Aesthetic Approach in Single Immediate Implant-Supported Restoration

The aim of this study was to analyze the main aspects that influence the aesthetics of single immediate implant-supported restorations through a literature review on the MEDLINE database. It was observed that immediate implant-supported restorations present clinical success with aesthetic predictability demonstrated by the literature. Proper patient selection and diagnostic and multidisciplinary planning are essential and should be associated to technical ability of professional and knowledge concerning the biology of peri-implant tissues. It is suggested that provisional restoration should be immediately inserted after implant fixation to guide healing of gingival tissues with a proper emergence profile besides psychologic comfort for a patient due to immediate aesthetic reestablishment.

Prototyping for Surgical and Prosthetic Treatment

Techniques of rapid prototyping were introduced in the 1980s in the field of engineering for the fabrication of a solid model based on a computed file. After its introduction in the biomedical field, several applications were raised for the fabrication of models to ease surgical planning and simulation in implantology, neurosurgery, and orthopedics, as well as for the fabrication of maxillofacial prostheses. Hence, the literature has described the evolution of rapid prototyping technique in health care, which allowed easier technique, improved surgical results, and fabrication of maxillofacial prostheses. Accordingly, a literature review on MEDLINE ( PubMed) database was conducted using the keywords rapid prototyping, surgical planning, and maxillofacial prostheses and based on articles published from 1981 to 2010. After reading the titles and abstracts of the articles, 50 studies were selected owing to their correlations with the aim of the current study. Several studies show that the prototypes have been used in different dental-medical areas such as maxillofacial and craniofacial surgery; implantology; neurosurgery; orthopedics; scaffolds of ceramic, polymeric, and metallic materials; and fabrication of personalized maxillofacial prostheses. Therefore, prototyping has been an indispensable tool in several studies and helpful for surgical planning and fabrication of prostheses and implants.

Care and Cleaning of Maxillofacial Prostheses

Both the cleaning and care of the prosthesis are fundamental for maintaining its quality. Therefore, the aim of this study was to show the methods of cleaning and care the patient needs to take as regards the prosthesis and adjacent tissue, starting with correct instruction and training by the professional. It has been verified that among the materials for fabricating maxillofacial prostheses, silicone was considered the major retainer of microorganisms on its surface. Therefore, for cleaning prostheses, the use of water and neutral soap, as well as chlorhexidine, is recommended. As regards care of the adjacent tissues, it is recommended to remove the prosthesis before going to sleep, in addition to washing the prosthesis receptor tissues with water and neutral soap or with a mixture of hydrogen peroxide and water. Whereas for the mucosal surfaces of the ophthalmic cavity, cleaning with filtered and boiled water or physiological solution at least 3 times a day is recommended.

Postsurgical Care for Rehabilitation With Implant-Retained Extraoral Prostheses

The health of a peri-implant tissue is a critical factor for the long-term success of treatment with extraoral implants. However, infection and inflammation may occur and lead to implant loss and prostheses failure. Therefore, some postsurgical care as hygiene with soap and water, soft toothbrush, and Superfloss type dental floss and medication with anti-inflammatory and antibiotic are suggested to avoid complications. In addition, a thin and smooth layer of subcutaneous tissue in the peri-implant area should be preserved during implant insertion to favor the assistance recommended in this phase.

Influence of Pigment and Opacifier on Dimensional Stability and Detail Reproduction of Maxillofacial Silicone Elastomer

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

Temporomandibular Joint Vibration Before and After Exercises and Occlusal Splints

Temporomandibular joint (TMJ) sounds are frequent in patients. The aim of this study was to analyze patients with clicking at the end of opening and at the beginning of closing their mouths treated by muscular exercises through chewing and by occlusal splints. Fifteen patients with clinically verified clicking and TMJ and 15 patients without sounds were selected by the Research Diagnostic Criteria for Temporomandibular Disorders. They were submitted to electrovibratography at consultation and 60 and 120 days of treatment by occlusal splints and exercises. Patients demonstrated significant reduction of TMJ sounds after treatment, but vibration intensity was not similar with that of the control group after 120 days.

Photoelastic Analysis of Biomechanical Behavior of Single and Multiple Fixed Partial Prostheses With Different Prosthetic Connections

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

Optical Impression Systems for CAD-CAM Restorations

Computer-aided design/computer-aided manufacturing images can be taken through either direct or indirect imaging. For the indirect systems, the digitalization is obtained from the impression material or cast, and for the direct ones the image is taken directly from the mouth using intraoral scanners.The direct acquisition systems have been constantly improved because these are less invasive, quicker, and more precise than the conventional method. Besides, the digital images can be easily stored for a long time. Therefore, the aim of this paper was to describe and discuss based on the literature the main direct image acquisition systems available on the market: CEREC Bluecam (Sirona), Lava C.O.S. System (3M ESPE), iTero System (Cadent/Straumann), and E4D System (D4D Technologies).

Passivity in Implant-Supported Prosthesis

Because of the widespread use of implant-supported restorations and that the success of this treatment depends on the passivity of the different component systems of implant-prosthesis, a literature review was performed to highlight issues related to passivity in framework of implant-supported fixed prosthesis. A search of English-language peer-review literature was completed using MEDLINE database (PubMed) focusing on acceptable levels of passivity, misfit classification, problems related to misfit, methods to evaluate misfit, general factors that affect the passivity, and the biologic tolerance in the presence of misfit. The information obtained in the present review suggested that even if it is hard to obtain an implant-supported prosthesis with complete passivity, the professional should use the technological resources to offer better conditions for their patients. An acceptable clinical level of passivity that does not cause any problem to the biologic, aesthetic, and functional parameters of the patient should be sought.

Methods Used for Assessing Stresses in Buccomaxillary Prostheses: Photoelasticity, Finite Element Technique, and Extensometry

The authors describe a literature revision on assessing stresses in buccomaxillary prostheses photoelasticity, finite element technique, and extensometry. They describe the techniques and the importance for use of each method in buccomaxillary prostheses with implants and the need of accomplishing more studies in this scarce literary area.

Effect of Superstructure Materials and Misfit on Stress Distribution in a Single Implant-Supported Prosthesis: A Finite Element Analysis

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

Evaluation of Different Retention Systems on a Distal Extension Removable Partial Denture Associated With an Osseointegrated Implant

The aim of this study was to evaluate the biomechanical behavior of a mandibular distal extension removable partial denture (DERPD) associated with an implant and different retention system, by bidimensional finite element method. Five hemimandible models with a canine and external hexagon implant at second molar region associated with DERPD were simulated: model A, hemimandible with a canine and a DERPD; model B, hemimandible with a canine and implant with a healing abutment associated to a DERPD; model C, hemimandible with a canine and implant with an ERA attachment associated to a DERPD; model D, hemimandible with a canine and implant with an O'ring attachment associated to a DERPD; and model E, hemimandible with a canine and implant-supported prosthesis associated to a DERPD. Cusp tips were loaded with 50 N of axial or oblique force (45 degrees). Finite element analysis was performed in ANSYS 9.0. model E showed the higher displacement and overload in the supporting tissues; the patterns of stress distribution around the dental apex of models B, C, and D were similar. The association between a DERPD and an osseointegrated implant using the ERA or O'ring systems shows lower stress values. Oblique forces showed higher stress values and displacement. Oblique forces increased the displacement and stress levels in all models; model C displayed the best stress distribution in the supporting structures; healing abutment, ERA, and O'ring systems were viable with RPD, but DERPD association with a single implant-supported prosthesis was nonviable.

Computer-Guided Surgery in Implantology: Review of Basic Concepts

The aim of the present study was to conduct a critical literature review about the technique of computer-guided surgery in implantology to highlight the indications, purposes, immediate loading of implants and complications, protocol of fabrication, and functioning of virtual planning software. This literature review was based on OLDMEDLINE and MEDLINE databases from 2002 to 2010 using the key words "computer-guided surgery" and "implant-supported prosthesis." Thirty-four studies regarding this topic were found. According to the literature review, it was concluded that the computer-assisted surgery is an excellent treatment alternative for patients with appropriate bone quantity for implant insertion in complete and partially edentulous arches. The Procera Nobel Guide software (Nobel Biocare) was the most common software used by the authors. In addition, the flapless surgery is advantageous for positioning of implants but with accurate indication. Although the computer-guided surgery may be helpful for virtual planning of cases with severe bone resorption, the conventional surgical technique is more appropriate. The surgical guide is important for insertion of the implants regardless of the surgical technique, and the success of immediate loading after computer-guided surgery depends on the accuracy of clinical and/or laboratorial steps.

Use of Facial Protection to Prevent Reinjury During Sports Practice

The objective of the study was to report the prevention of facial reinjury of a volleyball player using a custom-made protective facial shield. A custom-made protective partial facial shield was fabricated using polymethylmethacrylate and was fitted with a soft lining material to provide additional comfort and protection to the injured area. Facial protection provides greater security against possible facial injuries and allows injured areas to recover during sports practice.

Reconstruction of Skull Defects: Currently Available Materials

The restoration and recovery of a compromised skull continues to be a challenge to craniofacial surgeons and neurosurgeons. Different operative techniques and implant materials are being used to reconstruct the rigid framework of the skull. However, no currently available materials satisfy all of these criteria. According to this premise, the aim of this study was to report on the currently available materials for the reconstruction of the cranial vault and to describe their main characteristics, advantages, and disadvantages. Although the use of the materials discussed in this study is clearly positive for the reconstruction of skull defects and cranioplasties, there is a need for more complex studies and research into developing these materials to achieve all the ideal prerequisites stipulated by the scientific community and to evaluate their properties and aesthetic and functional results in the long term.