RESUMO

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.

Assuntos

RESUMO

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.

Assuntos

RESUMO

Introducción: La región anterior de la mandíbula, ubicada entre los agujeros mentonianos contiene conductos intraóseos con elementos vasculares y ramas nerviosas terminales provenientes del nervio alveolar inferior. El objetivo del trabajo es determinar las variantes anatómicas producidas en el conducto incisivo y las corticales superior, inferior, externa e interna en pacientes edéntulos con respecto a pacientes dentados en tomografía computarizada de haz cónico. Material y métodos: Se realizó un estudio comparativo, retrospectivo y observacional. Se estudiaron 50 tomografías en pacientes edéntulos y 50 en pacientes dentados de ambos sexos desde los 38 hasta los 81 años. En cada corte se realizó una medición en lo alto y ancho del conducto. También se determinó la posición del conducto incisivo mediante la realización de cuatro mediciones. Resultados: Se observaron diferencias significativas en lo que respecta al alto y ancho del conducto incisivo y también entre las distancias hacia la cortical vestibular, lingual, alveolar y basal entre pacientes dentados y desdentados. Conclusión: Se pudo comprobar una mayor resorción ósea en los pacientes desdentados, hallado entre el conducto incisivo y las corticales superior y vestibular y un menor calibre del conducto incisivo con respecto a los pacientes dentados (AU)

Introduction: The previous region of the mandible, located between the mental foramen, contains intraosseous ducts with vascular elements and terminal nervous branches from the inferior alveolar nerve. The objective of the work is to determine the anatomical variants produced in the incisive canal and the superior, inferior, external and internal cortices in edentulous patients with respect to dentate patients in cone beam computed tomography. Material and methods: A retrospective observation al comparative study was carried out. Fifty tomographies were studied in edentulous patients and 50 in dentate patients of both sex es from 38 to 81 years. In each cut a measure men twasmade in height and width of the conduit. The position of the incisive cannel was also determined by performing four measurements. Results: Significant differences were observed regarding the height and width of the incisal canal and also between the distances to the vestibular, lingual, alveolar and basal cortical area between dentate and edentulous patients. Conclusion: A greater bone reabsorption in thee dentulous patients found between the incisive canal and the superior and vestibular cortices and a smaller caliber of the incisive canal with respect to the dentate patient should be verified (AU)

Assuntos

RESUMO

PURPOSE: To perform a systematic review on studies assessing clinical outcomes in patients rehabilitated with complete-arch fixed implant-supported prostheses according to the time of loading. MATERIALS AND METHODS: Data obtained from patient and clinical outcomes, as implant failure, success rate, survival rate, biological complications, technical complications, mechanical complications, and marginal bone loss, were included on this review. The search was performed on databases PubMed, Scopus, and Cochrane. Cochrane Collaboration tool was used to assess the risk of bias of randomized controlled studies, and an adapted version of Newcastle-Ottawa scale was used for observational studies. All data were tabulated according to the time of loading: (1) immediate restoration/loading, (2) early loading, and (3) conventional loading. RESULTS: From a total of 4027 studies identified through the three databases, six of them were randomized controlled trials, five of them were prospective observational studies, and another five were retrospective observational studies. In total, 5954 implants, 1294 patients and 1305 full-arch fixed implant-supported prostheses were included in this review. There was a wide heterogeneity among clinical studies regarding the study design and treatment procedures. Thus, pooled estimates were not performed in order to avoid potential biases. The methodological assessment by the Modified Newcastle-Ottawa scale showed a moderate quality of observational studies. Regarding the RCTs studies, all of them presented at least one element of bias according to the Cochrane Collaboration tool for assessing risk of bias. CONCLUSION: There is evidence of high survival-success implant rate (95-100%) for either loading protocols (immediate restoration/loading, early loading, and conventional loading). However, careful attention must be taken by clinician when interpreting the results reported in clinical studies. Future studies should be performed using standardized methodology in order to determine the true predictability regarding immediate, early, and conventional loading protocols.

Assuntos

RESUMO

AIM: The aim of this study was to assess whether differences in inter-individual clinical and prosthodontic variables affect masticatory performance (MP) of edentulous subjects who received new complete dentures. MATERIALS AND METHODS: There were 204 edentulous participants who received new maxillary and mandibular complete dentures between October 2014 and March 2018 at a university clinic. MP was measured by a mixing ability test with a two-coloured chewing gum for 20 and 50 chewing cycles. The outcome variable was the degree of colour mixing of the chewed gum, expressed by the variation of hue (VOH) and measured by electronic colourimetric analysis. Explanatory variables included gender and age, quality of the dentures, classification of edentulous ridges and prognostic features, time since the insertion of the new dentures and patient-reported outcomes related to complete denture treatment. Bivariate correlation tests, multiple linear regression and a linear mixed model were used for data analysis. RESULTS: Mean VOH values were 0.57 (±0.13) and 0.43 (±0.16) for 20 and 50 chewing cycles, respectively. Mixing ability was higher in females than in males for 20 (P = 0.036) and 50 (P = 0.006) chewing cycles. No effects on the patient-reported outcome measures were observed. The time since denture delivery, gender, age and Prosthodontic Diagnostic Index (PDI) score were independently associated with masticatory performance at 20 and/or 50 chewing cycles. Overall masticatory performance tested by the linear mixed-effect model confirmed that VOH value was negatively influenced by male gender, older age and shorter time since denture delivery. CONCLUSION: Masticatory performance seems to be improved with the continuous use of newly inserted dentures and negatively influenced by advanced age.

Assuntos

RESUMO

The aim of this study was to test the reliability of a method to measure the masticatory performance of complete denture wearers employing a colour-mixing ability test and assessment by visual and electronic colourimetric analysis. A sample of 75 subjects was selected from patients who received new conventional complete dentures. Masticatory tests were performed using a two-colour chewing gum that was masticated for 5, 10, 20, 30 and 50 chewing cycles, performed in a random order. The mixing level of the two colours of the chewed gum was assessed visually by two independent raters based on a 5-point ordinal scale. The specimens were flattened into a 1-mm-width wafer, scanned and saved as a two-sided digital image. Each pair of images was submitted to an electronic colourimetric analysis to assess the level of colour mixture, measured by the circular variance of hue (VOH). Overall inter- and intra-rater agreements in visual analysis were 64% and 68%, respectively (almost 99% of scores ranged within ±1 point), whilst overall weighted kappa was >0.80. A proportional increase in the level of mixture occurred with increased number of chewing cycles (P < .001). Similarly, VOH and the visual analysis were highly correlated (r = -.89; P < .001). Bland-Altman plots revealed excellent agreement and extremely low systematic error between duplicated VOH measures. It was concluded that the two-colour chewing gum test is a reliable method to assess the masticatory performance in complete denture wearers using both visual and electronic colourimetric analyses.

Assuntos

RESUMO

Introdução: A reabilitação de pacientes desdentados totais é um dos principais desafios da Odontologia. Objetivo: Avaliar a satisfação e o impacto da saúde oral na qualidade de vida de pacientes reabilitados com próteses totais duplas convencionais. Método: Realizou-se um ensaio clínico com 25 pacientes reabilitados com PT duplas convencionais. Avaliou-se o impacto da saúde oral na qualidade de vida dos indivíduos através da versão brasileira do OHIP-EDENT e a satisfação do paciente com as próteses através de questionário específico. Os instrumentos foram aplicados antes e 3 meses após a reabilitação. Resultados: Houve uma melhora estatisticamente significante (p<0,001) do impacto na qualidade de vida dos usuários de prótese total dupla após a nova reabilitação. A análise dos 4 domínios do OHIP também apresentaram melhora estatisticamente significativa (p<0,001). A satisfação geral final com as próteses foi estatisticamente superior à satisfação inicial (p<0,001). Quando analisados os aspectos específicos de satisfação com a PT após 3 meses da reabilitação também observamos resultados importantes de melhoria em todos os aspectos. Conclusão: Pacientes usuários de prótese total dupla, insatisfeitos com suas próteses, após nova reabilitação convencional melhoraram a qualidade de vida, com diminuição do impacto negativo das próteses na saúde oral, e melhoraram a satisfação. (AU)

Introduction: The rehabilitation of edentulous patients is one of the main challenges of Dentistry. Objective: To assess the satisfaction and the impact of oral health on quality of life of patients rehabilitated with conventional complete dentures in both arcades. Method: A clinical trial with 25 patients rehabilitated with CCD was conducted. The impact of oral health in individuals quality of life was evaluated through the Brazilian version of the OHIP-Edent and the patient satisfaction was evaluated using a specific questionnaire. The instruments were applied before and 3 months after rehabilitation. Results: There was a statistically significant improvement (p <0.001) on the impact of the quality of life of the denture users after the new rehabilitation. The analysis of 4 OHIP domains also showed statistically significant improvement (p <0.001). The final overall satisfaction with the dentures was statistically superior to initial satisfaction (p <0.001). The analysis of the specific aspects of satisfaction with CCD after 3 months of rehabilitation also showed significant results in the improvement of every aspect. Conclusion: Patients disappointed with their dentures, have their quality of life improved after the new rehabilitation, reducing the negative impact of the prostheses on oral health, and improving their satisfaction with the rehabilitation. (AU)

Assuntos

RESUMO

El objetivo fue describir las diferentes presiones intraorales que se presentan en los espacios interoclusal vestibular (EIO) y subpalatino (ESP) bajo distintas condiciones biofuncionales en pacientes adultos desdentados totales maxilares. Fueron seleccionados 15 pacientes en la Clínica Odontológica Docente Asistencial, Universidad de la Frontera (Temuco, Chile). La medición de presiones intraorales se realizó con un dispositivo digital GMH 3156, mediante los métodos de cánulas (control) y escudo oral. Se realizó una medición de calibración por 15 minutos y luego cuatro mediciones funcionales: B1 (condición abierta; 0­25 s); B2 (condición semiabierta; 35­85 s); B3 (condición cerrada; 95­145 s) y B4 (presión bajo deglución; 150­165 s). Con el escudo oral, la Fase B1 mostró en el EIO una presión constante entre 0­4 mBar y el ESP entre ­1 y ­3 mBar. En la Fase B2, el EIO llegó a 10 mBar y el ESP entre 0 y ­1 mBar. La Fase B3 mostró en el EIO oscilaciones entre 0 y 20 mBar, y en el ESP un aumento hasta 20 mBar. En la Fase B4, el EIO presentó un peak de 40 mBar, mientras que el ESP un peak desde 20 hasta ­140 mBar. La formación de dos compartimientos cerrados con presión intraoral negativa también ocurre en pacientes edéntulos, donde el ESP muestra cambios de presión negativa mayores al EIO. Patrones regulares de presión intraoral en espacios biofuncionales se observan en más del 50% de los casos.

The aim was to describe the different intraoral pressures that occur in the vestibular interocclusal space (IOS) and subpalatal space (SPS) under different oral functions in adult patients with maxillary edentulism. A descriptive and cross-sectional study was conducted. We selected 15 patients at the Dental Clinic of the Dentistry Faculty (CODA), Universidad de la Frontera (Temuco, Chile). Intraoral pressure measurement was performed using a digital manometer GMH 3156, by methods of cannulas (control) and oral shield. A calibration measurement was made for 15 minutes; then four functional measurements were performed: B1 (open-mouth condition, 0-25 s), B2 (semi-open compartment condition, 35-85 s), B3 (closed compartments condition; 95-145 s) and B4 (swallowing, 150-165 s). With the oral shield, the B1 phase in the IOS showed a constant pressure between 0-4 mBar and SPS between ­1 and ­3 mBar. In B2 phase, the IOS reached 10 mBar and SPS between 0 and ­1 mBar . Phase B3 OIS oscillations showed between 0 and 20 mBar, and the SPS increased to 20 mbar. In B4 phase, the IOS showed a peak of 40 mbar, while the SPS showed a peak from 20 to ­140 mbar. The formation of two closed compartments with negative intra-oral pressure also occurs in edentulous patients, where the SPS shows greater negative pressure changes than IOS. Regular patterns of intra-oral pressure in biofunctional compartments were observed in over 50% of cases.

RESUMO

AIM: To assess the failures and complications of short (<10 mm) implants supporting single crowns in the posterior region and its potential risk factors (RkF). MATERIALS AND METHODS: Prospective studies were screened according to eligibility criteria, followed by contact with authors. Quality assessment was performed using a standardized protocol. Mean implant failure proportion (FP), biological and prosthetic failure proportions (BFP/PFP) and marginal bone loss (MBL) including 95% confidence intervals were estimated using random-effects models for meta-analysis. RESULTS: Sixteen studies with a medium methodological quality (mean score: 8 ± 3; 2-14) had data collected. In summary, 762 short implants were followed up for up to 120 months in 360 patients (mean follow-up: 44 ± 33.72 months; mean dropout rate: 5.1%). The means FP, BFP, PFP and MBL were 5.9% (95%CI: 3.7-9.2%), 3.8% (95%CI: 1.9-7.4%), 2.8% (95%CI: 1.4-5.7%) and 0.83 mm (95%CI: 0.54-1.12 mm) respectively. Quantitative analysis showed that placement in the mandible (p = 0.0002) and implants with length ≤8 mm (p = 0.01) increased FP, BFP and MBL, whereas qualitative assessment revealed that crown-to-implant ratio did not influence MBL. CONCLUSIONS: Single crowns supported by short implants in the posterior region are a predictable treatment option with reduced failure rates, biological/prosthetic complications and minimal bone loss.

Assuntos