Oral Prosthetic Rehabilitation Research Articles

Customized Prosthetic Oral Rehabilitation of a Child with Hypohidrotic Ectodermal Dysplasia: A Case Report

Customized Prosthetic Oral Rehabilitation of a Child with Hypohidrotic Ectodermal Dysplasia: A Case Report

Oral Prosthetic Rehabilitation in Patients with Epidermolysis Bullosa Hereditaria: A Systematic Review.

To review the oral prosthetic rehabilitation of patients with epidermolysis bullosa hereditaria (EBH) and study the level of evidence and quality of the presented available articles and establish clinical recommendations for the prosthetic management of these patients. An electronic search was done in July 2022 in five databases following PICOTS elements. The quality of the reports was established using the modified Pierson, Bradford Hills, and Ottawa Newcastle scale. Data extracted from 19 case reports for protocolized analysis corresponded to 64 patients and 80 dental prostheses, with almost 9 out of 10 patients being completely edentulous. The distribution of EBH types was 84% dystrophic, 10.5% junctional, and 5.5% simplex. The difficulties encountered by the authors synthesized in this review characteristically reflected those most likely encountered in dental practice. Most rehabilitations were implant-supported prostheses (85%), followed by removable dentures (10%) and dental-supported rehabilitations (5%). Fixed full-arch implant-supported prostheses represented 76.4% of implant-supported prostheses, and this prosthetic solution reflected the highest scientific quality. For an individualized approach to treatment, we recommend that in cases of total edentulism, fixed full-arch implant-supported prostheses are the most appropriate because they allow the best computer-aided planning, design, manufacture, and fitting of the prosthesis in such a complex clinical context.

Prosthetic Oral Rehabilitation with CAD/CAM Suprastructures in Patients with Severe Tissue Deficits: A Case Series.

This article presents the outcomes of prosthetic oral rehabilitation using CAD/CAM telescopic bar overdentures in patients with oral cancer (n = 3), severe facial trauma (n = 2), or various syndromes (n = 1), all suffering from severe tissue deficits and requiring complex and comprehensive oral rehabilitation. The aim was to assess the durability and functionality of implant-retained prosthetic structures, ensuring easy oral hygiene and minimizing specialized follow-up needs. The data for this study were sourced from a retrospective cohort at Helsinki University Hospital. The prosthetic reconstruction encompassed the Atlantis 2in1 and the Createch removable telescopic systems. Thus, 40 implants were placed (4 to 7 per patient), with prosthetic structures in the maxilla (n = 4 patients), in the mandible (n = 1), and in both jaws (n = 1). Two patients experienced no complications, two patients had part of the acrylic resin break, and one patient experienced loosening of the bar structure. All complications associated with prosthetic structures were successfully managed, and none of the implants were lost. The follow-up time ranged from 7 to 126 months. This rehabilitation is proved to be an effective solution for patients with complex oral conditions, facilitating both functional restoration and ease of maintenance. These findings underscore the importance of individualized treatment approaches in cases of tissue deficits.

Comparative in vitro study on biomechanical behavior of zirconia and polyetheretherketone biomaterials exposed to experimental loading conditions in a prototypal simulator

Zirconia and polyetheretherketone (PEEK) are two biomaterials widely investigated as substitute for metals in oral prosthetic rehabilitation. To achieve a proper biomechanical behavior, the prosthetic biomaterials must ensure a good resistance to loads, as this is a crucial characteristic enabling their use in dental applications. The aim of this study was to investigate differences in the fracture resistance of different biomaterials in an experimental environment: fixed partial dentures (FPDs) screwed in a prototype of biomimetic mandible. 10 Samples of FPDs were allocated in 2 groups (A and B): Group A (n=5) involved FPDs in zirconia-ceramic, and Group B (n=5) involved FPDs in PEEK-composite. The samples were loaded by means of a three-point bending mechanical test, and the load to fracture has been evaluated generating a point-by-point graphics (speed/load and time/deformation). The samples were further analyzed by micro-computed tomography (micro-CT) and described under experimental loading conditions. Zirconia-ceramic FDPs were the samples reporting the worst results, showing a lower value of vertical displacement with respect to PEEK-based samples. The micro-CT results have further confirmed the preliminary results previously described. This in vitro study aims to give analytic data on the reliability of PEEK as a reliable and strong biomaterial for prosthetic treatments.

Development of 3D printed dental resin nanocomposite with graphene nanoplatelets enhanced mechanical properties and induced drug-free antimicrobial activity.

Oral prosthetic rehabilitation has been used for a long time to restore function and natural appearance; however, it is still one of the most challenging areas in dentistry due to its technical fabrication process and biological behavior. Considering the advantages of additive manufacturing technology, this study introduced the feasibility of developing a 3D printed resin-based composition modified with graphene nanoplatelets (GNPs) to improve properties. Acrylate-based resin was impregnated with different concentrations of GNPs (0.0-0.25wt%), and then different aspects such as mechanical, physical, biological and antimicrobial were analyzed to evaluate the effectiveness. TEM and SEM were used to characterize GNPs and their existence within the resin. Surface topography and roughness were evaluated using AFM. The degree of conversion and composition were confirmed by FTIR. Mechanical properties were detected using bending strength, microhardness and nanoindentation. Biocompatibility and antimicrobial activities were assessed with oral fibroblast and Candida albicans (C. albicans), respectively. In addition, most of the measurements were performed repeatedly after 3 months of storage in artificial saliva to evaluate performance. GNPs improved strength significantly at low concentrations ≤0.05wt%, while the addition up to 0.25wt% enhanced printed nanocomposite hardness and elasticity. The modification did not induce a toxic response, as its biocompatibility was within the recommended range of biomedical devices. Antimicrobial activity was of prominence, as GNPs showed an outstanding route of reducing C. albicans activity associated with filler proportion. The embedment of GNPs in 3D printed resin can become a key material for customized applications that require high antimicrobial, stiffness and strength properties.

Dental Prosthetic Rehabilitation Interventions in Elderly Patients Hospitalized in the Nursing Homes of the Lombardy Region: A Retrospective Study.

Background: The difficulty of frail, non-self-sufficient or non-ambulatory collaborating elderly residents in nursing homes to eat due to a lack of teeth or the absence of a dental prosthesis leads to an increasingly evident increase in the patients' systemic pathological state, particularly in older patients who take a lot of medications. Total or partial edentulousness that is not filled with dental prostheses or that is filled with inadequate prostheses, associated with socioeconomic factors, depression, impaired motor functions, heart disease and a large number of chronic diseases including excessive use of drugs, often affects elderlies' feeding. Aim: In this study, prosthetic rehabilitation was performed on some frail elderly residents in 10 nursing homes in the Lombardy district, and, subsequently, meal behavior and social activity were examined in two information questionnaires through compilation. Methods: The research was conducted on only 67 patients, 26 men and 41 women, aged between 75 and 99, who were guests in 10 health facilities (nursing homes) in the Lombard district; only 8 residents did not undergo prosthetic rehabilitation, as they did not cooperate. All the patients who were visited underwent oral prosthetic rehabilitation, and, subsequently, some aspects such as nutrition and socialization were assessed with other residents through the aid of two information dossiers. Results: the results showed that all the residents, despite difficulties in chewing with the new prosthesis, were fed and did not refuse more consistent foods; in addition, there was an improvement in social activity among the residents. Only 19.3% of men and 22% of women continued to eat little; there was an improvement in the participation in social activities among the residents, with a percentage of 73% of men and 88% of women; in particular, during meals 35 residents conversed with the other residents. Discussion: The dental problems of elderly people residing in social welfare homes are increasingly evident when other systemic pathologies are present. It would be desirable to introduce telemedicine in residences for the elderly for the monitoring of dental problems. Conclusions: From the information obtained and from the evaluation of the change in the elderly, it can be concluded that it would be desirable to include specific dental protocols to create a network, including a telematic one, to monitor and perform more dental checks in nursing homes.

Duração da mastigação e da fase oral da deglutição em idosos com diferentes condições dentárias: análise clínica

ABSTRACT Purpose: to measure the total time of mastication and oral phase of swallowing in healthy elderly people, considering different food consistency, the presence of natural teeth, and the type of prosthetic oral rehabilitation, as well to compare dental conditions and consistencies. Methods: a cross-sectional study with 57 healthy elderly people, aged between 60 and 82 years, divided into: dentate group (D) (n=15); and rehabilitated groups; PD: fixed or removable partial dentures in one or both arches (n=15); CRD: maxillary and mandibular complete removable dentures (n=15); ISCD: complete dentures - maxillary removable denture and mandibular implant-supported dentures (n=12). The duration time (seconds) of chewing and of the oral phase of swallowing was measured in the consistencies: solid (a roll slice), pudding (10 ml) and liquid (10 ml). Results: healthy dentate elderly subjects had the following intervals: liquid=1.07±0.35 s; pudding=3.48±1.76 s; and solid=27.88±7.11 s. Statistically significant differences were observed between the D and ISCD groups (p=0.0056) and between D and CRD (p=0.0056) for liquid. For all groups, there was a statistically significant increase between liquid and solid consistencies and between pasty and solid ones (p<0.001). Conclusions: the dentate elderly had shorter oral phase time of swallowing for liquids than the rehabilitated edentulous elderly, but not different from the elderly with partial dentures. Chewing and swallowing time for solid food was longer than that for the other consistencies, regardless of dental condition.

Evaluation of the Behavior of Two CAD/CAM Fiber-Reinforced Composite Dental Materials by Immersion Tests.

Fiber-reinforced composites are used as restorative materials for prosthetic oral rehabilitation. Gastroesophageal reflux disease (GERD) is an accustomed affection with various oral manifestations. This study aimed to evaluate the behavior of two high-performance CAD/CAM milled reinforced composites (Trinia™, TriLor) in artificial saliva at different pH levels through immersion tests, and to determine if changes in mass or surface morphology at variable pH, specific for patients affected by GERD, appear. After investigating the elemental composition and surface morphology, the specimens were immersed in Carter Brugirard artificial saliva for 21 days at different pH values (5.7, 7.6, and varying the pH from 5.7 to 3). The values of the weighed masses during the immersion tests were statistically processed in terms of mean and standard deviation. Results suggested that irrespective of the medium pH, the two composites presented a similar mass variation in the range of −0.18 (±0.01)–1.82 (±0.02) mg after immersion, suggesting their stability when in contact with artificial saliva, an aspect which was also highlighted by scanning electron microscope (SEM) analysis performed on the immersed surfaces. Novel composite biomaterials can be a proper alternative for metal alloys used for prosthetic frameworks in patients suffering from GERD.

Status of Oral Prosthetic Rehabilitation of Edentulism at the University Clinics of Kinshasa (CUK), DR Congo

Objective: The present work aimed to identify the most common edentulousness and prosthesis type (prosthetic treatment), to improve the management in oral prosthetic rehabilitation in DR Congo. Material and Methods: It was a documentary, longitudinal, and retrospective study of the medical records of edentulous patients admitted to the prosthetic service of the Dental Department/Kinshasa University from January 1983 to December 2020. Age, sex, cause of teeth loss, and prosthetic treatment (partial removable prosthesis, complete removable prosthesis) were evaluated. The Chare square test was performed to compare significant differences between the variables and the P-value < 0.05 was set as significant. Results: One thousand six hundred and ninety patients in that 901 were men (47 ± 16 years) and 789 women (42 ± 15 years) had undergone prosthetic treatment. One thousand eight hundred and forty-four edentulous teeth were viewed according to the Kennedy classification. Kennedy class 1 was the most predominant (61.4%) followed by Kennedy class 3 (24.8%). Two thousand one hundred and ninety-one prostheses were performed. The removable partial prosthesis with plate (acrylic resin) was the most performed (78.8%; n = 1727) and followed by the joint (17.4%; n = 384). Dental caries (52.6%) and periodontitis (36.4%) were the main causes of these edentulous teeth. Conclusion: The present study showed that edentulism is becoming a concern for the implementation of a real oral health policy.

The Effect on Bone Stress in Oral Prosthetic Rehabilitation Supported by Different Number of Dental Implants: A Numerical Analysis

The aim of this study was to compare the mechanical behavior of two types of prosthesis as well as the stress distribution on the prostheses’ components and the bone. Two groups were analyzed: in the first group (M1), the prothesis was composed of two implants placed at a distance of 14 mm; in the second group (M2), the prothesis was composed of three implants installed at a distance of 9.7 mm from each other. An axial load of 100 N distributed on the cantilever throughout the region from the distal implant and a 30 N axial load on the implants in the inter-foramen region, were applied in both model 1 and model 2. In both models, the stress was concentrated in the region near the neck of the implant, resulting in a maximum value of 143 MPa in M1 and of 131MPa in M2. In M1, the stress along the bone varied from of -4.7 MPa to 13,57 MPa, whereas in M2, it varied from -10 to 12 MPa. According to the results obtained, the model corresponding to six implants presented a better distribution of bone stress around the implants.

Periodontal disease in a young Romanian convenience sample: radiographic assessment

BackgroundThe goal of this study was to determine the distribution of periodontal disease in a population seeking oral rehabilitation in a Romanian prosthodontics department and to identify the factors associated with each type of periodontal condition.MethodsThe study population consisted of patients presenting consecutively to the Prosthodontics Department of the Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, Timisoara. The diagnosis and classification of periodontal conditions, as well as dental pathologies and conditions, were based on examination of panoramic radiographs. A standardized questionnaire was administered to obtain socio-demographic characteristics (age, gender, ethnicity, education, residency, marital status), medical history, dental/periodontal history (family history of periodontal disease), and behavior (smoking, brushing, flossing and regular cleaning).ResultsAmong subjects presenting to the Prosthodontics department, only 34.2% were periodontal disease-free and 65.8% had periodontal disease, of which 11.4% had aggressive periodontitis. In univariate models, age, education, marital status, smoking, and tooth number were associated with chronic periodontitis. Age, education, family history, smoking, and tooth number were associated with aggressive periodontitis. However, in a multivariable model, only age, tooth number and family history were significant.ConclusionsThis study found a high prevalence of periodontal disease in patients seeking oral rehabilitation from the Prosthodontics department. Age, tooth number and family history of periodontal disease were associated with the type of periodontal disease. These results suggest the need for periodontal examination prior to prosthetic oral rehabilitation in this population.

Dental prosthetic rehabilitation of a child with ectodermal dysplasia: A case report

Ectodermal dysplasias (EDs) form a part of the complex group of rare congenital diseases, primarily observed as a result of the abnormal development of embryonic ectodermal derivatives. A 5-year-old male child reported to the Department of Pedodontics and Preventive Dentistry, with the typical features of hypohidrotic ectodermal dysplasia (HED), i.e., diff usely sparse hair, eyelashes and eyebrows, subsequent problems with thermoregulation and dry skin. The facial profi le showed a prominent forehead, sunken nasal bridge (“saddle nose”), and everted lips. Oral prosthetic rehabilitation was planned for the child to improve both the vertical and sagittal skeletal relationship, additionally providing better esthetics, improved speech, and masticatory function. The case report thus presents the early prosthetic oral rehabilitation of a young boy with HED associated with severe anodontia in the primary dentition.

Dental prosthesis use and/or need impacting the oral health-related quality of life in Brazilian adults and elders: Results from a National Survey

ObjectivesThis study aimed to assess the impact of use of and need for dental prosthesis (DP) on oral health related quality of life (OHRQoL) among Brazilian adults and elders. MethodsThis cross-sectional, population-based study, used data from the Brazilian Oral Health National Survey performed in 2010. The sample was representative of adults (35–44 years of age) and elders (65–74 years) at national level. Oral Impact on Daily Performance (OIDP) questionnaire was used to assess the individuals’ OHRQoL. Interest variables included use of and need for DP and location of tooth losses. Covariates included socioeconomic, behavioral and clinical characteristics. Associations were performed using Negative Binomial regression models, estimating the rate ratios (RR) and respective 95% confidence intervals. ResultsFrom the total of 17,398 individuals evaluated, 68.3% needed some type of DP, while the prevalence of DP usage was 49.2%. After adjustments, those needing prosthesis, regardless of already using prosthesis presented an impact more than 50% higher on OHRQoL, and those needing a greater the number of teeth to be replaced and those presenting losses on anterior and posterior regions had higher impact on OHRQoL. ConclusionsThese findings suggest that improvement of strategies focused on oral rehabilitation of adults and elders are crucial to promote population oral health. Clinical significanceThe high prevalence of normative need for prosthetic rehabilitation in adult and elder Brazilian population impacts significantly on oral health-related quality of life highlighting the importance of providing prosthetic oral rehabilitation in this population.

Representações ideativas sobre edentulismo e reabilitação protética na percepção de idosos

Objective: To identify the ideational representations of upper and/or lower edentulous elders regarding tooth loss and oral prosthetic rehabilitation. Methods: Qualitative study conducted between January and March 2011 with seven elders living in a Public Longterm Care Institution in Recife, PE, and 14 elders attending the Dental Prosthesis Clinic of the Universidade Federal de Pernambuco – UFPE (Federal University of Pernambuco). Data were collected through semi-structured interview and underwent content analysis. Results: The results enabled to identify that, for the elders, the teeth contribute to health and facilitate the social interactions, while edentulism has been associated with a plurality of negative feelings. Regarding prosthetic rehabilitation, they emphasized the harms to health due to poorly fitted dental prosthesis. Conclusion: The elderly believe that edentulism and prosthetic rehabilitation are mainly associated with a mechanistic concept of the profession that is widely spread among the professionals who focus more on curative Dentistry at the expense of prevention. In this context, so that aging can be considered a stage of life with the same qualities and difficulties of any other stage, we suggest that managers and health professionals themselves should undertake a humanizing and preventive dental practice in order to provide the minimum requirements for an aging with dignity.

Oral Prosthetic Rehabilitation with and without Implants after Radiation Therapy and Ablative Surgery

The aim of the present study was to evaluate the impact of oral rehabilitation with fixed versus removable prostheses with and without implants on Oral Health Related Quality of Life (OHRQoL) measured with OHIP-49 for patients treated with radiation therapy and/or ablative surgery. The study cohort included 51 patients (35 males, 16 females) with a mean age of 66 years. A significant improvement in OHRQoL was demonstrated after oral rehabilitation with fixed and removable dental pros - thesis for patients after radiation and/or ablative jaw surgery. Thirty-nine of the 43 patients improved oral health related quality of life after prosthetic rehabilitation. Twenty-four patients improved with more than 20 points. The oral rehabilita- tion resulted in better appearance and chewing function. No significant effect between fixed versus removable prostheses and no significant effect of implant on the OHIP-score. This may be explained by a limited sample size, a great variation between the included patients and the validity of the OHIP-49 questionnaire measure to demonstrate patient-reported improvements or deterioration of a prosthetic treatment in this group of very functional compromised patients.

The Help of Hypnodontics to a Patient With Scleroderma ‒ Case Report

Introduction:Scleroderma, or systemic sclerosis, is a chronic connective tissue disease generally classified as one of the autoimmune rheumatic diseasesCase Presentation:A 58-year-old woman was informed of her scleroderma, while receiving oral prosthetic rehabilitation. Mouth opening limitation had unfortunately led to treatment interruption. The psychological load of the disease itself, along with dental treatment cessation, resulted in patient’s disappointment and social separation. Three hypnosis sessions were conducted for normalizing patient’s psychological status primarily, and for the facilitation of dental treatment, as well. The range of mouth opening changed from 3.7 to 6.2 cm, allowing for easier entrance of dental appliances into the mouth for completion of prosthetic rehabilitation. With the tooth prostheses in place, the patient gained more social confidence and started sharing her experience with other patients with the same condition.Discussion:This case illustrates that hypnosis therapy may prove beneficial for patients with limited mouth opening secondary to scleroderma, facilitating the prosthetic rehabilitation programs for both dental specialists and patients, with a secondary important impact on the patient’s social perception of himself.

Oral Prosthetic Rehabilitation for Alzheimer Patients: Planning, Procedures, and Follow-Up

This work aims at discussing prosthetic oral rehabilitation for Alzheimer patients, from planning until followup. In general, techniques for making dentures and implants for such patient are the same used in a healthy one. However, Alzheimer’s Disease does not affect only patients, but also their entire personal relations, such as family members, caregivers, and, in a broader sense, all of society. Throughout this paper, a session on the importance of accessibility in dental clinics for these patients will be developed, followed by the peculiarities in planning their dental prosthesis, as well as orientations on diets, hygiene, and mastication. Thus, the planning of treatments will be altered according to the general physical state of the patient, his or her degree of dependence on others, and life expectancy. In later stages of the disease, for instance, the patient is commonly affected by dysphagia, which the dentists while dealing with Alzheimer patients are innumerous, which emphasizes the need for the dentist to maintain an inter professional line of communication, for example, with physicians, nutritionists, and speech therapists, providing the patient with a singular treatment plan.

Peut-on prélever une grande baguette osseuse radiale dans le lambeau antébrachial radial composite ? Étude radio-anatomique et microscannographique originale

The composite radial forearm flap is a surgical option in the reconstruction of large traumatic or oncologic orofacial defects. Nevertheless, it has been criticized for its poor bone transport faculties that would make this flap insufficient in large osseous mandibular reconstructions, or for oral prosthetic rehabilitation with dental implants. What is more, the morbidity of the donor site has often been pointed. The aim of this radioanatomic study was to revisit the vascularization of the composite radial forearm flap, focusing on the bone stick. A radioanatomic study was performed on seven upper limbs taken from fresh cadavers. First, the vessels were washed with a 40°C solution of potassium acetate. Then an intra-arterial injection of a mixture of lead oxide and agar-agar was performed. 3D-CT-scan examinations of the anatomical pieces were performed. In a second step, the flaps were harvested and analyzed with a Microscan examination (NanoSPECT-CT Bioscan(®), voxel 220microns). Collateral branches of the radial artery to the bone and the skin were counted and classified. One radial diaphyseal artery was present in all the cases. The nutrient foramen took place at the anteromedial aspect of the diaphysis, between 45and 65% of the length of the bone. A dense anastomotic periosteal network was highlightened, supplied by one to four musculoperiosteal branches, and one to six fascio-periosteal arteries arising from the radial artery. A total of mean five osseous branches, and 12cutaneous branches have been observed. The results of the present preclinical study suggested that a 16-cm bone stick could be harvested with an optimal vascular safety, without consideration for the morbidity at the donor site. The original approach in this study, relating anatomy to the preclinical imaging, allowed a precise visualization of the microvascularization of the soft and hard tissues. It opened a field of innovative research in plastic and reconstructive surgery.

Maxillary Sinusitis After Sinus Lift Due to Gemella morbillorum

Sinus lift is a predictable procedure for increasing alveolar bone height in the posterosuperior alveolar regions to allow oral prosthetic rehabilitation. Several complications have been documented in the literature and vary from sinus membrane perforation to maxillary rhinosinusitis. The authors present a case of Gemella morbillorum acute sinusitis after sinus lift surgery. The purpose of this report is to describe the surgical and pharmacological management of a patient allergic to penicillin.

A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland

The aim of this observational, cross-sectional study was to analyse the relationship between dental anxiety (DA) and health-related quality of life aspects associated with oral conditions of a population with dental treatment needs in Switzerland. The measurements of DA were collected by means of two questionnaires, the Dental Anxiety Scale (DAS) and a Visual Analogue Scale (VAS). Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP). The sample included 223 patients enrolled at a university clinic which specialises in oral prosthetic rehabilitation and temporomandibular disorders. Of them, 78.9% were at or above the age of 50. No gender or age dependencies were observed. A comparison of answers regarding OHRQoL and DA revealed a significant interdependence (p = 0.0118); highly anxious patients were 3.55 times more likely to suffer from poor quality of life compared with less anxious ones. This cross-sectional study of mostly elderly patients seeking dental treatment in Switzerland found that increased DA was associated with an impaired OHRQoL. The average DA was slightly higher than the results of other industrialised countries and the average OHRQoL was reduced.