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1.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 54-60, set.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1381314

RESUMO

The aim of this study is to report a clinical case of a patient with Cushing's syndrome, low self-esteem and need for oral rehabilitation. A 50-year-old female patient with hypercortisolism sought care at School of Dentistry of the Federal University of Minas Gerais. During anamnesis, the patient reported painful symptoms and mobility of the upper and lower teeth. On clinical examination, absence of many teeth were observed, periodontal disease and caries lesions. After discussion of the case, the planning involved the extraction of all teeth, and the preparation of Maxillary Immediate Complete Dentures (ICD's) and Immediate Mandibular Implant-retained Overdenture (IMIO). The treatment proposed allowed the restored aesthetics, phonetics and chewing(AU)


O objetivo desse estudo é relatar um caso clínico de uma paciente com síndrome de Cushing, baixa autoestima e necessidade de reabilitação oral. Paciente do sexo feminino, 50 anos de idade e com hipercortisolismo, procurou atendimento na Faculdade de Odontologia da Universidade Federal de Minas Gerais. Durante a anamnese, a paciente relatou sintomas dolorosos e mobilidade dos dentes superiores e inferiores. No exame clínico, foi observada a ausência de muitos dentes, doença periodontal e lesões cariosas. Após a discussão do caso, o planejamento envolveu a extração de todos os dentes, e o preparo de Prótese Total Imediata maxilar (PTI), e Overdenture Implantorretida Imediata mandibular. O tratamento proposto permitiu que restaurasse a estética, fonética e mastigação(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Síndrome de Cushing , Prótese Total Imediata , Doenças Periodontais , Extração Dentária , Cárie Dentária , Prótese Total , Revestimento de Dentadura , Estética Dentária
2.
Int J Oral Implantol (Berl) ; 15(3): 253-263, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36082659

RESUMO

PURPOSE: To evaluate the clinical performance of zirconia bars with distal extensions supporting mandibular implant overdentures based on biological and prosthodontic outcomes. MATERIALS AND METHODS: Fifteen edentulous patients (seven women and eight men) were included in a pilot study. Each patient received two interforaminal implants and a mandibular implant overdenture supported by a CAD/CAM zirconia bar with distal extensions, giving a total of 30 implants. The bar design, biological outcomes (implant survival and peri-implant conditions), peri-implant bone level changes recorded on a panoramic radiograph and prosthodontic maintenance (bar fracture and maintenance of the attachment system) were assessed at a 1-year follow-up. RESULTS: After 1 year, all 15 zirconia bars with their corresponding prostheses and implants were successfully in situ with no prosthodontic maintenance required and no biological complications. One patient showed moderate mucosal hyperplasia around the bar. The peri-implant radiographic measurements revealed a stable marginal bone level, with a mean of 0.20 ± 0.67 mm. The mean total length of the bar segments was 41.9 mm (range 35.0 to 51.0 mm), 8.6 mm (range 7.2 to 10.6 mm) of which came from the length of the distal extension, resulting in a mean increase in rigid support of 71% (range 60% to 99%). The mean distal bar connector area was 9.7 mm2 (range 6.8 to 18.7 mm2). CONCLUSION: Zirconia bars with distal extensions for implant overdentures appear to be a reliable option for the prosthodontic rehabilitation of edentulous mandibles. A survival rate of 100% was observed for implants, bars and prostheses, with stable peri-implant bone levels, no biological complications and a low risk of prosthodontic maintenance being required.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Projetos Piloto , Zircônio
3.
Int J Oral Implantol (Berl) ; 15(3): 277-286, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36082661

RESUMO

PURPOSE: To prove that a fully digital workflow, even for registration of the maxillomandibular relationship, can be employed to produce implant-supported overdentures and demonstrate that CAD/CAM techniques can be used to mill permanent implant-supported overdentures from polymethylmethacrylate discs, using polyetheretherketone as the sliding mechanism. MATERIALS AND METHODS: An edentulous 64-year-old woman received six implants in the maxilla after a bone augmentation procedure and two implants in the mandible. Five months after implant placement, intraoral scans were taken of her original complete dentures, of each prosthesis individually, and of both in centric relation, and another was taken of both edentulous arches, including the scan bodies. Along with facial photographs, sufficient digital data were gathered to design and mill titanium bars, polyetheretherketone female parts and a trial implant-supported overdenture. The tooth positions and colour were discussed with the patient using Smile Design software (3Shape, Copenhagen, Denmark). In the second session, the bars and trial implant-supported overdenture were inserted and checked, and in the third session, the final implant-supported overdentures were inserted. RESULTS: The milled titanium bar exhibited a passive fit, as did the implant-supported overdentures. After 1 year, no prosthetic complications were noted; the measured pockets were all less than 4 mm in depth. On a visual analogue scale from 0 to 10, with 0 being the worst and 10 being the best, the patient awarded a score of 9 for her satisfaction with the implant-supported overdentures. CONCLUSION: A fully digital workflow enables the production of robust wear-resistant implant-supported overdentures milled from polymethylmethacrylate, using polyetheretherketone female parts as the sliding mechanism, in just three clinical sessions.


Assuntos
Implantes Dentários , Arcada Edêntula , Benzofenonas , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Feminino , Humanos , Cetonas , Pessoa de Meia-Idade , Polímeros , Polimetil Metacrilato , Titânio , Fluxo de Trabalho
4.
Rev. Odontol. Araçatuba (Impr.) ; 43(2): 49-54, maio-ago. 2022.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1362035

RESUMO

Overdenture é uma prótese total que se caracteriza por usar apoios retentivos para que aumente sua estabilidade e retenção na cavidade bucal, gerando assim menor desconforto ao paciente e melhor adaptação. A Prótese overdenture dentossuportada necessita de elementos dentais remanescentes com canais tratados endodonticamente e que possuam suporte periodontal adequado. O objetivo deste relato de caso clínico é expor a sequência de confecção de uma prótese overdenture dentossuportada maxilar associada a uma prótese total convencional mandibular, com os passos clínicos detalhados por meio de uma abordagem teórica e visual. Esse tipo de reabilitação favorece a adaptação do paciente à nova condição, visto que o uso de próteses totais convencionais pode causar certo desconforto ao paciente devido à falta de retenção e estabilidade. Essa manutenção dos dentes remanescentes favorece à manutenção óssea e a futura decisão do paciente em optar pela instalação de implantes dentários, podendo confeccionar próteses implantorretidas (overdentures) ou implantossuportadas (protocolo).O Paciente demonstrou-se satisfeito com o resultado estético e funcional após a instalação da prótese concretizando que o tratamento é viável(AU)


Overdenture is a denture that utilizing retentive supports for increase stability and retention in oral cavity. The tooth-supported overdenture require dental elements with root canal therapy and good periodontal support. The aim of this study is to report the confection of a maxillary tooth-supported overdenture associated with mandibular denture and your clinical steps. This rehabilitation promotes the patient's adaptation the new condition, since the use of conventional dentures may cause discomfort due to lack of retention and stability. The preservation of dental elements promotes bone maintenance and forthcoming decision of the patient in the installation of dental implants that can choose implantretained or implant-supported prosthesis. Patient was satisfied with aesthetic and functional result after installation of prosthesis(AU)


Assuntos
Humanos , Masculino , Retenção de Dentadura , Prótese Total , Revestimento de Dentadura , Retenção em Prótese Dentária , Prótese Dentária
5.
Braz Oral Res ; 36: e081, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35946733

RESUMO

This longitudinal study aimed to assess the performance of the Facility-Equator system as mandibular overdenture (MO) retainers from a prosthetic perspective during 2 years of loading and to investigate the oral health-related quality of life (OHRQoL) and whether prosthetic events can affect the OHRQoL. Twenty-four patients (68.1 ± 7.51 years) reported their OHRQoL through the Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-EDENT) questionnaires before MO loading and after 1 and 2 years of usage. Prosthetic occurrences were recorded during this period. Data were analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation coefficients. Of the 127 prosthetic events that occurred in the first year, the most frequent events were prosthesis adjustments (16.5%), dislodgement of the Equator attachment (14.17%), and O-ring replacement (11.8%). Eighty-seven prosthetic events were recorded in the second year, the most frequent events being prosthesis adjustments (27.6%), O-ring replacement (20.7%), and recapturing the female matrix (11.5%). All domains of the GOHAI and OHIP-EDENT questionnaires exhibited a significant difference (p < 0.05) between the baseline and 1- and 2-year evaluations, except in the Social Disability and Psychological Discomfort domains (p > 0.05) of OHIP-EDENT after 1 year. Complications related to prosthetic maintenance, such as fracturing of the prosthesis, Equator dislodgement, prosthesis rebasing, and new overdenture confection, affect the OHRQoL (p < 0.05), primarily the Physical Pain and Discomfort domains, especially in the first year of MO loading.


Assuntos
Revestimento de Dentadura , Qualidade de Vida , Idoso , Prótese Dentária Fixada por Implante/efeitos adversos , Feminino , Humanos , Estudos Longitudinais , Mandíbula , Saúde Bucal , Satisfação do Paciente , Inquéritos e Questionários
6.
Gen Dent ; 70(5): 54-57, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35993934

RESUMO

Progressive wear of the components of an implant-supported overdenture can lead to loss of denture retention, which affects masticatory function and the patient's quality of life. The primary objective of this in vitro study was to investigate frictional wear in a type of commonly used abutment and thereby estimate the general clinical lifespan of a typical stud abutment and establish a protocol for replacement. Therefore, simulated overdenture insertions and removals equivalent to 2 years of overdenture use were performed to evaluate surface changes in the metal stud abutment component. A digital caliper, scanning electron micrographs taken at ×500 magnification, and profilometer data were used to determine the wear rate and surface roughness. A universal testing machine was used to measure retention load force with 4 clear male nylon inserts (5.0-lb retention) during 2160 insertion and removal cycles. The results showed that with a 6-month replacement program for clear male nylon inserts, the frictional wear on the titanium nitride coating of abutments placed at a 0° position resulted in a decrease of up to 50% in removal forces of the inserts after a simulated 2 years of wear. The combination of wear of the titanium nitride coating and the decrease in retention load values suggests that stud abutments should be replaced after 2 years of use for optimal retention.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Dente Suporte , Materiais Dentários , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Humanos , Masculino , Teste de Materiais , Nylons , Qualidade de Vida
7.
Gen Dent ; 70(5): 58-61, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35993935

RESUMO

The inability to place a sufficient number of implants posteriorly may limit tooth and soft tissue replacement because of the cantilever effects that would result from the unsupported prosthesis. Fabrication of a fixed removable overdenture that is implant retained and supported by both implants and soft tissue allows adequate replacement of teeth and soft tissue for optimal mastication and esthetics. This case report describes a design for implant overdentures that conforms to fundamental removable prosthetic principles by using a rigid bar with bilateral locking passive attachments. The rigid implant overdenture provides extra retention via the locking attachments while maintaining stability with proper extensions and full soft tissue support posteriorly. This removable implant overdenture design is a suitable treatment option for patients who desire the sensation of a fixed prosthesis but are unable to receive fully implant-supported prostheses.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Humanos , Mastigação
8.
J Contemp Dent Pract ; 23(5): 513-519, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35986459

RESUMO

AIM: To compare and evaluate the mean bite force and masticatory performance of conventional complete dentures (CD) in comparison with the lower implant-supported overdenture opposing an upper CD by using a strain gauge transducer and a test material respectively, in the same patient over a different period of time. MATERIALS AND METHODS: The study included 20 edentulous patients in the age range 45-65 years with a good general and oral health. In the first phase of the study, conventional CD were fabricated and delivered to each patient who participated in the study. A strain gauge transducer was used to analyze the maximum bite force and an agar test material was used to assess the masticatory performance using the sieve method. The existing lower denture was used to deliver a two-implant overdenture system and two implants were placed in the intermental-foraminal region of the mandible. One month after the delivery of implant-supported overdenture, the maximum bite force and masticatory performance were assessed as before. RESULTS: To test two independent variables, the data were analyzed statistically using an unpaired t-test. In comparison to the conventional upper and lower CD rehabilitations, the implant-supported lower denture and conventional upper CD rehabilitations resulted in statistically significant improvements in biting force and masticatory performance. CONCLUSION: Study findings demonstrate that the completely edentulous patients can be rehabilitated with the upper CD and lower two-implant supported overdenture system that offers improved biting force and masticatory performance than conventional upper and lower dentures. CLINICAL SIGNIFICANCE: Masticatory efficiency is one of the important indicators of functional state of stomatognathic system. Determination of individual masticatory performance has been used to ascertain the therapeutic effect of prosthetic device.


Assuntos
Implantes Dentários , Boca Edêntula , Idoso , Força de Mordida , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Prótese Total , Prótese Total Inferior , Revestimento de Dentadura , Humanos , Mandíbula , Mastigação , Pessoa de Meia-Idade , Satisfação do Paciente
9.
J Prosthet Dent ; 128(2): 205.e1-205.e10, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35842280

RESUMO

STATEMENT OF PROBLEM: How implant alignment impacts stud attachment retention and wear-induced alterations, notably when the attachment exhibits metal-to-metal frictional interlocking, is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of the interimplant angulation on retention forces and wear changes before and after 2 years of simulated clinical use of implant overdentures retained by titanium stud overdenture attachments. MATERIAL AND METHODS: The canine regions of 3 identical edentulous mandibular models were used to receive 2 dental implants analogs with TiTach attachments (Dental Evolutions, Inc) at interimplant angulations of 0, 30, and 60 degrees. Six identical overdentures were constructed over each model (n=6). A universal testing machine was used to determine overdenture retention forces at 0, after 1440, and after 2880 insertion and removal cycles to simulate the average insertion and removal cycles in 12 and 24 months. A stereomicroscope, a laser microscope, and a scanning electron microscope were used to evaluate the wear in the attachments. A linear regression model, ANOVA, and the Kruskal-Wallis tests were used to analyze the data (α=.05). RESULTS: All groups demonstrated reduced retention over the study duration (P<.001). The retention forces of the 0- and 30-degree groups were not significantly different after 2880 insertion and removal cycles, but both were significantly higher than those of the 60-degree group (P=.002). Within each group, the wear pattern of the matrix cap was more noticeable than that of the patrix abutment, with increased wear changes as interimplant angulation increased (P<.001). CONCLUSIONS: TiTach attachments could retain overdentures on parallel and divergent implants with a 30-degree angle of interimplant angulation. However, at a 60-degree angle of interimplant angulation, considerable reduction in retention forces and increased wear changes were observed after 2 years of simulated clinical use.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Titânio
10.
Clin Oral Implants Res ; 33(9): 953-964, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35818640

RESUMO

OBJECTIVE: This factorial randomized clinical trial (RCT) tested the effects of the surgical approach (flapped-FPS vs. flapless-FLS surgery) and loading protocol (delayed-DL vs. immediate-IL) for treatment with a four mini implant mandibular overdenture. MATERIAL AND METHODS: A total of 296 one-piece titanium-zirconium mini-implants were inserted in 74 patients (IL/FLS = 17; IL/FPS = 18; DL/FLS = 20; and DL/FPS = 19). Outcomes included patient's perceived surgical burdens, clinical time, implant survival, and post-surgical symptoms and complications, assessed immediately after surgery, in the 7-day and 6-week follow-ups. RESULTS: Perceived surgical burdens were relatively low, higher for females, and no difference was found between FPS and FLS surgery. Surgical time was lower for FLS surgery. Overall symptoms were mild after 24 h, and higher for females. Less symptoms were recorded for the FLS surgery compared to the FPS for the delayed loading patients, and FLS surgery was associated with a lower risk of bleeding. No early implant failure was observed until the 6-week follow-up. Delayed was associated with discontinuous use of the prosthesis and poor function. Lower complaint rates were observed for immediate loading regardless of the surgery protocol. CONCLUSIONS: Mini implants for mandibular overdenture are a feasible option regardless of surgical access and loading protocol, with high safety and predictable survival rates, and low incidence of post-insertion complications. FLS surgery requires less clinical time and results in easier intraoral prosthetic incorporation of attachments compared to FPS surgeries. Immediate loading did not increase the risk of early implant failure when satisfactory primary stability was achieved.


Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Revestimento de Dentadura , Feminino , Seguimentos , Humanos , Carga Imediata em Implante Dentário/métodos , Mandíbula/cirurgia , Resultado do Tratamento
11.
Clin Implant Dent Relat Res ; 24(4): 475-487, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35675561

RESUMO

AIM: To compare the long-term prospective clinical outcomes in a previous randomized controlled clinical trial (RCT) of 2 Mini Dental Implant (2MDI), 4 Mini Dental Implant (4MDI), and 2 Conventional Dental Implant (2CDI)-retained mandibular overdenture with follow-up between 5 to 8 years. MATERIALS AND METHODS: Thirty-seven patients formerly participated in the Comparative Clinical Study of CDI and MDI for Mandibular Overdenture were requested for examination of clinical outcomes. A total of 104 implants were placed with mean follow-up periods 6.64 ± 0.60 years. In Group 1 (2MDI) and Group 2 (4MDI), implants were placed and immediately loaded with Equator® attachments to retained mandibular overdenture. In Group 3 (2CDI), implants were placed and delayed 3 months for denture loading with ball attachment. The success rate, survival rate, clinical implant performance scale (CIP scale), peri-implant tissue status, prosthetic complication, implant stability quotient (ISQ), marginal bone level change (MBLC), and patient satisfactions were analyzed. RESULTS: After 5 to 8 years follow-up, the success rate in Groups 1, 2, and 3 were 90.91%, 93.33%, and 54.55%, respectively. The success rate in Group 3 was significantly lesser than Group 1 (p = 0.016) and Group 2 (p < 0.001). The survival rate in Groups 1, 2, and 3 was 100%, 96.67%, and 90.91%, respectively, and showed no significant differences. Mean ISQ reported no significant differences between groups. Mean MBLC were 0.57 ± 1.19 mm, 0.68 ± 0.90 mm, and 1.55 ± 1.60 mm in Groups 1, 2, and 3, respectively. Group 3 reported significantly greater mean MBLC than Group 1 (p = 0.016) and Group 2 (p = 0.011), but Groups 1 and 2 were not significantly differences. The overall patient satisfactions were reported as not significant differences between groups. CONCLUDE: Two MDI-retained mandibular overdentures with immediate loaded protocol performed had favorable clinical outcomes, cost effectiveness, and overall patient satisfactions after 5 to 8 years follow-up.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Seguimentos , Humanos , Arcada Edêntula/cirurgia , Mandíbula/cirurgia , Satisfação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
12.
Gen Dent ; 70(4): 41-43, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35749245

RESUMO

Endosseous root-form implants are the most popular type of implant used today. However, patients may present with subperiosteal implants that need treatment with a removable prosthesis. This case report describes the fabrication of a new set of overdentures for 30-year-old subperiosteal implants using the patient's current dentures as a guide to establish a proper vertical dimension of occlusion and occlusal scheme. In addition, the patient's older set of dentures was used as the record bases in an effort to reuse the existing custom Dolder bar attachments. Esthetics and lip support were enhanced by selecting new teeth and adjusting the tooth positions. The patient was pleased with the esthetic and functional results of the new overdentures.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Adulto , Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Humanos , Mandíbula , Dimensão Vertical
13.
Compend Contin Educ Dent ; 43(7): e10-e14, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35763457

RESUMO

Over time the case selection and surgical approach of zygomatic implants has evolved into a primary option for maxillary implant reconstruction. Typically, these implants have been immediately loaded and restored with fixed-hybrid prostheses. This article illustrates an alternative to this traditional approach by using zygomatic implants as a first line of treatment by placing them immediately but restoring them with a delayed loading bar-retained overdenture.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Maxila/cirurgia
14.
Int J Oral Maxillofac Implants ; 37(3): 549-555, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35727247

RESUMO

PURPOSE: The objectives of this in vitro study were to evaluate changes in the retention force of the indexed conometric system subjected to repeated insertion-removal cycles and to examine the elements (matrix and patrix) that cause retention changes in the system as a result of repeated cycles. MATERIALS AND METHODS: Monolithic zirconia crowns were cemented on 24 matrixes and 24 patrixes fixed on the implant analog. The pull-out test was performed with 12 matrixes and 12 patrixes attached, and the initial retention forces were recorded. Six of them were subjected to five insertion-removal cycles (5-cycle group), and the other six samples to 15 cycles (15-cycle group), and the final retention forces were calculated. Then, in both groups, an element of each pair exposed to the cycle was matched by an exchanging with new pieces: 5 cycles of matrix-new patrix (5M/0P), 5 cycles of patrix-new matrix (5P/0M), 15 cycles of matrix-new patrix (15M/0P), and 15 cycles of patrix-new matrix (15P/0M); thus, subgroups were created. A pull-out test was applied to these subgroups, and retention forces were recorded. Data were subjected to a paired-samples t test (α = .05). Two specimens from the 15-cycle group were randomly selected and analyzed by scanning electron microscopy. RESULTS: In the 5-cycle group, the mean initial retention force was 153.13 ± 7.08 N, and the mean final retention force was 111.59 ± 18.30 N. In the 15-cycle group, the mean initial retention force was 143.30 ± 15.46 N, and the mean final retention force was 78.55 ± 17.03 N. There was a statistically significant loss of retention in both groups (P < .05). The change in retention in the 5P/0M and 15P/0M subgroups was not statistically significant (P > .05). However, significant loss of retention was found in the 5M/0P and 15M/0P subgroups (P < .05). CONCLUSION: There was a significant loss of the retention force after insertion-removal cycles. The increase in these cycles caused a further decrease in retention force. The decrease in the retention force of this system mainly resulted from the changes in the surface characteristic of the frictional surfaces of the matrix.


Assuntos
Retenção de Dentadura , Revestimento de Dentadura , Coroas , Análise do Estresse Dentário , Teste de Materiais
15.
Int J Oral Maxillofac Implants ; 37(3): 556-562, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35727248

RESUMO

PURPOSE: The aim of this study was to measure and compare the retention degrees of different attachment systems before and after 1 year of mastication and removal/insertion simulations. MATERIALS AND METHODS: A 4 × 10-mm implant embedded in self-curing acrylic resin was placed inside a rectangular metal frame installed in a plastic container with artificial saliva at 37°C. Three different attachment systems were connected to the implants: Dalbo Classic, Locator (with blue, pink, and clear inserts), and Klockner Rotula. A loading test at 100 N and 1.25 Hz frequency was repeated 10 times for each attachment (changing the matrix component or plastic insert) until a total of 300,000 cycles and 1,095 removal/ insertion sequences. The retention force was assessed at baseline until the end of the test (1 year) after 3-month intervals of simulation. One-way analysis of variance (ANOVA) and post hoc Tukey test (P < .05) were performed for statistical analyses. RESULTS: Klockner Rotula showed the highest retention values at the beginning (69.6 ± 9.2 N; 7.1 ± 0.9 kg) and the end of the test (51.4 ± 5.4 N; 5.2 ± 0.6 kg), while Dalbo Classic showed the lowest values both at the beginning (13.1 ± 1.7 N; 1.3 ± 0.2 kg) and the end of the test (6.7 ± 1.6 N; 0.7 ± 0.2 kg). Locator with clear insert exhibited the lowest retention loss ratio (20.4%), while Locator with blue insert showed the highest (50.8%). At the end of the test, all attachment systems showed a significant decrease in retention force in comparison with the initial retention (P < .001). CONCLUSION: Locator attachments with clear and pink inserts and the Klockner Rotula attachment system showed retention forces > 20 N (2 kg) after 1 year of mastication and prosthesis insertion/removal simulation. All attachment systems showed a progressive loss of retention, which was higher for Locator attachments with blue and pink inserts and Dalbo Classic. The Klockner Rotula attachment system showed the highest retention values both at the beginning and the end of the test.


Assuntos
Retenção de Dentadura , Revestimento de Dentadura , Resinas Acrílicas , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário
16.
BMC Oral Health ; 22(1): 227, 2022 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-35681163

RESUMO

OBJECTIVES: The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip). MATERIALS AND METHODS: An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data. RESULTS: There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by - 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N. CONCLUSION: The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use. CLINICAL RELEVANCE: Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Éteres , Humanos , Mandíbula/cirurgia , Nylons , Instrumentos Cirúrgicos
17.
Molecules ; 27(12)2022 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-35745048

RESUMO

This study aimed to examine the retentive characteristics of each retentive element material and the effects from thermocycling using the two implant-retained mandibular overdenture model. Two stud abutments and three retentive element materials; nylon, polyetheretherketone (PEEK) and polyvinylsiloxane (PVS) were used in this study. Four tested groups, with a total of 40 overdentures, were fabricated, including a Locator® abutment with nylon retention insert (NY), Novaloc® abutment with PEEK retention insert (PK), Locator® abutment with PVS retention insert (RL), and Novaloc® abutment with PVS retention insert (RN). The retentive force (N) was measured before thermocycling, and at 2500, 5000, and 10,000 cycles after thermocycling. Significant changes in the percentage of retention loss were found in the NY and PK groups (p < 0.05) at 6 and 12 months for the RL group (p < 0.05) after artificial aging. The RN group exhibited a constant retentive force (p > 0.05). The tendency of the percentage of retention loss significantly increased for PEEK, nylon, and PVS silicone over time. The results of the present study implied that retentive element materials tend to lose their retentive capability as a result of thermal undulation and water dispersion. Nylon and PEEK, comprising strong polar groups in polymer chains, showed a higher rate of retention loss than polyvinylsiloxane.


Assuntos
Retenção de Dentadura , Revestimento de Dentadura , Retenção de Dentadura/métodos , Cetonas , Mandíbula , Nylons , Polietilenoglicóis
18.
Clin Implant Dent Relat Res ; 24(4): 522-531, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35679127

RESUMO

PURPOSE: This crossover study aimed to evaluate chewing efficiency and maximum bite force (BF) of conventional dentures, fixed prostheses, and milled bar overdentures (MO) used for All-on-4 implant rehabilitation of atrophied mandibular ridges. METHODS: Sixteen edentulous participants with resorbed mandibular ridges received new conventional dentures (CD, control). Four implants were inserted after 3 months in the mandible using the All-on-4 protocol and loaded immediately with acrylic prosthesis. In a crossover manner, each patient had either fixed restoration (FR, 12 occlusal units) or MO (14 occlusal units) randomly in a crossover study design. Chewing efficiency was evaluated using the mixing ability test. The hue deviation (HD) of two-colored gum was calculated after being chewed for 5, 10, 20, 30, and 50 masticatory cycles. Maximum BF was evaluated using a BF device. HD and BF were measured after using CD, FR, and MO prostheses. RESULTS: For all groups, the highest HD (i.e., the lowest chewing efficiency) was noted with 5 strokes, followed by 10, 20, 30 strokes, and the lowest HD (i.e., the highest chewing efficiency) was noted with 50 strokes. For all number of chewing strokes, CD showed the highest HD, then FR, and MO recorded the lowest HD. The highest BF was observed with MO, then FR, and the lowest BF was noted with CD. CONCLUSION: Within the limitations of this short-term investigation, both FR and MO used for All-on-4 implant rehabilitation of patients with resorbed mandibular ridges improve masticatory efficiency and maximum BFs compared to CD. However, MO was associated with significantly higher chewing efficiency and maximum BFs than fixed prosthesis.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Força de Mordida , Estudos Cross-Over , Prótese Dentária Fixada por Implante , Dentaduras , Humanos , Mandíbula/cirurgia , Mastigação , Satisfação do Paciente
19.
Clin Implant Dent Relat Res ; 24(4): 424-434, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35704472

RESUMO

INTRODUCTION: This study aimed to evaluate peri-implant tissue health and patient satisfaction of vertical and inclined posterior implants for mandibular bar overdentures. MATERIALS AND METHODS: Thirty edentulous participants received four implants in the interforaminal area of the mandible. The patients were randomly assigned into two equal groups; (1) vertical group (control): all implants were inserted vertically parallel to each other. Inclined group (study): the anterior implants were placed vertically, and the posterior implants were tilted 30° distally. Hader bar attachment with two 7 mm-distal cantilevers (vertical group) and without cantilevers (inclined group) was used to connect the implants to mandibular overdentures. Peri-implant tissue health (Plaque [PL] and gingival [GI] indices, pocket depth [PD], and crestal bone loss [CBL]) were evaluated after denture insertion (T0), 6 (T6), and 12 (T12) months after insertion. Patient satisfaction was evaluated using a visual analog scale after 12 months. RESULTS: At T12, the vertical group showed significantly higher PL, PD, and CBL than the inclined group for anterior (p < 0.037) and posterior (p < 0.017) implants. The vertical group showed significantly higher GI than the inclined group for anterior implants (p = 0.003), and the inclined group showed significantly higher GI than the vertical group for posterior implants (p = 0.016). The inclined group showed significantly higher scores for general satisfaction (p = 0.049), prosthesis as a part of you (p = 0.013), appearance (p < 0.001), stability (p = 0.002), ease of cleaning (p < 0.001), and comfort (p = 0.001) than the vertical group. CONCLUSION: Inclined posterior implants used to support mandibular bar overdentures are recommended than vertical implants, as it was associated with improved patient satisfaction and peri-implant tissue health.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Humanos , Mandíbula/cirurgia , Satisfação do Paciente
20.
Clin Implant Dent Relat Res ; 24(4): 510-521, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35500283

RESUMO

AIM: The study aimed to evaluate the effect of implant-supported prosthesis in completely edentulous participants in terms of osseoperception ability, neural activity, and stereognostic ability in comparison to removable prosthetic options. MATERIALS AND METHODS: A total sample of 18 patients, irrespective of gender and age were allocated into three groups according to the three-treatment protocol (upper and lower complete denture, upper complete denture opposing lower implant-retained overdenture, implant-supported fixed prosthesis in both arches). Four weeks after completion of the treatment procedure active tactile sensibility (ATS) was checked by using varying thicknesses (12, 40, 80, 100, 200 µ) of articulating foils and papers. Functional magnetic resonance imaging (fMRI) was performed to record neurophysiological activity in cerebral cortex in all the participants. Various forms of test pieces (heat cure acrylic resin) were used to evaluate stereognostic ability. Data regarding the neurophysiological activity were analyzed by using Krushkal-Wallis test and p ≤ 0.05 was considered to be statistically significant. Data from stereognostic ability test procedure and ATS were compared by using chi-squared test and p ≤ 0.05 was considered to be statistically significant. RESULTS: Statistically significant difference was found in between the articulating foils in terms of true negative responses as the foil thickness increased in participants wearing complete denture in both the arches (p = 0.004) and implant-supported fixed prosthesis in both the arches (p = 0.010). Participants in implant-supported fixed prosthesis group showed significantly more activation in primary motor cortex (right side), somatosensory cortex (left side), angular gyrus (both sides), temporal lobe (left) compared to other groups. No significant difference found in thalamus and premotor cortex region in between the participants of different groups. No statistically significant difference found in between the groups in terms of true responses identifying correct shapes. Mean number of correct responses in stereognostic ability test were 4.16 (83.33%), 3.5 (70%), 3.83 (76.66%) for participants of complete denture group, upper complete denture opposing lower implant retained overdenture group, and implant-supported fixed prosthesis group, respectively. CONCLUSION: Primary motor cortex, somatosensory cortex, and other regions of brain were diffusely activated in participants wearing implant-supported fixed prosthesis in both the arches. Less number of false responses were recorded in participants of implant-supported fixed prosthesis group and upper complete denture opposing lower implant-retained overdenture group in ATS test compared to participants wearing complete denture in both the arches.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Prótese Total , Revestimento de Dentadura , Humanos , Projetos Piloto
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