A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review

Background:It has been stated that mandibular overdentures are more satisfactory than conventional dentures, but problems relating to the use of retrospective ratings, lack of control group and sequential provision of treatment may compromise the findings.Objective:To establish a comparison between treatment with conventional complete dentures and implant-retained overdentures in elderly patients by conducting a literature review.Materials and methods:A search of English language peer-review literature was completed using Medline up to 2008 focusing on evidence-based research. Randomised clinical trials (RCTs) and longitudinal prospective studies were favoured in the review, using a general hierarchical classification. Articles that did not focus exclusively on the comparison of patient satisfaction between complete dentures and overdentures were excluded from further evaluation. The last search was conducted in February 2008. Key terms included quality of life, patient satisfaction, edentulism, complete denture and overdenture.Results:Among the 90 articles found in the initial search, 27 met the inclusion criteria. This included 18 RCTs and eight prospective and one cohort study. Most of the articles stated superiority of the mandibular implant-retained overdenture therapy over the conventional complete denture regarding patient satisfaction and quality of life.Conclusion:Even with implant treatment presenting higher patient satisfaction and improvement of quality of life, it was not possible to establish a direct comparison between the studies due to differences in adopted methodologies.

Aesthetic Approach in Single Immediate Implant-Supported Restoration

The aim of this study was to analyze the main aspects that influence the aesthetics of single immediate implant-supported restorations through a literature review on the MEDLINE database. It was observed that immediate implant-supported restorations present clinical success with aesthetic predictability demonstrated by the literature. Proper patient selection and diagnostic and multidisciplinary planning are essential and should be associated to technical ability of professional and knowledge concerning the biology of peri-implant tissues. It is suggested that provisional restoration should be immediately inserted after implant fixation to guide healing of gingival tissues with a proper emergence profile besides psychologic comfort for a patient due to immediate aesthetic reestablishment.

Prototyping for Surgical and Prosthetic Treatment

Techniques of rapid prototyping were introduced in the 1980s in the field of engineering for the fabrication of a solid model based on a computed file. After its introduction in the biomedical field, several applications were raised for the fabrication of models to ease surgical planning and simulation in implantology, neurosurgery, and orthopedics, as well as for the fabrication of maxillofacial prostheses. Hence, the literature has described the evolution of rapid prototyping technique in health care, which allowed easier technique, improved surgical results, and fabrication of maxillofacial prostheses. Accordingly, a literature review on MEDLINE ( PubMed) database was conducted using the keywords rapid prototyping, surgical planning, and maxillofacial prostheses and based on articles published from 1981 to 2010. After reading the titles and abstracts of the articles, 50 studies were selected owing to their correlations with the aim of the current study. Several studies show that the prototypes have been used in different dental-medical areas such as maxillofacial and craniofacial surgery; implantology; neurosurgery; orthopedics; scaffolds of ceramic, polymeric, and metallic materials; and fabrication of personalized maxillofacial prostheses. Therefore, prototyping has been an indispensable tool in several studies and helpful for surgical planning and fabrication of prostheses and implants.

Passivity in Implant-Supported Prosthesis

Because of the widespread use of implant-supported restorations and that the success of this treatment depends on the passivity of the different component systems of implant-prosthesis, a literature review was performed to highlight issues related to passivity in framework of implant-supported fixed prosthesis. A search of English-language peer-review literature was completed using MEDLINE database (PubMed) focusing on acceptable levels of passivity, misfit classification, problems related to misfit, methods to evaluate misfit, general factors that affect the passivity, and the biologic tolerance in the presence of misfit. The information obtained in the present review suggested that even if it is hard to obtain an implant-supported prosthesis with complete passivity, the professional should use the technological resources to offer better conditions for their patients. An acceptable clinical level of passivity that does not cause any problem to the biologic, aesthetic, and functional parameters of the patient should be sought.

The use of transitional implants to support provisional prostheses during the healing phase: a literature review

Objective: Transitional implants are indicated for cases in which immediate loading is counter-indicated because a healing period is necessary for osseointegration of the definitive implants. These provisional implants were developed to support an implant-supported fixed prosthesis or overdenture to provide retention, stability, and support. The aim of this article was to conduct a literature review on transitional implants to highlight the characteristics of the transitional implants and their advantages, indications, and contraindications, including the level of osseointegration of such implants according to the functional period. Method and Materials: The present literature review was based on the OldMedline and Medline databases from 1999 to 2010 using the key words "transitional implants" and "temporary implants." Fourteen articles were found: 11 clinical studies or techniques and three histologic and histomorphometric studies. Results: The transitional immediate prostheses were worn by completely and partially edentulous patients. Advantages of transitional implants include complete denture retention, stability, and support; maintenance of chewing, phonetics, and patient comfort; protection of bone grafts; vertical stop during healing period; easy and fast surgical and prosthetic procedures; lower cost in comparison to the definitive implant; and reestablishment of esthetics. The success of transitional implants as conservative treatment for conventional immediate loading is a reality if correctly indicated. Conclusion: Transitional implants are a provisional treatment alternative for completely and partially edentulous patients. However, additional studies are required to evaluate the level of remodeling and repair of the transitional implants under loading. (Quintessence Int 2011; 42: 19-24)

Computer-Guided Surgery in Implantology: Review of Basic Concepts

The aim of the present study was to conduct a critical literature review about the technique of computer-guided surgery in implantology to highlight the indications, purposes, immediate loading of implants and complications, protocol of fabrication, and functioning of virtual planning software. This literature review was based on OLDMEDLINE and MEDLINE databases from 2002 to 2010 using the key words "computer-guided surgery" and "implant-supported prosthesis." Thirty-four studies regarding this topic were found. According to the literature review, it was concluded that the computer-assisted surgery is an excellent treatment alternative for patients with appropriate bone quantity for implant insertion in complete and partially edentulous arches. The Procera Nobel Guide software (Nobel Biocare) was the most common software used by the authors. In addition, the flapless surgery is advantageous for positioning of implants but with accurate indication. Although the computer-guided surgery may be helpful for virtual planning of cases with severe bone resorption, the conventional surgical technique is more appropriate. The surgical guide is important for insertion of the implants regardless of the surgical technique, and the success of immediate loading after computer-guided surgery depends on the accuracy of clinical and/or laboratorial steps.

pH-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations

Despite a plethora of in situ studies and clinical trials evaluating the efficacy of fluoridated dentifrices on caries control, in vitro pH cycling models are still broadly used because they mimic the dynamics of mineral loss and gain involved in caries formation. This paper critically reviews the current literature on existing pH-cycling models for the in vitro evaluation of the efficacy of fluoridated dentifrices for caries control, focusing on their strengths and limitations. A search was undertaken in the MEDLINE electronic journal database using the keywords "pH-cycling", "demineralization", "remineralization", "in vitro", "fluoride", "dentifrice". The primary outcome was the decrease of demineralization or the increase of remineralization as measured by different methods (e. g.: transverse microradiography) or tooth fluoride uptake. Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. One hundred and sixteen studies were included, of which 42 addressed specifically the comparison of dentifrices using different pH-cycling models. The other studies included meta-analysis or reviews, data about the effect of different fluoride sources on de-remineralization, different methods for analysis de-remineralization and chemical variables and characteristics of dental hard tissues that might have influence on de-remineralization processes. Generally, the studies presented ability to detect known results established by clinical trials, to demonstrate dose-related responses in the fluoride content of the dentifrices, and to provide repeatability and reproducibility between tests. In order to accomplish these features satisfactorily, it is mandatory to take into account the type of substrate and baseline artificial lesion, as well as the adequate response variables and statistical approaches to be used. This critical review of literature showed that the currently available pH-cycling models are appropriate to detect dose-response and pH-response of fluoride dentifrices, and to evaluate the impact of new active principles on the effect of fluoridated dentifrices, as well as their association with other anti-caries treatments.

A importância da interação entre odontopediatrias e pediatrias no manejo de dentes natais e neonatais

OBJETIVO: Apresentar revisão de literatura sobre dentes natais e neonatais, abordando características clínicas, fatores etiológicos, medidas terapêuticas e a importância do conhecimento desta anomalia, por odontopediatras e pediatras. FONTES DE DADOS: Foram selecionados os artigos mais relevantes sobre o tema, desde 1950 até 2006, pesquisados no Medline e na Bibliografia Brasileira em Odontologia (BBO), além de livros de pertinentes. SÍNTESE DOS DADOS: Os dentes natais e neonatais consistem em uma anomalia de erupção, sendo caracterizados por seu irrompimento na cavidade oral durante o período intra-uterino ou no primeiro mês de vida respectivamente, podendo fazer parte da dentição decídua normal ou supranumerária. Esses dentes, em geral, apresentam bordos cortantes e podem estar relacionados ao aparecimento de ulcerações na base da língua do bebê e/ou no seio materno, comprometendo a amamentação. A fraca implantação óssea desses dentes favorece sua grande mobilidade, tornando-se, assim, um fator de risco à sua aspiração ou deglutição pela criança. A abordagem terapêutica depende da dentição à qual pertence o dente e dos possíveis problemas que este pode causar à saúde da criança ou da mãe. CONCLUSÕES: O conhecimento sobre as características clínicas e os possíveis distúrbios aos quais os dentes natais e neonatais estão relacionados por odontopediatras e pediatras possibilita a interação necessária para o diagnóstico precoce e a abordagem integral da criança.

Bruxismo na infância: um sinal de alerta para odontopediatras e pediatras

OBJETIVO: Apresentar uma revisão de literatura sobre o bruxismo na infância, abordando os fatores etiológicos, as características clínicas, os sinais e sintomas, a importância do diagnóstico por parte dos pediatras e odontopediatras e o tratamento multidisciplinar desta condição parafuncional. FONTES DE DADOS: Foram selecionados os artigos mais relevantes sobre o tema publicados desde 1907 até 2007, com pesquisa realizada no Medline, na Bibliografia Brasileira de Odontologia (BBO) e em livros de Odontologia. SÍNTESE DOS DADOS: O bruxismo é definido como um hábito não funcional do sistema mastigatório, caracterizado pelo ato de ranger ou apertar os dentes, podendo ocorrer durante o dia e durante o sono. A etiologia é multifatorial e a literatura sugere vários fatores associados: dentário, fisiológico, psicológico e neurológico. As forças exercidas pelo bruxismo podem provocar distúrbios em diferentes graus nos dentes e nos tecidos de suporte, na musculatura e na articulação têmporo-mandibular. O sinal mais comum é o desgaste nas faces incisais dos dentes anteriores e oclusais nos posteriores, além de mobilidade e hipersensibilidade dentárias, fratura de cúspides e restaurações e hipertonicidade dos músculos mastigatórios. CONCLUSÃO: O conhecimento dos fatores etiológicos e das características clínicas do bruxismo na infância é fundamental para que o diagnóstico seja precoce, permitindo que pediatras, odontopediatras e psicólogos possam estabelecer um tratamento multidisciplinar e favoreçam o desenvolvimento integral da criança para a promoção de saúde e bem-estar individual.

Epidemiological aspects of rheumatoid arthritis patients affected by oral bisphosphonate-related osteonecrosis of the jaws

This literature review aims to evaluate the epidemiologic profile of patients with rheumatoid arthritis (RA) that developed a bisphosphonate-related osteonecrosis that affect the jaws (BRONJ), including demographic aspects, as well as clinical and therapeutic issues. A search of PUBMED/MEDLINE, Scopus, and Cochrane databases from January 2003 to September 2011 was conducted with the objective of identifying publications that contained case reports regarding oral BRONJ in RA patients. Patients with RA who develop oral BRONJ are usually women above 60 years taking steroids and long-term alendronate. Most of them have osteoporosis, and lesions, triggered by dental procedures, are usually detected at stage II in the mandible. Although there is no accepted treatment protocol, these patients seem to have better outcomes with conservative approaches that include antibiotic therapy, chlorhexidine, and drug discontinuation.

Cytotoxicity of denture base and hard chairside reline materials: a systematic review

Statement of problem. Adverse reactions to the materials used for the fabrication and reline of removable denture bases have been observed.Purpose. The purpose of this study was to systematically review the published literature on the cytotoxicity of denture base and hard reline materials.Material and methods. MEDLINE via PubMed, Google Scholar, and Scopus databases for the period January 1979 to December 2009 were searched with the following key words: (biocompatibility OR cytotoxic* OR allergy OR burning mouth OR cell culture techniques) and (acrylic resins OR denture OR monomer OR relin* OR denture liners). The inclusion criteria included in vitro studies using either animal or human cells, in which the cytotoxicity of the denture base and hard chairside reline resins was tested. Studies of resilient lining materials and those that evaluated other parameters such as genotoxicity and mutagenicity were excluded. Articles published in the English language and in peer-reviewed journals focusing on the cytotoxicity of these materials were reviewed.Results. A total of 1443 articles were identified through the search. From these, 20 studies were judged to meet the selection criteria and were included in the review. In the majority of the studies, continuous cell lines were exposed to eluates of specimens made from the materials, and mitochondrial activity was used to estimate cell viability. The tested acrylic resins were grouped according to 5 major categories: (1) heat-polymerized; (2) microwave-polymerized; (3) autopolymerizing; (4) light-polymerized; and (5) hard chairside reliners.Conclusions. This review provided some evidence that the heat-polymerized resins showed lower cytotoxic effects than autopolymerizing denture base acrylic resins and light or dual polymerized reline resins. However, because of the large number of variables in the reviewed literature, a definitive conclusion could not be drawn. (J Prosthet Dent 2012;107:114-127)

Single crowns versus conventional fillings for the restoration of root filled teeth

BackgroundEndodontic treatment, involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth which may influence long term survival and cost. The comparative in service clinical performance of crowns or conventional fillings used to restore root filled teeth is unclear.ObjectivesTo assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials.Search methodsWe searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME and the reference lists of articles as well as ongoing trials registries. There were no restrictions regarding language or date of publication. Date of last search was 13 February 2012.Selection criteriaRandomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth which have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration, as well as indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any.Data collection and analysisTwo review authors independently assessed trial quality and extracted data.Main resultsOne trial judged to be at high risk of bias due to missing outcome data, was included. 117 participants with a root filled premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. At 3 years there was no reported difference between the non-catastrophic failure rates in both groups. Decementation of the post and marginal gap formation occurred in a small number of teeth.Authors' conclusionsThere is insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth. Until more evidence becomes available clinicians should continue to base decisions on how to restore root filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.

Atividade física sistematizada e sintomas de depressão na demência de Alzheimer: uma revisão sistemática

OBJETIVO: Realizar uma revisão sistemática de artigos científicos que analisaram os efeitos da atividade física sistematizada nos sintomas de depressão de pacientes com demência de Alzheimer. MÉTODOS: Foi realizada uma busca nas seguintes bases de dados: Web of Science, PubMed, PsycINFO, MedLine e Biological Abstracts, utilizando-se as seguintes palavras-chave: Alzheimer dementia , Alzheimer disease , Alzheimer, physical activity, physical exercise, motor intervention , physical therapy , exercise , aerobic , strength , fitness , depression , dysphoria , depressive symptoms e depressive episodes. Além da busca nas bases de dados, foi realizada também uma busca manual nas listas de referências dos artigos selecionados. RESULTADOS: Foram encontrados quatro estudos que preencheram todos os critérios de inclusão adotados para o presente trabalho. Dois estudos apresentaram reduções dos sintomas depressivos, e outros dois não encontraram redução desses sintomas. CONCLUSÃO: Com a realização desta revisão sistemática, observou-se que não há consenso em relação aos benefícios da atividade física aos sintomas depressivos em pacientes com demência de Alzheimer.

Atividade física sistematizada e desempenho cognitivo em idosos com demência de Alzheimer: uma revisão sistemática

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Papel do exercício físico na isquemia/reperfusão pulmonar e resposta inflamatória

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)