Immediate X delayed loading dental implants: An overview

The aim of this investigation was to accomplish an overview about the principles of the indication and of the success parameters involving immediate and delayed loading dental implants procedures. Studies about the philosophies (immediate and delayed loading dental implants) and their clinical indications will be discussed in order to overview the rules for the clinical success in both techniques. In addition, studies regarding the criteria for immediate loading implants as primary stabilization, surface treatments and bone density and amount will be also analyzed. More important than the philosophy selection, is how and when to use it according to biomechanical rules and principles. Among the vast limitations pointed by the literature regarding procedures of immediate and delayed loading are evidenced the parafunctional habits, primary stabilization, bone quality, surface treatments and the number of dental implants. The anterior region of the jaw seems to be associated with a major percentage of satisfactory results, regardless of rehabilitation procedures. Although several studies have demonstrated high success rates for the immediate loading dental implants, several aspects remain without an explicit definition and further studies are needed to elucidate some reservations.

Clinical manifestations and oral findings in fraser syndrome

This article is the first known case report of Fraser syndrome in the dental literature. Its purpose was to present the clinical manifestations, oral findings, and dental treatment of a 14-year, 10-month-old female patient. Fraser syndrome is a rare recessive autosomal genetic disorder characterized by multisystemic malformation, usually comprising cryptophthalmos, syndactyly, and renal defects. The child presented with: (1) hydrocephaly; (2) face asymmetry; (3) low-inserted ears; (4) flat nose bridge; (5) cryptophthalmos; (6) bilateral absence of eyeballs; (7) hypertelorism; (8) syndactyly on the left fingers and toes; (9) skeletal defects; and (10) lower limb asymmetry. The intraoral examination revealed: (1) complete primary denture; (2) malocclusion; (3) tooth crowding; (4) ogival palate; (5) normal labial frena; (6) absence of lingual frenum (not compromising the tongue movements); (7) parched lips; (8) supragingival calculus adhered to all tooth surfaces; and (9) moderate gingivitis. The dental treatment consisted of periodic monitoring of the patient's oral health status and supragingival scaling associated with topical applications of 0.12% chlorhexidine digluconate gel at 2-week intervals to reduce gingivitis.

Effect of a post-polymerization treatments on the flexural strength and vickers hardness of reline and acrylic denture base resins

This study evaluated the effect of water-bath and microwave post-polymerization treatments on the flexural strength and Vickers hardness of four autopolymerizing reline resins (Duraliner II-D, Kooliner-K, Tokuso Rebase Fast-TR and Ufi Gel Hard C-UGH) and one heat-polymerized acrylic resin (Lucitone 550-L), processed using two polymerization cycles (short cycle - 90 minutes at 73°C and 100°C for 30 minutes; and long cycle - 9 hours at 71°C). For each material, thirty specimens (64 x 10 x 3.3 mm) were made and divided into 3 groups (n=10). Specimens were tested after: processing (control group); water-bath at 55°C for 10 minutes (reline materials) or 60 minutes (L); and microwave irradiation. Flexural strength tests were performed at a crosshead speed of 5 mm/min using a three-point bending device with a span of 50 mm. The flexural strengths values were calculated in MPa. One fragment of each specimen was submitted to Vickers hardness test. Data were analyzed by 2-way ANOVA followed by Tukey's HSD test (α=0.05). L microwaved specimens (short cycle) exhibited significantly higher flexural strength means than its respective control group (p<0.05). Water-bath promoted a significant increase (p<0.05) in flexural strength of K and L (long cycle). The hardness of the tested materials was not influenced by the post-polymerization treatments. Post-polymerization treatments could be used to improve the flexural strength of some materials tested.

Dual path: A concept to improve the esthetic replacement of missing anterior teeth with a removable partial denture

The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch. © 2008 by The American College of Prosthodontists.

Evaluation of hardness and colour change of soft liners after accelerated ageing.

INTRODUCTION: Soft liners have been developed to offer comfort to denture wearers. However, this comfort is compromised when there is a change in the properties of the material, causing colour change, solubility, absorption and hardening. These characteristics can compromise the longevity of soft liners. AIM: The aim of this in vitro study was to investigate the effect of ageing on both the hardness and colour change of two soft liners following accelerated ageing. METHODS: Two denture liners, one resin based (Trusoft, Bosworth, Illinois, USA) and one silicone based (Ufi Gel P, Voco GMBH, Cuxhaven, Germany), were tested in this study for both hardness (using the Shore A scale) and colour change (using the CIE L*a*b* colour scale), initially and after 1008 hours (6 weeks) of accelerated ageing. Statistical analysis was performed using the unpaired t-test with the Welch correction. RESULTS: These indicated that both materials increased in hardness and underwent colour change after accelerated ageing. The initial hardness of Trusoft was far lower than that of Ufi Gel P (18.2 Shore A units vs 34.8 Shore A units). However, for Trusoft the changes for both hardness (from 18.2 to 52.1 Shore A units) and colour change (16.85 on the CIE L*a*b* colour scale) were greater than those for Ufi Gel P, for which hardness changed from 34.8 to 36.5 Shore A units and the colour change was 5.19 on the CIE L*a*b* colour scale. CONCLUSIONS: Ufi Gel P underwent less hardness and colour change after accelerated ageing than Trusoft. On the other hand, the use of Trusoft may be preferable in cases where initial softness is a major consideration, such as when relining an immediate denture after implant surgery.

Effect of ridge lap surface treatment and thermocycling on microtensile bond strength of acrylic teeth to denture base resins

This study evaluated the effect of denture base polymer type (heat- and microwave-polymerized), ridge lap surface treatment (with and without methyl methacrylate-MMA etching) and thermocycling on the microtensile bond strength (mTBS) of Biotone acrylic teeth. Flat-ground, ridge-lap surface of posterior artifcial teeth were bonded to cylinders of each denture base resin, resulting in the following groups (n=6): G1a - Clássico/with MMA etching; G1b - Clássico/without MMA etching; G2a - OndaCryl/with MMA etching; G2b - OndaCryl/without MMA etching. Rectangular bar specimens with a cross-sectional area of 1 mm 2 were prepared. Half of the bars in each group were thermocycled (5,000 cycles between 4°C and 60°C). mTBS testing was performed in an universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by three-way ANOVA (a=0.05). There was no statisti-caly signifcant difference (p>0.05) for the factors (resin, surface treatment,and thermocycling) or their interactions. The mean mTBS values (MPa) and standard deviations were as follows: Thermocycling - G1a: 41.00 (14.00); G1b: 31.00 (17.00); G2a: 50.00 (27.00); G2b: 40.00 (18.00); No thermocycling - G1a: 37.00 (14.00); G1b: 43.00 (25.00); G2a: 43.00 (14.00); G2b: 40.00 (27.00). The mTBS of Biotone artifcial teeth to the denture base acrylic resins was not infuenced by the polymer type, surface treatment or thermocycling.

The millennium development goals: a Latin American and Caribbean perspective

Includes bibliography

Effect of accelerated aging on the microhardness and color stability of flexible resins for dentures

Acrylic resins have been widely used due to their acceptable esthetics and desirable characteristics such as easy handling, good thermal conductivity, low permeability to oral fluids and color stability. Flexible resins were introduced on the market as an alternative to the use of conventional acrylic resins in the construction of complete and partial removable dentures. Although these resins present advantages in terms of esthetics and comfort, studies assessing chromatic and microhardness alterations of these materials are still scarce in the related literature. The aim of this study was to evaluate the chromatic and microhardness alterations of two commercial brands of flexible resins in comparison to the conventional resin Triplex when submitted to accelerated aging. The resins were manipulated according to manufacturers' instructions and inserted into a silicone matrix to obtain 21 specimens divided into 3 groups: Triplex, Ppflex and Valplast. Triplex presented the highest microhardness value (p < 0.05) for all the aging periods, which was significantly different from that of the other resins, followed by the values of Valplast and Ppflex. Comparison between the flexible resins (Ppflex and Valplast) revealed a statistically significant difference (p < 0.05) as regards color. The flexible resin Ppflex and the conventional resin Triplex presented no statistically significant difference (p < 0.05) as regards aging. The accelerated aging significantly increased the microhardness values of the resins, with the highest values being observed for Triplex. Valplast presented the greatest chromatic alteration after accelerated aging.

Estética en prótesis removibles

Nowadays, aesthetics is very appreciated in the social context and a attractive smile is the object of desire in most of patients requiring prosthesis treatment. In case of removable prosthesis, total or partial, this feature is more significant since some or all teeth may be absents. Implants leading to a significant improvement in relation to function and comfort of removable prosthesis users, but the aesthetics of these prostheses had little attention in the current scientific literature. Thus, the aim of present article was to make a review of the literature on the aesthetic features related to rehabilitation with removable prostheses. In present study we found as significant factors for the aesthetics in removable partial and total prostheses: Selection of artificial teeth and their arrangement, characterization of acrylic resin basis and also the types and location of retainers for the removable partial prostheses. We conclude that the involvement and the aesthetic knowledge during the appropriate planning of this process is responsibility of the professional.

Influence of ridge type on mandibular distal extension removable partial denture.

The aim of this study was to use photoelastic models to analyze the distribution of stress caused by the incidence of loads on a mandibular distal extension removable partial denture, both on the abutment teeth and on differently shaped residual ridges: distal ascending, descending-ascending, horizontal and distal descending. The best type of retainer and location of the rest on the last abutment tooth were determined for the different types of ridge. Four models were made from photoelastic resin (PL-1 for the teeth and PL-2 for the alveolar ridge), one for each kind of ridge. For each model, 4 removable partial dentures (RPD) were made (16 RPD altogether): T-bar retainer and distal rest, T-bar retainer and mesial rest, circumferential retainer and distal rest, and circumferential retainer and mesial rest. The models were placed on a circular polariscope and a 100 N axial load (point load) was applied to premolars and molars of the RPD. The formation of photoelastic bands was photographed for qualitative analysis. Results showed that the horizontal ridge had better distribution of stress, while the distal descending ridge had greater concentration of stress. The circumferential retainer had greater areas of stress for all types of ridges except the horizontal ridge, where there was no influence related to retainer type. The distribution of stress was similar among the different types of ridges when the rest was mesial or distal to the last abutment tooth, except for the distal descending ridge, where there was greater concentration of stress when the rest was located distally to the last abutment tooth. Thus, it may be concluded that (1) the situation was least favorable for the distal descending ridge and most favorable for the horizontal ridge, (2) the T-bar retainer had more favorable stress distribution, except when the ridge was horizontal, in which case there was no influence in relation to the type of retainer, (3) the location of the rest showed similar behavior in all except the distal descending ridge.

Impact strength of denture base and reline acrylic resins subjected to long-term water immersion

Water may influence the mechanical properties of the acrylic resins. Thus, the effect of water storage on the impact strength (IS) of one denture base (Lucitone 550 - L) and four reline resins (Tokuyama Rebase II - T; UfiGel Hard - U; Kooliner - K; New Truliner - NT) was evaluated. Bars of L were made (60 x 6 x 2 mm) and relined (2 mm) with T, U, K, NT and L. Intact specimens of each material (60 x 6 x 4 mm) were also fabricated for comparative purposes. Specimens were submitted to Charpy impact tests without water storage (control) and after immersion in water for 7, 90 and 180 days. Data (kJ/m 2) analyzed by two-way ANOVA and Tukey's test (p=0.05) revealed that after 90 days, U exhibited an increase in the IS (0.93) compared to 7 days (0.58). K (1.48) and L/K (7.21) exhibited a decrease at the 7-day period (1.01 and 3.23, respectively). NT (0.60) showed an increase in the IS after 180 days (1.52), whereas L/ NT (7.70) showed a decrease (3.17). Water immersion improved the IS of U and NT, and decreased the IS of K, L/K, and L/NT. Water may affect differently the IS of acrylic resins and, consequently, the resistance to fracture of relined denture bases.

A CAD/CAM flapless surgical technique and immediate prosthesis: A clinical report

Background: This article describes a clinical report with a new system for guided surgical treatment and immediate load prosthesis in the flapless surgical technique. Case report: Based on a computed tomography (CT) of a 64 - year-old edentulous patient, the cross sections were reformatted and used to construct a virtual planning of the implants and a guide template in Dental Slice. Six dental implants were placed in the maxilla and mandible using a Slice Guide System. Following a 30-month in maxilla and 24-month in mandible healing period, the clinical and radiographic evaluation and computed tomography (CT) showed good clinical stability. The Slice Guide System proved satisfactory for the Flapless Surgical Technique in dental implants.

Color stability of resins and nylon as denture base material in beverages

Purpose: Staining of prosthodontic materials may result in patient dissatisfaction and additional expense for replacement. This study aimed to determine the color stability of two heat-cured denture base acrylic (Lucitone 550, Vipi Cril) and one nylon denture base resin (Transflex) after immersion in beverages. Materials and Methods: Forty disks of each resin (20.0-mm diameter, 3.0-mm thick) were prepared and stored in distilled water for 24 hours at 37°C. During that time (T 0), the color of all specimens was spectrophotometrically measured. Each specimen was immersed in coffee, cola, red wine, and distilled water as a means of control. After 15-day (T 1) and 30-day (T 2) periods of immersion, the color of the specimens was measured again. The CIE (Commission Internationale de L' Eclairage) L*a*b* system was used to determine mean ΔE (color changes) values for each material and compared statistically with two-way ANOVA and Bonferroni intervals at 0.95. Results: In ΔET 0T 1 and ΔET 0T 2 the most severe staining was apparent with red wine (p < 0.001), followed by coffee (p < 0.01), when compared to the specimens stored in distilled water. Transflex also showed significant color change after immersion in cola (p < 0.01). In ΔET 1T 2 only red wine promoted significant staining of all resins (p < 0.0001). Conclusion: Chromatic changes were exhibited by specimens immersed in red wine, followed by coffee. For Transflex, cola also promoted color changes. The values of color changes converted to National Bureau of Standard units showed them to be perceivable to the human eye. © 2011 by the American College of Prosthodontists.

Effect of thermal cycling and disinfection on colour stability of denture base acrylic resin

Objectives: The purpose of this study was to investigate the effect of thermal cycling and disinfection on the colour change of denture base acrylic resin. Materials and Methods: Four different brands of acrylic resins were evaluated (Onda Cryl, QC 20, Classico and Lucitone). All brands were divided into four groups (n=7) determined according to the disinfection procedure (microwave, Efferdent, 4% chlorhexidine or 1% hypochlorite). The treatments were conducted three times a week for 60days. All specimens were thermal cycled between 5 and 55°C with 30-s dwell times for 1000 cycles before and after disinfection. The specimens' colour was measured with a spectrophotometer using the CIE L*a*b* system. The evaluations were conducted at baseline (B), after first thermal cycling (T 1), after disinfection (D) and after second thermal cycling (T 2). Colour differences (ΔE) were calculated between T 1 and B (T 1B), D and B (DB), and T 2 and B (T 2B) time-points. Results: The samples submitted to disinfection by microwave and Efferdent exhibited the highest values of colour change. There were significant differences on colour change between the time-points, except for the Lucitone acrylic resin. Conclusions: The thermal cycling and disinfection procedures significantly affected the colour stability of the samples. However, all values obtained for the acrylic resins are within acceptable clinical parameters. © 2012 The Gerodontology Society and John Wiley & Sons A/S.