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Across Europe, Hungary ranks first in the incidence and the prevalence of oral cancers, which are usually detected in a relatively late stage. Consequently, major resective surgeries are often the only final solution. Due to the complexity of restoration, a multi-disciplinary team approach with close interaction amongst several health science disciplines is required, in which dentist’s contribution is crucial. Maxillofacial prosthodontics, which deals with rehabilitation of patients with deficit and defects of jaws and surrounded soft tissue, is a less known specialty of dentistry. Unfortunately those patients are scarcely referred to these specialists. Yet, as the number of affected patients in Hungary is significantly higher than a European average, such patient’s care requires complex treatment planning and creativity to deliver a custom made, individual solution. This case report presents a review of a successful solution to patient rehabilitation following a mandibular segment resection. Following the resection, several deficiencies caused by the absence of the segment, required compensation. In order to achieve normal function and aesthetics Normally, lack of masticatory muscles attachment causing severe malocclusion and a strong deflection during the opening could be compensated with either a double denture or a removable prosthesis with a guiding flange. In this case report, the latter solution is presented. After a successful completion of the mandibular resection and the prosthodontic treatment planning, the lower and upper dentures were prepared simultaneously. A combined, fixed and partially removable denture with a palatal ramp was devised for the upper jaw. For the lower jaw, a removable partial denture with a guiding flange was fabricated. After the first two steps,- preparation and impression taking – an extremely challenging registration of the lower-upper jaw relationship was performed, which was repeated several times using different set of tools. Subsequently, the guiding flange and the palatal ramp were constructed and individualized. During the insertion, the occlusion and the proper function of the guiding flange were checked. As a result, completed upper and lower dentures functioned properly, resulting in the patient’s satisfaction with the final outcome. During the short and the long-term recalls only minor corrections were performed
PERI-implantitis, IATROGENIC diseases, DELAYED diagnosis, MEDICAL protocols, and PROSTHESIS design & construction
Abstract
Focused Clinical Question: What is the key clinically controllable preventive measure that may help reduce the incidence of biological complications? Summary: Implant complications are common, ineffective care, and delay in diagnosis can lead to expensive time‐consuming surgical and nonsurgical interventions. Careful selection and placement of implant allow development of adequate emergence design of the implant suprastructure. This helps achieve effective plaque control, adequate maintenance at hygiene visits, accurate follow‐up assessments of the peri‐implant tissues addressing the key underlying factor impacting biological complications. This clinically controllable preventative measure may be considered a vital strategy in averting peri‐implant disease. Conclusions: Surge in biological complications has led to increased patient dissatisfaction in terms of time, cost, esthetics, and maintenance. One of the factors identified in causing biological complications is the iatrogenic prosthesis‐related factor. Minimizing the impact of this factor is crucial to the overall implant success. Selection and placement of implant following meticulous planning, using careful surgical protocols, allow development of adequate suprastructure design that improves overall patient outcomes by reducing biological complications. Further research is essential to comprehensively assess the impact of these strategies in thwarting development of biological complications. [ABSTRACT FROM AUTHOR]
Introdução: As “endocrowns” são um novo meio de reabilitação oral em prótese fixa para os dentes endodonciados, que já provaram o seu interesse. A “endocrown” não requer qualquer preparação das raízes e conserva um máximo de esmalte. É um dos tratamentos mais conservadores de um dente extensamente destruído. A combinação de CAD/CAM com a “endocrown” poderia ser uma alternativa quando confrontada com dentes muito destruídos, mantendo-se ao mesmo tempo conservadora. Objetivos: Realizar uma revisão sistemática integrativa sobre o tema da biomecânica de restaurações “endocrown” realizadas pelo sistema CAD/CAM. Material e métodos: Foi realizada uma pesquisa bibliográfica na base de dados PubMed que incluem os estudos publicados que atenderem aos critérios de inclusão no período de 2015 a 2022. Resultados: Os resultados demonstraram um desempenho clínico aceitável para todos os materiais estudados. O protocolo clínico deve ser estritamente respeitado, a fim de optimizar a distribuição do stress. As "endocrowns" mostraram um desempenho semelhante ao das coroas com falso coto, mas reagiram de forma diferente à tensão. Conclusões: As "endocrowns" são uma alternativa viável para o tratamento de dentes tratados endodonticamente. Uma cuidadosa selecção de materiais e das técnicas de preparação são essenciais para optimizar a distribuição das tensões de lateralidade. No entanto, são necessários mais estudos in vivo para confirmar o seu desempenho.
INCISORS, LIPS, DENTAL fillings, BIOMETRY, VISUAL perception, and CHINESE people
Abstract
PURPOSE. The maximum width between the mesial and distal labial transitional line angles, described as "esthetic width" herein, could significantly influence the visual perception of the teeth and smile. This study aimed to conduct biometric research on esthetic width and to explore whether regular distribution exists in the esthetic width of human teeth. MATERIALS AND METHODS. A total of 4,264 maxillary and mandibular anterior teeth were measured using the Geomagic studio software program. The proportions of maxillary to mandibular homonymous teeth and proportions between the adjacent teeth were calculated. Bilateral symmetry and the correlation between the esthetic and mesiodistal widths were both accounted for during the measurement procedures. RESULTS. The mean esthetic widths were 6.773 ± 0.518 mm and 4.329 ± 0.331 mm for maxillary and mandibular central incisors, respectively, 5.451 ± 0.487 mm and 5.008 ± 0.351 mm for maxillary and mandibular lateral incisors, respectively, and 3.340 ± 0.353 mm and 5.958 ± 0.415 mm for maxillary and mandibular canines, respectively. Except for the mandibular canines, no significant difference in esthetic width was found among homonymous teeth from the same jaw. A high linear correlation was found between the esthetic and mesiodistal widths of the same tooth, except for the maxillary canines. Esthetic width proportions among different tooth categories showed some regular patterns, which were similar to those of the mesiodistal width. CONCLUSION. Esthetic width is regularly distributed among the teeth in the Chinese population. This could provide an important reference for anterior dental restorations and dimension recovery in esthetic reconstruction of anterior teeth. [ABSTRACT FROM AUTHOR]
Revista Cubana de Estomatologia. Apr-Jun2021, Vol. 58 Issue 2, p129-140. 12p.
Abstract
Introduction: Thanks to its efficiency and the exclusive use of metal-free ceramics, in oral rehabilitation it has been possible to achieve aesthetic and mechanical standards, maintaining or even exceeding the quality of the treatments compared to traditional metal-ceramic restorations. Currently, free ceramic manufacturing mechanisms are increasingly evolving towards CAD-CAM machined technologies and decreasing their conventional production through the PRESS Injection technique. Objective: Compare the survival rate of single-unit fixed prostheses made with conventional feldspathic ceramics and reinforced with lithium disilicate by the CEREC® CAD/CAM chairside system, with the conventional PRESS laboratory injection method. Methods: A systematic review was conducted of scientific evidence included in papers published until the year 2019 in PubMed, PubMed Clinical Queries, Epistemonikos, Tripdatabase, Cochrane Library, electronic resources of Los Andes Peruvian University, and retrograde bibliography. The papers selected dealt with conventional and lithium-disilicate reinforced feldspathic ceramic single-unit prostheses made by CAD/CAM and/or the conventional method. Results: A total 28 papers met the inclusion criteria. Of these, 21 were observational cohort studies, four were randomized clinical assays and three were non-randomized assays. Short- and mid-term, CEREC® CAD/CAM achieved survival rates of 98% and 91.9%, respectively. The conventional system achieved survival rates of 97.5% short-term and 93% mid-term. Conclusions: As described in the literature, CEREC® CAD/CAM had a slightly higher survival rate than the conventional system in the short term. In the medium term, however, CEREC® CAD/CAM displayed a slight reduction in comparison with the conventional system. No studies are available to determine the clinical survival of the treatments in the long term. [ABSTRACT FROM AUTHOR]
