Effect of retention design of artificial teeth and implant-supported titanium CAD-CAM structures on fracture resistance

Background: For implant-supported hybrid prostheses, high mastication forces and reduced acrylic resin thickness over a metal substructure often cause failures arising from tooth or resin fractures. To assay fracture resistance of artificial teeth and resin in implant-supported hybrid prostheses in relation to the titanium structure and retention design supporting teeth. Material and Methods: 40 specimens bearing incisors were divided into four groups according to the titanium structure supporting the teeth and the type of load force applied: Group I (Control; n=10): Application of static loading to ten incisors set over a metal structure with internal retention. Group II (Control; n=10): Application of static loading to ten incisors set over a metal structure with external retention. The remaining study specimens (n=20) were subjected to 120,000 masticatory and thermal cycles in a chewing simulator. Afterwards, static loading was applied until the point of fracture using an Instron machine. Group III (Study; n=10): Application of dynamic and static loading to ten incisors set over a metal structure with internal retention. Group IV (Study; n=10): Application of dynamic and static loading to ten incisors set over a metal structure with external retention. Data obtained for the four groups was analyzed and compared, determining the type of fracture (cohesive or adhesive) using a reflected light microscope. Results: Statistical analysis confirmed that there were significant differences in fracture resistance between the four groups. External retention was found to have more fracture resistance than the internal retention. Conclusions: Hybrid prostheses with titanium substructures and external retention obtained significantly better results than samples with internal retention

Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: retrospective study of a cohort of edentulous patients

Background: This work aims to confirm if implant-supported overdentures are a good treatment option for edentulous patients and offer an improvement in quality of life compared with traditional complete prostheses (dentures). Material and Methods: This retrospective clinical descriptive study included three evaluation groups: validation group (n=57); control group of patients with complete removeable prostheses (n=56); study group of patients with implant-supported overdentures retained with the Locator® system (n=80). The study also validated the Oral Health Impact Profile-20 questionnaire. Individual protocols were created that included socio-demographic data, the Oral Health Impact Profile-20 (OHIP-20) questionnaire and Oral Satisfaction Scale (OSS). Descriptive and bivariate statistical analysis was carried out applying χ², Pearson, Kruskal-Wallis, and Student t tests, transferring data into SPSS-Windows® software from a Microsoft® Excel spreadsheet. Results: The OHIP-20 proved to be a valid instrument and provided reliable assessment of health-related quality of life among both the Spanish general population and edentulous patients. The control and study groups proved comparable, showing socio-demographic homogeneity. For patients with overdentures retained by means of the Locator® system, these restorations had significantly lower impact on quality of life (19 vs 33), both generally and for each individual questionnaire item, and much higher satisfaction with the state of their oral cavities (8.3 vs 5.3) than patients wearing dentures; both sets of data showed a direct linear relationship, so that as the level of impact on quality of life increased, perceived oral satisfaction worsened. Conclusions: Patients rehabilitated with implant supported overdentures retained by the Locator® system, presented significantly lower levels of impact on their quality of life and significantly higher oral satisfaction than patients with conventional complete prostheses

Study of the interocclusal distortion in impressions taken with different types of closed-mouth trays and two types of impression materials

The aim of this study was to compare different types of impression trays for the closed-mouth impression technique, using two different types of impression material. For this study, five different types of impression trays were used with two different types of impression materials, one of addition silicone and the other of polyether. We designed a model used for taking the impressions and for measuring interocclusal distortion. The results obtained show that the impression trays COE (GC (R) GC America INC. Alsip) and Premier (Premier (R), Premier Dental Products Co. Canada) show a lesser degree of interocclusal distortion when taking closed-mouth impressions. In terms of impression materials, the polyether was the one that produced the best results. From a clinical point of view, our study shows that the use of these types of trays is absolutely recommendable when used according to the clinical indications for which they have been designed; that said, we must not fail to consider that selecting the proper type of tray is also important

Comparison of the retention strengths of three complete denture adhesives : an in vivo study

Statement of problem: One of the main problems posed by complete dentures is retention and stability. In order to solve this problem, dentists and the dental industry for a long time have attempted to improve denture adhesion by developing a range of ?glues? of highly varied composition and efficacy. Purpouse: The present in vivo clinical study evaluates whether the adhesives used to improve complete denture retention are truly effective and able to increase denture adhesion to the mucosa covering the edentulous alveolar ridge of the mandibular dentures. Material and Methods: An in vivo clinical study is made of 30 patients with complete mandibular dentures to evaluate the retention afforded by three commercial complete denture adhesives (Benfix®, Fittydent® and Supercorega®). A spring scale was used to measure retention strength (in grams). The purpose was to determine whether the use of complete denture adhesives is effective, and to establish which commercial brands offer the highest retention strengths. Results and Conclusion:The results obtained indicate that retention is enhanced by the use of such adhesives, and that Fittydent® offers the best retention performance, followed by Benfix® and Supercorega®. Clinical implications: the study of denture adhesives and his efficiency are necessary to improve the edentulous patient satisfaction. More in vivo investigations are necessary in dental literatur

Bone resorption processes in patients wearing overdentures : a 6-years retrospective study

1. ? To measure the alveolar resorption processes that occur in patients wearing mandibular overdentures on 2 implants and fully-removable maxillary dentures, and to evaluate the same process on patients wearing fullyremovable dentures on both arches. 2.- To verify whether Kelly?s Combination Syndrome occurs in the group of patients wearing overdentures. Method and Material: Forty patients were evaluated, of which a ?cases? group was formed by 25 patients wearing mandibular overdentures on 2 lower jaw implants and fully-removable dentures on the opposite arch. The other 15 patients formed a control group that wore fully-removable dentures on both arches. Each one of the patients underwent orthopantograms from the moment the dentures were inserted until an average of 6 years later, which were assessed based on the Xie et al. method to estimate vertical bone loss. Once the data was collected, it was subjected to statistical analysis. Results: In terms of the maxillary midline, we observed a greater loss in patients wearing overdentures, which was statistically significant, as it registered 0.32 mm/year. Mandibular bone loss was 2.5 times less in patients in the cases group. The rest of the clinical criteria for Kelly?s Combination Syndrome were not observed. Conclusions: Kelly?s Combination Syndrome did not occur in the patients in the cases group. In spite of the greater bone loss on a premaxillary level in this group, the placing of the overdenture on the implants significantly reduced mandibular bone resorption

Changes in Antioxidant Endogenous Enzymes (Activity and Gene Expression Levels) after Repeated Red Wine Intake

6 páginas, 7 figuras, 3 tablas.The antioxidant properties of wine have been largely related to the reactive oxygen species (ROS) scavenging ability of phenolic compounds. Polyphenolic compounds are hardly absorbed and quickly transformed into metabolites. Their antioxidant activities just as radical scavenging properties are therefore limited, but it is worth looking to other mechanisms. This study intended to test whether wine consumption affects antioxidant enzyme activity and gene expression. For this purpose, eight subjects drank 300 mL of red wine every day for a week and ate a low phenolic diet (LPD + W) specifically designed to avoid interferences from other polyphenols in the diet. The control period was a week with this diet, and volunteers refrained from drinking wine (LPD). Blood samples were taken at 0, 1, and 7 days. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione reductase (GR) activities were determined in erythrocytes (SOD), plasma (CAT and GR), and blood (GPx). Gene expression was determined in macrophages. Oxidative stress caused by LPD reduced SOD, CAT, and GR activities. After wine consumption, these activities significantly increased (P < 0.05), and this overcame the effect of oxidative stress on enzyme activity. The modulation of CAT activity may be independent of changes in their gene expression, which significantly increased after LPD. However, SOD gene expression increased only during the LPD + W week. Enzyme activities are not all regulated in the same way. The results show that subacute moderate wine ingestion modulated antioxidant enzyme expression and activity, which is important for the prevention of ROS-associated diseases.We thank the Spanish Ministry of Science and Education for financial support (AGL 2007-64622).Peer reviewe

Analysis of Predisposing Factors for Rapid Dental Calculus Formation

Background: Calculus accumulation varies widely between individuals. Dental calculus has been associated with the principal periodontal diseases. The aim of this study was to analyze individual characteristics, and salivary and microbiological parameters among patients considered to be rapid calculus formers and patients who form calculus slowly. Methods: Individual characteristics were recorded in a sample of 74 patients (age, sex, smoking, periodontal diagnosis, and dental crowding), as well as salivary parameters (unstimulated saliva flow, pH, and biochemical analysis of saliva) and microbiological parameters (by means of semi-quantitative polymerase chain reaction (PCR) analysis). Results: A statistically significant association (p = 0.002) was found between the rate of calculus formation and the diagnosis of periodontal disease. A greater presence of dental crowding was observed among the group of rapid calculus formers. Urea and phosphorus levels were higher among rapid calculus formers. Regarding microbiological parameters, differences were found in Streptococcus mutans, this being higher in the group of slow formers. Conclusions: Rapid calculus formation appears to be linked to patients diagnosed with more severe periodontal diseases. Rapid calculus-forming patients present more dental crowding and a lower proportion of S. mutans

Accuracy combining different brands of implants and abutments

Objective: To evaluate the vertical misfit between different brands of dental implants and prosthetic abutments, with or without mechanical torque, and to study their possible combination. Study design: Five different brands of implant were used in the study: Biofit (Castemaggiore, Italy), Bioner S.A. (Barcelona, Spain), 3i Biomet (Palm Beach, U.S.A.), BTI (Alava, Spain) and Nobel Biocare (Göteborg, Sweden), with standard 4.1 mm heads and external hexagons, and their respective machined prosthetic abutments. The implant-toabutment fit/misfit was evaluated at four points (vestibular, lingual/palatine, mesial and distal) between implants and abutments of the same brand and different brands, with or without mechanical torque, using SEM micrographs at 5000X. Image analysis was performed using NIS-Elements software (Nikon Instruments Europe B.V.). Results: Before applying torque, vertical misfit (microgaps) of the different combinations tested varied between 1.6 and 5.4 microns and after applying torque, between 0.9 and 5.9 microns, an overall average of 3.46±2.96 microns. For manual assembly without the use of mechanical torque, the best results were obtained with the combination of the 3i implant and the BTI abutment. The Nobel implant and Nobel abutment, 3i-3i and BTI-BTI and the combination of 3i implant with BTI or Nobel abutment provided the best vertical fit when mechanical torque was applied. Conclusions: The vertical fits obtained were within the limits considered clinically acceptable. The application of mechanical torque improved outcomes. There is compatibility between implants and abutments of different brand and so their combination is a clinical possibility.Solá-Ruiz, M.; Selva-Otaolaurruchi, E.; Senent-Vicente, G.; González-De-Cossio, I.; Amigó Borrás, V. (2013). Accuracy combining different brands of implants and abutments. Medicina Oral, Patología Oral y Cirugía Bucal. 18:332-336. doi:10.4317/medoral.18137S3323361

Maxillary Implant-Supported Overdentures: Mechanical Behavior Comparing Individual Axial and Bar Retention Systems. A Cohort Study of Edentulous Patients

Background and objectives: To compare the medium- to long-term mechanical behavior of overdentures with two different retention systems: overdentures with Locator&reg; axial retention, and vertical insertion overdentures with bar retention, used to rehabilitate edentulous maxillar. Material and Methods: This prospective study assessed patients presenting complete maxillary edentulism, rehabilitated by means of implant-supported overdentures (n = 20), 10 with Locator&reg; axial retention (ODA group) and 10 with overdentures on bars (ODB group). Patients also completed a questionnaire to determine their satisfaction with treatment. Results: The mean follow-up time in both groups was 11.4 years, with follow-up times in both groups ranging from 5 to 14 years. The ODA group suffered mechanical complications such as retention loss, need for nylon retention insert changes, resin fracture, and need for relining. In the ODB group, prosthetic dental wear, screw loosening, and complete prosthetic failure were more common. A total of 19 implants failed (23.8%); of these, 11 were in the ODA group (failure rate = 27.5%) and eight in the ODB group (failure rate = 20%). The patient satisfaction questionnaire obtained a mean score of 7.9 out of 10 in the ODA group, and 9.75 in the ODB group. Conclusions: in rehabilitations of edentulous maxillar by means of implant-supported overdentures, both the systems assessed were shown to be effective in the medium to long term. Patients expressed a high level of satisfaction with the treatments received