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

Halitose na geriatria: diagnóstico, causas e prevalência

Halitosis is the unpleasant odor of exhaust air through the mouth and lungs. There are over 50 causes, and approximately 90% of cases, is of oral origin. May have physiological origin (stress, breath of morning, fasting, and inappropriate diets), local reasons (bad oral hygiene, bacterial plaque retained on the tongue and/or tonsils, lower production of saliva, gum disease) or systemic reasons (diabetes, kidney or liver problems, constipation, etc.). In the Third Age, this problem tends to increase significantly. Thus, the aim of this study was to detect the presence of halitosis in the geriatric group attended in the dental clinic of UNIRP, identifying their incidence and principal causes. The sample consisted of 48 volunteer patients aged 60 years or older and included more than 90% of patients treated in this age group. It was performed a anamnesis and physical examination. The intra-oral halitosis was detected using a breath meter (halimeter). In the group studied, approximately 54.16% had halitosis, 84.61% of these were users of the prosthesis. The tongue coating was present in 80.76% of individuals with halitosis. After brushing the tongue, 88.46% of patients with halitosis have had the initial index oral malodor decreased. Based on the results of this study it was concluded that factors as dental prostheses and tongue coating are critical factors in causing halitosis.

A utilização de abutment de zircônia na reabilitação oral: aspectos protéticos e periodontais

Zirconia abutments are used to obtain satisfactory aesthetic results in implant fixed anterior prostheses when metal abutments promote a grayish mucosal discoloration of the peri-implant soft tissues. However, there is a lack of studies to confirm the clinical performance of the peri-implant soft tissues surrouding zirconia abutments. This study described a case report of a patient treated with implant fixed all-ceramic crown made out on zirconia abutment after 3 years of followup. A 47-year-old female patient was admitted to the dental clinic (Aracatuba Dental School) complaining about the fracture of her implant fixed single crown in the region of the left lateral incisor. The patient chose the replacement of the fractured prosthesis for an allceramic crown. After 3 years of follow-up it was observed that maintenance of the aesthetic results and the peri-implant soft tissue without any inflammation or gingival recessions. Within the limitations of a case report, it can be conclude that zirconia abutments is a effective rehabilitation treatment because it preserves the aesthetics and function through the maintenance of peri-implant tissues.

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

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.

Resolução estética associando prótese sobre implante e prótese convencional na região anterior

The combination of several methods for solving aesthetics in a clinical case can be a complicating factor. The diagnosis and planning of the event held in conjunction with the dental technician expand the possibilities of success. The present case illustrates the aesthetic resolution through the association of implant- and tooth-supported prostheses using metal free ceramic systems. A 38-year old male patient presented with a complex smile. After diagnosis and treatment planning, two ceramic crowns were made, one on tooth 11 and one on the implant region 21, along with a laminated porcelain veneer on the region of 12. Aesthetic needs of the patient are predictable only with a sound diagnosis.

Prótese total fixa na maxila: soluções protéticas

The modalities of treatment with prostheses over implants for total edentulous patients can be divided in fixed and removable prostheses (overdentures). The fixed prostheses modality has proven to offer better results as to the functional aspects and, results in higher longevity. Overdentures are considered as a modality of rehabilitation utilized to compensate the need for better retention, aside from augmenting chewing efficiency. Its use is justified by its facilitated hygiene, reduced surgical and prosthetic costs, reestablishment of labial support and elimination of the possibility of air escape. However, this option presents psychosocial downside, since the fact that it is considered a removable rehabilitation modality does not please the majority of patients. Although many patients prefer a fixed implant-supported prosthesis to a removable overdenture, frequently it is necessary to utilize an implant retained overdenture as an alternative to the treatment, due to anatomical, physiological, aesthetic, hygienic, and financial limitations regarding the patient. The objective of this study was to discuss a clinical case of a partially edentulous patient treated in the Implantodontic Surgery Post-Graduation Course from the Kenedy Dentistry Institute Mozarteum/Famosp Unit – Goiânia-Brazil), and submitted to osseointegrated implants surgical fixation techniques. A modality of differential diagnosis was established after osseointegration period, it aimed at facilitating the choice of a rehabilitation model that could favor the patient’s and professional`s expectations. Therefore the appreciated aspects were function, comfort, aesthetics, and especially the patient satisfaction.

Reabilitação estética por meio de prótese ocular a base de PMMA: relato de caso

Eye loss results on facial asymmetry compromising its aesthetics. Ocular prostheses are important to re-establish aesthetics; protect the anophthalmic cavity; recover function such as the redirection of lachrymatory liquid; and reintegrate the patient to society. The aim of this study was to describe a case report, demonstrating clinical and laboratorial procedures for confection of ocular prostheses and highlighting their advantages. A female patient was afflicted by toxoplasmosis, which led to the loss of her eye. An eye visceration was performed. The patient reported no previous use of ocular prosthesis. A PMMA ocular prosthesis was manufactured restoring patient’s aesthetic and facial contour. The patient was satisfied with the treatment. Therefore the present study has shown that PMMA ocular prosthesis is able to restore facial aesthetics and can be a safe and satisfactory alternative for patients that have lost their eyes due to toxoplasmosis.

Effect of weathering and thickness on the opacity of acrylic resin and ocular button for artificial eyes

The aim of this study was to evaluate the opacity of the polymethylmethacrylate for ocular prosthesis using an ocular button, a colorless resin for the ocular prostheses, and 4 brands of acrylic colorless resin in the function of weathering (0, 504, or 1008 h) and thickness (1 and 3.5 mm). One hundred twenty specimens were confectioned (made) and allocated into 12 groups (n = 10). Opacity analysis was carried out with a spectrophotometer of visible ultraviolet reflection before and after weathering by 504 and 1008 hours. Data for the opacity were expressed in ΔE. Data were then analyzed statistically by analysis of variance and the Tukey test (P < 0.01). The data demonstrated statistically significant differences; manufactured ocular button (ΔE = 47.4) and the resin Vipi Cril (ΔE = 38.11) presented greater and minor values of opacity, respectively. The weathering showed statistical difference among times (0 h, ΔE = 36.32; 504 h, ΔE = 39.98; and 1008 h, ΔE = 43.9). Ocular button and evaluated resins presented greater values of opacity when presented in 3.5 mm in thickness. The values of opacity increased with the progression of the time of weathering, independent of the evaluated material and the thickness.

Marginal deterioration of the silicone for facial prosthesis with pigments after effect of storage period and chemical disinfection

The failure of facial prostheses is caused by limitations in the properties of existing materials, especially flexibility and durability. Therefore, this study evaluated the marginal deterioration of a silicone used for fabrication of facial prostheses (Silastic MDX4-4210, Dow Corning Corporation, Midland, MI, USA) according to the influence of artificial aging, daily disinfection, and 2 types of pigmentation. Thirty specimens were fabricated and subdivided in 6 groups: without pigmentation, pigmented with make-up powder and iron oxide, and evaluated with and without the action of the disinfectant. Analysis of marginal deterioration was performed on a scanning electron microscope (magnification, ×5000) immediately 6 months and 1 year after fabrication of specimens, following the guidelines of ASTM International. After visual analysis of the photomicrographs, it was noticed that all groups presented marginal deterioration and alterations in surface texture with time. The use of disinfection did not contribute to the marginal deterioration of polymer (silicone), regardless of the pigmentation and artificial aging.

Influência da angulação do implante e tipo de intermediário na distribuição das tensões

The aim of this study was to evaluate the influence of implant angulation and abutment type (UCLA and Estheticone) on stress distribution in screw-retained implant-supported prostheses through photoelasticity. Three models were fabricated with photoelastic resin PL-2 (Vishay, Micro-Measurements Group, Inc Raleigh, N.C., USA) containing one external hexagon implant with 3.75x10mm (Master screw, Conexão Sistemas de Prótese Ltda., Arujá, São Paulo) with 0°, 17° and 30° degrees and a screw-retained prostheses with UCLA and Estheticone abutments. The assembly was positioned in a circular polariscope; axial and oblique (45° degrees) loads of 100N were applied in fixed points on the occlusal crown surfaces by a universal testing machine. The stress generated was photographed and analyzed qualitatively with appropriate software (Adobe Photoshop®). The results demonstrated the same number of fringes for both abutment types for each angulation, with fringes increasing in the same way. A higher number of fringes were closer in the oblique loading mode. It was concluded that there was no significant difference in stress distribution in prostheses with UCLA and Estheticone abutments. Higher stress concentrations were observed with increased implant angulation. Stress concentration and intensity were higher in the oblique load than in axial load application.

O impacto das próteses implantosuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.

Relation between bruxism and dental implants

OBJECTIVE: The aim of this study was to gather information and discuss the predictability of implant-supported prostheses in patients with bruxism by performing a literature review. METHODS: In order to select the studies included in this review, a detailed search was performed in PubMed and Medline databases, using the following key words: bruxism, dental implants, implant supported prosthesis, and dental restoration failure. Items that were included are: case reports, randomized controlled trials, in vitro studies, literature and systematic reviews, with or without meta-analysis, of the last 20 years that addressed the theme. Articles without abstracts, animal studies, articles in languages other than English and articles from journals unrelated to the dental field were excluded. RESULTS: after analysis according to inclusion and exclusion criteria, 28 articles were selected from a total of 54. It is known from the array of scientific articles which have assessed, either through retrospective, prospective or experimental studies, that the biomechanical and biological impact of bruxism on implant-supported prostheses is small, and that the literature has contributed little to exemplify the prosthetic limits of safety for the specialist from a clinical point of view. CONCLUSION: Although there is still no general consensus on this matter, most of the literature review articles do provide clinical guidelines that contribute to implant supported prostheses longevity and stability in patients with bruxism.

Implantes osseointegrados: evolução e sucesso

Introduction: The oral rehabilitation with dental implants is a very viable treatment modality for patients. Therefore the discovery of osseointegration, dentistry has reached the trigger with respect to treatment with a high predictability of success. For this various principles, since the surgical protocols, the choice of material and even the technique for the manufacture of implant-supported prosthesis influence a good prognosis for treatment. Objective: Therefore, it is proposed this study a literature review of the fundamentals of osseointegration, explaining the historical and technical parameters of implantology, focusing in what the literature currently is studying with more intensity, the acceleration of osseointegration. Conclusion:well conducted procedures promotes the best aimed success in implantology. Rough surfaces shows great are for implant-bone contact and better mechanical results. The bone quality is fundamental in results foresigh.

Prevalência de cárie dentária em gestantes atendidas no Sistema Único de Saúde em município paulista

The purpose of this study was to evaluate the dental caries prevalence and the use and needs of dental prosthetic in pregnant women attending in the National Health System in northwestern city of São Paulo state. The sample involved women, between 3 and 9 months of gestation, who were taking prenatal care in Health Units. Those who consented (n = 119) were examined and interviewed by calibrated dentists. We used the DMF-T index and indicators of the use and needs of dental prosthetic. The average age of the pregnant women was 24.7 years, the majority brown (48.7%) with complete high school (60.5%). The average DMFT was 11.7 and 25.2% and 46.2% of them require upper and lower prosthesis, respectively. The oral health indices showed a high DMT-F and great need for dental prostheses. The results show the need for actions directed, with the aim of to improve the specialized attention to the health of mothers and their babies.