Implant rehabilitation in bruxism patient

A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported.

Prosthetic rehabilitation of a patient after a partial mandibulectomy

The treatment of orofacial tumors may cause facial deformities by losses of structures that affect basic functions, i.e. feeding, speech, and the reduction of patient self-steam. A white male patient was diagnosed with epidermoid cancer on the mandibular alveolar ridge with infiltration staging IV A. The patient was submitted to a mandibulectomy associated with a complete extraction of mandibular teeth. For rehabilitation, a conventional denture for the mandibular arch and a removable partial denture for the maxillary arch were fabricated. A correct occlusal adjustment and a satisfactory amount of alveolar bone was favorable for conventional dentures of the prostheses bases improve their retention and stability. After one year of follow-up, the patient was adapted to the prostheses, satisfied with their retention, and reported an improvement on his feeding. The prosthetic rehabilitation of patients after a partial mandibulectomy is essential for their self-steam. Conventional dentures may have their retention and stability improved if they are well fabricated, recorded and have a balanced occlusion. A correct occlusal adjustment and an adequate retention of the prostheses bases may improve their retention and stability. Patients without xerostomy and with a satisfactory amount of alveolar bone may have a favorable prognosis for conventional dentures.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning. An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Uso de implantes zigomáticos na fixação de próteses bucomaxilofaciais

The maxillofacial prosthetic rehabilitation aims of individuals with craniofacial deformities resulting from trauma, congenital malformations or tumors. Many researches have been done to improve the stability and retention of dentures in patients. With the advent of osseointegration, the maxillofacial prosthesis suffered a major advance making possible the realization of prosthetic works with stability, aesthetic quality and predictable results. This paper reviews the literature regarding the use of zygomatic implants in the fixation of maxillofacial prostheses.

O desenho-estória na atenção psicológica a crianças na fase pré-cirurgica

The hospitalization process generates stress and, for a child who has already experienced a surgery can suffer from threatening, anxiety and distress. This search examines the experiences of children indicated for different craniofacial surgery which in many cases require more than esthetic or reconstructive surgery. It is quantitative and qualitative study, descriptive and comparative. The sample is intentional and it is made up of ten children, five boys and five girls in the pre-surgical Hospital for Rehabilitation of Craniofacial Anomalies HRAC-USP, Bauru-SP. As a tool for data collection, the design-themed story and data are used from subsequent survey developed by Walter Trinca. The results indicate that the design-themed story is suitable for the identification of the kid's childhood experiences in helping to deal with the stressful situation. Some of the children reveal their feelings of anxiety and fear and manifest other defenses such as denial. In all cases it identifies emotional states of concern such as anxiety and fear, or also denial of those feelings. It was concluded by the need of creating more favorable conditions in order to identify and address childhood experiences compared to surgery in a hospital environment, proposing the designthemed story technique that reveals those experiences. It emphasizes the relevance of psychological intervention in the hospital environment, considering childhood fantasies and feelings that generate or intensify emotional states of anxiety, fear and distress in pre-surgical level.

Prótese de palato em sujeitos com disfunção velofaríngea: expectativa e ansiedade

Cleft lip and palate (CLL) is a very common craniofacial anomaly. The cleft is usually corrected with surgery which may fail resulting in velopharyngeal dysfunction (VPD). The use of palatal prosthesis is an alternative treatment for correcting both, CLP and VPD. This study evaluated anxiety symptoms expectations of subjects of both genders, with velopharyngeal dysfunction, referred to palatal prosthesis program for VPD treatment. In this cross sectional and descriptive study 30 subjects with velopharyngeal dysfunction, aged 15 to 64 years old (mean age of 28) were interviewed at the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC). All subjects referred to the palatal prosthesis program at HRAC in the year of 2005 were considered for participation in the study but only the first 30 candidates were included. A questionnaire addressing expectation elaborated by the researcher and the Beck Scale on anxiety were used. All subjects showed expectation regarding speech modification. Changes in professional and affective aspects of their lives after changes in speech were obtained with palatal prosthesis were the most reported expectations. Subjects’ age and gender influenced anxiety levels significantly which were minimum across subjects. High levels of expectation were more frequent than anxiety in the sample population.

Indicadores de qualidade assistencial e Nursing Activities Score análise correlacional em um Hospital Especializado

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