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1.
Front Oncol ; 14: 1371405, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562168

RESUMO

Introduction: Mandibular reconstruction with the free fibula flap (FFF) has become a standardized procedure. The situation is different with oral rehabilitation, so the purpose of this study was to investigate the frequency of implant placement and prosthetic restoration. Additionally, the patients' situation, motivation, and treatment course were structurally assessed. Materials and methods: All cases between January 2013 and December 2018 that underwent mandibular reconstruction in our department with a free fibula flap and gave written informed consent to participate were interviewed with two structured questionnaires about their restoration and quality of life. Additionally, medical records, general information, status of implants and therapy, and metric analyses of the inserted implants were performed. Results: In total 59 patients were enrolled and analyzed in this monocentric study. Overall, oral rehabilitation was achieved in 23.7% at the time of investigation. In detail, implants were inserted in 37.3% of patients and showed an 83.3% survival of dental implants. Of these implanted patients, dental implants were successfully restored with a prosthetic restoration in 63.6. Within this subgroup, satisfaction with the postoperative aesthetic and functional result was 79.9% and with the oral rehabilitation process was 68.2%. Satisfaction with the implant-borne prosthesis was 87.5%, with non-oral-squamous-cell-carcinoma patients being statistically significantly more content with the handling (p=0.046) and care (p=0.031) of the prosthesis. Discussion: Despite the well-reconstructed bony structures, there is a need to increase the effort of achieving oral rehabilitation, especially looking at the patient's persistent motivation for the procedure.

2.
BMC Oral Health ; 24(1): 441, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38600517

RESUMO

BACKGROUND: Due to the increasing proportion of older adults in Korea and growing interest in aging, the concepts of oral aging and oral hypofunction have recently been introduced. Thus, it is necessary to investigate the age-specific oral function levels of Korean older adults and develop expert intervention methods for healthy aging. METHODS: Dysphagia, independence of daily living, and oral hypofunction were assessed in 206 older adults living in Wonju, Gangwon State, South Korea. Subjective dysphagia was assessed through self-report questionnaires using the Dysphagia Handicap Index (DHI), the Korean version of Eating Assessment Tool-10, and the Korean version of the Modified Barthel Index. In addition, the oral hypofunction assessment items included decreased chewing ability, occlusal pressure, tongue pressure, oral dryness, and oral cleanliness. RESULTS: DHI increased significantly with age, with those in their 80 s reporting the most difficulty swallowing. Oral function in terms of chewing ability (maximum occlusal pressure and number of remaining teeth), maximum occlusal pressure, and maximum tongue pressure also declined with increasing age. While there was no significant difference in oral dryness by age, those in their 80 s had dry mouth according to the criteria of the oral moisture checking device. CONCLUSIONS: In an assessment of oral function in community-dwelling, independent Korean older adults, the number of items that were assessed as oral hypofunction increased with age. The findings can be used to standardize the oral hypofunction assessment item and develop age-based individualized intervention plans for the early management of oral health and individual oral myofunctional rehabilitation in Korean community-dwelling older adults.

3.
Dent Mater ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38458918

RESUMO

OBJECTIVES: Aim of this prospective study was to assess full mouth rehabilitation of severe tooth wear patients using minimally invasive CAD/CAM resin-based composite (RBC) restorations and direct veneers by evaluating restoration survival up to 5.5-years. METHODS: Twenty-two patients with generalized severe tooth wear with functional and/or esthetic problems were included. Following minimally invasive preparation, CAD/CAM RBC restorations (LAVA Ultimate,3M) were adhesively luted, direct RBC veneers (Filtek Supreme XTE, 3M) were applied in the aesthetic region. Patients were recalled after 1m,1y,3y,5y and seen in between recalls by their general dentists or at the clinical study center if complaints occurred. Failures were categorized as F1 (severe deficiencies requiring replacement/extraction), F2 (localized deficiencies requiring re-cementation/repair) and F3 (small chippings requiring refurbishment/monitoring). Survival of indirect restorations was evaluated using lifetables and Kaplan-Meier-graphs, distinguishing between failure categories and tooth type (front teeth=FT, premolars=PM, molars=M). F1 + F2 and F1 + F2 + F3 failures were analyzed using Cox regression on the variables tooth type/ location, age, gender and VDO increase (p < 0.05). RESULTS: 568 indirect restorations and 200 direct veneers in 21 patients evaluated for up to 5.5-years. For indirect restorations, 96 failures were recorded (F1:6;F2:41;F3:49) and annual failure rates were 0.29%(FT), 1.56%(PM), 2.93%(M) for F1 +F2 and 0.53%(FT), 2.42%(PM), 6.11%(M) for F1 + F2 + F3. Reasons for failure were chipping fracture (48), adhesive fracture (32), complete debonding (7), caries (4), endodontic treatment (1) and reasons unknown (documentation general dentists, 4). Molar tooth type had a statistically significantly increased probability of failure compared with front teeth and premolars for F1 + F2 + F3 (p < 0.006). Direct veneer restorations showed 18 failures (F1:2;F2:9;F3:7). SIGNIFICANCE: Minimally invasive CAD/CAM RBC restorations combined with direct RBC veneers showed an acceptable clinical mid-term survival for restorative rehabilitation of severely worn dentitions.

4.
Dent J (Basel) ; 12(3)2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38534269

RESUMO

Measuring satisfaction can help us understand patients' expectations and adopt individualized treatment according to their expectations. In the current study, we applied the DPQ (Dental Practice Questionnaire) to analyze the degree of patient satisfaction regarding medical services in the public and private sector in a Romanian city from the central region. A group of 200 patients, 100 patients from the public sector and 100 patients from the private sector, participated in the survey. The results showed significant differences in response when patients were stratified by age, gender, visit frequency and length of time attending the same practice. Significant differences between public and private practices were encountered. Moreover, the degree of patient satisfaction was found to be related to appointment promptness/length of time and the confidentiality/ability to listen/knowledge/respect shown by the dentist, while patients' recommendations to others were influenced by dentists' explanations and warmth, followed by the appointment system and confidentiality. Patient satisfaction with oral rehabilitation dental services plays an essential role in maintaining patients' addressability, but there is a multitude of factors that can influence patients' opinions. Further analysis of the evolution of the influencing factors (causing satisfaction or dissatisfaction), in time, could provide deeper insights into the links between patient satisfaction and these factors.

5.
J Dent ; 143: 104887, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38360395

RESUMO

OBJECTIVES: Standardized bite training is required to prevent oral hypofunction in elderly individuals. We aimed to compare masticatory muscle activity between 24 young adults and 16 pre-elderly individuals during a biting task using a novel standardized bite device (BD). METHODS: The BD was made of silicone rubber and included a high-force or low-force plate spring or no plate spring (dummy). The compressive stiffness of the material in each BD was measured using a texture analyzer. All participants performed a biting task 50-times at a rate of 1/s each using the three types of BDs on the right first molar. Electromyographic (EMG) activity was recorded bilaterally from the masseter and temporalis muscles. The variability of each biting training session was calculated as the coefficient of variance (CV) from the EMG activity during each biting task for each muscle. Masticatory muscle fatigue was assessed using a numerical rating scale (NRS). RESULTS: Compressive stiffness was significantly different between each BD (P < 0.001). The CV and NRS scores were not significantly different between the groups. The EMG activities during each bite task in all muscles were not significantly different for any measurement item between the age groups. The EMG activities of high- and low-force BDs in the right temporalis (ipsilateral) muscle were significantly higher than those of the dummy BD (P < 0.001). CONCLUSIONS: Compressive stiffness of the BD affected EMG activity only in the ipsilateral temporalis muscle, but not in the masseter or contralateral temporalis muscles, without any age effect.


Assuntos
Força de Mordida , Músculos da Mastigação , Humanos , Adulto Jovem , Idoso , Músculos da Mastigação/fisiologia , Músculo Masseter/fisiologia , Músculo Temporal/fisiologia , Eletromiografia
6.
Spec Care Dentist ; 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38375899

RESUMO

BACKGROUND: Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non-black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin-1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo-plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin-shaped teeth may occur. OBJECTIVE: To describe an aesthetic alternative of oral rehabilitation using the mock-up technique in a patient with WHS. CLINICAL CASE: A 5-year-old female patient diagnosed with WHS from the National Institute of Child Health NIHCH: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra-nanow filling resin using the mock-up technique were proposed as alternative treatments. CONCLUSION: The making of supra-nano filling resin-based crowns using the mock-up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano-filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient.

7.
Int J Implant Dent ; 10(1): 8, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38334913

RESUMO

PURPOSE: Reconstruction with vascularized bone grafts after ablative surgery and subsequent dental rehabilitation with implants is often challenging; however, it helps improve the patient's quality of life. This retrospective case-control study aimed to determine the implant survival/success rates in different vascularized bone grafts and potential risk factors. METHODS: Only patients who received implants in free vascularized bone grafts between 2012 and 2020 were included. The free flap donor sites were the fibula, iliac crest, and scapula. The prosthetic restoration had to be completed, and the observation period had to be over one year after implantation. Implant success was defined according to the Health Scale for Dental Implants criteria. RESULTS: Sixty-two patients with 227 implants were included. The implant survival rate was 86.3% after an average of 48.7 months. The causes of implant loss were peri-implantitis (n = 24), insufficient osseointegration (n = 1), removal due to tumor recurrence (n = 1), and osteoradionecrosis (n = 5). Of all implants, 52.4% were classified as successful, 19.8% as compromised, and 27.8% as failed. Removal of osteosynthesis material prior to or concurrent with implant placement resulted in significantly better implant success than material not removed (p = 0.035). Localization of the graft in the mandibular region was associated with a significantly better implant survival (p = 0.034) and success (p = 0.002), also a higher Karnofsky Performance Status Scale score with better implant survival (p = 0.014). CONCLUSION: Implants placed in vascularized grafts showed acceptable survival rates despite the potential risk factors often present in these patient groups. However, peri-implantitis remains a challenge.


Assuntos
Implantes Dentários , Retalhos de Tecido Biológico , Peri-Implantite , Humanos , Retalhos de Tecido Biológico/transplante , Estudos Retrospectivos , Implantes Dentários/efeitos adversos , Estudos de Casos e Controles , Fíbula/transplante , Ílio/cirurgia , Qualidade de Vida , Escápula/cirurgia
8.
J Clin Periodontol ; 51(2): 135-144, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37915235

RESUMO

AIM: The aim of this study was to assess patient-reported outcomes (PROs) 8 years after dental implant rehabilitation in a sample with tooth loss due to periodontitis (TLP) and a sample with missing teeth for other reasons (MTOR). MATERIALS AND METHODS: The Norwegian National Insurance Scheme registry of subsidized dental implant therapy was searched, and patients (n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire. PROs were described by relative frequencies, and the TLP and MTOR subsamples were compared using chi-square test. Multiple linear regression analyses were used to investigate variables potentially predicting PROs. RESULTS: Of the respondents (n = 1299), more than 90% were partly or fully satisfied with the treatment outcome. Complications were reported by 44.2%. Patients who lost teeth due to periodontitis (n = 784) reported greater oral function improvement and better pre-treatment information, and were more likely to experience complications when compared with patients who lost teeth for other reasons (n = 515). Age, level of education, self-funded cost, pre-treatment information, history of complications and the reason for missing teeth were found to predict PROs. CONCLUSIONS: In a Norwegian population rehabilitated with dental implants in 2014, satisfaction with the treatment outcome and the aesthetic outcome was high, irrespective of the reason for missing teeth. Self-report of complications and lack of pre-treatment information were the strongest predictors of inferior patient satisfaction and also predicted inferior oral function.


Assuntos
Implantes Dentários , Periodontite , Perda de Dente , Humanos , Perda de Dente/complicações , Estética Dentária , Periodontite/etiologia , Inquéritos e Questionários , Serina-Treonina Quinases TOR , Prótese Dentária Fixada por Implante/efeitos adversos
9.
Orthod Craniofac Res ; 27(2): 228-236, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37632163

RESUMO

INTRODUCTION: Bruxism is a spectrum of masticatory muscles activities. According to the recent evidence and international consensus, there is no indication to treat bruxism unless clinical consequences are present. The aim of the present study was to investigate the approach of Italian dentists to bruxism in their clinical practice. METHODS: An anonymous online survey was developed, composed by 26 items grouped into five sections: (1) Characteristics of the respondent (Q1-Q6); (2) Bruxism frequencies (Q7-Q11); (3) Bruxism assessment (Q12-Q15); (4) Bruxism management (Q16-Q20); (5) Occlusal splints therapy (Q21-Q26). RESULTS: A total of 384 practitioners, including specialists and non-specialists, participated in this survey. The majority of the respondents reported that 1-3 out of ten patients presented with bruxism. The diagnosis is mainly performed with non-instrumental methods, and facial pain and dental wear are the major clinical consequence associated with bruxism. Almost the entire sample of respondents report to offer occlusal splints to bruxism patients, and 41% refer to perform occlusal adjustments. Almost half of the respondents have never proposed any form of cognitive-behavioural therapy. CONCLUSION: The results of the current survey highlighted several inconsistencies in Italian dentists' approaches to bruxism, suggesting the need for better education of practitioners and for the development of a standardized protocol to assess and manage bruxism in dental practices.


Assuntos
Bruxismo , Humanos , Bruxismo/diagnóstico , Bruxismo/terapia , Odontólogos , Papel Profissional , Inquéritos e Questionários , Itália
10.
J Oral Rehabil ; 51(1): 218-225, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37370261

RESUMO

BACKGROUND: Tooth wear is a multifactorial complex process related to the loss of dental tissue, due to chemical or mechanical processes, by abrasion, attrition, erosion. Restorative treatment represents an attempt to rebuild and recreate the lost structure. OBJECTIVE: This scoping review aims to investigate whether restorative treatment of worn dentition (either with direct or indirect adhesive composite adhesive procedures or with prosthetic techniques) can have an impact on the masticatory performance parameters. METHODS: A scoping review was conducted on multiple databases (Pubmed, Medline CENTRAL, ICTRP), following the PRISMA guidelines. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who satisfied the inclusion and exclusion criteria. RESULTS: Only one article meet the inclusion criteria of the review. Restorative treatment of worn dentition although have a positive impact on the self-report ability to chew, has no effect on the masticatory performance test. CONCLUSION: At the moment, not enough evidence to comment on the actual therapeutic role of restorative treatment on tooth wear is available. Clinicians, before taking any clinical decision, should carefully discuss with patients the needs and expectations of the treatment plan.


Assuntos
Dentição , Desgaste dos Dentes , Humanos , Restauração Dentária Permanente/métodos , Mastigação , Desgaste dos Dentes/terapia
11.
J Esthet Restor Dent ; 36(1): 231-238, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38108570

RESUMO

OBJECTIVE: In many esthetic treatments, clinicians may consider the option to modify the maxillo mandibular position. A raise of the vertical dimension of occlusion (VDO) may help restore esthetics, increase the space for dental materials, and reduce the invasiveness of dental procedures. Traditionally, VDO increases are done by using the centric relation (CR) position. Despite a long history of use, the neuromuscular effects of different maxillo mandibular relations are not fully studied. The aim of this study was to investigate the effect of alterations of maxillo-mandibular relation from maximal intercuspal position (MIP) to a raised VDO CR position on jaw-elevator muscle activity. MATERIALS AND METHODS: Fifteen healthy individuals were asked to carry out maximal voluntary clenching (MVC) in MIP and in CR on individual splints. Electromyographic (EMG) activity of the masseter and anterior temporalis muscles was assessed in µV as the root mean square of the amplitude. Specific indexes and ratios were also computed. Data analyzed in MIP and CR were compared by paired student's t-tests. RESULTS: MVC levels were not negatively affected by a VDO increase in CR position. On the contrary masseter muscles showed a statistically significant increase (p < 0.005). No significant effect on the anterior temporalis was observed. CONCLUSION: These results suggest that no immediate negative effect on maximum voluntary clenching was induced by a VDO increase in CR position. A slight increase observed in EMG clenching levels could be explained by the increase in VDO when clenching on the splint. CLINICAL IMPLICATIONS: The results of this study support the use of CR position as a pragmatic reference position due to the absence of relevant or negative changes in neuromuscular function.


Assuntos
Oclusão Dentária , Contração Muscular , Humanos , Relação Central , Dimensão Vertical , Contração Muscular/fisiologia , Eletromiografia/métodos
12.
Int J Oral Maxillofac Implants ; 38(6): 1151-1160, 2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38085746

RESUMO

PURPOSE: To assess the peri-implant and flap parameters of the prefabricated microvascular fibula flap and determine the dental implant survival rate. MATERIALS AND METHODS: This retrospective study investigated a cohort of subjects who received prefabricated microvascular fibula flaps at two highly specialized tumor reconstruction centers. The subjects had all suffered atrophy or a large segmental defect of the jaws due to tumor resection or injury. Two independent surgeons determined the dental implant survival rate and assessed the peri-implant parameters and flap parameters during clinical follow-up. RESULTS: In total, 41 subjects were treated with a prefabricated fibula flap between 1999 and 2012. Of these, 17 subjects (10 male, 7 female) with a total of 62 dental implants were examined. The other 24 subjects were unavailable for assessment and had to be excluded. Ten of the 62 dental implants (16.1%) had to be removed due to peri-implantitis before the follow-up assessment. Follow-up assessments were performed at intervals ranging from 2 to 12 years (mean: 7.2 years) after fibula flap transplantation. The dental implant survival rate was found to be 83.9%. A total of 208 dental surfaces were assessed. Overall, 96% of all surfaces had a pocket depth (PD) of ≤ 4 mm and 4% had a pocket depth of > 5 mm. An attachment level (AL) of 3 mm was measured in 48.5% of implants and ≥ 5 mm was measured in 15.9% of implants. Dental implants with a PD > 4 mm showed a significantly higher plaque index (PI) (75%; P = .0057), papillary bleeding index (PBI) (62.5%; P = .0094), and radiologic bone loss (P = .0014) compared to dental implants with a PD ≤ 4 mm. CONCLUSIONS: Reconstructive surgery using microvascular fibula flaps represents an alternative tool for oral rehabilitation in subjects suffering from a large segmental defect in the maxillary or mandibular bone compared to the conventional method. However, it appears that the different ossification processes that develop the fibula and the jawbones affect dental implant survival.


Assuntos
Implantes Dentários , Retalhos de Tecido Biológico , Neoplasias , Humanos , Masculino , Feminino , Implantes Dentários/efeitos adversos , Implantação Dentária Endóssea/métodos , Estudos Retrospectivos , Retalhos Cirúrgicos/cirurgia , Fíbula/cirurgia , Transplante Ósseo/métodos , Neoplasias/cirurgia
13.
Dent J (Basel) ; 11(12)2023 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-38132427

RESUMO

This article presents the outcomes of prosthetic oral rehabilitation using CAD/CAM telescopic bar overdentures in patients with oral cancer (n = 3), severe facial trauma (n = 2), or various syndromes (n = 1), all suffering from severe tissue deficits and requiring complex and comprehensive oral rehabilitation. The aim was to assess the durability and functionality of implant-retained prosthetic structures, ensuring easy oral hygiene and minimizing specialized follow-up needs. The data for this study were sourced from a retrospective cohort at Helsinki University Hospital. The prosthetic reconstruction encompassed the Atlantis 2in1 and the Createch removable telescopic systems. Thus, 40 implants were placed (4 to 7 per patient), with prosthetic structures in the maxilla (n = 4 patients), in the mandible (n = 1), and in both jaws (n = 1). Two patients experienced no complications, two patients had part of the acrylic resin break, and one patient experienced loosening of the bar structure. All complications associated with prosthetic structures were successfully managed, and none of the implants were lost. The follow-up time ranged from 7 to 126 months. This rehabilitation is proved to be an effective solution for patients with complex oral conditions, facilitating both functional restoration and ease of maintenance. These findings underscore the importance of individualized treatment approaches in cases of tissue deficits.

14.
BMC Oral Health ; 23(1): 940, 2023 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-38017429

RESUMO

BACKGROUND: Osteopetrosis comprises a group of inherited disorders that are rare and result in abnormal bone structure. Bone remodeling is extremely inhibited because osteoclasts are nonfunctional or lacking. This condition causes overgrowth of bone with disappearance of the bone marrow, leading to aplastic anemia; obstruction of nerve passages in the skull leads to blindness and often hearing impairment. In most cases, osteopetrosis results in oral complications such as tooth deformation, hypomineralization, and delayed or absent tooth eruption. The only curative treatment is hematopoietic stem cell transplantation (HSCT). The main treatment of the oral complications during childhood and adolescence consists in protecting the erupted teeth against caries disease through prophylactic treatment aimed at optimal oral hygiene through frequent regular dental visits throughout life. Many patients with osteopetrosis require major oral rehabilitation to treat complications of the disease. Improved results of HSCT increase the likelihood that dental professionals will encounter patients with osteopetrosis. CASE PRESENTATION: In this case report, we show that individuals with osteopetrosis who have severe oral complications can be treated successfully if they are treated for osteopetrosis at an early age. The boy had his dental care in pedodontics, and regular multidisciplinary meetings were held for future treatment planning. At the age of 15, he was then referred for rehabilitation. The initial evaluations revealed no further growth in the alveolar bone. The rehabilitation was done stepwise, with extraction of malformed and malpositioned teeth. Initially, the patient received a removable partial denture followed by reconstruction of the width of the alveolar process, titanium implants, temporary fixed bridges, and finally screw-retained titanium-ceramic bridges with titanium frames for the upper and lower jaws. CONCLUSIONS: The three-year follow-up after loading indicated a stable marginal bone level and optimal oral hygiene as a result of frequent professional oral hygiene care. The patient showed no signs of symptoms from the temporomandibular joint and has adapted to the new jaw relation without any functional or phonetical issues.


Assuntos
Cárie Dentária , Implantes Dentários , Osteopetrose , Anormalidades Dentárias , Masculino , Adolescente , Humanos , Osteopetrose/complicações , Osteopetrose/cirurgia , Titânio , Prótese Parcial Fixa , Prótese Dentária Fixada por Implante
15.
Cureus ; 15(10): e47689, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38021532

RESUMO

Disc displacement (DD) occurs when the cushioning disc of the temporomandibular joint (TMJ), situated between the jawbone and the skull, is out of position. The condition can be of two kinds: disc displacement with reduction (ddwr) and disc displacement without reduction (ddwor). The present systematic review was undertaken to assess the efficacy of anterior repositioning splints (ARS) for ddwr and ddwor. Three online databases were searched for relevant studies using MeSH keywords and Boolean operators. Initial searches of the databases extracted 552 records. Twelve studies equally representing ARS with ddwr and ddwor were selected. No clear difference could be assessed regarding ARS usage in both conditions. The outcome assessed was the improvement in TMJ symptoms. The results suggested that both ddwr and ddwor were effective in improving temporomandibular joint (TMJ) symptoms in patients who received ARS therapy. Efficacy levels ranged from 71-83% and 50-95% for ARS in ddwr and ddwor, respectively; odds ratio (OR) values ranging from 0.30 and 0.36 were obtained for ARS in both therapies, respectively, indicating similar performance levels. Both ddwr and ddwor respond well to the use of ARS; however, more clinical trials are needed to ascertain and validate the role of ARS as a treatment modality in this regard.

16.
J Clin Med ; 12(20)2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37892783

RESUMO

BACKGROUND: The purpose of this in vitro study was to compare the inter-implant distance, inter-implant axis, and intra-implant axis of three implants in a straight line by using a laboratory scanner (LBS) versus an intra-oral scanner (IOS) with two different intra-oral scan bodies (ISBs). METHODS: A 3D model was printed with internal hex implant analogs of three implants in positions 15#, 16#, and 17#. Two standard intra-oral scan bodies (ISBs) were used: MIS ISB (two-piece titanium) and Zirkonzhan ISB (two-piece titanium). Both ISBs were scanned using 7 Series dental wings (LBS) and 30 times using Primescan (IOS). For each scan, a stereolithography (STL) file was created and a comparison between all the scans was performed through superimposition of the STL files by using 3D analysis software (PolyWorks® 2020; InnovMetric, Québec, QC, Canada). A Kolmogorov-Smirnov test was performed followed by a Mann-Whitney test (p < 0.05). RESULTS: The change in inter-implant distance for the MIS ISB was significantly lower compared to the ZZ (p < 0.05). The change in intra-implant angle was significantly lower for the ZZ ISB compared to MIS (p < 0.05). The changes in inter-implant angle between the mesial and middle and between the middle and distal were significantly lower for MIS compared to ZZ in contrast to mesial to distal, which was significantly higher (p < 0.05). CONCLUSIONS: Both ISBs showed differences in all the parameters between the LBS and the IOS. The geometry of the scan abutment had an impact on the inter-implant distance as the changes in the inter-implant distance were significantly lower for the MIS ISB. The changes in the intra-implant angle were significantly lower for the ZZ ISB. There is a need for further research examining the influence of geometry, material, and scan abutment parts on the trueness.

17.
Int J Oral Maxillofac Implants ; 38(5): 915-926, 2023 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-37847833

RESUMO

PURPOSE: To evaluate the survival and success rates of short (> 6 mm and ≤ 8.5 mm) implants after at least 2 years of functional loading. Implants were assessed using clinical parameters such as marginal bone loss (MBL), pocket depth (PD), keratinized mucosa width (KMW), bleeding on probing (BoP), and the peri-implant condition (mucositis or peri-implantitis). Any correlations between clinical parameters were analyzed. MATERIALS AND METHODS: This observational and retrospective study included 114 posterior maxillary and mandibular implants placed in 27 women and 38 men with a mean age of 68.04 ± 9.07 years. Patients included in the study had received at least one short implant between 2001 and 2013, such that each implant was in occlusal function for at least 2 years by 2015. Patients with only long (≥ 10 mm) implants, patients with any systemic condition, and smokers were excluded from the study. PD, KMW, peri-implant condition, BoP, and MBL were the clinical parameters assessed in the study. Data on prosthesis type (single or splinted) and implant features were also obtained. All data were submitted to analysis via Mann-Whitney unpaired test, with a significance level of P < .05. Spearman correlation coefficient was also measured to verify the negative or positive correlation. RESULTS: The mean follow-up time was 74.08 months, and mean implant success and survival rates were 87.63% and 94.74%, respectively. There were 6 implant failures (5.26%). A total of 66 (59.46%) prostheses were screw-retained implant-supported restorations, and 45 (40.54%) were cemented. A total of 93 (86.49%) short implants were splinted to another implant, and 15 out of 111 (13.51%) restorations were single implants. Keratinized mucosa was missing around 43 (39%) implants, whereas PD was measured to be between 0 and 3 mm in 64.86% of implants and ≥ 4 mm in 31.53% of implants. MBL was ≤ 1.5 mm in 71.17% of cases and > two-thirds the length of the implant in 2.71% of cases. Mucositis and peri-implantitis were found in 22.52% and 7.21% of implants, respectively. The correlation coefficient showed a positive result for PD and MBL (0.11; P = .368) and negative results for PD and KMW (-0.42; P = .002) and KMW and MBL (-0.19; P = .183). CONCLUSIONS: Within the limitations of this study, it is possible to conclude that short implants are a feasible treatment option for dental rehabilitation. They are considered an excellent alternative to complex procedures and have high survival rates after at least 2 years of follow-up, with compatible peri-implant local tissue response. Moreover, a significant negative correlation between KMW and PD was observed.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Implantes Dentários/efeitos adversos , Estudos Retrospectivos , Seguimentos , Peri-Implantite/etiologia , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante/efeitos adversos
18.
Artigo em Inglês | MEDLINE | ID: mdl-37721553

RESUMO

INTRODUCTION: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs). METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05). RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses. CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.

19.
Int. j. odontostomatol. (Print) ; 17(3): 293-299, sept. 2023. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1514388

RESUMO

El desgaste dental severo se describe como la pérdida sustancial de la estructura dental, con exposición de la dentina y pérdida significativa de igual o más de 1/3 de la corona clínica. El uso de materiales compuestos de resina permite al clínico ser más conservador, debido a su aplicación mínimamente invasiva. Además de ello, son relativamente económicas, proporcionan buena estética general, así como un buen rendimiento y facilidad en la reparación. El objetivo de esta revisión de literatura sistematizada es recopilar información disponible en la literatura referente a cuál es el rendimiento clínico de las restauraciones adhesivas con resina compuesta en casos de pacientes con desgaste severo e incremento de la dimensión vertical como objetivo rehabilitador. Se analizaron artículos entre los años 2000 y 2022, seleccionando cuatro bases de datos (Pubmed, Scopus, Scielo y Web of Science). Para identificar los descriptores se utilizó los Medical subject headings (Mesh): Tooth Wear, Composite Restorations, Resin y Oral Rehabilitation. No se aplicó restricciones de idioma, país de origen, autor o lugar de publicación donde se realizó el estudio. Como resultado de la búsqueda se obtuvieron 71 artículos, de los cuales se seleccionaron 5 que cumplieron con los criterios de elegibilidad para ser considerados en la revisión de literatura sistematizada. Se encontró un promedio de tasa de éxito ente el 89,4 % - 100 % en un promedio total de 5.2 años de seguimiento. Se puede concluir, hasta donde se tiene conocimiento en la literatura científica disponible, que el tratamiento de restauraciones adhesivas con resinas compuestas en pacientes con desgaste severo es recomendable, enfocado en un periodo a corto-mediano plazo (3-5 años), siendo una opción de tratamiento económica y mínimamente invasiva.


Severe tooth wear is described as the substantial loss of tooth structure, with dentin exposure and significant loss of equal to or more than 1/3 of the clinical crown. The use of resin composite materials allows the clinician to be more conservative, due to its minimally invasive application. In addition to this, they are relatively inexpensive, provide good general aesthetics, as well as good performance and ease of repair. The objective of this systematic literature review is to collect information available in the literature regarding the clinical performance of adhesive restorations with composite resin in cases of patients with severe wear and increase in the vertical dimension as a rehabilitation objective. Articles between the years 2000 and 2022 were analyzed, selecting four databases (Pubmed, Scopus, Scielo and Web of Science). To identify the descriptors, the Medical subject headings (Mesh) were used: Tooth Wear, Composite Restorations, Resin and Oral Rehabilitation. No language, country of origin, author or place of publication restrictions where the study was conducted were applied. As a result of the search, 71 articles were obtained, of which 5 were selected that met the eligibility criteria to be considered in the systematic literature review. An average success rate between 89.4 % - 100 % was found in a total average of 5.2 years of follow-up. It can be concluded, to the best of our knowledge in the available scientific literature, that the treatment of adhesive restorations with composite resins in patients with severe wear is recommendable, focused on a short-medium term period (3-5 years), being a Inexpensive and minimally invasive treatment option.


Assuntos
Humanos , Resinas Compostas , Desgaste dos Dentes/reabilitação , Reabilitação Bucal/métodos
20.
Odontol.sanmarquina (Impr.) ; 26(3): e25813, jul.-set.2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1538054

RESUMO

Objetivo: Presentar el relato de un caso clínico de cirugía virtual guiada para rehabilitación implantosoportada de maxilar edéntulo con carga inmediata. Relato del caso: Paciente, edéntulo total en ambos maxilares, expresó su deseo de cambiar la prótesis total superior removible por una prótesis total fija sobre implantes. Durante la evaluación clínica, se observaron condiciones biológicas favorables al tratamiento como, adecuada faja de tejido queratinizado y leve reabsorción ósea. Como tratamiento se le sugiere al paciente, una planificación inversa, asistida por cirugía virtual guiada, utilizando un prototipo de guía quirúrgica para la colocación de seis implantes dentales en el maxilar y la instalación de una prótesis protocolo de carga inmediata. Conclusiones: Los resultados nos permiten concluir que la cirugía virtual guiada por computadora para rehabilitación protésica implantosoportada de maxilar edéntulo, con carga inmediata, proporciona precisión en los procedimientos quirúrgicos, es fundamental para la confección de prótesis inmediatas, representa una alternativa mínimamente invasiva y el resultado complace a los pacientes.


Objective: present the report of a clinical case of a virtual guided surgery for implant-supported rehabilitation of the edentulous maxilla with immediate loading. Case report: Patient, bi-maxillary edentulous expressed the desire to replace the removable upper total prothesis for a total fixed prothesis on implants. During the clinical evaluation, favorable biological conditions for treatment were observed, such as adequate keratinized tissue band and mild bone resorption. As part of the treatment, the patient was recommended a reverse planning approach, assisted by virtual guided surgery. This involved a prototype surgical guide for the fixation of six dental implants in the maxilla and the installation of an immediate loading protocol prosthesis. Conclusions: The results lead us to conclude that computer-guided virtual surgery for implant-supported prosthetic rehabilitation of the edentulous maxilla with immediate loading, provides a high precision in surgical procedures. It is essential to fabrication of immediate prostheses, represents a minimally invasive alternative, and results in patient satisfaction.

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