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.

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.

Reabilitação protética implantossuportada em região anterior maxilar com utilização de gengiva artificial cerâmica: relato de caso

The osseointegrated implants created a progress in oral rehabilitation. But this rehabilitation may be complicated by anatomical conditions, mainly in maxillary anterior region, where a higher aesthetic is required. The aim of study was to report one case which the use of angled abutments were necessary to allow the correct positioning of the prosthesis and also the prosthetic reconstruction with gingival-colored ceramic to provide best aesthetic result for patient. The aesthetic and functional results provided greater patient satisfaction with her smile. The correct planning is essential to provide to patient the best aesthetic and functional results, being necessary the use of abutments and gingival-colored ceramic to reach better results. Uniterms: dental implantacion, esthetics, mouth rehabilitation.

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

Reabilitação protética com associação entre prótese parcial removível e implante dentário: relato de caso

Removable partial denture improve functional and aesthetic failures caused by partial loss of teeth, however specific characteristics of each patients can determine the success of treatment, especially with regard to the support of the prosthesis, which may depend on teeth, the combination of teehe and mucosa and currently associated with the dental implants. The aim of this study is report a case in which there was the need of the association, to enable better aesthetics and self-esteem to the patients. After implant placement and fabrication of prosthetic patient reported satisfaction with the rehabilitation treatment, improving their quality of life.

Sistemas de retenção O'ring e barra-clipe em overdenture mandibular

The dissatisfaction of the treatment with mandibular complete dentures in edentulous patients has been a constant problem in Dentistry. Often, the absence of stability and retention, resultants of a physiologic condition and alveolar ridge resorption, bring reduction of chewing force, speech problems and social life interference. In these cases, the rehabilitation over osseointegrated implants can be an effective and safe alternative of treatment. When it is not possible to put implants in appropriate number and disposition, it is necessary to make a simple and low costing prosthetic planning, which makes resurge the overdentures. Various implant supported attachment systems for overdentures have been developed in the dental market. Thus, intending to facilitate the professional choice, this study review the literature about attachment systems O’ring and bar- clip in its following aspect: retention level, stress distribution, hygiene complications and patient satisfaction.

Avaliação longitudinal de duas técnicas de sinus lift

The implant has high success rates and predictability in this decade. However, bone availability is a factor that may limit the installation technique of dental implants in subsequent rehabilitation of the maxillary arch has been proposed technique’s maxillary sinus lifting when it presents itself pneumatized, for installation of dental implants The aim of this paper is to present two clinical cases using the surgical technique and rehabilitation to the patient with surgery maxillary sinus lifting with the use of a biomaterial alone or in combination with autogenous bone and the prosthetic resolution radiographic and clinical follow-up of three years.

Sobredentaduras mandibulares inmediatas: revisión de literatura

Conventional complete denture even though well confectioned, could present deficiencies in the retention, stability and support, in addition uncomfortable and retention of food below it. The overdentures have been considered an alternative to resolve problems and negative experiences with the conventional dentures, thus also can be an alternative to the complex treatments (surgical/prosthetic) with implant-supported prosthesis. In the attempt to reduce the healing time for the confection of the dentures showed higher rates of success to the implants when immediate mandibular overdentures were used in the rehabilitation of edentulous patients. The aim of this paper was to discuss by means of a Literature review, the viability of the use of mandibular implant-supported overdentures. The immediate mandibular overdentures have been showed like a reproducible method, predictable and confidence to provide an efficient function to the total edentulous patients.

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.

Complicações na reabilitação bucal com implantes osseointegravéis

The oral rehabilitation now has a powerful ally: the dental implants. There is no denying the importance of the implant within the context of dental practice. Initially indicated for the rehabilitation of fully edentulous patients, now has gained growing space, with indications for partial edentulism, multiple unit, with high predictability of success in esthetic restorations, combined with the techniques of manipulation of soft tissues, and guided tissue regenerationearly prosthetic loading. But like any dental procedure, whether surgical or medical implantology is also subject to the occurrence of failures and complications. This paper aims to provide a review of the literature for discussion of these complications, their causes, their managements and proservation.

THE INFLUENCE OF CHILDHOOD ABUSE ON LONGITUDINAL COURSE OF RECOVERY IN PSYCHIATRIC REHABILITATION

Background: Empirical outcome studies have identified specific symptomatic, cognitive, emotional and functional sequelae of childhood abuse in people with severe mental illness (SMI). These findings illuminate the need for an integrated understanding of biological, psychological, environmental, and developmental aspects of SMI. Purpose: The purpose of the present study includes the following: 1) to examine reliability and validity of the comprehensive child abuse rating system in a sample of individuals with SMI, 2) to examine the influence of childhood abuse severity on recovery of psychotic symptoms, neurocognition and social-cognition, and social functioning in people with SMI during 12 months of inpatient psychiatric rehabilitation, and 3) to examine moderating effects of social cognition on the relationship between severity of different types of child abuse history and social functioning. Results: In Study I (N=171), the child abuse rating system produced reliable ratings and some subtypes of child abuse history were related to poorer premorbid functioning and cognition, higher overall psychiatric symptoms, and lower social functioning. In Study II (N=161), the longitudinal factor pattern invariance of the measures of social functioning, externality, and psychiatric symptoms were confirmed across 3 time points (e.g., at admission, at 6 months, and at 12 months). In addition, significant but varied linear relationships between subtypes of child abuse and each level of assessment of functioning were identified. In Study III (N=143), the results showed that higher baseline social inference, independent of history of child physical abuse (CPA), played a protective role in improvements in social functioning. High externality appeared to be counter-therapeutic for individuals with no history of CPA but protective for individuals with a more severe history of CPA. Conclusion: The child abuse rating system appears to provide reliable and valid assessment of subtypes of child abuse history of individuals with SMI. Considering the extreme heterogeneity in both SMI and child maltreatment, the current finding sheds light on providing individualized treatment and assessment planning for individuals with SMI and a history of childhood abuse.

Characterization of the motor performance in infants with a diagnosis of Cerebral Palsy in process of rehabilitation: the importance of the proactivity of caregivers

Introduction: The progress in technology, associated to the high survival rate in premature newborn infants in neonatal intensive care units, causes an increase in morbidity. Individuals with CP present complex motor alterations, with primary deficits of abnormal muscle tone affecting posture and voluntary movement, alteration of balance and coordination, decrease of force, and loss of selective motor control with secondary problems of contractures and bone deformities. Objective: The aim of this work is to describe the spontaneous movement and strategies that lead infants with cerebral palsy to move. Methods: Seven infants used to receive assistance at the Essential Stimulation Center of CIAM (Israeli Center for Multidisciplinary Support - Philanthropic Institution), with ages ranging between six and 18 months with diagnosis of Cerebral Palsy (CP) were assessed. Results: The results show the difficulty presented by the infants with respect to the spontaneous motor functions and the necessity of help from the caregiver in order to perform the functional activity (mobility). Prematurity prevails as the major risk factor among the complications. Conclusion: The child development can be understood as a product of the dynamic interactions involving the infant, the family, and the context. Thus, the social interactions and family environment in which the infant live may encourage or limit both the acquisition of skills and the functional independence.

Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

OBJECTIVES: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. METHODS: Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements. RESULTS: Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged. CONCLUSION: Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.

Torque removal evaluation of prosthetic screws after tightening and loosening cycles: an in vitro study

Objectives: The aim of this study was to evaluate the variation in removal torque of implant prosthetic abutment screws after successive tightening and loosening cycles, in addition to evaluating the influence of the hexagon at the abutment base on screw removal torque. Material and methods: Twenty hexagonal abutments were tightened to 20 regular external hex implants with a titanium alloy screw, with an insertion torque of 32 N cm, measured with a digital torque gauge. The implant/abutment/screw assemblies were divided into two groups: ( 1) abutments without hexagon at the base and ( 2) abutments with a hexagon at the base. Each assembly received a provisional restoration and was submitted to mechanical loading cycles. After this, the screws were removed and the removal torque was measured. This sequence was repeated 10 times, then the screw was replaced by a new one, and another cycle was performed. Linear regression analysis was performed. Results: Removal torque values tended to decrease as the number of insertion/removal cycles increased, for both groups. Comparisons of the slopes and the intercepts between groups showed no statistical difference. There was no significant difference between the mean values of last five cycles and the 11th cycle. Within the limitations of this in vitro study, it was concluded that ( 1) repeated insertion/removal cycles promoted gradual reduction in removal torque of screws, ( 2) replacing the screw with a new one after 10 cycles did not increase resistance to loosening, and ( 3) removal of the hexagon from the abutment base had no effect on the removal torque of the screws.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies - USP (HRAC-USP) - Part 2: Pediatric Dentistry and Orthodontics

The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies - University of So Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.