Reabilitação oral simplificada da sequela decorrente de acidente complexo: caso clínico / A simple procedure for oral rehabilitation in a complex accident injury: a case report

The use of a removable partial prosthesis is an effective treatment modality in the reconstruction of large maxillary defects, because it provides adequate support for the soft tissue and improves facial contours. Oral functions, such as speech and swallowing, also benefit from the use of removable partial prostheses. Osseointegrated implants are generally not indicated due to systemic factors, lack of bone anchorage, very long treatment times, and high costs. Therefore, the use of a removable partial prosthesis has been proposed as an alternative because of its relatively short treatment time, especially in patients undergoing successive bone- and soft tissue-grafting procedures. This report describes the use of an obturator prosthesis for the prosthetic rehabilitation of a maxillectomy patient with fractures due to a motorcycle accident.

O uso de uma prótese parcial removível é uma modalidade de tratamento eficaz na reconstrução de defeitos maxilares grandes, porque fornece um apoio adequado para o tecido mole e melhora o contorno facial. As funções orais como a fala e a deglutição, também se beneficiam com o uso de próteses parciais removíveis. Implantes osseointegrados geralmente não são indicados devido a fatores sistêmicos, deficiência óssea, tempos de tratamento muito longo e custos elevados. Portanto, o uso de uma prótese parcial removível foi proposto como uma alternativa por causa de seu tempo de tratamento relativamente curto, especialmente em pacientes submetidos a sucessivos procedimentos cirúrgicos de enxerto de tecido duro e mole. Este artigo descreve o uso de uma prótese obturadora para a reabilitação protética de um paciente maxilectomizado devido a um acidente de motocicleta.

Assessment of rehabilitation in edentulous patients treated with an immediately loaded complete fixed mandibular prosthesis supported by three implants.

PURPOSE: Conventionally, in patients with completely edentulous mandibles, fixed prostheses have been supported by four or more implants. However, an alternative protocol employing three implants and immediate loading has been developed. The objective of the present study was to assess the rehabilitation of edentulous patients treated with a complete fixed mandibular prosthesis with immediate loading and supported by three implants. MATERIALS AND METHODS: In this observational study, a total of 99 implants placed in 33 patients was evaluated after 18 months in use. Panoramic radiographs were digitized to measure bone loss at the mesial and distal surfaces of each implant. RESULTS: Mean peri-implant bone loss was 0.66 ± 0.51 mm for the left implant, 0.92 ± 0.61 mm for the central implant, and 0.82 ± 0.53 mm for the right implant. The bone loss observed around the distal implants was similar to that seen around the central implant, and there were no statistically significant differences in peri-implant bone loss between the three implant locations. There was no significant correlation between implant length and bone loss. The results were compatible with the peri-implant bone loss that has been described for prostheses of the same type supported by larger numbers of implants. CONCLUSIONS: The use of a complete fixed mandibular prosthesis with immediate loading supported by three implants proved to be an adequate option for the rehabilitation of edentulous patients. The protocol allowed simplification of treatment while maintaining similar bone loss to that reported for the same type of treatment supported by a larger number of implants.

Implant-supported palatal lift prosthesis in a patient with velopharyngeal incompetence: a case report.

OBJECTIVE: To describe the use of dental implants in the treatment of velopharyngeal incompetence. BACKGROUND: Velopharyngeal incompetence is characterized by the inability to contract the tissues of the soft palate. The most common causes are neuromuscular problems resulting from concussion and degenerative conditions of the central nervous system. MATERIALS AND METHODS: The treatment using palatal lift prosthesis is well established in the literature; however, reports on the use of osseointegrated implants are scarce. Rehabilitation using only this type of fibromucosal support is difficult in edentulous patients, since the prosthesis has a palatal lift extension. RESULTS: The implants provided retention and stability to the prosthesis, improving swallowing and speech and contributing to improve the patient's quality of life. CONCLUSION: This article reports the rehabilitation of a patient with a totally edentulous maxilla with velopharyngeal incompetence using an implant-retained palatal lift prosthesis.

Avaliação do nível de satisfação e da qualidade de vida relacionada à saúde oral de pacientes edêntulos reabilitados com próteses fixas sobre três implantes em mandíbula / Assessment of patient satisfaction and oral health-related quality of life of edentulous patients with three-implant-supported mandibular fixed prosthesis

A reabilitação de pacientes desdentados totais inferiores sempre foi um dos grandes desafios da Odontologia. A descoberta da Osseointegração modificou o panorama das possibilidades terapêuticas de reabilitação oral. Além da questão técnica cirúrgica e protética, a avaliação da satisfação e da qualidade de vida é fundamental quando se visa o sucesso na terapia com implantes dentários. Objetivos: verificar o nível de satisfação e qualidade de vida relacionada à saúde oral de indivíduos edêntulos totais reabilitados com prótese fixa sobre três implantes sob carga imediata. Metodologia: 67 indivíduos participaram do estudo, sendo 24 do gênero masculino e 43 do gênero feminino. Os pacientes submeteram-se a colocação de três implantes e confecção de uma prótese fixa de carga imediata na arcada inferior. O nível de satisfação foi avaliado através da escala analógica visual (EAV) e a qualidade de vida relacionada à saúde oral foi verificada através do questionário Ohip-Edent, versão validada para o português brasileiro 18 meses após concluída a reabilitação protética. Resultados: a média de satisfação na escala EAV relatada foi de 9,15 (± 1,8). A média de escore Ohip-Edent foi de 2,60 (± 2,69). Conclusão: a avaliação do nível de satisfação e qualidade de vida relacionada à saúde oral demonstrou que o protocolo adotado no presente estudo proporcionou aos pacientes desdentados totais uma alternativa de tratamento capaz de reabilitar as funções orais, sociais e psicológicas, reduzindo custos e tempo de tratamento

Rehabilitation of the totally edentulous mandible has always been one of the greatest challenges of Dentistry. The advent of osseointegration has opened up a new range of therapeutic possibilities for oral rehabilitation. In addition to surgical and prosthetic management, assessment of patient satisfaction and quality of life is essential for achieving success in dental implant therapy. Objective: To determine patient satisfaction and oral health-related quality of life of edentulous patients treated with three-implant-supported mandibular fixed prosthesis with immediate loading. Methods: The sample consisted of 67 individuals, 24 men and 43 women. After placement of three implants, each patient received an immediately loaded implant-supported fixed prosthesis in the mandible. Patient satisfaction was assessed using a visual analog scale (VAS) and oral health-related quality of life by the Ohip-Edent questionnaire, validated for the Brazilian population, 18 months after completion of prosthetic rehabilitation. Results: Mean patient VAS satisfaction score was 9.15 (±1.8). Mean Ohip-Edent score was 2.60 (± 2.69). Conclusion: The assessment results of patient satisfaction and oral health-related quality of life showed that the protocol adopted in the present study provided totally edentulous patients with a treatment option capable of rehabilitating oral, social and psychological functions, associated with reduced costs and shorter treatment time

Length of the drilling holes of zygomatic implants inserted with the standard technique or a revised method: a comparative study in dry skulls.

AIM: This study aimed to evaluate the length of the holes drilled for the placement of zygomatic implants using two surgical techniques: the original Brånemark and the Exteriorized (extrasinus) protocols. The most frequent implant length used and position where the implants emerged in the zygomatic bone were recorded. MATERIALS AND METHODS: Both surgical techniques for inserting zygomatic implants were performed on the right and left sides of 18 dry adult skulls. The depth of the drilling holes in the zygomatic bone for placement of zygomatic implants and the corresponding implant length were measured. The position where the implant emerged was recorded using a standardized division of the zygomatic bone surface into 13 sections (Fig. 3). RESULTS: The Exteriorized technique showed significantly longer drilling holes for zygomatic implants than the Brånemark technique (P<0.001). For both techniques, the most commonly used implant lengths were 30 and 35 mm, and the most frequent position where the implants emerged were sections 9 and 12. CONCLUSIONS: The results suggest that the Exteriorized technique increases the length of the drilling holes in the zygomatic bone, which may provide higher initial mechanical stability for zygomatic implants than the original Brånemark technique.