-20) questionnaire and an adaptation of the McGill Denture Satisfaction Instrument using a visual analogue scale (VAS). RESULTS: A single patient dropped out. At the post-operative 12-week follow-up, 79.3% (95% CI: 64.6%-94.1%) of the patients displayed peri-implant mucosa hyperplasia and 69.0% (95% CI: 52.1%-85.8%) showed pain. After 1 year, 16 implants failed in 10 patients, leading to an implant survival rate of 86.2% (95% CI: 79.0%-92.5%), and the mean peri-implant bone loss was 1.01 ± 0.77 mm (95% CI: 0.85-1.16 mm). The prosthesis survival rate was 96.6% (95% CI: 82.2%-99.9%). The OHIP-20 and VAS scores both improved significantly from baseline to 1 year (p < .001). CONCLUSION: The implant survival rate was lower compared to the literature for the upper maxilla. Despite the encountered problems, PROMs showed significant improvement with the implant overdenture retained by 4 unsplinted implants compared to conventional dentures.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Prótesis Dental de Soporte Implantado , Dentición , Retención de Dentadura , Prótesis de Recubrimiento , Humanos , Maxilar , Satisfacción del Paciente , Estudios Prospectivos , Resultado del Tratamiento
16.
Gerodontology ; 37(3): 233-243, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32491236

RESUMEN

OBJECTIVES: To examine the McGill Denture Satisfaction Questionnaire (MDSQ) in terms of dimensionality, item reduction and construct validity in a binational sample of complete denture wearers. MATERIALS AND METHODS: We conducted secondary analyses of baseline data from two studies on implant-retained overdentures: a quasi-experimental study in the United States (n = 145) and a randomised trial in Brazil (n = 120). All participants wore upper/lower dentures and responded at baseline to the MDSQ items concerning their original mandibular dentures. A putative model of the MDSQ items resulted in two question subsets: (a) overall satisfaction, retention/stability, aesthetics, cleaning, speech and comfort, plus general chewing ability; (b) mastication of specific foods. Analyses focused on the internal consistency of each subset and possible item reduction, using Cronbach's alpha (Cα), inter-item correlation and exploratory factor analysis (EFA). RESULTS: The 1st subset showed high inter-item correlation for most question combinations and no redundancy (r ≤ .8). An item on cleaning had low correlation, but its removal does not increase internal consistency (Cα ≥ .83). Results were similar for both studies, with EFA showing a single significant factor (namely "overall satisfaction, lower denture") able to explain nearly 54% of the variance. The 2nd subset also shows strong internal consistency (Cα ≥ .95) and inter-item correlation, with a single factor representing 65% of the variation. CONCLUSIONS: This study discloses the reliability and construct validity of the MDSQ for patient-centred evaluation of complete dental prostheses in the edentulous mandible. Findings also support the use of both "overall satisfaction" and "masticatory ability" as summary scores, for improved outcome assessment.


Asunto(s)
Prótesis Dental de Soporte Implantado , Dentadura Completa , Satisfacción Personal , Brasil , Retención de Dentadura , Dentadura Completa Inferior , Prótesis de Recubrimiento , Estética Dental , Análisis Factorial , Humanos , Masticación , Satisfacción del Paciente , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
17.
Int. j. odontostomatol. (Print) ; 14(2): 236-241, June 2020. tab
Artículo en Inglés | LILACS | ID: biblio-1090680

RESUMEN

There is no information about the possible impact in denture retention after the use of common denture adhesives (DAs) when poor denture foundations (PDF) are present. Moreover, there is a lack of information about which current formulation provides greater retention and for how long. Twelve models from edentulous patients with different ridge shape and border height were used and complete dentures were manufactured. Four different formulation brands of DAs were tested after 10 minutes and three, six, nine, and 12 hours of DA application using a universal testing machine. The Fittydent® and Fixodent® adhesives had the highest retention at 12 hours. The PDF group increased on average its retention by 400 %. However, the group presented lower retention compared to the good denture foundation group. In conclusion, DAs significantly increased denture retention. The PDF group were the most benefited with the application of DAs. The Fixodent® paste had the highest retention.


No existe información acerca del posible impacto en la retención de dentaduras después del uso de adhesivos dentales comunes (DAs) cuando existen rebordes alveolares deficientes (PDF). Más aun, existe una falta de información acerca de cuál formula actual provee mayor retención y por cuanto tiempo. Doce modelos de pacientes edentulos con diferentes formas y alturas en sus rebordes alveolares fueron usados, y dentaduras completas les fueron realizadas. Cuatro diferentes fórmulas y marcas de DAs fueron evaluadas después de 10 minutos, tres, seis, nueve y 12 horas de que se aplicó el DA usando una maquina universal de pruebas. Los adhesivos Fittydent® y Fixodent® presentaron la retención más alta a las 12 horas. El grupo con PDF incrementó su retención hasta en un 400 %. Sin embargo, el grupo presentó menor retención cuando se comparó con el grupo que posee adecuados procesos alveolares. Los DAs incrementaron significativamente la retención de las dentaduras. El grupo PDF fue el más beneficiado con la aplicación de DAs. La pasta Fixodent® provee la más alta retención.


Asunto(s)
Humanos , Retención de Dentadura/métodos , Cementos Dentales/química , Proceso Alveolar , Técnicas In Vitro , Adhesivos
18.
Int J Oral Maxillofac Implants ; 35(3): 543-550, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32406652

RESUMEN

PURPOSE: The purpose of this study was to evaluate the influence of implant inclination on retention and peri-implant stresses of stud-retained implant overdentures during axial and nonaxial dislodgments. MATERIALS AND METHODS: Mandibular acrylic models (n = 4) received two implants in the canine areas with 0-, 5-, 10-, and 20-degree lingual inclinations. Dentures were attached to the implants with stud connectors. Four strain gauges were bonded at buccal, lingual, mesial, and distal surfaces of each implant to monitor strains around implants. Retention values (Newton) and peri-implant stresses (microstrains, µs) were recorded during axial (vertical) and nonaxial (anterior, posterior, and lateral) dislodging. A general linear model was used to compare retention forces and implant stresses between implant inclinations and dislodging direction. In addition, a linear regression model was used to test correlation of implant stresses with confounding factors. RESULTS: The highest retention and implant stresses were noted with 0 degrees, followed by 5 and 10 degrees (without difference), and the lowest values were noted with 20 degrees. Anterior dislodging was associated with the highest retention and implant stresses, followed by vertical dislodging, then lateral dislodging, and posterior dislodging. Peri-implant stresses significantly correlated with dislodging direction and retention forces. Every 1 N of increase in retention forces causes 19.17 µs increase in implant stresses. Anterior dislodging was associated with the highest predicted stress values (846.0 µs), and the lowest stress values (143.41 µs) were associated with posterior dislodging. CONCLUSION: Retention forces and peri-implant stresses decreased as lingual implant inclination increased during axial and nonaxial dislodging of stud-retained implant overdentures. Peri-implant stresses were significantly correlated with dislodging direction and retentive forces.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Retención de Dentadura , Mandíbula
19.
J Contemp Dent Pract ; 21(1): 41-46, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32381799

RESUMEN

AIM: Undercuts on abutment teeth (AT) should be identified and quantified to establish the exact location of the active tip of the retentive arm of the direct retainer. The aim of this study was to locate and evaluate tissue and tooth undercut areas in various Kennedy's classes and to assess the correlation, if any, between Kennedy's classes and the location and depth of undercuts. MATERIALS AND METHODS: One hundred and seven patients' casts, with designated AT and edentulous areas (EAs), were surveyed. The undercuts on AT and EAs were measured using undercut gauges. Statistical analysis was performed. RESULTS: The median depth of the undercut was maximum on distal the surface of mandibular AT in a Kennedy's class III edentulous situation. No significant difference was found between the amount of tissue undercuts measured on the EA in each of the Kennedy's classes in the maxillary and mandibular arches. CONCLUSION: No significant difference was found between the amounts of undercut measured on AT and the EA in each of the Kennedy's classes in the maxillary and mandibular arches. No correlation was found between Kennedy's classes and the location and depth of undercuts. CLINICAL SIGNIFICANCE: The results of our study reinforce that the diagnosis and selection of ideal abutments should be stressed while planning for a removable dental prosthesis (RDP). In the majority of the cases, the anticipated design of the direct retainer can be applied, though one cannot overlook the need for proper diagnosis and survey.


Asunto(s)
Dentadura Parcial Removible , Diente , Estudios Transversales , Retención de Dentadura , Humanos , Estudios Retrospectivos
20.
J Contemp Dent Pract ; 21(1): 68-72, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32381804

RESUMEN

OBJECTIVE: This study aimed to evaluate and compare the effect of locator attachment and ball and socket (BS) attachment on the peri-implant and periabutment supporting structures on clinical pocket depth and gingival index in cases of limited interarch spaces in mandibular Kennedy class I implant-supported removable partial overdentures. MATERIALS AND METHODS: A comparative clinical trial was conducted among twenty partially edentulous patients aged 30-60 years. The study participants were randomly divided into two study groups based on the attachment system used: group I - locator attachment, and group II - BS attachment. Two implants were positioned in the 1st or 2nd molar area following the two-stage surgical protocol. Evaluation of the peri-implant and periabutment supporting structures was done at the time of overdenture insertion and after 6, 12, and 18 months by measuring the pocket depth and gingival index. Inter- and intragroup comparisons were done using independent-samples t test and paired-sample t test respectively. p < 0.05 was considered statistically significant. RESULTS: It was observed that there was a statistically significant increase in the pocket depth around the implant as well as the abutment in both groups at 6, 12, and 18 months when compared to baseline. Intergroup comparison for pocket depth and gingival index revealed nonsignificant results. However, the values were higher in the BS group. CONCLUSION: The locator attachment group had lower, though statistically not significant, pocket depth and gingival index scores around both the dental implant and the natural abutment as compared with the BS attachment. CLINICAL SIGNIFICANCE: Gingival health surrounding dental implant attachments is very crucial for the long-term success of dental implant, this could help the clinician to select the proper design for implant attachment underneath the over denture prosthesis.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Adulto , Retención de Dentadura , Humanos , Mandíbula , Persona de Mediana Edad
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