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Atlas of the Oral and Maxillofacial... Sep 2022
Review
Topics: Facial Bones; Humans; Joint Prosthesis; Mandibular Prosthesis; Temporomandibular Joint; Tissue Engineering
PubMed: 36116883
DOI: 10.1016/j.cxom.2022.06.003 -
Dental Clinics of North America Jan 2024As the field of implant dentistry continues to evolve, new techniques and technologies arise that can provide great benefits to the partial or completely edentulous... (Review)
Review
As the field of implant dentistry continues to evolve, new techniques and technologies arise that can provide great benefits to the partial or completely edentulous patient. The purpose of this article is to review the history, definition, and rationale of immediate loading of dental implants with the goal of providing evidence-based recommendations for implementation into clinical practice. Relevant literature is summarized and includes discussion regarding prerequisites for immediate loading/restoration of an endosseous implant. Surgical techniques and methodologies to prevent implant failure in immediate-load cases are discussed as well. The greatest success has been demonstrated with 4 or more mandibular implants. Although there is support in the literature demonstrating successful outcomes in immediate functional loading of single implants, the opinion of the author is to opt for a nonfunctional load that does not have any occlusal contacts when considering immediate loading of a single dental implant.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dental Implantation, Endosseous; Mouth, Edentulous; Immediate Dental Implant Loading; Treatment Outcome; Follow-Up Studies
PubMed: 37951633
DOI: 10.1016/j.cden.2023.08.002 -
Bioengineering (Basel, Switzerland) Aug 2022Compared to conventional prostheses with homogenous structures, a stress-optimized functionally gradient prosthesis will better adapt to the host bone due to its...
Compared to conventional prostheses with homogenous structures, a stress-optimized functionally gradient prosthesis will better adapt to the host bone due to its mechanical and biological advantages. Therefore, this study aimed to investigate the damage resistance of four regular lattice scaffolds and proposed a new gradient algorithm for stabilized and lightweight mandibular prostheses. Scaffolds with four configurations (regular hexahedron, regular octahedron, rhombic dodecahedron, and body-centered cubic) having different porosities underwent finite element analysis to select an optimal unit cell. Meanwhile, a homogenization algorithm was used to control the maximum stress and increase the porosity of the scaffold by adjusting the strut diameters, thereby avoiding fatigue failure and material wastage. Additionally, the effectiveness of the algorithm was verified by compression tests. The results showed that the load transmission capacity of the scaffold was strongly correlated with both configuration and porosity. Scaffolds with regular hexahedron unit cells can withstand stronger loads at the same porosity. The optimized gradient scaffold showed higher porosity and lower maximum stress than the target stress value, and the compression tests also confirmed the simulation results. A mandibular prosthesis was established using a regular hexahedron unit cell, and the strut diameters were gradually changed according to the proposed algorithm and the simulation results. Compared with the initial homogeneous prosthesis, the optimized gradient prosthesis reduced the maximum stress by 24.48% and increased the porosity by 6.82%, providing a better solution for mandibular reconstruction.
PubMed: 36134969
DOI: 10.3390/bioengineering9090424 -
Journal of Prosthodontics : Official... Feb 2021To evaluate implant and prosthetic survival rates of full-arch rehabilitations retained by three implants in patients with edentulous mandibles. (Review)
Review
PURPOSE
To evaluate implant and prosthetic survival rates of full-arch rehabilitations retained by three implants in patients with edentulous mandibles.
MATERIALS AND METHODS
This systematic review was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The focused question was: Are fixed mandibular 3-implant retained prostheses safe and predicable for full-arch mandibular prostheses? The Medline/PubMed and Cochrane Library databases were used to conduct the systematic search for clinical trials on fixed mandibular 3-implant retained prostheses published between 1999 and 2020. Only English-language studies that presented information on implant and prosthetic survival were included.
RESULTS
A total of 302 studies were identified, of which 13 addressed the inclusion criteria. Additionally, 574 participants were included in these studies. As reported, 73 (4.57%) of 1596 implants failed, with a survival rate of 95.43%. In addition, the mean survival rate of the presented prostheses was 89.66%. The mean marginal bone loss was 1.09 mm.
CONCLUSION
Within the limitations of the present review, implant and prosthetic survival rates of fixed mandibular 3-implant retained prostheses were similar to those of full-arch mandibular prostheses retained by four or more implants. Further research exploring the topic is necessary.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Follow-Up Studies; Humans; Mandible; Mandibular Prosthesis
PubMed: 32893938
DOI: 10.1111/jopr.13253 -
Journal of Prosthodontics : Official... Oct 2022To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an... (Review)
Review
PURPOSE
To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an implant-supported mandibular overdenture (ISO).
METHODS
A literature search was performed in seven electronic databases: MEDLINE via PubMed interface, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and AgeLine. The search terms were developed by the primary investigators and the health sciences librarian, who then started with PubMed and adapted the original search strategy for the other databases. Included articles were those that compared the outcomes for mandibular RSOs and those with ISOs, for persons wearing a maxillary complete denture.
RESULTS
Seven articles were included in the review. There were limitations in this review because of small sample sizes, short study durations, and different methodologies. Also, no comparative studies were identified for clinically important outcomes, such as survival rates of abutments, prosthodontics/maintenance problems, and longitudinal cost of care. For prosthodontic complications, patient satisfaction, and ability to clean, no differences were reported. For oral tactile sensibility, RSOs presented significantly improved sensibility, whereas ISOs had higher maximum bite force capability, but the difference was not statistically significant, except when subjects had a cross-bite or a lingualized occlusion.
CONCLUSIONS
The results of this scoping review were not conclusive, except for maximum bite force, where ISOs seem to perform better than RSOs by the measured criteria. ISOs had higher survival rates than RSOs, and required less maintenance, but were more expensive. It was disappointing to find so few studies comparing these clinical treatment modalities, which suggests that either treatment may be clinically acceptable and depends upon a shared decision between patients and their dentists.
Topics: Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Complete; Bite Force; Mandible; Patient Satisfaction; Denture Retention
PubMed: 35187751
DOI: 10.1111/jopr.13498 -
Journal of Long-term Effects of Medical... 2022The prosthetic replacement is achieved for the functional aspect of the stomatognathic system. Achieving prosthetic occlusion is challenging and has an occlusal concept...
The prosthetic replacement is achieved for the functional aspect of the stomatognathic system. Achieving prosthetic occlusion is challenging and has an occlusal concept of its own when the type of prosthesis varies. The implant occlusion differs for its load transfer concept and longevity. The study was employed to assess the dynamic occlusal contact in implant occlusion through digital means. The study was carried out on implant prosthesis and its dynamic parameters were evaluated using T-Scan Novus (BioResearch, Inc., Brown Deer, WI, USA) in a university hospital setting after collecting 35 patients. Mandibular arch prosthesis tends to swing from high intensity to low or no contacts frequently and when the percentage of implant crown contact at 10% is present there is more of implant protected occlusion achieved. Use of T-Scan Novus can reveal more occlusal details in functional form which can help in achieving new treatment goals.
Topics: Animals; Humans; Deer; Crowns; Prostheses and Implants
PubMed: 36382699
DOI: 10.1615/JLongTermEffMedImplants.2022038732 -
Annals of Translational Medicine Nov 2021Ankylosis of the temporomandibular joint (TMJ) is a pathological disorder which results in patients' limited or even complete failure of mouth opening. When TMJ...
BACKGROUND
Ankylosis of the temporomandibular joint (TMJ) is a pathological disorder which results in patients' limited or even complete failure of mouth opening. When TMJ ankylosis occurs during the growing age, moderate to severe micrognathia might be the proposed scenario of such cases, accompanied by obstructive sleep apnea and hypopnea syndrome (OSAHS). TMJ reconstruction using total TMJ prostheses with mandibular advancement (MA) can simultaneously improve the function and aesthetic profile of such patients. The purpose of this study was to determine whether the upper airway can be improved after TMJ reconstruction with total TMJ prostheses combined with or without MA in TMJ ankylosis patients.
METHODS
Fourteen patients with pre-(T1) and post-(T2) operative CT scans were included. Patients were divided into two groups according to the operation with or without MA (MA/WoMA). The changes of the upper airway and jaw bones were comparatively analyzed within and between the two groups.
RESULTS
In MA Group, the volume of the total upper airway (Vt) and palatopharynx (V1), together with the surface area (SA) of the total upper airway (SAt) and palatopharynx (SA1) increased significantly after the operation by 41.4%, 43.2%, 36.3% and 36.6%, respectively. In WoMA Group, V1, SAt and SA1 increased significantly by 21.0%, 19.0% and 23.1% following surgery. The changes of Point B (P<0.01), Y-axis angle (P<0.01), SNB (P<0.01), and ANB (P<0.01) were significantly greater in MA Group than in WoMA Group. Comparing both groups, the maxilla, and mandible were more backward in MA Group than in WoMA group before the operation, but there was no significant difference of the final position of the maxilla and mandible after the operation between both groups.
CONCLUSIONS
Release of TMJ ankylosis and condylar reconstruction using total joint prostheses simultaneously with MA could significantly improve the total volume and other various parameters of the upper airway, while, only the dimension of the palatopharynx increased in cases without MA.
PubMed: 34988147
DOI: 10.21037/atm-21-1275 -
Journal of Oral Rehabilitation Dec 2023Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing... (Review)
Review
BACKGROUND
Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food.
OBJECTIVE
To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses.
METHODS
This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches.
RESULTS
Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND.
CONCLUSIONS
Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Topics: Humans; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture, Complete; Mastication; Muscles; Dental Implants; Denture, Overlay
PubMed: 37605296
DOI: 10.1111/joor.13564 -
Cureus May 2023Aim This study's objective was to assess and analyze, using 3D Finite Element Analysis, the impact of four mandibular complete arch superstructures on the distribution...
Aim This study's objective was to assess and analyze, using 3D Finite Element Analysis, the impact of four mandibular complete arch superstructures on the distribution of stress in the crestal bone during mandibular flexure. Materials and methods Four Finite element models of the mandible with different implant-retained framework designs have been developed. Three of these models had six axial implants placed at intervals of 11.8 mm, 18.8 mm and 25.8 mm from the midline, respectively. One model had two tilted implants and four axial implants splinted with a single piece of framework at intervals of 8.4 mm, 13.4 mm and 18.4 mm from the midline. For analyzing the stress distribution, the finished product was transferred to ANSYS R 18.1 software (Sirsa, Haryana, India) for finite element simulation, the models were constructed, the ends were restrained, and bilateral vertical loads of 50N, 100N and 150N were applied to the distal part of the framework. Results Bilateral loads were applied to each of the four 3D FEM and after assessment of Von Mises Stress and Total Deformation, a finding was made that the model with six axial implants supported by a single piece of framework underwent the highest total deformation and the model with four axial implants and two implants with distal tilts displayed most significant Von Mises stress. Conclusion Within the constraints of this 3D FEA, it was determined that mandibular flexure and peri-implant bone stress were affected by the way the framework is divided and the nature of mandibular movement. The three types of frames with the least bone stress are demonstrated by the mandibular deformation that results from two-piece frameworks on axial implants. Regardless of the number of implants, the single framework splinted with six implants shows a flexure in mandible with the highest bone stress around the implant irrespective of the angulation of the implant. Clinical significance When it comes to edentulous jaws, reducing stress in implant-supported restorative systems at varying degrees of the bone and implant interfaces and superstructures of prosthetics is one of the fundamental goals of implant treatment. A framework with proper design and a low modulus of elasticity reduces mechanical risk. Additionally, a larger number of implants helps to prevent cantilevers and spacing between the implants.
PubMed: 37378222
DOI: 10.7759/cureus.39357