RESUMO
Edentulism (total tooth loss) can be managed with four possible options: no prosthetic replacement, conventional complete dentures, implant-retained overdentures (removable), or implant-supported bridgework (fixed). Selection of these choices is influenced by social, medical, anatomical, technical, and economic factors. The care team involved in the decision-making process (be it patients, clinicians and occasionally commissioners of services) should be aware of the different treatment options and their potential impact on the patient's quality of life (QoL). The cost effectiveness of this impact can also be evaluated. Knowledge of the life-long sequelae of edentulism will also help practitioners guide patients in their treatment planning decisions when they may be approaching an edentulous state, preparing them for the challenges that may lie ahead. This paper aims to address the impact that edentulism has on QoL and the treatment options, focusing on the patient perspective.
Assuntos
Prótese Dentária Fixada por Implante , Boca Edêntula , Qualidade de Vida , Humanos , Boca Edêntula/reabilitação , Implantes Dentários , Revestimento de Dentadura , Prótese Total , Análise Custo-BenefícioRESUMO
This study investigated the integration of online learning into complete denture rehabilitation (CDR) training for dental interns, highlighting its impact on their education and readiness for clinical practice. Given that CDR poses significant challenges due to its technical complexity and profound influence on patient well-being, online learning has emerged as a strategic educational tool to enhance interns' knowledge and skills. This research included the administration of a comprehensive questionnaire to 63 dental interns to assess their backgrounds, experiences with online learning, and attitudes toward its application in CDR education. The results revealed strong engagement with online learning, with a majority valuing its flexibility, accessibility, and capacity to facilitate self-paced, individualized learning. Despite the enthusiasm for online modalities, the results identified notable gaps in interns' confidence in and preparedness for performing CDR, highlighting the need for targeted improvements in online curriculum development. By emphasizing the essential role of innovative teaching methods, including virtual reality (VR), this study underscores the need for a balanced educational approach that combines traditional and digital platforms. This strategy aims to prepare future dental professionals for the complexities of modern clinical environments, ensuring that they are well equipped to meet the diverse needs of the edentulous population.
Assuntos
Prótese Total , Educação em Odontologia , Educação a Distância , Humanos , Educação em Odontologia/métodos , Currículo , Masculino , Feminino , Internato e Residência , Inquéritos e Questionários , Competência Clínica , Adulto , Atitude do Pessoal de SaúdeRESUMO
BACKGROUND: Decreased salivary flow can make the patients uncomfortable with their complete dentures and affects the retention of the dentures. Milling and 3D printing have become an alternative to conventional denture construction techniques. The goal of this study was to evaluate the effect of conventional and digital techniques of the complete denture construction on the denture surface wettability with distilled water and saliva substitute before and after thermocycling. METHODS: A total of 30 specimens were utilized in the present study. Specimens were divided according to the construction techniques into 3 groups (n = 10 each). Group I: Heat-polymerized polymethylmethacrylate (PMMA) group, group II: Milled group, and group III: 3-dimensional (3D)-printed group. All the specimens were subjected to 2000 cycles of thermal aging in a thermocycler. The wettability of all specimens to water and saliva substitute was measured via a contact angle goniometer (Olympus TGHM, Rame-hart Inc, USA) before and after thermocycling. Descriptive statistical analysis, plots, and the Shapiro-Wilk test were used to verify normality for each variable. One-way ANOVA was used to compare the 3 study groups, while paired samples t-test was used to compare the differences within each group (P < .05). RESULTS: The smallest contact angle of drop of water to the denture base specimens before and after thermocycling were recorded in the milled group (53.0 ± 4.77 and 50.27 ± 2.30, respectively), followed by the heat polymerized PMMA group (85.65 ± 4.71 and 65.06 ± 2.27, respectively), and the 3D-printed group (91.34 ± 6.74 and 90.86 ± 8.57, respectively). While the smallest contact angle of drop of saliva substitute to denture base specimens was recorded in the milled group (56.82 ± 2.29 and 34.85 ± 7.51, respectively), followed by the 3D-printed group (72.87 ± 4.83 and 58.14 ± 9.58, respectively) and the heat polymerized PMMA group (83.62 ± 4.12 and 67.82 ± 4.93, respectively). There was statistically significant difference between the groups (P < .05). A significant decline in the average contact angle of drop of saliva has been reported in all groups after thermocycling. The contact angle values differed significantly between saliva substitute and distilled water in both 3D-printed and milled groups after thermocycling (P < .001). CONCLUSIONS: The milled denture base material presented the best wettability to water and saliva substitute than the 3D-printed and the heat-polymerized PMMA materials. Saliva substitutes improve the wetting ability of denture base materials manufactured by CAD/CAM compared with water.
Assuntos
Bases de Dentadura , Prótese Total , Polimetil Metacrilato , Impressão Tridimensional , Molhabilidade , Polimetil Metacrilato/química , Humanos , Técnicas In Vitro , Planejamento de Dentadura , Materiais Dentários/química , Teste de Materiais , Propriedades de Superfície , Desenho Assistido por Computador , ÁguaRESUMO
Centric relation (CR) was used in the complete dentures for edentulous jaws firstly. Then, CR was gradually applied in the clinical diagnosis and treatment of dentate jaws. Regarding the application of CR in dentate jaws, there are many doubts about its rationality. For instance, should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile, varieties of CR clinical applications are objective. According to the existing evidence, this paper summarizes the applicable conditions of several main clinical situations with little controversy. We preliminarily put forward the decision tree for the clinical application of CR, which can be used as a reference in clinical practice.
Assuntos
Transtornos da Articulação Temporomandibular , Humanos , Relação Central , Transtornos da Articulação Temporomandibular/diagnóstico , Prótese Total , Arcada EdêntulaRESUMO
OBJECTIVES: Oxidative stress, an imbalance between the body's natural antioxidant defenses and the production of reactive oxygen species (ROS), can result in serious oral diseases, including oral cancer, periodontal diseases, and oral lichen planus, through the activation of the redox-sensitive transcription factors and inflammation. The purpose of this study was to assess the potential effects of a removable complete denture on the levels of oxidative stress markers, such as lipid peroxidation (MDA), advanced oxidation protein products (AOPP), and catalase, and the quantitative expression of the redox-sensitive transcription factor NF-κB p65 subunit. MATERIALS AND METHODS: This interventional follow-up study enrolled 40 participants of both sexes aged 28-78 years, with a median age of 56 years, where unstimulated saliva was collected before denture placement, immediately after the denture placement, and 24 h, 7 days, and 30 days after the denture placement. The most prominent ROS overproduction was reported on the seventh day (p < 0.05), followed by a significant fall in antioxidative defense. RESULTS: The NF-κB p65 subunit, whose expression pattern was highest in the same time period on the seventh day, serves as a signaling molecule for redox imbalance due to ROS production. Over the next 30 days, its levels remained moderately increased compared to the basal value, which may influence pro-inflammatory pathways and the integrity of oral tissue components. These alterations may be induced by the dentures, which can produce high pressures on the supporting tissues or by the synthetic materials used for producing the dentures. CONCLUSION: Our research may help to clarify the potential pathways by which oxidative stress and redox-sensitive inflammatory mediators, as well as mechanical and chemical irritants, may serve as risk factors for premalignant lesions in the mouth. Further research on this topic is required to understand the molecular mechanisms behind the relationship between inflammation and oral premalignant lesions caused by mechanical and chemical irritation.
Assuntos
Antioxidantes , Biomarcadores , Oxirredução , Estresse Oxidativo , Espécies Reativas de Oxigênio , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Idoso , Adulto , Biomarcadores/metabolismo , Biomarcadores/análise , Seguimentos , Espécies Reativas de Oxigênio/metabolismo , Antioxidantes/metabolismo , Saliva/química , Saliva/metabolismo , Inflamação/metabolismo , Prótese Total/efeitos adversos , NF-kappa B/metabolismo , Peroxidação de Lipídeos , Catalase/metabolismo , Produtos da Oxidação Avançada de Proteínas/metabolismo , Boca/metabolismo , Fator de Transcrição RelA/metabolismoRESUMO
BACKGROUND: While we attempt to restore occlusion in completely edentulous patients there is a consensus among clinicians to articulate the cast using average value and avoid performing facebow transfer. Various studies question the application of facebow transfer in the fabrication of removable complete denture fabrication. AIM: This study was therefore aimed to study the effect on condylar guidance with casts mounted by the facebow method, Bonwill's method, and radiographic method. METHODS: A cross-sectional study was performed using casts of edentulous patients attending the Department of Prosthodontics. After establishing a tentative jaw relationship using wax occlusal rims in the edentulous participants, the casts were mounted by Bonwill's method and the facebow transfer method to a semi-adjustable articulator. Protrusive records of the subjects were used to program the articulator to obtain the condylar guidance values. Digital lateral cephalographs were made both in centric and protrusive jaw relationships. The mandibular condyles were then traced and overlapped to obtain radiographic values. The condylar guidance values obtained by Bonwill's method, facebow method and radiographic method were compared using Wilcoxon's signed rank test and Mann-Whitney U test. The SPSS Statistics for Windows (Version 21.0. Armonk, NY, USA:IBM Corp.), and, at a probability value of 0.05, the significance of every statistical test was predetermined. RESULTS: Ten edentulous 45-70 year olds participated in the study. The mean discrepancy between radiography and facebow methods was 12.8° for the right side and 12.7° for the left (P < 0.005). The difference between radiography and Bonwill's methods was significant (P < 0.005), with a mean difference of 34.3° for the right side and 34.7° for the left side. The difference between Bonwill's method and the facebow method was significant (P < 0.005), with a mean difference of 21.5° for the right side and 22° for the left side. CONCLUSION: The condylar guidance values obtained by clinical methods (Bonwill's and Facebow) were significantly lesser (P < 0.005) compared to the values obtained by radiographic method.
Assuntos
Articuladores Dentários , Côndilo Mandibular , Humanos , Estudos Transversais , Feminino , Masculino , Pessoa de Meia-Idade , Côndilo Mandibular/diagnóstico por imagem , Registro da Relação Maxilomandibular/métodos , Boca Edêntula/diagnóstico por imagem , Cefalometria/métodos , Idoso , Prótese TotalRESUMO
PURPOSE: To evaluate the clinical effect of three impression methods, conventional, closed-mouth, and tissue conditioner, on complete denture fabrication. METHODS: 60 subjects (edentulous with severely resorbed alveolar ridges - Atwood classification III or IV) who visited the Prosthodontic Department of Wuxi Stomatology Hospital, China, between January 2022 and June 2023, were selected for this study. The subjects were randomly divided into three groups of 20: a conventional impression group (CI group), a closed-mouth impression group (CM group), and a tissue conditioner group (TC group). Three months after denture restoration was completed, denture quality was assessed by clinicians in terms of marginal extension, retention, and stability. In addition, patients completed the oral health impact profile-edentulous (OHIP-EDENT) questionnaire to provide subjective satisfaction evaluations of the final denture restoration outcomes. RESULTS: The comprehensive denture quality evaluation results showed that the TC group had the lowest score, which was significantly lower than that of the CM (P= 0.014) and CI (P< 0.001) groups. The average score of the CM group was also significantly lower than that of the CI group (P= 0.004), indicating that tissue conditioner restoration was the most effective method. The OHIP-EDENT scores gradually decreased across the groups from CI to CM to TC (P= 0.001), indicating patients' oral health was significantly improved using tissue conditioner. CLINICAL SIGNIFICANCE: Tissue conditioner is a suitable dynamic functional impression method. It can significantly improve the effects for edentulous patients and increase their satisfaction.
Assuntos
Técnica de Moldagem Odontológica , Planejamento de Dentadura , Prótese Total , Satisfação do Paciente , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Inquéritos e QuestionáriosRESUMO
BACKGROUND: While many denture base materials are currently available on the market, little data exists regarding their dimensional stability after exposure to the oral environment. This study aimed to evaluate the effect of thermocycling on the trueness and precision of milled, 3-dimensional (3D)-printed, and conventional digitally fabricated complete denture bases (CDBs). METHODS: A completely edentulous maxillary stone model was scanned to generate a standard tessellation language (STL) file; this was imported into metal-milling-machine software (Redon Hybrid CAD-CAM metal milling machine, Redon, Turkey) to produce a metal model for fabricating 30 CDBs. These were divided into three groups (n = 10 in each) according to the construction technique: group 1, CAD-CAM milled CDBs; group 2, 3D-printed CDBs; and group 3, conventional compression molded CDBs. All CDBs were scanned after fabrication and evaluated before and after thermocycling using superimposition. The data were analyzed using a one-way ANOVA, Tukey's post hoc test, and a paired t-test. RESULTS: The level of trueness between the CAD-CAM milled, 3D-printed, and compression molded CDBs showed significant differences before and after thermocycling (P < 0.05). Group 1 showed the highest degree of trueness before and after thermocycling, group 3 exhibited a higher degree of trueness than group 2 before thermocycling, and group 2 had a higher degree of trueness than group 3 after thermocycling. There was a significant difference in the precision for each CDB type before and after thermocycling (P < 0.05). CONCLUSION: The trueness of the CAD-CAM milling system in complete denture (CD) fabrication is superior to that of the 3D printing and conventional compression molding systems before and after thermocycling. Thermocycling had a significant effect on the precision of all CDB types. The compression molding system in CD construction is the most negatively affected via thermocycling with regard to the measures of trueness and precision. CLINICAL TRIAL NUMBER: Not applicable, no human participants were involved.
Assuntos
Desenho Assistido por Computador , Bases de Dentadura , Planejamento de Dentadura , Impressão Tridimensional , Humanos , Planejamento de Dentadura/métodos , Prótese Total , Modelos Dentários , TemperaturaRESUMO
This study aims to assess the dimensional accuracy of complete denture bases fabricated from different CAD/CAM technologies and a conventional method, including milling (CNC), PolyJet (PJ), laser sintering (SLS), digital light processing (DLP), and injection molding (IM). It also examines the influence of the removal of technology-specific connectors or support structures when present. Denture base surfaces were digitized using a laboratory scanner, and virtual measurement points were calculated with tetrahedral reference geometries. Defined distances were measured in all spatial directions and compared to design data (p<0.05), revealing significant differences in sagittal (p=0.004), transversal (p<0.001), and vertical (p<0.001) dimensions. Connector removal had no significant impact for CNC but significantly affected DLP. All technologies yielded clinically acceptable results, with CNC milling demonstrating the best overall outcome.
Assuntos
Desenho Assistido por Computador , Bases de Dentadura , Planejamento de Dentadura , Prótese Total , Impressão Tridimensional , Humanos , Reprodutibilidade dos Testes , Propriedades de Superfície , LasersRESUMO
BACKGROUND We used the 14-item Oral Health Impact Profile-14 (OHIP-14) questionnaire to evaluate the association between sociodemographic variables and oral health-related quality of life in 241 wearers of removable partial or complete dentures attending a single center in Yemen. MATERIAL AND METHODS A total of 241 partial dentures (PD) and complete dentures (CD) wearers were enrolled from the Department of Prosthodontics at the Faculty of Dentistry, Sana'a University, and the University of Science and Technology. Data were collected before the commencement of denture wearing and after 3-6 months of denture use. The questionnaire consisted of sociodemographic information and denture type, and another for the OHIP to assess oral health-related quality of life (OHRQoL), oral health impact profile scale comprises 7 subscales, each evaluating different aspects of oral health and functionality. Descriptive statistics were calculated for participants. Independent t tests were performed to compare different patient groups, focusing on PD and CD wearers. Paired-sample t tests were used to examine changes within patient groups before and after removable denture use. RESULTS Among all participants, 67.6% were male, wearers of CDs were 74.6% male, PDs were 58.3%, and was consistent for CD (71.0%) and PD (72.8%) wearers. The wearing prostheses significantly impacted the OHRQoL of patients using both PDs and CDs (P<0.01). Among CD wearers, 4 of these subscales (3-6) were statistically significant, but the handicaps subscale showed evident reductions in physical pain after treatment among PD wearers. CONCLUSIONS Wearing dentures positively affects the OHRQoL of patients, influencing various aspects of their health, including functional, physical, psychological, and social well-being.
Assuntos
Saúde Bucal , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Masculino , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Iêmen , Inquéritos e Questionários , Idoso , Prótese Parcial Removível/psicologia , Prótese Total/psicologia , Adulto , Dentaduras/psicologiaRESUMO
OBJECTIVES: Conventionally and digitally manufactured removable complete dentures with different dentition forms were examined for manufacturing accuracy (trueness, precision), fracture forces under torsional loading and subsequent repairability. METHODS: A total of 90 mandibular prostheses were manufactured. Ten were made using the injection molding technique and finished with prefabricated teeth. 40 bases each, were manufactured subtractively and additively. Digitally the prosthesis' dental arch was divided either into two quadrants or three sextants, or kept as full arch. Afterwards, ten additive and subtractive bases were finished with prefabricated teeth and ten of each with milled quadrants, sextants and full arches. After manufacturing, all specimens were rescanned for accuracy comparisons using the Root Mean Square (RMS). Lastly, all specimens were tested to failure under torsional loading. RESULTS: Conventionally manufactured dentures showed the greatest deviation in accuracy. The type of base manufacturing did not determine the fracture resistance of the prostheses. The dentition form had a significant influence. While prefabricated teeth (86.01 ± 19.76 N) and quadrants (77.89 ± 9.58 N) showed a low fracture resistance, sextants (139.12 ± 21.41 N) and full arches (141.05 ± 17.14 N) achieved the highest fracture forces. Subtractive bases with prefabricated teeth or quadrants were assessed to be repairable, digital dentures with full arch were assessed as not repairable. SIGNIFICANCE: The presented testing set-up is suitable to determine the fracture behavior of dentures rather than of standards. With the possibility of digital design and individual manufacturing, dentures' mechanical stability can be significantly increased, especially with suitable dentition forms.
Assuntos
Desenho Assistido por Computador , Planejamento de Dentadura , Humanos , Análise do Estresse Dentário , Falha de Restauração Dentária , Teste de Materiais , Prótese Total , Reparação em DentaduraRESUMO
Background: This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures. Methods: The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA. Results: The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p < 0.001) of the overdenture use compared to the conventional denture. The PrMA insignificantly improved (p = 0.397) after six months of the single implant retained overdenture use. Discussion: The study's findings indicate that using immediate loading single implant-retained mandibular overdentures significantly improved PrMA in completely edentulous patients.
Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Mastigação , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Mastigação/fisiologia , Boca Edêntula/reabilitação , Prótese Total , Mandíbula/cirurgia , Egito , Implantes Dentários para Um Único DenteRESUMO
BACKGROUND: Edentulism remains a major disability worldwide, especially among the elderly population, although the prevalence of complete edentulism has declined over the last decades. In Uganda, the prevalence of edentulism in people aged 20 years and above is 1.8%. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design and computer-aided manufacturing (CADCAM), however, the provision of removable complete dentures continues to be the predominant rehabilitation for edentulous patients. However, no published study has explored the lived experiences with removable complete dentures among the Ugandan population. The aim of the present study was to explore patients' lived experiences on the usage of removable complete dentures among Ugandan edentulous patients attending Makerere University Dental Hospital. METHODS: This was a qualitative study approach using purposive sampling. Fifteen (15) respondents were selected across social demographics. Interviews were recorded and transcribed and themes were generated to draw a deeper meaning to the usage of removable complete dentures. A qualitative statistical package, Atlas Ti software was used to generate themes from the interviews followed by an interpretation of the generated data and the results were presented as text and in a table. RESULTS: The reported key positive experiences due to removable complete denture rehabilitation were the improvement in speech, eating ability, regaining good facial appearance, better oral hygiene management, self-esteem and confidence to smile in public, and a feeling of completeness. However, respondents complained of pain and discomfort due to the looseness of dentures, inability to eat certain foods, and regular cleaning of dentures. The respondents did not go through proper informed consent processes before getting removable complete dentures. CONCLUSION: The study found that patients were satisfied with their removable complete dentures rehabilitation due to the positive experiences registered, such as the ability to eat and talk well, and restoration of self-esteem, all of which improved their quality of life. However, they experience pain and discomfort due to the looseness of dentures.
Assuntos
Prótese Total , Boca Edêntula , Humanos , Uganda , Boca Edêntula/psicologia , Boca Edêntula/reabilitação , Feminino , Masculino , Prótese Total/psicologia , Pessoa de Meia-Idade , Idoso , Pesquisa Qualitativa , Adulto , Qualidade de VidaRESUMO
OBJECTIVE: To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction. METHODS: A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models. RESULTS: Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284). CONCLUSION: This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults. CLINICAL SIGNIFICANCE: Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders.
Assuntos
Estudos Cross-Over , Placa Dentária , Higienizadores de Dentadura , Higiene Bucal , Satisfação do Paciente , Estomatite sob Prótese , Humanos , Idoso , Feminino , Masculino , Higienizadores de Dentadura/uso terapêutico , Método Simples-Cego , Estudos Prospectivos , Placa Dentária/prevenção & controle , Estomatite sob Prótese/prevenção & controle , Estomatite sob Prótese/microbiologia , Escovação Dentária/métodos , Idoso de 80 Anos ou mais , Dentaduras , Resultado do Tratamento , Terapia por Ultrassom/métodos , Prótese Total , Serviços de Assistência Domiciliar , Pessoa de Meia-Idade , UltrassomRESUMO
This report describes a step-by-step staged digital protocol for the terminal dentition patient using a Provi-guide. This protocol will improve implant placement accuracy, shorten treatment time, and assure an implant-supported fixed complete denture immediately loaded after extraction of the remaining terminal dentition and complete edentulism. The novelty of the Provi-guide technique described is that it serves 2 objectives: (1) a nonlimiting surgical guide, and (2) a fixed interim prosthesis. Implants placed in the described digital stagged protocol can serve both the interim and the final prosthesis.
Assuntos
Prótese Dentária Fixada por Implante , Carga Imediata em Implante Dentário , Humanos , Carga Imediata em Implante Dentário/métodos , Prótese Total , Extração Dentária , Cirurgia Assistida por Computador/métodosRESUMO
Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.
Assuntos
Prótese Dentária Fixada por Implante , Prótese Total , Revestimento de Dentadura , Satisfação do Paciente , Qualidade de Vida , Faculdades de Odontologia , Humanos , Masculino , Feminino , Prótese Dentária Fixada por Implante/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Idoso , Clínicas Odontológicas , Adulto , Arcada Edêntula/reabilitaçãoRESUMO
BACKGROUND: Tissue conditioners are used for treating and improving the tissues supporting complete dentures. On the other hand, recent advances in nanotechnology have revolutionized various fields of science, including dentistry. The present study aimed to investigate novel antimicrobial applications of copper oxide nanoparticle-based tissue conditioner used in complete prostheses. METHODS: The present experimental study included 126 tissue conditioner samples with different concentrations of copper oxide nanoparticles (20%, 10%, 5%, 2.5%, 1.25%, 0.625%, and 0% w/w). The samples were incubated with Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans in 24-well plates for 24 h. Then, samples from the wells were re-incubated for 24 h, and the microorganisms were counted. RESULTS: The culture media containing E. faecalis and P. aeruginosa showed significantly different growth between different nanoparticle concentrations following 24 h (P < 0.001), showing a reduction in bacterial growth with increased nanoparticle concentration. Both bacteria did not show any growth at the 20% concentration. However, C. albicans showed significant differences in growth between different nanoparticle concentrations following 48 h (P < 0.001), showing a reduction in growth with increased nanoparticle concentration. Also, the least growth was observed at the 20% concentration. CONCLUSIONS: In conclusion, the CuO nanoparticles were prepared using a green synthesis methon in the suitable sizes. Moreover, the tissue conditioners containing CuO nanoparticles showed acceptable antimicrobial properties against E. faecalis, P. aeruginosa, and C. albicans.
Assuntos
Anti-Infecciosos , Candida albicans , Cobre , Enterococcus faecalis , Pseudomonas aeruginosa , Cobre/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/crescimento & desenvolvimento , Candida albicans/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Anti-Infecciosos/farmacologia , Prótese Total/microbiologia , Nanopartículas , Humanos , Nanopartículas MetálicasRESUMO
STATEMENT OF PROBLEM: Computer-aided design and manufacturing (CAD/CAM) have been increasingly used to enhance the patient and clinician experiences with removable complete dentures (CDs). Yet, evidence from systematic reviews is lacking to validate the clinical significance of these digital prostheses. PURPOSE: The purpose of this systematic review was to compare CAD/CAM CDs with the traditional ones in terms of patient and clinician-reported outcomes, post-insertion adjustment visits and costs. MATERIALS AND METHODS: An electronic search of four databases [Medline (Ovid), Embase, Scopus and Cochrane CENTRAL; last update: May 2022] was performed to retrieve clinical studies comparing CAD/CAM and traditional CDs. Two independent reviewers screened the articles, extracted data (methods and outcomes) and assessed risk of bias of the included studies. The following outcomes underwent meta-analysis (random-effects model): overall patient and clinician satisfaction, oral health-related quality of life (OHRQoL), number of post-insertion adjustment visits, as well as laboratory and total costs. RESULTS: This review included 11 studies. Meta-analysis revealed that CAD/CAM CDs are comparable to the traditional CDs in terms of overall patient satisfaction and OHRQoL. Clinician-reported data depended on the manufacturing technique: whereas milled CDs performed better than traditional CDs in terms of clinician satisfaction and number of adjustments, 3D printed and traditional CDs were similar. Fabrication of CAD/CAM CDs required significantly less laboratory and overall costs than the traditional CDs. CONCLUSIONS: There is some evidence showing that CAD/CAM CDs are at least comparable to traditional CDs. Further well-designed randomized clinical trials are needed to evaluate the performance of specific CAD/CAM approaches for manufacturing CDs, however.
Assuntos
Desenho Assistido por Computador , Planejamento de Dentadura , Prótese Total , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Qualidade de Vida , Humanos , Prótese Total/economia , Planejamento de Dentadura/economia , Planejamento de Dentadura/métodosRESUMO
Denture-induced fibrous hyperplasia (DIFH) is a persistent lesion caused by low-intensity chronic injury of the tissue in contact with an ill-fitting, over-extended denture. This fibrous connective tissue lesion commonly occurs in oral mucosa in patients showing important alveolar ridge atrophy. Surgical excision is the treatment of choice for DIFH. This article describes a successful laser surgery to remove a DIFH on a lower alveolar ridge of a patient wearing an ill-fitting completely removable denture. The use of a diode laser may result in less surgical time, less bleeding during surgery, more vestibular depth, better re-epithelialization of the wound, and no need for suturing.
Assuntos
Hiperplasia , Lasers Semicondutores , Humanos , Lasers Semicondutores/uso terapêutico , Hiperplasia/cirurgia , Feminino , Mucosa Bucal/patologia , Terapia a Laser/métodos , Terapia a Laser/efeitos adversos , Fibrose , Prótese Total , Pessoa de Meia-IdadeRESUMO
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Digitally versus conventionally fabricated complete dentures: A systematic review on cost-efficiency analysis and patient-reported outcome measures (PROMs). Tew, In Meei, Suet Yeo Soo, and Edmond Ho Nang Pow.The Journal of Prosthetic Dentistry (2023). SOURCE OF FUNDING: No fund was received. TYPE OF STUDY/DESIGN: Systematic review.