First clinical experience with a new non-indwelling voice prosthesis (Provox (R) NID (TM)) for voice rehabilitation after total laryngectomy

Conclusion. The new Provox(R) NID (TM) non- indwelling voice prosthesis investigated in this study provides a good option for laryngectomized patients using non- indwelling voice prostheses and can potentially improve safety and increase patients' satisfaction with their voice and speech. Objective. To investigate the feasibility of and patient satisfaction with the Provox NID non- indwelling voice prosthesis. Material and methods. Pre- and post- study questionnaires were used to evaluate the patients' former voice prosthesis and the Provox NID voice prosthesis. In addition, measurements of pull- out force, maximum phonation time and loudness were made for both voice prostheses. In vitro measurements of airflow characteristics were also made. Following a 6- week trial, all patients provided feedback on the new voice prosthesis and the results were used to further improve the Provox NID. This final version of the new voice prosthesis was subsequently trialled and evaluated by 10 patients 6 months later. Results. Overall results showed that patient satisfaction with the Provox NID non- indwelling voice prosthesis was favourable. The pull- out force for the new prosthesis was significantly higher than that for the formerly used prosthesis and its aerodynamic characteristics were better.

Effect of weathering and thickness on roughness of acrylic resin and ocular button

Purpose: The aim of this study was to evaluate the roughness of colorless ocular button and four brands of colorless acrylic resins designed to fabricate ocular prosthesis as a function of weathering (1008 h) and different thickness (1 and 3.5 mm). Materials and methods: One-hundred-and-twenty specimens were fabricated and distributed in 12 groups. The analysis was carried out by means of digital roughness meter. Results: Data were analyzed statistically by ANOVA and Tukey test at 1% significance. The results showed that there was no statistically significant difference after the weathering period. Both the Vipi Cril acrylic resin with 3.5 mm in thickness and ocular button with 1 mm in thickness presented the lowest roughness values (0.12. Ra). Conclusion: The roughness of the acrylic resins and the ocular button was not affect by the weathering of 1008 h. However, the thickness of the specimens proved to have a major influence on roughness property. © 2010.

Caracterização microestrutural e resistência à corrosão de ligas Co-Cr-Mo utilizadas em próteses dentárias

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise in vitro da proliferação celular e produção de mediadores inflamatórios por células da conjuntiva estimuladas por materiais utilizados na confecção de próteses oculares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Técnicas de reembasamento para prótese total

Alveolar bone resorption is continuous throughout the life of edentulous patients, the prosthesis mismatch can generate during speech and chewing. An alternative to this would be to destabilize the denture reline, a maneuver which aims to readjust the denture base to the rim by the addition of a plastic film to the inner surface of the prosthesis material. This procedure may be direct, when performed in the clinic, or indirect when made in prosthetic laboratory. The aim this study is to demonstrate the technical of two reline for denture.

FINITE ELEMENT ANALYSIS OF MAXILLARY BONE STRESS CAUSED BY ARAMANY CLASS IV OBTURATOR PROSTHESES

Statement of problem. The retention of an Aramany Class IV removable partial dental prosthesis can be compromised by a lack of support. The biomechanics of this obturator prosthesis result in an unusual stress distribution on the residual maxillary bone. Purpose. This study evaluated the biomechanics of an Aramany Class IV obturator prosthesis with finite element analysis and a digital 3-dimensional (3-D) model developed from a computed tomography scan; bone stress was evaluated according to the load placed on the prosthesis. Material and methods. A 3-D model of an Aramany Class IV maxillary resection and prosthesis was constructed. This model was used to develop a finite element mesh. A 120 N load was applied to the occlusal and incisal platforms corresponding to the prosthetic teeth. Qualitative analysis was based on the scale of maximum principal stress; values obtained through quantitative analysis were expressed in MPa. Results. Under posterior load, tensile and compressive stresses were observed; the tensile stress was greater than the compressive stress, regardless of the bone region, and the greatest compressive stress was observed on the anterior palate near the midline. Under an anterior load, tensile stress was observed in all of the evaluated bone regions; the tensile stress was greater than the compressive stress, regardless of the bone region. Conclusions. The Aramany Class IV obturator prosthesis tended to rotate toward the surgical resection when subjected to posterior or anterior loads. The amount of tensile and compressive stress caused by the Aramany Class IV obturator prosthesis did not exceed the physiological limits of the maxillary bone tissue. (J Prosthet Dent 2012;107:336-342)

Effect of veneering material on the deformation suffered by implant-supported fixed prosthesis framework

The aim of this study was to evaluate the deformation suffered by cantilevered implant-supported fixed prostheses frameworks cast in silver-palladium alloy and coated with two occlusal veneering materials: acrylic resin or porcelain. Material and Methods: Two strain gauges were bonded to the inferior surface of the silver-palladium framework and two other were bonded to the occlusal surface of the prosthesis framework covered with ceramic and acrylic resin on each of its two halves. The framework was fixed to a metallic master model and a 35.2 N compression force was applied to the cantilever at 10, 15 and 20 mm from the most distal implant. The measurements of deformation by compression and tension were obtained. The statistical 2-way ANOVA test was used for individual analysis of the experiment variables and the Tukey test was used for the interrelation between all the variables (material and distance of force application). Results: The results showed that both variables had influence on the studied factors (deformation by compression and tension). Conclusion: The ceramic coating provided greater rigidity to the assembly and therefore less distortion compared with the uncoated framework and with the resin-coated framework. The cantilever arm length also influenced the prosthesis rigidity, causing higher deformation the farther the load was applied from the last implant.

Validation of an experimental polyurethane model for biomechanical studies on implant supported prosthesis - tension tests

OBJECTIVES: The complexity and heterogeneity of human bone, as well as ethical issues, frequently hinder the development of clinical trials. The purpose of this in vitro study was to determine the modulus of elasticity of a polyurethane isotropic experimental model via tension tests, comparing the results to those reported in the literature for mandibular bone, in order to validate the use of such a model in lieu of mandibular bone in biomechanical studies. MATERIAL AND METHODS: Forty-five polyurethane test specimens were divided into 3 groups of 15 specimens each, according to the ratio (A/B) of polyurethane reagents (PU-1: 1/0.5, PU-2: 1/1, PU-3: 1/1.5). RESULTS: Tension tests were performed in each experimental group and the modulus of elasticity values found were 192.98 MPa (SD=57.20) for PU-1, 347.90 MPa (SD=109.54) for PU-2 and 304.64 MPa (SD=25.48) for PU-3. CONCLUSION: The concentration of choice for building the experimental model was 1/1.

Validation of an experimental polyurethane model for biomechanical studies on implant-supported prosthesis: compression tests

OBJECTIVES: The complexity and heterogeneity of human bone, as well as ethical issues, most always hinder the performance of clinical trials. Thus, in vitro studies become an important source of information for the understanding of biomechanical events on implant-supported prostheses, although study results cannot be considered reliable unless validation studies are conducted. The purpose of this work was to validate an artificial experimental model based on its modulus of elasticity, to simulate the performance of human bone in vivo in biomechanical studies of implant-supported prostheses. MATERIAL AND METHODS: In this study, fast-curing polyurethane (F16 polyurethane, Axson) was used to build 40 specimens that were divided into five groups. The following reagent ratios (part A/part B) were used: Group A (0.5/1.0), Group B (0.8/1.0), Group C (1.0/1.0), Group D (1.2/1.0), and Group E (1.5/1.0). A universal testing machine (Kratos model K - 2000 MP) was used to measure modulus of elasticity values by compression. RESULTS: Mean modulus of elasticity values were: Group A - 389.72 MPa, Group B - 529.19 MPa, Group C - 571.11 MPa, Group D - 470.35 MPa, Group E - 437.36 MPa. CONCLUSION: The best mechanical characteristics and modulus of elasticity value comparable to that of human trabecular bone were obtained when A/B ratio was 1:1.

Optimising the design and manufacture of a customised, prescription fit, Maxillo-facial prosthesis

This thesis is a continuation of the Enterprise-Ireland Research Innovation Fund (RIF) Project entitled’ "Design and Manufacturing of Customised Maxillo-Facial Prostheses" The primary objective of this Internal Research Development Program (IRDP) project was to investigate two fundamental design changes 1 To incorporate the over-denture abutments directly into the implant. 2 To remove the restraining wings by the addition of screws, which affix the. implant to the dense material of the jawbone. The prosthetic was redesigned using the ANSYS Finite Element Analysis software program and analysed to* • Reduce the internal von Mises stress distribution The new prosthetic had a -63.63 % lower von Mises stress distribution when compared with the original prosthetic. • Examine the screw preload effects. A maximum relative displacement of 22 6 * lO^mm between the bone and screw was determined, which is well below the critical threshold of micromotion which prevents osseointegration • Investigate the prosthetic-bone contact interface. Three models of the screw, prosthesis, and bone, were studied. (Axisymmetnc, quarter volume, and full volume), a recommended preload torque of 0 32 Nm was applied to the prosthetic and a maximum von Mises stress of 1.988 MPa was predicted • Study the overdenture removal forces. This analysis could not be completed because the correct plastic multilinear properties of the denture material could not be established The redesigned prosthetic was successfully manufactured on a 3-axis milling machine with an indexing system The prosthetic was examined for dimensional quality and strength The research established the feasibility of the new design and associated manufacturing method.

Prothèses totales de genoux. Analyse clinique et numérique des micromouvements de l'implant tibial [Total knee prosthesis. Clinical and numerical study of micromovements of the tibial implant].

INTRODUCTION: The importance of the micromovements in the mechanism of aseptic loosening is clinically difficult to evaluate. To complete the analysis of a series of total knee arthroplasties (TKA), we used a tridimensional numerical model to study the micromovements of the tibial implant. MATERIAL AND METHODS: Fifty one patients (with 57 cemented Porous Coated Anatomic TKAs) were reviewed (mean follow-up 4.5 year). Radiolucency at the tibial bone-cement interface was sought on the AP radiographs and divided in 7 areas. The distribution of the radiolucency was then correlated with the axis of the lower limb as measured on the orthoradiograms. The tridimensional numerical model is based on the finite element method. It allowed the measurement of the cemented prosthetic tibial implant's displacements and the micromovements generated at bone-ciment interface. A total load (2000 Newton) was applied at first vertically and asymetrically on the tibial plateau, thereby simulating an axial deviation of the lower limbs. The vector's posterior inclination then permitted the addition of a tangential component to the axial load. This type of effort is generated by complex biomechanical phenomena such as knee flexion. RESULTS: 81 per cent of the 57 knees had a radiolucent line of at least 1 mm, at one or more of the tibial cement-epiphysis jonctional areas. The distribution of these lucent lines showed that they came out more frequently at the periphery of the implant. The lucent lines appeared most often under the unloaded margin of the tibial plateau, when axial deviation of lower limbs was present. Numerical simulations showed that asymetrical loading on the tibial plateau induced a subsidence of the loaded margin (0-100 microns) and lifting off at the opposite border (0-70 microns). The postero-anterior tangential component induced an anterior displacement of the tibial implant (160-220 microns), and horizontal micromovements with non homogenous distribution at the bone-ciment interface (28-54 microns). DISCUSSION: Comparison of clinical and numerical results showed a relation between the development of radiolucent lines and the unloading of the tibial implant's margin. The deleterious effect of lower limbs' axial deviation is thereby proven. The irregular distribution of lucent lines under the tibial plateau was similar of the micromovements' repartition at the bone-cement interface when tangential forces were present. A causative relation between the two phenomenaes could not however be established. Numerical simulation is a truly useful method of study; it permits to calculate micromovements which are relative, non homogenous and of very low amplitude. However, comparative clinical studies remain as essential to ensure the credibility of results.

Estudo da viabilidade do processo de reciclagem do material descartado do sistema Zirkonzanh® de produção de próteses dentárias

At present, the material of choice for performing aesthetic dental prosthetic work is in the ceramic. Among them, the ceramic base of stabilized zirconia with 3% yttria (3Y - TZP) stand out for having excellent physical and mechanical properties. During the machining of blocks of zirconia in the laboratory to prepare the various types of prostheses, much of the material is given off in the form of powder, which is subsequently discarded. The waste of this material results in financial loss, reflecting higher final cost treatment for patients, as well as damage to the environment, thanks to the processes involved in the manufacture and disposal of the ceramic. This research, pioneered the recycling of zirconium oxide powder obtained during milling of dental crowns and bridges, we highlight the social and environmental aspects and aims to establish a protocol for the reuse of waste (powder of zirconia Zirkonzahn® system) discarded to obtain a new block of compacted zirconia to maintain the same mechanical and microstructural properties of commercial high-cost imported material. To compare with the commercial material, samples were uniaxially (20 MPa) and isostatically (100 MPa), and its mechanical and microstructural characterization was performed through tests of density, porosity, dilatometry, X-ray diffraction (XRD), hardness, fracture toughness, resistance to fracture electron microscopy (SEM) and analysis of grain size. The results observed in the samples were isostatically pressed similiares those obtained with samples from the commercial material demonstrating the viability of the process

Nasalance and nasality at experimental velopharyngeal openings in palatal prosthesis: a case study

The use of prosthetic devices for correction of velopharyngeal insufficiency (VPI) is an alternative treatment for patients with conditions that preclude surgery and for those individuals with a hypofunctional velopharynx (HV) with a poor prognosis for the surgical repair of VPI. Understanding the role and measuring the outcome of prosthetic treatment of velopharyngeal dysfunction requires the use of tools that allow for documenting pre- and post-treatment outcomes. Experimental openings in speech bulbs have been used for simulating VPI in studies documenting changes in aerodynamic, acoustic and kinematics aspects of speech associated with the use of palatal prosthetic devices. The use of nasometry to document changes in speech associated with experimental openings in speech bulbs, however, has not been described in the literature. Objective: This single-subject study investigated nasalance and nasality at the presence of experimental openings drilled through the speech bulb of a patient with HV. Material and Methods: Nasometric recordings of the word "pato" were obtained under 4 velopharyngeal conditions: no-opening (control condition), no speech bulb, speech bulb with a 20 mm(2) opening, and speech bulb with 30 mm(2) opening. Five speech-language pathologists performed auditory-perceptual ratings while the subject read an oral passage under all conditions. Results: Kruskal-Wallis test showed significant difference among conditions (p=0.0002), with Scheffe post hoc test indicating difference from the no-opening condition. Conclusion: The changes in nasalance observed after drilling holes of known sizes in a speech bulb suggest that nasometry reflect changes in transfer of sound energy related to different sizes of velopharyngeal opening.

Implant-retained thumb prosthesis with anti-rotational attachment for a geriatric patient

This report presents the use of a dental implant with an anti-rotational attachment for the retention of a thumb prosthesis. A retention system was manufactured with an attachment (UCLA) screwed into the implant with a two-bar system that was cast in metallic silver palladium. A substructure made from heat-cured acrylic resin was joined to the retention system by clips to join the thumb to the finger (bar clip) in the cast with implant rejoinder. The silicone material, Silastic-MDX 44210, was used to achieve function and aesthetics. Following osseointegration, no skin problems were observed. Whilst the implant-retained digital prosthesis presented some motor limitations, it allowed the patient to return to entertainment and achieve social conviviality.

Effect of Metal-Ceramic or All-Ceramic Superstructure Materials on Stress Distribution in a Single Implant-Supported Prosthesis: Three-Dimensional Finite Element Analysis

Purpose: This three-dimensional finite element analysis study evaluated the effect of different material combinations on stress distribution within metal-ceramic and all-ceramic single implant-supported prostheses. Materials and Methods: Three-dimensional finite element models reproducing a segment of the maxilla with a missing left first premolar were created. Five groups were established to represent different superstructure materials: GP, porcelain fused to gold alloy; GR, modified composite resin fused to gold alloy; TP, porcelain fused to titanium; TR, modified composite resin fused to titanium; and ZP, porcelain fused to zirconia. A 100-N vertical force was applied to the contact points of the crowns. All models were fixed in the superior region of bone tissue and in the mesial and distal faces of the maxilla section. Stress maps were generated by processing with finite element software. Results: Stress distribution and stress values of supporting bone were similar for the GP, GR, TP, and ZP models (1,574.3 MPa, 1,574.3 MPa, 1,574.3 MPa, and 1,574.2 MPa, respectively) and different for the TR model (1,838.3 MPa). The ZP model transferred less stress to the retention screw (785 MPa) than the other groups (939 MPa for GP, 961 MPa for GR, 1,010 MPa for TP, and 1,037 MPa for TR). Conclusion: The use of different materials to fabricate a superstructure for a single implant-supported prosthesis did not affect the stress distribution in the supporting bone. The retention screw received less stress when a combination of porcelain and zirconia was used. Int J Oral Maxillofac Implants 2011;26:1202-1209