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At least 217 records · Page 12Linked to original sources
PubMed2000

Treatment outcomes of fixed or removable implant-supported prostheses in the edentulous maxilla. Part I: patients' assessments.

STATEMENT OF PROBLEM: Distinct clinical parameters determine whether fixed or removable implant-supported prostheses are indicated to restore the edentulous maxilla. However, there is a strong belief that fixed implant prostheses meet with greater patient acceptance and satisfaction, but this may differ from the patients' perceptions, their psychological responses to treatment, and their assessments of the treatment outcome. PURPOSE: This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla with the main emphasis on the patient's point of view. MATERIAL AND METHODS: Twenty patients who requested an implant-supported superstructure to restore the edentulous maxilla were asked to complete a questionnaire measuring their satisfaction with the present situation and the psychologic impact of their oral health status with their responses marked on a Visual Analog Scale (VAS). Ten patients were treated with a fixed, screw-retained implant prosthesis (group 1), and 10 were treated with a removable, implant-supported and bar-retained overdenture (group 2). Six months after prosthetic rehabilitation, patients were again given the questionnaire to assess their psychologic well-being and satisfaction with the implant-supported restoration. RESULTS: Both prosthesis designs were associated with significant improvements in comfort and retention, function, esthetics and appearance, taste, speech, and self-esteem. No difference was found between the 2 groups with respect to how the patients assessed the implant therapy. However, the results indicated that patients in group 2 experienced greater differences between pretreatment and posttreatment scores for the parameters esthetics, taste, and speech. Treatment costs per unit were significantly higher in group 1 than in group 2. CONCLUSION: Patients in groups 1 and 2 were similarly satisfied with their implant-supported prostheses in the edentulous maxilla with regard to their well-being and the cost-utility, irrespective of whether the restoration was fixed or removable.

Adult↗
PubMed2000

Treatment outcomes of fixed or removable implant-supported prostheses in the edentulous maxilla. Part II: clinical findings.

STATEMENT OF PROBLEM: There is a widespread belief that maxillary overdenture prostheses are associated with a higher frequency of complications and require more maintenance than fixed implant prostheses. PURPOSE: This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla with the main emphasis on the clinician's point of view. MATERIAL AND METHODS: Ten patients were treated with fixed screw-retained implant prostheses (group 1), and 10 patients were treated with removable implant-supported overdentures (group 2) in the edentulous maxilla. Recall was scheduled at 6-month intervals to investigate the prosthodontic treatment outcomes, including implant survival, prosthesis time until retreatment, and maintenance issues. Clinical parameters gingival index (GI), plaque index (PI), the clinical attachment level, and radiographic marginal bone levels measured, along with any biologic and mechanical complications were recorded. RESULTS: Patients were followed over a mean period of 39 months (SD=7; group 1) and 27 months (SD=10; group 2) after implant placement. Cumulative implant survival was 97.6% for group 1 and 94.4% for group 2 after an 18-month observation period. The mean time until retreatment after prostheses insertion was 23.4 months for group 1 and 19.8 months for group 2 (n.s.). In both groups, the increase over time in the radiographically investigated bone level was found to be significant. The indices given for the mucosal health and oral hygiene status (GI and PI) were highly correlated in both groups at each recall appointment, but no significant differences were found between groups 1 and 2. CONCLUSION: In groups 1 and 2, comparable prosthodontic treatment outcomes were achieved. The majority of mechanical complications could be managed chairside during recall visits and did not require additional appointments, so that the time and costs involved in providing maintenance were kept down.

Alveolar Process↗
PubMed2000

Implant position record and implant position cast: minimizing errors, procedures and patient visits in the fabrication of the milled-bar prosthesis.

This article describes a new rationale and method involved in the fabrication of a patient detachable prosthesis supported by a milled bar. This simple procedure improves prosthesis retention. The overdenture is processed directly over a milled bar, which provides an intimate relation between the bar and the acrylic resin denture base to create resistance against rotational and lateral forces acting on the prosthesis. Incorporating simple and predictable attachments, with low maintenance needs, controls resistance to dislodgment along the path of insertion of the prosthesis. The concepts used in the fabrication of the milled bar include an implant position record (IPR) and an implant position cast (IPC) to reduce the need for time-consuming procedures, such as sectioning the cast bar and soldering it to make it fit the abutments. This procedure also reduces the number of patient visits required of the completion of the prosthesis.

Dental Abutments↗
PubMed2003

Analysis of the condyle/fossa relationship before and after prosthetic rehabilitation with maxillary complete denture and mandibular removable partial denture.

STATEMENT OF PROBLEM: The influence of the loss of posterior teeth on the condylar position and on temporomandibular disorders (TMDs) remains a controversial issue. PURPOSE: This study investigated whether prosthetic rehabilitation promoted modification of the condylar position in subjects without symptoms of TMDs. MATERIAL AND METHODS: The temporomandibular joints (TMJs) of 12 women (age 37 to 74), all with existing maxillary complete dentures but no removable partial denture (RPD) restoring the Kennedy class I partially edentulous mandibular arch and no clinical signs of TMDs according to the criteria established by Helkimo, were viewed in maximal intercuspal position with corrected lateral tomography before and after prosthetic rehabilitation with a new maxillary complete denture and a mandibular RPD. Before prosthetic rehabilitation, a mandibular stabilizing base was fabricated to prevent the existing maxillary complete denture from dislodging during tomographic examination. Two methods were used to evaluate tomograms: (1) linear measurements of the subjective narrowest anterior and posterior intra-articular joint spaces made from the tomograms by use of a digital caliper and (2) linear measurements of the anterior and posterior intra-articular joint spaces on the basis of drawings and tracings. Repeated-measures analysis of variance followed by orthogonal contrasts were used to evaluate differences between measurements carried out on the same subject under the different test conditions of the study (before prosthetic rehabilitation, before prosthetic rehabilitation with a mandibular stabilizing base in position, and after prosthetic rehabilitation) (P<.05). RESULTS: Before prosthetic rehabilitation, a predominance of posterior condylar positions was observed. Before prosthetic rehabilitation with a mandibular stabilizing base in position, a significant decrease was observed in posterior condylar positions (P=.03). This decrease was more marked after prosthetic rehabilitation (P=.02). The subjective evaluation and comparison on the basis of drawings and tracings used to analyze the tomograms produced similar results (P=.70). CONCLUSION: Within the limitations of this study, significant changes in the condylar position occurred after prosthetic rehabilitation in subjects without symptoms of TMDs.

Adult↗
PubMed2003

The combination syndrome: a literature review.

Although combination syndrome is recognized by many clinicians, documented observations seem to be rare. The aim of this article was to critically review the literature regarding combination syndrome to evaluate the evidence for this concept. A search of the dental literature with Medline/PubMed through July 2002, focusing on the combination syndrome and related features, was undertaken and combined with a hand search of older references and textbooks on removable prosthodontics.

Alveolar Bone Loss↗
PubMed1997

Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: a three-year retrospective study.

PURPOSE: This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss. MATERIAL AND METHODS: The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients. RESULTS: Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures. CONCLUSIONS: Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications.

Bone Resorption↗
PubMed1997

A short-term clinical follow-up study of superplastic titanium alloy for major connectors of removable partial dentures.

STATEMENT OF PROBLEM: Superplastic forming of Ti-6A1-4V alloy has been used in the fabrication of a removable denture framework. The method provides the titanium alloy denture framework with excellent physical properties not seen in cast titanium prostheses. PURPOSE: This study describes the technical procedure for fabricating removable dentures with this type of framework and evaluates clinical applications of the dentures in short-term follow-up periods from 6 months to 3 years. RESULTS: Results of this study demonstrated that the dentures functioned well and did not cause any major clinical difficulties. The patients have expressed satisfaction with the dentures at regular recall appointments. CONCLUSION: The clinical observations suggest that this method is suitable for fabricating titanium alloy removable dentures.

Acrylic Resins↗
PubMed1997

An implant-supported fixed-removable prosthesis with a milled tissue bar and Hader clip retention as a restorative option for the edentulous maxilla.

Restoration of the edentulous maxilla with implant retained and supported prosthesis is challenging because of inherent anatomic limitations present after the loss of teeth. A fixed-removable prosthesis is one treatment choice for restoration of the edentulous maxilla with implants. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favorable biomechanical stress distribution to the implants. This article presents a procedure for fabrication of a fixed-removable prosthesis with a precision milled bar, Hader clip attachments, and a superstructure prosthesis. The criteria for patient selection and the advantages and disadvantages of this prosthesis are discussed.

Centric Relation↗
PubMed1998

An accurate method for occlusal registration and altered-cast impression for removable partial dentures during the same visit as the framework try-in.

Preparation of mandibular distal-extension removable partial dentures usually requires a secondary impression (the altered-cast impression) to improve the stability of the prosthesis. A potential problem with conventional altered-cast impression procedures is incorrect or incomplete seating of the framework in the mouth or on the cast. This article describes a procedure for obtaining the interjaw relationship and an accurate altered-cast impression in a single appointment (that of the framework try-in).

Acrylic Resins↗
PubMed2004

Photoelastic analysis of the effect of palatal support on various implant-supported overdenture designs.

STATEMENT OF PROBLEM: The effect of palatal support on various types of implant-supported maxillary overdenture designs has not been sufficiently assessed. PURPOSE: The purpose of this study was to photoelastically evaluate the palatal support of 3 designs of maxillary implant-supported overdentures. MATERIAL AND METHODS: A photoelastic model of an edentulous maxilla was fabricated with four 3.75 x 13-mm 3i implants. Three maxillary overdenture designs were fabricated: a splinted Hader bar incorporating 2 distal ERA attachments with anterior clips; non-splinted Zaag 4-mm direct abutments and attachments; and nonsplinted Locator 2-mm direct abutments and attachments. All restorative components and attachments were fitted and observed for passivity of fit and alignment. The overdentures were first tested with complete palatal coverage. Unilateral 25-lb loads were applied at the left and right first molars and the incisive papilla area. The photoelastic effects were monitored and recorded photographically. The palatal area was removed from the 3 overdentures and the loading regimens were repeated. RESULTS: The highest stresses under central loading were seen with the splinted Hader bar and complete palatal coverage, followed by similar levels of stress with either Zaag or Locator attachments. After removal of the palate, the center load demonstrated greater differences between designs. The highest stresses were observed with the Hader bar, followed by the Zaag and then Locator attachments. Lack of palatal coverage demonstrated higher levels of stress around implants and visible supporting tissues. The unilateral load produced the highest stress for the splinted Hader bar, followed by Locator, and then Zaag. CONCLUSIONS: Removal of the palatal support produced a greater effect and more concentrated stress difference for maxillary overdentures than differences between the attachment designs tested.

Dental Abutments↗
PubMed2003

A comparison of patient's satisfaction between complete and partial removable denture wearers.

OBJECTIVES: The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers. MATERIALS AND METHODS: A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent). RESULTS: Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers (P<0.05). Removable partial denture wearers were significantly more satisfied with the retention and the comfort of wearing mandibular denture (P<0.05). There was no significant difference between CD and RPD wearers for general satisfaction with their dentures, aesthetics and comfort of wearing maxillary denture (P>0.05; N.S.). CONCLUSIONS: A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.

Attitude to Health↗