Reabilitação oral com próteses parciais removíveis após restabelecimento de dimensão vertical de oclusão e tratamento multidisciplinar: relato de caso / Oral rehabilitation with removable partial dentures after restoration of the vertical dimension of occlusion and multidisciplinary treatment: case report

As próteses parciais removíveis (PPRs) são uma alternativa de tratamento viável na prática clínica para reabilitar arcos parcialmente desdentados. Entretanto, o planejamento dessas próteses e preparo bucal prévio são frequentemente negligenciados. O presente artigo tem como objetivo relatar o caso clínico de uma reabilitação oral com PPRs superior e inferior após abordagem multidisciplinar, de modo a enfatizar as fases de um planejamento criterioso e de preparo prévio dos dentes pilares, visando o sucesso e a longevidade da reabilitação. Paciente do sexo masculino de 57 anos de idade compareceu à clínica da Faculdade de Odontologia de Bauru, Universidade de São Paulo, queixando-se da estética de seu sorriso e de algumas ausências dentárias. O indivíduo utilizava uma PPR provisória inferior insatisfatória e apresentava perda de dimensão vertical de oclusão (DVO). Após o exame clínico, radiográfico e estudo do caso em articulador semi-ajustável, realizou-se o planejamento com abordagens restauradoras, endodônticas, periodontais e protéticas. Após tratamento periodontal, foi realizada endodontia dos elementos 12, 15 e 47, confecção de núcleos e coroas nos dentes 12 e 15, restauração a nível gengival para apoio residual no dente 47, restaurações nos dentes 11, 13, 22, 24 e 44 e, por fim, a confecção das PPRs superior e inferior. A abordagem multidisciplinar utilizada neste caso clínico viabilizou o restabelecimento da DVO e possibilitou o sucesso da reabilitação protética(AU)

Removable partial dentures (RPDs) are a viable treatment alternative in clinical practice to rehabilitate partially edentulous arches. However, the planning of these dentures and prior oral preparation are often neglected. This article aims to report the clinical case of an oral rehabilitation with upper and lower RPDs after a multidisciplinary approach, to emphasize the phases of careful planning and prior preparation of the abutment teeth, aiming at the success and longevity of the rehabilitation. A 57-year-old male patient came to the clinic of the Bauru School of Dentistry, University of São Paulo, complaining about the esthetics of his smile and some missing teeth. The subject was using an unsatisfactory lower provisional prosthesis and had a loss of vertical dimension of occlusion (OVD). After the clinical and radiographic examination and the case study in a semi-adjustable articulator, planning was carried out with restorative, endodontic, periodontal and prosthetic approaches. After periodontal treatment, endodontics were performed on elements 12, 15 and 47, creation of cores and crowns on teeth 12 and 15, restoration at the gingival level for residual support on tooth 47, restorations on teeth 11, 13, 22, 24 and 44 and, finally, the making of the upper and lower PPRs. The multidisciplinary approach used in this clinical case enabled the restoration of the OVD and enabled the success of the oral rehabilitation(AU)

A meta-analysis indicating extra-short implants (≤ 6 mm) as an alternative to longer implants (≥ 8 mm) with bone augmentation.

Extra-short implants, of which clinical outcomes remain controversial, are becoming a potential option rather than long implants with bone augmentation in atrophic partially or totally edentulous jaws. The aim of this study was to compare the clinical outcomes and complications between extra-short implants (≤ 6 mm) and longer implants (≥ 8 mm), with and without bone augmentation procedures. Electronic (via PubMed, Web of Science, EMBASE, Cochrane Library) and manual searches were performed for articles published prior to November 2020. Only randomized controlled trials (RCTs) comparing extra-short implants and longer implants in the same study reporting survival rate with an observation period at least 1 year were selected. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. A quantitative meta-analysis was performed to compare the survival rate, marginal bone loss (MBL), biological and prosthesis complication rate. Risk of bias was assessed with the Cochrane risk of bias tool 2 and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. 21 RCTs were included, among which two were prior registered and 14 adhered to the CONSORT statement. No significant difference was found in the survival rate between extra-short and longer implant at 1- and 3-years follow-up (RR: 1.002, CI 0.981 to 1.024, P = 0.856 at 1 year; RR: 0.996, CI 0.968 to 1.025, P = 0.772 at 3 years, moderate quality), while longer implants had significantly higher survival rate than extra-short implants (RR: 0.970, CI 0.944 to 0.997, P < 0.05) at 5 years. Interestingly, no significant difference was observed when bone augmentations were performed at 5 years (RR: 0.977, CI 0.945 to 1.010, P = 0.171 for reconstructed bone; RR: 0.955, CI 0.912 to 0.999, P < 0.05 for native bone). Both the MBL (from implant placement) (WMD: - 0.22, CI - 0.277 to - 0.164, P < 0.01, low quality) and biological complications rate (RR: 0.321, CI 0.243 to 0.422, P < 0.01, moderate quality) preferred extra-short implants. However, there was no significant difference in terms of MBL (from prosthesis restoration) (WMD: 0.016, CI - 0.036 to 0.068, P = 0.555, moderate quality) or prosthesis complications rate (RR: 1.308, CI 0.893 to 1.915, P = 0.168, moderate quality). The placement of extra-short implants could be an acceptable alternative to longer implants in atrophic posterior arch. Further high-quality RCTs with a long follow-up period are required to corroborate the present outcomes.Registration number The review protocol was registered with PROSPERO (CRD42020155342).

Clinical Negative Pressure Measurement after Border Molding Procedure.

INTRODUCTION: Border molding of the custom tray's edge is an important stage in the treatment of an edentulous jaw that determines the stability of prosthesis at rest and function. Solid, thermoplastic and silicon impression materials may be used in border molding. After bolder molding procedure, the negative pressure between the custom tray and the prosthetic field is created. This is an informal indication for a good impression. AIM: To compare the negative pressure created after border molding procedure with different impression materials. MATERIALS AND METHODS: 35 patients (17 men and 18 women) aged 51 to 87 years with a complete edentulous upper jaw were examined. New clinical method for negative pressure measurement was created.  We used a special custom tray with palatal adaptor and a pump. Two groups of impression materials were tested:  thermoplastic (Kerr impression compound green sticks, GC Iso functional sticks) and silicones (Detaseal function, Sta-seal f). Statistical analysis was performed using ANOVA, confirmed by the absolute value analysis used to compare negative results, and a log transformation analysis for greater precision and also for negative data comparison. RESULTS: A statistically significant difference was found between the two thermoplastic materials - GC Iso functional sticks and Impression compound green sticks. The mean group difference between these materials was 0.049 bars. There was no statistically significant difference between the other groups of materials. CONCLUSION: Quantitative measurement of negative pressure, created between the custom tray and the prosthetic field is entirely possible under clinical conditions.

Laboratory investigation of Accuracy of Impression Materials for Border Molding.

INTRODUCTION: Border molding of the edge of the individual impression tray is an important stage of prosthetic treatment of edentulous jaws, which often depends on the final result of the treatment. Classical thermoplastic impression materials for border molding have positive qualities that make them preferable by clinicians for their hardness, unlimited manipulation time and high impression sharpness. Modern silicone impression materials for border molding have long manipulating time and appropriate viscosity to allow dentists to perform functional tests. AIM: To determine the accuracy of different impression materials for border molding of individual impression trays. MATERIALS AND METHODS: Four impression materials for border molding were laboratory tested: Kerr impression compound green sticks and thermoplastic GC Iso functional sticks, additive type silicone Detaseal function and condensation type silicone sta-seal f. A modified individual impression tray designed by authors was used, allowing for laboratory load and stability. Ten impressions were taken and their formed edges were measured at 10 points three times - immediately after hardening/elasification, and 24 hours and 48 hours after hardening/elasification. RESULTS: The results were analysed using ANOVA repetition analysis, where a statistically insignificant difference in the accuracy of three of the impression materials for border molding was established, except the C-type of silicone. CONCLUSIONS: Good manipulative qualities and measured accuracy in laboratory tests define these materials as very good for border molding procedures.

An International Survey among Prosthodontists of the Use of Mandibular Implant-Supported Dental Prostheses.

PURPOSE: To evaluate the use of implant-supported overdentures (IOD) and implant-supported fixed dental prostheses (IFDP) in patients with edentulous mandibles among international prosthodontists. MATERIALS AND METHODS: A questionnaire was sent by e-mail to all clinically active prosthodontists in the International College of Prosthodontists with questions related to implant treatment of the edentulous mandible performed in 2015. RESULTS: One hundred and sixteen prosthodontists from 33 countries responded to the questionnaire. The vast majority of the responding prosthodontists was faculty or worked in private practice, and the great majority had performed treatment with mandibular implant-supported dental prostheses; however, two thirds of the respondents reported that <20% of the implant patients in their clinic had received treatment related to edentulous mandibles. The majority reported using 2 implants (84%), while 13% used 4 for overdenture retention. There were great variations regarding retention systems used for mandibular IODs; the most common was individual Locator attachments. Cost was considered the most common reason to choose mandibular IOD, There was a wide variation of materials used for mandibular IFDPs. The most common combination included milled titanium frameworks and acrylic resin teeth. CONCLUSIONS: This survey, completed by 116 prosthodontists from 33 countries, showed that implant treatment for edentulous mandibles is common, but there was great variation among the respondents regarding amount of treatments performed, design, and materials used for the implant prostheses.

Levantamento de seio maxilar atraumático sem enxertia óssea: uma revisão integrativa / Atraumatic maxillary sinus augmentation without bone grafting: an integrative review

Objetivo: avaliar a eficácia do levantamento do seio maxilar atraumático sem enxerto ósseo e a taxa de sobrevivência da instalação de implantes imediatos. Material e métodos: realizou-se uma estratégia de busca nas bases de dados Pubmed, Web of Science e Science Direct, obtendo 103 artigos, sendo selecionados 07 estudos publicados entre 2008 até 2019. Resultados: foram registrados 576 pacientes com idades entre 19 e 85 anos de idade, de ambos os sexos e 1,113 implantes instalados. Verificou-se uma taxa de sucesso e sobrevivência dos implantes de 96,6%, após um seguimento de 1 a 3 anos e houve um ganho ósseo de aproximadamente 3mm. Considerações finais: o levantamento de seio maxilar atraumático sem enxerto ósseo é eficaz para reabilitação de áreas edêntulas e mostra um bom resultado ao longo do tempo, com uma taxa média de sobrevivência dos implantes de 96,3%. Ainda faltam estudos para determinar qual tipo de implante é melhor para este tipo de técnica. (AU)

Objective: To assess the efficacy of atraumatic maxillary sinus augmentation without bone grafting and the survival rate of the immediate implant installation. Material and methods: A search strategy was performed the in Pubmed, Web of Science, and Science Direct databases, resulting in 103 articles from which seven studies published between 2008 and 2019 were selected. Results: 576 patients of both sexes, aged between 19 and 85 years, were registered, as well as 1,113 implants installed. There was a success rate and survival of implants of 96.6% after a follow-up of 1 to 3 years and there was a bone gain of approximately 3 mm. Final considerations: The atraumatic maxillary sinus augmentation without bone graft is effective to rehabilitate edentulous areas and shows a good outcome over time, with an average rate of implant survival 96.3%. Further studies are still required to determine which type of implant is best for this type of technique.(AU)

Reabilitação oral de paciente com síndrome da combinação: relato de caso / Patient oral rehabilitation with combination syndrome: case report

Objetivo: o tratamento de pacientes desdentados com reabsorção alveolar severa é uma temática desafiadora na reabilitação protética. Identificada por Kelly em 1972, a síndrome da combinação é uma manifestação intraoral encontrada em pacientes totalmente desdentados na arcada superior, em oposição a uma prótese mandibular de extensão distal bilateral. Relato de caso: este estudo revisa e discute, por meio de um caso clínico, as características clínicas presentes em um paciente com manifestações da síndrome da combinação. Além disso, apresenta uma proposta de tratamento reabilita¬dor, restabelecendo a função fonética e a estética do paciente. Considerações finais: diagnosticar a síndrome e estabelecer um plano de tratamento adequado às necessidades do paciente, criando condições clínicas para o restabelecimento da saúde, são imprescindíveis para obter resultado e, assim, impedir o avanço do quadro clínico. (AU)

Objective: treatment of patients with reactivity with respiratory problems. Identified by Kelly in 1972, a combination syndrome and an intraoral manifestation found in fully edentulous patients in the upper arch as opposed to a mandibular prosthesis of bilateral distal extension. Case report: the present study reviews and discusses, through a clinical case, as clinical features present in a patient with manifestations of the combination syndrome, in addition, to present a proposal of rehabilitative treatment, restoring function, phonetics and esthetics to the patient. Final considerations: diagnosing a syndrome and establishing a treatment plan appropriate to the needs of the patient and creating clinical conditions for the reestablishment of health are essential to obtain the result and thus impeding the advancement of the clinical picture. (AU)

The patient general satisfaction of mandibular single-implant overdentures and conventional complete dentures: Study protocol for a randomized crossover trial.

BACKGROUND: Mandibular overdentures retained by a single implant placed in the midline of edentulous mandible have been reported to be more comfortable and function better than complete dentures. Although single-implant overdentures are still more costly than conventional complete dentures, there are a few studies which investigated whether mandibular single-implant overdentures are superior to complete dentures when patient general satisfaction is compared. The aim of this study is to assess patient general satisfaction with mandibular single-implant overdentures and complete dentures. METHODS: This study is a randomized crossover trial to compare mandibular single-implant overdentures and complete dentures in edentulous individuals. Participant recruitment is ongoing at the time of this submission. Twenty-two participants will be recruited. New mandibular complete dentures will be fabricated. A single implant will be placed in the midline of the edentulous mandible. The mucosal surface of the complete denture around the implant will be relieved for 3 months. The participants will then be randomly allocated into 2 groups according to the order of the interventions; group 1 will receive single-implant overdentures first and will wear them for 2 months, followed by complete dentures for 2 months. Group 2 will receive the same treatments in a reverse order. After experiencing the 2 interventions, the participants will choose one of the mandibular prostheses, and yearly follow-up visits are planned for 5 years. The primary outcome of this trial is patient ratings of general satisfaction on 100 mm visual analog scales. Assessments of the prostheses and oral health-related quality of life will also be recorded as patient-reported outcomes. The secondary outcomes are cost and time for treatment. Masticatory efficiency and cognitive capacity will also be recorded. Furthermore, qualitative research will be performed to investigate the factors associated with success of these mandibular denture types. Clinical outcomes, such as implant survival rate, marginal bone loss, and prosthodontic complications, will also be recorded. DISCUSSION: The results of this randomized crossover trial will clarify whether mandibular single implants and overdentures for edentulous individuals provide better patient general satisfaction when compared to conventional complete dentures. TRIAL REGISTRATION: This clinical trial was registered at the University Hospital Medical Information Network (UMIN) Center (UMIN000017883).

Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation.

The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics). The influence of the method used to obtain the centric relation on patients' stomatognathic system (condyle centralization, pain) was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

Complete dentures for a patient after a stroke by means of orofacial myofunctional therapy: A clinical report.

After a stroke, patients frequently show compromised swallowing, mastication, and speech, as well as unfavorable motion and deviation of the tongue and mandible. The dentist can improve the oral rehabilitation of a patient with deteriorated facial and oral muscles after a stroke by incorporating orofacial myofunctional therapy. This report describes a method for tongue exercises and correction of mandible deviation in an edentulous patient after a stroke by using a pearl on a wire in the anteriomedian palatal part of the maxillary denture.

Developing Prosthodontic Residents' Communication Strategies with Edentulous Patients: A Pilot Study.

The aim of this study was to investigate whether prosthodontic residents' attitudes toward provider-client communication would be shaped by a tailor-made communications skills course. In 2016, the pre-intervention attitudes of all six second- and third-year prosthodontic residents in a three-year residency at an academic dental institution in India were assessed using the Communication Skills Attitude Scale (CSAS). The residents' performance was then video-recorded while they treated complete denture patients and was analyzed using the Kalamazoo scale, a validated scale for communication skills assessment. The residents' weaknesses were identified, and a custom-made generic module was designed along with individual guidance counseling for addressing aspects relevant to complete denture patients. The residents' attitudes were again assessed immediately after they completed the training using CSAS, as well as after two and four months using Balint sessions. Analysis of the recordings showed that few of the deficiencies during intraoral procedures were contextual, and the Kalamazoo scale did not address them: these were noted as being "beyond Kalamazoo." After the training, the residents reported awareness of their weaknesses and feeling motivated to practice their newly acquired skills. The Balint sessions showed that they had started valuing patients' agendas and the rapport-building process, and they reported transfer of skills when treating other types of prosthodontic patients. In this study, a customized communication skills module brought about a positive change in residents' attitudes, which was sustained over four months. Similar training could be implemented in other dental specialties.

The Lip-Tooth-Ridge Classification: A Guidepost for Edentulous Maxillary Arches. Diagnosis, Risk Assessment, and Implant Treatment Indications.

Prosthetic rehabilitation of the edentulous maxilla is known to be challenging and requires meticulous planning. The purpose of this article is to describe a novel classification system, the Lip-Tooth-Ridge (LTR), that offers a guidepost for treatment planning the edentulous maxilla for fixed or removable prostheses. This tool will help clinicians identify the final prosthetic design and will provide a case-specific risk assessment guide regarding two different areas. A high (HER) or low (LER) esthetic risk will be determined based on lip dynamics, as well as a high or low structural risk according to the prosthetic space availability.

EVALUATION OF EDENTULISM, PROSTHETIC STATUS AND PROSTHODONTICS TREATMENT NEEDS AMONG THE ADULT POPULATION OF GEORGIA.

The aim of the present study is to identify the level of edentulism among the adult population of Georgia, to assess the prosthodontics status and normative needs for prosthetic treatment. Cluster- stratified method was used for sampling. Overall, 2370 adults including 1289 women and 1081 men and four age groups I - 20-34, II - 35-44, III - 45-64, IV - 65-74 in nine regions of Georgia and the capital, Tbilisi, were examined. The loss of teeth due to caries or periodontitis was observed to differing extents throughout the population. One (8.3%) or more bridges (7.6%) and removable dentures (3.2-4.7%) were more frequently observed than implants (0.1%). Metal-ceramic (12.4%) and metal crowns (6.3%) were more commonly detected than zirconia ceramic crowns (0.1%). Statistical analysis of the data demonstrates a rather high normative prosthetic need of implants and bridges and less needs for removable dentures among the population due to less severity of periodontitis and not too high values of missing teeth due to caries (despite the high caries prevalence (99%) throughout the Georgian population). Edentulism is a public problem in Georgia and needs serious attention from government or healthcare centers to prevent the complications .

THE RISK FACTORS INFLUENCING THE EDENTULISM AND PROSTHETIC STATUS OF THE ADULT POPULATION IN DIFFERENT REGIONS OF GEORGIA.

The aim of the present study was to identify the level of edentulism and prosthetic status of the adult population in different regions of Georgia and to assess the influencing risk- factors. Cluster- stratified method was used for sampling. Overall, 2370 adults including 1289 women and 1081 men and four age groups I- (20-34), II-(35-44), III-(45-64), IV- (65-74) in nine regions of Georgia and the capital, Tbilisi, were examined. Statistically reliable data received showed the different extent of teeth loss in various regions of Georgia. ≤10 teeth loss were characteristic for Mtskheta (60.2%) and Samtskhe-Javakheti (50.7%),whilst ≥20 teeth lost were noticed more in Achara(2.9%), Samtskhe-Javakheti(2.6%), Shida Qartli (2,5%). Therefore, prosthetic status was mostly presented with one or more bridges or artificial crowns, removable dentures were seen less. Differences in prosthetic status is generally related to low medical education background in all regions, though lack of money was considered as essential obstacle for dental visit for Mtskheta, Imereti and Samtskhe-Javakheti population. Education and family income dictate attitudes towards prosthetic dental care and choice of crown types. On the other hand, material disparity represents the main obstacle to prosthetic procedures, especially implants.

Importance of Dental Maxillofacial Aesthetics in Dental Therapy.

The recent development of aesthetic dentistry reflects a concentration of the dentists' concern for satisfying patients' requests for an aesthetic appearance of their teeth. Modern dentistry combines medical treatment with the art of aesthetic restorations. Over the years, the restoration of the facial harmony has changed its character, from random to necessary, and from optional to compulsory, as the aesthetic defects have become less and less accepted. Aim: Contributions to understanding the principles that must be respected in dental-facial aesthetics and their application in various accessible prosthetic techniques that lead to significant improvement of the aesthetic appearance of the final restoration. Material and methods: The study included 22 (aged 40 to 80 years) patients (mean age: 60 years), presenting to the Department of Clinical Dentistry for different types of prosthetic restorations. Results and discussions: Taking into consideration the aesthetic principles and criteria, the prosthetic restorations in two similar clinical situations were performed using a different methodology. Conclusions: To grant the actual interventions the necessary provisions of true clinical success, the dentist must have and develop the skills that allow him/her to be valued as both a scientist, and an artist.

Case Study: Management of a Loose Upper Denture Opposed by a Shortened Dental Arch.

For many years, it has been considered necessary to restore posterior support with a bilateral free-end saddle when a full upper denture is opposed by a shortened dental arch. It was thought that this would provide occlusal stability and prevent anterior bite collapse and temporomandibular dysfunction. As free-end saddle partial dentures are often poorly tolerated by patients, this case study tests whether a retentive full-upper denture occluding with a shortened dental arch offers enough to fulfil a patient's needs. Clinical relevance: An increasingly elderly population will present dental practitioners with more partially dentate patients requiring treatment.

Perfil de los pacientes rehabilitados por medio de prótesis atendidos en servicio público de salud en Ribeirão Preto, Brasil / Patients profile rehabilitated with dental prosthesis assisted by the health public service in Ribeirão Preto, Brazil

La prevalencia de sexo y el padrón de edad relacionado a los diferentes tipos de rehabilitaciones protésicas son variables importantes que deben ser estudiadas. De esta manera, el objetivo de este estudio fue evaluar el perfil de edad y género en pacientes rehabilitados con prótesis dentales en un curso de Odontología durante un periodo de cinco años. Fueron evaluados 638 fichas de pacientes que recibieron prótesis parcial fija (PPF), prótesis parcial removible (PPR) y prótesis total (PT). Las prótesis de los pacientes rehabilitados con PPR fueron clasificadas en dentomucosoportada (DM) o dentosoportadas (D). Para el análisis de los resultados, los pacientes fueron divididos en 2 grupos: A) >50 años y B) <50 años. Los datos fueron analizados estadísticamente por el test exacto de Fisher o chi-cuadrado (p<0,05). No se observaron diferencias significativas en relación a la edad y tipo de prótesis. Para la PPF 74% fueron <50 años, para la PPR 52%, >50 años y para la PT 92%, >50 años. En todas las prótesis, existió una mayor prevalencia del género femenino. Con relación a la clasificación de las PPRs, 47% fueron D y 53% DM, sin identificar diferencias estadísticamente significativas. De esta manera se puede concluir que la necesidad de rehabilitación de un mayor numero de elementos dentales aumenta con la edad, siendo prevalente en todos los periodos de la vida adulta, principalmente, en mujeres

The prevalence of gender and age related pattern of the different types of prosthetic restorations are important variables to be estimated. The aim of this study was to evaluate the profile of age and gender in patients rehabilitated with dental prostheses on School of Dentistry during five years. Were evaluated 638 records of patients who received fixed prosthesis (FP), removable partial (RP) or total dentures (T). Rehabilitated patients with RP had their prostheses classified into dental-mucous-supported (DM) or tooth-supported (D). To analyze the results, patients were divided into 2 groups: A) >50 years or B) <50 years. Data were statistically analyzed by Fisher's exact test or chi Square (p<0.05). No statistical significance relation to age and types of prostheses was observed. On RP, 47% was D and 53% DM, there was no statistically significant difference. It was possible to conclude that the rehabilitation of greater number of the teeth increases with age and is prevalent in all periods of adulthood, especially in women

Clinical study on survival rate of short implants placed in the posterior mandibular region: resonance frequency analysis.

OBJECTIVE: Short implants are increasingly used, but there is doubt about their performance being similar to that of regular implants. The aim of this study was to compare the mechanical stability of short implants vs. regular implants placed in the edentulous posterior mandible. MATERIAL AND METHODS: Twenty-three patients received a total of 48 short implants (5 × 5.5 mm and 5 × 7 mm) and 42 regular implants (4 × 10 mm and 4 × 11.5 mm) in the posterior mandible. Patients who received short implants had <10 mm of bone height measured from the bone crest to the outer wall of the mandibular canal. Resonance frequency analysis (RFA) was performed at time intervals T0 (immediately after implant placement), T1 (after 15 days), T2 (after 30 days), T3 (after 60 days), and T4 (after 90 days). RESULTS: The survival rate after 90 days was 87.5% for the short implants and 100% for regular implants (P < 0.05). There was no significant difference between the implants in time intervals T1, T2, T3, and T4. In T0, the RFA values of 5 × 5.5 implants were higher than values of 5 × 7 and 4 × 11.5 implants (P < 0.05). A total of six short implants that were placed in four patients were lost (three of 5 × 5.5 mm and three of 5 × 7 mm). Three lost implants started with high ISQ values, which progressively decreased. The other three lost implants started with a slightly lower ISQ value, which rose and then began to fall. CONCLUSIONS: Survival rate of short implants after 90 days was lower than that of regular implants. However, short implants may be considered a reasonable alternative for rehabilitation of severely resorbed mandibles with reduced height, to avoid performing bone reconstruction before implant placement. Patients need to be aware of the reduced survival rate compared with regular implants before implant placement to avoid disappointments.

New 3D technologies applied to assess the long-term clinical effects of misfit of the full jaw fixed prosthesis on dental implants.

OBJECTIVES: To assess implant:suprastructure misfit in patients with an edentulous jaw restored by an implant-retained fixed dental prosthesis (FDP) and its association with biologic and mechanical adverse events over an extensive period. MATERIAL AND METHODS: Thirty patients with an edentulous mandible treated with implant-supported prosthetics before 2000 were examined clinically in 2012. Each patient had received 4 to 6 implants to retain a FDP made from acrylic and three different metal alloys, that is, Ag-Pd, Pd-Ag, and Au type IV. The implant intra-oral locations were recorded digitally by use of an intra-oral scanner, and the intaglio surface of the detached FDP was recorded using a desktop scanner. The fit was estimated by digital matching of the STL files using industrial metrological software. The average misfit was correlated with the average marginal bone loss and the prevalence of screw loosening or fractures, using the patient as the statistical unit. RESULTS: Over an average of 19 years (range 12 to 32), 5 implants had been lost in 4 participants (96.7% implant survival) and 8 eight prostheses (26.7%) had been remade. Anaverage misfit was 150 µm (SD 35, range 95-232, CI 138-163). An average marginal bone loss of 2.2 mm (SD = 0.7) had occurred (range 0.6 to 5.8 mm) for individual implants. The correlation between framework misfit and marginal bone loss was weak (R² = 0.04) (P = 0.29). The prostheses with a history of screw-related adverse events showed average misfit of 169 µm (SD = 32) vs. those with no history of screw-related adverse events, that is, 134 µm (SD = 30) (P = 0.005, Student's t-test). Fourteen of the 30 participants had experienced at least one incidence of screw loosening or fracture of prosthetic or abutment screw(s) over the period of follow-up. The occurrence among the frameworks fabricated with different metal alloys did not differ (P > 0.05, Fisher's exact test). CONCLUSIONS: Combining STL files with best-fit algorithms to appraise misfit is feasible using metrological software. The effect of misfit between the superstructures on its supporting implants up to ~230 µm on the long-term clinical outcomes appears to be minor, apart from a slightly higher risk of screw-related adverse events.

Rendimiento masticatorio y nivel de satisfacción de pacientes tratados con prótesis totales en la Universidad Mayor / Masticatory performance and satisfaction level in patients treated with complete dentures

Se realizó un estudio para medir y comparar el rendimiento masticatorio empleando el Test de Manly en 2 grupos de 18 individuos cada uno. El primer grupo estaba conformado por pacientes desdentados totales tratados en la Universidad Mayor en el año 2012 con prótesis totales removibles, y el segundo grupo, por pacientes con dentadura natural completa. Además, al grupo de pacientes rehabilitados con prótesis totales se le aplicó la encuesta GOHAI para conocer el nivel de satisfacción con el uso de sus prótesis. Los resultados muestran que el rendimiento masticatorio es muy superior en los individuos dentados naturales con respecto a los portadores de prótesis totales, y esta diferencia es estadísticamente significativa. Los pacientes portadores de prótesis totales señalan un bajo nivel de satisfacción con el uso de sus dentaduras completas, en especial durante la función masticatoria.

This study was conducted in order to measure and compare the masticatory performance using the Manly Test in 2 groups of 18 people. The first group was formed by edentulous patients treated in the Universidad Mayor of Santiago, Chile, in 2012 with removable dentures, and the second group consisted of patients with complete natural dentition. In addition, the GOHAI questionnaire was also applied to determinate the level of satisfaction of the group of patients rehabilitated with complete dentures. The results showed that masticatory performance is much higher in individuals with complete natural dentition than in patients rehabilitated with complete dentures, with the difference being statistically significant. Patients with dentures indicated a low level of satisfaction with the use of their complete dentures, especially during masticatory function.