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1.
Cureus ; 16(8): e66732, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39268280

RESUMEN

Edentulism, the loss of all the natural teeth, significantly impacts a patient's functional, aesthetic, and psychological well-being. Traditional dentures often fail to provide the required stability and functionality. Implant-supported full-mouth rehabilitation has emerged as an advanced solution, leveraging strategically placed dental implants to support fixed prostheses that mimic natural teeth in appearance and function. This case report details the comprehensive treatment of a 78-year-old male patient with complete edentulism, utilizing six implants in both the maxillary and mandibular arches. Following a five-month healing period, a series of precise prosthetic procedures, including abutment-level impressions, custom tray fabrication, and implant-level impressions, were performed to ensure optimal fit and functionality. The final prostheses provided significant improvements in masticatory efficiency, speech, and overall quality of life. The report underscores the transformative potential of implant-supported rehabilitation, highlighting high success rates, patient satisfaction, and the multifaceted benefits of restoring oral function and aesthetics with advanced dental technologies.

2.
Cureus ; 16(7): e63696, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39092322

RESUMEN

INTRODUCTION: Bacteria can enter the bloodstream through simple actions such as brushing teeth, flossing, and even chewing food, increasing the chance of hematogenous seeding of prosthetic joints. Antibiotics before dental work in patients with orthopedic hardware is a topic of debate because of concerns for antibiotic resistance. Patients with dentures theoretically avoid this risk due to the lack of teeth and their maintenance. Most periprosthetic joint infections (PJIs) that occur in the first six months after surgery are due to wound infection, whereas late PJIs are more commonly caused by hematogenous seeding. MATERIALS AND METHODS: Charts from patients who received primary total joint arthroplasty were interrogated for the condition of their teeth at the time of operation. If the patient had a PJI, the time from surgery and the organism responsible were noted. Multivariate linear regressions were performed for statistical analysis to compare rates of dental status, infection, comorbidities, and demographics. RESULTS: From the 1,500 charts reviewed, patients with teeth and edentulous had similar rates of comorbidities. PJI patients had higher rates of chronic kidney disease than patients who did not have the infection. The overall rate of infections in patients with teeth was 2.14%, close to the national average. The rate of infection in patients without teeth was 0.78%. Patients with teeth have a higher rate of infection one month or longer from surgery than edentulous patients. CONCLUSIONS: There was an increased infection rate in patients with teeth at six months and greater since the primary total joint arthroplasty. The organisms responsible for many of the PJIs are commonly found in the mouth of humans. Having teeth is a potential risk factor for late PJI.

3.
BMC Oral Health ; 24(1): 709, 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38898433

RESUMEN

BACKGROUND: Edentulism remains a major disability worldwide, especially among the elderly population, although the prevalence of complete edentulism has declined over the last decades. In Uganda, the prevalence of edentulism in people aged 20 years and above is 1.8%. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design and computer-aided manufacturing (CADCAM), however, the provision of removable complete dentures continues to be the predominant rehabilitation for edentulous patients. However, no published study has explored the lived experiences with removable complete dentures among the Ugandan population. The aim of the present study was to explore patients' lived experiences on the usage of removable complete dentures among Ugandan edentulous patients attending Makerere University Dental Hospital. METHODS: This was a qualitative study approach using purposive sampling. Fifteen (15) respondents were selected across social demographics. Interviews were recorded and transcribed and themes were generated to draw a deeper meaning to the usage of removable complete dentures. A qualitative statistical package, Atlas Ti software was used to generate themes from the interviews followed by an interpretation of the generated data and the results were presented as text and in a table. RESULTS: The reported key positive experiences due to removable complete denture rehabilitation were the improvement in speech, eating ability, regaining good facial appearance, better oral hygiene management, self-esteem and confidence to smile in public, and a feeling of completeness. However, respondents complained of pain and discomfort due to the looseness of dentures, inability to eat certain foods, and regular cleaning of dentures. The respondents did not go through proper informed consent processes before getting removable complete dentures. CONCLUSION: The study found that patients were satisfied with their removable complete dentures rehabilitation due to the positive experiences registered, such as the ability to eat and talk well, and restoration of self-esteem, all of which improved their quality of life. However, they experience pain and discomfort due to the looseness of dentures.


Asunto(s)
Dentadura Completa , Boca Edéntula , Humanos , Uganda , Boca Edéntula/psicología , Boca Edéntula/rehabilitación , Femenino , Masculino , Dentadura Completa/psicología , Persona de Mediana Edad , Anciano , Investigación Cualitativa , Adulto , Calidad de Vida
4.
Cureus ; 16(5): e60443, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38756708

RESUMEN

OBJECTIVES: Accurate occlusal vertical dimension (OVD) establishment is an essential component of prosthodontic treatment. No accurate approach exists to determine the appropriate OVD for patients without posterior teeth. This study aimed to correlate the accuracy of the nose-to-chin distance with various facial measurements and thumb length in dentulous and edentulous Saudi patients. MATERIALS AND METHODS: The participants comprised 100 fully dentulous Saudi male dental students aged 20-30 years (group 1) and 20 completely edentulous patients aged 60-70 years (group 2). We evaluated the correlations between the OVD (nose-to-chin distance) and the distance from the pupil to the corner of the mouth, the vertical length at midline of the nose (from subnasion to glabella), the distance from the outer canthus of one eye to the inner canthus of the other, twice the distance between the inner canthi, and the distance from the thumb tip to the index fingertip. STATISTICAL ANALYSIS: Spearman's correlation and regression analysis were performed to analyze and assess the correlations between the clinically measured nose-to-chin distance and other parameters, with significance set at 0.05. RESULTS: In edentulous patients, the results showed a significant, strong, positive correlation between the nose-to-chin distance and the distance between the pupil and the mouth corner. In dentate subjects, a significant, strong, positive association was found between the nose-to-chin distance and the distance from the outer canthus of one eye to the inner canthus of the other. The linear regression analysis revealed that the distance between the pupil and the mouth corner in edentulous patients significantly predicted the OVD. CONCLUSIONS: In both groups, the distance from the outer canthus of one eye to the inner canthus of the other and the distance from the pupil to the mouth corner were reliable and accurate for OVD measurements. These could be considered appropriate methods for OVD determination during full-mouth rehabilitation.

5.
Cureus ; 16(5): e60421, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38756717

RESUMEN

Introduction Since the polished and fitting surface of the denture base may promote the colonization of microorganisms, it is essential to know how the different types of denture bases prevent or encourage the adhesion of microorganisms. This study aimed to compare the microbial adhesion to the polished and fitting surfaces of thermoplastic nylon, thermoplastic acetal, and thermoplastic acrylic denture bases in Kennedy Class Ⅰ, partially edentulous patients. Materials and methods Thirteen patients were included in the study. The group consisted of eight males (61.54%) and five females (38.46%), with an age range of 41-50 years (mean age 46.1 years). Three types (groups) of removable partial dentures will be made for each patient using different thermoplastic denture base materials: thermoplastic nylon; thermoplastic acetal; and thermoplastic acrylic. The polished and fitting surfaces of the denture bases were swabbed after a one-month follow-up period. Microbial adhesion was evaluated by counting the microorganisms' colony-forming units (CFU) in the collected specimens. The data were collected and statistically analyzed. Results The study revealed no statistically significant difference in microbial adhesion to both polished and fitting surfaces between all types of studied thermoplastic denture base materials. However, the results showed that for the polished surface, the microbial adhesion median of thermoplastic acrylic denture base (40.5 CC x 102/ml) was higher than that of thermoplastic acetal (29.0 CC x 102/ml) and thermoplastic nylon (16.0 CC x 102/ml). Regarding the fitting surface, the microbial adhesion median of thermoplastic acrylic (51.0 CC x 102/ml) is higher than that of thermoplastic acetal (41.0 CC x 102/ml) and thermoplastic nylon (23.0 CC x 102/ml). Conclusion The thermoplastic nylon denture base materials showed less microbial adhesion among the studied thermoplastic materials, so it may be recommended to be used as a denture base material for individuals at high risk of denture stomatitis.

6.
Cureus ; 16(3): e55394, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38562321

RESUMEN

In the field of removable prosthodontics, computer-aided design and computer-aided manufacturing (CAD/CAM) have become widely recognized. The traditional method, which uses heat-polymerized resins for injection or compression molding, necessitates up to five patient visits and laborious laboratory processes. A digital workflow combined with a CAD/CAM methodology can provide prompt prosthesis delivery for patients with time constraints. This article's goal is to outline the steps and the limitations in the fabrication of digital dentures as well as the challenges, limitations, and solutions developed while developing a clinical workflow for the rehabilitation of completely edentulous patients with the CAD/CAM System.

7.
J Prosthodont Res ; 68(2): 206-214, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-37648482

RESUMEN

PURPOSE: The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted. STUDY SELECTION: A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart. RESULTS: A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design. CONCLUSIONS: The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.


Asunto(s)
Implantes Dentales , Boca Edéntula , Humanos , Materiales Dentales , Prótesis Dental de Soporte Implantado/métodos , Diseño de Prótesis Dental
8.
Int J Comput Dent ; 27(1): 19-26, 2024 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-36815624

RESUMEN

AIM: The aim of the present in vivo study was to compare the clinical trueness of primary mucostatic impressions obtained either by a classical alginate or an optical intraoral scanner technique in patients with a fully edentulous maxilla. MATERIALS AND METHODS: A total of 30 patients with a fully edentulous maxilla were included in the study and underwent both conventional impressions and intraoral optical impressions (Trios 3). The conventional impressions were casted and the resulting plaster casts were digitized using a desktop scanner (Imetric D104i). These digitized impressions were superimposed over the optical impressions to compare the differences between the two data sets. Statistical analyses were performed to identify relevant deviations. RESULTS: For the 30 intraoral impressions, 80.88% of the surface areas were below the tolerance threshold of 25 µm and were thus considered similar to the areas scanned with the desktop scanner from the reference plaster cast. Interestingly, the differences (19.12% of the surface areas) were localized in depressible areas such as the vestibule, soft palate, incisive papilla, and flabby ridges. These locations were consistent with the mean of positive differences of +22.8 µm, indicating deformation or less compression with the use of the intraoral scanner. CONCLUSIONS: The digital primary impression of the fully edentulous maxilla can be considered similar to the conventional alginate impression except in the depressible areas. Considering the mucostatic objective of such a primary impression, one may consider the optical impression to be more accurate than the conventional one.


Asunto(s)
Imagenología Tridimensional , Boca Edéntula , Humanos , Imagenología Tridimensional/métodos , Maxilar , Técnica de Impresión Dental , Diseño Asistido por Computadora , Modelos Dentales , Paladar Blando , Alginatos
9.
Cureus ; 15(7): e42537, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37644937

RESUMEN

OBJECTIVES: The objectives of this study were to quantify the number and type of prosthetic complications associated with 3D-printed implant-supported fixed prostheses (3DISFP) and to evaluate patient satisfaction and oral health-related quality of life over a four-month period. METHODS:  Fifteen edentulous patients who underwent implant therapy were included in the study. Each patient received a 3D-printed prosthesis using OnX dental resin. Prosthetic complications were documented, and data from the 14-item Oral Health Impact Profile (OHIP) questionnaire were collected at two time points: at enrollment and during a four-month recall. RESULTS: During the four-month evaluation period, a total of nine complications were recorded, with three classified as catastrophic failures. Statistical analysis revealed statistically significant differences in OHIP scores between the preoperative and postoperative assessments (p<0.001). CONCLUSION: Within the limitations of this study, it can be concluded that utilizing 3D-printed prostheses with OnX resin represents a viable alternative for long-term implant-supported temporaries. The patients experienced a significant improvement in their oral health-related quality of life. These results suggest that 3D printing technology, combined with the use of OnX resin, holds promise in providing satisfactory clinical outcomes and enhanced patient satisfaction. However, it is important to acknowledge the limitations of this study, and further research is warranted to validate these findings and explore the long-term performance and durability of 3D-printed implant-supported fixed prostheses. This study contributes to the growing body of evidence supporting the effectiveness of 3D printing technology in implant dentistry. The results highlight the potential of 3DISFP with OnX resin to improve oral health-related quality of life in edentulous patients. Continued advancements in 3D printing materials and techniques will likely expand the utilization of these prostheses, ultimately benefiting patients in need of implant-supported restorations.

10.
J Dent ; 136: 104632, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37506810

RESUMEN

OBJECTIVE: To investigate the occurrence of mild cognitive impairment in edentulous patients up to 3 years after they received single-implant overdentures (1-IODs). METHODS: This was a follow-up study for a crossover randomized controlled trial comparing 1-IODs and conventional complete dentures, with patient satisfaction as the primary outcome. In the present study, the cognitive function of the patients, measured with the Japanese version of the Montreal cognitive assessment (MoCA-J), was evaluated as the secondary outcome at baseline and 2 months, 1 year, 2 years, and 3 years after 1-IOD placement. The total and domain (memory, executive function, visuospatial skills, language, attention, and orientation) MoCA-J scores of the patients at each timepoint were analyzed and compared. RESULTS: Twenty-two patients with edentulous mandibles received 1-IODs. Within-group comparisons revealed that the total MoCA-J scores at 1 year and 3 years after 1-IOD placement were significantly increased compared with baseline scores. Additionally, the memory domain scores at all timepoint were significantly increased compared with the baseline scores, and the executive function domain scores at the 2-month, 2-year and 3-year timepoint were significantly increased compared with the baseline scores. CONCLUSION: Patients with edentulous mandibles who underwent 1-IOD placement showed significantly improved total scores of MoCA-J after 1 year and 3 years of wearing 1-IODs. In addition, they showed significantly improved memory domain scores at 2 months, 1 year, 2 years, and 3 years after 1-IOD placement and executive function domain scores at 2 months, 2 years, and 3 years after 1-IOD placement. CLINICAL SIGNIFICANCE: The results of this study suggest that 1-IOD treatment for older adults, especially those with edentulous mandibles, may prevent cognitive decline regardless of the condition of the maxilla.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Humanos , Anciano , Estudios de Seguimiento , Calidad de Vida , Dentadura Completa , Satisfacción del Paciente , Cognición , Prótesis Dental de Soporte Implantado , Mandíbula , Retención de Dentadura
11.
J Clin Med ; 12(11)2023 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-37298020

RESUMEN

Background: This study aims to show the clinical outcomes of implants supporting mandibular overdentures in edentulous patients. Methods: Mandibular edentulous patients were diagnosed with an oral examination, panoramic radiograph, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants. After two-stage surgery, implants were early loaded with an overdenture at 6 weeks. Results: Fifty-four patients (28 females and 24 males) were treated with 108 implants. Thirty-two patients (59.2%) had a previous history of periodontitis. Twenty-three patients (46%) were smokers. Forty patients (74.1%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 147.8 ± 10.4 months. The clinical outcomes showed a global success of 94.5% of implants. Fifty-four overdentures were placed in the patients over the implants. The mean marginal bone loss was 1.12 ± 0.34 mm. Nineteen patients (35.2%) showed some kind of mechanical prosthodontic complication. Sixteen implants (14.8%) were associated with peri-implantitis. Conclusions: Based on the clinical results obtained, we can determine that the treatment of elderly edentulous patients with mandibular overdentures through the early loading of two placed implants is a successful implant protocol.

12.
Cureus ; 14(12): e32896, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36578847

RESUMEN

Mandibular advancement devices have been efficiently used for the treatment of mild to moderate obstructive sleep apnea (OSA) by forward positioning of the tongue-mandible complex with a resultant increase in oropharyngeal volume. However, the literature on the treatment of edentulous patients is limited. This clinical report describes a clinical and laboratory method for the fabrication of a mandibular advancement device in a 75-year-old completely edentulous patient with mild OSA.

13.
J Int Soc Prev Community Dent ; 12(5): 524-531, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36532320

RESUMEN

Introduction: Effective communication can aid in improving oral healthcare measures such as treatment outcomes and satisfaction of edentulous patients (EDPs) toward the treatment process. The triangle of communication (ToC) involves communication between the dentist, dental technician (DTech), and EDPs. This research aimed to explore the ToC between dental professionals (DPs) and patients undergoing complete denture prostheses (CDP) treatment in Fiji. Materials and Methods: A descriptive qualitative study was conducted among DPs under purposive sampling where focus group discussions were conducted at the four dental prosthetic clinics in Fiji. A semi-structured questionnaire with open-ended questions was applied to participants virtually via Zoom. The collected data were collated and analyzed manually using thematic analysis. Results: A total of 28 DPs participated in the study. Three themes were identified while exploring the ToC from DPs' perspectives on CDP treatment and care in Fiji: staff communication-dentist and DTech, ToC and information sharing (dentist-DTech and EDPs), and stage-by-stage procedural checks for CDP between DPs. Effective collaboration between dentists and DTechs is an essence of a successful CDP treatment outcome. Most DPs agreed to undergo continuous communication throughout the treatment to keep EDPs engaged throughout the treatment process. In addition, stage-by-stage procedural checks in dental clinics as well as in dental laboratories improved the quality of CDPs. Conclusion: DPs highlighted predominantly the ToC between DPs and EDPs when receiving CDP treatment in Fiji as an essential tool for effective DP and patient engagement. Discussions should be complemented with the use of verbal, nonverbal, and written modes together with the utilization of interpreters to improve CDP treatment and care in Fiji.

14.
Cureus ; 14(7): e27127, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-36004029

RESUMEN

Background Among many options that are available to replace missing teeth, dental implants are very popular. Information about patient awareness of dental implants is an important parameter for planning health care services and marketing. Knowledge of the treatment method minimizes any negative image that can be caused by a lack of proper communication. Aim and objective The objective of this study is to assess and obtain information about the knowledge, awareness, and attitude in using dental implants as an option for replacing missing teeth among dental patients. Materials and methods A questionnaire survey was conducted on 5000 subjects. This was a self-administered two-part questionnaire consisting of 18 questions. The percentage response for each question from all participants was obtained and the data collected was calculated and analyzed using Statistical Package for Social Sciences (SPSS) software version 21.0 (IBM Inc., Armonk, New York). Results Out of 5000 patients, 75% were already aware of dental implants from various means (dentist, family friends, social media such as television, radio, newspaper, or magazine). Based on the survey results, a significant number of patients had knowledge and awareness as well as a positive attitude towards using dental implants as an option for missing teeth. Conclusion People have a decent to fair level of understanding and awareness of dental implants, which are used to replace lost teeth. The dentist plays the most important role in this regard, and this can be accomplished by implementing patient education programs and counseling centers on the usage and benefits of dental implants.

15.
J Adv Prosthodont ; 14(3): 143-149, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35855316

RESUMEN

PURPOSE: Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS: Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low5 and High5) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS: Edentulous patients with implants had significantly greater HSD and High5 values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High5 values significantly increased after receiving implants (P < .022). CONCLUSION: The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.

16.
BMC Geriatr ; 22(1): 503, 2022 06 14.
Artículo en Inglés | MEDLINE | ID: mdl-35701747

RESUMEN

BACKGROUND: Facial ageing is a result of superficial wrinkling combined with changes to the underlying soft tissues and skeleton. The influence of tooth loss, as a geriatric characteristic, on facial appearance is still poorly explained. The aim was to evaluate the facial characteristics of older adults, correlate these characteristics with the dentition and make comparisons with young adults using a non-invasive 3D methodology. METHODS: 90 participants older than 65 years, classified into 3 subgroups (edentulous, partially edentulous, toothed) and 30 young adults were evaluated. Their faces were scanned with an optical Artec 3D-scanner. Cephalometric analyses were made using the RapidForm computer program. An independent t-test and ANOVA were used for the comparisons. Pairwise, post-hoc tests were applied with respect to the significant differences (P < 0.05). RESULTS: The faces of older adults are wider and longer because of the longer middle facial height. Older adults also have a longer upper lip, a larger nose, a smaller nasolabial angle (due to the nasal ptosis), narrower upper- and lower-lip vermilions and larger facial and lower-facial-height angles, resulting in a flat facial profile. The facial changes due to ageing are the most pronounced in the edentulous. In comparison with the toothed, they have a smaller facial height due to the smaller lower facial height, larger nasolabial angle, smaller mouth width, shorter upper lip and narrower lip vermilions. Their profile is flatter and their lips are more retruded. CONCLUSIONS: The proportions of the whole face are changed in older adults and they are the most expressed when this is combined with tooth loss.


Asunto(s)
Pérdida de Diente , Anciano , Cefalometría , Estudios Transversales , Cara/anatomía & histología , Humanos , Pérdida de Diente/epidemiología
17.
BMC Health Serv Res ; 22(1): 742, 2022 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-35659219

RESUMEN

BACKGROUND: Edentulism is a state of having no teeth in the oral cavity, an irreversible condition popularly known as the marker of disease burden on the oral health. For edentulous patients (EDPs) Complete Denture Prostheses (CDP) is a means to improve oral health. Due to limited studies in this area, this research aimed to explore the challenges faced by the EDPs during CDP service delivery in Fiji. METHODS: A directed descriptive qualitative study was conducted among EDPs attending Dental Prosthetic Clinics (DPCs) at the four centres in Fiji under purposive sampling. A semi-structured questionnaire with open ended questions was used for in-depth interview with EDPs who had worn CDP for 1 year via telephone. Participant responses were recorded, transcribed verbatim and analyzed manually using thematic analysis. RESULTS: A total of 30 EDPs participated in the study. Six themes were identified as challenges faced by the EDPs during CDP service delivery in Fiji: lack of information, non-compliance, overwhelmed by illness, reduction on quality of life (QoL) financial barriers to CDP treatment care and personal acceptance. 77% of EDPs felt they did not receive adequate information on CDP when attending DPCs which indicated the non-compliance nature irrespective of using and cleaning CDP on a daily basis. The Dental Professionals (DPs) at the DPCs gave their full support in attending to the CDP challenges faced by the EDPs in Fiji during the review clinics. CONCLUSION: The EDPs expressed a variety of challenges that was faced while seeking appropriate CDP services in Fiji. The findings demonstrate the need to explore approaches to develop patients' engagement practices during CDP service delivery by the Dental professionals (DPs), which leads to effective oral health promotion in Fiji for CDP wearers.


Asunto(s)
Dentadura Completa , Calidad de Vida , Humanos , Fiji , Investigación Cualitativa
18.
J Prosthodont ; 30(S1): 67-71, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33331655

RESUMEN

PURPOSE: This Best Evidence Consensus Statement evaluated the existing Angle's classification clinical literature to determine if the Angle's classification as historically determined in maximum intercuspal position (MIP) with hand held casts is coincident with the centric occlusion (CO) determined Angle's classification. In addition, it explored the value of using Angle's classification for edentulous patients MATERIALS AND METHODS: The search strategy was related to the focus questions and limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Trials (RCT) and Clinical Trials. Searches were completed using the term Angle's classification and Boolean Modifiers (AND) with the key terms: dental occlusion, dental occlusion centric, centric occlusion, centric relation, maximal intercuspation, MIP, intercuspal position, and edentulous patient, retrognathia, determination, and prognathia. Additional related articles were culled from the reference lists in the articles found in the PubMed searches. RESULTS: The search identified 494 articles related to the selected terminology. Titles were reviewed and selected if related to the focus questions for further review. Seven papers could be identified that addressed the specifics of the questions. CONCLUSIONS: There is evidence that the Angle's classification for many patients will change when recorded in CO compared to the historical MIP determination/definition. A different Angle's classification recorded in CO is potentially a significant diagnostic finding for patients needing complete mouth rehabilitation. The current definitions of Angle's Classification are not useful in the management of edentulous patients.


Asunto(s)
Maloclusión de Angle Clase III , Maloclusión , Relación Céntrica , Consenso , Humanos , Prostodoncia
19.
Int J Comput Dent ; 23(3): 269-279, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32789314

RESUMEN

The utilization of digital 3D surface images (STL format) for planning cases of computer-guided implant surgery is very useful in partially edentulous cases. In fully edentulous cases, however, the absence of teeth makes it necessary to add reference markers. The proposed protocol demonstrates a simple procedure that allows for the superimposition of STL and radiologic data (DICOM format). In the presented patient case, the tissue-bearing area of the prosthesis was relined with a polysulfide impression material and sent to the laboratory. A master cast was produced. The prosthesis was relined to improve intraoral stability and was provided with at least three radiopaque 3D markers. An STL copy of the prosthesis and the model was generated through a laboratory scanner. The patient wore the prosthesis with the attached markers during the 3D radiologic examination. In the planning software (CoDiagnostiX; Dental Wings), the prosthesis markers on the STL were matched to the corresponding markers visible on the DICOM data. Then, the STL of the model was matched to that of the prosthesis. Once the STL of the mucosa and the prosthesis were imported into the software, new possibilities arose, ie, the option to add other digital or traditional tooth setups to the same radiologic data or to design a surgical guide based on the actual mucosa of the patient.


Asunto(s)
Implantes Dentales , Tomografía Computarizada de Haz Cónico Espiral , Diseño Asistido por Computadora , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Humanos , Imagenología Tridimensional , Flujo de Trabajo
20.
Artículo en Inglés | MEDLINE | ID: mdl-32668790

RESUMEN

A minimally invasive implant treatment approach for future full arch implant prosthetic rehabilitations of trophic jaws represents a challenge. An optimal implant planning is strongly related with an accurate merge of the prosthetic information and the radiographic data. To comply with that, most computer aided implantology (CAI) systems require additional steps, as radiographic stents or fiducial markers to overlap digital jaw scans to cone beam computed tomography (CBCT) data. Using dynamic CAI, residual teeth (up to three) make it possible for the merge to avoid new radiographic scans. An additional challenge is the treatment involving immediate implants compared with delayed implants placed into healed bone. As for other static CAI systems, the operator's experience and the quality of the CBCT data make the planning affordable and secure the entire implants placement procedure. The literature reports accuracies in terms of comparison between placed implants and planned implants, following a double CBCT approach, based on radiographic volume overlapping. Thirteen consecutive future totally edentulous patients (77 implants), divided into two groups (group A: 3-4 teeth traced; group B: 5-6 teeth traced) requiring a full arch implant prosthetic rehabilitation were included in the reported case series. A dynamic CAI was used to plan and to place all implants following all the recommended digital steps. The software used provided a tool (Trace and Place) that made the merge between X-ray views of the residual teeth and their own positions possible. This method definitely registered that teeth positions comply with the required accuracy live check. After implants placement, a post-operative CBCT was taken in order to evaluate the deviations of the achieved implants at coronal, apical, and depth level as well as angular deviations. Statistically significant radiological mean difference between the two groups was found in the coronal position of implants (0.26 mm, p < 0.001), in the apical position of implants (0.29 mm, p < 0.001), in the depth of implants (0.16 mm, p = 0.022), and in the angular deviation (0.7, p = 0.004). The use of the TaP technology for the treatment of the patients with at least three stable teeth that need to be removed for a totally implant prosthetic treatment is a promising technique. The performed accuracy analysis demonstrated that this digital protocol can be used without a loss of accuracy of the achieved implants compared to planned ones.


Asunto(s)
Boca Edéntula , Cirugía Asistida por Computador , Flujo de Trabajo , Diseño Asistido por Computadora , Tomografía Computarizada de Haz Cónico , Humanos , Programas Informáticos
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