Prosthetic Treatment Of Patients Research Articles

Comparison of functional outcome and patient satisfaction between patients with socket prosthesis and patients treated with transcutaneous osseointegrated prosthetic systems (TOPS) after transfemoral amputation

PurposeThe aim of this retrospective analysis was to investigate and evaluate differences in functional outcome and satisfaction of patients treated with a TOPS and patients using socket prosthesis after transfemoral amputation.MethodsThis retrospective comprehensive analysis included patients from a single hospital, and was conducted between February 2017 and December 2018. Overall n = 139 patients with prosthesis were included and divided into two comparable groups (socket- and TOPS group). Incomplete data sets were excluded. This led to n = 36 participants for the socket- and n = 33 for the TOPS group. Functional outcome and satisfaction were evaluated by Patient Reported Outcome Measures (PROMs). The used PROMs were: Questionnaire for Persons with a Transfemoral Amputation (Q-TFA), EQ5D-5L, Satisfaction with Prosthesis Questionnaire (SAT-PRO), Prosthesis Mobility Questionnaire (PMQ 2.0) and Functional Independence Measure (FIM).ResultsSignificant results in favor of TOPS patients were identified for the EQ-5D 5L (p = 0.004), Q-TFA (p = 0.000), SAT-PRO (p = 0.000) and PMQ 2.0 (p = 0.000). For FIM, no statistical significance was found (p = 0.318).ConclusionIn this study, transfemoral amputees treated with an osseointegrated prosthetic attachment (TOPS) showed significantly higher scores for mobility and satisfaction. This demonstrates the high potential of TOPS in the prosthetic treatment of patients with transfemoral amputation with regard to their functional abilities in daily life.

IMPLEMENTATION OF NEUROMUSCULAR DENTISTRY PRINCIPLES IN REHABILITATION OF PATIENTS WITH COMPLETE ADENTIA

According to World Health Organization about 15% of the world’s adult population suffer from complete adentia, with a steady growth in the number of patients affecting not only the elderly which is accounted for by an increase in life expectancy, yet also among people in their working age. Apart from disturbed chewing and speech functions, complete adentia leads to altered anatomical and topographic proportions of the face and facial skeleton, progressive atrophy and osteoporosis of the jaws, masticatory and mimic muscle atrophy, as well as to dysfunction affecting these muscles and temporomandibular joints. Due to lack of proper nutrition, changed exterior, issues in interaction with others, this group of patients develop a whole set of psychosomatic reactions finally causing social withdrawal. Rehabilitation of patients with complete loss of teeth is an urgent issue. However, the effectiveness of prosthetic treatment depends not only on the denture manufacturing technology, but on the quality of functioning involving the maxillofacial organs in combination with the respective orthopedic appliances. Whereas precise and reliable assessment of the maxillofacial neuromuscular balance enables to predict immediate and long-term outcomes of orthopedic treatment. Employing the principles of neuromuscular dentistry allows us to assess reliably the changes in the reflex mechanisms of muscular apparatus. This was carried out throughout all the stages of prosthetic treatment in patients with complete adentia with intraosseous implants with fixed bridges and conditionally removable denture.

Non-surgical approach and prosthetic treatment of patients with Stage IV periodontitis

Non-surgical approach and prosthetic treatment of patients with Stage IV periodontitis

Возможности применения композиционных материалов и цифровых технологий на этапах ортопедического лечения пациентов с полным отсутствием зубов

The relevance of the study is dictated by the need to increase the efficiency of prosthetic treatment of patients with full absence of teeth, through the introduction of new composite materials, the use of which provides high strength of prosthetic structures, as well as the development of methods for the manufacture of full removable plate denture using modern digital technologies, which in general contributes to increase the service life of dentures, especially in the presence of difficult clinical conditions.
 Purpose of the work: increasing the efficiency of prosthetic dental treatment of patients with full absence of teeth on the basis of the development and implementation of a new design of a full removable plate denture with a base made of acrylic resin and an introduced frame made of composite material based on fiberglass.
 Materials and methods: taking into account the analysis of data from domestic and foreign literature, a design was developed and a technology for manufacturing a full removable plate denture with a combined basis was proposed, the frame of which was made of composite material Trinia. In the course of the work, the morphology and microstructure of a new combination of polymers were studied, and also, in a comparative aspect, their physical and mechanical properties were evaluated.
 Results: during the study of the microstructure, we found that the composite material based on glass fiber has a chemical bond with acrylic resin and a high homogeneity of the structure. Physicomechanical tests showed that when the base resin is reinforced with Trinia material, an increase in the strength of the samples under study is noted, which exceeds the existing analogues. Clinical and laboratory stages of manufacturing a new design, combining analog and digital methods, have been developed and tested.
 Conclusions: the introduction of a composite material into the design of a combined full removable plate denture will improve the strength properties of its base, increase performance and reduce weight. The use of digital technology will enable the use of high-strength composite materials.

Prosthetic treatment of patients with distal occlusion using a deprogrammer: A clinical case

Prosthetic treatment of patients with distal occlusion using a deprogrammer: A clinical case

Prosthetic treatment for patient with anterior overbite and partial edentulism using maxillary hybrid telescopic double crown RPD and mandibular fixed prostheses: A 11-yr follow-up

Prosthetic treatment for patient with anterior overbite and partial edentulism using maxillary hybrid telescopic double crown RPD and mandibular fixed prostheses: A 11-yr follow-up

Dental Implant Treatment In Patients With Oral Cancer: Literature Review

The aim of this review is to evaluate the timing of dental implants placement and long-term survival rates in patients who have had prosthetic rehabilitation with dental implants after ablative surgery and radiotherapy (RT), and have had head and neck cancer (HNC). For this purpose; implant survival (IS) rates placed as primary/secondary or placed in bones with/without RT were evaluated. The literature published between 2000 - 2020 has been reviewed for the evaluation of dental implant treatment in patients with HNC. The search terms used in PubMed scans were "head and neck cancer", "oral cancer", "dental implant" and "radiotherapy". 134 related articles have been defined in PubMed database searches and 16 were included in the final analysis. Dental implant applications have gained importance in the prosthetic treatment of patients with oral cancer. In cases where conventional prosthetic treatments are insufficient, dental implants provide retention and stability to dentures. However, before starting treatment, whether the patient is receiving chemotherapy, RT and the use of bisphosphonate should be taken into consideration and the timing of the surgical procedures should be adjusted correctly. In addition, these patients should be followed up regularly for a long time.

Full Mouth Rehabilitation of a Patient with Severe Attrition Using Digital Smile Design Concept: Case Report

Prosthetic treatment of patients with severe wear is challenging task. First step is controlling the causative factor that led to teeth wear along with the restoration of lost dentition.

Оцінка ефективності застосування еластичної підкладки як засобу для скорочення термінів адаптації до знімних пластинчастих протезів в процесі ранньої ортопедичної реабілітації пацієнтів

Objectives. Study of ways to increase the efficiency of immediate prosthetic treatment of patients with asymmetric distally unlimited defects of dental rows by using clinical relining of partial removable dentures with elastic material to reduce the time of adaptation to dentures and normalize the functional activity of the masticatory muscles. Materials and methods. The efficiency of clinical relining of partial removable dentures using an elastic lining with Ufi Gel P from VOCO (Germany) was evaluated by electromyographic examination with BioEMG III electromyograph from BioRESEARCH Associates, Inc. (USA). The bioelectrical activity of the temporal and masseter muscles was evaluated during maximum voluntary clenching and mastication. The quantitative indicators of the amplitude of biopotentials (μV) and the qualitative characteristics of the chewing cycles were evaluated. Results. Our study has revealed that patients with asymmetric distally unlimited defects of dental rows had shown a significant decrease in the amplitude of biopotentials of the masticatory muscles compared to patients in the control group during maximum voluntary clenching and chewing, as well as a significant asymmetry of the bioelectric activity of the masticatory muscles on the right and left. During mastication there were significant differences in the size and duration of chewing cycles, a decrease in the duration of rest periods and the average number of chewing movements increased almost two times compared with intact dentition. A month after prosthetics, the indicators of bioelectrical activity of the masticatory muscles improved in both study groups of patients, but the most significant increase in amplitude was observed in the second group with a soft lining. There was also revealed a significant increase in the symmetry of bioelectric activity of the masticatory muscles, an improvement in the characteristics of the masticatory cycles and normalization of the activity and rest periods duration ratio in patients of the second group, while in patients of the 1st clinical group the indicators of symmetry did not change significantly. The average number of chewing movements required to chew the hazelnut kernel decreased to 38.7±16.2 and 29.3±10.7 respectively, in groups 1 and 2, which indicates an increase of masticatory efficiency. Conclusions. In the framework of this study, the high efficiency of elastic lining for the successful rehabilitation of patients with asymmetric distally unlimited defects in case of early prosthodontic interventions was proved. Our observations have shown that the use of the soft lining significantly increases the functional parameters of the masticatory system, shortens the period of adaptation to removable dentures and supports the formation of the alveolar processes relief without irregularities.

Функциональный анализ результатов использования эластической подкладки «Ufi Gel P» компании «VOCO» (Германия) как средства для сокращения сроков адаптации к съемным пластиночным протезам в процессе ортопедической реабилитации пациентов с асимметричными дистально неограниченными дефектами зубных рядов на ранних этапахФункциональный анализ результатов использования эластической подкладки «Ufi Gel P» компании «VOCO» (Германия) как средства для сокращения сроков адаптации к съемным пластиночным протезам в процессе

Objectives. Study of ways to increase the efficiency of immediate prosthetic treatment of patients with asymmetric distally unlimited defects of dental rows by using clinical relining of partial removable dentures with Ufi Gel P material from VOCO (Germany) to reduce the time of adaptation to dentures and normalize the functional activity of the masticatory muscles. Materials and methods. The efficiency of clinical relining of partial removable dentures using an elastic lining with Ufi Gel P from VOCO (Germany) was evaluated by electromyographic examination with BioEMG III electromyograph from BioRESEARCH Associates, Inc. (USA). The bioelectrical activity of the temporal and masseter muscles was evaluated during maximum voluntary clenching and mastication. The quantitative indicators of the amplitude of biopotentials (μV) and the qualitative characteristics of the chewing cycles were evaluated. Results. Our study has revealed that patients with asymmetric distally unlimited defects of dental rows had shown a significant decrease in the amplitude of biopotentials of the masticatory muscles compared to patients in the control group during maximum voluntary clenching and chewing, as well as a significant asymmetry of the bioelectric activity of the masticatory muscles on the right and left. During mastication there were significant differences in the size and duration of chewing cycles, a decrease in the duration of rest periods and the average number of chewing movements increased almost two times compared with intact dentition. A month after prosthetics, the indicators of bioelectrical activity of the masticatory muscles improved in both study groups of patients, but the most significant increase in amplitude was observed in the second group with a soft lining. There was also revealed a significant increase in the symmetry of bioelectric activity of the masticatory muscles, an improvement in the characteristics of the masticatory cycles and normalization of the activity and rest periods duration ratio in patients of the second group, while in patients of the 1st clinical group the indicators of symmetry did not change significantly. The average number of chewing movements required to chew the hazelnut kernel decreased to 38.7±16.2 and 29.3±10.7 respectively, in groups 1 and 2, which indicates an increase of masticatory efficiency. Conclusions. In the framework of this study, the high efficiency of Ufi Gel P (VOCO) elastic lining for the successful rehabilitation of patients with asymmetric distally unlimited defects in case of early prosthodontic interventions was proved. Our observations have shown that the use of the Ufi Gel P (VOCO) soft lining significantly increases the functional parameters of the masticatory system, shortens the period of adaptation to removable dentures and supports the formation of the alveolar processes relief without irregularities.

OBTURATOR TREATMENT- BACTERIAL INFECTION RISK ASSESSMENT

Background: Consequences after oncological operations of the upper jaw are varying degrees of eating, swallowing and breathing disorders, from which the patient suffers biologically. Speaking is also affected in varying degrees, which makes the patient socially inferior as well. Often the newly formed communication between the oral and nasal cavity takes away the possibility of normal nasal breathing, food residue pass through the resulting opening, its decomposition result in chronic inflammation of the nose and paranasal sinuses. Patients maxillary resection post-surgery stage require maintaining of good oral hygiene and appropriate materials usage for laboratory development of obturators.Objective: The purpose of this study is to review the literature data assessing the risk of bacterial infection in the treatment of patients with maxillary defects treated by different types of obturators.Discussion: Surgical treatment of cancer and other pathological conditions in the maxillofacial area lead to different size, location and type of defects of soft and hard tissues that impair appearance and aesthetic look of the face of the operated patients. Changes that occur in appearance and functional disorders are directly dependent on the size and type of defect after the operation. The problems after maxillary resection are often exacerbated by concomitant radiotherapy, and leads to dry mouth, difficulty swallowing and impaired speech intelligibility.The prosthetic treatment of patients after maxillary resection is accompanied by many difficulties and problems. Patients maxillary obturators after the bone resection can cause risk of bacterial infection. This is more commonly observed because of silicone materials and buccal flange sealers application. The acrylic and light-curing plastics usage significantly reduces the risk of infection. Nevertheless, disinfectant solutions irrigation and good oral hygiene maintenance are mandatory. Their use is considered to significantly reduce the risk of bacterial infection during all stages of prosthetic treatmentConclusion: Prosthetic rehabilitation of patients with maximal resection requires the specific treatment modalities usage. The type and shape of prosthetic structures, as well as the choice of materials for their construction, must ensure good oral hygiene. The use of disinfectants significantly reduces the risk of bacterial infection, especially when silicone materials are applied.

Postępowanie kliniczne podczas leczenia protetycznego pacjentów z ubytkami tkanek w obrębie jamy ustnej i twarzy

Postępowanie kliniczne podczas leczenia protetycznego pacjentów z ubytkami tkanek w obrębie jamy ustnej i twarzy

Prosthetic treatment of adolescents with craniomaxillofacial fibrous dysplasia

Craniomaxillofacial fibrous dysplasia may cause structural anomalies in the facial part of the skull, leading to anatomical and functional abnormalities in the stomatognathic system, requiring multi-disciplinary treatment. Depending on the location of dysplastic lesions, stage and course of the disease, each patient presents with a specific picture of the disorder and requires an individual therapeutic approach. Prosthetic treatment of patients at developmental age requires regular check-ups and frequent corrections or replacement of prosthetic restorations. This is particularly important in patients whose prosthetic field is deformed in such disorders as fibrous dysplasia or following numerous surgical procedures. The effectiveness of therapeutic procedures, which in such cases must be multidisciplinary, depends mainly on the commitment and cooperation of the patient and their carers. We present difficulties in the prosthetic rehabilitation of maxillofacial dysplasia based on the example of a patient diagnosed with fibrous dysplasia, severe oligodontia multiorgan congenital malformations, and a history of numerous surgical procedures within the stomatognathic system.

Prosthetic treatment for patient with congenital bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture

Prosthetic treatment for patient with congenital bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture

Innovative use of collagen in prosthetic treatment of patients with complete absence of teeth in the lower jaw

Innovative use of collagen in prosthetic treatment of patients with complete absence of teeth in the lower jaw

Case report: Cerebral arterial thrombosis in a child with nephrotic syndrome

The prosthetic treatment of patients with total maxillectomies is an enormous reconstruction challenge because of insufficient support and retention from the residual tissues. It is not possible to place the bulb in the presence of unfavorable undercuts throughout the nasal cavity floor and borders. The purpose of this article was to describe a prosthetic reconstruction technique which accomplishes optimum sealing, retention, stabilization, and easy placement of an open‑hollow acrylic resin obturator using a spring with a resilient liner for a patient who underwent a total maxillectomy. The springs were placed in the resilient liner to facilitate the placement of the obturator prosthesis because of unfavorable undercuts. It was possible to fit the prosthesis in two stages by means of springs. The objective of this technique is to improve the patient’s psychological, functional, and social well‑being by producing a stable, retentive, leakproof, comfortable, easy‑fitting prosthesis. This technique is appropriate for patients who have undergone total maxillectomies when implant placement is not possible. Keywords: Dental obturators, maxillectomy reconstruction, maxillofacial prosthesis, open‑hollow acrylic resin obturator, total maxillectomy

Principles of prosthetic treatment in patients with neoplasms of the oropharyngeal zone

Principles of prosthetic treatment in patients with neoplasms of the oropharyngeal zone

CAD/CAM occlusal splint fabrication after implant prosthetic treatment in patients with bruxism

CAD/CAM occlusal splint fabrication after implant prosthetic treatment in patients with bruxism

Prediction of biomechanical complications in patients with implant supported fixed dental prostheses in different terms of functional loading

Objective – to study features of biomechanical complications (structural fractures, loss of retention, screw loosening/fracture) of implant restorations in different terms of functional loading and work out preventive measures. Materials and Methods. The results of prosthetic treatment with implant supported fixed dental prostheses were analyzed among 65 patients, who were treated between 2011 and 2016. There were 28 (47.1 %) men, 37 women (56.9 %), the average age of patients was 35.6 ± 12.7 years. All patients had small defects of dentition in posterior region without severe periodontal or general pathology. Prosthetic treatment was performed on two-staged osteointegrated “root form” implants with a screw design. According to the objective of the study all patients were divided into three groups depending on the period within implant placement and tooth extraction (6–8 month or more than 2 years), the terms of functional loading and usage of protective occlusal splits. The incidence of biomechanical complications and functional activity of masticatory muscles were detected. Results. The incidence of mechanical complications during 5-year period was 3.85 times higher in patients with long-term existing defects of dentition after tooth extraction and conventional prosthetic treatment with deferred occlusal loading (3 cases (15 %) of loss of retention, 5 cases (25 %) of veneering material fracture, 1 case (5 %) of abutment screw loosening and 1 case (5 %) of abutment screw fracture) in comparison to patients with early functional loading and shorter period after tooth extraction (1 case (4.3 %) of loss of retention and 2 cases (8.7 %) of veneering material fracture). Protective occlusal splints’ application and early functional loading in prosthetic treatment of patients with long-term existing defects of dentition after tooth extraction allowed to decrease the incidence of mechanical complications in 1.57 times in comparison to conventional treatment with deferred loading. Conclusions. The incidence of biomechanical complications of implant restorations is higher in patients with long-term existing defects of dentition after tooth extraction and deferred occlusal loading in comparison to cases of well-timed prosthetics and early functional loading. Protective occlusal splints are proved as effective preventive measures to decrease the incidence of mechanical complications of implant supported fixed dental prostheses and to induce faster normalization of masticatory activity.

Fixed prosthetic treatment in patients with cleft lip and palate

Introduction. The prosthetic treatment of patients with cleft palate includes various treatment options such as fixed partial dentures, removable partial prosthesis, etc. The type of prosthetic appliance is determined by the oral health of each individual and the circumstances. We presented three adult patients with the cleft lip and palate subjected to prosthetic treatment. Case report. From the possible prosthetic solutions according to the conditions in the oral cavity and the circumstances, fixed partial dentures veneered with composite or ceramic were chosen. A proper relationship between the teeth was reached with the fixed partial dentures, and function established, the phonetics improved and satisfying aesthetics effect accomplished improving the profile appearance of the patient?s face. Plastic surgery of the nose was performed after that. Conclusion. Multidisclipinary treatment is necessary for favourable long-term outcome in cleft lip and palate patients.