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1.
Artigo em Inglês | MEDLINE | ID: mdl-32032413

RESUMO

This investigation has been stimulated by the Osseointegration Foundation, working in conjunction with the Zest Anchors implant company. There are three basic valuable activities that emerge from a professional foundation, which were reflected in this case study. They include disseminating information to practitioners, to persuade young clinicians to become research investigators, and to reach out to patients in need of treatment who cannot afford it without a charitable opportunity.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Instituições de Caridade , Prótese Dentária Fixada por Implante , Humanos , Osseointegração
2.
Int J Prosthodont ; 33(2): 169-175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069341

RESUMO

PURPOSE: To investigate the long-term (up to 20 years) outcomes of customized post copings (PC) and to evaluate potential factors influencing the risk for complications. MATERIALS AND METHODS: Patients treated with PC-retained overdenture prostheses (OD) in a university setting were selected. Data collected included dental and periodontal parameters, periapical radiographs, and assessment of the OD design. Patient-reported satisfaction levels were evaluated using visual analog scales (VAS), and 20-year cumulative survival and success rates were calculated. RESULTS: A total of 73 patients with 81 ODs and 152 PCs were included. PC survival rate was 80.9%, and the success rate amounted to 64.5% after a mean observation period of 105.4 (± 67.9; range: 6 to 240) months. The 20-year cumulative PC rates were 91.5% for survival and 79.3% for success. Activation of matrices was more frequent with ball attachments than with cylindrical retention (odds ratio [OR] 0.43; 95% confidence interval [CI] 0.2 to 0.94; P = .034). Cylindrical retention was rated significantly better at 96% (interquartile range [IQR] 89.5% to 100%) compared to ball attachment at 88% (IQR 79% to 98.2%; P = .012). The risk for PC complications was higher for OD designs with coverage of the periodontal tissues compared to open designs (OR 0.34; 95% CI 0.15 to 0.78; P = .010). CONCLUSION: Customized PCs on natural abutment teeth for the retention of ODs are a valid treatment in partially dentate patients. Correct prosthesis design and integration into a regular dental hygiene program are mandatory factors for long-term success.


Assuntos
Implantes Dentários , Boca Edêntula , Adaptação Psicológica , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Seguimentos , Humanos
3.
Int J Prosthodont ; 33(2): 184-191, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069343

RESUMO

PURPOSE: To analyze the current evidence on bone loss in the posterior edentulous mandible restored with complete dentures (CDs), two-implant-supported overdentures (2-IODs), or four-implant-supported overdentures (4-IODs). MATERIALS AND METHODS: A search was conducted in the Ovid MEDLINE, Embase, Web of Science, CINAHL, and Cochrane databases for clinical studies comparing bone loss in posterior edentulous mandibles restored with CDs, 2-IODs, or 4-IODs. A meta-analysis was performed using statistical software to estimate the mean differences in bone loss with 95% CI. The level of significance was set at P < .05. RESULTS: The search strategy identified 2,806 articles, of which 14 met the inclusion criteria. The meta-analysis included 7 two-arm studies comparing CDs vs 2-IODs or 2-IODs vs 4-IODs. No statistically significant difference was found in bone loss between 2-IODs and CDs (mean difference -0.25 [95% CI -0.85 to 0.36]; P = .43), whereas bone loss was significantly lower with 4-IODs than with 2-IODs (mean difference -0.96 [95% CI -1.86 to -0.06]; P = .04). Overall, the data were highly heterogenous (I2 > 74%). CONCLUSION: 4-IODs can benefit the patient by decreasing bone loss in the posterior edentulous mandible. However, 2-IODs may not be superior to CDs in reducing bone loss in the posterior mandible. A validation of these results is needed through well-designed RCTs.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Prótese Total , Humanos , Mandíbula
4.
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
5.
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
6.
J Prosthet Dent ; 123(1): 6-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31113663

RESUMO

The functionality of a new overdenture attachment (LOCATOR R-Tx) was described for different clinical situations: a conventional mandibular implant overdenture (IOD) retained by 2 implants, a straightforward chairside maintenance procedure for replacing a worn LOCATOR (Legacy) attachment with the new LOCATOR R-Tx, and a complex clinical situation with nonideal implant positions with compromised parallelism. The LOCATOR R-Tx is an advance on the existing LOCATOR Legacy attachment and has an improved abutment head design with a more durable surface coating to prevent attachment wear and thereby reduce frequency of maintenance.


Assuntos
Retenção de Dentadura , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Mandíbula
7.
J Prosthodont ; 29(1): 74-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28913855

RESUMO

PURPOSE: Limited information is currently available relative to the effect of masticatory loads on the retentive properties of Locator attachments. The aims of this in vitro study were to assess and compare the effect of simulated mastication on the retention of white, pink, and blue Locator inserts for overdentures retained by 2 implants. MATERIALS AND METHODS: Thirty specimens simulating a nonanatomic edentulous flat ridge with two implants and an overdenture were divided into 3 groups according to the color of the fitted insert: transparent clear group (n = 10), pink group (n = 10), and blue group (n = 10). Retention forces were measured in an axial direction initially and after 100,000 cycles of simulated masticatory loads. One-way ANOVA followed by Tukey's post hoc tests were used to compare retention values and percentage retention loss between the 3 groups with significance set at p = 0.05. RESULTS: The 3 groups presented significant differences in retention at baseline (9.95 ± 1.91 N, 15.43 ± 4.08 N, and 41.73 ± 9.29 N for the blue, pink, and clear groups, respectively) and after simulated mastication (6.37 ± 2.64 N, 14.00 ± 3.89 N, 38.20 ± 5.11 N for the blue, pink, and clear groups, respectively). Within the same group, cyclic loading did not significantly affect retention in the clear and pink groups, while the blue inserts showed a significant retention loss (-37%) after loading. CONCLUSIONS: The results suggest that short-term simulated mastication affects the extra-light blue inserts but not the more-retentive inserts.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Mastigação , Projetos Piloto
8.
Indian J Dent Res ; 30(5): 716-721, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31854362

RESUMO

Aim: This study was conducted aiming to optimize the selection of bar material that can minimize stresses on mandibular bone. Subjects and Methods: One finite-element model was created under ANSYS environment to evaluate the use of different materials as a bar-manufacturing material in mandibular implant-supported overdenture (OD). Model components were created on engineering computer-aided design software and then assembled under the finite-element package. A force of 200 N was unilaterally and vertically applied on the left second premolar area. Results: Within these study conditions, the polyether ether ketone bar produced the lowest Von Mises stress on OD and the maximum value of deformation. Stainless steel bar produced the maximum OD total deformation. Conclusions: Cortical and spongy bones are not sensitive to the bar material. Increasing bar material stiffness increases Von Mises stresses in the bar itself and reduces its total deformation, in what is called overconstrained system.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Análise de Elementos Finitos , Mandíbula , Estresse Mecânico
9.
Indian J Dent Res ; 30(5): 810-815, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31854380

RESUMO

In elderly patients with few remaining teeth, overdenture is a good treatment option. Roots beneath the denture protect the alveolar ridge, offer proprioception and improve retention, stability and masticatory efficiency of dentures. Customization of attachments available is a viable alternative for some patients in which prefabricated attachments cannot be placed or in which cost is a factor; to improve the final outcome of the treatment. Due to competitive commercialization, implant treatment has become the norm in current dentistry and the concept of tooth supported overdentures has eclipsed, but with proper case selection, thorough treatment planning and modifications in the denture such as customization of attachments, amalgam stops, cross-linked teeth, and metallic mesh can be applied to prolong the longevity and success of the attachment overdenture prosthesis.


Assuntos
Revestimento de Dentadura , Dente , Idoso , Processo Alveolar , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Humanos
10.
Int J Oral Maxillofac Implants ; 34(6): 1466-1474, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31711087

RESUMO

PURPOSE: To investigate the influence of age and time since edentulism on masticatory function and quality of life related to oral health (OHRQoL) in totally edentulous patients after implant-retained mandibular overdenture (IMO) loading. MATERIALS AND METHODS: The sample consisted of 33 patients categorized in two age groups (≤ 65 and > 65 years, respectively), and two time since edentulism groups (< 25 and ≥ 25 years). The masticatory function was evaluated through the masticatory performance and swallowing threshold tests before IMO loading, and 1, 3, 6, and 12 months after IMO loading. The OHRQoL was evaluated by applying the Oral Health Impact Profile (OHIP-EDENT) and Geriatric Oral Health Assessment Index (GOHAI) questionnaires, before loading and after 3, 6, and 12 months. Data were subjected to the Mann-Whitney test and Wilcoxon signed-rank test for paired samples. RESULTS: The masticatory performance and swallowing threshold were not influenced by the age nor by time since edentulism, except 6 months after IMO loading when patients ≤ 65 years of age performed the swallowing threshold test in a significantly shorter time with a reduced number of masticatory cycles (P < .05). The masticatory performance and swallowing threshold outcomes showed a gradual improvement up to 12 months, irrespective of the patient categorization. The GOHAI questionnaire scores showed that the OHRQoL was influenced by age in complete denture wearers with a difference between groups in the psychosocial and global domains. The time since edentulism was not affected by the GOHAI scores of complete denture wearers (P < .05). The OHIP-EDENT questionnaire only indicated significant differences as a function of age or time since edentulism between complete denture wearers. Age was associated with significant differences in the physical pain domain outcome, while time since edentulism did not affect only the psychologic discomfort, psychologic inability, and handicap domains. CONCLUSION: Neither the age nor the time since edentulism influenced the masticatory function of IMO-wearing patients. However, IMO significantly improved the masticatory function in totally edentulous patients, and this is more evident for younger patients (≤ 65 years) with a shorter time since mandibular edentulism (< 25 years). The OHRQoL is only influenced by age and time since edentulism in complete denture wearers; IMO treatment eliminates these differences.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Boca Edêntula , Qualidade de Vida , Idoso , Prótese Total , Humanos , Mastigação , Saúde Bucal , Satisfação do Paciente
11.
Int J Prosthodont ; 32(6): 482-496, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664264

RESUMO

Implant parallelism is considered a cardinal criterion for the successful rehabilitation of edentulous jaws with implant-retained overdentures (IODs), especially if freestanding anchorage systems (unsplinted attachments) are employed. This report aimed to demonstrate the successful use of a novel IOD attachment with a true-alignment capability in complex cases with large inter-implant angular discrepancies. The report further aimed to highlight the use of a novel polyetherketoneketone (PEKK) framework as a reinforcement material for fabricating a completely metal-free IOD. Although some freestanding attachments exploit their geometric form and/or use various retentive inserts to compensate for inter-implant angular discrepancies, a true-alignment correction is seldom achieved. The CM LOC FLEX (Cendres+Métaux attachment provides a true alignment correction and produces parallelism between implants in clinical situations where the implants are not parallel to one another. The functionality of the CM LOC FLEX was described in this case report for two different clinical situations: a conventional mandibular IOD retained by two implants, and a maxillary IOD retained by four implants. Both cases involved a complex clinical situation with compromised implant parallelism. The CM LOC FLEX abutment has a true-alignment correction mechanism that can be advantageous in clinical situations where the inter-implant axial alignments are not parallel. PEKK frameworks are lightweight, strong, and can be esthetic substitutes for conventional metal frameworks. However, well-designed clinical studies are further needed to assess the clinical performance as well as the maintenance requirements of the illustrated novel attachment and the PEKK framework before advocating them as validated and standard protocols.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Estética Dentária , Mandíbula
12.
Int J Prosthodont ; 32(6): 503-508, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664266

RESUMO

PURPOSE: To compare maximum bite force, masseter thickness, and oral health-related quality of life (OHRQoL) in elderly patients rehabilitated with conventional complete dentures (CDs) and single-implant overdentures (SIOs). MATERIALS AND METHODS: A paired design was conducted, and 12 elderly patients were selected. Initially, a set of new CDs was manufactured and placed. After a 2-month adaptation period, the mandibular CD was transformed into an SIO by inserting one osseointegrated implant into the symphysis region. All variables were evaluated 2 months after both treatments (CD and SIO). Maximum bite force was evaluated using pressure sensors, while masseter thickness was obtained via ultrasound during muscle contraction and relaxation. The Oral Health Impact Profile for edentulous people (OHIP-Edent) was used to measure OHRQoL. Data were analyzed using Student t test and Wilcoxon test. Pearson coefficient of correlation between bite force and masseter thickness was calculated. RESULTS: Values for maximum bite force and masseter thickness during contraction increased significantly after SIO use (P < .001), indicating an improvement in muscle function. Considering OHRQoL, the general score and the domains functional limitation and physical pain were reduced (P < .05), indicating better perception of OHRQoL, with SIO use. Moreover, masseter thickness during contraction was moderately correlated with bite force (r = 0.480; P = .018). CONCLUSION: Using SIO increased the maximum bite force and masseter thickness of elderly patients, leading to an improved OHRQoL.


Assuntos
Força de Mordida , Revestimento de Dentadura , Idoso , Prótese Dentária Fixada por Implante , Humanos , Saúde Bucal , Qualidade de Vida
13.
Int J Prosthodont ; 32(6): 509-518, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664267

RESUMO

PURPOSE: To investigate the influence of splinted vs unsplinted designs for a maxillary overdenture supported by four implants in terms of the outcome measures implant survival, overdenture longevity, and patient satisfaction. MATERIALS AND METHODS: A systematic search, complemented by a handsearch, was carried out in the Embase, MEDLINE (PubMed), and Web of Science databases from 2000 to 2018. The PRISMA statement and a PICO approach were adopted. Free-text words were used in the strategy search, including "4-implant-retained overdenture," "4-implant-supported overdenture," "implant-supported overdenture," "implant-retained overdenture," "maxillary overdenture," "splinted design," "un-splinted design," and their combinations. All selected articles provided at least a 1-year follow-up, 10 fully edentulous patients, and at least one of the following clinical outcomes: survival rate of implants, survival rate of overdentures, and/or patient satisfaction scores. Nonparametric Fisher test for unpaired data was adopted in order to analyze data deriving from the survival rates of implants and overdentures. RESULTS: The initial electronic search produced a total of 2,922 articles. After applying the inclusion criteria, 14 articles were included. The mean follow-up time after implant placement ranged from 1 to 10 years. No statistical difference was detected in the survival rate of implants between the splinted implant group and the unsplinted implant group (P = .1). Only 4 included studies reported an overdenture survival rate of lower than 95%. It is interesting to note that among these 4 studies, 3 employed four splinted implants with a bar anchorage; however, no statistical difference was detected in the survival rate of overdentures between the splinted and unsplinted groups (P = .47). High scores were reported by all studies investigating patient satisfaction. CONCLUSION: Within the limits of this systematic review, it can be concluded that the survival rates of implants and overdentures and patient satisfaction with a maxillary overdenture supported by four implants were not influenced by the overdenture design, and no statistical difference was detected between the splinted and unsplinted groups.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Humanos , Maxila
14.
Clin Implant Dent Relat Res ; 21(6): 1199-1205, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31625683

RESUMO

BACKGROUND: The follow-up of the peri-implant marginal bone loss is the most important criterion for the determination of implant success. PURPOSE: The purpose of this study is to measure marginal bone loss using panoramic radiographic images (PRI) of patients treated using a mandibular, two implant-supported, locator-retained denture and to evaluate the compatibility of these findings with those of the finite element analysis (FEA). MATERIALS AND METHODS: The PRI of patients who had a mandibular, two implant-supported, locator-retained denture were assessed, and the mesial and distal marginal bone loss of both right- and left-sided implants was measured. Mandibular and maxillary models, which have the features of bilateral balanced occlusion, were created. The surfaces of the generated models were converted in a computer-aided design model that could be transferred to the FEA software, and the forces were defined on contacts formed in maximum intercuspation, lateral, and protrusive movement position for bilateral balanced occlusion. RESULTS: The bone loss in the mesial and distal regions at the right- and left-sided implants was not statistically significant. Higher stresses were formed on the vestibular side under protrusive movement, on the lingual side under maximum intercuspation, on the distolingual side under left unilateral biting, and on the mesiolingual side under right unilateral biting in the FEA. CONCLUSION: According to FEA, peri-implant bone resorption may be higher in the buccal and palatal regions, implying that panoramic radiographs can be misleading in understanding the amount of peri-implant bone resorption.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Radiografia Panorâmica , Prótese Dentária Fixada por Implante , Análise de Elementos Finitos , Humanos , Mandíbula , Projetos Piloto , Estudos Retrospectivos
15.
J Contemp Dent Pract ; 20(7): 794-800, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31597798

RESUMO

AIM: Proper stress distribution on dental implants is necessary in bar-retained implant overlay dentures. The purpose of the study is to comparatively assess the stress distribution pattern on the crestal bone at the bone-implant interface due to different bar heights using finite element models (FEMs). MATERIALS AND METHODS: Eight 3D FEMs were developed from mandibular overdentures with two implants in the canine region separated by a distance of 20 mm. In these models, four different bar heights from the mucosa (0.5, 1, 1.5, and 2 mm) with 12 mm occlusal plane height were analyzed. A unilateral and a bilateral vertical load of 150 N were applied to the central occlusal fossa of the first molar and the stress of bone around the implant was analyzed by finite element analysis (FEA). RESULTS: By increasing the bar height, the maximum stress values around implants on the crestal bone were found to be increased in unilateral and bilateral loading models. In unilateral loading models, the maximum stress was found in a model with a 2 mm bar height (0.46 MPa) on the distal side of the ipsilateral implant, and in bilateral loading cases, the maximum stress was also found in a model with a 2 mm bar height (0.456 MPa). CONCLUSION: As the vertical cantilever increases (here the bar height), the maximum stress on the crestal bone increases. A minimum of 0.5 mm of space is sufficient between the mucosa and the inferior border of the bar to maintain oral hygiene. CLINICAL SIGNIFICANCE: From the present study, it can be concluded that an increase in bar height causes an increase in stress levels on the peri-implant crestal bone.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Análise de Elementos Finitos , Mandíbula
17.
Br Dent J ; 227(6): 463-467, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31562441

RESUMO

This clinical report describes a staged approach using a removable partial denture (RPD) and a transitional implant-supported overdenture as interim prostheses in treating a failing anterior dentition with posterior implant-supported fixed dental prostheses (FPD), until the time a full-arch fixed implant-supported prosthesis may be inserted. The RPD replaced the anterior teeth following their extraction and during implant osseointegration. The implant-supported overdenture rehabilitated the arch during the fabrication phase of the definitive restoration.


Assuntos
Implantes Dentários , Prótese Parcial Removível , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Dentição , Revestimento de Dentadura , Humanos
18.
J Oral Implantol ; 45(5): 363-370, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31536445

RESUMO

The biomechanical behavior of the edentulous mandible with bone irregularities that has been rehabilitated with implant-supported overdentures has become an important factor for treatment planning. Restorative options, including dental implants with various attachments, affect the stress distribution. The purpose of this study was to evaluate the stress distribution of cortical bone around the implant neck and implant structures in overdentures with two different attachment types at the edentulous mandible and with different bone heights using three-dimensional finite element analysis. Five three-dimensional models of an edentulous mandible were designed and implemented. Ten models were constructed with ball and locator attachments. Static bilateral and unilateral vertical and oblique occlusal loads with magnitudes of 100 N were applied to the overdentures. The principal stresses were higher in the presence of oblique loads compared to vertical loads in all the analyzed models. Maximum principal stresses were observed around the mesial side of the contralateral implant, and the minimum principal stresses were noted around the distal side of ipsilateral implant during unilateral vertical loading. These patterns were reversed during oblique loadings. The ball attachment models yielded lower von Mises stress values than the locator models at all the loading conditions, while the stress distributions were similar in the models with the same and different bone levels. Correspondingly, bone corrections due to irregularities may not be necessary in terms of biomechanics. The results of this study may provide clinicians a better understanding for the mandibular overdenture design in the cases at which different bone heights exist.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Análise de Elementos Finitos , Mandíbula , Estresse Mecânico
19.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(4): 428-432, 2019 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-31512839

RESUMO

The aging society of the global population has led to an increase in the number of patients with edentulous jaw, a common multiple disease. Given the developments in implant techniques, the method of implant denture has received a positive and good response in terms of the quality of life and psychological well-being of patients. Implant-supported overdenture in mandible has two main advantages. 1) It has better retention and chewing efficiency than those of mandibular conventional denture. The required implant site of implant-supported overdenture is less than that of fixed implant-supported denture and can repair more defect tissues to help restore beauty and pronunciation. The price of the former is more acceptable than that of the latter. Therefore, this article aimed to systemically analyze and further discuss the clinical effect of implant-supported overdenture in elderly patients; combine existing related studies on the selection of number, site, and upper restoration of implants; and illustrate the advantages of removable implant-supported protheses in the repair of toothless mandible.


Assuntos
Implantes Dentários , Arcada Edêntula , Idoso , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Humanos , Mandíbula , Satisfação do Paciente , Qualidade de Vida , Resultado do Tratamento
20.
Int J Oral Maxillofac Implants ; 34(6): 1434­1440, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31532825

RESUMO

PURPOSE: To treat mandibular edentulous patients by fitting immediately loaded two-implant overdentures via guided flapless surgery and evaluate their masticatory performance. MATERIALS AND METHODS: Nineteen patients who presented with edentulous mandibles (mean age: 69.8 years; range: 60 to 85 years) at the Dental Hospital, Tokyo Medical and Dental University, were enrolled in this study. A newly fabricated complete denture was used as a radiographic guide. Computer planning followed the design procedure, and surgical guides were fabricated for each patient. Flapless surgery was performed using this guide, and two implants were placed in the canine positions. On the day of surgery, a removable overdenture supported by two ball attachments was fitted. Masticatory function was evaluated on the basis of masticatory performance with a color-changeable chewing gum, maximum occlusal force with an occlusal force meter, and occlusal contact area with an occlusal diagnostic system. RESULTS: The masticatory performance significantly improved from 48 months after surgery. The maximum occlusal force significantly increased 24 months after surgery. The occlusal contact area significantly increased from 6 months after surgery. This prospective study indicated that maximum occlusal force and occlusal contact area significantly improved at a comparatively earlier period after implant surgery and were maintained for up to 5 years with the immediate loading of two-implant overdentures with stud attachments. However, masticatory performance took more time to improve than maximum occlusal force and occlusal contact area. CONCLUSION: According to this 5-year prospective study, masticatory performance, maximum occlusal force, and occlusal contact area showed significant improvement after 4 to 5 years, 2 years, and 6 months postsurgery, espectively.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Idoso , Idoso de 80 Anos ou mais , Prótese Dentária Fixada por Implante , Humanos , Mandíbula , Pessoa de Meia-Idade , Estudos Prospectivos
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