Clinical Satisfaction and Quality of Ceramic Fixed Dentures

It is known that several factors can affect the clinical success and durability of fixed partial dentures. Therefore, the aim of the present study was to present a literature review about the longevity, clinical success, and quality, as well as, patients' and dental surgeons' satisfaction of ceramic fixed dentures. High rate of patients' satisfaction has been observed in relation to the esthetic of ceramic crowns. In addition, the literature has shown that dental ceramics can be used in several clinical situations with high success rate and longevity. Despite of failures and complications of ceramic restorations, nowadays, with the improvement of mechanical properties of such materials, ceramic crowns present a favorable prognosis and can be used in several clinical situations with high success rate, clinical quality, and great patients' satisfaction. © 2013 The American Ceramic Society.

Correlation of previous experience, patient expectation and the number of post-delivery adjustments of complete dentures with patient satisfaction in a Brazilian population

A number of variables may influence the outcome of complete denture therapy. The objective of this study was to verify possible correlations between previous experience with dentures, patient expectation and the number of post-delivery adjustments with patient satisfaction after treatment. One hundred patients (mean age 61·9 ± 10·3) rated their previous experiences with complete dentures and their expectations before and satisfaction after treatment on a visual analogue scale (VAS) using scores from 0 (worst results) to 10 (best results). The number of post-delivery adjustments and other patient-related clinical variables was also noted. Patient expectation scores were higher than previous experience scores and satisfaction after treatment scores. Positive and weak correlations were found between previous chewing experiences with complete dentures, with regard to chewing expectations and comfort of use. Phonetics and comfort of use in previous experiences presented a positive correlation with expectations for chewing, aesthetics, phonetics and comfort of use. Groups of patients with different levels of education presented significant differences in expectation scores regarding comfort of use as well. A negative and weak correlation was found between phonetics satisfaction and the number of post-delivery adjustments. Patients' expectations for the therapy were higher than their satisfaction after treatment. Previous experiences with complete dentures could slightly influence patients' expectations and satisfaction, whereas lower scores for previous experience with complete dentures caused lower scores for both expectation and satisfaction. Patients' educational levels and the number of post-delivery adjustments influenced negatively the expectations about comfort of use and patient satisfaction, respectively. © 2013 John Wiley & Sons Ltd.

Maxillary Rehabilitation Using Fixed and Removable Partial Dentures with Attachments: A Clinical Report

Despite requiring dental crown preparation and possible root canal treatment, besides the difficulty of clinical and laboratory repairs, and financial burden, the association between fixed (FPD) and removable partial dentures (RPD) by means of attachments is an important alternative for oral rehabilitation, particularly when the use of dental implants and FPDs is limited or not indicated. Among the advantages of attachment-retained RPDs are the improvements in esthetics and biomechanics, as well as correction of the buccal arrangement of anterior teeth in Kennedy Class III partially edentulous arches. This article describes the treatment sequence and technique for the use of attachments in therapy combining FPD/RPD. © 2013 by the American College of Prosthodontists.

The role of superstructure material on the stress distribution in mandibular full-arch implant-supported fixed dentures. A CT-based 3D-FEA

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

Non-linear 3D finite element analysis of full-arch implant-supported fixed dentures

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

Failures in the rehabilitation treatment with removable partial dentures

Background. Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients. Methods and results. For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs. Conclusions. This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.

Removable Partial Dentures: Use of Rapid Prototyping

The CAD/CAM technology associated with rapid prototyping (RP) is already widely used in the fabrication of all-ceramic fixed prostheses and in the biomedical area; however, the use of this technology for the manufacture of metal frames for removable dentures is new. This work reports the results of a literature review conducted on the use of CAD/CAM and RP in the manufacture of removable partial dentures.

Impact of Replacing Conventional Complete Dentures with Implant-Supported Fixed Complete Dentures

The aim of this study was to assess the impact of replacing conventional mandibular complete dentures with implant-supported fixed complete dentures (ISFDs) on the oral health related quality of life (OHOOL) of edentulous patients and on the associated kinesiographic parameters. The patients had their complete dentures replaced by ISFDs and were assessed after 1, 2, 3, 6, and 12 months. An improvement of general OHQOL was observed 2 months after treatment with ISFDs. Kinesiographic recordings revealed significant mandibular vertical and horizontal opening increases and a greater vertical intrusion of the maxillary complete dentures during clenching after the treatment with ISFD.

Clinical evaluation of failures in removable partial dentures

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

Effect of different solutions on color stability of acrylic resin-based dentures

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

Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients

The aim of this study was to investigate oral yeast colonization, antifungal susceptibility and strain diversity in insulin-dependent diabetes mellitus patients (175), as well as to evaluate the influence of dental prostheses. Oral rinse samples were cultured on selective media, in order to isolate, count and identify the yeasts recovered. More than half of the diabetic subjects (53%) carried significant amounts of Candida cells in the buccal cavity and these organisms were recovered at higher densities in diabetics wearing dentures. A total of 93 yeast strains were isolated from these patients, including: Candida spp. (n = 89); Pichia (n = 02); Trichosporon (n = 1), and Geotrichum (n = 1). C. albicans represented 56% of these strains, non-albicans Candida 39.8%, and other genera of yeast 4.3%. C. albicans was prevalent, followed by C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. rugosa and C. guilliermondii. Agar disk-diffusion tests of the susceptibility of non-albicans Candida and other genera of yeast to fluconazole showed resistance in 21.9%, mainly in C. rugosa (100%), C. glabrata (57%) and C. krusei (50%). Local oral factors, such as the presence of dentures, in association with diabetes, seemed to have the effect of increasing the amount and variety of Candida species in the oral cavities, mainly those with lower drug susceptibilities.

Influence of the Connector and Implant Design on the Implant-Tooth-Connected Prostheses

Purpose:The purpose of this study was to evaluate stress transfer patterns between implant-tooth-connected prostheses comparing rigid and semirigid connectors and internal and external hexagon implants.Materials and Methods:Two models were made of photoelastic resin PL-2, with an internal hexagon implant of 4.00 x 13 mm and another with an external hexagon implant of 4.00 x 13 mm. Three denture designs were fabricated for each implant model, incorporating one type of connection in each one to connect implants and teeth: 1) welded rigid connection; 2) semirigid connection; and 3) rigid connection with occlusal screw. The models were placed in the polariscope, and 100-N axial forces were applied on fixed points on the occlusal surface of the dentures.Results:There was a trend toward less intensity in the stresses on the semirigid connection and solid rigid connection in the model with the external hexagon; among the three types of connections in the model with the internal hexagon implant, the semirigid connection was the most unfavorable one; in the tooth-implant association, it is preferable to use the external hexagon implant.Conclusions:The internal hexagon implant establishes a greater depth of hexagon retention and an increase in the level of denture stability in comparison with the implant with the external hexagon. However, this greater stability of the internal hexagon generated greater stresses in the abutment structures. Therefore, when this association is necessary, it is preferable to use the external hexagon implant.

Peripheral Ossifying Fibroma

The peripheral ossifying fibroma (POF) is a common gingival growth usually arising from the interdental papilla. The anterior maxilla is the most common location of involvement. The etiology and pathogenesis of POF remains unknown. Some investigators consider it a neoplastic process, whereas others argue that it is a reactive process; in either case, the lesion is thought to arise from cells in the periodontal ligament. Trauma or local irritants, such as dental plaque, calculus, microorganisms, masticatory force, ill-fitting dentures, and poor quality restorations, have been implicated in the etiology of POF. The recommended treatment is the excisional biopsy; however, it can leave a defect if the procedure is not followed by a subepithelial connective tissue graft. The main objective of this article was to present a clinical case of excisional biopsy of a POF followed by a subepithelial connective tissue graft to correct the defect caused by the biopsy. The biopsy defect was satisfactorily repaired, and the lesion has not recurred after 6 years of follow-up.

Photoelastic Analysis of Cemented or Screwed Implant-Supported Prostheses With Different Prostheses Connections

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

Flexural strength of acrylic resins polymerized by different cycles

Despite the large number of studies addressing the effect of microwave polymerization on the properties of acrylic resin, this method has received limited clinical acceptance. This study evaluated the influence of microwave polymerization on the flexural strength of a denture base resin. A conventional heat-polymerized (Classico), a microwave-polymerized (Onda-Cryl) and a autopolymerizing acrylic (Jet) resins were used. Five groups were established, according to polymerization cycles: A, B and C (Onda-Cryl, short cycle - 500W/3 min, long - 90W/13 min + 500W/90 see, and manufacturing microwave cycle - 320W/3 min + OW/3 min + 720W/3 min); T(Classico, water bath cycle - 74 degrees C/9h) and Q (Jet, press chamber cycle - 50 degrees C/15 min at 2 bar). Ten specimens (65 x 10 x 3.3 mm) were prepared for each cycle. The flexural strength of the five groups was measured using a three-point bending test at a cross-head speed of 5 mm/min. Flexural strength values were analyzed by one-way ANOVA and the Tukey's test was performed to identify the groups that were significantly different at 5% level. The microwave-polymerized groups showed the highest means (p<0.05) for flexural strength (MPa) (A = 106.97 +/- 5.31; B = 107.57 +/- 3.99; C = 109.63 +/- 5.19), and there were no significant differences among them. The heat-polymerized group (T) showed the lowest flexural strength means (84.40 +/- 1.68), and differ significantly from all groups. The specimens of a microwavable denture base resin could be polymerized by different microwave cycles without risk of decreasing the flexural strength.