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1.
Shanghai Kou Qiang Yi Xue ; 29(3): 262-266, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043342

RESUMO

PURPOSE: To observe and compare the stress distribution of implant, crown, abutment and surrounding bone tissues in the aesthetic zone after restoration of resin-ceramic composite single crown, and provide theoretical basis for clinical restoration. METHODS: Three-dimensional finite element models of alveolar bone, implant, crown, and the thickness of different adhesives between crown and abutment (0.05 mm and 0.1 mm) were established by using Mimics 17.0 software.Force was applied at the angle of 130° with the long axis of the implant, the loading position was 2 mm from the incisal cingulum, and other force on the incisal margin was loaded in parallel to the long axis of the implant. The size was 100 N. Linear static stress analysis was carried out to compare the Von Mises stress after single crown restoration with different materials. RESULTS: When the thickness of adhesive was 0.05 mm, and resin cement was selected, after restoration of Enamic, Ultimate resin ceramic composite crown, the peak stress of alveolar bone, implant, crown and abutment was more uniform and decreased slightly, but the difference was not significant compared with that of IPS Empress, blocs Mark Ⅱ ceramic crown. When the thickness of adhesive was 0.05 mm, the peak stress was significantly lower than that of 0.1 mm. There was no significant difference in the stress between glass ionomer cement and resin cement.Under the same conditions, restoration with Ultimate crown had smaller stress value of peak Von Mises. CONCLUSIONS: The stress of resin composite ceramics single crown when applied to implantation in aesthetic area is slightly less and more uniform. The proportion of resin in composites and the thickness of adhesive can affect the stress distribution and peak value.


Assuntos
Implantes Dentários , Cerâmica , Coroas , Análise do Estresse Dentário , Estética Dentária , Análise de Elementos Finitos
2.
Shanghai Kou Qiang Yi Xue ; 29(3): 312-315, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043351

RESUMO

PURPOSE: To compare the aesthetic effects of all-ceramic micro-veneer and minimally invasive ultra-thin veneer in repairing deformed anterior teeth. METHODS: One hundred and twenty patients with deformed anterior teeth were selected for aesthetic restoration. According to the patient's personal condition, a suitable repair protocol was selected. Patients in the experimental group (60 cases) were repaired with all-ceramic micro-adhesive surface, while patients in the control group (60 cases) were treated with minimally invasive ultra-thin veneer. The US Public Health Administration's Evaluation Criteria (USPHS) scores were recorded and compared 6 months, 12 months, and 24 months after restoration. Statistical analysis was performed using SPSS 25.0 software package. RESULTS: There was no significant difference in the integrity, color, marginal closeness, translucency and marginal staining of the restorations between the two groups 24 months after operation (P>0.05). The satisfaction rate of the aesthetics of the experimental group was significantly lower than that of the control group (71.60% vs 93.83%, P<0.05). The incidence of complications such as broken, detached and secondary caries during the follow-up period was significantly lower in the experimental group than in the control group (1.23% vs 11.11%, P<0.05). CONCLUSIONS: The results showed that there is no significant difference in the success rate between the two methods. All-ceramic micro-veneer technique has good long-term effect, fewer complications, easy to collapse and stain the lip margin, but it has a small amount of teeth preparation and a low incidence of pulpitis in the later period. Minimally invasive super-thin veneer has high aesthetic value, so it is necessary to choose appropriate aesthetic repair methods according to the patients' needs.


Assuntos
Porcelana Dentária , Facetas Dentárias , Cerâmica , Cor , Estética Dentária , Humanos
3.
Compend Contin Educ Dent ; 41(9): e1-e4, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33001660

RESUMO

Recession defects can affect both tooth and implant sites. The objective of connective tissue grafting is to correct recession defects and develop a soft-tissue architecture that is both stable and natural in appearance. By protecting the integrity of the interdental papillae, tunnel techniques are intended to maximize esthetic results. The use of an acellular dermal matrix (ADM) allows treatment of multiple adjacent recession defects without the need for a palatal donor site. The dental literature is scarce on the use of ADMs to treat recession affecting implant sites. The purpose of this article is to discuss and demonstrate the use of a modified tunnel technique and a double layer of an ADM in the treatment of recession defects affecting multiple teeth and an implant.


Assuntos
Derme Acelular , Implantes Dentários , Retração Gengival/cirurgia , Estética Dentária , Gengivoplastia , Humanos
4.
Compend Contin Educ Dent ; 41(9): e5-e9, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33001661

RESUMO

This article describes the case of a partially edentulous patient who had undergone template-guided implant placement and was treated using a triple digital scanning protocol that allowed for CAD/CAM prosthodontic rehabilitation in a complete digital workflow. At the impression appointment, the provisional implant-supported screw-retained prosthesis was digitally scanned both intraorally (first scan) and, after removal, extraorally (second scan). After the second scan, scan bodies were placed intraorally and an implant-level digital impression was taken (third scan). The three standard tessellation language (STL) files derived from the three digital scans were imported in a CAD software and superimposed into one file that contained all of the information from the implant 3D position, prosthesis contours, and transmucosal part of the peri-implant soft tissues. The superimposition of the three STL files led to one master file to serve as a blueprint for the definitive prosthesis. The definitive monolithic zirconia prosthesis was CAM copy-milled, externally stained, and inserted. The patient was satisfied with both the esthetic and functional outcome and the minimally invasive, time-efficient, two-visit restorative protocol. In summary, this case report illustrates a technique for a complete digital workflow in an implant rehabilitation for the replacement of multiple missing teeth in the esthetic zone in two visits.


Assuntos
Implantes Dentários , Fluxo de Trabalho , Desenho Assistido por Computador , Prótese Dentária Fixada por Implante , Estética Dentária , Humanos
5.
J Contemp Dent Pract ; 21(7): 808-814, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020368

RESUMO

AIM: This literature review aims to update the evidence for prevention of white spot lesion (WSL) using orthodontic sealants among patients with fixed orthodontic appliances. BACKGROUND: As a major issue among orthodontists, prolonged treatment duration increases the risk of plaque development around orthodontic brackets and bands. In consequence, this can lead to heightened risk for caries development and higher possibility of WSL development around fixed orthodontic brackets. RESULTS: Increased prevalence of WSLs generally occurs during orthodontic treatment. This review explored various products of orthodontic sealants used to prevent WSL. Orthodontic sealants do not require patient compliance and thus will further lessen the burden among orthodontists as well as support enamel surface for a long period of time during treatment. Certain factors, however, are considered important in the efficacy of these sealants, such as antibacterial activity, color stability, resistance to acid and brush abrasion, and their effect on shear bond strength (SBS). CONCLUSION: The review showed that the use of orthodontic sealants in preventing WSLs during and after fixed orthodontic treatment is significantly effective. However, the bioactive glass is deemed more effective against WSL development due to its ability to immediately repair enamel surface, low cytotoxicity, and high biocompatibility. Moreover, clinical studies on bioactive glass are still needed to determine its acceptability among patients with fixed orthodontic appliance. CLINICAL SIGNIFICANCE: Development of WSL around the orthodontic brackets during treatment is a difficult task among orthodontists. As such, this review explored various strategies to effectively combat WSL development for good oral health and esthetics during orthodontic treatment.


Assuntos
Cárie Dentária/etiologia , Cárie Dentária/prevenção & controle , Braquetes Ortodônticos/efeitos adversos , Ortodontia , Materiais Dentários , Estética Dentária , Humanos
6.
J Contemp Dent Pract ; 21(7): 815-818, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020369

RESUMO

AIM: An apparatus named "laser pointer apparatus" is proposed for accurate iris positioning in a prosthetic eye. BACKGROUND: Loss of an eye leads to significant psychological stress due to functional disability and societal response to the facial disablement. Custom-made eye prosthesis is a good option to rehabilitate such defects. Inaccurately positioned iris in a prosthetic eye results in squint eye appearance leading to poor esthetics and poor psychological impact among such unfortunate patients. TECHNIQUE: A new apparatus called a laser pointer apparatus, which is an assembly of an occlusal plane analyzer, web camera, laser pointer, and software, has been introduced for iris positioning in a prosthetic eye. CONCLUSION: Iris positioning is one of the key steps in fabricating an eye prosthesis. Laser pointer apparatus is a reliable method for iris positioning in a prosthetic eye. CLINICAL SIGNIFICANCE: Positioning the iris to the ideal symmetrical position is a cardinal step in the fabrication of an ocular prosthesis. This article aims to introduce a "laser pointer apparatus" to orient iris in a prosthetic eye objectively to overcome the subjective errors.


Assuntos
Estética Dentária , Olho Artificial , Humanos , Iris/cirurgia , Desenho de Prótese
7.
Swiss Dent J ; 130(10): 785-790, 2020 10 12.
Artigo em Alemão | MEDLINE | ID: mdl-33044805

RESUMO

Minimally invasive dentistry includes a wide range of treat­ment options for replacing lost tooth substance or constructing new tooth shapes. An additive restoration concept in combina­tion with composite or ceramic restorations ensures that the tooth substance is protected. The dentist's preferences deter­mine the choice of the restoration material. In this case, a direct composite restoration was selected to close a diastema between tooth 11 and 21.


Assuntos
Dente , Cerâmica , Materiais Dentários , Estética , Estética Dentária
8.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 710-715, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045780

RESUMO

Accurate and measurable tooth preparation under the principle of protecting dental tissue, vital pulp and periodontal tissue health is a challenging procedure in esthetic dental restoration. The traditional protocol of tooth preparation often leads to complications after restoration because of the lack of precise preparation control. The pre-operative analysis and design, intraoperative guidance and sequence guidance technology of post-operative prosthesis production, with the target restoration space (TRS) as the core and digital technology as the support technology, embody the numerical requirements of the prosthesis space based on the actual measurement, and will lay the core foundation of the future digital prosthodontics. This paper introduces the new understanding of tooth preparation guidance, the classification and application of digital guides, the practice of micro tooth preparation guided by digital template, and summarizes the development direction of prosthodontics from experience guidance to digital guidance.


Assuntos
Estética Dentária , Preparo do Dente , Polpa Dentária , Periodonto , Prostodontia
9.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 729-736, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045783

RESUMO

Objective: To explore and evaluate a three-dimensional (3D) digital simulated design and implementation technique in esthetic rehabilitation. Methods: Thirty patients with esthetic deficiency, who came to the Department of Prosthodontics, Peking University School and Hospital of Stomatology from December 2017 to July 2019, were recruited and randomly assigned into 2 groups. Four males and 11 females which were (36.0±10.5) years old in the experimental group, 6 males and 9 females which were (32.0±6.7) years old in the control group, were enrolled. In the experimental group, 3D digital simulated design was used to predict the post-treatment effect; and the final restorations were designed duplicating from the pre-treatment digital design confirmed by the patient and milled. In the control group, the final restorations were manufactured by the dental technician according to the design of two-dimensional (2D) digital smile design. The simulation degree of digital design and the similarity between preoperative design and postoperative rehabilitation were scored by the patients with visual analogue scales (VAS) in both groups; and the satisfaction rate to the restorations was evaluated by the patients. The quality of the restorations was accessed by a prosthodontist who did not know the grouping of patients according to the modified criteria of United States Public Health Service (USPHS). Results: Three-dimensional digital simulated design and implementation technique was successfully established. The VAS score on the simulation degree of digital design in the experimental group (8.5±0.5) was higher than that in the control group (7.2±0.7) (P<0.01); the VAS score on the similarity between preoperative design and postoperative rehabilitation in the experimental group (9.6±0.3) was higher than that in the control group (7.0±0.9) (P<0.01). The satisfaction rate of the patients to the restorations was significantly higher in the experimental group than in the control group (P<0.05). There was no significant difference of the quality of the restorations between the two groups on the anatomic form, the marginal adaption and the surface quality (P>0.05). Conclusions: Three-dimensional digital simulated design and implementation technique can help achieving 3D digital simulated design before treatment and duplication to the final restorations, and can improve the patients' satisfaction in esthetic rehabilitation.


Assuntos
Estética Dentária , Sorriso , Adulto , Odontólogos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prostodontia , Estados Unidos
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 799-802, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045795
11.
Pediatr Dent ; 42(5): 367-372, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33087221

RESUMO

Purpose: The purpose of this study was to compare the 12-month clinical outcomes of primary maxillary incisors restored with composite strip crowns (CSCs), NuSmile preveneered stainless steel crowns (PVSSCs), and NuSmile zirconia crowns (ZCs). Methods: A total of 135 teeth in 49 two- to four-year-olds with early childhood caries were randomly assigned to crown groups. Demographic and tooth-related variables at baseline and 12 months were assessed by calibrated examiners. Fisher's exact or chi-square tests were used to test associations (P<0.05). Parental satisfaction of crown esthetics was evaluated by questionnaire. Results: Children were, on average, 3.4 years old, female (55 percent), and had a mean decayed, missing, and filled primary teeth (dmft) index score of 10.6. At 12 months, crown retention was significantly lower for CSCs versus PVSSCs or ZCs (79 percent, 100 percent, and 95 percent, respectively; P=0.002). Partial and complete loss of material was significantly higher in CSCs than PVSSCs or ZCs (29 percent, 11 percent, and zero percent, respectively; P<0.001). CSCs presented with increased marginal discrepancies and color change (P<0.001). Most parents were very satisfied (87 percent); those dissatisfied were concerned with the color of CSCs and PVSSCs (63 percent versus 37 percent; P=0.005). Conclusions: Composite strip crowns showed significantly reduced clinical success in retention, durability, marginal adaptation, and color compared to preveneered stainless steel crowns or zirconia crowns. Parental esthetic satisfaction was highest for NuSmile ZCs.


Assuntos
Estética Dentária , Incisivo , Criança , Pré-Escolar , Coroas , Feminino , Humanos , Maxila , Dente Decíduo
12.
Int J Esthet Dent ; 15(4): 390-400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33089256

RESUMO

The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate after tooth extraction and avoiding tissue collapse. Therefore, it could be considered a valid option in the immediate implant scenario. A careful shield preparation and handling are paramount for the success of the treatment and to minimize complications. Raising a flap can improve visibility and simplify the procedure. This article reports on a case in which a small crestal approach is used to visualize the root and the buccal plate, combined with a buccal semilunar flap, to gain access to the apical area. This surgical management is especially indicated when long roots are involved, in order to determine the correct axis for cutting and sectioning the root and to remove the apex if conventional drills are not long enough. Possible esthetic complications of raising a flap are also discussed.


Assuntos
Implantes Dentários para Um Único Dente , Carga Imediata em Implante Dentário , Estética Dentária , Humanos , Extração Dentária , Alvéolo Dental/cirurgia
13.
Int J Esthet Dent ; 15(4): 428-439, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33089258

RESUMO

OBJECTIVE: The combination of partial edentulism and a worn anterior tooth in the esthetic zone can be a challenge for the dentist. This clinical situation requires extensive knowledge of soft and hard tissue management, surgical planning and execution for implant therapy, and conservative tooth preparation with ideal bonding protocols for the tooth-supported prosthesis. Moreover, an optimal selection of the final restorative materials is imperative to manage occlusal forces and fulfill the patient's esthetic demands. MATERIALS AND METHODS: The patient presented with partial edentulism on site 11, a worn incisal edge, and facial defects on tooth 21. Minimally invasive implant therapy for site 11 was performed with a papilla-sparing flap design that only included the edentulous site, and the soft tissue contouring was started for an immediate provisional restoration. A suturing technique was executed that aimed at maintaining an interproximal papilla. Conservative veneer preparation was performed on tooth 21 in order to bond the restoration to the enamel structure. Final restorations included a custom abutment with a lithium disilicate fused to zirconia crown for the implant on site 11 and a lithium disilicate veneer on tooth 21. CONCLUSIONS: A well-planned single implant and a ceramic veneer restoration was able to fulfill the patient's esthetic expectations. The selection of materials for the final restoration was crucial to manage the occlusal forces and to mimic the shade and shape of the adjacent teeth.


Assuntos
Implantes Dentários , Estética Dentária , Coroas , Materiais Dentários , Estética , Humanos
14.
Int J Esthet Dent ; 15(4): 440-453, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33089259

RESUMO

Soft tissue augmentation techniques have become crucial to improve tissue volume and quality in periodontal and peri-implant dental surgery. A clinician's knowledge of the principle of flap design and management is a key aspect for treatment success, particularly in the esthetic area. Implant failures in the esthetic area are one of the most challenging situations in modern dentistry, and often cases have to be resolved through multidisciplinary treatments in which soft tissue management and patient selection are substantial aspects. Ridge defects are commonly treated with bone regeneration-like techniques in order to place implants. However, in young patients, where implant treatment should be carefully selected, fixed prosthetic restorations in combination with mucogingival surgery could be a successful option to enhance esthetics. The present case report describes a treatment approach for implant failure in the esthetic area in young patients, consisting of a combination of connective tissue platform technique, resective surgery, and a Maryland bridge restoration.


Assuntos
Aumento do Rebordo Alveolar , Estética Dentária , Tecido Conjuntivo/transplante , Implantação Dentária Endo-Óssea , Humanos , Retalhos Cirúrgicos/cirurgia
15.
Int J Esthet Dent ; 15(4): 474-488, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33089261

RESUMO

This article illustrates a new technique for repositioning the lip in the treatment of gummy smile. In particular, it introduces a formula to precisely calculate how much tissue should be eliminated to avoid the recurrence of gummy smile. The modified lip-repositioning technique (MLRT) also involves the microsurgical division of the tissue components (mucosa, periosteum, and bone) as well as the fixation of the surgically modified tissue to the periosteum component. The results of the technique are shown through case presentations of seven patients with follow-up of up to 3 years. Stable results were achieved with no recurrence of gummy smile.


Assuntos
Lábio , Sorriso , Estética Dentária , Gengivectomia , Humanos , Lábio/cirurgia
16.
Shanghai Kou Qiang Yi Xue ; 29(4): 410-413, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-33089292

RESUMO

PURPOSE: To investigate the effect of invisalign on anterior and posterior upper airway and maxillary bone changes in the treatment of high-angle skeletal Class II malocclusion. METHODS: Thirty-seven patients with malocclusion undergoing invisible orthodontic treatment in Hospital of Stomatology of Xi'an Jiaotong University from June 2016 to June 2018 were enrolled. Before and 18 months after correction, the correction effect was evaluated. Cone-beam CT (CBCT) was performed to measure the upper airway volume and tongue position. Cephalometric examination was performed to determine the anteroposterious diameter of the upper airway and the position of hyoid bone. The pre-therapy and post-treatment facial profile images of patients and stars were graded by 0-10 numerical rating scale. SPSS 20.0 software package was used to analyze the data. RESULTS: After correction, oropharyngeal volume, glossopharyngeal volume and minimum cross-sectional area of upper airway significantly increased(P<0.05). Sagittal diameter of the upper airway at mandibular plane significantly increased after correction (P<0.05). After correction, ANB angle, GoGn-SN angle, OPP-SN angle, Y-axis angle, UI-SN angle, UI-PP angle, UI-AP angle, and UI-AP distance significantly decreased, SNB angle and UI- LI angle significantly increased(P<0.05). The aesthetics scores of facial profile images significantly increased after correlation(P<0.05), which was significantly lower than that of the stars(P<0.05). CONCLUSIONS: Invisalign can effectively correct open upper airway and malocclusion, achieving better treatment results and satisfactory facial aesthetics effect.


Assuntos
Má Oclusão , Aparelhos Ortodônticos Removíveis , Cefalometria , Estética Dentária , Humanos , Maxila/diagnóstico por imagem
17.
Dental Press J Orthod ; 25(4): 85-100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965392

RESUMO

INTRODUCTION: Due to the search for more aesthetic and comfortable alternatives to perform orthodontic treatments and to the great technological development, orthodontic aligners have assumed great importance. More and more complex treatments have been carried out with these appliances without, however, having all aspects involved in their use being studied in depth. Its biomechanical planning requires different approaches than those used in fixed orthodontics, as the force systems involved in movements, responses and side effects are distinct, and the professional must be prepared when opting for the technique. OBJECTIVE: The objective of this article is to perform an evaluation of the force systems created on the space closure with aligners, its characteristics, and problems, as well as make some suggestions to overcome the difficulties inherent to its use. CONCLUSION: Space closure with aligners is possible, but depends on the correct selection of the patient, in addition to requiring the proper planning of the applied forces. The use of auxiliary resources and overcorrections to address the deficiencies of the aligner systems should always be considered. Digital planning should be used as a map of the force systems that will be applied, and not just as a marketing tool, keeping in mind that determining the objectives and the way to achieve them is the responsibility of the orthodontist, and that treatment plans must be individualized for each situation, following appropriate biomechanical precepts.


Assuntos
Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Removíveis , Estética Dentária , Humanos , Ortodontistas , Técnicas de Movimentação Dentária
18.
Int J Oral Maxillofac Implants ; 35(5): 1022-1036, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32991655

RESUMO

PURPOSE: This 3-year study aimed to evaluate hard and soft tissue modification around a two-piece implant characterized by a transmucosal hyperbolic neck in healthy consecutive patients with a need for single-tooth replacement. MATERIALS AND METHODS: Two-piece implants (n = 66) were placed with a flapless technique in 56 patients (27 men; 29 women; mean age 55 ± 9 years): 16 immediately after root extraction (immediate group), 20 after 8 to 12 weeks (early group), and 30 after 10 or more months (delayed group). The transmucosal hyperbolic neck was exposed 1 to 1.5 mm above gingival level. Customized abutments were positioned 3 months later with the implant-abutment connection located approximately 1 to 1.5 mm above soft tissue level. Provisional cemented resin crowns were designed with the finishing line at the hyperbolic neck and then positioned to avoid excessive compression of soft tissue, to guide gingival contours. Twenty days later, a definitive metal-ceramic crown was cemented. In all patients, the gingival biotype (thin or thick) was also evaluated. The primary outcomes were as follows: 36-month implant survival rate, peri-implant marginal bone level (MBL, in mm) changes observed in single-blind on radiographs at 1, 3, 6, 12, 24, and 36 months (T1, T3, T6, T12, T24, and T36), and pink esthetic score (PES) at T6, T12, and T36 to analyze soft tissue adaptation after loading and crown application. The secondary outcomes were as follows: plaque score and bleeding on probing (BOP). Linear regression models and multilevel mixed logistic regression were used to detect any statistical difference of MBL according to operative parameters. Kruskal-Wallis one-way analysis of variance (ANOVA) on ranks was performed to assess statistical differences of PES at T6, T12, and T36. RESULTS: The survival rate was 100%. The dropout rate was 1.79%. No infections, mucositis, or peri-implantitis were reported. Implants placed in thick-biotype tissues showed a statistically different lower bone loss at 36 months with respect to the thin biotype (P < .05). At 36 months, the early group showed lower bone loss compared with the delayed group (P < .05). Multilevel mixed logistic regression revealed that gingival biotype was the parameter that was most related to MBL variations (P = .025). The PES value (mean ± SD) at T6 was 10.76 ± 1.19 (median: 11; range: 8 to 13; IQR: 10 to 12). The values statistically increased at T12 and T36, where the mean values were 11.76 ± 1.10 (median: 12; range: 9 to 13; IQR: 11 to 12) and 11.83 ± 1.03 (median: 12; range: 9 to 14; IQR: 11 to 13). CONCLUSION: MBL and soft tissue clinical parameters measured around two-piece hyperbolic-neck implants were stable during the 3-year follow-up and free from complications. The exposure of the hyperbolic neck for 1.0 to 1.5 mm allowed a flapless one-stage surgery, which supported fast adaptation of the soft tissues, evidenced by high PES values and low percentages of BOP. The results from the study imply a new simple approach in the clinical management of gingival and bone tissue.


Assuntos
Implantes Dentários para Um Único Dente , Implantação Dentária Endo-Óssea/efeitos adversos , Estética Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Método Simples-Cego
19.
J Craniomaxillofac Surg ; 48(10): 985-993, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32863126

RESUMO

PURPOSE: The aim of this prospective study was to address the anthropometric changes in the morphology of the lower eyelid and esthetic outcomes after performing subciliary, subtarsal, and transconjunctival approaches in patients with orbital and periorbital fractures. PATIENTS AND METHODS: A prospective randomized controlled clinical study was undertaken on patients with orbital floor and infraorbital rim fractures. These were equally divided into three groups: in group 1, the fractures were approached via a stepped subciliary approach; in group 2, they were approached via a subtarsal approach; in group 3, a retroseptal transconjunctival approach was performed. The patients were assessed for anthropometric changes in the morphology of the lower eyelid, esthetic outcomes, and postoperative lower eyelid complications (LLCs). A one-way ANOVA test was used to analyze differences between the operated and non-operated sides and the effect of the surgical approach on anthropometric measurements. RESULTS: A total of 45 patients were included in the study. All the surgical approaches provided adequate surgical exposure of the infraorbital rim and orbital floor. The subtarsal approach allowed rapid access to the field (10.5 ± 1.9 min). All incisions resulted in adequate postoperative esthetic outcomes. Anthropometric analysis revealed that there were no significant differences between the three approaches, except for measurements of the eye fissure index (EFI) and lower iris coverage (LIC). Mean EFI measurements increased on all operated sides. The subciliary approach showed the highest percentage of increased measurements of this variable (34.5 ± 4.6), followed by the subtarsal approach (32 ± 2.1), and then the transconjunctival approach (31.1 ± 3.7), with p = 0.046. Furthermore, the subciliary approach significantly decreased the measurements of LIC. This change was also bigger with the subciliary approach (1.09 ± 2.3) than with the subtarsal approach (2.1 ± 2.4) or transconjunctival approach (3.4 ± 2.6), with p = 0.048. CONCLUSION: Based on the results of this study, the subtarsal approach is a minimally invasive incision that provides an adequate and direct approach to orbital floor and infraorbital rim fractures, with a favorable periorbital architecture and the lowest incidence of LLCs. Therefore, the subtarsal technique should be preferred over subciliary and transconjunctival approaches.


Assuntos
Fraturas Orbitárias/cirurgia , Túnica Conjuntiva/cirurgia , Estética Dentária , Pálpebras/cirurgia , Humanos , Órbita/cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos
20.
Int J Oral Maxillofac Implants ; 35(5): 982-989, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32991649

RESUMO

PURPOSE: This investigation aimed to evaluate clinical, prosthetic, and patient-based outcomes of a milled bar with polyether ether ketone (PEEK) and metal housings for inclined implants supporting mandibular overdentures. MATERIALS AND METHODS: Eighteen edentulous participants received four implants in the interforaminal area of the mandible (two vertically and two distally inclined), and implants were connected with milled bars. Overdentures were attached to the bars with PEEK female housing (test group). The control group consisted of participants who received milled bar overdentures with conventional metal housings but were case matched to the test group and served as a historical cohort. Clinical parameters (Plaque Index, Gingival Index, pocket depth, and bone loss) were measured at baseline, 6 months, and 12 months. Patient satisfaction (using visual analog scale) and prosthetic complications were recorded after 12 months. RESULTS: The control group showed a significantly higher plaque score and marginal bone resorption compared with the test group. The test group showed higher satisfaction with retention, stability, speech, and esthetics compared with the control group (P < .048). The test group showed a significantly lower incidence of female housing wear (P = .017), plastic clip wear (P < .001), and plastic clip fracture/renewal (P = .049) than the control group. No difference between groups was noted for other clinical, prosthetic, and patient-based outcomes. CONCLUSION: PEEK housing of a milled bar may be a successful alternative to conventional metal housing for inclined implants supporting mandibular overdentures, as it is associated with favorable clinical, prosthetic, and patient-based outcomes after 1 year.


Assuntos
Implantes Dentários/efeitos adversos , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Estética Dentária , Éter , Éteres , Feminino , Humanos , Cetonas , Mandíbula/cirurgia , Metais
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