Reconstrução imediata de fenestração peri-implantar com enxerto autógeno em bloco de ramo mandibular

Alveolar wall fenestrations are common during implant placement. The aim of this paper is to report a case where a peri-implant bone fenestration was reconstructed immediately after implant placement by an autogenous mandibular bone block. A male patient was referred to the Department of Surgical and Integrated Clinics to substitute his Kennedy´s Class IV removable partial denture for an implantsupported fixed prosthesis. A peri-implant bone fenestration at the buccal wall was seen at the region of 12, being reconstructed by a mandibular bone block secured by a bicortical screw. Six months later the surgical procedures, an implant-supported complete fixed partial prosthesis was developed. The autogenous bone block harvested from the mandibular ramus was a safe alternative to reconstruct the peri-implant bone defect such as fenestration types.

Impacto do uso de fita adesiva na qualidade de vida de pacientes institucionalizados e usuários de próteses totais convencionais

Objective: Evaluate the impact of the use of strip adhesive over the quality of life of institutionalized patients and wearers of complete dentures. Material and method: Twenty-nine institutionalized patients wearers of complete denture were selected to this study and after a clinical exam, a questionnaire (adjusted and based upon the index of Oral Health Impact Profile and Oral Health-Related Quality of Life, OHIP and OHQOL) was applied to evaluate issues related to epidemiological conditions (gender and age), quality of life (pain, discomfort, functional limitations, phonetic, social, psychological and esthetic), taste and notion of implant treatment. Following this part, the patients received instruction to use the strips adhesives (Corega Fita Adesiva, Glaxo-Smith-Kline, Rio de Janeiro, Brazil), considering three in maxillary prosthesis and two in the lower prosthesis during a period of 30 days. After this period, all the patients were recall and the questionnaire was reapplied; add some adhesive performance questions, to compare the results before and after the adhesive use in terms of percentage. Result: After the adhesive strips use there were improvement of the functional, social and physcological limitation aspects, but without percentual increasement of phonetic and esthetics aspects. The results showed 65.5% of the answers stating adhesive maintenance between 6-12 hours, easy removal (68.9%), and without change the taste (89.6%). The notion for implant treatment was decreased changing from 75.8 to 37.9% after the adhesive use. Conclusion: The results enhanced a positive impact over quality of life of the respondents after the strip adhesive use, showing decrease of pain and discomfort, mainly of inferior dental prosthesis.

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.

Fatores biomecânicos relevantes na seleção dos grampos em próteses parciais removíveis com extremo livre: estudo clínico

The free-end removable partial dentures (RPD) shows a complicated and peculiar biomechanical behavior that impose high occlusion forces to the abutment teeth. By this way, the aim of this study was to evaluate the several factors that influence the clasps indication to free-end RPD. It was analysed 84 designed and planned study models of 71 patients, involving 130 clasps near-by a free-end; followed by clinical and radiographical informations. It was observed that bar clasps (“T”, “Tmod”, “i”) were used in 88.46% of abutment teeth. In the others (11.55%), it was used simple, combinated or ring circumferential clasps, and MDL. In abutment teeth with high equator line the “i” clasps were predominant (48.48%). The “Tmod” clasps were predominant in abutment teeth with low equator line (50%) or in middle third (51.35%) and “T” clasps were predominant in inclined equators with mesio-buccal (56.52%) or disto-buccal (66.66%) retention. In the posterior abutment teeth, it was prevalent the distal rest (63.52%) and embracing to the adjacent tooth. Some others factors like long clinical crown (5.38%), wrong position of abutment teeth (4.61%), aesthetics (3.07%), retention in alveolar ridge (2.3%), fragility of abutment teeth (1.53%), short clinical crown (0.76%) and short space to the clasp (0.76%) influenced directly during the clasps selection. Factors like mobility of abutment teeth, height of muscular insertions, depth of buccal fornix and antagonist arch acted like secondary factors. After the informations analysis it may be concluded that the bar clasps with distal rest and embracing to the adjacent tooth were the most indicated to free-end RPD

Análise por computação gráfica das alterações produzidas em próteses totais superiores imersas diretamente em água e pela termociclagem

Objectives: This study aimed to assess dimensional changes in acrylic resin base and artificial teeth position after water storage and thermocycling using computer graphics measurements. Methods: Twenty-four waxed replicas were obtained from a previous upper complete denture. For linear measurements, points in cusps tips of left central incisor and second premolars and molars were marked in one of the prostheses with graphite and transferred to the others using an acrylic resin guide. The prostheses were scanned after waxing, polymerization and treatments and the images were exported to “AutoCad 2002 Today®” software for measurements. Results: There was no statistically significant difference in changes of each segment for each group and between the phases evaluated after polymerization and thermocycling. In groups I and III, the values after polymerization are higher than those after treatment, which suggests shrinkage while the prostheses in group II have expanded. Conclusion: The three groups exhibited artificial teeth movement after tests in comparison to the polymerized prosthesis. The prostheses submitted to water storage in kiln at 36ºC during seven days showed different behavior than the other groups.

Molhabilidade de material reembasador: efeito dos agentes químicos de limpeza

Risk of mechanical injuries contraindicate brushing and elect chemical agents as appropriate for daily cleaning of dentures relined with resilient materials. It was evaluated the effect of denture cleansers on the wettability of denture relining material (Dentusoft, Dental Medrano). We used 20 discs of acrylic resin thermoactivated VipiCril ® with 30mm diameter and 4mm thick, covered by 2mm Dentusoft ®. Divided into 4grupos were stored in artificial saliva at 37 +1 º C for 30 days, immersed daily for 15minutes in distilled water (GI), Corega ® Tabs (GII), a solution of sodium bicarbonate (GIII) or solution of sodium hypochlorite (GIV) after which, on the soft liner were poured 2 ml of type IV gypsum (Durone IV, Dentsply). Reached the final setting of the gypsum specimens were sectioned vertically and medially, settled water with sandpaper No. 400 and mounted on suitable device for reading (in the right and left) of the contact angle Carl Zeiss microscope (precision, 001). The results were submitted to analysis, showed non-normal distribution, opting for non-parametric test. Kruskal Wallis test performed at 5% significance, there was statistical difference between the groups with lower average contact angle for GII. It was concluded that the chemical cleaning Corega Tabs ® allowed a better adaptation of relining the gypsum studied.

Aspectos clínicos influentes no planejamento das próteses sobre implantes tipo overdenture e protocolo

The aim of his study was to review the current scientific literature in order to discuss the surgical, prosthetics and psychological/psychosocial aspects during the treatment planning of edentulous patients, when a total fixed prosthesis or overdenture is indicated. To identify studies to take part in this review, a search was conducted for the following databases: PubMed, Dentistry and Oral Sciences Source, Journals@Ovid, SpringerLink, Wiley Online Library, Nature (NPG), Oxford Journals. It was used as descriptors: total fixed prostheses and overdentures. Inclusion criteria were: clinical articles, clinical case reports, case series, literature reviews and systematic reviews that addressed the study and comparison of total fixed prostheses and overdentures for a surgical- prosthetic planning. Exclusion criteria were: laboratory and in vitro studies and those whose first language was not English or Portuguese. Of a total of 454 articles, after an analysis according to inclusion and exclusion criteria, 76 articles were selected. During an implantsupported prosthesis rehabilitation with dental in edentulous patients, the use of alternative procedures appear to be effective when compared to more invasive surgical techniques, and thus, the amount of dental implants possible to install associated with prosthetic issues such as lip support, smile line, quantity and quality of mucosa, phonetics, etc., will allow an appropriate treatment planning to each clinical case

Prótese total imediata: relato de caso clínico

The immediate complete denture is defined as a removable or partial denture made to be installed immediately after the extraction of the natural teeth. This type of prosthesis can be used for a short period of time, for aesthetic reasons, mastication, occlusal support, convenience or for the adaptation of the patients to the edentulous state, until the final prosthesis is installed. The objective of this study was to report a surgical and prosthetic rehabilitation planning of a patient by means of an immediate complete maxillary denture, and the results obtained with this treatment modality. The immediate complete denture is a necessary, well-established, useful and effective prosthetic procedure for patients who, inevitably, will present an edentulous state, despite it is a slightly more expensive and it requires more sessions for adjust

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.

O Uso do Arco Facial para o correto posicionamento dos modelos no articulador

It presented the main features so that the wax plan can be conveniently filling the aesthetic and functional requirement of a denture. The steps of face bow mounting and wax plan transfer form the mouth to the articulator, considering the necessary requirement for this purpose are shown. This sequence aims to instruct and warn those who work with dentures about the needs of using face bows for correct reproduction of the models positioning in the articulator

Como realizar o selamento periférico e a moldagem funcional?

The functional impression technique is one of the most important steps for complete and/or partial edentulism treatment. So, correct analysis and record of supporting structures are essential to determine the denture extension. The functional impression technique has two stages - a customized final impression tray and a border impression - which aims to record the optimal denture supporting area. The aim of this study was to review the literature related to border impression and functional impression techniques, describing the technique and materials, and identifying the procedure’s objectives and function.

Técnicas de obtenção da posição de relação central em pacientes edêntulos

Edentulism causes loss of horizontal intermaxillary relationship, which is defined by the condyle position in the joint cavities, called centric relation. The correct record of centric relation in edentulous pacients has a strong influence on the treatment final result and is considered one of the most difficult clinical steps to achieve success. The aim of this study was to describe the main centric relation recording methods for edentulous patients reported in the literature. The study described physiological methods such as swallowing and pull tongue back, manipulative and graphic methods. It is concluded that the combination of different methods facilitates the correct centric relation record. Dentists must have a good knowledge of those techniques to perform this procedure satisfactorily.

Técnicas de reembasamento para prótese total

Alveolar bone resorption is continuous throughout the life of edentulous patients, the prosthesis mismatch can generate during speech and chewing. An alternative to this would be to destabilize the denture reline, a maneuver which aims to readjust the denture base to the rim by the addition of a plastic film to the inner surface of the prosthesis material. This procedure may be direct, when performed in the clinic, or indirect when made in prosthetic laboratory. The aim this study is to demonstrate the technical of two reline for denture.

Recuperação da dimensão vertical em pacientes com parafunção severa

The association between emotional stress and intense bruxism has as consequence the Temporomandibular Disorder (TMD), which is an increasingly apparent problem at the dental clinic, requiring judicious means of diagnosis and especially treatment.. Several factors, of equivalent importance, may be related to the DTM, one of them is the loss of vertical dimension of occlusion (VDO), and parafunctional habits and also the loss of stable contacts between the posterior teeth or lack thereof, which generates an increase functional anterior teeth for excessive wear or buccal and consequent.. This paper proposes using a clinical case, to present and discuss the steps for clinical diagnosis, planning and execution of oral rehabilitation with Fixed Partial Denture for restoring vertical dimension of occlusion in a patient with severe parafunction.. Oral rehabilitation of these patients should be carefully planned, respecting the functional and aesthetic aspects.. The parafunction control by monitoring the Temporomandibular Disorder is essential to the longitudinal prediction of rehabilitation performed in these types of rehabilitative treatment.

Técnicas de confecção de prótese total imediata mucossuportada

The immediate complete denture is a prostheses made prior to teeth extraction, that aims to re-establish the patient aesthetics and function immediately after the removal of the remaining teeth. The objective of this paper is to report the technical procedures during the manufacture of immediate prosthesis. The study reports the clinical steps prior to teeth extraction as well as the surgical and maintenance procedures. The immediate complete denture is a viable rehabilitation method, especially to restore patients’ self-esteem, aesthetics and function promptly. An accurate planning and manufactory beholds better results