RESUMEN
BACKGROUND: The present prospective, randomized, double-blind study evaluated the bone-forming process around implants inserted simultaneously with anorganic bovine bone (ABB) in sinus grafting. METHODS: A total of 18 threaded mini-implants with Osseotite (O) and Nanotite (N) surfaces were placed in seven patients (nine sites). After 12 months, the implants were retrieved and processed for histological analysis. A total of 18 cutting and grinding sections were investigated with bright-field light microscopy, circularly polarized light microscopy (CPLM), confocal scanning laser microscope (CSLM), and scanning electron microscope (SEM) with energy dispersive spectrometer (EDS). RESULTS: The bone-to-implant contact rate in native crestal bone was 62.6 ± 0.4% for N implants and 54.3 ± 0.5% for the O implants (p = 0.001). The collagen fibre density, as assessed by CPLM, was 79.8 ± 6.0 nm for the N group and 74.6 ± 4.6 nm for the O group (p < 0.05). Line scan EDS starting from ABB to newly formed bone showed a decrease in calcium content and an increase of carbon while phosphorus content was constant. CONCLUSIONS: While the N surface improved the peri-implant endosseous healing properties in the native bone, when compared to the O surface, it did not improve the healing properties in the bone-graft area.
Asunto(s)
Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Implantes Dentales , Oseointegración/fisiología , Cicatrización de Heridas/fisiología , Adulto , Animales , Matriz Ósea/patología , Matriz Ósea/cirugía , Matriz Ósea/trasplante , Bovinos , Método Doble Ciego , Femenino , Humanos , Masculino , Maxilar/patología , Maxilar/cirugía , Maxilar/trasplante , Persona de Mediana Edad , Estudios Prospectivos , Elevación del Piso del Seno Maxilar/métodosRESUMEN
AIM: According to the literature, a high quality prosthetic rehabilitation consists of physical and psychological acceptance of the denture by the patient, an empathic relationship between the clinician and the patient and correct application of complete denture construction principles. To apply these principles correctly, it is important to establish excellent communication with the technician. Interactions between dentists and technical laboratories is typically characterised by minimal communication, which is considered to be the most significant problem for achieving a qualitatively elevated prosthetic manufacture. The aim of the simplified edentulous treatment (SET) method is to correctly transmit clinical data to the laboratory and maintain these data throughout the entire treatment period. METHODS: One hundred twenty-three completely edentulous, Caucasian patients (71 men and 52 women; medium age: 66 years; range 27 to 85 years) were recruited for this study. The inclusion criteria were total edentulism, both maxillary and mandibular, both in patients wearing and not wearing a complete denture. To complete the denture, the patients were entrusted to 65 teams of two students each, attending the fifth year of their degree course in dentistry and performing their first rehabilitation of an edentulous patient, under the supervision of six skilled tutors. The denture manufacturing was performed by 12 technical laboratories. RESULTS: In the rehabilitation of an edentulous patient, transmission of clinical data to the technical laboratory is effective and reliable. CONCLUSION: The data transfer block allows one to transfer all of the necessary information to the laboratory at one time.
Asunto(s)
Registros Odontológicos , Técnicos Dentales/psicología , Odontólogos/psicología , Diseño de Dentadura , Dentadura Completa/psicología , Mecánicos Dentales/psicología , Comunicación Interdisciplinaria , Relaciones Interprofesionales , Boca Edéntula/rehabilitación , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Control de Formularios y Registros , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/psicología , Satisfacción del Paciente , Relaciones Profesional-PacienteRESUMEN
A new technique for making complete denture in a reduced number of clinical sessions maintaining high quality standards is described. This method has been named SET, acronymic for simplified edentulous treatment. SET is a flexible method that can be performed in one, or more sittings, to meet the patient's requirements and/or according to the dentist's preference. All the traditional principles in making complete denture are respected, but new and innovative materials have been designed, built, tested and set up: the multilayer impression tray (MIT) and the bone resorption compensating curve (BRCC). In the first sitting the clinician can obtain, without the need of a dental laboratory, all the clinical information necessary for processing and delivering the denture.
Asunto(s)
Técnica de Impresión Dental , Diseño de Dentadura/métodos , Dentadura Completa , Materiales de Impresión Dental , Diseño de Dentadura/instrumentación , Femenino , Humanos , Boca Edéntula , Resinas SintéticasRESUMEN
Non-carious cervical lesions (NCCL) are characterized by a loss of hard dental tissue near the cement-enamel-junction. Commonly, their shape is like a wedge with the apex pointing inwards. Other times, they appear as regular depressions, like a dome or a cup. Their main characteristic is the presence of hard-mineralized tissue. According to the literature, the prevalence of cervical lesions is 85%, while their incidence is about 18% among permanent teeth. NCCL are currently classified as erosion, abrasion, or abfraction. Their etiology seems to be related to different factors: hexogen and endogen acids, mechanical abrasive action, tooth flexion under axial and non-axial loads. Moreover, it seems that a fundamental role is ascribable to tooth bending phenomena due to the strength components parallel or oblique to the occlusal level, which occur during the normal function as well as during parafunctions. The frequent therapeutic failures are probably due to the same factors causing the onset of the original lesion. Several materials have been proposed to restore NCCL: amalgam (abandoned), glass-ionomer cements, compomers, and composite resins. Early failures of these restorations have often been reported in the literature, probably due to the same factors which originally caused the lesions. Further investigations are required to determine more reliable restorative therapies.
Asunto(s)
Abrasión de los Dientes/patología , Cuello del Diente/patología , Erosión de los Dientes/patología , Compómeros/uso terapéutico , Resinas Compuestas/uso terapéutico , Fracaso de la Restauración Dental , Restauración Dental Permanente/métodos , Cementos de Ionómero Vítreo/uso terapéutico , Humanos , Incidencia , Abrasión de los Dientes/etiología , Abrasión de los Dientes/terapia , Cuello del Diente/lesiones , Erosión de los Dientes/etiología , Erosión de los Dientes/terapia , Resultado del TratamientoRESUMEN
The aim of this study was to investigate the adaptation process of masticatory patterns to a new complete denture in edentulous subjects. For this purpose, muscle activity and kinematic parameters of the chewing pattern were simultaneously assessed in seven patients with complete maxillary and mandibular denture. The patients were analysed (i) with the old denture, (ii) with the new denture at the delivery, (iii) after 1 month and (iv) after 3 months from the delivery of the new denture. Surface electromyographic (EMG) signals were recorded from the masseter and temporalis anterior muscles of both sides and jaw movements were tracked measuring the motion of a tiny magnet attached at the lower inter-incisor point. The subjects were asked to chew a bolus on the right and left side. At the delivery of the new denture, peak EMG amplitude of the masseter of the side of the bolus was lower than with the old denture and the masseters of the two sides showed the same intensity of EMG activity, contrary to the case with the old denture. EMG amplitude and asymmetry of the two masseter activities returned as with the old denture in 3 months. The EMG activity in the temporalis anterior was larger with the old denture than in the other conditions. The chewing cycle width and lateral excursion decreased at the delivery of the new denture and recovered after 3 months.
Asunto(s)
Dentadura Completa , Masticación , Músculos Masticadores/fisiología , Adaptación Fisiológica , Anciano , Fuerza de la Mordida , Oclusión Dental , Electromiografía , Femenino , Humanos , Masculino , Músculo Masetero/fisiología , Persona de Mediana Edad , Músculo Temporal/fisiología , Resultado del TratamientoRESUMEN
AIM: The aim of this paper is to verify how the length of the fiber post may influence its retention in an insertion site. METHODS: Forty double conicity posts were used: 20 were inserted in epoxy resin cubes, the other 20 were inserted in extracted teeth at 2 different depth (5 mm and 10 mm). The samples were tractioned by an Instrom machine registering the postsite detach value. The root canals were examined by SEM. Statistical evaluation was made using the t-test. RESULTS: The results of the sample with resin cubes show a direct proportionality between the insertion length and the post retention. This relation was not appreciated in the sample which used extracted teeth: the differences between the 5 mm and 10 mm insertion are not statistically significant. The extracted posts observation show that the fixing cement stays on the post. CONCLUSIONS: In ideal conditions the retention is directly proportional to the insertion length. The weakest interface of the adhesive system is the one between dentin and fixing cement.
Asunto(s)
Técnica de Perno Muñón , Mecánica , Diseño de PrótesisRESUMEN
AIM: Obstructive sleep apnea syndrome (OSAS) is a disorder characterised by repeated obstructions of the upper airway, with consequent episodes of apnea and hypopnea during sleep, snoring, and daytime sleepiness. Recently, a role of edentulism in the occurrence or in the worsening of this disorder was suspected. The aim of the study was to assess, through a cephalometric analysis, if the removal of denture induces, and where, modifications that can favour the pharynx collapse. METHODS: A total of 27 subjects with complete or partial loss of teeth and with heavy loss of the vertical dimension, were examined. The patients were submitted to radiographs of the cranium in supine position, to simulate as much as possible the night condition, with the denture in intercuspal position (ICP), and in relaxed position both with denture (D-RP) and without it (edentule-relaxed position, E-RP). The radiographs were analysed through specific measures for OSA evaluating the parameters that could be modified by the denture. RESULTS: The pharyngeal airway space (PAS) decreases, at the level of uvula, from ICP (6.7 mm) to RP (5.3 mm) (P< 0.05). The distance between the base and the tip of the tongue significatively decreased both from ICP vs E-RP (7.35 mm vs 6.87 mm; P< 0.05), both from D-RP to E-RP (7.22 mm vs 6.87 mm; P< 0.005). CONCLUSIONS: From the data obtained from the cephalometric analysis it seems that wearing denture induces modifications in the position of the tongue, of the jaw and of the pharyngeal airway space that can favour the reduction of apnea episodes.
Asunto(s)
Obstrucción de las Vías Aéreas/diagnóstico por imagen , Cefalometría , Dentadura Completa , Maxilares/diagnóstico por imagen , Boca Edéntula/diagnóstico por imagen , Faringe/diagnóstico por imagen , Apnea Obstructiva del Sueño/diagnóstico por imagen , Lengua/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Obstrucción de las Vías Aéreas/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/complicaciones , Radiografía , Apnea Obstructiva del Sueño/etiología , Apnea Obstructiva del Sueño/prevención & control , Posición Supina , ÚvulaRESUMEN
Hygienic home care maintenance for patients who have received a maxillofacial prosthesis is very important in order to secure a long-term success of a facial rehabilitation. Craniofacial implant therapy requires a specific protocol to care for the peri-implant tissues and material used for the prosthesis. This article presents the maintenance and care protocol for proper follow-up management of a maxillofacial ear prosthesis. Home care methods for the prosthesis hygiene are described, including: the insertion and the disconnection of the ear prosthesis, hygiene of the bar abutments before and after postdefinitive connection to the craniofacial fixtures, washing of the device, professional follow-up.
Asunto(s)
Prótesis Maxilofacial , Humanos , Higiene , MantenimientoRESUMEN
The stability of titanium dental implants is determined by osseointegration. Bone is a dynamic tissue continuously remodeled through resorption and formation, processes controlled by local cytokine production. This study investigated osseotropic cytokine expression in gingival mucosa, in the intraforamina and inferior first molar zones, during rehabilitation with implant-retained overdentures. Specimens were taken from six patients prior to placement of implants in the intraforamina bone; at connection of healing abutments; and 4, 8, and 12 months after prosthetic anchorage. Through semi-quantitative reverse-transcriptase polymerase chain-reaction, the following constitutively expressed cytokines were found at first surgical stage: interleukin-1, -6, and -8; small amounts of interleukin-11; stem cell factor; and transforming growth factor-beta1, -beta2, and -beta3. From the connection of healing abutments to 12 months after prosthetic anchorage, transforming growth factor-beta1, -beta2, and -beta3 were markedly higher than initial values. Expression of interleukin-6 and -8 decreased 8 months after prosthetic anchorage, while that of interleukin-1 increased at 12 months. In cultured gingival fibroblasts, modulation of cytokine secretion was also time-dependent. Cell culture supernatants influenced osteoclast-like multinucleated cell formation in long-term human marrow culture or osteoblast function, depending on the cytokine profile produced. These results are consistent with functional contributions of cytokines to osseointegration and minimization of posterior edentulous zone bone resorption.
Asunto(s)
Remodelación Ósea/fisiología , Citocinas/biosíntesis , Prótesis Dental de Soporte Implantado , Dentadura Completa , Prótesis de Recubrimiento , Anciano , Secuencia de Bases , Citocinas/análisis , Implantación Dental Endoósea , Femenino , Encía/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Boca Edéntula/metabolismo , Boca Edéntula/rehabilitación , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/estadística & datos numéricos , Factores de Tiempo , TitanioRESUMEN
Thirty-seven white Caucasian subjects with unsatisfactory dentures were tested for interocclusal thickness discrimination threshold. New dentures were prepared and the test was repeated on days 1, 4 and 90 (from delivery). Eight patients whose situation was still unsatisfactory were given osseointegrated implant anchored dentures and the test repeated at the same intervals. Results were analysed statistically. Improved denture fit was found to increase interocclusal sensitivity. Decreased sensitivity during follow-up might indicate the need to check denture fit.
Asunto(s)
Oclusión Dental , Dentadura Completa , Mecanorreceptores/fisiología , Boca Edéntula/fisiopatología , Anciano , Diseño de Prótesis Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Boca Edéntula/rehabilitación , Umbral SensorialRESUMEN
The resorption of edentulous alveolar crests has been correlated to a variety of factors which may be briefly summarised as anatomic, metabolic, functional and prosthetic factors. With regard to functional factors, some researchers have found that some psychological aspects in edentulous subjects may be indicative of a parafunctional damaging habit leading to consequent alterations of the physical characteristics of forces applied to the bone. The aim of this study was to evaluate whether alveolar crest resorption in edentulous subjects was correlated to aspects of their psychological status, such as trait anxiety and the presence of psychosomatic symptoms. A group of 70 totally edentulous subjects were examined and trait anxiety and the presence of psychosomatic symptoms were evaluated. The orthopantomographies of the 70 subjects were then analysed in order to assess the degree of edentulous crest resorption. The present study showed the absence of statistically significant correlations between edentulous crest resorption and trait anxiety and between edentulous crest resorption and the presence of psychosomatic symptoms. These results appear to indicate that "anxious" subjects might not have parafunctional habits or that the latter play a minor role in the process of edentulous mandibular crest resorption.
Asunto(s)
Pérdida de Hueso Alveolar/psicología , Enfermedades Mandibulares/psicología , Boca Edéntula/psicología , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Hueso Alveolar/epidemiología , Ansiedad/epidemiología , Ansiedad/psicología , Femenino , Humanos , Modelos Lineales , Masculino , Enfermedades Mandibulares/epidemiología , Persona de Mediana Edad , Boca Edéntula/epidemiología , Pruebas Psicológicas/estadística & datos numéricos , Trastornos Psicofisiológicos/epidemiología , Trastornos Psicofisiológicos/psicologíaRESUMEN
The base myoelectric of masticatory muscles, and their response to stressor, was studied in a group of patients affected with craniomandibular disorders (CMD) and in a control group. Patients suffering from craniomandibular disorders were affected by at least two of these three groups of symptoms: 1) articular and/or muscular pain; 2) articular noise; 3) alteration of mandibular mobility. The psychofunctional investigation was as follows: in order to measure the base myoelectric activity of the masticatory muscles and their response to stress, the Myotron 222 two-channel electromyographs were used, so as to record the activity of four muscles contemporaneously. The research was conducted on the masseter and anterior fascia of the temporal muscles, which are the most readily accessible of the elevator muscles. A non-specific stressor (shot pistol) was administered to the subjects after the base myoelectric level had been established. These factors were evaluated on the electromyograms: base activity before the stressor; the shape of the response to the stressor; the recovery time after the stressor. The minimum activity before the stressor was usually measured as the minimum activity the subject was able to maintain for roughly one minute. The psychometric investigation used "Minnesota Multiphasic Personality Inventory" (MMPI); this is a nonprojective personality test widely used in clinical psychology. The base level of myoelectric activity was higher in patients affected with craniomandibular disorders than in healthy patients, who generally had low initial values.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Trastornos Craneomandibulares/psicología , Adulto , Trastornos Craneomandibulares/diagnóstico , Electromiografía/instrumentación , Electromiografía/métodos , Femenino , Humanos , MMPI , Masculino , Músculo Masetero/fisiopatología , Personalidad , Psicometría , Músculo Temporal/fisiopatologíaRESUMEN
The authors report a rare case of fibrous dysplasia of the upper jaw bone in an elderly patient. Diagnostic iter, surgical therapy and rehabilitation are reported.
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Displasia Fibrosa Monostótica/cirugía , Enfermedades Maxilares/cirugía , Prótesis Maxilofacial , Anciano , Enfermedad Crónica , Femenino , Displasia Fibrosa Monostótica/diagnóstico , Displasia Fibrosa Monostótica/rehabilitación , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Enfermedades Maxilares/diagnóstico , Enfermedades Maxilares/rehabilitación , Radiografía Panorámica , Recuento Corporal TotalRESUMEN
Self-curing resins enable the operator to prepare directly temporary prosthesis on single crown abutments. However such a technique may involve the danger of an inflammation of the pulp, due to the exothermic polymerization reaction of self-curing resins. The Authors suggest experimentally assessing the thermic increase during the polymerization reaction of seven different resins. Moreover they want to estimate the influence of the ratio monomer-polymer on the thermic curve of such reactions.