Patients' expectation and satisfaction with removable dental prosthesis therapy and correlation with patients' evaluation of the dentists

Objective. Considering that patients' satisfaction is one of the most important goals in conducting removable dental prosthesis (RDP) therapy and the fact that there are many factors which influence this parameter, the present study aims to evaluate the expectation before and satisfaction after therapy with RDP in patients who seek such therapy. As a secondary objective, other variables that may be associated with patient satisfaction are also evaluated, such as gender, age, Kennedy's classification of the arch supporting the RDP, the number of RDP adjustments after delivery and patients' evaluation of the dentists' conduct. Materials and methods. A sample of 44 patients who received RDP therapy were assigned visual analog scale scores for their expectation before and satisfaction after therapy regarding chewing, aesthetics, comfort and phonetics. They also completed a questionnaire concerning the dentists' conduct. Results. There was no statistically significant difference among scores concerning different genders, age, number of post-delivery settings and arch involved in the RDP. Regarding patients' evaluation of the dentists' conduct, there was a predominance of positive evaluations, but only different answers to the statement (i.e. 'The dentist I saw thoroughly explained the recommended treatment before it commenced') present statistically significant different scores for chewing (p = 0.040) and phonetics (p = 0.046). Conclusions. The average visual analog scale scores were high for both expectation prior to treatment and satisfaction after treatment; however, the scores for expectations were higher than those for satisfaction. © 2013 Informa Healthcare.

Análise das tensões em próteses unitárias implantossuportadas com diferentes tipos de conexões e qualidade óssea: estudo pelo método dos elementos finitos tridimensionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The Role of Implant/Abutment System on Torque Maintenance of Retention Screws and Vertical Misfit of Implant-Supported Crowns Before and After Mechanical Cycling

Purpose: This study aimed to evaluate the role of the implant/abutment system on torque maintenance of titanium retention screws and the vertical misfit of screw-retained implant-supported crowns before and after mechanical cycling. Materials and Methods: Three groups were studied: morse taper implants with conical abutments (MTC group), external-hexagon implants with conical abutments (EHC group), and external-hexagon implants with UCLA abutments (EHU group). Metallic crowns casted in cobalt-chromium alloy were used (n = 10). Retention screws received insertion torque and, after 3 minutes, initial detorque was measured. Crowns were retightened and submitted to cyclic loading testing under oblique loading (30 degrees) of 130 +/- 10 N at 2 Hz of frequency, totaling 1 x 10(6) cycles. After cycling, final detorque was measured. Vertical misfit was measured using a stereomicroscope. Data were analyzed by analysis of variance, Tukey test, and Pearson correlation test (P < .05). Results: All detorque values were lower than the insertion torque both before and after mechanical cycling. No statistically significant difference was observed among groups before mechanical cycling. After mechanical cycling, a statistically significantly lower loss of detorque was verified in the MTC group in comparison to the EHC group. Significantly lower vertical misfit values were noted after mechanical cycling but there was no difference among groups. There was no significant correlation between detorque values and vertical misfit. Conclusions: All groups presented a significant decrease of torque before and after mechanical cycling. The morse taper connection promoted the highest torque maintenance. Mechanical cycling reduced the vertical misfit of all groups, although no significant correlation between vertical misfit and torque loss was found.

The role of superstructure material on the stress distribution in mandibular full-arch implant-supported fixed dentures. A CT-based 3D-FEA

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

Impact of Replacing Conventional Complete Dentures with Implant-Supported Fixed Complete Dentures

The aim of this study was to assess the impact of replacing conventional mandibular complete dentures with implant-supported fixed complete dentures (ISFDs) on the oral health related quality of life (OHOOL) of edentulous patients and on the associated kinesiographic parameters. The patients had their complete dentures replaced by ISFDs and were assessed after 1, 2, 3, 6, and 12 months. An improvement of general OHQOL was observed 2 months after treatment with ISFDs. Kinesiographic recordings revealed significant mandibular vertical and horizontal opening increases and a greater vertical intrusion of the maxillary complete dentures during clenching after the treatment with ISFD.

Repair Technique for Fractured Implant-Supported Metal-Ceramic Restorations: A Clinical Report

The fracture of porcelain structures have been related in either natural dentition or implant-supported restorations. Techniques using a composite resin or indirect methods can be used. This article presents a porcelain fracture on implant-supported metal-ceramic restoration. IPS Empress e.max laminate veneer restoration was used to repair the fracture. With this technique, it was possible to restore aesthetics and function, combined with low cost and patient satisfaction.

Three-dimensional finite element analysis of anterior single implant-supported prostheses with different bone anchorages

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

Solução estética para prótese sobre implante

Próteses sobre implantes esteticamente favoráveis estão diretamente relacionadas com a condição dos tecidos moles e duros que as envolvem. A preservação dos tecidos mucogengivais ao redor de implantes dentários instalados na maxila anterior propicia um sorriso harmonioso, com uma estética bastante agradável. No entanto, em alguns casos, isso não ocorre principalmente pela grande reabsorção tecidual na região, na qual deveria ter sido realizado enxerto ósseo, antes mesmo da instalação dos implantes. Desse modo, o objetivo deste trabalho foi apresentar uma solução reabilitadora estética para essas possíveis falhas durante o planejamento com reabilitações sobre implantes, por meio de gengiva artificial cerâmica.

Preload Evaluation of Different Screws in External Hexagon Joint

Purpose: This study compared the maintenance of tightening torque in different retention screw types of implant-supported crowns. Materials and Methods: Twelve metallic crowns in UCLA abutments cast with cobalt-chromium alloy were attached to external hexagon osseointegrated implants with different retention screws: group A: titanium alloy retention screw; group B: gold alloy retention screw with gold coating; group C: titanium alloy retention screw with diamond-like carbon film coating; and group D: titanium alloy retention screw with aluminum titanium nitride coating. Three detorque measurements were obtained after torque insertion in each replica. Data were evaluated by analysis of variance (ANOVA), Tukey's test (P < 0.05), and t test (P < 0.05). Results: Detorque value reduced in all groups (P < 0.05). Group A retained the highest percentage of torque in comparison with the other groups (P < 0.05). Groups B and D retained the lowest percentage of torque without statistically significant difference between them (P < 0.05). Conclusions: All screw types exhibited reduction in the detorque value. The titanium screw maintained the highest percentage of torque whereas the gold-coated screw and the titanium screw with aluminum titanium nitride coating retained the lowest percentage. (Implant Dent 2012;21:46-50)

Stability of Contour Augmentation and Esthetic Outcomes of Implant Supported Single Crowns in the Esthetic Zone. 3-Year Results of a Prospective Study With Early Implant Placement Post Extraction

Early implant placement is one of the treatment options after tooth extraction. Implant surgery is performed after a healing period of 4 to 8 weeks and combined with a simultaneous contour augmentation using the guided bone regeneration technique to rebuild stable esthetic facial hard- and soft-tissue contours.

Maintenance of implant-supported maxillary prostheses: a 2-year controlled clinical trial

To analyze maintenance service of fixed maxillary prostheses and overdentures based on conventional gold bars or titanium bars and frameworks fabricated with computer-aided design/computer-assisted manufacture (CAD/CAM) technology.

Implant-supported single tooth restoration in the aesthetic zone: transmucosal and submerged healing provide similar outcome when simultaneous bone augmentation is needed

AIM: The aim of this study was to compare the clinical outcomes after 2 years with bone level implants placed to restore a single missing teeth that needed simultaneous augmentation and were treated with a transmucosal or submerged approach. METHODS: This study analyzed a subset of patients included in an ongoing prospective multicenter randomized clinical trial (RCT) involving12 centers where patients were to be followed-up to 5 years after loading. Of the 120 implants that were placed in the original study, and randomly assigned to submerged or non-submerged healing, 52 needed simultaneous augmentation (28 women patients and 24 men patients, between 23 and 78 years of age). Twenty-seven of them received implants with submerged healing (AuS), while in 25 patients the implants were inserted with a non-submerged protocol (AuNS). At the 2-year follow-up visit, radiographic crestal bone level changes were recorded as well as soft tissue parameters included Pocket probing depth (PPD), bleeding on probing (BoP) and clinical attachment level (CAL) at teeth adjacent to the implant site. RESULTS: After 2 years a small amount of bone resorption was found in both groups (0.37 ± 0.49 mm in the AuS group and 0.54 ± 0.76 in the AuNS group; P < 0.001). There was no statistically significant difference between AuS Group and AuNS group for PPD (2.5 vs. 2.4 mm), BOP (BOP + sites: 8.8% vs. 11.5%) and CAL (2.8 vs. 2.4 mm) at the 2-year follow-up visit. CONCLUSIONS: When a single implant is placed in the aesthetic zone in conjunction with bone augmentation for a moderate peri-implant defect, submerged and transmucosal healing determine similar outcome, hence there is no need to submerge an implant in this given clinical situation.

What is the optimal number of implants for removable reconstructions? A systematic review on implant-supported overdentures

The aim of this systematic review was to assess the optimal number of implants for removable reconstructions.

Reconstruction of the severely atrophic mandible using calvarial split bone grafts for implant-supported oral rehabilitation

OBJECTIVES: This article describes reconstruction of the severely atrophic mandible using calvarial bone grafts for implant-supported prosthetic oral rehabilitation. The study aim was to evaluate the efficacy of the treatment by determining implant survival and complication rates, and the extent of the postoperative graft resorption. STUDY DESIGN: Ten patients who underwent the treatment were followed clinically and radiologically using panoramic radiographs and CT scans during a mean postoperative period of 30 months. RESULTS: Good bone healing was observable 6 months postoperatively. The height reduction measured on panoramic radiographs was insignificant (mean 0.68 mm). Only minor complications occurred. Implant survival was 95%. Prosthodontic treatment was successfully performed in all cases, resulting in an improvement of oral function. Histological analysis of 1 bone biopsy showed minimal resorptive changes in otherwise very dense bone. CONCLUSION: Augmentation using calvarial grafts is a promising treatment alternative for the severely atrophic mandible.

[Implant-supported bridges in the edentulous jaw. Clinical aspects of a simple treatment concept]

Clinical aspects of a simple treatment concept with fixed prostheses in the edentulous jaw are described. Fixed implant-supported reconstructions in the edentulous jaw require multiple implants, are technically complex, aesthetically demanding and metal-ceramic solutions are expensive. Specific surgical techniques to enhance the hard and soft tissue conditions become often necessary. Thus the bar-supported overdenture may be preferred, because problems with aesthetics and alveolar ridge deficiencies can be solved more easily and the number of implants is reduced. Both, the "All-on-Four" technique and the "Procera implant bridge" are simple type of fixed prostheses, comparable to overdentures or complete dentures with regard to design and technology. They present a cost-effective alternative, with predictable aesthetics and optimum passive fit.