Total Edentulism Research Articles

MO934: Correlation Between Sarcopenia and Oral Health in Patients on Chronic Haemodialysis

Abstract BACKGROUND AND AIMS Patients on haemodialysis have signs of chronic systemic inflammation and a higher incidence of sarcopenia. Poor oral health can also trigger systemic inflammation and thus affect sarcopenia. The aim of the study was to examine oral health and the presence of sarcopenia in patients on chronic haemodialysis and to determine whether there is a correlation between them. METHOD This study included 100 patients on chronic haemodialysis at the Clinical University Hospital `Sestre Milosrdnice’ in Zagreb, who underwent oral status, routine laboratory measurements, bioimpedance analysis of body composition and measurement of hand grip strength. RESULTS Of the total number of participants (N = 100), 28.0% had sarcopenia. The majority of participants were male (61.0%). Poor oral hygiene was recorded in as many as 39.0% of participants, while 46.0% had their last visit to the dentist several years ago. It is interesting to note that 64.3% of patients with confirmed sarcopenia were last examined by a dentist several years ago, while in those without sarcopenia the proportion was 38.9%. The median total number of erupted teeth in all patients was 12.0 (7.0–23.0). A positive correlation of the total number of erupted teeth and erupted premolars with sarcopenia was confirmed. CRP was significantly elevated in patients with sarcopenia (P = 0.035), in contrast to those without sarcopenia (3.45 versus 2.70). A total of 51% of patients had increased calculus formation, 49% had oral candidiasis and 38% periodontitis, with as many as 24% of petechiae on the mucosa and 22% of dental caries. A total of 8% of patients had an ammonia breath and 4% had a metallic taste in their mouth. Of all the examined signs and symptoms of oral health, significant differences were observed only in the incidence of dental caries, which was significantly more common in the group that did not have sarcopenia (P = 0.031). However, it should be noted that in patients with sarcopenia, total edentulousness was present in 17.9% as opposed to 9.7% in patients who did not have sarcopenia, i.e. 12% of the total number of participants had total edentulousness. Moreover, in 21% of patients with sarcopenia, a complete denture was present in combination with a partial denture, while that was the case in only 9.7% of patients without sarcopenia. CONCLUSION This study confirmed poorer oral health in haemodialysis patients who had sarcopenia. Therefore, intervention studies are needed to improve oral health of patients on HD, which could possibly influence the incidence and severity of sarcopenia.

Determination of Morphogeometric Patterns in Individuals with Total Mandibular Edentulism in the Interforaminal Region from Cone Beam Computed Tomography (CBCT) Scans: A Pilot Study

The aim of this study was to determine the morphogeometric patterns of the interforaminal region from cone beam computed tomography (CBCT) scans of individuals with total mandibular edentulism. CBCT images were obtained from 40 patients with total edentulism who are older (12 men and 28 women; average age of 69.5 ± 9.4 years) and who wore a non-implant-supported, lower, removable, total prosthesis. We conducted a two-dimensional (2D) morphogeometric analysis of the Digital Imaging and Communication in Medicine (DICOM) files from the CBCT scans, and five equidistant cross sections were planned. For the three-dimensional (3D) morphogeometric analysis, standard triangular language (STL) files were obtained after segmentation of the interforaminal mandibular region, and four anatomical landmarks and their respective curves were digitized. The patterns among the shapes were determined using principal component analysis (PCA) on MorphoJ software (version 1.07a). The results of the 2D morphogeometric analyses for PCA of the interforaminal mandibular paramedian region were PC1 or elongated drop shape, 54.78%; PC2 or wineskin shape, 17.65%; PC3 or pear shape, 11.77%; and PC4 or eggplant shape, 5.71%, and those for PCA of the symphyseal region were PC1 or elongated drop shape, 62.13%; PC2 or ovoid shape, 11.64%; PC3 or triangular shape, 9.71%; and PC4 or tuber shape, 4.96%. The results of the 3D morphogeometric analyses for the interforaminal hemimandibular region were PC1, 59.83%; PC2, 10.39%; PC3, 7.67%; and PC4, 5.09%. This study provides relevant information for future clinical guidelines on prosthetics and implants, in addition to proposing the use of new technologies that support diagnosis and treatment in patients with edentulism.

3D assessment of facial contours of patients wearing either complete denture or implant-supported fixed dentures.

Total edentulousness leads to soft tissue changes causing esthetic problems. Being aware of the significant effects of different treatment approaches on facial soft tissue can help to obtain more satisfying esthetic results. The current study's objective was to evaluate three-dimensional facial soft tissue changes in edentulous patients rehabilitated with a complete denture (CD) and implant-supported fixed partial denture (FPD). Fourteen edentulous patients, mean age of 47.6 years (42-63), were assessed before prosthetic treatments (T0), after CD (T1), and after FPD (T2). 3dMDface System (3dMD LLC) obtained the images and transferred them to 3dMD Vultus software (3dMD Vultus software Version 2.3.0.2). Nine linear, five angular, and one topographical measurement were performed for facial soft tissue analysis. For statistical analysis of facial soft tissue, ANOVA was used with a level of significance set at 5% (p <.05). Significant differences were observed in lower lip height (Sto-Sl) and nasolabial angle (Prn Sn Ls) with CD. There is no significant difference with the implant-supported fixed partial dentures in these measurements when compared with pretreatment. Significant differences were observed in the lower lip angle (Chr Li Chl) with the implant-supported fixed partial dentures. There is no significant difference with CD in this measurement when compared with pretreatment. According to the paired comparisons, a significant difference was observed in philtrum height (Ls-Sn) between the treatment approaches. CD and implant-supported fixed partial dentures, both treatment approaches, cause facial soft tissue changes, which may help to improve the facial esthetic. The effects of these treatment methods on facial soft tissues are not significantly different, except the philtrum height.

Oral Health among Adult Residents in Vilnius, Lithuania.

According to the World Health Organization (WHO) oral conditions may be determined by social, biological, behavioral, and psychosocial factors. The study assessed oral health status and its determinants associated with oral health conditions among adult residents in Vilnius, Lithuania. A total of 453 of 35–74-year-olds participated (response rate 63%). A self-reported questionnaire was administered. Dental caries experience (D3MFS score), periodontal probing depth (PPD), andnumber of missing teeth were assessed clinically. Data were analyzed using χ2 test, independent samples t-test, and multivariable linear regression. The mean (sd) of D3MFS scores was 67.3 (33.5), the mean (sd) number of teeth with PPD 4+ mm was 5.9 (5.3), prevalence of periodontitis was 33%, the mean (sd) number of missing teeth was 6.9 (6.8), and prevalence of total edentulism was 3.8%. Medication use was associated with all oral health conditions, while age was associated with caries experience, and missing teeth. Sugar-containing diet was associated with caries experience, and missing teeth, and smoking with caries experience and periodontal status. Systemic diseases were associated with periodontal status, while behavioral determinants, last dental visit, and use of fluoridated toothpaste were associated with missing teeth. Oral health status among adult Vilnius residents was poor. Oral conditions were associated with both biological and behavioral determinants. Oral health promotion should focus on modifying behavioral determinants.

In Vitro Comparison of the Accuracy of Conventional Impression and Four Intraoral Scanners in Four Different Implant Impression Scenarios.

The aim of this study was to compare the trueness and precision of four intraoral scanners (IOSs) and splinted open-tray conventional implant impression (SOCI) in partial and total edentulism. Four gypsum models (Model A-implants at mandibular right second molar, right second premolar, and right canine; Model B- implants at mandibular right canine, left central incisor, and left canine; Model C-implants at mandibular right second molar, right second premolar, right canine, left central incisor, and left canine; and Model D-implants at mandibular right second molar, right second premolar, right canine, left central incisor, left canine, left second premolar, and left second molar) were prepared, and four different IOSs (Aadva IOS, CS 3600, Trios 3, and Emerald) and one polyvinyl siloxane (PVS) were used. Reference models were digitized with a high-resolution industrial scanner, and data were superimposed. Root mean square (RMS) values were calculated by software and defined as deviation values after superimposition. The oneway analysis of variance (ANOVA) test and Tukey honest significant difference (HSD) test were performed to analyze the data (P < .05). For Models A and B, the truest impressions were made with Aadva, followed by CS 3600, PVS, Trios 3, and Emerald, respectively, while for Model C, the truest impressions were made with CS 3600, followed by Aadva, PVS, Trios 3, and Emerald, and for Model D, the truest impressions were made with Aadva, followed by CS 3600, PVS, Emerald, and Trios 3 (P < .05). There was no statistical difference between groups for precision in Models A, B, and C (P > .05); however, PVS showed lower precision values than other groups in Model D (P < .05). In partial edentulism, IOSs are true and precise as SOCI except Emerald. However, the trueness of IOSs is not favorable in total edentulism cases. SOCI with PVS in total edentulism treated with implants is less precise than IOSs.

Effect of Prosthodontic Rehabilitation on Perioral Units in Edentulous Patients

Background: Complete edentulous patients experience loss in fundamental mastication functions, the progressive absorption of the alveolar bone, and variation in facial appearance. Complete dentures (CD) fundamentally target edentulous patients and not only increase functionality but also restore the appearance of the face. This study aims to evaluate the effect of rehabilitation with removable CD on perioral wrinkles in complete edentulous patients, in line with growing aesthetic demand.&#x0D; Methods: Patients who had CD rehabilitation performed due to total edentulism were photographed before and after rehabilitation from the same angles to evaluate the perioral soft tissue changes. The photographs were scored using verified ranking scales and through evaluation by two observers. To evaluate the repeatability of the scales, measurements were repeated with the same method one month later.&#x0D; Results: When the effect of prosthetic rehabilitation administered successfully on perioral aesthetics and lip volume was analyzed, a significant improvement was observed in all other parameters evaluated, except for in the labiomental crease. The improvement in the labiomental crease was not statistically significant. In addition, re-measurement reliability was high (≥0.80) for all four perioral units (nasolabial folds, corners of mouth, labiomental crease and upper radial lip). In addition, all correlations were statistically significant (p

Overview on Steps of Complete Dentures: A Review

Total edentulism is a serious public health issue, particularly among the aged people. Edentulism has a detrimental impact on various elements of a patient's everyday life, including masticatory function, phonetics, and facial structure, with significant psychosocial implications. For those patients, complete dentures remain the first option. Despite the fact that age-specific rates of edentulism are expected to decline, demand for complete dentures will continue to rise in the next decades. Patients with new complete dentures who are edentulous are fairly pleased, however up to 30% of them have issues. They continue to struggle with issues such as unattractive appearance, ripping pain or discomfort owing to the failure of holding and stabilization, impaired articulation, food deposition under the denture, and trouble with chewing. These types of issues can lower one's quality of life and force him to seek additional help to resolve them. In some circumstances, a specific clinical technique known as rebasing is recommended as a solution to these issues.

Total Edentulism and Its Epidemiological Surveillance in Oaxaca, Mexico from 2009–2019

Total edentulism is the loss of all teeth for any cause by a multifactorial process that involves biological and patient-related factors. Studies on edentulism and risk factors in Mexico are limited, and the epidemiological surveillance data is scarce and controversial since official governmental reports are not statistically representative of the country. We estimate the distribution for edentulism according to sociodemographic and socioeconomic variables in adults from a low-income state in 2003 and its progress in Mexico. We analyzed data from the National Performance Evaluation Survey in Oaxaca, Mexico, and the annual reports of the Epidemiological Surveillance System of Oral Pathologies in 2009–2019 using X2. Oaxacan patients older than 75 y.o. (17.9%, p &lt; 0.05), those with lower schooling (11.2%), and diabetes (14.5%) presented the highest percentage of edentulism. We do not observe differences in edentulism between sex or residence (p &gt; 0.05). From 2009 to 2019, country data reports the lowest rate of edentulism in adults over 20 y.o. (0.32%; 95% CI 0.18–0.48%) and the most affected population over 79 y.o. (7.29%; 95% CI 5.2–9.30%). As it is a cumulative phenomenon, it is necessary to establish better surveillance, prevention, and treatment programs to improve the oral health of older thus reducing edentulism.

Condiciones de edentulismo y fragilidad en un grupo de personas mayores que acudieron a la clínica odontológica de la Universidad San Martín de Porres de Lambayeque, Perú.

Introduction: Dentistry should contribute to achieving healthy aging based on the identification of the well-being and oral health needs of the elderly. Objective: To evaluate the conditions of edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru, between the years 2016 and 2018. Material and Methods: An observational, descriptive, retrolective, and cross-sectional study was conducted. Two hundred and seven medical records that included an odontogram were randomly selected to identify cases of total or partial edentulism according to the Kennedy classification. The files were assessed with Fried’s test to evaluate the conditions of frailty. The association between variables was estimated by means of a significance analysis using the Chi square test. Results: There was a statistically significant difference between edentulism in both jaws and conditions of frailty (p&lt;0.05). An association of edentulism with physical inactivity and weakness was also demonstrated. Additionally, a statistically significant difference between degrees of edentulism was observed regarding poor diet (p&lt;0.05). Conclusion: The absence of teeth in the elderly acts as a risk factor leading to negative changes in diet, weight, and physical activity. These changes may be associated with frailty, as masticatory insufficiency results in a poor diet and subsequent weakness.

Tooth loss in relation to serum cotinine levels - A cross-sectional study from the Belville South area in South Africa

Tooth loss constitutes a major public health challenge, sharing common risk factors with non-communicable diseases. To report the relationship between tooth loss and serum cotinine levels in a population sample of mixed ethnic heritage from the Belville South area in South Africa. Cross-sectional epidemiological study.Subjects were invited from 2014 to 2016 according to a consecutive sampling technique and all those who met the inclusion criteria were included. In all, 1876 individuals were included, being 1416 females (75.5%), with a combined average age of 49.5 ± 15.3 years. In total 46.7% of the sample was edentulous, with females presenting a higher proportion than males (50.7% vs. 34.1%, p &lt; 0.001). The relative risk (RR) of being edentulous was higher for females (RR=1.8, 95% CI=1.35-2.41, p&lt;0.001) and for participants with cotinine levels 15-299 ng/ml (RR = 1.37, 95% CI=1.02=1.83, p=0.04) and ≥300 ng/ml (RR=1.51, 95% CI=1.09-2.08, p=0.01). Maxillary incisors and mandibular molars were the most prevalent missing teeth. The burden of tooth loss is high in the studied population sample, as well their unmet needs for dental care. Female gender, tobacco exposure, and aging were associated with partial and total edentulism.

Tooth Loss and Blood Pressure in Parkinson's Disease Patients: An Exploratory Study on NHANES Data.

:Objectives: To evaluate tooth loss severity in PD patients and the impact of missing teeth on blood pressure (BP) and glycated hemoglobin (Hba1c) levels. Methods: All adults reporting specific PD medication regimens with complete dental examinations were included from the NHANES 2001 to 2018 databases. Sociodemographic, systolic BP (SBP), diastolic BP (DBP) and Hba1c data were compared according to tooth loss severity, and linear regression analyses on the impact of tooth loss on SBP, DBP and Hba1c levels were conducted. Results: The 214 included participants presented 9.7 missing teeth, 23.8% severe tooth loss and 18.2% total edentulousness. Severe tooth loss cases were significantly older (p < 0.001), had higher smoking prevalence (p = 0.008), chronic medical conditions (p = 0.012) and higher Hba1c (p = 0.001), SBP (p = 0.015) and DBP (p < 0.001) levels. Crude and adjusted linear models revealed a relationship between SBP, DBP and missing teeth; however, age confounded these links (SBP: B = 0.10, SE = 0.16, p < 0.05; DBP: B = 0.16, SE = 0.10, p < 0.05). Tooth loss presented no significant relationship with Hba1c levels. Conclusions: Severe tooth loss is prevalent among PD patients. Blood pressure levels showed a positive linear relationship with the number of missing teeth, although age was a confounding factor. Furthermore, tooth loss and Hba1c levels revealed no significant linear relationship.

TREATMENT OPTIONS WITH COMBINED DENTURES IN PATIENTS WITH MAXILLARY RESECTION

Background: Resection of upper jaw violates the border between oral and nasal cavity; thereby leading to the impossibility of feeding, speaking and breathing. The prosthetic treatment methods are the main tool for restoration of the damaged functions. Aim: The aim of this publication is to investigate the options for the application of combined dentures, made from acrylic resin and silicone, in the treatment of patients with maxillary resection and total edentulism. Materials and methods: The prosthetic treatment of a 70-year-old female patient with resection of the frontal area of the upper jaw and total edentulism is studied. The preliminary impressions were taken with alginate and the definitive ones – with custom trays and silicone impression material. An obturator and complete denture of the lower jaw were fabricated from heat cured acrylic resin after fixing the occlusion closure and trial denture. Silicone material for direct relining is used to provide retention and stability to the obturator. Results: Patient's feeding, speaking and breathing functions were successfully restored. The silicone substitution part provided a non-traumatic distribution of the masticatory pressure and tightly insertion in the retentive areas of the defect. The created border between oral and nasal cavity fostered breathing and fluid intake. Conclusion: The performed treatment shows that prosthetic treatment methods continue to be an important method for improving patients' life quality after maxillary resection, despite the progress in modern surgical procedures.

Full mouth rehabilitation with maxillary equator® attachment over denture and mandibular hybrid denture - A case report

Implant-supported prosthodontic rehabilitation of total edentulism remains the most complex restorative challenges. The main reason being the number of variables that affect both the aesthetic and functional aspects of the prosthesis. A hybrid denture or the ‘Toronto prosthesis’ is one that is fabricated over a metal framework and retained by screws threaded into implants. This article presents the fabrication of implant-retained maxillary Equator® attachment overdenture opposing mandibular implant-retained hybrid prosthesis. A total of four implants (Equinox® Myriad plus) were placed the maxillary arch and six implants (Equinox® Myriad plus) in the mandibular arch. The patient's occlusal vertical dimension, centric relation, aesthetics and phonetics were determined and maintained throughout the restorative process. This case report describes the management of a completely edentulous patient with a mandibular implant-supported fixed prosthesis and maxillary implant-retained overdenture with Equator® attachment.

Dental disorders and self-perception of oral health in patients with paracoccidioidomycosis

Paracoccidioidomycosis, a systemic fungal disease, can lead to dental disorders. As studies on dental problems in patients with paracoccidioidomycosis are few, we evaluated dental disorders and self-perceived oral health in this population. The objective is to evaluate the oral condition of patients with paracoccidioidomycosis as well as their perception of the problem through a cross-sectional study of 52 adult patients with current or previous paracoccidioidomycosis in a reference hospital in Mato Grosso do Sul between December 2017 and July 2018. Demographic data, dental history, and self-perception of oral health were obtained from the National Oral Health Survey—SB Brazil 2010. The number of permanent decayed, missing, or filled teeth; presence and intensity of gingival bleeding; dental calculus; periodontal pockets; and periodontal attachment loss were recorded. Most patients had chronic paracoccidioidomycosis (n = 50; 96.2%), with involvement of the mouth in the active phase of the disease (n = 38; 73.1%). Participants had a high number of decayed, missing, or filled teeth (median: 30 teeth). The most compromised component was “missing” teeth (median of 21 teeth), and total edentulism was observed in 17 patients (32.7%). Periodontal disease was seen in 15 of 35 patients (43.3%) who had at least one tooth. Regarding satisfaction with their oral health, 27 patients (51.9%) reported being satisfied or very satisfied. There was no association between the degree of satisfaction with the other data. Tooth loss is the major dental problem in patients with paracoccidioidomycosis, and in patients with teeth, periodontal disease was highly prevalent. A general positive self-perception of oral health observed in these patients may reduce their willingness to seek dental treatment.

RECONSTRUÇÃO ÓSSEA EM MAXILA ATRÓFICA COM ENXERTO DE CRISTA ILÍACA: RELATO DE CASO

O edentulismo total, apesar de toda evolução da Odontologia, ainda é uma condição comum na atualidade.Os tratamentos para esse tipo de patologia mais utilizados são: prótese muco suportada e implanto suportada. Em ambas as opções, a perda óssea pode inviabilizar o tratamento. São vários os tipos de biomateriais disponíveis para enxertia, podendo ser classificados como: autógenos, homólogos, heterógeno, e aloplástico. O objetivo do trabalho é relatar o caso clínico de um paciente com maxila atrófica severa, realizada a reconstrução óssea com enxerto autógeno removido da crista ilíaca em ambiente hospitalar e sob anestesia geral. Observou-se como principal vantagem a disponibilidade do material para enxertia, biocompatibilidade e rápida incorporação do enxerto

U.S. state correlations between oral health metrics and Alzheimer\u2019s disease mortality, prevalence and subjective cognitive decline prevalence

Given the association between periodontal disease (PdD) and Alzheimer’s disease (AD), we examined correlations between states’ age-adjusted AD mortality rates, AD prevalence, subjective cognitive decline (SCD) prevalence, and oral health data. Data sources include the Centers for Disease Control and Prevention, scientific literature, and oral health rankings formulated by WalletHub.com and Toothbrush.org. Pearson (r) or Spearman (rs) correlation coefficients were generated and evaluated. AD mortality rates correlate with dental visits (r = − 0.50, p = 0.0003), partial (r = 0.39, p = 0.005) or total (r = 0.44, p = 0.001) edentulism, WalletHub.com (rs = 0.30, p = 0.03) and Toothbrush.org (rs = 0.35, p = 0.01) rankings. AD prevalence correlates with dental visits (r = − 0.30, p = 0.03), partial (r = 0.55, p = 0.00003) or total (r = 0.46, p = 0.0009) edentulism, prevalence of any (r = 0.38, p = 0.006) or severe-stage (r = 0.46, p = 0.0009) PdD, and WalletHub.com (rs = 0.38, p = 0.006) rankings. SCD prevalence in adults aged ≥ 45 years correlates with dental visits (r = − 0.69, p < 0.00001), partial (r = 0.33, p = 0.02) or total (r = 0.37, p = 0.008) edentulism, prevalence of any (r = 0.53, p = 0.0001) or severe-stage (r = 0.57, p = 0.00002) PdD, WalletHub.com (rs = 0.53, p = 0.00008) and Toothbrush.org (rs = 0.60, p < 0.00001) rankings. State metrics indicative of compromised oral health correlate with AD mortality rates, AD prevalence and SCD prevalence.

Study of the Clinical Efficiency of an Interdisciplinary Approach to the Treatment of Orofacial Pain and Temporomandibular Joint Disorders in Patients with Complete or Partial Edentulism.

Objective The aim of this study is to improve the safety and efficiency of prosthodontic treatment of patients with dental defects. It is necessary to perform a comprehensive assessment of the dentofacial system disorders, including the analysis of the features of pain manifestations. This study also supports to improve the efficiency of prosthodontic rehabilitation of patients with complete dental reconstruction on the basis of an assessment of the severity of orofacial pain manifestations. Materials and Methods The study was a single-site prospective open nonrandomized study with the examination and treatment of 452 patients (age = 44.3 ± 15.2 years, including 282 men and 170 women) with partial or total edentulism. The patients were divided into two groups: group 1 (control) of 218 patients treated with a standard prosthodontic approach and group 2 (study) of 234 patients treated which the proposed interdisciplinary approach to prosthodontic rehabilitation. Results The study establishes higher safety and clinical efficiency of the proposed interdisciplinary approach. The patients undergoing full-mouth reconstruction with the use of the interdisciplinary approach demonstrated statistically significant decrease in the rate of pain in muscles of the maxillofacial area on palpation, pain, and spasms in the neck area, statistically significantly less frequent pains in the temporomandibular joint (TMJ) during chewing, pain during opening and closing the mouth. Conclusion The application of the developed comprehensive approach to prosthodontic rehabilitation planning makes it possible to improve essentially the results of treatment at the expense of reduction of pain manifestations in the area of maxillofacial muscles and pain sensations associated with functioning of the TMJ.

Biomechanical comparison of implantation approaches for the treatment of mandibular total edentulism.

Applying four anterior implants placed vertically or tilted in the mandible is considered to provide clinically reasonable results in the treatment of mandibular posterior edentulism. It is also reported that a combination of four anterior and two short posterior implants can be an alternative approach for the rehabilitation of severe atrophy cases. In this study, we aimed to evaluate the biomechanical responses of three different implant placement configurations, which represent the clinical options for the treatment of mandibular edentulism. Three-dimensional models of the mandible, prosthetic bar, dental implant, abutment, and screw were created. Finite element models of the three implant configurations (Protocol 1: Four anterior implants, Protocol 2: Four anterior and two short posterior implants, Protocol 3: Two anterior and two tilted posterior implants: All-on-4™ concept) were generated for 10 patients and analyzed under different loading conditions including chewing, biting, and impact forces. Protocol 2 led to the lowest stress concentrations over the mandible among the three protocols (p < 0.016). Protocol 2 resulted in significantly lower stresses than Protocol 3 and Protocol 1 over prosthetic bars under chewing forces (p < 0.016). None of the implant placement protocols consistently exhibited the lowest stress distribution over abutments. The lowest stresses over dental implants under the chewing, biting, and impact forces were obtained in Protocol 1, Protocol 2, and Protocol 3, respectively (p < 0.016). Protocol 3 was the best option to obtain the lowest stress values over the screws under all types of loading conditions (p < 0.016). In conclusion, Protocol 2 was biomechanically more ideal than Protocol 1 and Protocol 3 to manage the posterior edentulism.

Results of Total Maxillary Edentulism Rehabilitation Protocol with Implant-Supported Prostheses in the Pterygomaxillary-Pyramidal Region as Posterior Anchorage Loci.

To present functional and esthetic success of a well-defined protocol for rehabilitation with implant-supported complete-arch prostheses in the treatment of patients with maxillary edentulism. Medical records of patients treated from 1990 to September 2014 were reviewed. This clinic history should include clinical, anatomicalfunctional, and esthetic data for at least the first 5 years of follow-up. Two hundred eighty-two implants were inserted into the pterygomaxillary-pyramidal region in 141 edentulous patients using cylindrical osteotomes to form bone sites and thereby minimize the use of drills in bone preparation. Also, 580 implants were inserted in the premaxilla using lyophilized bone of bovine origin as a graft material and platelet-rich plasma for repairing small bone defects around implants and as a volume-generating material to support perioral structures. Of the 282 implants placed in the pterygomaxillary-pyramidal region, 272 survived (96.1% survival rate). The 10 failures occurred after being subjected to functional load. Of the 580 implants placed in the premaxilla, 19 implants failed; thus, the survival rate was 96.7%. Moreover, from the results obtained in the study sample, it was observed that the retention and stability obtained with the implant-supported prosthesis helps improve the ability to speak, swallow, and chew, which improves patient comfort and satisfaction. The rehabilitation of total maxillary edentulism with an implant-supported complete-arch prosthesis achieves a high level of functional and esthetic success, which is reflected directly in oral health and patient satisfaction.

Important the marking of dental prosthesis in the recognition of people: description of two techniques

The recognition of people who lose their lives in natural disasters or accidents are complicated when the victims are total edentulous, therefore, the need to look for new forms of identification that are reliable and easy to be implemented. Taking into account this premise, a search of the information in the literature was carried out in order to demonstrate that the marking of dental prostheses is important in the recognition of people and that they can be implemented by the government of Peru. For which three marking techniques were chosen: QR code, Digital cards and Incorporation of metal band. A rigorous selection procedure of the information was carried out in the databases, Pubmed, Scielo and VHL (Virtual Health Library), with articles published between 2012-2019, in Spanish and English. 105 articles were found of which only 18 of them were chosen, which met the inclusion criteria. It is concluded that this technique is important in the identification of people, and it is suggested to consider its implementation in our country. At the end, two prosthesis marking techniques are presented on models taken from a simulator.