[Photoelastic analysis of the influence of prosthetic material on the stress distribution in bone around implant].

Objective: To provide a reference for a suitable alternative treatment choice for implant-supported prostheses, and to explore the influence of 3 types of prosthetic material on the stress distribution around implant. Methods: The implant-abutment analogs were embedded individually into photoelastic resin blocks, which were medical pure titanium castings reproducing the surface and outline of implant (diameter 4.3 mm, length 11.5 mm) and esthetic abutment (regular profile, 1 mm). The prostheses were divided into 3 groups according to the type of prosthetic material. Each group consisted of 5 samples. The samples of composite resin ceramic and zirconia group were milled by chair-side computer aided design and computer aided manufacture (CAD/CAM) system. The samples of porcelain-fused-to-metal crown group were made manually and a pre-arranged silicone rubber impression of CAD/CAM crown would guide to shape the veneer porcelain. Each set was submitted to a 300 N compressive load axially or obliquely (75°). The stress value in the peri-implant bone at the level of the neck, neck1/3, middle1/3 and root1/3 of the sections (0.5, 1.5, 2.5, 3.5 mm) from implant was analyzed by digital photoelasticity, and the stress cushioning effect of 3 types of prosthetic material was comprehensively evaluated. Results: The time spent reaching the stress peak of composite resin ceramic group [(1.58±0.08) s, axially; (2.75±0.21) s, obliquely] was larger than that of the zirconia group [(1.40±0.12) s, axially; (2.30±0.25) s, obliquely] (P<0.05) under the same download mode. Although there were no significant differences in equivalent stress values of the measurement points among the three groups (P>0.05), a downward trend of equivalent stress values of composite resin ceramic group was observed compared to zirconia group, regardless of load type. When loaded obliquely, the highest degree of stress concentration at the level of the neck of implant were found in the porcelain-fused-to-metal crown group. Conclusions: Within the limitations of this study, composite resin ceramic was more beneficial to the biomechanical behavior of implant in stress buffer compared to zirconia.

Dental devices; reclassification of temporary mandibular condyle prosthesis. Final order.

The Food and Drug Administration (FDA) is issuing a final order to reclassify temporary mandibular condyle prosthesis, a preamendments class III device, into class II (special controls), and rename the device "temporary mandibular condyle reconstruction plate.'' FDA is also issuing the special controls guideline entitled "Temporary Mandibular Condyle Reconstruction Plate Class II Special Controls Guideline'' that sets forth the special controls that are necessary to provide a reasonable assurance of the safety and effectiveness of the device.

Types of implant surgical guides in dentistry: a review.

Various techniques have been proposed for the fabrication of surgical guide templates in implant dentistry. The objective of this paper is to review the associated literature and recent advancements in this field, based on design concept. An electronic and hand search of the literature revealed 3 categories, namely, nonlimiting, partially limiting, and completely limiting design. Most clinicians still adopt the partially limiting design due to its cost-effectiveness and credibility. Moreover, clinicians use cross-sectional imaging during the preimplant assessment of surgical sites.

Treatment options for the replacement of missing mandibular incisors.

The replacement of a mandibular incisor is a dental treatment warranting special consideration. Some of the challenges associated with the anterior mandible are limited space, challenging surrounding anatomy, and tough esthetic requirements. Proper diagnosis and treatment planning may require a multidisciplinary approach to successfully meet the demands of replacing a missing tooth in this sextant. Several treatment options currently exist for mandibular incisor replacement. These options include (1) resin-bonded fixed dental prostheses (RBFDPs), (2) orthodontic treatment, (3) full-veneer fixed dental prostheses (FDPs), (4) dental implants for single-tooth replacement, (5) possible extraction of one or more incisors and restoration with implant-supported FDPs, (6) possible extraction of one or more teeth and restoration with FDPs from #22 to 27, (7) possible extraction of one or more teeth and restoration with removable dental prostheses (RDPs). This manuscript outlines the various treatment options for the replacement of mandibular incisors and discusses benefits and drawbacks of each.

General health, dental status and perceived dental treatment needs of an elderly population in Istanbul.

BACKGROUND: Comprehensive data on the oral health status and dental treatment needs of the elderly population in Turkey are deficient. OBJECTIVES: This pilot study determined the general and dental health status, perceived medical and dental treatment needs of an elderly population dwelling in residential homes in Istanbul. METHOD: Subjects at three different residential homes, namely one belonging to the state and two supported by foundations in Istanbul (N=121, female: 63 and male: 58) were involved in this study. A detailed questionnaire was prepared and dental examinations were conducted. Information was collected related to age, education levels, financial status, current physical functional status, general health, mental health, previous dental history, current dental status, oral hygiene practices and denture hygiene of these elderly people. The prevalence of edentulism, the presence and type of dental prostheses, dental and denture status and denture cleanliness were further evaluated. RESULTS: The three most prevalent reported general health problems were associated with genito-urinary problems (24%) followed by cardiovascular (18%) and respiratory problems (14%) varying significantly between genders, with males suffering more from cardiovascular problems than females (p < 0.05). Females showed significantly higher gastrointestinal and orthopaedic problems than males (p < 0.05). Females were more frequently edentulous than males but denture hygiene was significantly better in females than in males (p < 0.05). Brushing frequency did not significantly increase denture hygiene (p = 0.6). More than one-third of the subjects had not been to the dentist within the previous 5-10 years, mainly due to lack of demand, followed by the cost of the dental care and fear. More than two-thirds of denture-wearing subjects wore their dentures only during eating. CONCLUSIONS: There was significant perceived dental treatment and care need for the sample population of elderly studied.

Long-term observation of autotransplanted teeth with complete root formation in orthodontic patients.

INTRODUCTION: The objective of this investigation was to examine the factors influencing the long-term prognosis of autotransplanted teeth with complete root formation. METHODS: Thirty-eight teeth, autotransplanted in 32 patients, were examined more than 6 years after transplantation. Periodontal health, condition of restoration, mobility, occlusal contact, level of gingival margin, and course of orthodontic movement were investigated clinically and with radiographs. RESULTS: More than 6 years after autotransplanation, 33 teeth survived in 27 patients. The survival rate was 86.8% (mean observation time, 9.2 years). Abnormal findings were observed in 9 teeth, so the success rate was 63.1%. An inadequate root filling tended to give rise to abnormal findings. CONCLUSIONS: The success of autotransplantation of a tooth with complete root formation is affected by the quality of root filling. When possible, clinicians should consider autotransplantation before root formation is complete.

Oral prostheses and oral health-related quality of life: a survey study of an adult Swedish population.

PURPOSE: The purpose of the study was to investigate whether oral health-related quality of life (OHRQOL) in an adult Swedish population could be explained by social attributes; individual attributes; dental status, with a special focus on the role of prosthodontics; and dental care attitudes. MATERIALS AND METHODS: The study was based on responses to a questionnaire sent in 1998 to a random sample of 1,974 persons aged 50 to 75 years (66% response rate). Three factors representing various aspects of OHRQOL were set as dependent variables in multiple-regression models: oral health impact on everyday activities, oral health impact on the psychologic dimension, and oral health impact on oral function. Independent variables in the models were social attributes, individual attributes, number of teeth, denture (ie, type of denture, if present), and dental care attitudes. RESULTS: General health in relation to age peers had the strongest association with all 3 dependent variables, followed by number of teeth and need care--cost barrier. When number of teeth was excluded, removable denture was found to covary with the dependent variables in each of the 3 regression models. CONCLUSION: The number of remaining teeth is more important than the type of denture in explaining OHRQOL. It is less important that a denture is fixed for those with few remaining teeth, in contrast to all others. Explanations are also found in general health and various aspects of dental care costs.

Necesidades protésicas de los pacientes que acudieron al Centro de Atención a Pacientes con Enfermedades Infectocontagiosas Dra. Elsa La Corte, CAPEI, de la Universidad Central de Venezuela, entre noviembre del 2003 y noviembre del 2004 / Prosthetic needs of the patients who attended the Center for the Care of Infectio and Contagious Diseases Dra. Elsa La Corte, CAPEI, Central University of Venezuela, between November 2003 and November 2004

Objetivo: El presente estudio fue realizado con la finalidad de conocer las necesidades protésicas de los pacientes que acudieron al Centro de Atención a Pacientes con Enfermedades Infectocontagiosas Dra. Elsa La Corte (CAPEI) de la Universidad Central de Venezuela entre noviembre del 2003 y noviembre del 2004. Materiales y Métodos: Se realizó un estudio descriptivo de tipo transversal con la revisión de 300 historias clínicas. Se analizaron las variables: sexo, nivel de instrucción y necesidades protésicas. Se agruparon los datos y se analizaron con el método de porcentajes y números absolutos. Resultados: El 78,67 por ciento de los pacientes estudiados pertenecían al sexo masculino, el 49 por ciento de estos pacientes cursaron incompletos o terminaron sus estudios de bachillerato. En cuanto a las necesidades protésicas el 73,67 por ciento necesitaban algún tipo de prótesis dental, de estos, el 94,12 por ciento eran edéntulos parciales y el 5, 88 por ciento edéntulos totales. El 74,21 por ciento de los pacientes con necesidades protésicas pertenecían al sexo masculino y el 25,79 por ciento al sexo femenino. Solo el 16,29 por ciento de estos pacientes fueron restaurados protésicamente. Conclusiones: En la población estudiada existe un alto porcentaje de necesidades de prótesis dental, con predominio de prótesis parciales.

A retrospective study of the prosthodontic management of patients with amelogenesis imperfecta.

PURPOSE: This article reports on a retrospective study on patients with a diagnosis of amelogenesis imperfecta and on their prosthodontic management, oral health status, and attitudes toward their condition. MATERIALS AND METHODS: The study comprised 15 patients and consisted of a clinical evaluation and questionnaire. Clinical examination included records of types of restorations and cements used, rating of restoration quality, as well as complications and periodontal variables. RESULTS: The 15 patients had a total of 213 prosthetic restorations. The median age of the restorations was 60 months. Following the California Dental Association's system, all restorations were rated as acceptable to excellent, with one exception. During the follow-up period, four (2%) restorations had been recemented and 16 (8%) restorations had been redone, five (2%) because of porcelain fractures and 11 (5%) because of caries; two (1%) endodontic treatments were performed after prosthetic restoration. Plaque and Bleeding Indices were 28% and 21%, respectively, while pocket depths of more than 3 mm were found at 7% of all tooth surfaces. All patients judged their condition as having affected them negatively. However, after prosthodontic rehabilitation, patients experienced an improvement in self-esteem. CONCLUSION: Patients with severe clinical manifestations of amelogenesis imperfecta obtained extensive prosthodontic treatment at an early age. The restorations had in general performed well, and all patients were affected positively as a result.

A proposal for universal nomenclature in implant prosthodontics.

Attempts have been made at formulating standardized nomenclature for implantology. Although these classification systems have advanced the concept of universal nomenclature in implantology, they can be improved upon. Most of them present terms in glossary form, which can limit their applicability. Others deviate significantly from accepted basic terminology and can be foreign or ambiguous to the average clinician. This article outlines the semiotic approach to language formulation, discusses slight changes to accepted conventional prosthodontic terminology to better encompass implant dentistry, and introduces the shortform and support-retention-connection-prosthesis classification systems.

Dental devices; dental noble metal alloys and dental base metal alloys; designation of special controls. Final rule.

The Food and Drug Administration is amending the identification and classification regulations of gold-based alloys and precious metal alloys for clinical use and base alloys devices in order to designate a special control for these devices. FDA is also exempting these devices from premarket notification requirements. The agency is taking this action on its own initiative. This action is being taken under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Safe Medical Devices Act of 1990 (SMDA), and the Food and Drug Administration Modernization Act of 1997 (FDAMA). Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the draft guidance documents that would serve as special controls for these devices.

Costos en odontología / Costs in dentistry

El análisis minucioso y aplicación de los verdaderos costos de la odontología, son el camino posible para solucionar los problemas actuales de la profesión, a partir de la categorización y acreditación ya propuesta por numerosos autores(3,10). En este sentido, y teniendo en cuenta que la mayoría de los autores reconoce la gran influencia tanto de los costos indirectos como de los costos directos, en la estructura arancelaria, es en este momento de profunda crisis que sería importante lograr un amplio consenso entre los mismos, para asesorar objetivamente a las instituciones y empresas de salud en la conformación de convenios que sean realistas y beneficiosos para todos los sectores intervinientes en la atención odontológica (pacientes, empresas, odontólogos).

Costos en odontología / Costs in dentistry

El análisis minucioso y aplicación de los verdaderos costos de la odontología, son el camino posible para solucionar los problemas actuales de la profesión, a partir de la categorización y acreditación ya propuesta por numerosos autores(3,10). En este sentido, y teniendo en cuenta que la mayoría de los autores reconoce la gran influencia tanto de los costos indirectos como de los costos directos, en la estructura arancelaria, es en este momento de profunda crisis que sería importante lograr un amplio consenso entre los mismos, para asesorar objetivamente a las instituciones y empresas de salud en la conformación de convenios que sean realistas y beneficiosos para todos los sectores intervinientes en la atención odontológica (pacientes, empresas, odontólogos). (AU)

Lesiones de la mucosa oral ocasionadas por materiales de uso odontológico / Oral mucosal lesions caused by dental materials

Existe una gran cantidad de patologías que asientan sobre la mucosa bucal, cuyo origen está relacionado con materiales o instrumental utilizado durante la práctica odontológica diaria. Ellas van desde erosiones hasta ulceraciones o lesiones crónicas como las pigmentaciones y leucoplasias, entre otras. En este trabajo se propone una clasificación de estas lesiones según su etiopatogenia

Prótesis parcial removible, estética al alcance del paciente / Removable partial denture aesthetics reach of the patient

La prótesis parcial removible es una alternativa de solución para muchos casos en la clínica diaria, convirtiéndola en un tema por demás interesante para todos los odontólogos, pero a su vez compleja, debido que al buen funcionamiento y la elección de este tratamiento dependen de muchos factores. En el presente trabajo, se expondrán algunas generalidades sobre la P.P.R., las distintas clases, consideraciones sobre el diseño, etc. y con el propósito de presentar un material de consulta actualizado, para docentes y estudiantes con los avances más importantes y recientes en este campo en particular.

Lesiones de la mucosa oral ocasionadas por materiales de uso odontológico / Oral mucosal lesions caused by dental materials

Existe una gran cantidad de patologías que asientan sobre la mucosa bucal, cuyo origen está relacionado con materiales o instrumental utilizado durante la práctica odontológica diaria. Ellas van desde erosiones hasta ulceraciones o lesiones crónicas como las pigmentaciones y leucoplasias, entre otras. En este trabajo se propone una clasificación de estas lesiones según su etiopatogenia (AU)

Avaliaçäo comparativa da perda de retençäo de quatro sistemas de encaixes do tipo ERA e O-Ring empregados sob overdentures em funçäo do tempo de uso / Comparative evaluation of retention loss in four types of attachments used on overdentures in function of time of use

O objetivo deste trabalho foi avaliar e comparar a capacidade retentiva entre dois sistemas O-ring e O-SO (Grupo I) e dois sistemas ERA - cápsulas de retençäo cinza e brancas - (Grupo II), em funçäo simulada, com ciclos de inserçäo e remoçäo, do início, 6 meses, 1, 2, 3, 4 e 5 anos depois. Dois implantes do tipo Brånemark foram fixados em duas bases metálicas trapezoidais, sendo os testes de inserçäo e remoçäo feitos numa máquina de costura ajustada para este propósito, usando um sistema de correias e polias, movendo um virabrequim. Uma platina de delineador foi usada para fixaçäo dos corpos de prova às bases metálicas na máquina de costura. Os testes de resistência ao movimento axial das cápsulas por tensäo foram feitos numa máquina de ensaios universal em períodos de tempo pré-estabelecidos, antes e após o término do ciclo na máquina de costura. Baseado nos resultados, esse estudo pôde concluir que houve perda de retençäo de todos os sistemas testados, porém o sistema ERA apresentou, desde o início, maior retençäo quando comparado aos outros sistemas e a cápsula cinza mostrou o melhor resultado no final da simulaçäo

La percepción de salud bucal como medida de la calidad de vida en ancianos / Oral health perception as a measurement of quality of life in elderly

La investigación odontológica se ha enfocado principalmente al estudio de los aspectos biológicos, mientras que los sujetos han recibido poca atención. La salud bucal ha sido vista como componente de la calidad de vida. El propósito de este estudio fue someter a prueba la existencia de asociación entre la percepción de salud bucal con el bienestar subjetivo como medida de la calidad de vida en ancianos. Se aplicaron tres instrumentos (bienestar, calidad de vida y salud bucal) a 80 ancianos. Este grupo le atribuye mayor importancia a la funcionalidad de los dientes, al componente social y en menos medida al emocional. La percepción de salud bucal no es diferente para los edéntulos y con dientes. En cambio, la forma en que perciben su salud bucal está relacionada con el bienestar y calidad de vida. Es por ello que la percepción de salud bucal puede considerarse como factor predictor de calidad de vida