Relationship between the occlusal plane and three different levels of ala-tragus line in a sample of sudanese adults / Relación entre el plano oclusal y tres niveles diferentes de la línea ala-trago en una muestra de adultos sudaneses

Aim: Correct orientation of the occlusal plane plays a vital role in achieving the perfect occlusal balance and function of complete dentures. This study aimed to evaluate the most reliable posterior reference point of the ala-tragus line (ATL) concerning occlusal plane (OP) in a sample of the dentate Sudanese population. Materials and Methods: A total of 150 subjects with healthy and well-aligned permanent teeth were randomly selected. Right lateral profile photographs were taken with subjects having a fox plane placed intra-orally, contacting the occlusal plane. Reference points corresponding to inferior, middle, and superior borders of the tragus and inferior border of the ala of the nose were marked on photographs. The angles between the lines were measured using the Auto-CAD software program, and the most parallel relationship was determined. Descriptive statistics in terms of means and standard deviations were presented. Independent t-test and one-way ANOVA tests were used to compare as appropriate. A p-value < 0.05 was considered significant. Results: The mean angle formed by the OP and ATL was 8.5±3.69º for the superior level, 4.68±3.13º for the middle line, and 2.89±2.57º for the inferior line. A significant difference was found between the means of the three angles (p< 0.001), while no significant difference (p> 0.05) was found between both genders regarding the measured angles. Conclusions: The line joining the inferior border of the ala of the nose with the inferior border of the tragus of the ear was the most reliable line in terms of parallelism to determine the occlusal plane orientation.

Antecedentes: La orientación correcta del plano oclusal juega un papel vital para lograr el equilibrio oclusal perfecto y la función de las prótesis completas. Este estudio tuvo como objetivo evaluar el punto de referencia posterior más confiable de la línea ala-trago (ATL) con respecto al plano oclusal (OP) en una muestra de la población dentada de Sudán. Materiales y Métodos: Se seleccionaron aleatoriamente un total de 150 sujetos con dientes permanentes sanos y bien alineados. Se tomaron fotografías de perfil lateral derecho de sujetos a los que se les colocó un plano de zorro intraoralmente, en contacto con el plano oclusal. En las fotografías se marcaron los puntos de referencia correspondientes a los bordes inferior, medio y superior del trago y al borde inferior del ala de la nariz. Los ángulos entre las líneas se midieron utilizando el programa de software Auto-CAD y se determinó la relación más paralela. Se presentaron estadísticas descriptivas en términos de medias y desviaciones estándar. Se utilizaron prueba-t independiente y prueba ANOVA unidireccional para las comparaciones, según correspondiera. Se consideró significativo un valor de p<0,05. Resultados: El ángulo medio formado por OP y ATL fue de 8,5±3,69º para el nivel superior, 4,68±3,13º para la línea media y 2,89±2,57º para la línea inferior. Se encontró una diferencia significativa entre las medias de los tres ángulos (p< 0,001), mientras que no se encontró diferencia significativa (p>0,05) entre ambos sexos con respecto a los ángulos medidos. Conclusión: La línea que une el borde inferior del ala de la nariz con el borde inferior del trago de la oreja fue la línea más confiable en términos de paralelismo para determinar la orientación del plano oclusal.

Qualitative evaluation of immediate rehabilitation: a case report with 5 years of follow-up / Avaliação qualitativa de reabilitação imediata: relato de caso com 5 anos de acompanhamento

Próteses totais imediatas e overdentures mandibulares em carga imediata, são boas alternativas para restaurar a função e a estética. Além disso, proporcionam um fator psicológico positivo, eliminando as consequências emocionais e sociais da perda dos dentes. O objetivo deste estudo foi relatar um caso clínico, com cinco anos de acompanhamento, utilizando parâmetros clínicos e ferramentas qualitativas, para analisar o impacto na qualidade de vida do paciente e no sucesso do tratamento. Este caso clínico foi desenvolvido em um projeto assistencial da Faculdade de Odontologia da Universidade Federal de Minas Gerais, Brasil, que promove a reabilitação oral de pacientes de baixa renda com dentes severamente comprometidos. Paciente do sexo masculino, 57 anos, apresentou-se para tratamento com condição severa de saúde dental e periodontal. O plano de tratamento proposto foi a extração dos dentes remanescentes e confecção de prótese total imediata maxilar e overdenture mandibular, em carga imediata, sobre implantes. O paciente foi acompanhado periodicamente, a cada seis meses, para substituição do o´rings, conforme recomendação do fabricante. Após 5 anos, as próteses foram reembasadas com resina acrílica termopolimerizável e os componentes protéticos da overdenture foram substituídos. Em um acompanhamento qualitativo, a equipe utilizou uma entrevista narrativa, com foco nos impactos do tratamento na qualidade de vida desse paciente. Ele confirmou, em um relato em primeira pessoa, sua satisfação com o tratamento realizado e a melhora nas relações sociais, afetivas e no trabalho, mostrando como a reconquista do sorriso pode transformar a experiência pessoal do indivíduo(AU)

Immediate complete dentures and mandibular immediately loaded overdentures are good alternatives to restore function and aesthetics. Moreover, they provide positive psychological factor, eliminating the emotional and social consequences of tooth loss. The aim of this study was to report a clinical case, with five years of follow-up using clinical parameters and qualitative tools, to analyze the impact on quality of life and the success of treatment. This clinical case was developed in an assistance project of the Dental School of Federal University of Minas Gerais in Brazil, which promotes oral rehabilitation of low-income patients with severely damaged dentitions. A 57-yearold male patient presented for treatment with a severe dental and periodontal health condition. The proposed treatment plan was extraction of the remaining teeth and making maxillary immediate complete denture and mandibular immediately loaded implant-supported overdenture. The patient was monitored periodically, every six months, to replace the polymer ring ball attachment, according to the manufacturer's recommendation. After 5 years, the prostheses were relining with heat-polymerized acrylic resin and overdenture prosthetic components were replaced. In a qualitative follow-up, the team used a narrative interview, focusing on the impacts of treatment in the quality of life of this patient. He confirms, in a firstperson account, his satisfaction with the treatment performed and improvements in social and affective relations and in the work, showing how the reconquest of the smile can transform the personal experience of the individual(AU)

Impact of Wearing Dentures on Dietary Intake, Nutritional Status, and Eating: A Systematic Review.

INTRODUCTION: A key purpose of denture provision is to enable eating, yet the body of evidence pertaining to the impact of dentures on wide-ranging nutritional outcomes has not been systematically reviewed. OBJECTIVES: To systematically review published evidence pertaining to the effect of wearing removable dental prosthesis on dietary intake, nutritional status, eating function, and eating related-quality of life (ERQoL). METHODS: Eight questions relating to the impact of wearing dentures on nutritional outcomes were addressed. The target population was healthy adults aged ≥18 y. Data sources included Medline, Embase, CINAHL, and PubMed. Included were all human epidemiologic studies. The Newcastle-Ottawa score was used for appraisal of study quality. Harvest plots, vote counting, and accompanying narrative provided the basis for synthesis. RESULTS: Of the 1,245 records identified, 134 were retrieved and eligibility assessed by 2 reviewers, and 41 studies were included in the synthesis (14 rated good quality, 20 fair, and 7 poor). The balance of data supported a positive impact of wearing full (5/7 studies) or partial (3/3 studies) dentures (vs. no dentures) on nutritional status, though no clear direction of effect was detected for the impact of dentures on dietary intake. The balance of data clearly showed that objective measures of eating function were compromised in full (14/15 studies) and partial (6/7 studies) denture wearers as compared with the dentate. Data showed that ERQoL was also compromised in denture wearers as compared with the dentate (3/3 studies). However, data showed a positive impact of wearing dentures on ERQoL (5/5 studies) as opposed to wearing no dentures. CONCLUSION: The balance of evidence shows that despite no clear pattern on impact of wearing dentures on measured dietary intake, in those with tooth loss, wearing dentures can have a positive impact on nutritional status and enjoyment of eating. KNOWLEDGE TRANSFER STATEMENT: The results of this systematic review can be used to advocate for health care services to address prosthodontic need to benefit nutritional outcomes. The findings will be of use in educating health care professionals on the impact of wearing dentures and not addressing prosthodontic need on nutritional outcomes.

Therapeutic effects of finger pressing on Hegu acupoint on nausea in first-time complete denture wearers / 中国基层医药

Objective:To investigate the therapeutic effects of finger pressing on Hegu acupoint on nausea and to find an optimal method to reduce nausea in first-time complete denture wearers. Methods:Forty-one first-time complete denture wearers who received treatment between June 2016 and December 2019 in Huxi Hospital Affiliated to Jining Medical University were included in this study. They were randomly divided into observation group ( n = 21) and control group ( n = 20). The observation group received finger pressing on Hegu acupoint for 3 minutes before complete denture wearing and before three meals. The control group received self-adaptive therapy. After 3, 7 and 14 days of wearing complete denture, the number of wearers without nausea, the number of wearers with normal swallowing function, and the number of wearers with masticatory efficiency were recorded in each group. Efficacy was compared between two groups. Results:After 3 and 7 days of wearing complete denture, the percentage of complete denture wearers without nausea was 85.71% (18/21) and 95.24% (20/21), respectively, which were significantly higher than those in the control group [45.00% (9/20), 65.00% (13/20), χ2 = 5.58, 4.19, both P < 0.05 ]. After 14 days of wearing complete denture, there was no significant difference in number of wearers without nausea between observation and control groups ( P > 0.05). After 3 days of wearing complete denture, there was significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups [57.14% (12/21) vs. 15.00% (3/20), χ2 = 8.16, P < 0.01). After 7 and 14 days of wearing complete denture, there was no significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups (both P > 0.05). After 3 and 7 days of wearing complete denture, masticatory efficiency in the observation group was (42.03 ± 5.02)% and (50.34 ± 5.05)%, which were significantly higher than those in the control group [(37.00 ± 4.00)%, (47.13 ± 4.03)%, t = 3.51, 1.65, both P < 0.05]. After 14 days of wearing complete denture, there was no significant difference in masticatory efficiency between the two groups ( P > 0.05). Conclusion:Finger pressing on Hegu acupoint has good clinical effects on alleviating nausea in complete denture wearers and can shorten the adjustment time to first time wearing complete denture.

Disposable Fox Ruler: a proposal to avoid cross-contamination / Régua de Fox descartável: uma proposta para evitar a contaminação cruzada

ABSTRACT Numerous pathogens, including SARS-CoV-2, can remain viable on surfaces over days, which favors cross-contamination. Preventive measures are essential to prevent infections and control the spread of COVID-19. Fox ruler is an essential device in the clinical planning of complete dentures and the contact with the patient's oral fluids during handling is unavoidable. Despite its importance, the conventional polycarbonate Fox ruler is easily damaged in the sterilization process. Therefore, the purpose of this article is to propose the use of a disposable Fox ruler. The confection is carried out in a simple way with wooden toothpicks joined by cyanoacrylate glue, following the same shape as the conventional one, but with the additional advantage of being made in an individual size according to the upper edge. The proposed disposable Fox ruler makes it possible to obtain the parallelism of the upper wax roller with the bipupillary line and with the Camper plane. Therefore, the disposable device described in this article was able to perform the same functions as the conventional one, in a practical way, without risks of cross contamination and with low cost.

RESUMO Vários patógenos, incluindo SARS-CoV-2, são capazes de permanecer viáveis em superfícies durante dias, o que favorece a contaminação cruzada. Medidas preventivas são essenciais para prevenir infecções e controlar a propagação da COVID- 19. A régua de Fox é um dispositivo essencial no planejamento clínico de próteses totais e é inevitável o contato com os fluidos orais do paciente, durante seu manejo. Apesar de sua importância, a régua de Fox convencional de policarbonato é facilmente danificada com o processo de esterilização. Portanto, o objetivo deste artigo é propor a utilização de uma régua Fox descartável. A confecção é feita de forma simples com palitos de madeira unidos por cola de cianoacrilato, seguindo o mesmo formato do convencional, mas com a vantagem adicional de ser produzida em tamanho individualizado de acordo com o rebordo superior. A régua Fox descartável proposta permite obter o paralelismo do rolete de cera superior com a linha bipupilar e com o plano de Camper. Portanto, o dispositivo descartável descrito neste artigo foi capaz de desempenhar as mesmas funções do convencional, de forma prática, sem riscos de contaminação cruzada e com baixo custo.

A study comparing patient satisfaction and retention of CAD/CAM milled complete dentures and 3D printed CAD/CAM complete dentures versus conventional complete dentures: a randomized clinical trial / Um estudo comparando a satisfação do paciente e a retenção de próteses totais fresadas em CAD/CAM e próteses totais 3D impressas com tecnologia CAD/CAM versus próteses totais convencionais: um ensaio clínico randomizado

Objective: To compare the three different methods of complete denture fabrication assessing patient satisfaction and retention after insertion for six months' follow-up period. Material and Methods: The study was conducted in the Prosthodontic Department where a total of forty-eight patients were recruited from the outpatient clinics fulfilling the inclusion criteria. This study was designed as a randomized controlled clinical trial. All patients followed the steps of complete denture construction till jaw relation record. Then, all eligible patients were randomized to intervention and control groups. For intervention groups digital scanning, designing, manufacturing of complete dentures was done; 3D printing for first and milling for second intervention. For the comparator group, complete dentures were manufactured the conventional way. After 2 weeks of delivery of the dentures, patients received a patient satisfaction questionnaire, retention was measured by retention force gauge. Both readings were also recorded after 3 months and at 6 months. The mean and standard deviation values were calculated for each group in each test. The significance level was set at P≤ 0.05. Results: No statistical difference was found in terms of patient satisfaction and retention between the three groups at different time intervals. Conclusion: The manufacturing technique seemed to have no influence on patient satisfaction and retention with milled showing the least results.(AU)

Objetivo: Comparar três métodos diferentes de fabricação de prótese total avaliando a satisfação do paciente e a retenção após a inserção por um período de acompanhamento de seis meses. Material e Métodos: O estudo foi conduzido no departamento de Prótese onde um total de quarenta e oito pacientes foram recrutados das clínicas ambulatoriais atendendo os critérios de inclusão. Este estudo foi designado como um ensaio clínico randomizado controlado. Todos os pacientes seguiram as mesmas etapas de confecção de prótese total até o registro da relação maxilo-mandibular. Então, todos os pacientes qualificados foram divididos de forma aleatória nos grupos de intervenção e grupo controle. Para os grupos de intervenção foram realizados escaneamento digital, projeto e fabricação de próteses totais; Impressão 3D para o primeiro e fresagem para o segundo grupo de intervenção. Para o grupo de comparação, próteses totais foram feitas com o método convencional. Depois de 2 semanas após a entrega das próteses os pacientes receberam um questionário de satisfação e a retenção foi mensurada com um medidor de força de retenção. Ambas as leituras também foram registradas após 3 e 6 meses. Os valores de média e desvio padrão foram calculados para cada grupo em cada teste. O nível de significância foi estabelecido em P ≤ 0,05. Resultados: Nenhuma diferença estatística foi encontrada em termos de satisfação do paciente e retenção entre os três grupos em diferentes intervalos de tempo. Conclusão: A técnica de fabricação pareceu não ter influência na satisfação do paciente e retenção da prótese, com o grupo fresado apresentando o mínimo de resultados.(AU)

Comprehensive prosthodontic treatment of an elderly patient with compromised ridges: a clinical case report / Tratamiento prostodóntico integral de un paciente anciano con proceso alveolar comprometido: informe de un caso clínico

Introduction: The objective of a complete denture prosthesis is restoring aesthetics, comfort, and function by the replacement of missing dental and alveolar structures employing a stable prosthesis. Case Report: Many conditions can complicate the treatment plan and fabrication of a complete denture prosthesis. Complete denture fabrication in clinically compromised conditions is a challenging task for the dentist. In this clinical report, we present comprehensive management of a patient with denture-induced hyperplasia, flabby ridge, and severely resorbed edentulous ridge. The three part strategy for management of the above-mentioned challenges can provide high-quality complete dentures, based on recognized prosthodontic principles. This first part will discuss the management of denture induced hyperplasia by elimination of the inflammation and excision of the lesion. Part two will cover management of the flabby ridge using a modified window technique for the impression of maxillary flabby tissues for an improved and controlled application of the impression material that is usually obtainable in dental practice. Part three highlights the rehabilitation procedure of the resorbed mandibular ridge using a functional impression technique with minimum soft tissue displacement and neutral zone arrangement of teeth to improve stability of the denture. Conclusion: rehabilitation of a patient with denture induced hyperplasia, flabby ridge, and severely resorbed edentulous ridges was successful.

Introducción: El objetivo de una prótesis completa es restaurar la estética, la comodidad y la función mediante el reemplazo de las estructuras dentales y alveolares faltantes empleando una prótesis estable. Case Report: Muchas condiciones pueden complicar el plan de tratamiento y la fabricación de una prótesis completa. La fabricación completa de la dentadura en con-diciones comprometidas clínicamente es una tarea desafiante para el dentista. En este reporte de un caso clínico, presentamos el ma-nejo integral de un paciente con hiperplasia inducida por dentadura postiza, cresta flácida y cresta edéntula severamente reabsorbida. La estrategia de tres partes para el manejo de los desafíos mencionados anteriormente puede proporcionar prótesis completas de alta calidad, basadas en reconocidos principios protésicos. La primera parte discutirá el manejo de la hiperplasia inducida por dentadura postiza mediante la eliminación de la infla-mación y la extirpación de la lesión. La segunda parte cubrirá el manejo de la cresta alveolar flácida utilizando una técnica de ventana modificada para la impresión de tejidos flácidos maxilares para una aplicación mejorada y controlada del material de impresión que generalmente se obtiene en la práctica dental. La tercera parte destaca el procedimiento de rehabilitación del reborde mandibular reabsorbido utilizando una técnica de impresión funcional con un desplazamiento mínimo de los tejidos blandos y una disposición de la zona neutra de los dientes para mejorar la estabilidad de la dentadura. Conclusion: La rehabilitación de un paciente con hiperplasia inducida por dentaduras postizas, cresta flácida y reabsorbida fue exitosa.

Perfil sociodemográfico e odontológico de usuários de próteses totais do programa de extensão universitária Resgatando Sorrisos / Sociodemographic and dental profile of users of total protheses in the university extention program "Resgatando Sorrisos"

Objetivo: Realizar uma análise transversal do perfil sociodemográfico e clínico de pacientes edêntulos bimaxilares e dos hábitos de uso das suas próteses totais (PT) antigas. Posteriomente, os participantes foram reabilitados com próteses totais, em um período de 3 anos (2017- 2019)), em três municípios do estado de Pernambuco - Brasil, por meio de um programa de extensão universitária. Métodos: 58 participantes foram avaliados por meio de um questionário composto de 73 questões. Os dados coletados permitiram uma avaliação quantitativa, e o nível de significância considerado foi de 0,05. Resultados: Destaca-se um perfil de pacientes idosos com uma média de tempo de desdentado total de 24,3±15,3 anos (maxila) e 22,14±14,22 (mandíbula), havendo uma maior prevalência de usuários com próteses bimaxilares (74%). Destaca-se em 57,1% da amostra, a predo-minância da escovação com creme dental e, em 42,9%, a utilização de sabão/detergente, solução de hipoclorito de sódio (NaClO) e/ou bicarbonato de sódio (NaHCO3) como coadjuvantes na higienização. Além disso, 66,6% da amostra apresentou necessidade de intervenção clínica para reparos na PT. Com relação aos hábitos deletérios, os idosos apre-sentaram menos o hábito de dormir com a prótese quando comparados a adultos (p≤0,001). Conclusão: O perfil dos participantes apresentou prevalência do gênero feminino e idade média de 63 anos, além de uma média de 20 anos desdentados (maxila e mandíbula), um tempo elevado de uso das próteses (>10 anos) e o hábito de uso contínuo. Mais da metade dos participantes utilizava métodos de higienização inadequados.

Objective: To conduct a cross-sectional analysis of the sociodemographic and clin-ical profile of edentulous bimaxillary patients and their habits of using old complete den-tures (CD).Subsequently, the participants were rehabilitated with complete dentures, in three years (2017-2019), in three municipalities located in the state of Pernambuco, - Bra-zil, through a university extension program. Methods: We evaluated a total of 58 partici-pants through a questionnaire with 73 questions. Data collected were used for quantitative assessment, and the level of significance was set at 0.05. Results: Most of the participants were elderly patients with an average total edentulous time of 24.3 ± 15.3 years, and 22.14 ± 14.22 years at the maxilla and mandible, respectively. In addition, there was a high prev-alence of users who had bimaxillary prostheses (74%). In 57.1% of the sample, there was a predominance of brushing with toothpaste, 42.9% used soap/detergent, sodium hypochlo-rite solution, and (or) sodium bicarbonate as adjuvants in cleaning. Moreover, 66.6% of the patients needed a clinical intervention for CD repairs. About the harmful habits, the elderly showed a less frequent habit of sleeping with their prostheses compared to the adults (p ≤ 0.001). Conclusion: Most of the participants were female with an average age of 63 years. They presented an average of 20 years of edentulousness (maxilla and mandible) and the extended use of the dentures (> 10 years), in addition to the habit of continuous use. More than half of the participants used inadequate cleaning methods.

Esquema oclusal em prótese total / Occlusal scheme in complete dentures

O objetivo foi revisar a literatura e discutir os conceitos oclusais em reabilitações orais com próteses totais, enfatizando as vantagens e as necessidades de cada esquema oclusal. Realizou-se uma busca nas bases de dados PubMed, SciELO, Google Scholar e em li-vros didáticos com as palavras-chave "Oclusão Dentária", "Oclusão Dentária Balanceada", "Orientação de Canino", "Planejamento de Dentadura", "Planejamento de Prótese Dentá-ria" e "Prótese Total" e com os operadores booleanos AND (E), OR (OU), NOT (MENOS). Dentro dos esquemas oclusais disponíveis para o planejamento protético, a oclusão balan-ceada bilateral (OBB) e a oclusão guiada pelo canino (OGC) foram as mais estudadas e discutidas na desoclusão de próteses totais. Os estudos indicam que o tipo de oclusão pode interferir na atividade muscular do sistema estomatognático, na eficiência mastigatória, na reabsorção óssea, na retenção e estabilidade das próteses removíveis e na satisfação do pa-ciente. Na literatura examinada, foi perceptível a recomendação da OGC como o esquema oclusal de preferência no planejamento das próteses totais, pois os resultados dos estudos indicam menor atividade muscular durante a mastigação, melhor retenção e estabilidade da prótese total. A OGC é o esquema oclusal mais simples e fácil de ser obtido comparada à OBB, beneficia a fonética, é esteticamente preferida pelos pacientes e, em termos de qua-lidade de vida, autopercepção da força mastigatória e oclusal, tem se mostrado satisfatória. Conclui-se que a OGC pode ser recomendada como um esquema oclusal favorável para as reabilitações orais com próteses totais.Descritores: Oclusão Dentária. Oclusão Dentária Balanceada. Orientação de canino. Pró-tese Total. Planejamento de Prótese Dentária.

The aim was to review the literature and discuss the occlusal concepts in oral rehabilitation with complete dentures, emphasizing the advantages and needs of each occlusal scheme. A search was carried out on the databases PubMed, SciELO, Google Scholar and in textbooks, using "Dental Occlusion"; "Dental Occlusion Balanced"; "Canino guidance"; "Denture complete"; and "Denture design" as keywords and the Boolean operators AND, OR, and NOT. Among the occlusal schemes available for prosthetic planning, the bilateral balanced occlusion (BBO) and the canine guided occlusion (CGO) were the most studied and discussed in the disocclusion of complete dentures. Studies indicate the type of occlusion can interfere with muscle activity of the stomatognathic system, masticatory efficiency, bone resorption, retention and stability of removable dentures, and patient satisfaction. In the literature examined, the recommendation of the CGO as the preferred occlusal scheme in the planning of complete dentures was noticeable. The results of the studies indicate less muscle activity during mastication, better retention, and stability of the total denture. It is simpler and easier to obtain this occlusal scheme than the BBO. CGO benefits phonetics; it is aesthetically preferred by patients; and, in terms of quality of life, self-perception of masticatory and occlusal strength, has shown to be satisfactory. We conclude that CGO can be recommended as a favorable occlusal scheme for oral rehabilitation with complete dentures.

Self-perception of older adults regarding rehabilitation with dentures / Autopercepção de idosos sobre a reabilitação com próteses dentárias

ABSTRACT Objective: To analyze the self-perception that older adults have about rehabilitation regarding their uni or bimaxillary dentures. Methods: A form was applied to investigate the sociodemographic, economic and medical-dental variables of the users, a questionnaire to assess the satisfaction level of patients with their dentures, another to investigate the technical quality of the dentures from the aesthetic-functional point of view, and the Oral Health Impact Profile (OHIP-14) to ascertain the impact of prosthetic rehabilitation on the quality of life of users. Results: The majority of the participants (65.2%) used complete bimaxillary dentures, reported dissatisfaction during chewing, while the lower dentures had unsatisfactory technical quality for the retention requirements (69.6%) and stability (69.6%). The older adults' complaints were predominantly related to the "physical pain" and "physical disability" domains. There were significant associations between general satisfaction with the dentures in use, their general technical quality and the OHIP-14 domains. Conclusion: The patient complaints were related to difficulties in their ability to chew, speak and with the retention and comfort of the lower dentures. The technical quality of the dentures had compromised retention and stability from the aesthetic-functional point of view. Dentures considered unsatisfactory caused negative impacts on the quality of life of users, especially in comfort during meals which was related to difficulty chewing and swallowing. The association between the instruments used in the study provides important tools for the performance of dental surgeons, in addition to enabling more adequate planning in the oral health services offered to the population.

RESUMO Objetivo: Analisar a autopercepção que os idosos têm sobre a reabilitação com suas próteses dentárias totais uni ou bimaxilares. Métodos: Aplicou-se um formulário para investigar as variáveis sociodemográficas, econômicas e médico-odontológicas dos usuários, um questionário para avaliar o nível de satisfação dos pacientes com seus aparelhos protéticos, outro para investigar a qualidade técnica das próteses, do ponto de vista estético-funcional, e o Oral Health Impact Profile (OHIP-14), para averiguar o impacto da reabilitação protética na qualidade de vida dos usuários. Resultados: A maioria dos participantes (65,2%) utilizava prótese total dupla, relatava insatisfação durante a mastigação, os aparelhos protéticos inferiores apresentavam qualidade técnica insatisfatória para os requisitos de retenção (69,6%) e estabilidade (69,6%). As queixas dos idosos estavam relacionadas, predominantemente, aos domínios "dor física" e "incapacidade física". Houve associações significativas entre a satisfação geral com a prótese em uso, a qualidade técnica geral das mesmas e os domínios do OHIP-14. Conclusão: As queixas dos pacientes estavam relacionadas com dificuldades na capacidade de mastigar, falar e com a retenção e o conforto das próteses totais inferiores. A qualidade técnica dessas próteses, do ponto de vista estético-funcional, apresentava retenção e estabilidade comprometidas. Os aparelhos protéticos considerados insatisfatórios causaram impactos negativos na qualidade de vida dos usuários, sobretudo, no conforto durante as refeições, o qual estava relacionado à dificuldade na mastigação e deglutição. A associação entre os instrumentos utilizados no estudo fornece ferramentas importantes para a atuação do cirurgião-dentista, além de possibilitar um planejamento mais adequado nos serviços de saúde bucal oferecidos à população.

Masticatory efficiency, quality of life, comfort, retention and satisfaction on digital denture: case report / Eficiência masticatória, qualidade de vida, conforto, retenção e satisfação com prótese total digital: caso clínico

ABSTRACT The aim of this study was to describe a clinical protocol for fabrication of maxillary and mandibular dentures using CAD/CAM technology. Further, digital and conventional dentures fabricated for the same patient were compared. The comparison was based on patient's satisfaction, comfort, retention, number of follow-up sessions, masticatory performance and quality of life. No laboratorial step was needed for CAD/CAM fabrication and less sessions were required up to denture insertion. Compared to the conventional dentures, digital dentures provided better satisfaction, comfort and retention and required less follow-up sessions. Both dentures presented similar results about masticatory performance and quality of life. As a conclusion, digital denture is a viable treatment alternative for edentulous patients. However, controlled and randomized clinical trials are required to reveal the real benefits of this treatment alternative compared to the conventional denture.

RESUMO O objetivo deste estudo foi descrever um protocolo clínico para a fabricação de próteses superiores e inferiores usando a tecnologia CAD/CAM. Além disso, as próteses digitais e convencionais fabricadas para o mesmo paciente foram comparadas. A comparação foi baseada na satisfação, conforto, retenção, número de sessões de acompanhamento, desempenho mastigatório e qualidade de vida do paciente. Nenhuma etapa laboratorial foi necessária para a fabricação de CAD/CAM e menos sessões foram necessárias até a inserção da prótese. Comparadas às próteses convencionais, as próteses digitais proporcionavam melhor satisfação, conforto e retenção e exigiam menos sessões de acompanhamento. Ambas as próteses apresentaram resultados semelhantes sobre desempenho mastigatório e qualidade de vida. Como conclusão, a prótese digital é uma alternativa viável para o tratamento de pacientes desdentados. No entanto, ensaios clínicos controlados e randomizados são necessários para revelar os benefícios reais dessa alternativa de tratamento em comparação com a prótese convencional.

[Immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses: a retrospective analysis of 225 cases].

Objective: To evaluate the outcomes of immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses and analyse the risk factors of the complications. Methods: This retrospective study included 273 patients treated with immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses from April 2008 to December 2018 in Department of Implantology, Peking University School and Hospital of Stomatology. The patients' sex, age, place of residence, jaw position, opposing dentition, number of implants, diameter and length of implants, abutment height and abutment angle were recorded. The survival rate of implants and marginal bone loss were calculated and analyzed. Cox proportional hazards ratio model was adopted to analyze the potential risk factors of prosthetic complications. Results: A total of 225 patients (288 jaws) and 1 260 implants were included, with 126 males and 99 females, aged (57.3±11.0) years, with a following time of (5.04±3.08) years. The 1-year cumulative survival rate of implants was 98.0% (1 235/1 260). Forty-eight implants were lost during the follow-up, with 39 implants in the maxillae and 9 implants in the mandible. The risk of implant failure of the maxillae ï¼»7.2% （39/541）］ is significantly higher than that of the mandible ï¼»1.3% （9/719）］ (P<0.01). Average marginal bone loss at 1 and 5 years was (0.7±0.2） mm and （1.1±0.3） mm. One hundred and twenty patients experienced prosthetic complications including screw/abutment loosening (44 cases), screw/abutment fracture (2 cases) and artificial tooth/denture base fracture (99 cases). The possibility of immediate prosthesis fracture within 6-8 months was high but declined over the following years with the final prosthesis delivered. Cox regression analysis showed that the use of 17° abutments in the anterior region was significantly related to the prosthetic complications （hazard ratio=1.797, P=0.002）. Conclusions: Immediate rehabilitation of the edentulous jaws with implant-supported full-arch prostheses can be a predictable technique. The immediate prosthetic mechanical complication prevalence was high. The use of 17° abutments in the anterior region may increase the risk of screw/abutment loosening. It is necessary to review in time.

Factors associated with the need for a complete denture in one arch or both arches among the elderly population

Abstract: This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

Incidência e fatores de risco a não adaptação de novas próteses mandibulares: ensaio clínico / Incidence and risk factors for non-adaptation of new mandibular prostheses: clinical trial

Este ensaio clínico não randomizado se propôs a investigar a incidência e os fatores de risco a não adaptação de prótese total convencional mandibular (PTCM). Um total de 108 edêntulos bimaxilares foram reabilitados com próteses totais e acompanhados por um período de 3 e 6 meses. Nesses períodos, os pacientes foram alocados em PTA (Pacientes adaptados a PTCM) e PTN (Pacientes não adaptados a PTCM). Os critérios que confirmaram a adaptação dos pacientes foram: realizar a mastigação, fonética e deglutição confortavelmente com as próteses. As variáveis analisadas como possíveis fatores de risco foram registradas em ficha clínica e estavam relacionadas aos aspectos sociodemográficos e fatores centrados no paciente. A estimativa do tempo médio para adaptação à PTCM foi obtida a partir da curva de Kaplan-Meier. Inicialmente, os fatores de risco foram analisados estatisticamente pelo Teste do Qui-quadrado ou Exato de Fisher. Em seguida, foi realizada uma análise multivariada e o risco relativo foi ajustado através da regressão múltipla de Poisson. Os resultados revelaram incidência de 38,0% (n=41) dos indivíduos não adaptados a novas próteses totais mandibulares após 3 meses. Essa não adaptação à prótese total mandibular esteve associada significativamente à ausência de experiência prévia com PTCM (p=0,042), à presença de ulcerações após 15 dias da reabilitação (p<0,001) e à altura do rebordo mandibular posterior reduzida (p=0,035). Após 6 meses, essa incidência reduziu para 14,1% (n=14), sendo a ocorrência de lesões ulcerosas após 15 dias (p<0,001) e 30 dias (p<0,001) da instalação das novas próteses e o uso não regular da nova PTCM (p<0,001) os fatores de risco associados à não adaptação à PTCM. A análise de sobrevida mostrou que 78,53 ± 36,11 dias são suficientes para adaptação da maioria dos pacientes à prótese, com o menor tempo médio de adaptação à PTCM associado significativamente à experiência prévia com PTs inferiores (p=0,032), ao uso de próteses antigas confeccionadas por dentista (p=0,034), à ausência de registro de lesões nos primeiros dias após reabilitação (p=0,023), à rebordo mandibular posterior não-reabsorvido (p=0,005) e ao uso regular das novas próteses mandibulares (p=0,002). Conclui-se que a incidência de indivíduos não adaptados a PTCM foi maior em um período de 3 meses, com redução após 6 meses de acompanhamento. As variáveis sociodemográficas não influenciaram na adaptação à prótese mandibular nos períodos de 3 e 6 meses. No tempo de 3 meses, a ausência de experiência prévia com PTCM, registro de úlceras traumáticas em arco mandibular e a presença de rebordos mandibulares reduzidos interferiram negativamente na adaptação às novas próteses inferiores constituindo-se como fatores de riscos ao não uso da PTCM. Todavia, após 6 meses de uso das próteses, apenas a ocorrência de lesões ulcerativas e o uso não regular das próteses foram fatores de risco à não adaptação à prótese mandibular. Em média, a maioria dos indivíduos se adaptou a nova PTCM em 2,6 meses. Essa adaptação em menor tempo esteve associada à experiência prévia com prótese inferior, ao uso de próteses antigas confeccionadas por dentista, à ausência de registro de úlceras traumáticas após tratamento reabilitador, à presença de rebordo não reabsorvido e ao uso regular das novas PTCM (AU).

This non-randomized clinical trial aimed to investigate the incidence and the risk factors to the non-adaptation of the conventional mandibular complete denture (CMCD). A total of 108 bimaxillary edentulous were rehabilitated with full dentures on a 3 month and 6 month follow-up. During these periods, patients were allocated into PTA (Patients adapted to CMCD) and PTN (Patients non-adapted to CMCD). The criteria that confirmed the patients' adaptation were: chewing, phonetics, and swallowing comfortably with the dentures. The variables analyzed as possible risk factors were recorded in a clinical record and were related to sociodemographic aspects and patientcentered factors. The estimate of the average time for adaptation to CMCD was obtained from the Kaplan-Meier curve. Initially, the risk factors were analyzed statistically by the Chi-square test or Fisher's Exact test. Then, a multivariate analysis was performed and the relative risk was adjusted by Poisson regression. The results revealed an incidence of 38.0% (n=41) of individuals non-adapted to new mandibular complete dentures after 3 months. Non-adaptation to the mandibular complete denture was significantly associated with the absence of past mandibular denture experience (p=0.042), the presence of ulcerations after 15 days of rehabilitation (p<0.001), and the height of the reduced posterior mandibular ridge (p=0.035). After 6 months, this incidence decreased to 14.1% (n=14), with the occurrence of ulcerative lesions after 15 days (p<0.001) and 30 days (p<0.001) of the delivery of new dentures and the nonregular use of new CMCD (p<0.001) being the risk factors associated with the nonadaptation of CMCD. Survival analysis showed that 78.53 ± 36.11 days are enough for most patients to adapt to the dentures, with the lower average time to adapt to CMCD significantly associated with previous experience with mandibular CDs (p=0.032), use of old dentures made by a dentist (p=0.034), no record of ulcers after the first days after rehabilitation (p=0.023), posterior mandibular ridge non-reabsorbed (p=0.005) and regular use of new mandibular dentures (p=0.002). It concluded that the incidence of patients non-adapted to CMCD was higher in 3 months, with a reduction after 6 months follow up. Sociodemographic variables not influenced the adaptation to the mandibular dentures in the periods of 3 and 6 months. After 3 months, the absence of previous experience with CMCD, registration of traumatic ulcers in the mandibular arch, and the presence of lower mandibular ridges interfered negatively in the adaptation to new lower dentures, constituting risk factors for non-use CMCD. However, after 6 months of wearing the prostheses, only the occurrence of ulcerative lesions and non-regular wear of dentures were risk factors for non-adaptation to mandibular prostheses. On average, most individuals adapted to the new CMCD in 2.6 months. This adaptation in less time was associated with previous experience with an inferior dentures, the use of old prostheses made by a dentist, the absence of a record of traumatic ulcers after rehabilitation treatment, the presence of non-resorbed ridge and the regular use of the new CMCD (AU).

Surgical and nonsurgical treatment of papillary hyperplasia: A case report / Tratamiento quirúrgico y no quirúrgico de la hiperplasia papilar inflamatoria: Reporte de Caso

Dentures with dental plaque predispose recurrent hyperplasia on the palatal mucosa. Surgical procedures for the treatment of inflammatory papillary hyperplasia involve postsurgical discomfort and morbidity. This repot describes clinical and histologic aspects of a patient with severe akantolitic inflammatory papillary hyperplasia. The palatal mucosa was treated with a surgical bur with a low-speed handpiece. A new removable denture was performed and adapted. A follow-up of 4 years showed staility of health at palatal mucosa. Patient referred low discomfort and morbidity when using bur technique. Control of removable denture was critical for long-term healing and soft tissue stability.

Las prótesis dentales con placa bacteriana predisponen a la hiperplasia recurrente en la mucosa palatina. Los procedimientos quirúrgicos para el tratamiento de la hiperplasia papilar inflamatoria implican molestias y morbilidad posquirúrgicas. Este reporte describe los aspectos clínicos e histológicos de un paciente con hiperplasia papilar inflamatoria acantolítica severa. La mucosa palatina fue tratada con una fresa quirúrgica con una pieza de mano de baja velocidad. Se realizó y adaptó una nueva prótesis parcial removible. Después de un seguimiento de 4 años, se encontró estabilidad de la salud de la mucosa palatina. El paciente se refirió a la baja incomodidad y morbilidad al usar la técnica de la fresa. El control de la prótesis parcial removible fue crítico para la cicatrización a largo plazo y la estabilidad de los tejidos blandos, evitando la recidiva de la hiperplasia papilar inflamatoria.

Síndrome da combinação: um relato de prontuário / Síndrome de la combinación: un relato de prontuario / Combination syndrome: an accounting report

Objetivos: O presente estudo teve como objetivo relatar a análise de um prontuário de paciente portador da Síndrome da Combinação, cuja reabilitação bucal foi realizada através da associação de diferentes tipos de próteses. Materiais e Métodos: Um prontuário de uma paciente que procurou tratamento reabilitador no complexo odontológico da FSG Centro Universitário dentro das disciplinas de Prótese Dentária do curso de Odontologia da FSG Centro Universitário entre os anos de 2017 e 2018 foi escolhido contemplando a condição clínica de necessidade de três modalidades de prótese (prótese total, prótese fixa e prótese parcial removível) ao mesmo tempo para reabilitação, configurando um paciente com Síndrome da Combinação Protética. Resultados: Foi encontrada as seguintes condições: 1) Reabsorção óssea na região anterior da maxila; 2) Aumento das tuberosidades; 3) Extrusão dos dentes naturais anteriores mandibulares; 4) Perda óssea abaixo da base de resina acrílica da PPR inferior. Conclusão: Foi possível relatar que, provavelmente, o motivo da instalação da Síndrome da Combinação para o prontuário analisado foi: 1) Ausência de saúde periodontal; 2) Tempo prolongado de uso das próteses antigas; 3) Desarmonia oclusal; e 4) Condição financeira como motivo de retardo na procura do cirurgião-dentista(AU)

Objectives: This study aimed to report the analysis of a patient's chart of the Combination Syndrome, whose oral rehabilitation was performed through the association of different types of prostheses. Materials and Methods: A medical record of a patient who sought rehabilitation treatment at the Complex Dentistry of FSG University Center within the Dental Prosthesis disciplines of the Odontology course at FSG University Center between the years 2017 and 2018 was chosen considering the clinical condition of need for three types of prosthesis (total prosthesis, fixed prosthesis and removable partial prosthesis) at the same time for rehabilitation, configuring a patient with Prosthetic Combination Syndrome. Results: The following conditions were found: 1) Bone resorption in the anterior region of the maxilla; 2) greater tuberosity; 3) Extrusion of anterior mandibular natural teeth; 4) Bone loss below the acrylic resin base of the lower PPR. Conclusion: It was possible to report that, probably, the reason for the installation of the Combination Syndrome for the analyzed medical record was: 1) Absence of periodontal health; 2) Prolonged use of old prostheses; 3) Occlusal disharmony; and 4) Financial condition as a reason for delay in the demand of the dental surgeon(AU)

Objetivos: El presente estudio tuvo como objetivo relatar el análisis de un prontuario de paciente portador del Síndrome de la Combinación, cuya rehabilitación bucal fue realizada a través de la asociación de diferentes tipos de prótesis. Materiales y Métodos: Un prontuario de una paciente que buscó tratamiento rehabilitador en el complejo odontológico de FSG Centro Universitario dentro de las disciplinas de Prótesis Dentales del curso de Odontología de la FSG Centro Universitario entre los años 2017 y 2018 fue elegido contemplando la condición clínica de necesidad de tres modalidades de prótesis (prótesis total, prótesis fija y prótesis parcial removible) al mismo tiempo para rehabilitación, configurando un paciente con Síndrome de la Combinación protética. Resultados: Se han encontrado las siguientes condiciones 1) Reabsorción ósea en la región anterior de la mandíbula; 2) Aumento de las tuberías; 3) Extrusión de los dientes naturales anteriores mandibulares; 4) Pérdida ósea debajo de la base de resina acrílica de la PPR inferior. Conclusión: Fue posible relatar que, probablemente, el motivo de la instalación del Síndrome de Combinación para el prontuario analizado fue: 1) Ausencia de salud periodontal; 2) Tiempo prolongado de uso de las prótesis antiguas; 3) Desarmonía oclusal; y 4) Condición financiera como motivo de retraso en la demanda del cirujano-dentista(AU)

Efetividade do tratamento com próteses totais convencionais em idosos: ensaio clínico controlado e randomizado / Effectiveness of treatment with conventional complete dentures in the elderly: randomized controlled clinical trial

Este ensaio clínico controlado e randomizado teve o objetivo de avaliar a efetividade do tratamento com PTs bimaxilares na performance mastigatória (PM), qualidade de vida relacionada à saúde bucal (QVRSB), satisfação e qualidade técnica das próteses (QT) em idosos totalmente edêntulos. Um total de 50 participantes foi randomizado em dois grupos: grupo controle (GC; PTs antigas avaliadas no T0 e reavaliadas após 3 meses ­ T1; n = 25) e grupo teste (GT; PTs antigas avaliadas no T0 e PTs novas avaliadas após 3 meses de uso; n = 25). A PM foi analisada pela determinação do diâmetro mediano das partículas (X50). A QVRSB foi obtida a partir do OHIP-Edent e a Satisfação foi avaliada em relação a critérios funcionais e psicológicos por meio de um questionário previamente validado. A QT foi obtida por uma avaliação clínica quanto a fatores técnicos relacionados às próteses, como arranjo dos dentes anteriores, retenção e estabilidade. A depender da distribuição normal dos dados, testes paramétricos e não-paramétricos foram utilizados na análise estatística (intervalo de confiança de 95%). A amostra final foi composta por 48 idosos, com idade média de 68,77 anos (± 6,01), predominantemente do sexo feminino. A PM do GC foi significativamente melhor do que a do GT no T0 (p = 0,024), no entanto, no T1, os grupos foram semelhantes, com um X50 aproximado de 6,7 mm. No GC, o X50 aumentou 0,21mm do T0 para o T1; e o GT apresentou uma pequena redução, de -0,02 mm. Quando se compara a variação do X50 entre os grupos, verifica-se que não houve diferença significativa entre eles (p = 0,105). Para o GT, a mediana do OHIP-Edent total reduziu significativamente após o tratamento (de 12,00 pontos para 5,00; p = 0,001). Essa redução foi significativa também para os domínios: problemas relacionados à mastigação (p = 0,010), dor e desconforto oral (p = 0,014) e desconforto e incapacidade psicológica (p = 0,003). A variação na satisfação aumentou significativamente apenas no GT, de uma média de 59,04 pontos para 93,82 (p < 0,001), assim como a QT no GT, que apresentou uma variação positiva de 55,00 pontos (p < 0,001). A partir dos resultados, conclui-se que novas PTs convencionais bimaxilares promoveu melhora significativa na QVRSB, satisfação e QT das próteses em idosos, porém não melhorou a PM. Assim, essa opção de tratamento é viável para idosos, principalmente para aqueles que não apresentam tantas expectativas em relação a um ganho relevante na mastigação. No entanto, trabalhos futuros podem avaliar essa variável quanto a um maior período de adaptação às novas próteses, podendo associar também a efetividade da substituição de PTs antigas por novas quanto à condição nutricional de idosos (AU).

This randomized controlled trial aimed to evaluate the effectiveness of bimaxillary complete dentures (CDs) on masticatory performance (MP), oral health-related quality of life (OHRQoL), satisfaction and technical quality of dentures (TQ) among totally edentulous older adults (aged 60 years and over). A total of 50 participants were randomized into two groups: control group (CG; old CDs evaluated at T0 and reassessed after 3 months - T1; n = 25) and test group (TG; old CDs evaluated at T0 and new CDs evaluated after 3 months of use; n = 25). The MP was analyzed by determining the median particle size (X50). OHRQoL was obtained from the OHIP-Edent Questionnaire and satisfaction was assessed through functional and psychological criteria using a previously validated questionnaire. TQ was obtained by a clinical evaluation regarding technical factors related to the dentures, such as anterior teeth arrangement, retention and stability. Depending on the normal distribution of data, parametric and nonparametric tests were used in the statistical analysis (95% confidence interval). The final sample consisted of 48 older adults, with a mean age of 68.77 years (± 6.01), predominantly female. The MP for the CG was significantly better than the TG at T0 (p = 0.024). However, at T1, the groups were similar, with an approximate X50 of 6.7 mm. In the CG, the X50 increased 0.21mm from T0 to T1; and the TG showed a small reduction of -0.02 mm. There was no significant difference between the groups regarding the variation of X50 (p = 0.105). For the TG, the total OHIP-Edent median decreased significantly after treatment (from 12.00 points to 5.00; p = 0.001). This reduction was significant for the following domains: masticatory-related complaints (p = 0.010), oral pain and discomfort (p = 0.014) and psychological discomfort and disability (p = 0.003). The variation in satisfaction means increased significantly only in the TG, from 59.04 to 93.82 points (p <0.001). Similarly, for the test group, TQ also presented a positive variation of 55.00 points (p <0.001). Taken together, these findings suggest that new bimaxillary conventional CDs promote a significant improvement in the OHRQoL, satisfaction and TQ among older adults. However, it did not improve the masticatory performance when a 3 months period of use was considered. Nonetheless, conventional CDs are still considered viable for the older adults. As a suggestion for future studies, a longer adaptation period for the new dentures should be evaluated as well as effectiveness of replacing old CDs related to the nutritional condition of the patients (AU).

Prevalence of risk factors for denture stomatitis in complete denture wearers

Aim: The prevalence of denture stomatitis and the relationship with its risk factors was evaluated via secondary data from 62 complete denture (CD) wearers, between 2015 and 2017. Methods: The data was stored in an Excel database and was analyzed using the statistics software STATA/SE 12.0. A descriptive analysis was performed taking into account a categorization of the clinical variables according to risk factor in 4 domains: CD usage, systemic health, hygiene habits, and usage habits. The association amongst the denture stomatitis and risk factors variables was tested by the Chi-square test and the results were statistically significant at p-values <0.05. Results: The CD wearers participants were composed by a majority of elderly (80.64%) and women (72.78%); with 45.16% having been using the current denture for more than 10 years and another 74.19% related a continuous usage. Diabetes and hypertension were related by 83.87% and 67.74%, respectively, with 87.10% using medication. Although 75.80% reported cleaning their dentures 3 times per day or more, and 59.68% considered their oral hygiene very good, 50% of the complete dentures showed dirtiness and clinical signs of Denture Stomatitis were present in 30.64% of the patients. Despite of the evaluated sample shows many risk factors for the development of the disease, an association between the variables was not observed. Conclusion: Considering the high prevalence of the disease in the studied sample, preventive and educational measures on denture usage and hygiene must be reinforced in order to maintain the oral health of the edentulous patients

Mandibular single-implant overdenture as an alternative for full arch rehabilitations: a literature review

Oral rehabilitation with mandibular single-implant overdentures (SIO) has been characterized as a solution to improve retention and stability of conventional complete dentures (CD). Among the benefits of this therapy, it can be mentioned minimally invasive surgery, simple prosthetic technique, better retention, and significantly reduced costs. However, the application of this protocol in daily clinic is still not widespread. Aim: Thus, this study aimed to perform a literature review to address the clinical characteristics of this rehabilitation, when compared to two-implant mandibular overdentures and CD. Methods: For this, a search was conducted in the PubMed database, considering articles published in English language, without date limitation. Results: It was found 243 manuscripts, of which 20 were compatible with the aim of this study after title/abstract reading. The selected papers focused on masticatory muscles function, satisfaction levels and self-reported quality of life, as well as surgical and prosthetic outcomes, such as maintenance, repair and implant failure rates. All evaluated manuscripts showed similar masticatory function and patient's satisfaction with SIO and two-implant overdenture, while results for a SIO were greater when compared to rehabilitations with CD. In addition, SIO have proven to do not damage the implant, being implant loss close to zero. However, the prosthesis fracture adjacent to the implant was a recurrent clinical outcome, which requires further studies to solve this impairment. Conclusion: Thus, it can be concluded that SIO represents an alternative treatment for frail elders or low-income patients, leading to higher masticatory function, as well as improved quality of life

Oclusão bilateral balanceada: um princípio básico de prótese total: relato de caso / Balanced bilateral occlusion: a basic principle of full arch prosthesis: case report / Oclusión bilateral balanceada: un principio básico de prótesis total: reporte de caso clínico

A oclusão equilibrada e em perfeita harmonia é objetivo primordial em prótese total. Este trabalho tem como objetivo mostrar a influência da utilização dos princípios na confecção de prótese total e seu resultado. Paciente do sexo feminino, 67 anos, portadora de prótese total bimaxilar buscou atendimento especializado tendo como queixa principal mobilidade de sua prótese total superior, acompanhada de queixa estética. Dentre os planos de tratamento propostos, foi realizada a confecção de novas próteses totais respeitando princípios e passos visando o reestabelecimento de função e estética. No momento da instalação observou-se a oclusão bilateral balanceada, tendo objetivo do tratamento alcançado. A confecção de prótese odontológica deve respeitar os princípios básicos e fundamentais de confecção, bem como os requisitos inerentes às possibilidades reabilitadoras, tendo em vista que o seu resultado influencia diretamente na qualidade de vida do paciente(AU)

The right balanced occlusion and perfect harmony are the main target in full arch prosthesis. The aim of this work is to evidence the influence on correct use of full arch prosthetic rehabilitation precepts in manufacture and its result. A 67-year-old female patient with a total bimaxillary prosthesis sought specialized care having as main complaint the mobility of her maxillary total prosthesis and aesthetic complaint. Among the proposed treatment plans, it was carried out making new dentures respecting principles and steps towards the function and aesthetics re-establishment. When installing observed balanced bilateral occlusion, with the aim reached treatment. The preparation of dental prosthesis must respect the steps and basic principles of preparation and requirements inherent to rehabilitation possibilities, considering that its result directly influences the quality of life of patient(AU)

La oclusión equilibrada y en perfecta armonía eres objetivo primordial en prótesis total. Este trabajo tiene como objetivo mostrar la influencia de la utilización de los básicos principios en la confección de prótesis total y su resultado. Paciente, sexo femenino, 67 años, hace uso de prótesis total bimaxilar recurrió al atendimiento especializado y como principal reclamación la movilidad de su prótesis total superior tan cómo la estética. Entre las proposiciones de planos de tratamiento, se fue realizada la confección de nuevo par de prótesis totales respetando los principios y etapas en busca de la devolución de función y estética. Al momento de la instalación se fue posible observar la oclusión bilateral balanceada, teniendo el objetivo alcanzado. Para que la prótesis odontológica sea confeccionada se debe respetar los principios básicos fundamentales de la confección y los requisitos inherentes a las posibilidades rehabilitadoras, observando que su resultado tiene directa influencia en la calidad de vida del paciente(AU)