RESUMEN
This retrospective study was designed to verify the factors that influence implant failures. Six prosthodontic clinics in Sweden participated in the study, and together they included a total of 54 patients treated between January 1988 and December 1996. All patients were completely edentulous in the maxilla, and received either a fixed prosthesis or an overdenture supported by at least 4 implants (Brånemark System). Half of the patients belonged to the study group, and an inclusion criterion for this group was that they had lost at least half of their implants. To reduce bias, the patients in the control group were matched to the study group, i.e. they were selected so that both groups were as identical as possible. The results of the study indicate that the control group had a better initial bone support than the study group. Furthermore, the patients in the study group suffered from circumstances that could induce implant failure, such as bruxism, personal grief, depression, as well as addictions to cigarettes, alcohol and/or narcotics. On the study form the clinicians were asked to give their own opinion of the reason for implant failure. The answers given could easily be grouped into 5 different topics, and this experience can be useful to improve patient selection. This study suggests that there are certain factors of importance to consider to prevent a cluster phenomenon of implant failures i.e. lack of bone support, heavy smoking habits and bruxism.
Asunto(s)
Implantes Dentales , Fracaso de la Restauración Dental , Adulto , Anciano , Alcoholismo/complicaciones , Bruxismo/complicaciones , Estudios de Casos y Controles , Retención de Prótesis Dentales , Prótesis Dental de Soporte Implantado , Diseño de Dentadura , Dentadura Completa Superior , Prótesis de Recubrimiento , Depresión/complicaciones , Femenino , Pesar , Humanos , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Trastornos Relacionados con Opioides/complicaciones , Oseointegración , Selección de Paciente , Estudios Retrospectivos , Fumar/efectos adversosRESUMEN
All patients (n = 46) treated with implant-supported overdentures at the Department of Prosthetic Dentistry, Dental and Medical Health Centre, Halmstad, Sweden, from 1986 to 1993 were studied. The clinical examination was completed in 1994. The material was divided into two subgroups: Group A had been initially treatment planned for an implant-supported overdenture, and Group B had been planned for fixed prostheses but because of loss of implants before loading, treatment with a fixed prosthesis was not possible. The authors present their experience and patient reactions to overdenture therapy in two defined groups of patients. The implant failure rate before loading for Group A (n = 12) was 15% (six implants out of 39), and the rate before loading for Group B (n = 29) was 43.6% (68 implants out of 156). After prosthodontic treatment in Group A, the implant success rate after loading was 87.9%, and the overdenture stability was 84.6%. In group B, 17 implants placed in the maxillae were lost after overdenture therapy, which resulted in an implant success rate of 79.3%. A total of eight overdentures, all of which had been placed in the maxillae, were lost, resulting in an overdenture stability of 73.3%. In this study "change of retentive clips" was the predominant prosthodontic complication related to the overdentures, especially in Group B. Most of these complications (62%) occurred in patients with clinical signs of bruxism. Patient reactions to treatment with an overdenture were positive regarding esthetics for both groups. More negative views were recorded in Group B than in Group A in response to function and retention of the overdenture.
Asunto(s)
Prótesis Dental de Soporte Implantado , Diseño de Dentadura , Prótesis de Recubrimiento , Arcada Edéntula/rehabilitación , Anciano , Fracaso de la Restauración Dental , Retención de Dentadura/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Satisfacción del Paciente , Selección de Paciente , Retratamiento , Estudios Retrospectivos , Encuestas y CuestionariosRESUMEN
A 3-year multicenter study on 63 maxillary and 10 mandibular fixed prostheses in 71 patients is reported. Angulated abutments or a combination of angulated and standard abutments were used to support prostheses; all components were from the Brånemark System. Of 425 implants initially placed, 4 were lost before abutment connection. Of the remaining 421 implants, 209 angulated (test) abutments and 212 standard (control) abutments were placed to support fixed prostheses. The prosthesis success rates were 96.8% for maxillae and 100% for mandibles. A total of 5.3% of the loaded test implants and 7.5% of the loaded control implants failed. The survival rates after 3 years were 91.3% for maxillary control implants, 94.8% for maxillary test implants, 97.4% for mandibular control implants, and 94.1% for mandibular test implants. The findings in this study pointed out that angulated abutments will not necessarily promote peri-implant mucosal problems. The study indicated that angulated abutments on Brånemark System implants have exhibited good preliminary results and should be comparable to the standard abutment as a predictable modality in prosthetic rehabilitation.
Asunto(s)
Pilares Dentales , Implantes Dentales , Diseño de Prótesis Dental , Adolescente , Adulto , Anciano , Implantación Dental Endoósea/efectos adversos , Implantación Dental Endoósea/métodos , Índice de Placa Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Gingivitis/etiología , Humanos , Tablas de Vida , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Índice Periodontal , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
The masticatory cycles of 11 men (mean age 51.5 years) with extensive tooth wear were investigated before and after rehabilitation with fixed partial dentures. Parameters such as the tooth wear index (IA) and masticatory mandibular movement were recorded. Before treatment, the patients were also given a questionnaire related to possible background factors of importance to tooth wear. At baseline a mean score of 48.6 (range 0 to 100) for the tooth wear index (IA) was found. The clinical recall examination 3 years after prosthodontic rehabilitation displayed obvious wear of restorative material for two patients, and, in another patient, one of the fixed partial dentures had to be remade because of fracture of abutment teeth. Following rehabilitation, the duration of the masticatory mandibular opening movement increased and mandibular movement velocity decreased. The mandibular closing angle, near to occlusal contact, became steeper after prosthodontic treatment, indicating a changed mandibular movement pattern.
Asunto(s)
Coronas , Oclusión Dental Traumática/fisiopatología , Alisadura de la Restauración Dental , Dentadura Parcial Fija , Atrición Dental/fisiopatología , Adulto , Anciano , Oclusión Dental Traumática/etiología , Humanos , Masculino , Mandíbula/fisiopatología , Masticación/fisiología , Persona de Mediana Edad , Atrición Dental/complicaciones , Atrición Dental/rehabilitaciónRESUMEN
The material consisted of 527 randomly selected children and adolescents from the community of Jönköping, Sweden, who in 1983 reached the age of 3, 5, 10, 15, or 20 years. The degree of incisal or occlusal tooth wear was evaluated for each single tooth in accordance with the following criteria: score 0 = no wear or negligible wear of enamel; score 1 = obvious wear of enamel or wear through the enamel to the dentin in single spots; score 2 = wear of the dentin up to one-third of the crown height; and score 3 = wear of the dentin more than one-third of the crown height. In the age groups 3 and 5 years the primary dentition was studied, and in the age groups 10, 15, and 20 years the permanent dentition. In the 3-year-old children 63% and in the 5-year-olds 19% had no or slight incisal or occlusal wear in the primary dentition. In the permanent dentition the corresponding figures for the 10-, 15-, and 20-year-olds were 78%, 51%, and 35%, respectively. The 5-year-olds had the highest percentage of primary teeth with incisal or occlusal wear related to existing teeth in accordance with criteria 1-3 (32.2%), and the 10-year-olds had the lowest score for permanent teeth (2.5%). There were small or no differences in tooth wear between the sexes in these age groups. Eighteen children (17%) among the 5-year-olds had one or more teeth with wear scored 2 in the primary dentition, and one individual had 4 primary teeth scored 3. The corresponding figures for the 3-, 10-, 15-, and 20 year-olds were 2%, 1%, 7% and 6%, respectively. No permanent teeth with wear scored 3 were found in these age groups. The number of teeth with incisal or occlusal wear increased with age both in the primary and in the permanent dentition.
Asunto(s)
Atrición Dental/epidemiología , Adolescente , Adulto , Análisis de Varianza , Niño , Preescolar , Estudios Transversales , Dentición Permanente , Femenino , Humanos , Masculino , Prevalencia , Reproducibilidad de los Resultados , Muestreo , Suecia/epidemiología , Diente PrimarioRESUMEN
This retrospective study of Brånemark implants presents results from 93 implants for single-tooth replacements placed in 77 patients from 1987 to 1990. Only two implants were lost: one before the abutment operation and one during the first year in function. Patients' reactions to the rehabilitations were very positive regarding esthetic aspects and function. The most obvious problem was related to loose abutment screws. Forty-three percent of the abutment screws had to be retightened during the follow-up period, and for this reason, nine cemented crowns had to be remade.
Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Diente Artificial , Adulto , Anciano , Pilares Dentales , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Falla de Prótesis , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
This paper is a literature review of various aspects of the wear of occluding tooth surfaces. It presents classification and terminology of occlusal tooth wear, and discusses etiology and differential diagnosis. It may be difficult to differentiate among abrasion, attrition, and erosion because there is nearly always a combination of the various processes. These processes of wear are described, and the in vitro and in vivo wear of some restorative materials is discussed. Treatment of severe tooth wear is considered difficult; prophylactic measures are therefore important. Some guidelines for restorative treatment of patients with extensive occlusal tooth wear are given, with special emphasis on the type of treatment, the vertical dimension of occlusion, the space available, and choice of material for the restorations.
Asunto(s)
Restauración Dental Permanente , Saliva/química , Abrasión de los Dientes , Materiales Dentales , Oclusión Dental , Humanos , Saliva/fisiología , Abrasión de los Dientes/etiología , Abrasión de los Dientes/fisiopatología , Abrasión de los Dientes/terapiaRESUMEN
This report presents our experience with 12 consecutive patients treated by the method of SAILER19, comprising bone grafting to the floor of the nose and the maxillary sinus after a Le Fort I inferior repositioning of the maxilla followed by immediate implantation of endosseous implants. The corticocancellous grafts were harvested from the iliac crest. Fifty-nine implants were inserted in the bone grafts and eight in the adjacent nongrafted bone. Fourteen implants (21%) had to be removed because of nonintegration, of which 10 had been placed in two patients. The follow-up ranged from 11 to 24 months. No implants have been lost after loading. Six patients received fixed prostheses, and four overdentures. The importance of complete preoperative positional stability of the bone grafts and implants is emphasized.
Asunto(s)
Trasplante Óseo , Implantación Dental Endoósea , Implantes Dentales , Arcada Edéntula/cirugía , Maxilar/cirugía , Osteotomía/métodos , Adulto , Anciano , Atrofia , Trasplante Óseo/métodos , Pilares Dentales , Diseño de Dentadura , Ajuste de Precisión de Prótesis , Prótesis de Recubrimiento , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar/patología , Persona de Mediana Edad , OseointegraciónRESUMEN
The purpose of this study was to compare a gravimetric method and an impression technique in the evaluation of occlusal substance loss. The wear of gold, porcelain, and microfilled resin was studied in vivo. The gravimetric method showed lower substance loss for porcelain than for gold, whereas the microfilled resin had the highest substance loss. To obtain a higher accuracy for the measurement of occlusal substance loss of restorative materials with an impression technique, the test area has to be restricted, the antagonizing occlusal contacts carefully recorded before the test period, and the number of cuts increased. The observed structure of wear facets (SEM) corroborated with previous findings of the wear mechanism of these materials; that is, gold has mainly abrasive wear in contact with porcelain, whereas porcelain has a fatigue type and microfilled resin a tribochemical type of wear.
Asunto(s)
Resinas Compuestas/química , Porcelana Dental/química , Dentadura Parcial Removible , Aleaciones de Oro/química , Ensayo de Materiales/métodos , Metacrilatos , Cementos de Resina , Silanos , Fenómenos Químicos , Química Física , Humanos , Masculino , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Propiedades de SuperficieRESUMEN
The purpose of this investigation was to assess the influence of differences in design of the occlusion rim on recorded vertical dimension in complete denture therapy. Edentulous patients were studied with an opto-electronic method when the vertical dimension of rest was established with and without labial support of the occlusion rim. As no significant differences were found, the results did not support the hypothesis that the contour of the lip support will influence the recorded physiological rest position. However, a significant difference between intra and extraoral placement of the point of measurement was found.
Asunto(s)
Registro de la Relación Maxilomandibular , Labio/fisiología , Boca Edéntula/patología , Dimensión Vertical , Anciano , Diseño de Dentadura , Dentadura Completa , Músculos Faciales/fisiología , Femenino , Humanos , Masculino , Mandíbula/patología , Relajación Muscular , FonéticaRESUMEN
The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.
Asunto(s)
Abrasión de los Dientes/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Bruxismo/epidemiología , Esmalte Dental/patología , Dentina/patología , Análisis Discriminante , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Análisis de Regresión , Factores Sexuales , Suecia/epidemiología , Diente/patología , Abrasión de los Dientes/epidemiologíaRESUMEN
The aim of this investigation was to study quantitative and qualitative aspects of the wear process of some prosthodontic materials in three different persons in vivo. The in vivo models combined two methods: removable double crowns and a replica technique. The wear resistance of gold (types III and IV), porcelain and a microfilled resin was studied opposing metal ceramic crowns and in one person when opposing all four materials. All three persons had earlier histories of occlusal wear of teeth and/or restorations. The wear rate of gold and porcelain showed equal values antagonizing metal ceramic crowns in all three persons. The microfilled resin had a wear rate three or four times higher in the same situations. No significant difference in wear resistance could be found between type III and type IV gold alloys. The wear mechanism seemed to be a fatigue type in porcelain, and in gold a combined fatigue and abrasive type of wear. The microfilled resin showed mainly a fatigue type of wear but some observations indicating a tribochemical reaction were also made.
Asunto(s)
Resinas Compuestas , Coronas , Porcelana Dental , Aleaciones de Oro , Ensayo de Materiales , Humanos , Masculino , Ensayo de Materiales/métodos , Microscopía Electrónica de Rastreo , Saliva/análisis , Estrés Mecánico , Propiedades de SuperficieRESUMEN
The aim of this investigation was to describe the wear mechanism in occlusal contact areas of porcelain and acrylic resin denture teeth opposing different dental materials. A 55-year-old man with earlier extensive wear was given two complete dentures, as identical as possible, in the upper jaw. One of the dentures had diatoric teeth in cross-linked resin and the other denture had diatoric teeth in porcelain. The dentures were antagonizing a new gold-acrylic fixed bridge from 46 to 36. Two contralateral segments of the bridge were made as removable double crowns. The removable segments were made in different materials: gold, porcelain, light-cured resin, and heat-cured resin. Wear of the denture teeth was studied by scanning electron microscopy on replica models made after 1 and 2 months of antagonizing contact with the various materials. Wear of both porcelain and modern cross-linked resin teeth was mainly a fatigue type of wear. Abrasion was observed when hard particles were assumed to be part of the wear debris.
Asunto(s)
Porcelana Dental , Metilmetacrilatos , Diente Artificial , Diseño de Dentadura , Dentadura Completa Superior , Dentadura Parcial Fija , Dentadura Parcial Removible , Humanos , Masculino , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Propiedades de SuperficieRESUMEN
In the epidemiological studies of this thesis, the aims were to elucidate the prevalence of incisal and occlusal wear in a normal Swedish population, and to present factors related to incisal and occlusal wear in that population. In the clinical studies, the aims were to develop methods for and to perform in vivo studies of wear of prosthodontic materials and to present quantitative and qualitative data of occlusal contact wear in these materials. The epidemiological part of this study consisted of 585 randomly selected dentate individuals from the Community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70 or 80 years. The results showed that the severity and prevalence of incisal and occlusal wear increased with age. Men presented more teeth with occlusal wear than women. An individual tooth wear index (IA), with the potential to rank individuals with respect to incisal and occlusal wear, has also been introduced. Factors which were found to correlate significantly to increased incisal and occlusal wear were: number of teeth, age, sex, occurrence of bruxism, use of snuff and the saliva buffer capacity. From the in vivo studies, data of occlusal contact wear of gold, porcelain and some resin based materials in four different persons, with earlier histories of occlusal wear of teeth and/or restorations, were presented. The in vivo models combined two methods: removable segments or double crowns, and a replica technique. The combination of a polyvinylsiloxane impression material (President) and an epoxy resin (Metapox) was chosen for the replica model technique. All materials tested showed increased wear rate when the opposing material was porcelain. Gold and porcelain showed equal wear resistance when opposing porcelain. The resin-based materials showed at least a three to four times higher wear rate. No difference in wear resistance could be observed between gold type III and type IV. Gold showed a combined abrasive and fatigue type of wear and porcelain mainly a fatigue type of wear. The resin-based materials showed a fatigue type of wear, sometimes in combination with a tribochemical reaction.
Asunto(s)
Restauración Dental Permanente , Dentaduras , Abrasión de los Dientes/diagnóstico , Erosión de los Dientes/diagnóstico , Adulto , Anciano , Estudios Transversales , Materiales Dentales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Propiedades de Superficie , Suecia/epidemiología , Abrasión de los Dientes/epidemiología , Erosión de los Dientes/epidemiologíaRESUMEN
The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.
Asunto(s)
Abrasión de los Dientes/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Esmalte Dental/patología , Dentina/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales , Suecia , Diente/patología , Abrasión de los Dientes/patologíaRESUMEN
The wear of gold, porcelain, and heat- and light-cured resins in occlusal contact with resin and porcelain teeth has been studied in vivo. Both weighing of removable segments of fixed partial prostheses and a replica technique allowing scanning electron microscope observations of the worn surfaces were used. The results showed that all materials had the greatest loss of substance when the opposing teeth were of porcelain. The heat-cured, unfilled resin was the least wear-resistant material, followed by light-cured resin, porcelain, and gold. The heat-cured resin showed a combined tribochemical and fatigue type of wear. The light-cured resin and porcelain showed mainly a fatigue type of wear, whereas gold showed a combined abrasive and fatigue type of wear.
Asunto(s)
Oclusión Dental , Porcelana Dental , Dentadura Parcial Fija , Aleaciones de Oro , Resinas Sintéticas , Bruxismo , Diseño de Dentadura , Humanos , Masculino , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Estrés Mecánico , Propiedades de SuperficieRESUMEN
In order to obtain a replica technique suitable for a complete or segments of a dental arch two different impression materials were combined with two epoxy resin model materials. The models were examined and photographed in an optical microscope and a scanning electron microscope. No systematic differences were found between the used combinations of materials except a tendency towards greater contraction of one of the model materials. The A-silicone impression materials combined with one of the epoxy resin material seemed to be the easiest to handle and to give the best models.
Asunto(s)
Materiales de Impresión Dental , Restauración Dental Permanente , Microscopía Electrónica de Rastreo/métodos , Diente/anatomía & histología , Sulfato de Calcio , Resinas Epoxi , Estudios de Evaluación como Asunto , Humanos , Masculino , Persona de Mediana Edad , Modelos Dentales , Proyectos Piloto , Elastómeros de Silicona , Propiedades de SuperficieRESUMEN
In a group of nine dentate students with a mean age of 23.1 years, a comparison of their interocclusal distances was determined using tooth and chin reference points. This determination was made with two reference LEDs, one attached to a lower tooth and the other attached to a point on the chin. These two LEDs were registered simultaneously using the Selspot system and analyzed with the use of a computer. Three different methods were used to establish the interocclusal distance: a phonetic method, a relaxation method, and a swallowing method. Independent of the method selected, there was a greater interocclusal distance recorded by the tooth-attached reference LED. This study indicates that, in the clinical determination of interocclusal distance, where a chin reference is used the dentist should be aware of this difference--especially when lip activity is involved.