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Journal of Oral & Maxillofacial Research 2015The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical... (Review)
Review
OBJECTIVES
The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible.
MATERIAL AND METHODS
A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN) repositioning with a minimum 6 months of follow-up.
RESULTS
A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented.
CONCLUSIONS
Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments.
PubMed: 25937873
DOI: 10.5037/jomr.2014.6102 -
Journal of Indian Prosthodontic Society Jun 2012The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is...
The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is supported by both natural teeth and implant. The periodontal ligament and osseointegrated interface distribute force differently to the supporting bone. Therefore problems can develop when tooth and implants are combined in the same prosthesis. However, clinicians can apply biomechanical principles, to negate the deleterious leverages exerted by the fixed prosthesis by using non rigid components and to equalize the stress applied by the prosthesis on implant and teeth. A case of partially edentulous situation was rehabilitated successfully with a combination of prostheses. Maxillary arch was restored to function with crowns, fixed dental prosthesis and with an extra coronal castable attachment prosthesis and the mandibular arch with a combination of tooth and implant supported attachment prosthesis. The clinical and laboratory steps for the fabrication of these prostheses are explained in this report.
PubMed: 23858285
DOI: 10.1007/s13191-012-0116-y -
Contemporary Clinical Dentistry 2022This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth...
This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth with a 5-year follow-up. A female patient used an old complete denture in the maxilla and was willing to extract her remaining mandibular teeth to have new dentures. The treatment included preservation of semierupted premolars because of the high surgical risk for mandibular fracture and paresthesia, a new maxillary complete denture, and a mandibular overdenture supported by combined telescopic crowns and ball attachments. The prosthetic rehabilitation restored function and esthetics with high patient satisfaction after 5 years in function.
PubMed: 36213847
DOI: 10.4103/ccd.ccd_240_21 -
Materials (Basel, Switzerland) Aug 2021Few studies have assessed active tactile sensibility in patients rehabilitated with implants. Improved knowledge about functional tactile sensibility will contribute to...
Few studies have assessed active tactile sensibility in patients rehabilitated with implants. Improved knowledge about functional tactile sensibility will contribute to several clinical applications, such as protocols for immediate loading, prosthesis design, occlusal improvement in implantology, and physiological integration of implant-supported prostheses. The present study evaluated active tactile sensibility in patients rehabilitated with Brånemark-type mandibular prostheses that impede the total mucosa-supported maxillary prosthesis. Thirty-five subjects participated in this study. The experimental group ( = 18) inclusion criteria were as follows: Brånemark-type prosthesis and a total mucosa-supported maxillary prosthesis. The control group ( = 17) was composed of participants with complete healthy dentition. Carbon foils with different thicknesses (12 μm, 24 μm, 40 μm, 80 μm, and 200 μm) were placed in the premolar region to evaluate the brink of active oral tactile sensibility. The researchers assessed the participants 120 times. After evaluation, we observed a statistical difference ( < 0.05) between the groups. Additionally, the degree of sensibility was found for all thicknesses, except for 12 μm, on both sides. There was a more significant increase in perception in the control group as the carbon thickness increased. The tactile sensibility threshold was 2.5 times greater for participants with prostheses. Thus, the tactile sensibility for mandibular implant-supported and maxillary mucosa-supported prostheses is significantly lower than that of dentate patients, which was detected above the thickness of 80 μm; in patients with natural dentition, different thicknesses were seen starting from 24 μm.
PubMed: 34443165
DOI: 10.3390/ma14164644 -
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 -
Technology and Health Care : Official... 2023In the absence of contraindications to implants, implant repair is the preferred method to treat mandibular second molar loss. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In the absence of contraindications to implants, implant repair is the preferred method to treat mandibular second molar loss.
OBJECTIVE
To compare the clinical effects of a traditional implant guide and digital implant guide in the early implant restoration of second molars.
METHODS
The study included 35 patients with second molar loss randomly divided into two groups. Eighteen patients in the experimental group had an implant procedure using a computer-aided design/computer-assisted manufacturing (CAD/CAM) digital implant guide, and 17 patients in the control group had the procedure using a traditional film pressing implantation guide. Then, the surgical procedure was completed using the two different implant guides. At 3 months after surgery, four parameters including screw hole exit position, coronal deviation of the implant site, disease improvement rate, and clinical effects, which included marginal adaptation, anatomic form, marginal discoloration, postoperative sensitivity, surface roughness, and secondary caries of the upper prosthesis were compared between the two groups.
RESULTS
The screw hole exit position in the experimental group was directed to the functional cusp of the opposite jaw, and there was a statistically significant difference between the two groups. There was no statistically significant difference in the rate of disease improvement and the clinical effect of the upper prosthesis between the two groups. There was no statistically significant difference in the bilateral coronal deviation and deviation direction of implants in the two groups. The bilateral coronal deviation of the experimental group was smaller than that of the control group.
CONCLUSION
The digital implant guide can effectively reduce the deviation of the screw hole and the upper prosthesis in the restoration of the second molar. The prosthesis used in the experimental group had a good clinical outcome, which provides a theoretical basis for the restoration of the posterior molar.
Topics: Humans; Artificial Limbs; Bone Screws; Computer-Aided Design; Molar; Surgery, Computer-Assisted
PubMed: 37038778
DOI: 10.3233/THC-236003 -
Journal of Oral and Maxillofacial... Jan 2011The purpose of this study was to develop a motion simulator capable of recreating and recording the full range of mandibular motions in a cadaveric preparation for an...
PURPOSE
The purpose of this study was to develop a motion simulator capable of recreating and recording the full range of mandibular motions in a cadaveric preparation for an intact temporomandibular joint (TMJ) and after total joint replacement.
MATERIAL AND METHODS
A human cadaver head was used. Two sets of tracking balls were attached to the forehead and mandible, respectively. Computed tomographic (CT) scan was performed and 3-dimensional CT models of the skull were generated. The cadaver head was then dissected to attach the muscle activation cables and mounted onto the TMJ simulator. Realistic jaw motions were generated through the application of the following muscle forces: lateral pterygoid muscle, suprahyoid depressors (geniohyoid, mylohyoid, and digastric muscles), and elevator muscles. To simulate muscle contraction, cables were inserted into the mandible at the center area of each muscle's attachment. To provide a minimum mouth closing force at the initial position, the elevator muscles were combined at the anterior mandible. During mandibular movement, each motion was recorded using a high-resolution laser scanner. The right TMJ of the same head was reconstructed with a total TMJ prosthesis. The same forces were applied and the jaw motions were recorded again. CT scan was performed and 3-dimensional CT models of the skull with TMJ prosthesis were generated.
RESULTS
Mandibular motions, before and after TMJ replacement, with and without lateral pterygoid muscle reattachment, were re-created in a cadaveric preparation. The laser-scanned data during the mandibular motion were used to drive 3-dimensional CT models. A movie for each mandibular motion was subsequently created for motion path analysis. Compared with mandibular motion before TMJ replacement, mandibular lateral and protrusive motions after TMJ replacement, with and without lateral pterygoid muscle reattachment, were greatly limited. The jaw motion recorded before total joint replacement was applied to the mandibular and prostheses models after total TMJ replacement. The condylar component was observed sinking into the fossa during jaw motion.
CONCLUSION
A motion simulator capable of re-creating and recording full range of mandibular motions in a cadaveric preparation has been developed. It can be used to simulate mandibular motions for the intact TMJ and total joint prosthesis, and to re-create and record their full range of mandibular motions. In addition, the full range of the recorded motion can be re-created as motion images in a computer. These images can be used for motion path analysis and to study the causation of limited range of motion after total joint replacement and strategies for improvement.
Topics: Arthroplasty, Replacement; Biomechanical Phenomena; Cadaver; Computer Simulation; Dental Occlusion, Centric; Fluoroscopy; Holography; Humans; Imaging, Three-Dimensional; Joint Prosthesis; Lasers; Mandible; Mandibular Condyle; Masseter Muscle; Models, Biological; Motion Pictures; Muscle Contraction; Neck Muscles; Pterygoid Muscles; Range of Motion, Articular; Temporal Bone; Temporal Muscle; Temporomandibular Joint; Tomography, X-Ray Computed
PubMed: 21050636
DOI: 10.1016/j.joms.2010.05.085 -
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 -
Contemporary Clinical Dentistry Apr 2013A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid...
A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses.
PubMed: 24015016
DOI: 10.4103/0976-237X.114862 -
Journal (Canadian Dental Association) 2010Open-field aluminum-nickle-cobalt magnets have been used in prosthodontics for many years, but success has been limited because these magnets are susceptible to... (Review)
Review
Open-field aluminum-nickle-cobalt magnets have been used in prosthodontics for many years, but success has been limited because these magnets are susceptible to corrosion by the saliva and because their retentive force is weak relative to the initial retention offered by mechanical attachments. More recently, magnets have been made from alloys of the rare earth elements samarium and neodymium, which provide stronger magnetic force per unit size. In addition, a new generation of laser-welded containers has improved protection from salivary corrosion. The current resurgence of interest in this type of attachment appears justified because, unlike mechanical attachments, magnets have potential for unlimited durability and might therefore be superior to mechanical ball or bar attachments for the retention of removable prostheses on implants. To date, no long-term prospective trials have been conducted to confirm the clinical durability of this new generation of magnets for retaining dentures on either teeth or implants. The aim of this study was to document initial clinical experiences and levels of satisfaction among edentulous patients treated with mandibular implant-supported overdentures retained using a new generation of rare-earth magnetic attachments. At the outset, all but one of the 17 patients had had several years of experience with implant-supported overdentures. During the first year, the mean overall satisfaction among these 17 patients increased from less than 70 to over 90 out of 100 (standardized visual analogue scale). No unusual difficulties were encountered in rendering the treatment or maintaining the attachments. This report offers preliminary evidence of the excellent potential of these magnets for retaining mandibular implant-supported overdentures.
Topics: Contraindications; Corrosion; Dental Plaque; Dental Prosthesis, Implant-Supported; Dental Soldering; Denture Retention; Denture, Overlay; Humans; Lasers; Magnetic Resonance Imaging; Magnetics; Mandible; Neodymium; Patient Satisfaction; Samarium; Welding
PubMed: 20943036
DOI: No ID Found