RESUMO
A mandibular implant-retained overdenture is considered a first-choice treatment for edentulism. However, some aspects limit the use of standard implants-for example, the width of edentulous ridges, chronic diseases, fear, or costs. This randomized trial compared mandibular overdentures retained by 2 or 4 mini-implants with standard implants, considering oral health-related quality of life (OHRQoL), patient satisfaction, and complications such as lost implant. In sum, 120 edentulous men and women (mean age, 59.5 ± 8.5 y) randomly received 4 mini-implants, 2 mini-implants, or 2 standard implants. Participants provided data regarding OHRQoL and satisfaction until 12 mo. Clinical parameters, including implant survival rate, were also recorded. Both 2 and 4 mini-implants led to better OHRQoL, compared with 2 standard implants. Treatment with 4 mini-implants was more satisfying than 2 standard implants, with 2 mini-implants presenting intermediate results. Implant survival rate was 89%, 82%, and 99% for 4 mini-implants, 2 mini-implants, or 2 standard implants, respectively. Overdentures retained by 4 or 2 mini-implants can achieve OHRQoL and satisfaction at least comparable with that of 2 standard implants. However, the survival rate of mini implants is not as high as that of standard implants (ClinicalTrials.gov NCT01411683).
Assuntos
Implantes Dentários , Prótese Total Inferior , Revestimento de Dentadura , Implantes Dentários/efeitos adversos , Falha de Restauração Dentária , Prótese Total Inferior/efeitos adversos , Revestimento de Dentadura/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Qualidade de VidaRESUMO
The retention of removable dentures by mini-implants is a relatively recent treatment modality and may lead to minimal post-operative trauma. This study compared post-operative pain and discomfort following the insertion of mini-implants (two or four) or two standard-size implants for the retention of mandibular overdentures. One hundred and twenty edentulous participants (mean age 59.5 ± 8.5 years) were randomly allocated into three groups according to received treatment: (GI) four mini-implants, (GII) two mini-implants or (GIII) two standard implants. Seven days after implant insertion, patients answered questions (100-mm VAS) relating to pain, swelling, and discomfort with chewing, speech and hygiene, considering their experiences during the 1st and 6th day. Groups were compared by two-way anova (α = 0.05). All participants (GI: 38; GII: 42; GIII: 40) were analysed after 7 days. At the 6th day, GI felt significantly higher pain than GII and GIII. GI also reported more difficulty in performing oral hygiene practices than GIII during the 1st day. There was no significant difference between groups for the other questions and periods. No participant suffered unexpected side effects. The use of four mini-implants induces more intense post-operative pain at the 6th day than the insertion of two mini- or conventional fixtures, as well as more difficult oral hygiene on the 1st day. Clinicaltrials.gov, NCT01411683; FAPESP, 2011/00688-7 and 2011/23347-0.
Assuntos
Implantes Dentários/efeitos adversos , Prótese Dentária Fixada por Implante/efeitos adversos , Prótese Total Inferior/efeitos adversos , Revestimento de Dentadura/efeitos adversos , Arcada Edêntula/reabilitação , Idoso , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Pessoa de Meia-Idade , Dor Pós-Operatória , Resultado do TratamentoRESUMO
AIM: The aim of this report is to present a clinical case of extensive alveolar resorption in the mental region of the mandible of a complete denture wearer for which capsaicin was used for alleviation and remission of post-traumatic painful peripheral neuropathy. BACKGROUND: Resorption of the residual ridge occurs in a chronic and progressive manner, altering the configuration of the ridge and the mucosa covering it and subsequently compromising the stability of the complete denture prosthesis. Individual variability associated with such factors as gender, age, edentulous period, nutrition, excessive load and compression on the ridge, parafunctional habits, occlusal instability, and maladaptation of the prosthesis may have a role in the rate and manner of bone loss. REPORT: A 62-year-old woman, edentulous at the age of 30, presented with complaints of pain and spontaneous "electrical shocks" in the mucosa under her mandibular complete denture. The pain increased while chewing approximately two years ago due to the pressure of this denture on her supporting tissues. The patient indicated the level of pain corresponded to a score of ten out of ten on the Visual Analogical Scale (VAS). Treatment included denture replacement and topical application of capsaicin gel using a custom tray technique. SUMMARY: The review of the literature and the results obtained from the management of this case have served to emphasize how much neuropathic pain research has demonstrated the complexity of its neurophysiologic mechanism due to the lack of association with any somatic manifestation. During the fabrication of a new lower denture the topical application of capsaicin was shown to be effective in the relief and remission of the painful symptoms of the neuropathy as of this writing.
Assuntos
Perda do Osso Alveolar/etiologia , Capsaicina/uso terapêutico , Doenças dos Nervos Cranianos/tratamento farmacológico , Prótese Total Inferior/efeitos adversos , Fármacos do Sistema Sensorial/uso terapêutico , Traumatismos do Nervo Trigêmeo , Doenças dos Nervos Cranianos/etiologia , Dor Facial/etiologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
A case is presented of fractured genial tubercles, revealed by occlusal radiography, in a 63-year-old edentulous woman. Isolated fractures are a rare event that may present with pain and edema in the floor of the mouth. It occurs mainly in patients wearing a complete denture when the mandible is atrophied and the genial tubercles are hypertrophied. Only 11 case reports have been found in the English literature.
Assuntos
Fraturas Espontâneas/etiologia , Hiperostose/complicações , Fraturas Mandibulares/etiologia , Perda do Osso Alveolar/complicações , Queixo/lesões , Prótese Total Inferior/efeitos adversos , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Denture hyperplasia is a reactive lesion of the oral mucosa, usually associated to an ill-fitting denture. This lesion is easily diagnosed and in some cases distinct microscopic variations such as osseous, oncocytic and squamous metaplasia may be found. These metaplastic alterations probably are associated with the lymphocytic infiltrate usually present in denture hyperplasia. We present a case of denture hyperplasia containing salivary gland tissue with ductal alterations mimicking an oral inverted ductal papilloma.
Assuntos
Prótese Total Inferior/efeitos adversos , Papiloma Invertido/diagnóstico , Neoplasias das Glândulas Salivares/diagnóstico , Estomatite sob Prótese/etiologia , Estomatite sob Prótese/patologia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia/etiologia , Hiperplasia/patologia , Soalho Bucal/patologia , Mucosite/etiologia , Mucosite/patologia , Glândulas Salivares Menores/patologiaRESUMO
A patient was seen at the Total Prosthesis Clinic complaining of facial pain after using the same prosthesis for 46 years. Clinical examination revealed TMJ disturbance due to a loss of the vertical dimension caused by a wearing of the teeth. Diagnosis indicated replacement with new prostheses, with a gradual recuperation in the vertical dimension by the application of resin over the lower teeth and a reconditioning of the support tissues. After the alleviation of pain, correction of the dysfunction and reestablishment of the vertical dimension of occlusion, new prostheses were made. At the end of treatment, the patient felt a relaxed facial musculature, lifting the mandible to a resting position instead of constantly maintaining it in occlusion as before. The patient was given instructions as to use, conservation and hygiene of the prostheses and oriented to return for annual evaluation of occlusion and of the supporting oral structures, as well as the stability of the prostheses.