Qualidade de vida em portadores de paralisia cerebral: associação com nível funcional e aspectos sócio-demográficos

Pós-graduação em Saúde Coletiva - FMB

Uso de um distrator ósseo dentoimplantossuportado, feito a partir de tornos expansores convencionais, na reabilitação oral

Osteodistraction is a clinical reality, available in the last decades for the resolution of large bone deficiencies, in cases that there are pre-existing, but misplaced implants and teeth. The aims of thearticle is to present a case report in which a new possibility for bone distraction, based on tooth-implant bone distractors, made from standard orthodontic expansion-screws, was used in an area where there was an extensive need of alveolar bone and aesthetical recovery, allied to teeth and dental implant misplacement. This technique presented good clinical results, associated to effective simplicity and low cost, becoming viable clinical solution for bone tissue augmentation and aesthetical optimization. In resume, it is possible to say that the suggested technique achieved its objectives, improving the hard and soft tissue profile, whilst allowing completion of oral rehabilitation.

Reabilitação oral de paciente com síndrome da combinação: relato de caso

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and loss of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Reabilitação oral de paciente com sequela cirúrgica utilizando a técnica da zona neutra: relato de caso clínico

Objective and Case report: The purpose of this paper is to describe the neutral zone technique in a patient with oral deformity on the right labial commissure due to the resection of an oral cancer, enhancing the difficulty resulting from mouth limited opening and the use of tissue conditioner material to determine the neutral zone. Complete denture was obtained through this technique, providing good retention and stability which made functional rehabilitation feasible to patient of his or her masticatory function. Final considerations: The neutral zone technique in complete dentures will determine a specific intraoral area for tooth position and denture base contour where the forces generated by lips, cheeks and tongue are neutralized. The objective of this technique is to provide an alternative approach for patients who presented an historic instability of lower complete denture: atrophic ridge, oral deformities and also with disorder problems. An oral rehabilitation using this technique improves comfort to the patient providing retention and stability of mandibular complete dentures.

Prótese metalocerâmica associada à prótese metaloplástica implantossuportada em paciente desdentado total

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.

Técnica estrutural: confecção de pilar personalizado cerâmico para otimizar a estética

Na reabilitação protética com implantes, a reconstituição das características anatômicas do tecido peri-implantar é fundamental para a obtenção de uma estética ótima. Como os componentes metálicos não transmitem a luz, fazem com que os pacientes com fenótipos gengivais finos apresentem uma coloração escurecida, resultante da limitação estética desses componentes. Pilares cerâmicos (alumina ou zircônia) têm sido utilizados para resolver esse problema, os quais possibilitam a complementação com próteses metal free. A indústria fornece, para alguns sistemas, componentes pré-fabricados cerâmicos a serem personalizados por desgastes e componentes personalizados confeccionados com sistemas CAD/CAM e CAD/MAN. Tendo em vista as limitações de algumas das conexões desses componentes, o objetivo desse estudo é apresentar a técnica laboratorial para confecção de um pilar personalizado cerâmico realizado sobre pilar UCLA de sobrefundição. Concluiu-se que a utilização da cerâmica feldspática proporciona ótima estética, boa transparência, resistência mecânica, baixo custo, melhor capacidade adesiva, com utilização de cimentos resinosos, e, principalmente, técnica de amplo domínio dos laboratórios.

Análise das proporções faciais e sua relação com o formato dentário e com a dimensão vertical de repouso e de oclusão entre discentes institucionalizados

Considering the importance of the esthetic and the adequate register of vertical dimension (VD) to the oral rehabilitation, this study had as aims the analysis and comparison of two methods to get VD (Pleasure and Willis), functional space (FE), acquisition and correlation of facial and dental measurements. To do this, rest (RVD) and occlusal vertical dimension (OVD) and FE were achieved from the 30 students of the Federal University of Goias College of Dentistry. Following that, dental measurements of height and of the superior central incisors (SCI) and canine distance were registered. A facial analysis was performed to get the intercomissura, interalar, interpupilar, intercantal distance, besides register parameters as coincidence of dental and facial line, type of smile, face and SCI forms, and mastication type. The collected data were tabulated, compared by medias and standard deviations, and submitted to non-parametrical statistical analysis of Kruskal-Wallis and .Mann-Whitney with 5% of probability. The results doesn’t indicated statistical significant difference between FE of the two techniques. The measures of facial analysis are comparable with literature published data’s, but can’t be used as a parameter to the selection of intercanine distance. In 56.7% of the cases, there were coincidences of face and SCI forms, which could be a viable parameter in the selection of acrylic resin artificial tooth.

Reabilitação protética com associação entre prótese parcial removível e implante dentário: relato de caso

Removable partial denture improve functional and aesthetic failures caused by partial loss of teeth, however specific characteristics of each patients can determine the success of treatment, especially with regard to the support of the prosthesis, which may depend on teeth, the combination of teehe and mucosa and currently associated with the dental implants. The aim of this study is report a case in which there was the need of the association, to enable better aesthetics and self-esteem to the patients. After implant placement and fabrication of prosthetic patient reported satisfaction with the rehabilitation treatment, improving their quality of life.

A utilização de abutment de zircônia na reabilitação oral: aspectos protéticos e periodontais

Zirconia abutments are used to obtain satisfactory aesthetic results in implant fixed anterior prostheses when metal abutments promote a grayish mucosal discoloration of the peri-implant soft tissues. However, there is a lack of studies to confirm the clinical performance of the peri-implant soft tissues surrouding zirconia abutments. This study described a case report of a patient treated with implant fixed all-ceramic crown made out on zirconia abutment after 3 years of followup. A 47-year-old female patient was admitted to the dental clinic (Aracatuba Dental School) complaining about the fracture of her implant fixed single crown in the region of the left lateral incisor. The patient chose the replacement of the fractured prosthesis for an allceramic crown. After 3 years of follow-up it was observed that maintenance of the aesthetic results and the peri-implant soft tissue without any inflammation or gingival recessions. Within the limitations of a case report, it can be conclude that zirconia abutments is a effective rehabilitation treatment because it preserves the aesthetics and function through the maintenance of peri-implant tissues.

Reabilitação Oral: prótese livre de metal, Removível e implantes. Um caso de 12 anos de acompanhamento

The literature has suggested that the association of removable partial dentures with dental implants can improve the quality of life of patients. Thus, the purpose of this study was to present a case report. This case report describes the development of a removable partial denture associated with dental implants bilaterally been monitored for 12 years, and the efficacy of the proposed treatment. The radiographic controls demonstrated no changes on bone tissue. The maxillary arch was rehabilitated with metal-free crowns. The patient was fully satisfied with this technique providing stability, esthetics, and proper function. It was concluded that the technique of using removable partial dentures associated with dental implants is viable and show the advantages of improved function, aesthetics and cost reductions in rehabilitation treatment.

A oclusão nas próteses totais implantossuportadas mediatas e imediatas

Rehabilitation of edentulous patients has been a challenge for professionals since the primary concepts and fundaments of occlusal rehabilitation. However, this philosophy has been improved by implant-supported fixed dentures that represent a predictable clinical modality on modern dentistry. Nevertheless, considering that the traditional protocol requires a long period for bone healing and definitive rehabilitation, immediate loading of implants has been advantageous for functional and esthetic rehabilitation of patients in a reduced period. The aim of this study is to discuss the biomechanical and functional fundaments of occlusion for implant-supported fixed dentures with mediate and immediate loading to provide clinical evidences for longevity of this treat ment modality based on the current literature. According to this, some prerequisites as proper bone quality, excellent primary stability, sufficient number of implants, rigid splinting, and control and mastering of biomechanical fundamentals of static and dynamic occlusion are mandatory for treatment predictability and longevity.

Planejamento em reabilitação oral: restabelecimento da relação intermaxilar por meio de prótese provisória overlay

The present article describes the treatment planning and fabrication of overlay denture to restore the jaw relationship in a partial edentulous patient with bruxism. A male patient, 51 years old, was referred to the oral rehabilitation clinic complaining about the chewing and aesthetic. The occlusal surface of the superior teeth presented severe wear. The fabrication of an interim overlay denture to restore the jaw relationship was planned. The overlay had metallic projections and covered the occlusal surface of superior teeth. After overlay insertion both function and aesthetic of the patient were recovered. It was concluded that the use of overlay improved the physiological normal position of the jaw and could provide a favorable prognosis for a definitive oral rehabilitation with implant-supported fixed denture.

O impacto das próteses implantosuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.

Parafunção severa: reabilitação oral com prótese total mandibular x overlay maxilar: relato de caso

In many oral rehabilitation professionals seeking venture renew people smile. However, these procedures have functional implications and aesthetic criteria which must be satisfied so that the final result is predictable. The restoration of relations intermaxillary, phonetics, masticatory function, esthetics and patient comfort are the goals to be achieved. An effective way to achieve these goals when immediate reconstruction with permanent dentures is not possible, make use of a type of partial denture called overlay. Bruxism is a manifestation of biopsychological imbalance that affects the stomatognathic system, characterized by clenching and / or attrition of teeth together so centric or eccentric, can be manifestation of nocturnal or diurnal. Its effects can manifest themselves in different parts of the stomatognathic system, varying the severity of the damage as the resistance of the structures affected, the time of existence, its regularity and the general state of the wearer. The description of the steps followed in solving this case, in which the patient edentulous mandibular arch while the maxillary arch showed absence of teeth 16 and 26 and, except for the teeth 17 and 27, all other teeth showed wear very sharp in the sense denoting incisal cervical, severe impairment of the vertical dimension, the quality of masticatory function and a marked impairment phonetic, this case report aims to guide the beginning of a rehabilitation, as well as the transitional phase of treatment for recovery of functional and aesthetic relationships intermaxillary .

O impacto das próteses implantossuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.