RESUMO

STATEMENT OF PROBLEM: Obtaining a passive and well-adapted framework is challenging when intraoral scanning edentulous arches with multiple implants. The trueness of the printed casts is unclear. PURPOSE: The purpose of this clinical study was to evaluate the trueness of frameworks made from conventional and printed casts regarding clinical passivity and misfit. MATERIAL AND METHODS: Ten participants with complete mandibular fixed implant-supported interim prostheses retained by 4 implants were included. Each participant had a conventional impression and a digital scan made. The digital scan was made using an innovative device. Both conventional and digital casts were made, and the virtual images were used for milling the digital framework in cobalt chromium alloy. All frameworks were evaluated for passivity and marginal vertical misfit with the single screw test, with 4 attempts consisting of the tightened screw position, a test with all screws tightened, and an interspersed tightening test. The Kruskal-Wallis test was used to evaluate the trueness of the tested device for framework construction through the single screw test on vertical marginal misfit in the conventional and printed groups (α=.008). The Friedman test was used to assess the effect of test type (α=.05), and the Wilcoxon test was used to identify group-to-group differences (α=.017). RESULTS: The absence of space between the framework and the abutments and interferences during its placement, as well as good stability, were observed clinically. In laboratory analysis, greater framework misfits were observed in the printed group compared with the conventional group when the single screw test was applied. Comparing the 3 tests used, the greatest misfits were observed when the framework was screwed onto the printed cast. CONCLUSIONS: The innovative device tested for the intraoral scanning of multiple implants had clinically acceptable accuracy for the construction of passive and adapted frameworks. The conventional cast was more accurate than the printed cast, with lower misfit values, in all tests.

RESUMO

This article describes a technique for making complete-arch implant-supported fixed prostheses by using intraoral scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) technology for the fabrication of a metal substructure and conventional processing for the prosthesis base. For this, a device was designed to accurately capture the position of multiple implants and the associated digitalized surgical guide, and the metal substructure was planned and milled directly in cobalt-chromium. The color of the gingiva and artificial teeth was selected by using the intraoral scanner software program, and the prosthesis base was processed conventionally. The straightforward methods used to fabricate the prostheses eliminated possible errors associated with conventional substructure casting and occlusal registration.

Assuntos

RESUMO

OBJECTIVE: To assess whether wearing complete dentures during sleep influences the cardiorespiratory parameters of patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS: A systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to determine whether wearing complete dentures during sleep influences the cardiorespiratory parameters of patients with OSA. An electronic search was performed in four databases, PubMed/MEDLINE, Cochrane Library, Web of Science, and SCOPUS, and in the gray literature (TRIALS) until November 2021. This review included clinical trials, randomized clinical trials, and studies in which patients using conventional complete dentures were diagnosed with OSA using polysomnography and the cardiorespiratory parameters were measured using oximetry or polysomnography during sleep. RESULTS: In total, 788 references were found in the database, and 12 articles were selected for full reading. Six articles were selected for qualitative and quantitative analyses after applying the inclusion and exclusion criteria and reading the full article. The meta-analysis showed that mean oxygen saturation (SpO2) increased with the use of complete dentures (p = 0.001), but the other parameters showed no significant differences between those wearing and not wearing dentures during sleep. CONCLUSIONS: The mean SpO2 reduced in patients wearing complete dentures, but the other cardiorespiratory parameters evaluated were not affected. CLINICAL RELEVANCE: This study indicates a possible influence of the use of complete dentures on the mean SpO2 during sleep. The use of complete denture could aid other treatments in improving respiratory and sleep quality.

Assuntos

RESUMO

This is an in silico study aimed to evaluate the biomechanical influence of different implant-abutment interfaces (external hexagon and Morse taper implants), retention systems (cement and screw retained), and restorative crowns (metal-ceramic and monolithic) using 3-dimensional finite element analysis (3D-FEA). Eight 3D models were simulated for the maxillary first molar area using InVesalius, Rhinoceros, and SolidWorks and processed using Femap and NEi Nastran software. Axial and oblique forces of 200 and 100 N, respectively, were applied on the occlusal surface of the prostheses. Microstrain and von Mises stress maps were used to evaluate the deformation (cortical bone tissue) and stress (implants/fixation screws/crowns), respectively, for each model. For both loadings, Morse taper implants had lower microstrain values than the external hexagon implants. The retention system did not affect microstrain on the cortical bone tissue under both loadings. However, the cemented prosthesis displayed higher stress with the fixation screw than the external hexagon implants. No difference was observed between the metal-ceramic and zirconia monolithic crowns in terms of microstrain and stress distribution on the cortical bone, implants, or components. Morse taper implants can be considered as a good alternative for dental implant rehabilitation because they demonstrated better biomechanical behavior for the bone and fixation screw as compared to external hexagon implants. Cement-retained prosthesis increased the stress on the fixation screw of the external hexagon implants, thereby increasing the risk of screw loosening/fracture in the posterior maxillary area. The use of metal-ceramic or monolithic crowns did not affect the biomechanical behavior of the evaluated structures.

Assuntos

RESUMO

OBJECTIVE: The objective of this systematic review was to evaluate the efficacy of non-surgical periodontal therapy on rheumatoid arthritis activity. MATERIAL AND METHODS: Articles published until April 2019 were electronically searched and screened using PubMed / MEDLINE, Scopus, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). This study was recorded in the international PROSPERO database (CRD42019132205). The PICO question (population, intervention, comparison, results) was: in adult patients with rheumatoid arthritis and periodontitis (P), does non-surgical periodontal treatment (I), as compared to no treatment (C), provides better outcomes in rheumatoid arthritis activity (O). RESULTS: After searching the databases, seven articles were selected for qualitative and five for quantitative analysis. The total number of participants included was 292, with an average age of 50.5 years. All patients had rheumatoid arthritis and periodontal disease. Non-surgical periodontal treatment significantly reduced Disease Activity Score 28 (P = 0.004; I2 = 92%) and erythrocyte sedimentation rate (P = 0.01; I2 = 78%), but with no significant effect on C-reactive protein (P = 0.34; I2 = 92%). CONCLUSIONS: It can be concluded that non-surgical periodontal treatment can benefit patients with rheumatoid arthritis.

RESUMO

The objective of this study was to perform a quality analysis of systematic reviews with meta-analyses that focused on the comparison of platform-switching (implant-abutment mismatching) and platform-matched (PM) implants. The assessment of multiple systematic reviews (AMSTAR) and Glenny (Checklist) Scales were used to qualify the studies. PubMed, Scientific Electronic Library Online (SciELO), Web of Science (formerly ISI Web of Knowledge), and Cochrane databases were searched, by topic, for systematic reviews on dental implants with switching platforms. A total of 8 systematic reviews, including 7 studies with meta-analyses, were selected. The AMSTAR scale indicated a high (n = 6) to moderate (n = 2) score for the included studies. The quantitative analysis indicated that platform-switching implants preserved more bone tissue when compared with platform-matched implants (6 meta-analyses; P < .001, smaller mean difference: -0.29 mm, 95% CI: -0.38, -0.19 and greater mean difference: -0.49 mm, 95% CI: -0.73, -0.26). Quantitative analysis based on 7 systematic reviews with meta-analysis indicated positive peri-implant bone preservation for implants restored with an implant-abutment mismatching (PSW). Further, there is evidence to improve the design of current systematic reviews. Future systematic reviews in this thematic area should consider searches in gray literature and different databases and include only randomized controlled clinical studies.

Assuntos

RESUMO

We aimed to conduct an analysis of the systematic reviews (SRs) in literature about the implant survival rate (ISR) and marginal bone loss (MBL) in diabetic and nondiabetic patients. This work was registered in The International Prospective Register of Systematic Reviews (CRD42018095314) and was developed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Library Handbook. A search was performed on PubMed, Cochrane, Scopus, Embase, and LILACS. The PICO (problem/patient/population, intervention/indicator, comparison, outcome) question was "Do the survival rates of dental implants and marginal bone loss differ between diabetic and nondiabetic patients?" A total of 130 articles were retrieved. After eliminating repetitions, 118 were reviewed. Finally, 6 SRs were included. All the reviews indicated that there is no effect of diabetes on the ISR; however, a negative effect of the disease can be observed in MBL. Analysis of the quality of the studies was performed using the assessment of SRs in dentistry (Glenny Scale) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2). Glenny Scale showed a moderate to high quality of the included studies. In contrast, AMSTAR 2 pointed out a critically low level for 4 studies, with no study fulfilling the criteria for high quality. It may be concluded that there is no effect of diabetes on the ISR; however, a negative effect of the disease can be observed on MBL.

Assuntos