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BMC Oral Health Mar 2024Rehabilitation of the anterior area when the mesio-distal space is reduced is a challenge for the clinician, due to the patient's anatomical limitations and aesthetic...
BACKGROUND
Rehabilitation of the anterior area when the mesio-distal space is reduced is a challenge for the clinician, due to the patient's anatomical limitations and aesthetic requirements. Narrow Diameter Implants (NDI) are an option of treatment when the standard diameter implant is not possible, but the evidence is scarce. This prospective clinical study aims to analyze the formation of the tooth-implant papilla between the implant and the adjacent natural tooth in the maxillary lateral incisors and mandibular incisors.
METHODS
A total of 40 patients treated with NDI, of titanium-zirconium (Ti-Zr) alloy i.e., 2.9 mm Test Group (TG) and 3.3 mm Control Group (CG), were included. The mesiodistal distance between the adjacent natural teeth was used for implant selection, maintaining 1.5 mm between the fixation and the adjacent tooth. Clinical assessment was performed by a clinical examiner at 6 and 12 months after the final prosthesis. The primary variable was the Jemt Papillary Index. Also, implant survival rate (SR), complications, Implant Stability Quotient (ISQ), and patient-reported outcomes measures (PROMs) such as aesthetics, chewing, phonation, comfort, and self-esteem were analyzed.
RESULTS
A significant amount of papilla filling was observed concerning the baseline, with a trend towards more formation of the papilla in the TG, with a JPI score of 3. No significant differences were observed between the two groups regarding implant SR, clinical parameters, and complications. In terms of PROMs, a higher satisfaction in the TG was observed, with significant intergroup differences for aesthetics, comfort, self-esteem, and primary stability ISQ (TG: 59.05 (SD: 5.4) vs. CG: 51.55 (SD: 5.7)).
CONCLUSIONS
The 2.9 mm diameter Ti-Zr implants achieved a formation of papilla similar to 3.3 mm implants in the anterior region at 12 months of follow-up after the final prosthetic restoration. The use of Ti-Zr implants with a diameter of 2.9 mm to rehabilitate single teeth in areas of the anterior region, where the mesiodistal distance is limited, showed favorable clinical results and a high degree of satisfaction during 1 year of observation similar to 3.3 mm dental implants.
TRIAL REGISTRATION
This study was retrospectively registered in ClinicalTrials.gov with the number NCT05642520, dated 18/11/2022.
Topics: Humans; Dental Implants; Prospective Studies; Research Design; Titanium; Zirconium
PubMed: 38443879
DOI: 10.1186/s12903-024-04075-2 -
Head & Neck Jun 2024We sought to review our institution's experience with dental implant placement in free flap jaw reconstruction to determine factors impacting restoration of dental...
BACKGROUND
We sought to review our institution's experience with dental implant placement in free flap jaw reconstruction to determine factors impacting restoration of dental occlusion.
METHODS
Exactly 48 patients underwent free flap jaw reconstruction with or without dental restoration from 2017 to 2022. Primary outcome was achievement of restored dental occlusion after jaw free flap reconstruction.
RESULTS
A total of 48 patients with a mean age of 59.8 ± 16.4 years underwent jaw reconstruction from 2017 to 2022. Ten patients (20.8%) received osteointegrated dental implants. Two patients received a temporary dental prosthesis, 12 ± 4 months after initial reconstruction. Three patients received a final prosthesis, with a mean time to final prosthesis of 17.7 ± 12.4 months. Five patients did not receive any prosthesis despite placement of implants.
CONCLUSION
A minority of patients received dental implant placement with free flap jaw reconstruction and only a small subset of these received a definitive dental prosthesis.
Topics: Humans; Middle Aged; Free Tissue Flaps; Female; Male; Aged; Retrospective Studies; Adult; Dental Implantation, Endosseous; Plastic Surgery Procedures; Treatment Outcome; Dental Implants; Dental Implantation; Mandibular Reconstruction
PubMed: 38420709
DOI: 10.1002/hed.27683 -
Medicina (Kaunas, Lithuania) Feb 2024The temporomandibular joint (TMJ) is one of the most complex joints in the human anatomy. In advanced degenerative stages, conservative or minimally invasive surgical...
The temporomandibular joint (TMJ) is one of the most complex joints in the human anatomy. In advanced degenerative stages, conservative or minimally invasive surgical therapies have failed to restore joint function, and joint replacement with prostheses has been required. Stock prostheses, compared to custom-made prostheses, are much less expensive and require less pre-operative preparation time. Four patients followed for years for temporomandibular dysfunction and previously operated on by arthroscopy or open joint surgery that have been reconstructed with stock TMJ prostheses (STMJP) through virtual surgical planning (VSP) and an STL model with surgical and positioning guides were included. The median follow-up was 15 months; the median number of previous TMJ surgeries was 2. The mean preoperative MIO was 24.6 mm and at longest follow-up was 36.4 mm. The median preoperative TMJ pain score was 8, and the median postoperative TMJ pain was 3. All patients have improved their mandibular function with a clear improvement of their initial situation. In conclusion, we believe that stock TMJ prostheses with virtual surgical planning and surgical guides are a good alternative for TMJ reconstruction at the present time. Nonetheless, prospective and randomized trials are required with long-term follow up to assess their performance and safety.
Topics: Humans; Pilot Projects; Temporomandibular Joint Disorders; Prospective Studies; Treatment Outcome; Joint Prosthesis; Temporomandibular Joint; Pain
PubMed: 38399626
DOI: 10.3390/medicina60020339 -
Clinical Oral Investigations Feb 2024Unilateral temporomandibular joint ankylosis with jaw deformity (UTMJAJD) may require simultaneous total joint prosthesis (TJP) reconstruction, sagittal split ramus...
Simultaneous standard total joint prosthesis reconstruction with SSRO and Le Fort I osteotomy in the treatment of unilateral temporomandibular joint ankylosis with jaw deformity: a case cohort study.
OBJECTIVE
Unilateral temporomandibular joint ankylosis with jaw deformity (UTMJAJD) may require simultaneous total joint prosthesis (TJP) reconstruction, sagittal split ramus (SSRO), and Le Fort I osteotomies. The purpose of this study was to evaluate outcomes in patients treated with these procedures.
METHODS
Patients diagnosed UTMJAJD between 2016 and 2018 were selected for the study. Mandible-first procedure was performed after ankylosis release with TJP on the ankylosed side and SSRO on the contralateral side. Le Fort I osteotomy with and without genioplasty was lastly performed. Maximal incisor opening (MIO), facial symmetry, and jaw and condyle stability were compared before, after operation, and during follow-ups.
RESULTS
Seven patients were included in the study. Their average chin deviation was 9.5 ± 4.2 mm, and maxillary cant was 5.1 ± 3.0°. After operation, jaw deformity significantly improved, with chin deviation corrected 7.6 ± 4.1 mm (p = 0.015) and advanced 5.9 ± 2.5 mm (p = 0.006). After an average follow-up of 26.6 ± 17.1 months, MIO significantly increased from 11.4 ± 9.3 to 35.7 ± 2.6 mm (p = 0.000). The occlusion was stable with no significant positional or rotational changes of the jaw (p > 0.05). There was no obvious condylar resorption during follow-ups.
CONCLUSION
Simultaneous TJP reconstruction, SSRO, and Le Fort I osteotomy are reliable and effective methods for the treatment of UTMJAJD.
Topics: Humans; Mandibular Condyle; Cohort Studies; Dental Implants; Osteotomy; Mandible; Joint Prosthesis; Jaw Abnormalities; Polymers; Ankylosis; Temporomandibular Joint; Osteotomy, Le Fort; Osteotomy, Sagittal Split Ramus; Temporomandibular Joint Disorders
PubMed: 38383876
DOI: 10.1007/s00784-024-05543-3 -
Clinical Oral Investigations Feb 2024Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients' occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses.
MATERIALS AND METHODS
Twenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05.
RESULTS
Groups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months.
CONCLUSION
Implant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations.
CLINICAL RELEVANCE
Implant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Jaw, Edentulous; Mandible; Mouth, Edentulous; Muscles; Occlusal Adjustment; Patient Satisfaction; Quality of Life
PubMed: 38378935
DOI: 10.1007/s00784-024-05558-w -
Heliyon Feb 2024Dentin hypersensitivity is common problem between procedure of vital tooth preparation and cementation procedure of final prosthesis. So, use of desensitizing agents may...
BACKGROUND
Dentin hypersensitivity is common problem between procedure of vital tooth preparation and cementation procedure of final prosthesis. So, use of desensitizing agents may be helpful to minimize the errors.
AIM
To Compare retention of cast crown luted with glass ionomer cement in presence of two different types of desensitizer agent on extracted teeth.
MATERIAL
Desensitizing agents used are bioactive Glass and GLUMA, Glass Ionomer Cement has been used as luting agent. Other required items are crown cutting bur, airotor handpiece, spatula, glass Cement carrier, microtip brush, universal testing machine.
METHODOLOGY
In this study total number of 60 premolars with good coronal anatomy, which are extracted for orthodontic purposes, were collected from Department of oral and maxillofacial surgery, Institute of dental Sciences. Then they were mounted individually in die stone block. Tooth preparation for the metal prosthesis of maxillary and mandibular premolars was carried out following the standard principles of tooth preparation use milling surveyor and they are grouped randomly into Group A- Luting cement (Control group), group B- Luting cement + Kulzer Gluma Desensitizer, group C- Luting cement + Bioactive glass. After fabrication of metal coping, tooth conditioning has been carried out then cementation was done using GIC. Retention of coping was checked using universal testing machine.
RESULT
A comparison was made for the mean stress value within three groups. GIC + Bioactive had the highest mean stress (6.52 ± 1.81) followed by Control group (3.88 ± 2.37). GIC ± Gluma had the least mean stress of 2.59 ± 1.19.
CONCLUSION
Bioactive glass + GIC exhibited higher retentive value as compared to prosthesis luted only with GIC and GIC + Gluma. So clinically it can be inferred that for vital tooth preparation bioactive glass can be used as desensitizing agent for the intermediate period till the permanent crown is luted.
PubMed: 38371974
DOI: 10.1016/j.heliyon.2024.e25891 -
Clinical and Experimental Dental... Feb 2024To evaluate how various tooth preparation designs impact the adaptation-both at the margins and internally-and the retentive strength of computer-aided design and...
Effect of ceramic materials and tooth preparation design on computer-aided design and computer-aided manufacturing endocrown adaptation and retentive strength: An in vitro study.
OBJECTIVES
To evaluate how various tooth preparation designs impact the adaptation-both at the margins and internally-and the retentive strength of computer-aided design and computer-aided manufacturing (CAD/CAM) produced endocrowns.
MATERIALS AND METHODS
60 extracted human mandibular first molars were endodontically treated and assigned into three groups (n = 20) according to the tooth preparation design: Group N: butt joint design, Group F and F1 received 1- and 2-mm circumferential ferrule preparation, respectively. Endocrowns were milled using either lithium disilicate glass-ceramic (IPS emax ceramic) or monolithic zirconia. The internal and marginal adaptation of the endocrowns were evaluated using the replica technique. After cementation, the endocrowns of all test groups were dislodged axially at 0.5 mm/min using a universal testing machine. A 2-way ANOVA and the independent samples t-test (α = .05) were performed to statistically analyze the data.
RESULTS
The effect of changing the design of the tooth preparation (butt joint, ferrule) on the marginal and internal gap was shown to be statistically significant (p < .05); the lower gap values were recorded at the axial followed by cervical, marginal, and pulpal floor walls in both ceramic groups regardless of the teeth preparation design. The ANOVA test revealed similar average removal forces and stresses for the two types of tested ceramic materials.
CONCLUSION
IPS emax ceramic adapted better than monolithic zirconia ceramic, regardless of the preparation design. Ferrule preparation design is more retentive than butt joint preparation, regardless of the type of ceramic material used.
Topics: Humans; Crowns; Dental Prosthesis Design; Materials Testing; Ceramics; Tooth Preparation; Computer-Aided Design; Zirconium
PubMed: 38345492
DOI: 10.1002/cre2.843 -
Journal of Dental Sciences Jan 2024Segmental body defects of the mandible result in the complete loss of the affected region. In our previous study, we investigated the clinical applicability of a...
Use of customized 3-dimensional printed mandibular prostheses with a dental implant pressure-reducing device in mandibular body defect: A finite element study performing multiresponse surface methodology.
BACKGROUND/PURPOSE
Segmental body defects of the mandible result in the complete loss of the affected region. In our previous study, we investigated the clinical applicability of a customized mandible prosthesis (CMP) with a pressure-reducing device (PRD) in an animal study. In this study, we further incorporated dental implants into the CMP and explored the use of dental implant PRD (iPRD) designs.
MATERIALS AND METHODS
By employing a finite element analysis approach, we created 4 types of CMP: CMP, CMP with iPRD, CMP-PRD, and CMP-PRD with iPRD. We developed 2 parameters for the iPRD: cone length (CL) in the upper part and spring pitch (SP) in the lower part. Using the response surface methodology (RSM), we determined the most suitable structural assignment for the iPRD.
RESULTS
Our results indicate that CMP-PRD had the highest von Mises stress value for the entire assembly (1076.26 MPa). For retentive screws and abutments, CMP with iPRD had the highest von Mises stress value (319.97 and 452.78 MPa, respectively). CMP-PRD had the highest principal stress (131.66 MPa) in the anterior mandible. The iPRD reduced principal stress in both the anterior and posterior mandible. Using the RSM, we generated 25 groups for comparison to achieve the most favorable results for the iPRD and we might suggest the CL to 12 mm and the SP to 0.4 mm in the further clinical trials.
CONCLUSION
Use of the PRD and iPRD in CMP may resolve the challenges associated with CMP, thereby promoting its usage in clinical practice.
PubMed: 38303793
DOI: 10.1016/j.jds.2023.09.011 -
National Journal of Maxillofacial... 2023Hemifacial microsomia (HFM) is a complex congenital malformation with an extremely variable phenotypic presentation. It usually involves structures of the first and...
Hemifacial microsomia (HFM) is a complex congenital malformation with an extremely variable phenotypic presentation. It usually involves structures of the first and second pharyngeal arches. Anomalies of the cardiac, pulmonary, renal, and gastrointestinal systems are present, but the main characteristic is the mandibular hypoplasia. This is commonly treated with orthodontic hardware and various surgical modalities. Most recently, a total joint replacement with a customized prosthesis is idealized to provide the best outcomes to these patients, so it has been used in some cases. The following case is of a 23-year-old female with congenital hypoplastic mandibular head and the absence of mandibular fossa. The proposed treatment was to reconstruct the mandible with a customized prosthesis and orthognathic surgery to correct the asymmetry and provide better phonation, speech, and facial contour. The patient is under six years follow-up with a complete adaptation of the prosthesis.
PubMed: 38273912
DOI: 10.4103/njms.njms_14_22 -
International Journal of Oral and... Jun 2024The aim of this study was to retrospectively analyse a series of patients with posterior mandibular atrophy rehabilitated with custom-made subperiosteal implants. The...
The aim of this study was to retrospectively analyse a series of patients with posterior mandibular atrophy rehabilitated with custom-made subperiosteal implants. The study included patients with severe posterior mandibular atrophy who had undergone rehabilitation with subperiosteal implants between September 2018 and August 2022 in the Maxillofacial Surgery Operative Unit of the University Hospital of Sassari. Complications and the success rate were reviewed. Data from 30 implants placed in 17 patients were included and analysed. There were no major complications during the surgeries. The main postoperative sequela was oedema, which was reported as moderate by most patients and had completely regressed within 10 days of surgery. No partial or complete exposures, infections, or loss of the implants were detected during follow-up (average follow-up 22.5 months). Control computed tomography scans, performed at 6 months and then annually in all cases, did not show significant bone loss below the abutments, displacement of the implants, or loss or loosening of the osteosynthesis screws. Subperiosteal implants may represent a safe and reliable technique for the rehabilitation of severe atrophy of the posterior mandible. Prospective studies with a long follow-up will be needed to establish the long-term results of this type of implant-prosthetic rehabilitation.
Topics: Humans; Female; Male; Middle Aged; Retrospective Studies; Atrophy; Mandible; Aged; Dental Prosthesis Design; Dental Implants; Dental Implantation, Endosseous; Adult; Treatment Outcome; Postoperative Complications; Dental Prosthesis, Implant-Supported; Tomography, X-Ray Computed
PubMed: 38272739
DOI: 10.1016/j.ijom.2024.01.003