Denture Adaptation Research Articles

Extremes in Denture Adaptation - Clinical and Psychological Influences

During evolutionary stages of different living organisms, new and challenging environments has prompted the development of adaptations that may be structural, physiological and behavioral. The clinical success of denture prosthesis treatment largely rests on patient’s ability to adapt which is time dependent. While the usual outcome by most of the patients is either an adaptation or maladaptation, it is rare to observe patients adapted to extremely faulty prosthesis. This article in the form of two case reports presents unique cases of extreme adaptation to the partial denture prosthesis. Both patients had their respective partial dentures resulted in the loss of their natural abutment tooth to which they were attached. In both cases the respective abutment teeth were dangling within the prosthesis. The extent of damage to the respective abutments were to the level of the apex of the root with one case being that of maxillary canine (longest root). Removal of the denture prosthesis led to the loss of natural tooth in both cases. Psychological aspects of such extreme denture adaptation have also been discussed.

An In Vitro Study of Intaglio Surface, Periphery/Palatal Seal Area, and Primary Bearing Area Adaptation of 3D-Printed Denture Base Manufactured in Various Build Angles.

The objective of this research was to compare the adaptation in the overall intaglio surface, peripheral/posterior palatal seal area, and primary bearing area of the 3D-printed complete denture produced in 0, 45, and 90° build angles. A reference edentulous maxillary arch model was scanned to design virtual denture bases with computer-aided manufacturing (CAD) software with standard tessellation language (STL) files as output. Denture bases were fabricated by printing with a digital light processing (DLP) technique and divided into 3 groups according to build angles of 0°, 45°, and 90° (n = 10). To assess the adaptation, each STL file of the intaglio denture base was superimposed on the STL file of the reference model using surface-matching software. The adaptation was reported in root mean square error (RMSE) values and statically compared using one-way analyses of variance (ANOVA) and followed by the Turkey's test for multiple comparisons with a significance level of α = 0.05. Overall, intaglio surface adaptation of denture bases printed from three angles had no significant difference in adaption. In the peripheral/posterior palatal seal area, denture bases printed at a 90° build angle showed significantly better adaption than other groups. In the primary bearing area, denture bases printed at 45° and 90° had no significant difference in denture adaptation; however, they exhibited better denture base adaptation than the 0° group significantly. The build angle has no effect on adaptation in the overall intaglio surface area. The build angle of 90° provided the best adaptation in the peripheral/posterior palatal seal area. The 45° and 90° build angles provided better adaptation than 0° in the primary stress-bearing area.

Evaluation of the potential denture covering area in buccal shelf with intraoral scanner

Background/purposeThe characteristic of soft tissue changes in buccal shelf area during function is unclear. This study aimed for evaluating the potential denture covering area in buccal shelf area in different ranges of mouth opening by a digital approach. Materials and methodsNineteen qualified dentate participants were enrolled. An intraoral scanner was used to record soft tissue in buccal shelf area in different ranges of mandibular opening, which were maximum intercuspation, 10 mm, 20 mm, and 30 mm of interincisal distance. The experiment was performed by two examiners. The common area of each range was generated within the clinically acceptable denture adaptation range, which was represented as the potential denture covering area. Data were statistically analyzed using descriptive statistic, one-way repeated measure ANOVA, intraclass correlation coefficient (ICC), and the Pearson correlation test. ResultsTrends of the mean distance of the potential denture covering area increased from the frenum area to the second premolar and the first molar area then decreased in the second molar area, along with the ranges of mouth opening increased. The distance in the second molar area had drastic percentage changes during the mouth opening. The mean distances changed significantly when the mouth opening increased (P < 0.001). All ICC values of intra-, inter-rater reliability indicated good to excellent reliability. The correlation between the results from two examiners was strong (P < 0.001). ConclusionThe characteristic of the denture covering area posteriorly to the first molar area is inversely proportional in length to ranges of mouth opening.

Prevention of inflammatory changes in the denture-bearing mucous membrane

Relevance. Advanced clinical and cytological studies have not been conducted yet to examine denture adhesive effect on the prevention of inflammatory changes in the mucous membrane of the prosthetic bed, and thus, the prevention of denture-related stomatitis. Purpose: to assess the clinical and functional condition of the oral mucosa beneath the denture during the adaptation period using a denture adhesive cream to prevent inflammation of the denture bed mucous membrane.Materials and methods. The study clinically and cytologically (washing, scraping) assessed the condition of oral mucosa beneath complete acrylic dentures on days 14-16 and 28-30 of the adaptation period in 15 fully edentulous patients (main group), who used an adhesive cream after they were delivered their dentures, and in 21 fully edentulous patients (control group) who did not use the cream during the denture adaptation period. All the patients were elderly.Results. At different times of the adaptation period, the study more frequently detected inflammatory changes in the denture-bearing mucosa in subjects who did not use the denture adhesive cream. The cytological study confirmed the results of the oral clinical examination, as, at the end of the adaptation period, the number of cellular elements and various microorganisms was significantly lower in the main group than in the controls, which proved the effectiveness of the denture adhesive cream for the prevention of denture stomatitis.Conclusions. Regardless of sex, patients with complete acrylic dentures, who used a denture adhesive cream, had a lower bacterial accumulation on the prosthetic bed and inflammatory changes during the adaptation period, which allowed us to recommend the adhesive cream for the prevention of denture stomatitis.

AESTHETIC REHABILITATION OF MAXILLARY AND MANDIBULAR HOPELESS TEETH WITH IMMEDIATE REMOVABLE PARTIAL DENTURE

ABSTRACTBackground: Edentulism post tooth extraction is an undesirable state among patients, specifically with the involvement of anterior dentition. Immediate denture in cases of anterior teeth extraction is a selected treatment to recover aesthetic and phonetic function. This treatment shows an impact on psychological stability and improves patients’ confidence level. Objective: This case report provides information on the management of immediate removable partial denture for maxillary and mandibular teeth. Case: A female teacher suffered from tooth loss of 26, 28, 36, 46, 47. Tooth 11, 14, 21, 22, 31, 32, 41, 42 were not supported with adequate periodontal tissue and presented with level 3 tooth mobility. Patient expected the teeth to be removed and managed with prosthodontic appliance, yet disfavoring the stage of edentulism because her profession demanded high social performance. Case management: The treatment for this case includes immediate removable partial denture with acrylic material in upper and lower jaw. Denture was fabricated prior to the extraction of tooth 11, 14, 21, 22, 31, 32, 41, 42, and inserted promptly. The insertion result showed good occlusion, retention, stabilization, and tissue adaptation of denture. It also demonstrated good aesthetic result. On 24 hours control post insertion, wound closure was gradually established with the presence of redness. A week after insertion, wounded tissue had been fully covered and redness had been diminished. Conclusion: Immediate removable partial denture provides good aesthetic and function. Patient was satisfied with the treatment because it improved her appearance without experiencing any period of edentulism.Keywords: Aesthetics, Edentulous, Extraction, Immediate Removable Partial Denture.

Carnivorous mammals from the middle Eocene Washakie Formation, Wyoming, USA, and their diversity trajectory in a post-warming world

AbstractThe middle Eocene Washakie Formation of Wyoming, USA, provides a rare window, within a single depositional basin, into the faunal transition that followed the early Eocene warming events. Based on extensive examination, we report a minimum of 27 species of carnivorous mammals from this formation, more than doubling the previous taxic count. Included in this revised list are a new species of carnivoraform,Neovulpavus mccarrollin. sp., and up to ten other possibly new taxa. Our cladistic analysis of early Carnivoraformes incorporating new data clarified the array of middle Eocene taxa that are closely related to crown-group Carnivora. These anatomically relatively derived carnivoraforms collectively had an intercontinental distribution in North America and east Asia, exhibiting notable variations in body size and dental adaptation. This time period also saw parallel trends of increase in body size and dental sectoriality in distantly related lineages of carnivores spanning a wide range of body sizes. A new, model-based Bayesian analysis of diversity dynamics accounting for imperfect detection revealed a high probability of substantial loss of carnivore species between the late Bridgerian and early Uintan North American Land Mammal ‘Ages’, coinciding with the disappearance of formerly common mammals such as hyopsodontids and adapiform primates. Concomitant with this decline in carnivore diversity, the Washakie vertebrate fauna underwent significant disintegration, as measured by patterns of coordinated detection of taxa at the locality level. These observations are consistent with a major biomic transition in the region in response to climatically induced opening-up of forested habitats.UUID:http://zoobank.org/9162f1a6-a12c-4d55-ba1d-dc66e8cda261

Effects of fabrication techniques on denture base adaptation: An in vitro study

Statement of problemInformation about the accuracy of maxillary and mandibular denture bases made with different fabrication techniques under uniform test conditions is lacking. PurposeThe purpose of this in vitro study was to evaluate the denture base adaptation of computer-aided design and computer-aided manufactured (CAD-CAM) milled, 3D printed, and conventional heat-polymerized resin fabrication techniques. Material and methodsMaxillary and mandibular edentulous models fabricated from cobalt-chromium alloy were scanned, and 2-mm-thick denture bases were designed and fabricated by using 4 fabrication techniques and materials: CAD-CAM milled (CCM), 3D printed (3DP), injection molded (IM), and compression molded (CM). Denture base adaptation was assessed by measuring the thickness of silicone between the denture base and model under a 49-N load at 8 sites. A digital superimposition method was used to compare different groups, and adaptation was assessed by superimposing the scanning data from denture bases and models. The pairwise Wilcoxon signed rank test and Kruskal-Wallis analysis of variance were used for statistical analyses (α=.05). ResultsAccording to the silicone thickness method, the lowest values (0.127-0.567 mm) were present at the bilateral maxillary tuberosities, and the highest values (0.529-2.211 mm) occurred at the postpalatal seal area in all groups. The CCM group had the lowest silicone thickness (P<.05). The 3DP group recorded greater thickness than the IM and CM groups (P<.05). In the mandible, the 3DP group recorded the lowest silicone thickness, followed by the CCM group. The overall results for digital superimposition revealed no significant difference (P>.05) in the trueness of the intaglio surfaces among CCM, IM, and CM. The 3DP group recorded the lowest trueness significantly among all the groups. ConclusionsCCM, IM, and CM exhibited superior denture adaptation, especially CCM, to both maxillary and mandibular arches compared with 3DP.

Evaluation of the Adaptation of Complete Dentures Fabricated Using Intraoral Scanning and Conventional Techniques

This study aimed to digitally analyze the 3-dimensional variations existing between conventional impressions and intraoral scans made in edentulous maxillae. Ten (n = 10) edentulous maxillae of patients seeking a maxillary complete denture were scanned using an intraoral scanner. The same participants were subject to the conventional impression procedure for the fabrication of maxillary complete dentures. The dentures' intaglio surfaces were scanned and superimposed over their corresponding IOS files with a 2-base best-fit alignment. Deviation analyses were calculated using the digital subtraction technique. Four anatomical regions were preselected to evaluate the deviations at these sites (posterior palatal seal, anterior border seal, the crest of the ridge and palate). Based on the results and color maps of all selected regions, the overall difference between the two scans [IOS and denture intaglio surface scanning (DISS)] was not significant. The IOS technique allowed for predictable outcomes of treatment compared to those observed with conventional impression. The palatal area seems to be the region with the least deviation, while the highest incidence of discrepancy was reported in the anterior border seal. Within the limitations of this study, the IOS technique allowed the capturing of intraoral tissues and their immediate interpretation and transfer to a designing software making the impression procedure faster and easier. The computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies can help overcome many limitations related to conventional impressions and therefore should be well investigated to improve the edentulous patient's quality of life.

Recording and incorporating Oromuscular balance for a complete denture prosthesis

Excessive and loose movable flabby tissue is often present in the mandibular anterior residual alveolar ridge area and mild to moderate cases resolve by oral physiotherapy. However, they compromise denture stability to a large extent. The use of the neutral zone to locate placing artificial denture teeth enhances stability since the orofacial musculature does not tend to unseat the denture in such cases. We present a case of an elderly male patient who was wearing a two-month-old complete denture and had developed mild to moderate flabby tissue in the mandibular anterior residual alveolar ridge. While most of the flabby tissue was resolved by physiotherapy, the location of artificial denture teeth in the neutral zone ensured faster denture adaptation of the patient thus producing better compliance. A novel technique of recording and incorporating neutral zone using zinc oxide eugenol impression paste on the occlusal rims have also been described.

AMELOBLASTOMA RECURRENCE 10 YEARS AFTER CONSERVATIVE SURGICAL APPROACH: A CASE REPORT

A 36-year-old male patient showed up for evaluation because of lack of adaptation of partial denture with ± 1-year evolution. He had a previous diagnosis of ameloblastoma in the anterior mandible, excised 10 years ago. Intraoral examination revealed solitary swelling with smooth surface with the same color as the adjacent mucosa involving both vestibular and lingual surfaces of the mandible around the left premolars. Panoramic x-ray showed an expansive soap-bubble lesion with well-demarcated borders. Histopathologic examination of the incisional biopsy specimen revealed follicles that consist of a core of loosely arranged angular cells resembling the stellate reticulum of the enamel organ, sometimes presenting a squamous differentiation and microcyst formation, surrounded by a single layer of tall columnar ameloblast-like cells with nuclei located at the opposite pole of basement membrane. These findings plus the previous medical history established the diagnosis of ameloblastoma. The patient is waiting for another resection surgery.

QUANTITATIVE CHARACTERISTICS OF GENERAL MICROBIAL COLONIZATION OF ORAL MUCOSA DURING ADAPTATION TO ACRYLIC REMOVABLE PARTIAL DENTURE

Relieving the process of dentures adaptation and, as a result, the quality of prosthetic care arouses growing interest to the investigation of the adhesion and microbial contamination of the bases of removable dentures made of various materials. The purpose of this work was to study the oral microbial colonization during adaptation to removable partial dentures with an acrylic basis. Materials and methods. The study involved 15 patients. The first group consisted of 10 patients with dentition defects who were recommended to wear removable partial dentures for dentition correction. The comparison group included 5 patients with sanitized oral cavity, who did not need any orthodontic treatment. To study aerobes and facultative anaerobes of oral mucosa, sampling of material for microscopy was performed using the sterile dental paper pin (No. 30) from a total area of 1 cm2 with following of microorganism culturing in a nutrient medium at 37 °C. The microbial population of the oral mucous was determined on Petri plates by counting the number of colony-forming units per 1 cm3 of biomaterial taken from patients before denture wearing, and then in 3 and in 4 days of denture wearing. The results obtained were statistically processed by the standard software package Microsoft Excel 2016, the analysis of reliability was performed by Student’s t-test. Results. Wearing removable partial dentures with a basis of acrylic plastic contributed to a significant increase in the total microbial colonization of the mucous membranes of the oral cavity by the third day of denture wearing. Moreover, the number of colony-forming units/cm3 on the oral mucosa under the dentures steadily was growing during the next two weeks of denture adaptation.

In-vitro antifungal efficacy of tissue conditioner-chitosan composites as potential treatment therapy for denture stomatitis

Tissue conditioners are commonly used to improve the adaptation of ill-fitting dentures. These materials are easily colonized by Candida albicans (C. albicans), resulting in “denture stomatitis”. Chitosan and its derivative possess inherent antifungal activity. This study aims to formulate a chitosan-based tissue conditioner and assess its anti-fungal efficacy against C. albicans over time.A chitosan oligosaccharide (COS) was synthesized from commercially purchased chitosan and was characterized by Fourier Transform Infrared spectroscopy (FTIR) and X-ray diffraction analysis (XRD). The minimum inhibitory concentration (MIC) of COS and commercial chitosan against C. abicans was evaluated using broth micro-dilution assay (n = 3). Next, it was incorporated into tissue conditioners and two experimental groups i.e. tissue conditioner modified by chitosan (TC-CH) and tissue conditioner modified by COS (TC-COS) were prepared. The in-vitro antifungal activity of experimental group was compared with a control group (chitosan-free tissue conditioner) by counting numbers of colony forming units (CFUs) (n = 3). The antifungal potential of experimental formulations over time in a simulated oral environment was also evaluated using a spectrophotometry (n = 3).A potent in-vitro antifungal activity against C. albicans was observed. The minimum inhibitory concentration (MIC) of pure commercial chitosan and COS was 0.625 mg/ml and 0.3125 mg/ml respectively. Compared to the control group, experimental groups showed a reduction in number of CFUs of C. albicans density. Once immersed in saliva, the TC-CH retained its inhibitory effect for 24 h, while TC-COS exhibited improved inhibition until the third day, beyond which a gradual reduction in the inhibitory effect was observed. Experimental formulations showed a reduction in C. albicans density compared to the control group. Thus, a novel combination of chitosan and tissue conditioners is a promising alternative for prevention and treatment of denture stomatitis.

Reabilitação temporária com mini-implantes em criança com displasia ectodérmica

Objetivo: apresentar a versatilidade de mini-implantes para reabilitação temporária de pacientes com displasia ectodérmica hipoidrótica (DEH). Relato de Caso: descreve a reabilitação iniciada em abril / 2015 em um menino de oito anos de idade com DMC e histórico familiar da doença. Tendo em vista o grande número de casos relatando a difícil adaptação de próteses removíveis em crianças, a reabilitação oral desse paciente foi planejada com base na fabricação de próteses apoiadas em mini-implantes ortodônticos. Conclusão: esta abordagem alternativa facilita o uso e adaptação de próteses, promove a preservação do osso alveolar e melhora as condições funcionais, estéticas e psicossociais do paciente. Deve haver acompanhamento clínico anual radiográfico e trimestral até o final do estirão de crescimento, para reavaliação e renovação das próteses sempre que necessário, de acordo com a crista alveolar.

Clinical evaluation of chewing efficiency for flexible removable partial dentures in bilateral free-end saddle cases

Statement of problem: Increasing flexibility of removable partial denture increase the patient comfort and esthetics at the cost of bite force and chewing efficiency. Purpose: To compare and study the variation of chewing efficiency in different types of thermoplastic denture base materials used for restoring Kennedy class I removable partial dentures. Materials and Methods: Eight patients were included in the study. Four types (groups) of removable partial dentures will be made for every patient in the test group: thermoplastic Nylon RPD, thermoplastic Acetal RPD, thermoplastic PMMA RPD and thermoplastic PMMA with hard PMMA combination. Nylon and Acetal dentures were made using thermo-injectable technique. F. PMMA and H. & F. PMMA dentures were made using compression moulding technique. Chewing efficiency was measured after 1 week, 3 months and 6 months follow-up period for the two types. Chewing efficiency was evaluated by colored chewing gum and computerized color analysis. The test data were collected and analyzed. Results: H. & F. PMMA and F. PMMA had higher chewing efficiency than Nylon and Acetal 1 week after insertion for all chewing cycles. Only 10 chewing cycles affected by increasing the follow up period and denture adaptation for all types. Conclusion: Combination of flexible denture base materials with hard denture base material is recommended to enhance chewing efficiency.

Adaptation to new complete dentures-is the neuromuscular system outcome-oriented or effort-oriented?

The aim of this study was to observe the adaptation strategy of the stomatognathic system during the adaptation of complete dentures, comprising masticatory parameters and subjective measures. Our hypothesis was that with new dentures, masticatory performance would increase while the effort of the system is kept constant. Thirty-two patients received standardized new complete dentures. Masticatory performance tests were conducted with old dentures (T1), immediately after incorporation of new dentures (T2) and after an adaptation period of 3months (T3). Patients habitually chewed the silicone-based artificial test food Optocal. The comminuted test food was analyzed and mean particle sizes (x50) were calculated. Simultaneously, surface EMGs of the anterior temporalis and masseter muscles were recorded. Specific (SMW) and total muscle work (TMW) were determined. Patients filled in the OHIP-49 questionnaire. Test conditions were compared using repeated-measures ANOVA with SPSS 22 (SPSS Inc.) RESULTS: Masticatory performance increased (P = 0.016) between old (x50 = 4.99 ± 0.28) and adapted new dentures (x50 = 4.80 ± 0.33). TMW deteriorated (P = 0.004) at T2 (from TMW1 = 119.77 ± 56.49 to TMW2 = 92.12 46.27), and increased again (P = 0.028) at T3 (TMW3 = 107.66 ± 44.65). OHIP scores decreased significantly in all subscales (P < 0.001…P = 0.046); the total score was reduced (P < 0.001) from 56.24 ± 29.05 (T1) to 34.66 ± 24.74 (T3). In complete denture wearers, masticatory performance improves over an adaptation period. Muscle work initially decreased before reaching its original level again after adaptation. Subjective parameters overestimated the functional improvements. The subjective evaluation does not adequately reflect functional improvements. The assessment of function requires an adaptation period.

The Knowledge And Practice Of Copy Denture Technique Among Dentist And Dental Technologist

Introduction: Copy denture technique is a classic technique for construction of a new denture based on the favourable aspects of the original denture using a replica. This technique helps in adaptation of new denture in elderly population. The aim of this paper was to assess the knowledge and practice of copy denture technique among dentists and dental technologists. Materials and Methods: A pre-tested questionnaire was sent to all participants who attended the Copy Denture Workshop organized by USIM on 13th April 2017. Two sets of the same questionnaire were distributed to the participant before and after the seminar. Results: Out of 100 participants, only 77% (n=77) have given valid feedbacks. The results showed, even though 54.5% (n=42) participants had more than 5 years of clinical experience, 42.9% (n=33) of the participants have poor knowledge in this technique before the seminar begin. However 55.9% presented with positive attitude towards copy denture. Most of the participants did not know about copy denture technique (43.1%) and the advantages of the technique (32.9%). 74.1% (n=57) participants were uncertain to perform the technique and did not have the skills to perform the copy denture technique. However, after attending the workshop, their attitude towards copy denture increased (+15.6%) and the mean score value was statistically significance with p-value 0.049. Conclusion(s): Awareness and workshop on copy denture technique should be encouraged to improve knowledge and practice, so that the patient who requested for replacement denture will benefit from this technique.

CARCINOMA EX PLEOMORPHIC ADENOMA OF A MINOR SALIVARY GLAND: A CASE REPORT

Carcinoma ex pleomorphic adenoma is a rare and aggressive malignancy that usually develops in primary or recurrent pleomorphic adenoma. A 55-year-old male patient presented a swelling on the palate with 2 years history of evolution, reporting difficulty in adaptation of upper dentures. Intraoral examination revealed a mass covered with non-ulcerated mucosa of firm consistency, non-tender. The lesion was completed excised and sent to microscopic evaluation. Histopathologic examination revealed a neoplastic lesion characterized by proliferation of cells, resembling myoepithelial cells, disposed in lumen structure bounded by eosinophilic, cuboidal, intercalated duct-like cells, embedded in a myxoid background stroma. Capsular integrity was incomplete with infiltration by islands of atypical cells with hyperchromatic and hypertrophic nucleus, amid necrosis areas suggesting malignancy. The diagnosis of carcinoma ex pleomorphic adenoma was established. The patient is on follow-up of 1 year and there are no signs of recurrence.

Does a face-bow lead to better occlusion in complete dentures? A randomized controlled trial: part I.

In a double-blinded randomized controlled clinical trial, the impact of face-bow registration for remounting complete dentures (CDs) on the occlusal parameters (part I) was evaluated. New CDs of 32 patients were duplicated and mounted after intraoral pin registration according to mean settings (group 1) and (group 2) using a face-bow (arbitrary hinge axis). The vertical dimension was reduced to the first occlusal contact point, and a bite record was fabricated in the articulator. The number of contacts and the number of teeth in contact were evaluated by a computer program (laboratory result). After randomization, half of the CDs were adjusted according to protocol of group 1 and group 2 and delivered to the patients. After 3days (T1) and 84days (T2), clinical static contact points and teeth in contact were counted. Contact points and teeth in contact of both groups (laboratory results) and at different moments (clinical results) were analyzed statistically with the F test and bootstrapping. Laboratory: No. 2 (face-bow) showed more occlusal contact points than no. 1 (mean setting), p>0.05. The number of teeth with at least one occlusal contact was significantly higher in no. 2 (p=0.027). Clinic: The mean number of teeth with at least one clinical contact point was significantly higher in no. 1 (no. 1=7.13, no. 2=5.31; p=0.042). Extent of the vertical shift poorly correlated with number of laboratory occlusal contact points (R 2=0.017). Considering the complex multistep study design, a limited number of participants, and referring to one specific arbitrary face-bow, the following conclusion could be drawn: no substantial difference by the use of the arbitrary face-bow compared to a mean setting could be determined, when changing the vertical dimension in the articulator within a remounting procedure of complete dentures. Further research is necessary to determine the effects of different arbitrary face-bows on the fabrication and adaptation of removable dentures.

Assessing different patterns of laser welding with Nickel-Chromium (Ni-Cr) alloy for structures applicable to fixed prosthesis

Among all desired requirements to dental prosthesis, marginal adaptation and passive fit are the most important. In some cases, in order to achieve these goals, it is necessary to cut and weld the teeth / implant-supported framework. Nowadays, the laser welding process shows a great advantage in comparison to other methods. The aim of this study was to evaluate the optimal laser welds point that is more appropriate to Ni-Cr prosthetic framework. A total of 60 specimens of Ni-Cr (35 mm x 4 mm) were designed and welded using a Nd:YAG laser device model EV 900. They were fixed in a metal piece 0.27 mm between the ends to be welded. All specimens were welded with 21 laser pulses diametrically opposed (frequency of 1.0Hz, load time 3.0 ms and 0.5 mm of diameter pulse). They were divided into three groups according to the electric current of the laser weld: A – 180A; B – 200A and C – 220A. To determinate the flexural mechanic strength, all specimens were submitted to a three-point bending test. The results obtained were: Group A = 553 Mpa; B = 751 Mpa and C = 802.1 Mpa. The control group was 1040.9 Mpa. ANOVA and Tukey’s test were performed and statistical significance differences were observed between group A and B as well as between group A and C. However, no significant difference was observed between B and C.

REGULATIONS «MULTISTEP» DENTAL CARE FOR CHILDREN WITH NEUROPSYCHIATRIC DISORDERS

Given the high rates of dental disease de children with neuropsychiatric disorders, there is a need to develop an algorithm to provide the necessary dental care. Embedded regulations Multistep represents rehabilitation area dental individualized care for children with neuropsychiatric disorders, in which the central place is occupied by the interaction of the child and the adult (the doctor and parents) in terms of medical and correctional environment, creating favorable conditions for the compensation of polymorphic disorders, dental adaptation full rehabilitation.