198 resultados para edentulous
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This case report presents details of a new surgical technique for mandibular ridge sagittal osteotomy and expansion associated to immediate dental implants in atrophic ridges. The bone atrophies represents a challenge for the surgeons that intends to modify this situation. In the past, the only viable option was the onlay bone graft. However, the bone graft requests a second surgical site that certainly increases the postoperative morbidity, without mentioning the longer treatment time required. The sagittal osteotomy of the alveolar crest represents a faster option, because it eliminates the time requested for bone graft integration, providing rehabilitation of edentulous areas with thin alveolar crests that otherwise would need additi onal surgical procedures for a satisfactory result. The authors report a clinical case in which this technique was used with the installation of a Bicon dental implant in the same surgical time, showing all the steps for this single-tooth rehabilitation.
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Immediate functioning of osseointegrated implants has been widely employed in edentulous patients due to its safety and high predictability. However, viability and success of immediate-loaded implants is defined by factors such as number of implants, distribution and splinting, as well as reduction of oblique loads and excessive occlusal contacts. The indirect composite resin-modified glass enable building of a highly aesthetic prosthesis, combining satisfactory resistance and better force dissipation on occlusal loading. This article describes a resin composite, mandibular fixed prosthesis on osseointegrated implants in immediate function.
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Jaws atrophy represents a great challenge to Implantology regarding rehabilitation of edentulous areas. This paper reports an extreme mandibular atrophy with only 9mm of height between the mental foramina. In these situations, treatment options include bone augmentation techniques, transmandibular, or short dental implants. It is well accepted that bone grafts to improve height do not have good predictability. Besides, osteogenic distraction is associated with a great patient discomfort and transmandibular implants are related with high failure rates. Also, surgical-prosthetic rehabilitations with short dental implants had been associated to good success rates. The purpose of this clinical case is to report a severe mandibular atrophy, successfully treated with four short dental implants between mental foramina for implant-supported prosthesis.
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The incidence of fractures of the atrophic edentulous mandible is still low, even with the increasing life expectancy. The reduced blood supply of the sclerotic bone, the diminished contact area between bone fragments and the patient’s systemic condition makes the treatment of those fractures a challenge for any professional. Treatment of atrophic mandibular fractures by means of miniplate osteosynthesis has not been the preferred method of fixa- tion by many authors. Yet, many surgeons have applied this type of fixation for the atrophied jaw sections. This paper reports 2 cases of fractured atrophic mandibles treated with the pencilboneplate, a monocortical 2.0 mm titanium, 8 or 10-hole hardware with reinforcement on its middle portion, highlighting important considerations of its use. The pencilboneplate appears to be a valuable option for the treatment of atrophic mandibular fractures, espe- cially by an intra-oral approach, and warrants further bio- mechanical and clinical studies.
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The surface of dental implants is an important factor for osseointegration process and different methods of surface treatment have been described. Objective: To investigate the bone apposition in implant surface treated with sandblasting and acid-etching. Material and methods: Ten rabbits were selected and received one implant treated with method I in the left tibia and one implant treated with method II in the right tibia. Then, twenty implants were divided in two groups, according to methods of sandblasting and acid-etching (method I and method II). After 7, 14, 30, 45 and 60 days, tibias were retrieved and submitted to histotechnical procedures. The percentages of bone–implant contact (BIC) and bone area between threads (BABT) were determined throughout histomorphometric analysis and bone apposition was detected in implants of both groups. Results: In BABT measurements, an increase was observed after 45 and 60 days in the method II, compared to method I and no differences were found after 7, 14 and 30 days. In BIC measurements, an increase was detected with method II at 45 days when compared to method I. No differences between groups in BIC values were observed after 7, 14, 30 and 60 days. Conclusion: Our data demonstrated that implants treated with the method II presented increase in the contact between bone and implant after 45 days compared to method I. Moreover, with concern to bone area between threads, it was observed an increased in the method II after 45 and 60 days. However, both groups can be successfully used as a therapeutic strategy to rehabilitation of edentulous patients. Then, further experiments are needed to evaluate, in depth, the putative differential role of each surface treatment.
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Introduction: the oral rehabilitation in edentulous patients using removable complete dentures is a classic treatment, easily accessible, and presenting satisfactory results. However, to succeed in this type of treatment, stability is an extremely important factor. The neutral zone technique for the production of complete dentures determines the oral cavity space for the positioning of teeth and denture base that provide a neutralization of the forces delivered by lips, cheeks, and tongue, providing better stability and retention of prostheses, which is indicated in cases with history of difficulties in adapting the conventional mandibular denture. Objective and case report: this paper aimed to describe a clinical case report of the oral rehabilitation of a patient with paraprosthetic muscles hypertonicity through removable complete dentures produced by the neutral zone technique, using condensation silicone. Final considerations: the use of condensation silicone for the development of the neutral zone technique showed to be a good alternative for the development of this clinical case, providing satisfactory stability and retention of the complete mandibular denture.
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The process of bone resorption can reduce the volume of the alveolar crest, which makes may make difficult impression taking of the alveolar tissue and the subsequent fit of a new denture. This clinical report describes a fast and simple technique for impressions of edentulous ridges to replace complete dentures, using a temporary tissue conditioner material on the denture base. The existing denture must cover the whole supporting area and should be in harmony with the adjacent oral structures. This technique reduces the number of steps involved and minimizes treatment time and expenses.
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Nowadays, the fixed partial dentures and/or dental implants is the most requested treatmentby the majority of partially edentulous patients. However, depending on the periodontal condition of the remaining teeth, as well as the bone condition of the prosthetic space, the oral rehabilitation with these treatments may be limited or even contraindicated. In such cases, the use of removable partial dentures associated to attachments becomes an important alternative for aesthetic and functional rehabilitation. Attachments are mechanical devices consisted of two parts (patrix-matrix), one placed inside another, which act as direct retainer, providing retention, support and stability to the dentures. These devices can be classified as intra or extracoronal attachments, considering their position in relation to the abutment tooth. However, regardless the type of attachment, the association between fixed and removable partial dentures should be performed respecting the biomechanical principles of both. Therefore, the purpose of this study was to review and discuss the literature about the clinical and laboratory implications of the association between fixed and removable partial dentures by means of attachments.
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The objective of this study was to evaluate the impact of replacing conventional mandibular complete dentures by complete fixed dentures on the oral health-related quality of life and kinesiographic parameters of maxillary edentulous patients. Material and Methods: edentulous patients (n = 16) received one set of new complete dentures and after the intraoral adjustments and adaptation period (30 days), the Brazilian version of Oral Health Impact Profile for assessing edentulous subjects (Ohip-Edent) was used to evaluate the oral health-related quality of life (OHQOL) of the participants. Additionally, the kinesiograph instrument K6-I (Myotronics Research Inc., Seattle, WA) was used to record opening and closure range of movement, mandibular movement, and the pattern of maxillary complete denture movement on chewing. Afterwards, the patients had their mandibular complete dentures replaced by a complete fixed denture and the same evaluation protocol was performed after 3 and 6 months. Ohip-Edent responses were analyzed using Wilcoxon's test for repeated measures (α = .05) and Kinesiographic data using the Student´s t test (α = .05). Results: The Ohip-Edent showed an improvement of general oral health-related quality of life after 3 and 6 months of the treatment with complete fixed dentures. Kinesiographic recordings revealed a significant increase on maximum mandibular movements of vertical opening and no differences for the movement of the maxillary complete denture on chewing after treatment with complete fixed dentures was observed. Conclusion: the installation of complete fixed dentures improved the OHQOL and changed mandibular movements, with increases in vertical amplitude of maximal opening.
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The use of different methods and materials should be considered during the planning of implant-supported prostheses. Complications such as fractures of the acrylic resin base, wear and fracture of teeth can occur frequently, creating the need for careful planning for each patient, which can make the selection of the type of treatment more complex. Thus, this article describes the oral rehabilitation of a completely edentulous patient with bimaxillary fixed implant-supported prosthesis, with complaints on aesthetics, loss of vertical dimension and fracture of acrylic resin teeth of the upper arch. After the restoration of vertical dimension, his dentures were replaced with new bimaxillary implant-supported fixed prostheses, ceramic and acrylic resin were used as veneering material for maxilla and mandible, respectively. At the end of the treatment, the patient received bimaxillary flat occlusal splints to protect the teeth and implants of possible parafunctional habits. The approach for the treatment allowed a quick and effective resolution, with aesthetic and functional outcomes very favorable for the patient.
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The contemporary implant dentistry is in constant technological development, improving the oral rehabilitation process of partial or totally edentulous patients. On the other hand, anatomical limitations, such as the maxillary sinus and the mandibular canal in the posterior region of the jaws can limit the implant placement. Furthermore, due to the absence of dental elements, alveolar ridge atrophy is frequently observed. This aspect represents a loss either in quantity or quality of the bone tissue available for the dental implant rehabilitation. To make possible the dental implant rehabilitation even in adverse conditions, some solutions have been considered, such as the use of short implants (≤ 10 mm length) and/or small diameter implants (2,8; 3,3 and 3,5 mm width). The aim of this study is to present a literature review considering the use of short implants in oral rehabilitation, presenting the currently view of the matter. Based on the literature review, the use of short implants produced similar clinical success to conventional implants (greater than 10 mm in length). Therefore, its use can be considered a viable alternative, where anatomical limitations are present.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Statement of problem Masticatory performance analysis of conventional complete denture wearers who use denture adhesives is scarce in the dental literature. Purpose The purpose of this study was to assess the effect of the use of 2 denture adhesives on the masticatory performance of conventional complete denture wearers by means of a crossover study. Material and methods Forty individuals who were edentulous received new maxillary and mandibular complete dentures, and, after an adaptation period, were submitted to masticatory performance analysis without denture adhesive (control). The participants were randomly divided and assigned to 2 protocols: protocol 1, denture adhesive 1 (Ultra Corega cream tasteless) use during the first 15 days, followed by no use of denture adhesive over the next 15 days (washout), and then use of denture adhesive 2 (Ultra Corega powder tasteless) for 15 days; protocol 2, denture adhesive 2 (Ultra Corega powder tasteless) use during the first 15 days, followed by no use of denture adhesive during the next 15 days (washout), and then use of denture adhesive 1 (Ultra Corega cream tasteless) for 15 days. The masticatory performance was assessed immediately after the use of denture adhesive by means of the sieve method, in which participants were instructed to deliberately chew 5 almonds for 20 chewing strokes. Masticatory performance was calculated by the weight of comminuted material that passed through the sieves. Data were analyzed by a 1-way ANOVA for paired samples and the multiple comparison of means by using the Bonferroni test (α=.05). Results A significant increase in masticatory performance was noted after using the Ultra Corega cream (mean, 32.6%) and Ultra Corega powder (mean, 31.2%) when compared with the control group (mean, 19.8%) (P<.001). No significant difference was found between the 2 denture adhesives evaluated. Conclusion The use of denture adhesive improved the masticatory performance of conventional complete denture wearers. No difference was found in masticatory performance with the use of cream or powder denture adhesive.
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The aim of this study was to relate the clinical case of a patient with oral lichen planus (OLP) and a history of epidermoid carcinoma associated with metallic restorations. The etiology of OLP is a mucocutaneous disease, which is poorly understood. Studies point to the potential of malignant transformation of OLP and its association with metallic restorations. The metallic restorations were replaced by crowns with a ceramic covering associated and osseointegrated implants in the edentulous areas. About 1 year later, it was observed a bilateral regression of the tongue lesions. The replacement of metallic restorations can contribute to improvement of OLP.
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The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time.