Implant-prosthetic therapy failure in smoker and nonsmoker patients

Introduction: Implant-prosthetic therapy has predictable success, and the complications are associated with a lot of factors. Smoking cigarettes is reason for different oral diseases, bone loss, loss of soft tissue and teeth, appearance of periimplantitis and implant loss. The corellation of smoking and implant-prosthetic therapy failure was examined in the clinical study. Materials and method: Fifty patients with FDP on 61 implants in frontal and molar region were investigated. They were divided in two groups: smokers and nonsmokers. Thirty four patients were smokers, and sixteen didn’t smoke cigarettes in the last two years. Criteria data for the success of the therapy were mobility of the implant, pain, peri-implant bone loss higher than 1.5 mm, absence of technical complications and function and aesthetics appeal. Control checkups were made after six months, one and two years. Patients had questionnaires, clinical examination and X-ray. Results: There is a statistically significant difference between smokers and nonsmokers in the failure rates of dental implants. During first year 0,5 mm of bone was lost around eleven implants, and 0,05 mm next years.Total seven implants failed, five in smoker group at the beginning of the first year, and 2 in nonsmoker group during second year. Conclusion: Results showed that smoking habit can increase the risk of early implants loss two times more often in smokers. For some complications like periimplantitis, local factors have greater influence. Smoking does not increase the risk of late implant loss, but the implants at patients with smoking habit, in correlation with several different local risk factors, is contraindicated. Early complications are results of smoking, while quality and quantity of surrounding bone are responsible for late complications.The results from the investigation, also give informations for proper treatment planning, and patient education for quiting their harmfull habit. Keywords Implants, therapy failure, smoking, periimplantitis

Comparative evaluation of clinical effects after operative extraction of impacted mandibular third molars using piezosurgery and rotary instruments

Background: Impacted mandibular third molars are frequently encountered in daily oral surgery practice. Surgical extraction of these teeth is indicated when they cause multiple problems that interfere with the normal functioning of the masticatory system, or as a prophylactic measure to prevent clinical symptoms. Due to the shortcomings of traditional rotary instruments, piezosurgery appears as an alternative technique to osteotomy whose main benefits are that it is inert to soft anatomical structures and it reduces the risk of damage or thermal necrosis of osteocytes. Aim: The aim of this study is to compare piezosurgical and conventional osteotomy with hand piece and burs evaluating the time needed for the osteotomy and the intensity of postoperative complications, including pain and trismus. Materials and Methods: Intraoperative and postoperative aspects were evaluated for the comparison between piezosurgical osteotomy and osteotomy with rotary instruments in the surgical removal of mandibular impacted wisdom teeth in total of 15 young patients through a split-mouth study. Results: It takes more time to perform an osteotomy using piezosurgery compared to the conventional technique with rotatory instruments, but statistically non-significant. Postoperative pain and trismus were lower in the test group where the osteotomy was performed piezosurgically, also without statistical significance. Conclusion: Due to the lower intensity of postoperative symptoms, piezosurgery is a good therapeutic option for osteotomy, especially in cases where there is a high risk of injury to adjacent soft tissues. Keywords: Impacted mandibular third molars; rotary instruments; piezosurgery; osteotom

Fracture Localisation of Porcelain Veneers with Different Preparation Designs

BACKGROUND: Porcelain veneers are permanent restorations that combine good aesthetic with functionality by minimal destructive techniques. AIM: This study aimed to investigate the influence of the preparation designs on the fracture localisation. MATERIAL AND METHODS: Three preparation designs of porcelain veneers fabricated by a method of laying on a fireproof abutment on maxillary central incisor were examined in this in vitro study-feather preparation, bevel preparation and incisal overlap – palatal chamfer. The samples from all three groups were loaded into a universal test machine-TRITECH WF 10056 until damage occurred on the porcelain veneer. Fracture localisation was classified as an incisal, gingival or combination. Data were analysed with statistical programs: STATISTICA 7.1; SPSS 17.0. RESULTS: In feather preparation, as a consequence of the mechanical force, the most common is the incisal localisation (66.7%), followed by the combined (33.3%), while the gingival fracture localisation is not registered. In bevel preparation, the most common fracture localisation is combined (53.6%), followed by incisal (35.7%) and subsequent gingival localisation (10.7%). In incisal overlap (palatal chamfer), combined and gingival localisation of the fracture is equally recorded in 14.3% of the samples, while the incisal is the most common localisation and is registered in 72.4%. CONCLUSION: During the study, a statistically significant dependence was found between the localisation of the occurred changes (incisal, gingival and combination) and the three different types of preparation

Contemporary Dental Ceramic Materials, A Review: Chemical Composition, Physical and Mechanical Properties, Indications for Use

BACKGROUND: The high esthetic expectations from the prosthodontic restorations have directed the qualitative development of the materials towards the all-ceramic materials that are capable of replacing porcelain-fused-to-metal systems. AIM: This article reviews the literature covering the contemporary all-ceramic materials and systems with a focus on the chemical composition and materials’ properties; also it provides clinical recommendations for their use. RESULTS: The glass-matrix ceramics and polycrystalline ceramics are presented, as well as recently introduced machinable materials, all-zirconia and resin-matrix ceramics. The specific properties of zirconia, such as transformation toughening, stabilisation of the crystallographic structure, low-temperature degradation and factors affecting the zirconia’s ageing, are emphasised. CONCLUSION: The favourable properties of the resin-matrix ceramics, such as modulus of elasticity similar to dentin, shock-absorbing characteristics and high resilience and fracture resistance, are also covered in this article

Retention of Approximal Guiding Plane Surfaces in Removable Partial Skeletal Prosthesis

BACKGROUND: The morphology of the retention tooth often does not correspond with the required design; hence there is often an indication for enamel recontouring or other restorative procedures.AIM: The study aimed to determine the impact of changing the path of insertion of the prosthesis by reshaping the anatomical and morphological structures of the natural teeth predetermined for the retention of the prosthesis.MATERIAL AND METHODS: The group of 40 patients with Class II, Subclass 1 according to Kennedy was formed, and 120 approximal surfaces of retention teeth were obtained. Two different types of prostheses were made on the models: one group in the zero point position of the model, and another group in the zero position of the model, with changing of the direction of input at an angle of 2Ëš.RESULTS: The difference between the established and theoretical normal distribution of frequencies was tested with the Kolmogorov-Smirnov and Lilliefors tests (r < 0.10; r < 0.01). The first group showed a retention force of 0.08 N. In the second group the retention force was 0.94 N.CONCLUSION: It could be concluded that the change in the path of insertion of the dental prosthesis with conservative restorations as composite inlays, as well as the accurate extension of the prosthesis onto guiding plane surfaces, will undoubtedly increase the retention force of the prosthesis

Acid Etching as Surface Treatment Method for Luting of Glass-Ceramic Restorations, part 1: Acids, Application Protocol and Etching Effectiveness

AIM: The purpose of this review is to represent acids that can be used as surface etchant before adhesive luting of ceramic restorations, placement of orthodontic brackets or repair of chipped porcelain restorations. Chemical reactions, application protocol, and etching effect are presented as well.STUDY SELECTION: Available scientific articles published in PubMed and Scopus literature databases, scientific reports and manufacturers' instructions and product information from internet websites, written in English, using following search terms: “acid etching, ceramic surface treatment, hydrofluoric acid, acidulated phosphate fluoride, ammonium hydrogen bifluorideâ€, have been reviewed.RESULTS: There are several acids with fluoride ion in their composition that can be used as ceramic surface etchants. The etching effect depends on the acid type and its concentration, etching time, as well as ceramic type. The most effective etching pattern is achieved when using hydrofluoric acid; the numerous micropores and channels of different sizes, honeycomb-like appearance, extruded crystals or scattered irregular ceramic particles, depending on the ceramic type, have been detected on the etched surfaces.CONCLUSION: Acid etching of the bonding surface of glass - ceramic restorations is considered as the most effective treatment method that provides a reliable bond with composite cement. Selective removing of the glassy matrix of silicate ceramics results in a micromorphological three-dimensional porous surface that allows micromechanical interlocking of the luting composite

Temporomandibular Disorders Treatment with Correction of Decreased Occlusal Vertical Dimension

BACKGROUND: The term decreased occlusal vertical dimension refers to the reduced distance between two anatomical points while the teeth are in a state of occlusion. The development of this situation is about some parafunctional activities of the masticatory system. AIM: To evaluate the value of decreased occlusal vertical dimension in cases with temporomandibular disorder and to follow up the influence of corrective treatment with occlusal splints and definitive prosthetic construction upon the elimination of clinical symptoms. MATERIAL AND METHODS: Eight cases with decreased occlusal vertical dimension accompanied with temporomandibular disorders were treated with an occlusal splint, as part of reversible occlusal treatment. After reducing, or complete elimination of the symptoms related to problems of decreased occlusal vertical dimension, the definitive prosthetic therapy was performed. RESULTS: The mean value of decreased occlusal vertical dimension in our patients is 8.5 mm, and the mean value of therapy time with an occlusal splint in these patients was 3.5 months. CONCLUSION: Occlusal splint is a part of reversible occlusal therapy in cases with decreased occlusal vertical dimension. After reducing the symptoms related to decreased occlusal vertical dimension definitive prosthetic therapy can be done

Fracture localization of composite veneers with different preparation designs exposed to compressive load

Background: The aim of this in vitro study was to evaluate the localization of fracture of composite veneers with three different incisal preparations. Methods and Materials: 15 extracted human permanent maxillary central incisors were divided into three groups (n=5). Teeth from each group were prepared with different type of preparation for producing veneers. Group 1: feather preparation; group 2: bevel preparation and group 3: incisal overlap-palatal chamfer. Composite veneers were produced using light-curing technical composite In:joy (DeguDent) and bonded to the prepared maxillary central incisors using resin cement RelyX Veneer (3M ESPE). Specimens were loaded to fracture in universal testing machine TRITECH WF 10056 (WykehamFarrance,Milan,Italy). The localization of fracture was recorded and data were statistically analyzed. Results: The most common localization of fracture in group 1 was gingival, group 2 incisal, while in group 3 in two specimens only incisal and three specimens with incisal and gingival localization. Conclusion: Preparation design had a significant effect on the fracture localization. According to the results, the preferred preparation designs is incisal overlap-palatal chamfer. The veneers with this type of preparation exhibited better fracture resistance and superior aesthetic for the patient

Oral hygiene in patients with fixed prosthodontic restorations

The aim of this study was to estimate the oral hygiene and gingival condition in patients with fixed prosthodontic restorations for a period of 3 months along with the oral hygiene instructions. The study included 60 patients with fixed prosthetic appliances. Medical examinations of dental condition were carried out using basic diagnostic tools like dental mirror and periodontal probe. As well, we examine how factors, such as: age, gender, type of fixed dental prosthesis (single crown or fixed partial denture) and material (metal or porcelain fused to metal) are statistically associated with oral hygiene and gingival condition. Plaque and Gingiva index was taken according to the method of Silness and Löe. The examination was accomplished on the first dental visit, after 14 days and three months appropriately with the oral hygiene instructions. Statistical analysis was performed by using paired sample t-test from Statistical software SPSS for Windows version 23. A p-value <0.05 was considered as statistically significant. Our results confirmed that the Plaque and Gingiva index had higher values in the first visit than that found in the other periods. Patients with crowns had better oral hygiene levels compared to fixed dental prosthesis wearers. No statistical differences were found for type of material. Also, younger patients showed better hygiene levels than the older ones. Our research showed that adequate education and instructions for oral hygiene maintenance lead to improved oral hygiene both in patients with single crown or fixed dental prosthesis

Oral surgery treatment in the patients with combination syndrome

Introduction: Combination syndrome is periodicly associated in wearers with removable dentures, were upper is complete denture and lower is partial denture with some of the anterior natural teeth still in the mouth. Material and method: The study was provided on five patients with removable dentures at the Department of prosthodontics in the period of last three years. Three of them have weared the dentures more then ten years, and came to the clinic for new one. Another two patients have weared removable dentures between two and four years, and came because in the frontal part of the upper jaw appeared swollen. By clinical examination in all patients we noticed: hyperplastic tissue in the pre-maxillary region, reduction of the residual ridge on the frontal part of the maxilla as a result of the increasing pressure from the anterior teeth of thelower jaw.This tissue was removed by oral surgery (laser removing of hyperplastic tissue). Also we noticed periodontal changes and extrusion of natural lowerfrontal teeth and increased reduction of mandibular residual ridge. Results and conclusion: After healing period we made: new dentures in the three patients which were covered by the HIFM andin another two patients we made indirect relining on the upper denture, re-occlusion and re-articulation achieving a weak contacts between the lower natural teeth and upper teeth of the complete denture. We cautioned the patients not to bite food with anterior teeth and to avoid chewing very hard food which tends to imprint and displace dentures and of course to came to regular controls. Keywords removable dentures, combination sindrom, hyperplastic tissue, oral surgery treatment