RESUMEN
Using a planimetric method, the size of horizontal wear facets on maxillary anterior teeth was studied longitudinally in the permanent dentition of 35 subjects at ages 14, 18, and 23?years. The study subjects had not previously undergone any orthodontic treatment and had Class I occlusion. We studied the association between the amount of wear and reported parafunctions and maximal bite force. Total wear areas in age groups 14, 18, and 23 years were 29.5 mm2 (SD 11.4), 39.1 mm2 (SD 12.7), and 45.0 mm2 (SD 13.0), respectively. The total wear area increased significantly both from 14 to 18 years of age and from 18 to 23 years of age (p <0.0001). Between 18 and 23?years of age, the maxillary canines showed strongest wear, although the central incisors had largest wear facets. It can be concluded that wear of permanent anterior teeth is a continuous phenomenon in adolescence and young adulthood.
Asunto(s)
Atrición Dental/epidemiología , Adolescente , Conducta del Adolescente , Adulto , Fuerza de la Mordida , Diente Canino , Femenino , Finlandia/epidemiología , Humanos , Incisivo , Estudios Longitudinales , Masculino , Maxilar , Estadísticas no ParamétricasRESUMEN
OBJECTIVES: To compare the quality of conventional complete dentures fabricated with two different techniques. A randomized controlled clinical trial was conducted to compare traditional (T) and simplified (S) methods of making complete conventional dentures on patients' ratings of satisfaction, comfort and function at 3 and 6 months following delivery. The quality of the prostheses was rated by prosthodontists at 6 months. MATERIALS AND METHODS: One hundred twenty-two male and female edentulous individuals, aged 45-75 years, were randomly allocated into groups that received dentures made with either T or S methods. Following delivery, patients' ratings of several denture-related factors were measured using 100mm visual analogue scales, and denture quality was assessed by blinded prosthodontists using ratings on a validated quantitative scale. RESULTS: There were no significant differences between the two groups in patient ratings for overall satisfaction (3 months: mean T = 83 mm, mean S = 83 mm, P = 0.97; 6 months: mean T = 79 mm, mean S = 79 mm, P = 0.96) or in prosthodontists' ratings of denture quality (T = 66, S = 63; P = 0.38). CONCLUSION: These results show that the quality of complete dentures does not suffer when manufacturing techniques are simplified to save time and materials. Dental educators should consider these findings when re-designing prosthodontic training programs.
Asunto(s)
Diseño de Dentadura/métodos , Dentadura Completa/normas , Anciano , Articuladores Dentales , Materiales de Impresión Dental , Técnica de Impresión Dental , Oclusión Dental , Retención de Dentadura , Estética Dental , Femenino , Estudios de Seguimiento , Humanos , Registro de la Relación Maxilomandibular , Masculino , Masticación/fisiología , Persona de Mediana Edad , Higiene Bucal , Satisfacción del Paciente , Método Simple Ciego , Habla/fisiología , Resultado del TratamientoRESUMEN
PURPOSE: The purpose of this study was to compare elderly patients' satisfaction and oral health-related quality of life with mandibular two-implant overdentures and conventional dentures. MATERIALS AND METHODS: Sixty edentulous subjects aged 65 to 75 years were randomly assigned to two groups treated with maxillary conventional dentures and either a mandibular conventional denture (n = 30) or an overdenture supported by two implants with ball retainers (n = 30). Subjects rated their general satisfaction, as well as other features of their dentures (comfort, stability, ability to chew, speech, esthetics, and cleaning ability), prior to treatment and 2 months postdelivery. Changes in ratings on the original Oral Health Impact Profile (OHIP) and its short form (OHIP-EDENT) were also used as indicators of oral health-related quality of life. RESULTS: The primary outcome of this study, ratings of general satisfaction 2 months postdelivery, was significantly better in the group treated with mandibular two-implant overdentures (P = .001). In addition, the implant group gave significantly higher ratings on comfort, stability, and ability to chew. Furthermore, using OHIP-EDENT, subjects who received mandibular two-implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. CONCLUSION: These short-term results suggest that mandibular two-implant overdentures combined with maxillary conventional dentures provide better function and oral health-related quality of life than conventional dentures.
Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Dentadura Completa Inferior , Prótesis de Recubrimiento , Mandíbula/cirugía , Satisfacción del Paciente , Calidad de Vida , Anciano , Retención de Dentadura , Estética Dental , Femenino , Estudios de Seguimiento , Estado de Salud , Humanos , Masculino , Masticación/fisiología , Salud Bucal , Higiene Bucal , Habla/fisiología , Resultado del TratamientoRESUMEN
PURPOSE: The purpose of this study was to compare clinicians' ratings of the state of oral tissues and their satisfaction with treatment to edentulous patients' ratings of treatment success after provision of mandibular implant overdentures or conventional dentures. MATERIALS AND METHODS: Sixty subjects randomly received either mandibular overdentures retained by two implants (n = 30) or new conventional mandibular complete dentures (n = 30). All were given new conventional maxillary dentures. Baseline measures included clinical evaluation of the oral soft and hard tissues. Patients rated their general satisfaction before and after treatment, as well as their satisfaction with stability, speech, and esthetics on visual analogue scales. The treating prosthodontist rated the dentures for the same categories. Patient and clinician ratings were compared using correlations, t tests, and linear regression. RESULTS: None of the clinical variables were significantly correlated with patient satisfaction before or after treatment. The prosthodontist rated mandibular implant overdentures significantly better than conventional dentures regarding general satisfaction, stability, speech, and esthetics. Implant overdentures were also easier to fabricate (P < .0001). The prosthodontists' scores were not significantly correlated with patient scores for any question. CONCLUSION: Clinicians' assessments of the quality of denture-supporting tissues are poor predictors of patient satisfaction with mandibular implant or conventional prostheses. Prosthodontists and patients both rate mandibular implant overdentures as significantly superior to conventional dentures, but patients and clinicians do not usually agree when evaluating individual prostheses.
Asunto(s)
Prótesis Dental de Soporte Implantado/psicología , Dentadura Completa Inferior/psicología , Anciano , Actitud del Personal de Salud , Implantación Dental Endoósea , Prótesis de Recubrimiento , Femenino , Humanos , Modelos Lineales , Masculino , Mandíbula , Boca Edéntula/rehabilitación , Evaluación de Resultado en la Atención de Salud/métodos , Satisfacción del Paciente , Estadísticas no ParamétricasRESUMEN
In order for clinicians to effectively manage their practices, they need to know how much time they spent in carrying out procedures. The provision of two-implant overdentures for edentulous patients is becoming more prevalent as increasing evidence demonstrates their great benefit to patients. The aim of this study was to measure the number of visits and the time required during the surgical phase (from pre-op examination to preliminary impressions) of mandibular two-implant overdenture treatment. Thirty edentulous patients were assigned to receive two root-form implants in the mandible between the mental foramen, as part of a randomized controlled clinical trial. All visits and time spent by the oral surgeon, the surgical assistant and the prosthodontist were measured individually. The mean number of scheduled visits with the oral surgeon was four, and the mean time taken was 104 min. The mean time taken by the surgical assistant was 122 min. On average, the prosthodontist was required for two visits, with a total mean time of 36 min. In addition to the scheduled visits, 14 patients solicited additional appointments (unscheduled visits) for various problems (e.g. loose healing cap). The average time taken for unscheduled visits was 32 min. Combining scheduled and unscheduled visits, the mean total time taken by the oral surgeon was 109 min. The surgical assistant was needed for a mean total of 125 min, and the prosthodontist spent, on average, 46 min in this phase of treatment. Results from this study will assist clinicians in establishing the total time and number of visits needed for the surgical phase of two-implant mandibular overdenture treatment.
Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Arcada Edéntula/cirugía , Mandíbula/cirugía , Cuidados Posteriores , Anciano , Protocolos Clínicos , Intervalos de Confianza , Prótesis Dental de Soporte Implantado , Rebasado de Dentaduras , Prótesis de Recubrimiento , Humanos , Visita a Consultorio Médico , Asistentes Médicos , Cuidados Posoperatorios , Cuidados Preoperatorios , Prostodoncia , Cirugía Bucal , Suturas , Factores de TiempoRESUMEN
Success rates for titanium dental implants in the anterior mandible are very high. Because of these success rates, as well as lower costs, it is common to treat edentulous patients with just 2 implants and ball anchors for retention of the overdenture, instead of 4 implants and a bar. In this paper the fabrication of 2-implant overdentures is described. In a controlled clinical trial (to be reported elsewhere), 30 subjects received a 2-implant overdenture for the mandible and a conventional prosthesis for the maxilla. The 30 control patients received conventional complete dentures for both jaws. The stability of the overdentures was excellent, and the lingual dimensions of the denture could be reduced to the level of the mylohyoid line to provide more space for the tongue. In patients with tense labial musculature or a limited amount of attached gingiva, it was important to elevate the shoulder of the implant and ball abutment above the gingival level to avoid peri-implant problems. Significantly fewer visits for adjustment related to post-placement pressure spots were required for mandibular overdentures than for conventional mandibular prostheses.
Asunto(s)
Prótesis Dental de Soporte Implantado , Diseño de Dentadura , Retención de Dentadura/instrumentación , Prótesis de Recubrimiento , Anciano , Implantación Dental Endoósea , Implantes Dentales/efectos adversos , Técnica de Impresión Dental , Fracaso de la Restauración Dental , Dentadura Completa Inferior , Humanos , Mandíbula , Periodontitis/etiologíaRESUMEN
PURPOSE: In this article, the time taken by a prosthodontist to fabricate and maintain mandibular overdentures retained by two implants and conventional dentures is compared. MATERIALS AND METHODS: Sixty edentulous patients between the ages of 65 and 75 completed a randomized clinical trial. All received new maxillary conventional dentures and either a mandibular conventional denture (n = 30) or a two-implant overdenture on ball attachments (n = 30). The time spent by the prosthodontist and the number of visits required for treatment, including both scheduled and unscheduled visits, were recorded for each patient from preliminary impressions to 6 months following delivery. Data from the two groups were compared using Mann-Whitney U tests. RESULTS: The prosthodontist spent a mean total time of 296 minutes in treating an implant overdenture patient and 282 minutes on a conventional denture patient during the period from preliminary impressions to the 6-month follow-up. The mean numbers of appointments were 10.1 (implant group) and 10.8 (conventional group). These differences were not significant. CONCLUSION: Although additional knowledge is required to treat patients with implant prostheses, the time required by the prosthodontist to provide two-implant mandibular overdentures with ball attachments was not significantly different than the time needed for conventional denture treatment.