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[The effect of the arrangement of the artificial sets of teeth on the physical stability of total protheses].

The effect of masticatory forces within and outside the stable stress-bearing areas of the complete upper denture on the pressure gradient and the flow of saliva into the space under the prosthesis were demonstrated with standardized tests. It was shown that masticatory stress within the stable area led to a continual increase in pressure in the space under the prosthesis. Masticatory force outside the stable area led to a decrease in pressure and an equalization of pressure in this space as well as dislocation and tilting of the complete denture. Due to masticatory force outside the stable area, the shape of the ridge influences the stability of the complete denture.

Dental Impression Technique↗

Fixed rehabilitation of a patient with hypohidrotic ectodermal dysplasia using zygomatic implants.

We found few references in the dental literature on implant rehabilitation of patients with hypohidrotic ectodermal dysplasia and only 1 case on zygomatic fixations and maxillary prosthesis in a patient with hypohidrotic ectodermal dysplasia. Two zygomatic fixations were placed according to the sinus slot technique, together with 3 implants in the anterior maxillary region. After 6 months, an upper complete prosthesis was screwed onto the implants, and lower overdentures were placed over the remnant canines. After 18 months of follow-up the patient reported important improvement in oral function and self-esteem.

Adult↗

The influence of maxillary dentures on mid-facial fracture patterns.

The presence of upper arch dentures modifies fracture patterns occurring in mid-facial trauma. The fracture patterns of 16 upper denture wearers suffering maxillary fractures were retrospectively studied. Mid-facial fractures in this group were predominantly of the Le Fort I type and in 14 patients demonstrated an atypical fracture path with a vertical fracture passing from the main Le Fort I fracture to the inferior orbital rim. Full upper arch dentures generally protected the upper alveolus from fracture but, where there was discontinuity of the prosthesis, alveolar fractures mirroring the edge of the denture as it crossed the alveolar region were seen. These findings should alert the clinician to the possibility of unusual maxillary fractures in denture wearers and aid our understanding of fracture patterns in the mid-facial skeleton.

Adult↗

Effect of denture adhesive on stability of complete dentures and the masticatory function.

This study examines the effects of denture adhesive on the retention and stability of complete dentures and the masticatory function. The authors estimated the stability of complete dentures from 3-dimensional (3-D) denture movement and rotational denture movement and additionally the masticatory function from cycle time and chewing time. Six edentulous subjects who participated in this study had old and newly fabricated complete dentures. Upper denture movement was recorded using a 3-D motion capture system while chewing 3 kinds of food (peanuts, fish paste, raisins). Both the new and old dentures showed that using a denture adhesive contributes to reducing 3-D denture movement, rotational denture movement and chewing time during chewing the various foods. The cycle time in new and old dentures was statistically unaffected by applying denture adhesive. There was no statistically significant difference in improvement in 3-D denture movement or rotational denture movement between the new and old dentures, for any of the foods. This study observes the overall effect of denture adhesive during use for both dentures. The results of this study suggest that denture adhesive contributes to reducing denture movement and so improves chewing function.

Adhesives↗

Early loading of endosseous implants in the augmented maxilla: a 1-year prospective study.

In 10 patients, 68 endosseous implants were inserted in the augmented edentulous maxilla using a one-stage implant placement technique. Three months before implant insertion, the width and height of the alveolar crest were augmented with autologous bone grafts from the iliac crest. In all cases, the resulting bone volume was sufficient for implant insertion. According to an early loading protocol, the implant-supported overdenture was fabricated 2 months after insertion of the implants. Evaluation was performed according to a standardised protocol immediately and 1 year after fabrication of the prosthetic construction. The protocol included assessment of both clinical (bleeding score, pocket depth, implant mobility) and radiographic (marginal bone level on standardised radiographs) parameters. Three implants in two patients in the upper jaw were lost (survival rate: 95.6%). The peri-implant tissues had a healthy appearance and bone loss was minimal. Overall, the patients were very satisfied with the prosthetic construction. From this preliminary study, it is concluded that in selected cases, early loading of implants may develop into a predictable treatment modality after augmentation of the maxilla.

Adult↗

Fixed ceramometallic prostheses over anterior and transzygomatic implants by using the sinus slot technique--report of a case.

Atrophy of the upper jaw poses problems for fixed rehabilitation of implants. Of the different management possibilities that have been developed, transzygomatic implant placement is a good option and affords a high success rate. These implants are positioned in zygomatic bone by using 2 possible techniques. We present a 48-year-old woman with severe posterior maxillary atrophy in which the canine and frontozygomatic prominence were used to place 6 anterior and 2 transzygomatic implants by using the sinus slot technique for fixed bridge rehabilitation. The advantages of the sinus slot technique over the sinus window technique are discussed.

Alveolar Ridge Augmentation↗

Within-subject comparison of maxillary long-bar implant-retained prostheses with and without palatal coverage: patient-based outcomes.

Although maxillary implant overdentures are used in oral rehabilitation, different designs have not been compared previously in clinical trials. This crossover trial was designed to measure differences in patient satisfaction with maxillary long-bar implant overdentures with and without palatal coverage opposed by a fixed mandibular implant-supported prosthesis. Data were also gathered on new conventional dentures and on maxillary conventional dentures opposed by mandibular fixed prostheses. Sixteen participants were selected from a population wearing conventional dentures. Fifteen received new upper and lower dentures (1 drop-out). Four implants were placed in the maxilla and mandible (2 drop-outs). A mandibular fixed prosthesis was inserted in 13 participants, who were then divided into 2 groups. One group (n = 7) received long-bar overdentures with palate, then long-bar overdentures without palate. The other group (n = 6) received the same treatments in the reverse order. Mastication tests and psychometric evaluations using Visual Analog Scales and Categorical Scales were performed throughout the study. General satisfaction was very high with both maxillary implant-supported prostheses, as were ratings of almost all psychosocial and functional variables. There were no significant differences between treatments, suggesting that patients are equally satisfied with long-bar overdentures with and without palate when these are opposed by mandibular fixed prostheses. However, the ratings given to the maxillary implant prostheses were not significantly higher than for new conventional maxillary prostheses. This suggests that maxillary implant prostheses should not be considered as a general treatment of choice in patients with good bony support for maxillary conventional prostheses.

Adult↗

Prospective analysis of masticatory function following lateral mandibulotomy.

Based on clinical impressions and subjective reports by patients, it is generally accepted that a loss of mandibular continuity will result in decreased masticatory function while preserving continuity will result in maintenance of masticatory function. Surprisingly, there is a paucity of well controlled studies objectively evaluating masticatory function to support these statements. The purpose of this study was to objectively evaluate masticatory function in a patient who underwent surgical resection for cure of a tonsillar carcinoma where a lateral mandibulotomy was used. Masticatory performance and swallowing threshold were assessed using a 0.5 gm frito as the test food substance and a sieve analysis. The subject was evaluated pre and post surgery and post prosthetic rehabilitation. When compared with pre surgery function, masticatory function and swallowing threshold were maintained and enhanced with prosthetic treatment 1 year post surgery. Maintenance of mandibular continuity did have functional merit for the subject studied.

Denture, Complete, Upper↗

Dental resin materials in vivo - TEM results after one year: a pilot study.

Dental resins deteriorate clinically due to chewing forces, temperature changes, chemical agents or biological attack. Findings concerning these influences on the different components of a resin are limited. The aim of this study was to evaluate an alternative method for assessing the influence of the oral cavity on dental materials and their individual components as well as analyzing degradation effects over time. Seven dental composite and resin materials were inserted into the upper complete dentures of two subjects and evaluated after one year with a transmission electron microscope. The various resin components showed different degrees or deterioration. Composites with an urethandimethacrylate matrix were less vulnerable. A layer of salivary proteins (pellicle) was found on all materials but the polymethylmethacrylate reference. An accumulation of pellicle on filler particles and the crevice between filler and matrix was noted. We conclude that the tested method is effective for evaluating the interaction between the material's components and the biological environment. Further studies are needed to confirm these observations.

Administration, Oral↗