Reabilitação Oclusal com Prótese Parcial Removível Provisória Tipo “Overlay” – Relato de Caso

An appropriate design of a prosthetic rehabilitation should not impute the restoration of occlusal vertical dimension (OVD) to new prostheses, at the risk of the patient does not adapt to a new condition, since a certain amount of time is often necessary for adaptation to a new OVD. This article performed prosthetic rehabilitation with an overlay provisional removable partial denture prior to definitive treatment because the patient showed a considerable decrease in the OVD. Three techniques for OVD determination were used. It is possible to conclude that the use of interim removable partial dentures is of great importance at the beginning of the rehabilitation treatment in order to adapt the patient to a new occlusal condition.

Reabilitação Oclusal com Prótese Parcial Removível Provisória Tipo “Overlay” – Relato de Caso

An appropriate design of a prosthetic rehabilitation should not impute the restoration of occlusal vertical dimension (OVD) to new prostheses, at the risk of the patient does not adapt to a new condition, since a certain amount of time is often necessary for adaptation to a new OVD. This article performed prosthetic rehabilitation with an overlay provisional removable partial denture prior to definitive treatment because the patient showed a considerable decrease in the OVD. Three techniques for OVD determination were used. It is possible to conclude that the use of interim removable partial dentures is of great importance at the beginning of the rehabilitation treatment in order to adapt the patient to a new occlusal condition.

Prosthetic rehabilitation and treatment outcome of partially edentulous patients with severe tooth wear: 3-years results

The purpose of this study was to report on the management and treatment outcomes of partially edentulous elderly patients with severe tooth wear.

10-Year Survival and Success Rates of 511 Titanium Implants with a Sandblasted and Acid-Etched Surface: A Retrospective Study in 303 Partially Edentulous Patients

Purpose: This retrospective study assessed the 10-year outcomes of titanium implants with a sandblasted and acid-etched (SLA) surface in a large cohort of partially edentulous patients. Materials and Methods: Records of patients treated with SLA implants between May 1997 and January 2001 were screened. Eligible patients were contacted and invited to undergo a clinical and radiologic examination. Each implant was classified according to strict success criteria. Results: Three hundred three patients with 511 SLA implants were available for the examination. The mean age of the patients at implant surgery was 48 years. Over the 10-year period, no implant fracture was noted, whereas six implants (1.2%) were lost. Two implants (0.4%) showed signs of suppuration at the 10-year examination, whereas seven implants had a history of peri-implantitis (1.4%) during the 10-year period, but presented with healthy peri-implant soft tissues at examination. The remaining 496 implants fulfilled the success criteria. The mean Plaque Index was 0.65 (±0.64), the mean Sulcus Bleeding Index 1.32 (±0.57), the mean Probing Depth 3.27 mm (±1.06), and the mean distance from the implant shoulder to the mucosal margin value -0.42 mm (±1.27). The radiologic mean distance from the implant shoulder to the first bone-to-implant contact was 3.32 mm (±0.73). Conclusion: The present retrospective analysis resulted in a 10-year implant survival rate of 98.8% and a success rate of 97.0%. In addition, the prevalence of peri-implantitis in this large cohort of orally healthy patients was low with 1.8% during the 10-year period.

A pilot study to evaluate the success and survival rate of titanium-zirconium implants in partially edentulous patients: results after 24 months of follow-up

Implants made from a new titanium-zirconium (TiZr) alloy (Roxolid) have shown good osseointegration with no adverse effects in animal studies. This single-cohort pilot study was performed to evaluate the performance and safe use of reduced-diameter implants made from this new TiZr alloy for the first time in human subjects, in a prospective case-controlled series.

Microbiota at teeth and implants in partially edentulous patients. A 10-year retrospective study.

OBJECTIVE To determine the microbiota at implants and adjacent teeth 10 years after placement of implants with a sandblasted and acid-etched surface. MATERIAL AND METHODS Plaque samples obtained from the deepest sites of 504 implants and of 493 adjacent teeth were analyzed for certain bacterial species associated with periodontitis, for staphylococci, for aerobic gram-negative rods, and for yeasts using nucleic acid-based methods. RESULTS Species known to be associated with periodontitis were detectable at 6.2-78.4% of the implants. Significantly higher counts at implants in comparison with teeth were assessed for Tannerella forsythia, Parvimonas micra, Fusobacterium nucleatum/necrophorum, and Campylobacter rectus. Higher counts of periodontopathogenic species were detectable at implants of current smokers than at those of non-smokers. In addition, those species were found in higher quantities at implants of subjects with periodontitis. The prevalence of Prevotella intermedia, Treponema denticola, C. rectus, and moreover of Staphylococcus warneri might be associated with peri-implant inflammation. Selected staphylococcal species (not Staphylococcus aureus), aerobic gram-negative rods, and yeasts were frequently detected, but with the exception of S. warneri, they did not show any association with periodontal or peri-implant diseases. CONCLUSIONS Smoking and periodontal disease are risk factors for colonization of periodontopathic bacteria at implants. Those bacterial species may play a potential role in peri-implant inflammation. The role of S. warneri needs further validation.

Cleft Palate Obturation With Branemark Protocol Implant-Supported Fixed Denture and Removable Obturator

A 41-year-old man with cleft palate presented with a wide dehiscence and missing teeth. Six implants had been placed for fabrication of an overdenture, which was unsatisfactory. A bar was waxed and cast for connection to the implants; precision attachments were placed laterally for retention. A fixed partial denture was fabricated, and milled crowns were fabricated at the molar region to provide a guiding plane for insertion of a removable palatal obturator. Good swallowing and speech outcomes were achieved. This technique provided functional and esthetic benefits, enhanced oral hygiene, and improved the psychological condition of the patient.

Removable dentures with implant support in strategic positions followed for up to 8 years

PURPOSE: The aim of this study was to analyze prosthetic maintenance in partially edentulous patients with removable prostheses supported by teeth and strategic implants. MATERIALS AND METHODS: Sixty patients with removable partial prostheses and combined tooth-implant support were identified within the time period from 1998 to 2006. One group consisted of 42 patients (planned group) with a reduced residual dentition and in need of removable partial dentures (RPDs) or overdentures in the maxilla and/or mandible. They were admitted consecutively for treatment. Due to missing teeth in strategic important positions, one or two implants were placed to improve symmetrical denture support and retention. The majority of residual teeth exhibited an impaired structural integrity and therefore were provided with root copings for denture retention. A few vital teeth were used for telescopic crowns. The anchorage system for the strategic implants was selected accordingly. A second group of 18 patients (repair group) wearing RPDs with the loss of one abutment tooth due to biologic or mechanical failure was identified. These abutment teeth were replaced by 21 implants, and patients continued to wear their original prostheses. The observation time for planned and repair groups was 12 months to 8 years. All patients followed a regular maintenance schedule. Technical or biologic complications with supporting teeth or implants and prosthetic service were registered regularly. RESULTS: Three maxillary implants were lost after loading and three roots with copings had to be removed. Biologic problems included caries and periodontal/peri-implant infection with a significantly higher incidence in the repair group (P < .05). Technical complications with the dentures were rather frequent in both groups, mostly related to the anchorage system (matrices) of root copings and implants. Maintenance and complications were observed more frequently in the first year after delivery of the denture than in the following 3 years (P < .05). No denture had to be remade. CONCLUSIONS: The placement of a few implants allows for maintaining a compromised residual dentition for support of RPDs. The combination of root and implant support facilitates treatment planning and enhances designing the removable denture. It also proves to be a practical rescue method. Technical problems with the anchorage system were frequent, particularly in the first year after delivery of the dentures.

An Implant-Transfer Technique Without Impression Material

Different transfer impression techniques for implant-supported prostheses have been suggested to obtain a working cast. This article describes and illustrates clinical and laboratory pros-thodontic procedures to transfer implant positions with splinted transfer copings and without impression material to form a laboratory analog transfer template. With this technique, a preliminary cast is modified to place the analogs according to a corrected position and obtain the master cast. Although this technique does not record adjacent tissues, it is a simple procedure, less time consuming, and easily performed.

Characterization of ceramic powders used in the inCeram systems to fixed dental Prosthesis

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

Effect of disinfectant agents on dimensional stability of elastomeric impression materials.

STATEMENT OF PROBLEM: Difficulties in sterilizing impressions by traditional methods have led to chemical disinfection as an alternative, and some studies have shown that disinfectants may adversely affect impressions. PURPOSE: This study investigated the effect of disinfection methods on the dimensional stability of 6 elastomeric materials. MATERIAL AND METHODS: Impression materials were submitted to the following treatments: immersion in 5.25% sodium hypochlorite solution for 10 minutes, immersion in 2% glutaraldehyde solution for 30 minutes, and no immersion (control). After treatments, impressions were poured, and respective stone casts were measured with a Nikon Profile projector and compared with the master model. RESULTS: The elastomeric materials had different reproduction capacities, and the disinfecting treatments did not differ from the control.

Avaliação clínica do grau de paralelismo obtido no preparo de planos de guia de dentes suportes de prótese parcial remóvivel, utilizando paralelizador intrabucal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

[The stamp technique for direct composite restoration]

The indications for direct resin composite restorations are nowadays extended due to the development of modern resin materials with improved material properties. However, there are still some difficulties regarding handling of resin composite material, especially in large restorations. The reconstruction of a functional and individual occlusion is difficult to achieve with direct application techniques. The aim of the present publication was to introduce a new "stamp"-technique for placing large composite restorations. The procedure of this "stamp"-technique is presented by three typical indications: large single-tooth restoration, occlusal rehabilitation of a compromised occlusal surface due to erosions and direct fibre-reinforced fixed partial denture. A step-by-step description of the technique and clinical figures illustrates the method. Large single-tooth restorations can be built-up with individual, two- piece silicone stamps. Large occlusal abrasive and/or erosive defects can be restored by copying the wax-up from the dental technician using the "stamp"-technique. Even fiber-reinforced resin-bonded fixed partial dentures can be formed with this intraoral technique with more precision and within a shorter treatment time. The presented "stamp"-technique facilitates the placement of large restoration with composite and can be recommended for the clinical use.

Tooth replacement for partially dentate elders: a willingness-to-pay analysis

Objectives: The primary aim of this study was to investigate partially dentate elders' willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures (RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups' WTP for dental implant treatment.Methods: 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n=27) and SDA (n=28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients' social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted.Results: The median age for the patient sample was 72.0 years (IQR: 71-75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500-650) than those patients who had received SDA treatment (€500; IQR: 450-550) (p=0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600-650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500-600) (p<0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500-1000).Conclusions: Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Clinical significance: Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs.

Avaliação da desadaptação das selas de próteses parciais removíveis após 1 a 5 anos de uso

The non-adaptation of the removable partial prosthesis (RPP) base to fibromucosal tissue is caused by resorption of residual ridges (RRR). The onset of bone resorption, which occurs after tooth extraction and continues throughout life, is accelerated by local or systemic factors. Aim: Assess the degree of non-adaptation of removable partial prosthesis saddles and the factors that influence it. Methodology: A sectional study was conducted with 81 patients using RPP who had their prostheses installed between 2003 and 2007 (1 to 5 years of use) at the Faculty of Dentistry of the Universidade Federal do Rio Grande do Norte (UFRN). After anamnese and clinical examination, a cast was made with polyether-based material, using the base of the prosthesis to make the impression. The base of the saddle was loaded with the casting material and positioned in the mouth, applying pressure on the supports. After polymerization, the material was removed from the saddle and measurements were taken at 3 different points using a pachymeter. Results: The non-adaptation of the saddle increased significantly with years of use (p = 0.005). The tooth-tissue supported prostheses obtained higher mean non-adaptation values than those of tooth supported prostheses (p < 0.001). Flaccid mucosa showed the worst non-adaptation results, which were statistically different from resilient mucosa (p < 0.001). The greater the extension of the saddle, the greater the non-adaptation (p < 0.001). The natural tooth antagonistic arch yielded better results than did RPP and total prosthesis (p < 0.001). Saddle non-adaptation at the free end was less near the pillar tooth and greater in the more posterior region (p < 0.001). When adaptation of the supports to the niches was poor, greater saddle non-adaptation occurred than when it was good or fair (p < 0.001). Saddles located in the posterior region of the arch had greater non-adaptation than those in the anterior region (p = 0.023). Conclusion: The mean non-adaptation of the saddle to the residual ridges was 0.27 mm. It can be concluded that, even with the use of RPP, bone height reduction was slight within the 1-5-year period of use. The following are factors that influence adaptation of the RPP saddle base: years of use, age, force transmission path to the alveolar bone, location of the toothless area, antagonistic arch, type of mucosa, adaptation of supports to the niche and extension of the saddle