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1.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(1): 30-36, 2020 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-32037763

RESUMO

OBJECTIVE: This study aims to investigate the occlusal and myoelectric characteristics of implant-supported fixed denture in the mandibular region and provide reference for the design of fixed restoration. METHODS: Sixty edentulous patients with implant-supported fixed denture were selected and divided into three groups: group A, 20 cases with implant-supported fixed restoration in the maxillary region; group B, 20 cases with natural dentition, and group C, 20 cases with removable partial denture. The T-scan 8.0 digital occlusion analysis system was used to evaluate the occlusal characteristics of patients in the three groups at intercuspal, protrusion, and left and right lateral positions. Electromyography was used to analyze the myoelectric amplitude and bilateral asymmetry index of the anterior temporalis and masseter of the three groups in different states such as resting and clenching. The relationship between occlusion and myoelectricity was also investigated. RESULTS: In the occlusion analysis by T-scan, the occlusion time, the balance of left and right bite force, the left and right asymmetry of the occlusion center, the trajectory of central occlusion force, and the disclusion time were higher in group C than in groups A and B (P<0.05). No significant differences were observed in the anterior and posterior asymmetry of the occlusion center and percentage of bite force at anterior region among the three groups. In the analysis of myoelectricity, the myoelectric amplitude at resting state and the asymmetry index of masticatory muscles in group C were higher than those in groups A and B (P<0.05). The myoelectric amplitude during clenching in groups A and B groups was higher than that in group C (P<0.05). CONCLUSIONS: In implant-supported fixed restoration at edentulous mandibular, when maxillary includes the removable partial denture, degree of occlusal instability and left and right asymmetry of occlusion center are greater than those with the natural dentition and implant-supported fixed denture at maxillary. The myoelectricity is closely related to occlusion. The removable partial denture can increase the myoelectric activity and reduce the potential of the masticatory muscle. The asymmetry of bilateral myoelectricity is related to the occlusion imbalance.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Força de Mordida , Humanos , Mandíbula , Músculos da Mastigação
2.
Artigo em Inglês | MEDLINE | ID: mdl-32032414

RESUMO

The purpose of this study was to evaluate the effect of implant platform-switching design and abutment materials on the stress distribution around implants. Implants were fixed in epoxy-resin models restoring posterior missing first molars, representing two main groups according to the implant-abutment connection. Each group was subdivided according to the type of abutment material used (titanium or zirconia). Twenty monolithic fully anatomical zirconia crowns were fabricated. Stress analysis was measured around the implants using strain gauges during the static loading of each implant-supported crown. Data were collected, tabulated, and statistically analyzed. Standard implant-abutment connection groups recorded the highest (statistically significant; P < .05) mean strain values compared to platform-switching connection groups. Abutment materials in both groups recorded statistically nonsignificant (P > .05) mean strain values. The platform-switching concept showed better crestal-bone stress distribution around implant-supported restorations. Abutment materials expressed no statistically significant effect on the stress distribution around implant-supported restorations. Zirconia and titanium abutments could withstand the functional loads developed during physiologic chewing in the molar area.


Assuntos
Dente Suporte , Projeto do Implante Dentário-Pivô , Coroas , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Teste de Materiais , Titânio , Zircônio
3.
Quintessence Int ; 51(3): 230-237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32020133

RESUMO

OBJECTIVES: Severe atrophied edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal may require transposition of the inferior alveolar nerve in order to insert dental implants. Mandibular fractures are considered a rare complication of this procedure. Implant-related spontaneous fractures of the mandible represent 0.2% of patients with inserted implants in an edentulous mandible. This report presents two cases of mandibular fractures that occurred 3 to 4 weeks after inferior alveolar nerve transposition, and were managed successfully by conservative nonsurgical treatments. METHOD AND MATERIALS: Overall, 132 procedures of inferior alveolar nerve transposition in 98 patients were performed over a period of 10 years with 379 dental implants inserted in one stage with the procedure. Patients were examined every 2 weeks. The inferior alveolar nerve function was evaluated with various sensory tests. Panoramic radiographs were obtained immediately, at 3 months, and at 1 year after the surgery. The patients received implant-supported fixed prostheses after 3 to 5 months. RESULTS: The healing process was uneventful in 96 patients; however, in two patients (1.5%) spontaneous fracture of the treated site was observed 3 and 4 weeks postoperatively. The fractures lines occurred at a failed implant site. Both cases were treated conservatively. CONCLUSIONS: Spontaneous fractures following inferior alveolar nerve transposition are an important but rare complication. Conservative treatment modalities might be useful and indicated in some of those cases.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Fraturas Espontâneas , Fraturas Mandibulares , Tratamento Conservador , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Humanos , Mandíbula , Nervo Mandibular
4.
Compend Contin Educ Dent ; 41(1): 34-41, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895581

RESUMO

Dental implants are often a preferred option when replacing missing teeth. In the esthetic zone, however, a proper soft-tissue framework is essential to accommodate the final restorations. A wax-up and subsequent esthetic provisional prototype are key components for planning prior to implant placement and performing any grafting procedures that may be needed. This case report describes a combination treatment approach that incorporates orthodontics, implant placement, and restorative dentistry to achieve the maximum esthetic potential the patient desired. The article outlines proper diagnosis, treatment planning, and sequencing.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Estética Dentária , Humanos , Sorriso
5.
J Prosthet Dent ; 123(2): 290.e1-290.e8, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31902534

RESUMO

STATEMENT OF PROBLEM: The adhesion properties of modified cement-retained implant prostheses have not been elucidated. PURPOSE: The purpose of this in vitro study was to compare the adhesion strength and the flow conditions of the adhesives of 3 common modified cement-retained methods (MCRMs). MATERIAL AND METHODS: Four cement-retained methods were used: an occlusal hole for screw access (OH), a lingual hole for releasing the excess adhesive (LH), a resin replica for the titanium abutment (RR), and a control group (no holes and no resin trial abutments). Eight zirconia prostheses in each group were processed and cemented. The adhesion strength was examined by mechanical tensile experiments (MTE) in vitro. One-way ANOVA and the LSD post hoc tests were used to compare the results of the MTE (α=.05). The flow conditions of adhesives in the adhesion process were analyzed by computational fluid dynamics (CFD). CFD-Post 16.0 (ANSYS, Inc) was used to analyze the results of the CFD analyses. RESULTS: The adhesion strength of each group was 289.3 ±37.7 N in the LH group, 281.3 ±50.1 N in the OH group, 263.3 ±49.3 N in the RR group, and 239.2 ±29.4 N in the control group. A statistically significant difference is seen in the adhesion strength between the LH group and the control group (P=.025). The internal filling ratio of adhesives between the groups ranges from high to low in the order the LH group, the OH group, the RR group, and the control group. The amount of cervical overflow of adhesives between the groups ranges from less to more in the order the RR group, the OH group, the LH group, and the control group. CONCLUSIONS: MCRMs can effectively reduce the amount of cervical overflow of adhesives and improve the filling condition of the adhesive and its clearance to ensure the adhesion strength of the prostheses.


Assuntos
Dente Suporte , Implantes Dentários , Cimentos Dentários , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Hidrodinâmica , Teste de Materiais , Resistência à Tração
6.
Quintessence Int ; 51(2): 118-126, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942573

RESUMO

OBJECTIVE: Marginal bone loss (MBL), a prognostic parameter for implant success, is associated with implant- and patient-related variables. The purpose of this study was to analyze the effects of the crown-to-implant ratio and independent factors of implant diameter, implant length, implant type, location, and platform switching on distal and mesial MBLs at the 6-, 12-, 24-, and 36-month recall sessions of single crown implant-supported restorations. METHOD AND MATERIALS: Radiographic and clinical data of patients treated with single crown implants were collected. MBL was measured at the baseline and recall sessions on panoramic radiographs. The crown-to-implant ratio was calculated by dividing the length of the crown by that of the dental implant. RESULTS: The crown-to-implant ratio had a moderately positive correlation with distal MBL at the 6-month recall session (P < .05, r = 0.469) and a weakly positive correlation at the 12- (P < .05, r = 0.220), 24- (P < .05, r = 0.214), and 36- (P < .05, r = 0.250) month recall sessions. Distal and mesial MBL did not significantly differ among the four implant types at any recall session (P > .05). The crown-to-implant ratio had no significant correlation with mesial MBL at the 12-, 24-, or 36-month recall session (P > .05), and a moderately positive correlation at the 6-month recall session (P < .001, r = 0.434). CONCLUSIONS: MBL was similar among different implant types in the short and medium terms. There was a positive correlation between distal MBL and the crown-to-implant ratio.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Coroas , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Estudos Retrospectivos
7.
Quintessence Int ; 51(2): 128-141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942574

RESUMO

OBJECTIVES: The aim of this study was to determine the influence of patient-related systemic factors, local bone and intraoral factors, and implant-related factors on peri-implant marginal bone loss (MBL). METHOD AND MATERIALS: The following data were collected from patients who received dental implants and were recalled for examinations at least 3 years after treatment completion: medical history, age, sex, habits, periodontal health, implant size and surface, surgical procedure, prosthesis type, implant failure, Plaque Index, and oral hygiene. MBL was investigated using both baseline and follow-up panoramic radiographs. RESULTS: The study included 1,126 dental implants placed in 304 patients (185 [60.9%] women and 119 [39.1%] men). The mean age was 54.30 ± 13.52 years (range 22 to 83 years). The mean follow-up period was 58.8 ± 11.2 months. The MBL was observed in 271 (24.1%) implants, of which 160 (14.2%) were ≤ 2 mm and 111 (9.9%) were > 2 mm. Respective mean MBL values on mesial and distal sides were 0.42 ± 1.03 mm and 0.42 ± 1.02 mm. Of the implants, 19 (1.7%) were lost, leading to an implant success rate of 98.3%. Age, history of hysterectomy, history of periodontitis, oral hygiene, abrasions, smoking, implant location, implant surface, implant length, surgical procedure type, and prosthesis type were all found to be statistically significant for MBL (P < .05). Certain combinations of these factors resulted in increased MBL. CONCLUSION: In the present study, local factors had more significant effects on MBL than did systemic factors, and combinations of these factors had greater effects on MBL.


Assuntos
Perda do Osso Alveolar , Doenças Ósseas Metabólicas , Implantes Dentários , Adulto , Idoso , Idoso de 80 Anos ou mais , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Panorâmica , Estudos Retrospectivos , Adulto Jovem
8.
Quintessence Int ; 51(2): 170-177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942577

RESUMO

OBJECTIVE: Some patients with Down syndrome experience premature edentulism, which can lead to severe alveolar atrophy. This may cause retention problems with purely mucosa-supported dentures and ill-fitting total dentures. The intellectual disability associated with Down syndrome, with an (implied) inadequate ability for compliance, may pose a further challenge to dental treatment. The aim of this case report was to demonstrate that a combined implant-prosthetic denture with bar constructions can, nevertheless, be implemented in elderly Down syndrome patients with limited cooperation ability. METHOD AND MATERIALS: This report is the first to describe the procedure for an implant-supported total prosthetic restoration with bar joint in a 52-year-old edentulous patient with Down syndrome and limited ability to cooperate. Previous dental solutions had severely curtailed the patient's quality of life. By combining various forms of treatment, including behavior management, the course of therapy could be adapted to the patient's cooperation capability. RESULTS: The implant-supported total prosthetic restoration with bar joint was well accepted by the patient. Moreover, the patient's relatives reported that his life quality had improved distinctly (eg, considerable weight-gain, more positive mood). No impairments of the prostheses were observed during the 24-month follow-up period, and both implants remained clinically inconspicuous. CONCLUSION: The lack, or inadequacy, of dental prostheses can impair the life quality of individuals in need of such restorations. Implant-supported dentures in combination with a bar construction improve the retention of prostheses in atrophied jaws. This form of restoration is also proving to be a successful therapy option for elderly persons with Down syndrome.


Assuntos
Implantes Dentários , Síndrome de Down , Arcada Edêntula , Idoso , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Revestimento de Dentadura , Seguimentos , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento
9.
Int J Oral Maxillofac Implants ; 35(1): 100-106, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923292

RESUMO

PURPOSE: To test a novel implant metal-acrylic prosthesis design in comparison to a conventional prosthesis design through simulation of cyclic masticatory loading. The novel design involved digital designing and fabrication of the framework and the matched veneering acrylic resin material. MATERIALS AND METHODS: Ten prostheses were fabricated for each group. All the prostheses exhibited a similar external design on two implants with a distal cantilever. The conventional group comprised a milled metal framework with mechanically retained acrylic denture teeth via vertical pins. The digital prosthesis group incorporated an inverted T-shape bar and a monolithic milled acrylic resin veneer. The resin veneer was subsequently adhesively attached on the bar. All prostheses were thermally aged and subjected to laboratory cyclic loading at the cantilever region. The load-to-failure and the number of cycles until failure were collected. Furthermore, failed specimens were analyzed to determine the mode of failure. RESULTS: The digital prostheses failed at significantly greater load-to-failure (1,570.0 N ± 116.0 N) and number of cycles (124,857 ± 21,608) than the conventional prostheses (load-to-failure = 1,015.0 N ± 47.4 N; number of cycles = 28,452 ± 6,559). The conventional prostheses failed by fracturing of the acrylic teeth and veneering material that led to exposure of the metal framework. Half of the digital prostheses failed by superficial chipping of the veneering material, while the other half failed by the deformation and fracture of screws. CONCLUSION: Within the limitations of this study, the digital prostheses with the novel design and monolithic veneering material showed significantly higher strength compared with the conventional prostheses. The mode of acrylic failure of the digital prostheses was more favorable.


Assuntos
Prótese Dentária Fixada por Implante , Facetas Dentárias , Resinas Acrílicas , Falha de Restauração Dentária , Teste de Materiais , Metais
10.
Int J Oral Maxillofac Implants ; 35(1): 121-129, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923295

RESUMO

PURPOSE: This study aimed to biomechanically evaluate the effects of cantilever length and implant inclination on the stress distribution of mandibular prosthetic restorations constructed from monolithic zirconia ceramic. MATERIALS AND METHODS: Mandibular full-arch prostheses supported by four implants constructed from monolithic zirconia were designed using either a 5-mm or 9-mm cantilever length and a 15-degree or 30-degree distal tilt for the posterior implants. A simulated static load of 600 N was applied from the right side at a 45-degree angle. Von Mises and principal stress values in superstructures were analyzed using the Mesh VR Studio program. RESULTS: When the effects of cantilever length were examined, in the models with the 15-degree implant tilt, stress values for posterior implants, porcelain, and cortical bone were lower when the cantilever length was shorter (5 mm). In the models with the 30-degree implant tilt, stress values in all implants (except for the anterior implant on the right) and in the porcelain superstructure were lower when the cantilever length was shorter; however, stress values for cortical and spongious bone were lower with the longer (9 mm) cantilever. When the effects of implant inclination were examined, in the models with a 5-mm cantilever, stress values for posterior implants and cortical bone were lower when the implant tilt was more severe (30 degrees). In the models with a 9-mm cantilever length, stress values for the right anterior implant, posterior implants, and cortical bone were lower when the implant tilt was less severe (15 degrees). CONCLUSION: Cantilever length and posterior implant inclination affected the distribution of force. Increasing the cantilever length led to a reduction in stress values in distally tilted posterior implants. Moreover, increasing the distal inclination led to a reduction in stress values in both the distally tilted posterior implants and cortical bone tissue in the model with a short cantilever. The monolithic zirconia full-arch porcelain superstructure was not affected by implant angulation, but was affected by cantilever length, with lower stress values observed with a longer cantilever.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Cerâmica , Análise do Estresse Dentário , Análise de Elementos Finitos , Estresse Mecânico , Zircônio
11.
Int J Oral Maxillofac Implants ; 35(1): 150-159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923298

RESUMO

PURPOSE: To clinically evaluate a recently developed, standardized, three-implant-supported full-arch treatment concept for fully edentulous mandibles. MATERIALS AND METHODS: This ongoing multinational prospective cohort study is evaluating the performance of the treatment concept over 5 years in patients who were fully edentulous or had failing dentition of the mandible. The primary outcome was the cumulative survival rate of implants (CSRI). Secondary outcomes included the cumulative survival rate of the prostheses (CSRP), marginal bone level change, soft tissue outcomes, impact on quality of life, and patient and clinician satisfaction. The 1-year report is presented here. RESULTS: In total, 110 patients (330 implants) were included. Prostheses underwent immediate loading in 76.4% of cases and early loading in 23.6% of cases. The mean surgical time was 1.60 ± 0.78 hours, and the mean laboratory time was 3.99 ± 1.74 hours. At 1 year, eight implants and three prostheses failed, yielding an implant-level CSRI of 97.5% and a CSRP of 97.3%. All prosthetic failures were due to loss of two implants in the patient. The mean marginal bone level change at 1 year was -0.62 ± 1.39 mm. Among soft tissue outcomes, the Bleeding Index improved significantly between the 6-month and 1-year follow-up, and 242 implants (75%) were surrounded by keratinized mucosa by the 6-month follow-up. Patients reported a significant improvement in quality of life between prosthesis placement and the 6-month follow-up based on the Oral Health Impact Profile for Edentulous 21 questionnaire. Both patient and clinician satisfaction with function and esthetics were high throughout treatment. CONCLUSION: This novel treatment concept using a passively fitting standardized framework with simplified surgical and prosthetic workflow demonstrated high survival and excellent outcomes at 1 year while reducing chair and fabrication time. This concept may offer patients a safe and efficient option for full-arch mandibular prostheses.


Assuntos
Implantes Dentários , Arcada Edêntula , Mandíbula , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Estética Dentária , Seguimentos , Humanos , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
12.
Int J Oral Maxillofac Implants ; 35(1): 178-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923300

RESUMO

PURPOSE: The aim of this investigation was to compare the chewing efficiency after immediate and delayed loading of mini-implants that served as supplementary support for removable partial dentures (RPDs). MATERIALS AND METHODS: In this four-center randomized trial, patients who had RPDs in arches with unfavorable tooth distributions, ie, no canine and at most two posterior teeth in one or both quadrants, received strategic mini-implants with ball abutments. The mini-implants in group A were loaded immediately either by housings with O-rings (insertion torque ≥ 35 Ncm) or by soft relining material (insertion torque < 35 Ncm). In group B, the RPDs were only hollowed over the balls. After 4 months, the soft relined RPDs and all RPDs of group B received the housings. Masticatory efficiency was evaluated with a validated mixing ability test of two-colored chewing gum before surgery and 14 days, 4 months (before housing pickup), 4.5 months, and 12 months after surgery. The circular variance of hue was the measure of mixing. RESULTS: From 76 participants with 79 RPDs, 38 each were randomly allocated to group A or B. In group A, the housings in six participants were picked up immediately, and the remaining RPDs were primarily soft relined. There was a significant group difference only after 4 months. The mixing ability was better after immediate loading than after delayed loading (P < .0001). In group B, the chewing efficiency was notably deteriorated after the RPDs were hollowed over the ball abutments. However, immediately after all housings were picked up, the chewing efficiency in both groups was substantially improved, and the variance of hue values after 1 year were very similar in the groups. CONCLUSION: The chewing performance can be improved by inserting supplementary mini-implants under existing RPDs with unfavorable tooth support. This improvement occurred faster by immediate loading than by delayed loading.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Prótese Parcial Removível , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mastigação
13.
Int J Oral Maxillofac Implants ; 35(1): 207-213, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923304

RESUMO

PURPOSE: To prospectively evaluate the survival at 1 and 4 years of short implants retaining removable partial dentures (RPDs) in Kennedy Class I and II edentulism. MATERIALS AND METHODS: Twenty patients (Kennedy Class I and II) rehabilitated with RPDs were selected for the insertion of one short implant in the distal edentulous ridge, connected to the RPD with a Locator attachment after osseointegration. The following data were recorded at the 1- and 4-year follow-up: bone loss, bleeding on probing (BOP), probing depth (PD), implant mobility, and survival. RESULTS: Thirty-five implants were placed from September 2012 to April 2014. At the 4-year follow-up, 12 implants showed BOP, and for PD, 15 implants showed 2 mm, 16 implants showed 3 mm, and 2 implants showed 4 mm. One implant showed mobility, and two were lost (survival rate: 94.3%; 95% CI: 80.84 to 99.30). The mean bone loss was 1.04 ± 1.88 mm. CONCLUSION: Within the limitations of this study, the implant survival rate and the mean bone loss values reported are comparable with those reported by other authors. The use of short implants for retaining RPDs may be considered a viable treatment option for patients with distal edentulism and contraindications for more complex implant rehabilitation.


Assuntos
Implantes Dentários , Prótese Parcial Removível , Prótese Dentária Fixada por Implante , Seguimentos , Humanos
14.
J Oral Sci ; 62(1): 98-102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996534

RESUMO

This study evaluated marginal bone loss and prosthetic complications associated with single implant-retained mandibular overdentures (1-IODs) with locator attachments. The 1-IOD was placed in the mandibular midline by using a conventional loading protocol in 22 patients with an edentulous mandible. Marginal bone loss at the start of loading and 12 months postoperatively was assessed by radiographic and crestal bone evaluation. The crestal bone was defined as the distance between the customized abutment shoulder and the top of the bone, as indicated by probing. In addition, implant stability quotient and prosthetic complications were recorded. The cumulative implant survival rate was 95.5%. Median implant stability quotient remained greater than 80, and median radiographic bone loss was 0.56 mm. Crestal measurement showed a median crestal bone loss of 0.16, 0.43, 0.39, and 0.52 mm on the buccal, right, lingual, and left sides, respectively. Both radiographic and crestal bone loss values significantly differed between the start of implant loading and 12 months postoperatively (except on the buccal and lingual sides; P < 0.05). The need to replace the nylon insert was the most common complication. Conventional loading of a 1-IOD with a locator attachment resulted in a high survival rate, good implant stability, and acceptable marginal bone loss.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Humanos , Mandíbula
15.
J Prosthodont ; 29(1): 3-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31650669

RESUMO

PURPOSE: To report the rate of technical complications and prosthesis survival in a cohort of edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of at least 1 year. MATERIALS AND METHODS: The single-visit examination included clinical and radiographic assessment, occlusal analysis, photographs and questionnaire assessing patient satisfaction in a cohort of 52 patients rehabilitated with 71 IFCDPs (supported by 457 implants). The IFCDPs were assessed for technical complications, number of implants and cantilever extension, retention type and prosthetic material type. Comparison was made between ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Kaplan-Meier survival curve analysis was carried out for assessment of prosthesis survival and was done for both Groups 1 and 2 separately. The Cox proportional hazard model was used for survival analysis, adjusting for a number of potential confounders, to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. Responses to patient satisfaction questions were compared with Fisher's exact test. RESULTS: Out of 71 edentulous arches (52 patients) restored with IFCDPs, 6 IFCDPs had failed, yielding a cumulative prosthesis survival rate of 91.6 % after a mean observation period of 5.2 years (range: 1-12 years) after definitive prosthesis insertion. Three IFCDPs were lost due to implant failures after 5.8 to 11 years of functional loading. Additionally, 3 metal-resin IFCDPs failed due to technical complications. Minor complications were the most frequent complications observed, namely wear of the prosthetic material (9.8% annual rate) being the most common, followed by decementation of cement-retained IFCDPs (2.9%), and loss of the screw access filing material of the screw-retained IFCDPs (2.7%). The most frequently observed major complication was fracture of the prosthetic material (1.9% annual rate), followed by fracture of occlusal screw (0.3%), and fracture of framework (0.3%). The annual rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (n = 19/55) and 19.4% for metal-resin IFCDPs (n = 13/16), yielding a statistically significant difference between the 2 groups (p = 0.01). CONCLUSIONS: After a mean exposure time of 5.2 years, 91.6% prosthesis survival rates were achieved (65 out of 71 IFCDPs). The most frequent minor technical complication was wear of the prosthetic material with estimated 5-year rate of 49.0%, while the most frequent major complication was fracture of the prosthetic material with estimated 5-year dental unit-based rate of 9.5%. The cumulative rates for "prosthesis free of minor complications" at 5- and 10-years were 60.5% (95% CI: 47.2-71.3%) and 8.9% (95% CI: 2.9-18.0%), respectively. The cumulative rates for "prosthesis free of major technical complications" at 5- and 10-years were 85.5% (95% CI: 73.0-92.5%) and 30.1% (95% CI: 12.0-50.6%), respectively. Presence of bruxism, and absence of a nightguard were associated with increased risk for chipping of the prosthetic material of the IFCDPs.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Seguimentos , Humanos , Falha de Prótese , Estudos Retrospectivos
16.
J Oral Rehabil ; 47(2): 229-234, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31452211

RESUMO

OBJECTIVES: To compare the patient-reported effect of treatment with implant-supported fixed prosthesis (ISFP) and fixed dental prosthesis (FDP) in patients with a small number of tooth losses to replace. METHODS: From a population of 155 patients receiving either ISFP or FDP, 68 patients were matched in pairs based on gender, number of teeth replaced, zone of replacement, age and number of remaining teeth. The patient-reported effect was prospectively obtained by measuring change in the short-form oral health impact (OHIP-14) from before to one month after treatment. Effect size (ES), standardised response mean (SRM) and a minimal important difference of two units were applied to estimate the magnitude of the change. RESULTS: Both the ISFP and FDP groups decreased significantly in OHIP-14 after treatment (P < .01). The change was not significantly different between the ISFP and FDP groups. The magnitude of the change was for both treatments moderate and slightly higher in the ISFP group (ES = 0.52 and SRM = 0.58) than in the FDP group (ES = 0.48 and SRM = 0.47). Applying the minimal important difference showed that 23 participants in the ISFP group and 21 in the FDP group had good effect. CONCLUSIONS: The patient-reported effect of treatment with ISFP or FDP was similar, clinically meaningful and of moderate magnitude in patients with a small number tooth losses to replace.


Assuntos
Implantes Dentários , Perda de Dente , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Prótese Parcial Fixa , Humanos , Saúde Bucal , Medidas de Resultados Relatados pelo Paciente
17.
Clin Oral Implants Res ; 31(1): 64-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605405

RESUMO

OBJECTIVE: The aim of this multicenter parallel-group randomized controlled trial is to compare 6-mm-short with 11-mm-long implants in the rehabilitation of totally edentulous mandible in a completely comparable clinical situation, from anatomical, surgical, and prosthetic point of view. MATERIAL AND METHODS: Thirty patients were selected in three study centers to receive a fixed full-arch mandibular rehabilitation supported by five inter-foraminal implants. Patients were randomly allocated, at the time of surgery, half to the test group (6-mm-long implants) and half to the control group (11-mm-long implants). No bone augmentation procedure was performed. After 3 months, a screw-retained full-arch prosthesis with distal cantilevers was positioned (baseline). Peri-implant marginal bone level change (MBLc), implant and prosthesis survival rate, and biological/technical complications were evaluated after 1 and 3 years. RESULTS: Thirty subjects (150 implants) were evaluated after 1 year and 28 (140 implants) after 3 years. No implant or prosthesis loss occurred. No significant inter-group difference for biological/technical complications was registered. No statistically significant (p > .025) intra-group or inter-group difference in the mean MBLc values was registered. The mean MBLc was 0.01 ± 0.19 mm and -0.04 ± 0.21 mm at 1 year, and -0.10 ± 0.24 mm and 0.02 ± 0.25 mm at 3 years (test and control groups, respectively). CONCLUSIONS: 6-mm-short implants may be a reliable option when used in the rehabilitation of total edentulous mandibles. These results need to be confirmed by longer follow-up data from well-designed randomized controlled clinical trials.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Edêntula , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mandíbula , Resultado do Tratamento
18.
J Prosthet Dent ; 123(1): 79-84, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31079880

RESUMO

STATEMENT OF PROBLEM: Osseointegrated implants can be prone to occlusal overloading because of the absence of the periodontal ligament and limited tactile sensitivity. However, current scientific evidence of the occlusion variation of implant-supported fixed prostheses is lacking. PURPOSE: The purpose of this clinical study was to analyze changes in occlusal force distribution and occlusal contact in single posterior partial fixed implant-supported prostheses over time. MATERIAL AND METHODS: Partially edentulous patients who had received implant-supported single crowns in the posterior region between December 2012 and December 2013 were enrolled. The participants underwent occlusal examinations by using the T-Scan III system at 0.5, 3, 6, 12, 24, and 36 months after implant prosthesis delivery. The relative occlusal forces (ROFs) of implant prostheses, mesial adjacent teeth, and control natural teeth were recorded, and implant prosthesis occlusion time ratios were calculated. The paired t test was used to compare the implant prosthesis occlusion time ratios and ROFs of implant prostheses at 2 different times as a self-control. The differences in ROFs between implant prostheses and control teeth in the same participant at the same time were also analyzed by using a paired t test. The Pearson correlation coefficient was used to analyze the statistical correlation between implant prosthesis occlusal force and the implant prosthesis occlusion time ratio (α=.05). RESULTS: Thirty-seven posterior partial fixed implant-supported prostheses in 33 participants (18 women and 15 men aged 23.9 to 70 years) were followed up for 3 to 36 months (mean: 31.4 months). The ROFs of implant prostheses increased significantly (P<.05) from 2 weeks (7.46 ±4.21%) to 3 months (9.87 ±6.79%), whereas those of control natural teeth decreased significantly (P<.05) from 13.78 ±6.00% to 11.43 ±5.47%. The ROFs of implant prostheses continued to increase from 6 to 12 months and from 12 to 24 months, with significant differences (P<.05). However, they were statistically similar to those of control natural teeth at 6, 12, 24, and 36 months after restoration. Implant prosthesis occlusion time ratios also increased significantly between 2 weeks and 3 months and between 3 and 6 months (P<.05). No significant differences were found between the other time points (P>.05). CONCLUSIONS: The occlusal force and occlusal contact time of implant prostheses changed significantly with time.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Adulto , Idoso , Coroas , Oclusão Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
19.
J Prosthet Dent ; 123(1): 45-49, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31079888

RESUMO

With the transition to digital workflows, moving from a digital platform to an articulator for laboratory procedures such as adding porcelain or luting titanium abutments is sometimes required. This report describes a technique to facilitate the transfer of jaw-relation records to a digital mounting template. Once digitally mounted, the casts can be printed with mounting plates attached to the temporomandibular joints in the appropriate orientation. They can then be placed in an articulator and used for layering porcelain or luting titanium abutments for screw-retained restorations.


Assuntos
Prótese Dentária Fixada por Implante , Fluxo de Trabalho , Projeto Auxiliado por Computador , Porcelana Dentária , Registro da Relação Maxilomandibular
20.
J Prosthet Dent ; 123(1): 38-41, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31153611

RESUMO

The advancements in computer-aided design and computer-aided manufacturing (CAD-CAM) serve to facilitate the management of clinical challenges in restorative dentistry. This technique article describes the fabrication of implant-supported restorations by using a completely digital workflow to manage a patient with severely tilted implants.


Assuntos
Implantes Dentários , Planejamento de Prótese Dentária , Projeto Auxiliado por Computador , Prótese Dentária Fixada por Implante , Humanos , Fluxo de Trabalho
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