Conventional Total Prosthesis Research Articles

IMMEDIATE PROSTHESIS:

The immediate total prosthesis is a device made before the exodontia and is installed soon after the accomplishment of the same ones. Faced with a situation in which the patient encounters the remaining condemned teeth, many resist to remain edentulous while awaiting the healing phase for the manufacture of a conventional total prosthesis; thus, the total immediate prosthesis becomes an ally in these cases, promoting the return of aesthetics, phonetics, chewing and social coexistence. Through a literature review, this work aims to clarify the pertinent issues of the immediate total dentures, where they were presented their classifications, advantages and disadvantages, indications and contraindications, technique of making this prosthetic device, besides post-installation care. Searches were made in the databases Scielo, Medline, Bireme, Google academic, Capes and books; using the key words: immediate total prosthesis; immediate oral rehabilitation; oral surgery and selected articles between the years 2009 to 2019. It was possible to conclude that the advantages of the rehabilitation with immediate prosthesis are very evident, being thus an advantageous alternative of treatment.

Effects of dental implant treatment on sleep quality in edentulous older people: A prospective cohort study.

Background Edentulism and sleep disturbances are commonly seen among older people and cause serious negative effects on their daily lives. Edentulism can induce sleep problems by changing maxillo-mandibular anatomy and surrounding soft tissues. The effect of the treatment of complete edentulism on sleep disturbances is not sufficiently understood. The purpose of this cohort study is to detect how different treatment options affect sleep quality, daytime fatigue and sleep disorder breathing in totally edentulous elderly people. Material and Methods Ninety-six individulas (50 male and 46 female) participated in this prospective cohort study. The patients were non-randomly assigned to three groups, fixed implant-supported prostheses (FP), removable implant-supported prostheses (RP) and conventional total prostheses (CP). The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the STOP-Bang questionnaire were calculated before (T0) and one year after (T1) their prosthetic rehabilitations. Results Although there was no statistically significant difference between groups in terms of mean PSQI (p=0.524), ESS (p=0.410) and STOP-Bang (p=0.697) scores at T0, there was a significant difference between groups in terms of mean PSQI (p=0.011), ESS (p=0.030) and STOP-Bang (p=0.024) scores at T1. The FP group, when compared to CP group was associated with significantly better scores in the PSQI (Δ = -3.399, 95% CI= -4.612 to -2.187), ESS (Δ = -1.663, 95% CI= -3.149 to -0.176) and STOP-Bang (Δ = -0.994, 95% CI= -1.592 to -0.397). Conclusions Within the limitations of this study FP was associated with a positive influence on sleep disturbances. Randomized controlled trials will be needed to provide reliable inference on this association. Key words:Dental implant, edentulism, older people, sleep disturbances.

Does number of implants or type of attachment affect patient satisfaction with implant-retained mandibular overdentures?

Aim This study aimed to determine, from the patients’ perspective, the optimal number of implants and the type of attachment used to support a mandibular overdenture. Materials and methods This study was conducted with 166 patients who had received new implant-retained overdentures (IODs) in the mandible and conventional total prostheses in the maxilla, and have been using for at least 1-year. Three types of attachment (ball attachment, bar holder, and locator) were connected to either two or four implants. Patients completed the OHIP–14 questionnaire, and the results were statistically analyzed. Results Patients were, in general, satisfied with their mandibular IODs (OHIP-ADD: 7.07 ±9.09, OHIP-SC: 0.95 ±2.11). While the satisfaction rate was higher for males (P 0.05). Higher satisfaction was observed for 4-implant support (P = 0.014), especially with bar holders (OHIP-SC: 0.13 ±0.43). No difference was found between the locator and ball attachment in prostheses with 2-implant (P > 0.05). Conclusion Four implant-support, in particular, with bar-holders, exhibited higher satisfaction. There was no difference between locator and ball attachment in terms of patient satisfaction.

Pain and function in eight hundred and fifty nine patients comparing shoulder hemiprostheses, resurfacing prostheses, reversed total and conventional total prostheses

Functional results of reversed total prostheses (RTP) have-to a very limited degree-been compared with those of other shoulder prosthesis types. The aim of our study was to compare results of four different types of shoulder prostheses in terms of function, pain, and quality of life (QoL). Questionnaires were completed by 859 patients with shoulder prostheses registered in the Norwegian Arthroplasty Register. Patients with osteoarthritis (OA), rheumatoid arthritis (RA), or fracture sequela (FS) were included. Symptoms and function were assessed using the Oxford Shoulder Score (OSS, scale 0-48), and the EuroQoL-5D (EQ-5D) was used to assess QoL. Best functional results were obtained using conventional total prostheses (TPs) and RTPs -mean OSS improvement 18 and 16 units, respectively, vs 11 with hemiprostheses (HPs). For patients with OA, TPs performed best; for those with RA and FS, RTPs performed best; and those with HPs had the worst results in all diagnostic groups. The greatest improvement in QoL was seen in patients with TPs and RTPs. Conventional TPs provide the best improvement in pain, function and QoL in OA patients; RTPs are superior in patients with RA and FS.

Technique and results of endoscopic tenotomy in iliopsoas muscle tendinopathy secondary to total hip replacement: A series of 10 cases

There have been numerous recommendations for management of iliopsoas tendinopathy secondary to hip replacement: medical treatment, cup replacement, and open or arthroscopic tenotomy. We report on a series of 10 endoscopic iliopsoas tenotomies. Arthroplasty comprised five primary conventional total prostheses, two large head diameter metal-metal models, one resurfacing and one revision arthroplasty. All patients underwent clinical (PMA, WOMAC), imaging (X-ray, CT, scintigraphy) and biological assessment. Seven cases showed mechanical impingement (six involving the anterior edge of the cup, and one a cement fragment); the other three involved large femoral components (two large head diameter models, one resurfacing). Infiltration test was positive in eight cases out of nine. Endoscopic iliopsoas tenotomy for recurrence was performed in dorsal decubitus on an ordinary table, under fluoroscopy, using two approaches (inferior for the endoscope, superior for the instruments) converging on the lesser trochanter. There were no complications. At a mean 20 months' follow-up (range, 12-60 months), mean pain grade was 5.5 (4-6). Eight patients showed complete relief, and two partial relief (two atypical cases). Mean PMA score was 16.9 (15-18) and mean WOMAC score 84 (60-95). Muscle force was recovered at a mean 3.25 months (0.5-6). Eight patients were very satisfied, one satisfied and one moderately satisfied. This technique is much less heavy than implant replacement; postoperative course is shorter than for open tenotomy and the technique is simpler than arthroscopic tenotomy, with lower risk. Subsequent cup change, where necessary, is not compromised. IV, retrospective, case series.

Flabby Ridge Correction Using an Auxiliary Technique With Connective Tissue Graft

A common finding in patients with edentulous maxilla and partially dentate mandible is mainly the presence of flabbiness in the anterior edentulous alveolar ridge that can compromise the retention and stability of a denture. Thus, this case report presents the correction of a flabby ridge, using an auxiliary technique combining surgical excision and autogenous connective tissue grafting. The technique improved the quality of the osteomucosal support of the alveolar ridge and increased the vestibule deepness, whose result increased the success rate of the new conventional total prosthesis.

Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population

Anthropometric data on the proximal tibia and distal femur of 172 normal knees (94 male knees, 78 female knees) were obtained using three dimensional computer tomographic measurements. We measured the tibial mediolateral (tML) and tibial anteroposterior (tAP) dimension in resected proximal tibia surface, femoral mediolateral (fML) and femoral anteroposterior (fAP) dimension in resected distal femur surface. The measurements were compared with the similar dimensions of five total knee prostheses conventionally used in China. We found that in the smaller sized prostheses the tibial mediolateral dimension was undersized, while in the larger size prostheses the tibial mediolateral dimension was overhang. For all sizes of prostheses the femoral mediolateral dimension was overhang. We found a progressively decreased in the aspect ratio (ML/AP %) with an increasing anteroposterior dimension both in the tibia and femur, as compared to the constant aspect ratio shown by the conventional total prostheses. Male had larger values in mediolateral dimension and aspect ratio than female under a given anteroposterior dimension both in the tibia and femur. There were strong correlations between measurements of the tibia and femur. The results of this study may provide guidelines for designing suitable total knee prosthesis for the Chinese population, especially for design of gender-specific prostheses.