Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Eficiência mastigatória e impacto da saúde oral na qualidade de vida em pacientes reabilitados com próteses totais removíveis implanto-suportadas

Edentulous patients with complaint about mandibular conventional denture might experience poor masticatory function and negative impact of oral health on quality of life. The aim of this controlled clinical trial was to evaluate the effect of mandibular overdenture on oral health-related quality of life and masticatory efficacy in patients wearing mandibular complete dentures. The edentulous patients (n=16) were rehabilitated with new maxillary and mandibular complete dentures and, after 3 months, mandibular overdentures retained by 2 implants (bar-clip system) were fabricated. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral healthrelated quality of life. Masticatory efficacy was evaluated through a colorimetric method with chewing capsules. The mean OHIP-Edent score was 8.5 with conventional dentures and 2.0 with mandibular overdenture, which means a positive impact of oral health on quality of life with overdentures (p=0.001). The mean absorbance for masticatory efficacy was 0.025 for conventional dentures and 0.073 for overdentures. There was statistically significant difference for masticatory efficacy before and after implants rehabilitation (p=0.003). However, there was no correlation between masticatory efficacy and OHIP (p>0.05). So, mandibular overdenture retained by 2 implants improved the quality of life and masticatory efficacy of edentulous patients with complaint about mandibular conventional complete dentures

Influência do número de refundições da liga Ni-Cr-Mo-Ti sobre as propriedades de próteses metalocerâmicas

A frequently encountered difficulty in oral prosthetics is associated with the loss of metallic alloys during the melting stage of the production of metal-ceramic replacement systems. Remelting such materials could impar their use in oral rehabilitation due to loss in esthetics, as well as in the chemical, physical, electrochemical and mechanical properties. Nowadays, the Ni-Cr-Mo-Ti alloy is widely used in metal-ceramic systems. Manufacturers state that this material can be remelted without significant alterations in its behavior, however little has been established as to the changes in the performance of this alloy after successive remelting, which is common practice in oral prosthetics. Therefore, the objective of this study was to evaluate possible changes in the esthetics and associated properties of metalceramic samples consisting of Ni-Cr-Mo-Ti and dental porcelain. Three to five remelting steps were carried out. The results revealed that Ni-Cr-Mo-Ti can be safely used even after three remelting steps. Further remelting significantly affect the characteristics of the alloys and should not be recommended for the manufacture of metal-ceramic systems

CAD e engenharia reversa como ferramentas de auxílio na fabricação de cartuchos para próteses ortopédicas

The manufacturing of above and below-knee prosthesis starts by taking surfac measurements of the patient s residual limb. This demands the making of a cartridg with appropriate fitting and customized to the profile of each patient. The traditiona process in public hospitals in Brazil begins with the completion of a record file (according to law nº388, of July 28, 1999 by the ministry of the health) for obtaining o the prosthesis, where it is identified the amputation level, equipment type, fitting type material, measures etc. Nowadays, that work is covered by the Brazilian Nationa Health Service (SUS) and is accomplished in a manual way being used commo measuring tapes characterizing a quite rudimentary, handmade work and without an accuracy.In this dissertation it is presented the development of a computer integrate tool that it include CAD theory, for visualization of both above and below-knee prosthesis in 3D (i.e. OrtoCAD), as well as, the design and the construction a low cos electro-mechanic 3D scanner (EMS). This apparatus is capable to automatically obtain geometric information of the stump or of the healthy leg while ensuring smalle uncertainty degree for all measurements. The methodology is based on reverse engineering concepts so that the EMS output is fed into the above mentioned academi CAD software in charge of the 3D computer graphics reconstruction of the residualimb s negative plaster cast or even the healthy leg s mirror image. The obtained results demonstrate that the proposed model is valid, because it allows the structura analysis to be performed based on the requested loads, boundary conditions, material chosen and wall thickness. Furthermore it allows the manufacturing of a prosthesis cartridge meeting high accuracy engineering patterns with consequent improvement in the quality of the overall production process

Satisfação dos usuários e qualidade dos tratamentos protéticos realizados nos centros de especialidades odontológicas da grande Natal RN

Aim: To evaluate user satisfaction and quality of prosthetic treatments performed in specialized dental clinics (CEOs) of Natal Metropolitan Region - RN. Methods: Cross-sectional study with subjects who underwent prosthetic CEOs in the cities of Natal, Macaíba, Parnamirim and Sao Goncalo do Amarante in the period 2007 to 2009. Data collection was performed by questionnaire, clinical examination of the oral cavity and examination of fabricated denture. This analysis involved the following aspects: retention, stability, aesthetics and prosthesis fixation. The variables are presented by means of absolute numbers and proportions. The determination of the association between the independent and dependent variables was conducted by the association of Chi-square test and Fisher exact test. Results: A total of 149 users, totaling 233 conventional dentures (148 upper and 85 lower). Most patients (56.4%) were rehabilitated with conventional complete dentures. The technical quality of the denture was regarded as satisfactory in the majority (52.7%), whereas the inferior dentures were rated as unsatisfactory in 90.5% of cases. Satisfaction with the prosthesis was 69.1% (N = 103). The average time to begin treatment was 3 months to receive while the prosthesis was 4 months old. The presence of injury from the upper prosthesis occurred in 21.5% of cases (N = 32), candidiasis being the most frequent (N = 18). The technical quality of the upper prosthesis (p=0,041), as well as retention (p=0,002) and stability (p<0,001) were significantly associated with user satisfaction. Conclusions: The specialized Dental clinics has been fulfilling its role of providing treatment of intermediate complexity for low-income population with the majority of satisfield patients, even when their dentures have problems of technical quality

Satisfação e impacto da saúde oral na qualidade de vida em pacientes reabilitados com prótese total dupla

Introduction: The rehabilitation of edentulous patients is one of the main challenges of Dentistry. Objective: To assess the satisfaction and the impact of oral health on quality of life of patients rehabilitated with conventional complete dentures in both arcades. Method: A clinical trial with 25 patients rehabilitated with CCD was conducted. The impact of oral health in individuals quality of life was evaluated through the Brazilian version of the OHIP-Edent and the patient satisfaction was evaluated using a specific questionnaire. The instruments were applied before and 3 months after rehabilitation. Results: There was a statistically significant improvement (p <0.001) on the impact of the quality of life of the denture users after the new rehabilitation. The analysis of 4 OHIP domains also showed statistically significant improvement (p <0.001). The final overall satisfaction with the dentures was statistically superior to initial satisfaction (p <0.001). The analysis of the specific aspects of satisfaction with CCD after 3 months of rehabilitation also showed significant results in the improvement of every aspect. Conclusion: Patients disappointed with their dentures, have their quality of life improved after the new rehabilitation, reducing the negative impact of the prostheses on oral health, and improving their satisfaction with the rehabilitation.

Influência do número de refundições da liga Ni-Cr-Mo-Ti sobre as propriedades de próteses metalocerâmicas

A frequently encountered difficulty in oral prosthetics is associated with the loss of metallic alloys during the melting stage of the production of metal-ceramic replacement systems. Remelting such materials could impar their use in oral rehabilitation due to loss in esthetics, as well as in the chemical, physical, electrochemical and mechanical properties. Nowadays, the Ni-Cr-Mo-Ti alloy is widely used in metal-ceramic systems. Manufacturers state that this material can be remelted without significant alterations in its behavior, however little has been established as to the changes in the performance of this alloy after successive remelting, which is common practice in oral prosthetics. Therefore, the objective of this study was to evaluate possible changes in the esthetics and associated properties of metalceramic samples consisting of Ni-Cr-Mo-Ti and dental porcelain. Three to five remelting steps were carried out. The results revealed that Ni-Cr-Mo-Ti can be safely used even after three remelting steps. Further remelting significantly affect the characteristics of the alloys and should not be recommended for the manufacture of metal-ceramic systems