Interim Prosthesis Research Articles

Designing a complete-arch digital trial tooth arrangement for completely edentulous patients by using an open-source CAD software program: A dental technique

A method for creating a complete-arch digital trial tooth arrangement for completely edentulous patients is described. The technique demonstrates an effective way to reproduce the dental and gingival anatomies by using a free 3D modeling software program. This cost-effective, time-saving, and versatile method allows dental professionals to digitally plan challenging treatments for completely edentulous patients. The technique can also be used to fabricate diagnostic prostheses and implant-supported interim prostheses.

The Prosthetic Management of a Case of Epulis Fissuratum by a Novel Technique

The clinical management of the epulis involves the elimination of causal factors, excision of fibrous tissue excess accompanied by an appropriate prosthetic rehabilitation. The confection of interim prosthesis or the rectification of old prosthesis for the setting up of a tissue conditioner if necessary, to improve the healing and prevent the decrease of the vestibule depth after the surgical exeresis. Throughout this paper, we are going to present a new technique for the correction of old prostheses poorly adapted for the management of a case of the epulis fissuratum.

Effect of two chromatogens on the color stability of three provisional materials before and after thermocycling –an in vitro study

Introduction: An acceptable cosmetic effect in any dental restoration has been regarded as a very important aspect of quality dentistry. In long term cases of full mouth rehabilitation with interim prosthesis or even cases of provisionalization in the anterior region of the mouth, staining and discoloration of restorations is the main esthetic concern of the patients which brings them back to the dentist's time and again, adding to the number of visits and costs. The Indian food consists of various chromatogenic substances such as tea, coffee, turmeric/ red chilli powder, spices, oil etc. which are consumed on a daily basis and can adversely affect the color of the provisional restorative material. Thermocycling can be done to simulate this clinical situation in the laboratory. Considering these facts, the present study was palnned. Aim:- To evaluate and compare the effect of two chomatogens on colour stability of three provisional materials before and after thermocycling. Materials and methods:- Three commercially available provisional materials were chosen – DPI heat-cure, protempTM4chemical-cure and Luxatemp solar dual cure. Flat circular metallic dies were prepared of 22 mm diameter and 2mm thickness. Total 150 samples were prepared from the materials using these dies. The samples were finished and polished using standardized method. They were divided into 5 groups. Two groups from each material were subjected to a standardized thermocycling regimen. The samples were immersed in two staining solution- coffee solution and sambhar solution for 30 days. Then artificial saliva was used for the control group. The solutions were prepared using a standardized method and were changed everyday. The color measurements were done twice- once before thermocycling and staining and another after, in CIE L*a*b* color system using a reflectance spectrophotometer. Results:-Statistical analysis was done in SPSS version 20.0 using one- way ANOVA and Tukey's post-hoc test. p value <0.05 was considered statically significant. Conclusions:- Luxatemp Solar showed least color stability, followed by ProtempTM4whereas DPI showed maximum color stability. Sambhar showed higher staining ability. The color changes seen with coffee and control were not clinically perceptible. Thermocycled samples showed more color change than non thermocycled samples.

Integrating a Facially Driven Treatment Planning to the Digital Workflow for Rehabilitation of Edentulous Arches: A Case Report

This case report presents the integration of a digital facially driven prosthetic plan to the computer-assisted implant planning for rehabilitation of edentulous arches. Diagnosis of edentulous arches is hampered by the lack of intraoral references. However, a digital facial profile analysis facilitates the treatment plan, taking into consideration the harmony among teeth, lips, and face to restore a pleasant smile. The first appointment consisted of digital documentation including intraoral scans, facial scans, and photographs. Based on these data, a smile frame was created to guide the digital wax-up. Cone-beam computed tomography (CBCT) scans were merged to facial and intraoral scans to perform the virtual surgical planning. Integration between facial, intraoral, and bone tissues were used as a reference to define implant position and prosthetic planning. The digital planning was integrated into the surgical procedure using stackable templates, and an immediate loading was performed. The interim prosthesis was manufactured based on the digital wax-up. With digital data, quality control could be performed to evaluate the esthetic outcome of the treatment. An esthetic and functional rehabilitation was possible using the respective digital workflow to define harmony between a smile and facial tissues. A digital treatment implant planning can be conducted considering patient's individual needs to improve the esthetic outcome.

Immediately loaded interim complete-arch implant-supported fixed dental prostheses fabricated with a completely digital workflow: A clinical technique

A digital method for delivering an immediately loaded interim complete-arch implant-supported prosthesis is described. Reference pins were used to accurately superimpose a postoperative scan with the scan bodies in place on a preoperative scan with the framework design, including the interocclusal relationship and the occlusal scheme. A prefabricated auxiliary device was used after surgery to record the position of the implants and after scanning to obtain an accurate transfer of the implant positions by means of a free software program, allowing an excellent fit of the fabricated prosthesis. This technique can help in the fabrication of an interim prosthesis with better fit and comfort and reduced chair time than conventional techniques.

CAD/CAM: Applications for transitional bonding to restore occlusal vertical dimension.

ObjectiveExplore the best technique for achieving stable and comfortable occlusion. This is critical for long‐term oral health and the foundation of durable esthetic, restorative, periodontal, and prosthodontic treatments.Clinical considerationsVarious techniques and therapies have been proposed for establishing, determining, and restoring ideal centric relation (CR) and vertical dimension of occlusion (VDO) in patients who require restorations and/or full‐mouth rehabilitation. An interim prosthesis phase can help establish and stabilize an enhanced esthetics and/or functional outcome for a limited period of time before the definitive dental restorations are placed. Transitional direct composite bonding and its additive nature have provided clinicians and patients with advantages when establishing a physiologic CR and VDO in interim restorations. However, it is time consuming, tedious, and challenging chairside. The author has been using additive CAD/CAM designed and milled restorations for over 10 years to make transitional bonding more efficient, manageable, and predictable.ConclusionTransitional bonded prostheses are significantly important to providing patients with an interim therapy to determine if the proposed esthetic outcome and occlusal scheme will function as expected, or if adjustments are needed prior to the delivery of the definitive long‐term restorations. CR and VDO are essential for establishing a functional and healthy occlusion, ideal restoration proportions and smile design, and treatment planning esthetic and prosthodontic restorations for long‐term durability.Clinical significanceThis article reviews CR, VDO, and the characteristics of a CAD/CAM transitional bonding technique in reversing the signs and symptoms of a compromised dentition and reestablishing an ideal esthetic and functional occlusal outcome. Transitional bonded prostheses are significantly important to providing patients with an interim therapy to determine if the proposed esthetic outcome and occlusal scheme will function as expected, or if adjustments are needed prior to the delivery of the definitive long term restorations.

Application of the palatogram technique to improve speech with complete-arch fixed implant-supported zirconia prostheses

While maxillary complete-arch fixed implant-supported prostheses are a popular treatment for patients with complete edentulism or with a terminal dentition, how speech is best optimized with this treatment is unclear. One popular method used in complete denture therapy for immediate improvement of speech, as well as to reduce the speech adaptation period for patients, is the use of a palatogram technique. Contemporary biomaterials such as zirconia used for complete-arch fixed implant-supported prosthesis are difficult to adjust and modify. Therefore, the purpose of this article was to describe the application of the palatogram technique during the evaluation stage of the maxillary screw-retained milled prototype prosthesis (interim acrylic resin prosthesis) to improve the palatal contours and optimize contact areas of the tongue with the palatal aspect of the prosthesis. The modified interim prosthesis can then be used for copy milling the definitive zirconia prosthesis. This technique is useful when other prosthodontic factors related to speech, such as the occlusal vertical dimension and tooth positions, have already been optimized.

Digital protocol for creating a virtual gingiva adjacent to teeth with subgingival dental preparations

PurposeThis article describes a digital technique used to record gingival emergence profiles modeled for the prosthetic restoration of teeth prepared using biologically oriented preparation technique (BOPT). Materials and methodsThe description of the technique of intraoral recording, manipulation of digital files, and chairside protocol of prosthetic restorations is developed in the present manuscript on two anterior teeth treated with vertical and subgingival dental preparations for restoration with ceramic crowns. The manipulation of the digital files registered with an intraoral scanner with software that allows its alignment (best-fit) and the performance boolean of operation manages to create a virtual gingival emergency like the one it presents when it is adapted on the cervical part of the interim prosthesis. ConclusionsThe technique allows the dentist and laboratory technician to obtain a digital reproduction of the subgingival soft tissues around the prosthetic crown, unaffected by the collapse of the gingival sulcus when the provisional crown is removed, as well as an exact copy of the provisional restoration, making it possible to fabricate a definitive prosthesis that ensures precise anatomy, and so good compatibility with periodontal tissues.

Long-term stainability of interim prosthetic materials in acidic/staining solutions.

To evaluate the long-term color stainability, translucency, and contrast ratio (CR) of different resins used to fabricate interim prostheses after immersion in acidic/staining solutions. A total of 160 specimens were divided into 16 groups (n = 10) according to the material (heat-polymerized acrylic resin [HPAR], auto-polymerized acrylic resin [APR], nanoparticulated bis-acrylic resin [BR], and prefabricated poly(methyl methacrylate) block for CAD/CAM [CADR]) and immersion solutions (artificial saliva, cola beverage, coffee, and red wine). A spectrophotometer was used before and after each immersion period (7, 14, 28, 90, and 180 days). Color differences (CIEDE2000 and CIELab) were calculated. A three-way repeated-measures analysis of variance and Bonferroni test (α = .05) were used. After 180 days, the APR presented the highest value for coffee and the CADR presented the smallest value for the cola (P < .001). For the CR, the highest values were obtained at 180 days for BR in coffee (1.35) and wine (1.18) (P < .001). Higher translucency parameters were obtained in the BR and CADR in the initial, 14, 28, and 90 days (P < .001). From the greatest to the smallest staining potential, the solutions were classified as: wine > coffee > cola beverage > saliva, while for the materials as: APR > BR > HPAR > CADR. The knowledge of the long-term optical behavior of interim prosthetic materials is important for clinicians to decide which material to use to match the dietary intake of their patients and their esthetic demands. Prefabricated blocks for CAD/CAM systems have been shown to maintaining their optical characteristics even after a long period of immersion in acidic/staining solutions.

Definitive Obturator for Class IV Maxillary Defect with Cast Retainers -A Case Report

Retention, stability &amp; support are three important factors which determine the basic objectives, success and comfort of any removable prosthesis.In acquired surgical maxillary defects; the degree of impairment, size and location of the defect influences the outcome of the overall prosthetic overhaul.Prosthetic therapy with obturator closes the defect by re-establishing the oro-nasal separation, thereby, improving deglutition, speech and hypernasality. After maxillectomy, 3-6 months after surgery,patients with class 4 maxillary defects complains of frequent loosening of temporary prosthesis due to more amount of tissue changes, dimensional stabilization of surgical site, more loss of mucogingival support and rapid healing changes. As a result, there is an every chance of endangerment with the use of temporary prosthesis and allow the patients in seeking the definitive prosthesis over interim prosthesis. In this regard, designing of cast partial metal frame work with linear configuration for class 4 maxillary defects enhances the quality and comfort of the definitive prosthesis over conventional acrylic prosthesis. This article mainly describes the fundamental designing technique in improving the retention, stability and support of the definitive prosthesis with cast retainers.

Influence of a light-activated glaze on the adhesion of Streptococcus sanguinis to the surface of polymers used in fabrication of interim prostheses.

This study aimed to investigate the adhesion of Streptococcus sanguinis to the surface of interim prostheses that were treated or not treated with a light-activated glaze, and subjected or not subjected to a thermocycling procedure. 36 specimens of each resin were divided into 4 groups: heat-activated acrylic resin; chemically-activated acrylic resin; bis-acryl composite resin (Protemp; 3M ESPE); and bis-GMA (Charisma; Heraeus Kulzer). Half of the specimens underwent application of glaze and the other half underwent mechanical polishing. Specimens were randomly distributed into groups (N=9) with and without thermocycling (2000 cycles). Surface energy, roughness and microbiological analyses were performed. Groups treated with glaze showed lower roughness when compared with the same groups without glaze treatment, before and after thermocycling, except for the bis-acryl groups after thermocycling. Surface energy values were higher in the groups treated with glaze, except the bis-acryl group before and after thermocycling. After thermocycling, the values of bacterial adhesion decreased numerically, with the exception of the chemically-activated acrylic resin group treated with glaze and the heat-activated acrylic resin group without glaze treatment. The application of glaze and the thermocycling do not influence, in a statistically significant manner, the bacterial adhesion on polymer surfaces.

Transitioning a patient with failing anterior dentition and pre-existing posterior implant-supported fixed restorations using a staged approach.

This clinical report describes a staged approach using a removable partial denture (RPD) and a transitional implant-supported overdenture as interim prostheses in treating a failing anterior dentition with posterior implant-supported fixed dental prostheses (FPD), until the time a full-arch fixed implant-supported prosthesis may be inserted. The RPD replaced the anterior teeth following their extraction and during implant osseointegration. The implant-supported overdenture rehabilitated the arch during the fabrication phase of the definitive restoration.

Avulsed Anterior Permanent Tooth Replaced by Fixed Functional Interim Prosthesis with Natural Crown: A Case Report Interim Prosthesis with Natural Crown: A Case Report

The incidence of trauma to the anterior teeth is a common occurrence in children. From the very moment the child tries to walk erect independently, the susceptibility of the child’s anterior teeth getting injured begins. Avulsion (a type of traumatic injury) is the complete loss of the tooth from its socket. Various treatment modalities are available to treat such accidents. The tooth can be replanted back or replaced by a prosthesis, it depends upon the extraoral drytime and the stage of development of root of the avulsed tooth. The present case-report describes the way in which an avulsed permanent maxillary central incisor of a 12 year old boy was replaced aesthetically, and satisfactorily after 1 month of avulsion by means of a biological fixed functional prosthesis ( a modified “Hollywood Bridge” ) where the crown of the avulsed tooth was used as a pontic and stainless steel wires and bands were used to fix the prosthesis in the mouth as an interim treatment option.

Effect of milling tool wear on the internal fit of PMMA implant interim prosthesis

Effect of milling tool wear on the internal fit of PMMA implant interim prosthesis

Digital workflow for predictable immediate loading in the mandible by using a shape memory dental implant abutment system: A clinical report

Digital surgical planning for immediately loaded dental implants can be a predictable and accurate procedure, with the interim prosthesis also designed digitally. If the planning and execution are meticulous, chairside adjustments can be minimized because the outcome should be closely matched to the proposed digital plan. A novel dental implant abutment system made from a shape memory metal could be an answer to the cement versus screw controversy as it uses neither. This new system can provide patients with better esthetics and is biologically favorable.

Efecto de la incorporación de nanopartículas de óxido de zinc en la resistencia a la flexión de las resinas acrílicas autopolimerizadas.

Background: Auto-polymerized acrylic resins are commonly used in many applications in dentistry including in maxillofacial rehabilitation such as interim prostheses, denture repair, reline, orthodontic appliances, record base, among others. These substances, however, have some negative aspects such as poor mechanical properties. Aim: The objective of the current study was to evaluate the effect of incorporating zinc oxide nanoparticles to auto-polymerized acrylic resins on their flexural strength. Materials and methods: Thirty specimens were made from auto-polymerized acrylic resins, divided into three main groups (1 control and 2 experimental). Each group had ten specimens. The two experimental groups comprised the zinc oxide powder at 1% and 2% concentrations, respectively. Acrylic specimens were fabricated with the dimension of 65mm length, 10mm width and 2.5mm thickness according to ISO 1567 specification 1999. Each specimen was subjected to the flexural strength test by a universal testing machine. The crosshead speed for the flexural strength test was 5mm/min until fracture occurred. The SPSS version 16 was utilized for the statistical analysis. The ANOVA and Tukey were used for the comparison among all groups. Results: there was a significant increase (p&lt;0.001) in the flexural strength of the acrylic resins following the addition of zinc oxide particles (control group: 133.27 SD 1.73, ZnO 1%: 154.28 SD 2.90, ZnO 2%: 176.45 SD 0.94). Conclusions: The incorporation of zinc oxide nanoparticles has a significant effect on the flexural strength of auto-polymerized acrylic resins.

Use of Implant-Supported Custom Milled Impression Copings to Capture Soft-Tissue Contours and Incisal Guidance.

A technique is presented where a custom milled impression coping is used to replicate the clinically established anterior incisal guidance to the definitive prosthesis when multiple implants are restored in the esthetic zone. A conventional impression is initially made, then the stone cast is scanned, and a digitally designed custom screw-retained, implant-supported interim prosthesis is milled from a polymethylmethacrylate (PMMA) billet. This is aimed to digitally design the pontic areas, contour the gingival soft tissue, and establish an anterior incisal guidance. A custom milled impression coping (CMIC) is then fabricated. The CMIC has contours similar to the contours of the interim prosthesis and is fabricated from a PMMA billet. Titanium inserts are placed in the interim prosthesis and the CMIC. The CMIC is inserted intraorally and used for the final impression by using a custom tray and by following the open tray impression protocol. With the proposed technique, the exact contours of the digitally designed and clinically verified interim prosthesis are used to fabricate the definitive restoration.

Color alterations of a PMMA resin for fixed interim prostheses reinforced with silica nanoparticles.

PURPOSEThe aim of the present study was to evaluate the color changes of an autopolymerizing PMMA resin used for interim fixed restorations, reinforced with SiO2 nanoparticles.MATERIALS AND METHODSSilica nanoparticles were blended with the PMMA resin powder through high-energy ball milling. Four shades of PMMA resin were used (A3, B3, C3, D3) and total color differences were calculated through the equations and . Statistically significant differences between ΔEab and the clinically acceptable values of 3.3 and 2.7 and those between ΔE00 and the clinically acceptable value of 1.8 were evaluated with one sample t-test (P<.05). Differences among the different shades were assessed through One-Way ANOVA and Bonferroni multiple comparison tests.RESULTSSignificantly lower values were detected for all groups concerning ΔEab compared to the intraorally clinical acceptable values of 3.3 and 2.7. Significantly lower mean values were detected for groups B3, C3, and D3, concerning ΔE00 compared to the intraorally clinical acceptant value of 1.8. Color pigments in red-brown (A3) and red-grey (D3) shades affect the total color change to a greater extent after the reinforcement with SiO2 nanoparticles compared to the red-yellow (B3) shade.CONCLUSIONWithin the limitations of this in vitro study, it can be suggested that reinforcing PMMA with SiO2 nanoparticles at 0.25 wt% slightly affects the optical properties of the PMMA resin without being clinically perceivable.

Unconventional single - visit interim prosthesis – A case report

Unconventional single - visit interim prosthesis – A case report

The CAD/CAM Compound Prosthesis: Digital Workflow for Fabricating Cement-Retained Zirconia Prosthesis Over Screw-Retained Milled Titanium Bars

The computer-assisted design/computer-assisted manufactured compound prosthesis involves designing and milling a cement-retained prosthesis over milled titanium bars. In the presented clinical case report, a diagnostic wax pattern was made to assess esthetics, contours, and occlusion. A total of eight maxillary root-form implants were restored by following the combined prosthesis design concept. The mandibular arch was restored with a screw-retained implant-supported zirconia fixed prosthesis. A milled polymethyl methacrylate (PMMA) maxillary interim prosthesis was fabricated to intraorally confirm the diagnostic wax pattern. The interim PMMA prosthesis was then scanned, and three screw-retained titanium milled bars were designed that provided the substructure of the definitive restoration. A cement-retained milled zirconia prosthesis was then designed and fabricated. The zirconia prosthesis provided the superstructure of the definitive complete-arch restoration. After confirming esthetics, phonetics, occlusion, and accessibility for oral hygiene, the superstructure was cemented with temporary cement to enable retrievability.