Periodontal ligament influence on the stress distribution in a removable partial denture supported by implant: a finite element analysis

Objective: The non-homogenous aspect of periodontal ligament (PDL) has been examined using finite element analysis (FEA) to better simulate PDL behavior. The aim of this study was to assess, by 2-D FEA, the influence of non-homogenous PDL on the stress distribution when the free-end saddle removable partial denture (RPD) is partially supported by an osseointegrated implant. Material and Methods: Six finite element (FE) models of a partially edentulous mandible were created to represent two types of PDL (non-homogenous and homogenous) and two types of RPD (conventional RPD, supported by tooth and fibromucosa; and modified RPD, supported by tooth and implant [10.00x3.75 mm]). Two additional FE models without RPD were used as control models. The non-homogenous PDL was modeled using beam elements to simulate the crest, horizontal, oblique and apical fibers. The load (50 N) was applied in each cusp simultaneously. Regarding boundary conditions the border of alveolar ridge was fixed along the x axis. The FE software (Ansys 10.0) was used to compute the stress fields, and the von Mises stress criterion (sigma vM) was applied to analyze the results. Results: The peak of sigma vM in non-homogenous PDL was higher than that for the homogenous condition. The benefits of implants were enhanced for the non-homogenous PDL condition, with drastic sigma vM reduction on the posterior half of the alveolar ridge. The implant did not reduce the stress on the support tooth for both PDL conditions. Conclusion: The PDL modeled in the non-homogeneous form increased the benefits of the osseointegrated implant in comparison with the homogeneous condition. Using the non-homogenous PDL, the presence of osseointegrated implant did not reduce the stress on the supporting tooth.

Photoelastic Analysis of Stress Distribution in Oral Rehabilitation

The purpose of this study was to present a literature review about photoelasticity, a laboratory method for evaluation of implants prosthesis behavior. Fixed or removable prostheses function as levers on supporting teeth, allowing forces to cause tooth movement if not carefully planned. Hence, during treatment planning, the dentist must be aware of the biomechanics involved and prevent movement of supporting teeth, decreasing lever-type forces generated by these prosthesis. Photoelastic analysis has great applicability in restorative dentistry as it allows prediction and minimization of biomechanical critical points through modifications in treatment planning.

Alteration of blue pigment in artificial iris in ocular prosthesis: Effect of paint, drying method and artificial aging

The artificial iris is the structure responsible for the dissimulation and aesthetics of ocular prosthesis. The objective of the present study was to evaluate the color stability of artificial iris of microwaveable polymerized ocular prosthesis, as a function of paint type, drying method and accelerated aging. A total of 40 discs of microwaveable polymerized acrylic resin were fabricated, and divided according to the blue paint type ( n = 5): hydrosoluble acrylic, nitrocellulose automotive, hydrosoluble gouache and oil paints. Paints where dried either at natural or at infrared light bulb method. Each specimen was constituted of one disc in colorless acrylic resin and another colored with a basic sclera pigment. Painting was performed in one surface of one of the discs. The specimens were submitted to an artificial aging chamber under ultraviolet light, during 1008 h. A reflective spectrophotometer was used to evaluate color changes. Data were evaluated by 3-way repeated-measures ANOVA and the Tukey HSD test (alpha = 0.05). All paints suffered color alteration. The oil paint presented the highest color resistance to artificial aging regardless of drying method. (C) 2010 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Evaluation of the Shore A Hardness of Silicone for Facial Prosthesis as to the 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 Shore A hardness of silicone used for fabrication of facial prostheses, Silastic MDX4-4210, according to the influence of storage period, daily disinfection, and 2 types of pigmentation. Thirty specimens were fabricated and divided in 3 groups: colorless, pigmented with makeup, and pigmented with iron oxide. Analysis of results was assessed on a Shore A hardness meter immediately, 6 months, and 1 year after fabrication of specimens, following the guidelines of the American Society for Testing and Materials. The hardness values were statistically analyzed by the Tukey test. The silicone exhibited an increase in hardness with time. However, the hardness was stable from 6 months to 1 year. It was concluded that the silicone is within the values of Shore A hardness reported in the literature, regardless of the storage period, pigmentation, and chemical disinfection.

Color Stability of Polymers for Facial Prosthesis

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

Skeletal and dental components of Class II correction with the bionator and removable headgear splint appliances

The purpose of this study was to differentiate the dentoalveolar and skeletal effects to better understand orthodontic treatment. We evaluated the treatment changes associated with the bionator and the removable headgear splint (RHS). Methods: The sample comprised 51 consecutively treated Class II patients from 1 office who had all been successfully treated with either a bionator (n = 17) or an RHS appliance (n = 17). Class II patients waiting to start treatment later served as controls (n = 17). A modified version of the Johnston pitchfork analysis was used to quantify the dentoalveolar and skeletal contributions to the anteroposterior correction at the levels of the molars and the incisors. Results: Both appliances significantly improved anteroposterior molar relationships (2.15 mm for the bionator, 2.27 mm for the RHS), primarily by dentoalveolar modifications (1.49 and 2.36 mm for the bionator and the RHS, respectively), with greater maxillary molar distalization in the RHS group. Overjet relationships also improved significantly compared with the controls (3.11 and 2.12 mm for the bionator and the RHS, respectively), due primarily to retroclination of the maxillary incisors (2.2 and 2.38 mm for the bionator and the RHS, respectively). The differences between overall corrections and dentoalveolar modifications for both molar and overjet relationships were explained by skeletal responses, with the bionator group showing significantly greater anterior mandibular displacement than the RHS group. Conclusions: The bionator and the RHS effectively corrected the molar relationships and overjets of Class II patients primarily by dentoalveolar changes. (Am J Orthod Dentofacial Orthop 2008; 134: 732-41)

Wax Teeth and Metallic Superstructure Trials at the Same Session: Simplified Technique for Implant-Supported Prosthesis

This clinical report describes a method to reduce the number of clinical sessions for the rehabilitation of implant-supported fixed dentures through a simplified and versatile procedure indicated mainly for immediate loading. According to this method, the immediate implant-supported fixed dentures for edentulous patients can be safely fabricated within 2 days. In this technique, the teeth in the wax are prepared on a base of light-polymerized resin, and both wax teeth and metallic superstructure trials are accomplished at the same session.

Bonding strength between a hard chairside reline resin and a denture base material as influenced by surface treatment

Direct relining of dentures made with hard chairside reline resins is faster than laboratory-processed reline systems and the patient is not without the prosthesis for the time necessary to perform the laboratory procedures. However, a weak bond between the autopolymerizing acrylic reline resins and the denture base material has been observed. This study evaluated the effect of six different surface treatments on the bond strength between a hard chairside reline acrylic resin and ia heat-cured acrylic resin. Specimens of the heat-cured acrylic resin were divided into seven groups. one of these groups remained intact. In the other groups, a 10-mm square section was removed from the centre of each specimen. The bonding surfaces were then treated with (i) methyl methacrylate monomer, (ii) isobutyl methacrylate monomer, (iii) chloroform, (iv) acetone, (v) experimental adhesive and (vi) no surface treatment-control group. Kooliner acrylic resin was packed,into the square sections and polymerized. The bonding strength was evaluated by a three-point loading test. The results were submitted to one-way analysis of variance (ANOVA) followed by a Tukey multiple range test at a 5% level of significance. No significant difference was found between the surface treatment with Lucitone 550 monomer or chloroform, but both were stronger than the majority of the other groups. The bond strength provided by all the surface treatments was lower than that of the intact heat-cured resin.

Maxillary complete denture movement during chewing in mandibular removable partial denture wearers

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

Accuracy of Impression Techniques for an Implant-Supported Prosthesis

Purpose: This in vitro study compared the dimensional accuracy of a stone index and of two impression techniques (squared impression copings and modified squared impression copings) for implant-supported prostheses. Materials and Methods: A master cast with four parallel implant-abutment analogs and a passive framework were fabricated. Vinyl polysiloxane impression material was used for all impressions with a metal stock tray. Three groups of impressions were tested (n = 5): index (1), squared (S), and modified squared (MS). The measurement method employed was just one titanium screw tightened to the framework. The measurements (60 gap values) were analyzed using software that received the images from a video camera coupled to a stereomicroscope at x 100 magnification. The results were evaluated statistically (analysis of variance, Holm-Sidak method, alpha = .05). Results: The mean abutment/framework interface gaps were: master cast = 31.63 mu m; group I = 45.25 mu m; group S = 96.14 mu m; group MS = 51.20 mu m. No significant difference was detected among the index and modified squared techniques (P = .05). Conclusion: Under the limitations of this study, the techniques modified squared and index generated more accurate casts than the squared technique. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:715-721

Comparison of impression techniques and materials for implant-supported prosthesis

Purpose: To investigate, in vitro, the dimensional accuracy of two impression techniques (squared impression copings and squared impression copings sandblasted and coated with impression adhesive) made of vinyl polysiloxane and polyether impression materials. Materials and Methods: A master cast (control group) with four parallel implant abutment analogs, a passive framework, and a custom aluminum tray was fabricated. Four groups (n = 5 each group) were tested: squared Impregum (SI), squared Express (SE), sandblasted adhesive squared Impregum (ASI), and sandblasted adhesive squared Express (ASE). The measurement method employed was just one titanium screw tightened to the framework. A stereomicroscope was used to evaluate the fit of the framework by measuring the size of the gap between the abutment and the framework. The results were analyzed statistically. Results: The mean values for the abutment/framework interface gaps were: master cast, 31.63 mu m (SD 2.16); SI, 38.03 mu m (SD 9.29); ASI, 46.80 mu m (SD 8.47); SE, 151.21 mu m (SD 22.79); and ASE, 136.59 mu m (SD 29.80). No significant difference was detected between the SI or ASI techniques and the master cast. No significant difference was detected between the SE and ASE techniques. Conclusion: Within the limitations of this study, it can be concluded that Impregum Soft medium consistency was the best impression material and the impression technique did not influence the accuracy of the stone casts. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:771-776

Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study

The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index, as well as denture hygiene of patients provided with removable partial denture (RPD) during a 12-month follow-up.A total of 53 partially edentulous patients were recruited for this study. The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit. The plaque and gingival indexes were measured using the Loe index. Following treatment, the patients were randomly divided into three groups. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, participants were given verbal instructions and a self-educational manual on oral hygiene without illustrations. In Group III, oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces (day zero examination) and re-examined 7, 15 and 30 days, 3, 6 and 12 months following RPD placement. The state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6 and 12 months following rehabilitation. Parametric statistics was applied to dental plaque and gingival indexes. For accumulation of plaque and calculus on the RPD, non-parametric statistic was applied.The frequency of plaque found during the preliminary visit was higher than that found in the other periods. With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and III.The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance.

Accuracy of impression and pouring techniques for an implant-supported prosthesis

Purpose: The purpose of this in vitro study was to compare the dimensional accuracy of a stone index and of 3 impression techniques (tapered impression copings, squared impression copings, and squared impression copings splinted with acrylic resin) associated with 3 pouring techniques (conventional, pouring using latex tubes fitted onto analogs, and pouring after joining the analogs with acrylic resin) for implant-supported prostheses. Materials and Methods: A mandibular brass cast with 4 stainless steel implant-abutment analogs, a framework, and 2 aluminum custom trays were fabricated. Polyether impression material was used for all impressions. Ten groups were formed (a control group and 9 test groups formed by combining each pouring technique and impression technique). Five casts were made per group for a total of 50 casts and 200 gap values (1 gap value for each implant-abutment analog). Results: The mean gap value with the index technique was 27.07 mu m. With the conventional pouring technique, the mean gap values were 116.97 mu m for the tapered group, 5784 mu m for the squared group, and 73.17 mu m for the squared splinted group. With pouring using latex tubes, the mean gap values were 65.69 mu m for the tapered group, 38.03 mu m for the squared group, and 82.47 mu m for the squared splinted group. With pouring after joining the analogs with acrylic resin, the mean gap values were 141.12 jum for the tapered group, 74.19 mu m for the squared group, and 104.67 mu m for the squared splinted group. No significant difference was detected among Index, squarellatex techniques, and master cast (P > .05). Conclusions: The most accurate impression technique utilized squared copings. The most accurate pouring technique for making the impression with tapered or squared copings utilized latex tubes. The pouring did not influence the accuracy of the stone casts when using splinted squared impression copings. Either the index technique or the use of squared coping combined with the latex-tube pouring technique are preferred methods for making implant-supported fixed restorations with dimensional accuracy.

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals.Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants.Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations.Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.