Prosthetic Therapy Research Articles

A New Era of Tooth Preparation and Gingitage Retraction Technique: A Case Report

The demand for procedures intended to improve dental aesthetics has increased recently. Preserving the teeth and surrounding soft structures to the greatest extent possible is preferred in this situation by both patients and dentists. When using fixed prostheses, maintaining the stability and health of soft tissues is a constant struggle. Bone tissue health and soft tissue health are directly correlated. The long-term efficacy of prosthetic therapy thus depends on preserving tissue health and being free of mucositis. This case report describes the successful application of the gingitage technique in a patient requiring aesthetic enhancement of the gingival margins surrounding dental restorations. The patient presented with uneven gingival contours and mild inflammation around subgingival margins of existing restorations, compromising both function and aesthetics. Results demonstrated significant improvements in gingival health, a more balanced gingival margin, and an enhanced aesthetic outcome. Follow-up assessments revealed stable gingival contours and an overall increase in patient satisfaction. This case report underscores the effectiveness of the gingitage technique as a minimally invasive solution for enhancing soft tissue aesthetics and supporting the longevity of dental restorations.

Bio-materials Used to Enhance Bone Healing in Implant Dentistry – A Review from the Past to Current

Abstract An alternating way of replacing the missing teeth involves the use of implants. In implant dentistry, an adequate amount of bone is crucial for the long-term prognosis. Bone volume loss can be caused by congenital, post-traumatic or post-surgical abnormalities, as well as disease processes. In scenarios with a bone defect at a site, where the primary stability of an implant cannot be established or where implant placement is not achievable in the best possible position for subsequent prosthetic therapy, guided bone regeneration before implantation represents the method of choice. During implant placement, a partial discrepancy between the implant’s surface and the socket’s osseous walls frequently leaves the peri-implant region with insufficient bone. It has been shown that barrier membranes can be successfully placed to allow the peri-implant space to be filled with new bone rather than lowering the height of the alveolar ridge to produce a sufficient breadth for implantation.

Prevalence of the Gingival Phenotype in Adults and Associated Risk Factors: A Systematic Review of the Literature.

The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However, publications on this subject are either old or concerned with the means of assessing the gingival phenotype or the main factors likely to modify it. The main objective of this systematic review of the literature was therefore to investigate the prevalence of different gingival phenotypes in adults in good general health and with a healthy periodontium. A systematic review of the literature was performed following the guidelines of PRISMA recommendations using an electronic search strategy on four databases (PubMed, Scopus, Cochrane Library, and Embase) complemented by a manual search. Three independent authors were involved in study selection, data extraction, and bias assessment. Results: Of 807 articles, 17 of them, published between 2012 and 2023, involving 3277 subjects from 11 countries and 9766 dental sites, fulfilled the inclusion criteria. The prevalence of the gingival phenotype could not be determined at the level of an individual or a dental arch because all the publications assessed this phenotype only at the level of certain dental sectors, and were not chosen at random. The maxillary central incisors and maxillary or mandibular first molar sectors were associated with a high and thick gingival phenotype, independently of the dental morphology, gender, and age of adult subjects. Furthermore, in these regions, this gingival phenotype tended to be associated with a thick vestibular bone table. In contrast, maxillary and mandibular incisors and premolars more often had a thin gingival phenotype. For other teeth, the results were less conclusive. It is important not to rely solely on the overall appearance of the dentition but to independently assess the thickness and height of the gingiva at each dental site requiring intervention. Finally, this study highlights a key point, namely the need for further longitudinal studies to determine the prevalence in healthy adults. For practicality and feasibility reasons, these studies should be designed according to therapeutic needs, dental sector by dental sector, and within homogeneous source populations. PROSPERO registration: CRD 42023392602.

ASSESSMENT OF DENTAL STUDENTS’ AND DENTISTS’ KNOWLEDGE OF POST AND CORE TECHNIQUE USE IN ENDODONTICALLY TREATED TEETH

Restoring the morpho-functionality of a dental crown that shows extensive surface and depth lesions can be achieved by means of prosthetic therapy represented by different post and core techniques. Purpose The present study aims to assess dental students’ and dentists’ knowledge of post and core techniques using a questionnaire. Material and methods. For this survey-based study a questionnaire was designed consisting of 15 questions related to the category of participants, questions related to the sources of information and questions related to the topic discussed. Results. This study included 55 participants including 39 students in years IV, V and VI, and 16 dentists. Of the 55 participants, 44 were in the 20-29 age group, 10 in the 29-39 age group, and 1 participant was over 40 years old. In terms of gender, 43 were females and 12 males. 74.5% of the participants (n=41) thought that prefabricated fiberglass posts are most often used, followed by cast metal posts, mentioned by 58.2% (n=32) of the respondents. 81.8%(n=45) of the respondents specified intra-radicular aggregated metal-ceramic crowns as the most used substitution method. Conclusion. Based on the results of the study, it can be concluded the main types of prefabricated posts used in post and core techniques were: fiberglass posts and screwed metal posts.

Exploring dimensions and shapes of edentulous patients consulting the prosthodontics centre at Ibn Sina University Hospital in Rabat, Morocco: a cross-sectional study

This cross-sectional study conducted at the Prosthodontics Centre, Ibn Sina University Hospital in Rabat, Morocco, investigates the dimensions and shapes characterizing maxillary and mandibular edentulous arches in a patient population seeking consultation. The objective is to provide insights crucial for optimizing outcomes in prosthetic therapy, informing decisions on impression trays, occlusion planes, prosthetic teeth, and implant attributes. Sixty-seven edentulous Moroccan patients (40 men, 27 women), aged 31 to 90, were recruited at the Prosthodontics Centre. Maxillary and mandibular casts were meticulously crafted, and precise measurements of anterior and posterior width and length were acquired for both arches. Arch shapes were categorized into O-shape, V-shape, and U-shape. Data were analyzed using Microsoft® Excel 2013 and SPSS software (IBM SPSS Statistics 23). Analysis revealed maxillary arch lengths ranging from 40 to 58 mm, maxillary arch widths from 38 to 58 mm, mandibular arch lengths from 33 to 56 mm, and mandibular arch widths from 30 to 60 mm. The predominant arch shape was the ovoid, constituting 34% (n=23) of maxillary cases and 54% (n=36) of mandibular cases. This study provides novel insights into the dimensions and shapes of maxillary and mandibular edentulous arches in patients seeking consultation at Ibn Sina University Hospital, Rabat, Morocco. The findings offer valuable guidance for prosthetic therapy decisions, emphasizing the importance of integrating established references and arch classifications for optimal outcomes in the treatment of edentulous patients in Morocco.

Success, Survival and Prognostic Factors in Implant Prosthesis: Experimental Study

The primary objective of this study was to detect the success and short-term survival rate of dental implant prosthetic therapy. The valuation of a possible relationship between the general and local clinical conditions of the patients (presence of risk factors and type of dental implant-supported prosthesis) and the satisfaction perceived by the patient, with success and survival of implant devices was investigated. The sample trial consisted of 23 patients, for a total of 50 dental implants supporting a prosthetic therapy. Preliminarily, an analysis of averages and frequencies of the anamnestic data was presented, as numbers and percentages. The implant success rate was calculated by assessing whether the implants fulfilled the success criteria defined by the Pisa Consensus Conference. The ANOVA test was used to check whether there was an association between the success of the implant device, the anamnestic data collected, and the type of prosthesis supported by the implants. Finally, the survival rate was calculated using the Kaplan - Meier method. The 2-year success rate of 50 implants was assessed at 98%. The 2-year survival rate was 97%. Finally, sex, age, compensated diabetes, a smaller and equal number of cigarettes per day (10 per day), the BOP, and the type of titanium dental implants supported by prosthesis, do not determine a change in success and are therefore not adequate parameters to predict the outcome of implant success. Following the results obtained, it is appropriate to continue the research by expanding the clinical observation times in order to obtain more solid scientific and clinical evidence.

Assessment of Various Risk Factors for Biological and Mechanical/Technical Complications in Fixed Implant Prosthetic Therapy: A Retrospective Study.

The study group consisted of 67 edentulous patients (mean age: 63.88 ± 11.709 yrs; 20 males, 47 females) with implant prosthetic therapy for posterior edentulism. A total of 76 implant-supported fixed partial dentures (IP-FPDs) and 178 implants were assessed using clinical and paraclinical assessments. Risk factors for biological complications (peri-implantitis) and technical complications were determined by using the Pearson Chi-squared test and multivariate analysis. The implant success (the absence of biological and mechanical/technical complications) was 66.30%. The prevalence of biological complications was 13.5%. The prevalence of technical complications was 28.70%. Variables that were associated with a higher risk of peri-implantitis were poor oral hygiene and bruxism. In univariate analysis, poor oral hygiene increased the risk of peri-implantitis 5.778 times and bruxism 5.875 times. Variables that were associated with a higher risk of mechanical/technical complications were age group > 60 yrs, smoking, history of periodontal disease, and bruxism. In univariate analysis, the risk of technical complications increased 4.14 times for patients in the age group > 60 years (vs. age group 40-60 years) and 20.5 times for patients with bruxism. Bruxism and smoking were significant predictors of mechanical/technical complications in the multivariate model. In univariate models, patients with poor oral hygiene and bruxism have an increased risk of peri-implantitis. In multivariate models, we did not identify significant predictors of peri-implantitis. Age group > 60 yrs, smoking, history of periodontal disease, bone grafting, and bruxism are risk factors for the increase in the mechanical/technical complication rate. In the multivariate model, smoking and bruxism are significant predictors of the mechanical/technical complications.

Microscopic and Mechanical Characterization of Co-Cr Dental Alloys Joined by the TIG Welding Process.

Due to their good mechanical and other properties, cobalt-chromium alloys (Co-Cr) are often used in prosthetic therapy. The metal structures of prosthetic works can be damaged and break, and depending on the extent of the damage, they can be re-joined. Tungsten inert gas welding (TIG) produces a high-quality weld with a composition very close to that of the base material. Therefore, in this work, six commercially available Co-Cr dental alloys were joined by TIG welding, and their mechanical properties were evaluated to determine the quality of the TIG process as a technology for joining metallic dental materials and the suitability of the Co-Cr alloys used for TIG welding. Microscopic observations were made for this purpose. Microhardness was measured using the Vickers method. The flexural strength was determined on a mechanical testing machine. The dynamic tests were carried out on a universal testing machine. The mechanical properties were determined for welded and non-welded specimens, and the results were statistically evaluated. The results show the correlation between the investigated mechanical properties and the process TIG. Indeed, characteristics of the welds have an effect on the measured properties. Considering all the results obtained, the TIG-welded I-BOND NF and Wisil M alloys showed the cleanest and most uniform weld and, accordingly, satisfactory mechanical properties, highlighting that they withstood the maximum number of cycles under dynamic load.

Ten-year clinical performance of non-precious metal double crowns with friction pins in severely reduced dentitions—a retrospective study

ObjectivesThis follow-up study aimed at collecting long-term data for removable partial dentures (RPDs) retained by double crowns with spark-eroded friction pins (DCP) and comparing them in the presence of severely reduced dentition (SRD) and non-SRD (NSRD, i.e. residual dentition with more than three abutment teeth) after a 10-year wearing period.Materials and methodsA total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth were followed up between 2006 and 2022. The SRD group included 144 RPDs supported by 314 abutment teeth. The data collection was performed retrospectively. 10-year survival rates of RPDs and abutment teeth were determined using the Kaplan–Meier method and compared using the log-rank test for SRD and NSRD, among others. Cox regression analyses were conducted to isolate risk factors for the survival of both RPDs and abutment teeth.ResultsThe 10-year cumulative survival rate of all abutment teeth was 65.6% with significantly lower values in the SRD group (53.5%) (p < 0.001). The survival rate for all RPDs was 65.5%. The SRD group showed lower survival rates (57.9%) (p = 0.004). The number and location of the abutment teeth had a significant influence on the survival rates of the RPDs and the abutment teeth. Age, sex, jaw, relining, and vitality had a significant influence on the abutment teeth survival rates.ConclusionsRPDs showed an acceptable clinical survival rate after 10 years. The number, location, and vitality of abutment teeth were factors that influenced the survival of both RPDs and abutment teeth.Clinical relevanceConsideration of the influencing factors found can help improve the prognostic assessment of double crown-retained dentures in the context of prosthetic therapy planning.

Ceramic cantilever bridge: A simplified clinical technique

The anterior single missing tooth is a challenge to the dental surgeon when it comes to functional, aesthetic and biological integration especially when in adolescents or young adults, where passive eruption of the tooth is still active and where implant placement must be postponed. As a temporary or a long-term treatment, a fixed prosthesis can be placed, but in the era of maximum tissue preservation, dental practice is moving towards a harmless and conservative prosthetic therapy “the cantilever bonded bridge”.The indication is limited to the replacement of central or lateral maxillary incisor and mandibular incisors and therefore requires following a precise and rigorous clinical protocol. This article will discuss a simplified clinical realization of the ceramic cantilever bridge.The use of cantilever bonded bridges (single retainer) seems to be an excellent alternative compared to other therapeutic solutions.

A comparison between rural and urban residents attending Basrah Dental College south of Iraq for tooth extraction between 2018-2021 and its relation to the dental health care situation in Iraq

Most studies confirmed caries are the main cause of tooth extraction in urban and rural areas, especially in young people. There is a relationship between the level of education and dental extraction, particularly in rural areas. In this cross-sectional examination overall 1257 patients were treated in the teaching clinic of the oral and maxillofacial surgery department, College of Dentistry, the University of Basrah between 2018-2021. Data were collected from patients' data after taking the agreement of the ethical committee in the college. The comparisons include age, gender, educational level, occupation, chief complaint, diagnosis and tooth site. reasons and pattern of tooth loss were recorded and data were computed on SPSS. Version 20. The numbers of tooth extraction in urban and rural were very close 632(50.3%) and 624(49.7%) extractions respectively. The male to female percentage was 38.2 %, 61.8% respectively and the highest number of extractions was observed in females in rural areas most of the patients are a housewife. Tooth extraction has seen more in the third, fourth and fifth decade than other age groups 20.4%, 22%, 19.9% respectively. A significant difference between education and dental extraction was noted between urban and rural areas. The main complaint was for prosthetic therapy 45.3% and 43.2% because of pain. The largest proportion considered as the main cause of extraction was dental caries consequences of 80.5% and the lowest 16.9% from periodontal disease. Key Words: Extraction, Rural, Urban, dental health care, First Molar.

Definitive Impression Technique for Maxillary Defects in Patients with Reduced Mouth Opening- A Novel Approach

Palatal defects are categorised as a multicausal pathology, with its aetiology ranging from trauma and microbial infections to oncogenic origin. This by and large leads to surgical defects of the palatal tissues which warrants immediate treatment. Due to this, the patient faces a plethora of challenges, namely psychological, functional and social. These defects can be catered to by means of surgical closure or prosthetic therapy. Thereby, this uplifts the patient’s self-confidence and performance of day-to-day activities. However, surgical closure by free flaps is not feasible in all cases due to the dearth of favourable tissues or prevalent co-morbid conditions. So, this makes fabrication of a palatal obturator the treatment of choice to rehabilitate these cases. An obturator is a maxillofacial prosthesis which blocks the oro-nasal communication and thus ameliorates the mastication, phonation and aesthetic profile of the affected subject. For fabricating well-fitting obturator prosthesis, making an accurate impression with appropriate spatial orientation of the orofacial structures is imperative. Many obstacles come in the way of a prosthodontist while making impression in such cases due to the complexity of the supporting stomatognathic system in terms of compressibility and multitude of geometric planes of the tissues. These patients present with restricted mouth opening due to scarring of tissues or radiation therapy. In this article, the authors describes a technique which predominantly addresses most of the problems related to the impression making procedures in patients treated with maxillectomy experiencing limited mouth opening.

Tooth Loss and Prosthesis Replacement at El-Koms City

Background and objective.Lossof at least one tooth disturbs the structural balance of the remaining natural teeth and may result in widening of proximal contacts, and other deformities.The proportion of full and partial edentulous people, as well as their prosthetic therapy, were investigated El-Koms cityMethods.Patient demographics, the percentage of partial and completely edentulous patients, and their prosthetic treatment were collected at four dental clinics. Health services. Ministry of Health in El-Koms city. The study was approved by the prosthodontics department, Faculty of Dentistry, University of Al Marqab.In 2020, a total of 1000 people were assessed in four dental clinics, with 472 individuals being chosen as part of the sample study group. Patients were chosen based on their age, which ranged from 25 to 75 years old, and their dental records. ResultsThe majority of the study participants (n = 472) had missing teeth as follows: 27 patients are completely edentulous, 36 patients having a single edentulous arch, 348 patients being partially edentulous, and 61patients having no missing teeth.Edentulous jaws werecorrelated statistically significantly with age, being more common in older age (𝑝value 0.03).Males had a higher percentage of missing teeth than females, and as people got older, edentulous persons grew increasingly common. In both jaws, Class IIIpartial edentulous people were the most common. Conclusion.There is a high demand for prosthodontic treatment. The incidence of edentulous patients in Libya, as well as predisposing factors, are both unknown

Patient-reported outcome measures (PROMs) comparing digital and conventional workflows for treatment with posterior single-unit implant restorations: A randomized controlled trial

ObjectivesThe aim of this randomized controlled trial (RCT) was to analyze patient-reported outcome measures (PROMs) of prosthetic therapy with monolithic implant crowns in completely digital workflows (test) with intraoral optical scanning (IOS) and conventional workflows (control) with conventional impressions. Secondary, an objective evaluation of the final implant restorations was performed using the Functional Implant Prosthodontic Score (FIPS). Materials and MethodsForty patients who required an implant-supported single crown on posterior regions were randomly divided into test (n = 20) and control (n = 20) groups for impression taking. Each group was then equally separated into two subgroups according to the restorative material used: lithium disilicate (LS2, N!CE®, Straumann AG, Basel, Switzerland) or polymer-infiltrated ceramic networks (PICN, Enamic®, Vita, Bad Säckingen, Germany). Patient satisfaction was evaluated using PROM questionnaires with visual analog scales (VAS) after impression-taking and 1 week after prosthetic delivery. Patient satisfaction with the impression technique was assessed in six domains: length, comfort, anxiety, taste, nausea, and pain, whereas patient satisfaction with the final restoration was assessed in four domains: overall treatment outcome, functionality, esthetics, and cleanability. In addition, the final implant restorations were objectively assessed by an independent prosthodontist using the FIPS. Mann-Whitney U test was used to analyze the defined outcomes. Statistical analysis was completed with a level of significance set at α=0.05. ResultsPROMs focusing on the impression technique demonstrated higher levels of patient satisfaction for IOS compared to conventional impressions, especially in terms of “taste irritation” (p = 0.036); whereas no significant differences were found between both restorative CAD/CAM-materials. Mean FIPS values demonstrated similar results among subgroups. ConclusionsWithin the limitation of this study, both completely digital and conventional protocols provided great levels of patient satisfaction in implant rehabilitation of single-tooth gaps in posterior sites with monolithic implant crowns. The restorative material, LS2 versus PICN, does not impact patient satisfaction with their treatment. However, a long-term follow up is needed to draw more specific conclusions on patient satisfaction with the restorations.

Esthetic and functional reconstruction of large mandibular defects using free fibula flap and implant-retained prosthetics - a case series with long-term follow-up

BackgroundThe reconstructive and rehabilitative management of large mandibular defects with basal continuity is challenging in many respects, especially in the vertical dimension. The free fibula flap is an under-utilised but efficient approach in this indication. The aim of this case series is to demonstrate its use and long-term success.Case presentationThree cases are presented, where the patient had a large bone defect (at least 5 cm in length and 1 cm in the vertical dimension), but the continuity of the mandible was maintained. Two cases were related to pathological fracture and one was a large defect due to oncological surgery. Vertical augmentation with free microvascularised fibula flap was carried out, followed by implant-retained prosthetic therapy. Clinical status has been followed up for 5 to 6 years, with special attention to the condition of the peri-implant tissues and any radiographically detectable alterations or complications. No complications occurred during the follow-up. Function and esthetics have remained unchanged throughout.ConclusionsFree microvascularised fibula flap reconstruction combined with implant-retained prosthetics allows a lasting functional and esthetic solution in the discussed indication.

Cost analysis of prosthetic rehabilitation in young patients with Amelogenesis imperfecta

Objectives: Children and adolescents with amelogenesis imperfecta (AI) have extensive treatment needs, but costs have not been explored previously. We calculated the costs of prosthetic rehabilitation and analyzed whether costs of treatment begun in early adolescence are lower compared with in early adulthood. Methods: Data from the dental records of 25 patients with AI and 25 age- and sex-matched controls were analyzed. Patients were followed for a mean period of 12.3 ± 1.5 years. Number of dental visits, dental treatment costs, and indirect costs were calculated during three time periods, before, during and after prosthetic therapy. Swedish national reference prices for general and specialist dental care were used. Results: The mean number of visits was significantly higher in the AI group: 43.3 ± 19.7 (controls: 17.5 ± 19.8; p < .001). Mean total costs were 8.5 times higher for patients with AI: €16,257 ± 5,595 (controls: €1,904 ± 993). Mean number of crowns made in patients with AI was 12 ± 7 (range 1 − 31). Indirect costs were significantly higher in the AI group and constituted 22% of the total costs. After crown therapy, costs between groups ceased to differ significantly. Calculations of total costs in the hypothetical scenario (discount rate at 3% annually) were €18,475 for prosthetic rehabilitation began at age 12 years compared with €20,227 if treatment began at 20 years of age. Conclusions: Prosthetic rehabilitation costs for children and adolescents with AI can be high. Early crown therapy is associated with lower costs and a lower number of dental visits. Clinical ImplicationsEarly crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.

PREPARATION FOR PALATOPLASTY SURGERY WITH AN ACRYLIC FEEDING OBTURATOR: A CASE REPORT

ABSTRACTBackground: Clefts on the lips and palate are common cases to be found frequently in the field of dentistry. This gap connects the oral cavity and the nasal cavity so that it interferes with the nutritional intake in patients. The age and size of the oral cavity in patients become particular challenges for prosthetic rehabilitation. Another challenge lies at the impression procedure, because it is an essential part in the making of obturator. Objective: To provide information on the management of patient with cleft palate using feeding obturator from acrylic material. Case: A 13-months-old male patient arrived at Prof. Soedomo Gadjah Mada University Dental Hospital with his parents and was seeking for prosthetic therapy to cover the cleft on his palate because it had been muddling with food and beverage intake. Patient had undergone cheiloplasty surgery and further arranged for palatoplasty procedure. Intraoral examination exhibited a cleft extended from hard palate, soft palate, and uvula. Case management: Upper jaw impression was performed for individual tray fabrication, followed by impression procedure in an upright straight position until the patient bawled. The impression result was casted to construct an obturator using acrylic heat cure material. Fitting surface was covered with soft liner. Treatment result showed that the obturator was retentive, stable and able to assist the nutritional intake in patient. Conclusion: Acrylic feeding obturator can recover the condition in patient with cleft palate and improve nutritional intake as well as body weight to prepare patient for palatoplasty surgery.Keywords: Cleft Palate, Feeding Plate, Obturator

TREATMENT OF COMMON DENTAL INJURIES DURING SPORT ACTIVITIES -CASE REPORT

Several different sports like karate, handball, basketball, or some other sport activities like riding a bike or roller skaters often cause dental trauma in young patients. Accidental falls, impacts and hits play major role in these injures, sometimes even with serious health impact. Soft tissue trauma presents a high percentage of injures, but 40% are dental traumas, and upper maxillary incisors are most affected.Fractured or lost upper first maxillary incisor demands immediate restoration. Prosthetic solutions for different sport facial and dental traumas are crowns, removable partial dentures or implants. Managing the pain fast with different treatment choices like extraction of the tooth, endodontic treatments and early temporary prosthetic therapy protocols are showing good results. Individual approach for every type of trauma is needed, and most of the patients are accepting the suggested treatment plan. Restored teeth show good aesthetic and function solutions, too. Choosing the best therapy treatments in these patients is very important, because dental trauma can also cause some psychological and social problems. Immediate treatment is necessary, and proper restoring often demands a team effort. Keywords: sport dental injuries, fracture, mouthguards.

Digital Systems in Medical Science and Modern Dentistry

Digital expert systems, commonly used in medicine, can be implemented successfully in the analysis and planning of treatments in dentistry. In implant-prosthetic therapy, these software applications epresent necessary adjuvant tools in optimizing therapeutic decisions regarding the pro-implant and implant stages as well as in creating a therapeutic planning algorithm. PRODENT Acad Expert (data recording and database) and PRODENT Indices (calculation of biological indices and recommendation for the optimal treatment solution) (Neo-Tech, Romania) are tools that allows the registration and entry of data in the database, registration of clinical and biological indices in pretreatment and post-implant stage, respectively the recommendation of an optimal prosthetic solution. The use of this application is necessary in monitoring changes related to the biological components of the stomatognathic system in postimplant stage. Expert applications for the assessment of mucosal and bone support, planning of bone addition procedures and positioning of dental implants laid the foundations of digital implantology (Implant 3D, Universe; NobleGuide, Nobel Biocare; Digital Smile Design, DSD; SimPlant, Dental Materialize; Virtual Implant Placement, BioHorizons; ImplantMaster, iDent; Implant 3D, Media Lab; EasyGuide, Keystone Dental). The Digital Smile Design favors the planning of prosthetic therapy and the design of the future prosthetic work in accordance with the aesthetic principles and the requirements of the patients, based on a motivational mock-up. Literature data demonstrate the increase in the long-term success rate in digital-assisted implant-prosthetic therapy and justify the widespread expansion of the use of digital applications in current contemporary dental practice.

Effect of prostheses on children with congenital upper limb deficiencies.

Individual weaknesses in motor skills are a characteristic of children with congenital upper limb deficiencies. These weaknesses increase with age. In Japan, however, prosthetic prescription and subsequent rehabilitation approaches for children with upper limb deficiencies are insufficient and often delayed. This study aimed to elucidate whether rehabilitation approaches, including prostheses prescription and occupational therapy, improve these children's adaptive behaviors, especially their motor skills. The study included nine children, aged 0-6years, with unilateral transradial or transcarpal upper limb deficiencies. We measured their adaptive behaviors and motor skills at the beginning of prosthetic therapy and after 1.5 years, using the Vineland Adaptive Behavior Scales - Second Edition. The score for the motor skills domain was significantly lower than the median score of the domains at the beginning of prosthetic therapy. The motor skill weaknesses significantly improved after 1.5 years of prosthetic therapy. Although children with congenital upper limb deficiencies have individual weaknesses in their motor skill behavior, it was shown that these weaknesses can be improved through rehabilitation approaches, including occupational and prosthetic therapies. Issuing the appropriate prostheses and implementing the appropriate training to use the prostheses for congenital upper limb deficiencies are reasonable and meaningful interventions to improve quality of life.