Validation of the "Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)" scale for wearers of implant-supported fixed partial dentures.

PubMed

Castillo-Oyagüe, Raquel; Perea, Carmen; Suárez-García, María-Jesús; Río, Jaime Del; Lynch, Christopher D; Preciado, Arelis

2016-12-01

To validate the 'Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)' questionnaire for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-supported fixed partial denture (FPD) wearers. 107 patients were assigned to: Group 1 (HP; n=37): fixed-detachable hybrid prostheses (control); Group 2 (C-PD, n=35): cemented partial dentures; and Group 3 (S-PD, n=35): screwed partial dentures. Patients answered the QoLFAST-10 and the Oral Health Impact Profile (OHIP-14sp) scales. Information on global oral satisfaction, socio-demographic, prosthetic, and clinical data was gathered. The psychometric capacity of the QoLFAST-10 was investigated. The correlations between both indices were explored by the Spearman's rank test. The effect of the study variables on the OHRQoL was evaluated by descriptive and non-parametric probes (α=0.05). The QoLFAST-10 was reliable and valid for implant-supported FPD wearers, who attained comparable results regardless of the connection system being cement or screws. Both fixed partial groups demonstrated significantly better social, functional, and total satisfaction than did HP wearers with this index. All groups revealed similar aesthetic-related well-being and consciousness about the importance of health-behavioural habits. Several study variables modulated the QoLFAST-10 scores. Hybrid prostheses represent the least predictable treatment option, while cemented and screwed FPDs supplied equal OHRQoL as estimated by the QoLFAST-10 scale. The selection of cemented or screwed FPDs should mainly rely on clinical factors, since no differences in patient satisfaction may be expected between both types of implant rehabilitations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Design of Complete Dentures by Adopting CAD Developed for Fixed Prostheses.

PubMed

Li, Yanfeng; Han, Weili; Cao, Jing; Iv, Yuan; Zhang, Yue; Han, Yishi; Shen, Yi; Ma, Zheng; Liu, Huanyue

2018-02-01

The demand for complete dentures is expected to increase worldwide, but complete dentures are mainly designed and fabricated manually involving a broad series of clinical and laboratory procedures. Therefore, the quality of complete dentures largely depends on the skills of the dentist and technician, leading to difficulty in quality control. Computer-aided design and manufacturing (CAD/CAM) has been used to design and fabricate various dental restorations including dental inlays, veneers, crowns, partial crowns, and fixed partial dentures (FPDs). It has been envisioned that the application of CAD/CAM technology could reduce intensive clinical/laboratory work for the fabrication of complete dentures; however, CAD/CAM is seldom used to fabricate complete dentures due to the lack of suitable CAD software to design virtual complete dentures although the CAM techniques are in a much advanced stage. Here we report the successful design of virtual complete dentures using CAD software of 3Shape Dental System 2012, which was developed for designing fixed prostheses instead of complete dentures. Our results demonstrated that complete dentures could be successfully designed by the combination of two modeling processes, single coping and full anatomical FPD, available in the 3Shape Dental System 2012. © 2016 by the American College of Prosthodontists.

Longitudinal research on the oral environment of elderly wearing fixed or removable prostheses.

PubMed

Tanaka, Junko; Tanaka, Masahiro; Kawazoe, Takayoshi

2009-04-01

The purpose of this study was to investigate oral environmental risk factors involved in caries incidence in the elderly. We investigated the relationship between the oral environment factors of the elderly with both fixed prostheses and removable prostheses at baseline and at follow-up and examined time-course changes of each oral environmental factor by prosthesis type. The subject group consisted 11 elderly patients with fixed prostheses and 11 who wore removable prostheses. We examined oral environmental factors by saliva tests. Five oral environmental factors were examined: the stimulated salivary flow rate, buffering capacity, and the counts of mutans streptococci (SM), lactobacilli (LB), and Candida (CA). We compared these factors for subjects with fixed prostheses and those wearing removable prostheses at baseline and at follow-up. Furthermore, 3-year changes in the factors of each oral environment were compared and evaluated. Significant differences were observed between the two groups in the salivary microbial counts of SM and LB at baseline and at follow-up. The LB counts increased in the Denture group during the 3-year period and significant differences were noted. We found that fixed prostheses are less cariogenic, and removable prostheses cause an increase in the cariogenic bacterial count. Regarding time-course changes by the type of prosthesis, the LB count tended to increase in the subjects with removable prostheses. The risk of caries due to a fixed prosthesis may be lower than that of removable prostheses.

Retrospective chart analysis on survival rate of fixtures installed at the tuberosity bone for cases with missing unilateral upper molars: a study of 7 cases.

PubMed

Park, Young-Jin; Cho, Sung-Am

2010-06-01

To evaluate the survival rate of implants placed in the maxillary tuberosity region using the fixed prosthesis in partially edentulous cases. Of implant-treated patients who visited Kyung Pook National University Hospital, 7 partially edentulous patients (2 male and 5 female; mean age, 52.3 years; range, approximately 43 to 65) were selected according to the following criteria: 1) less than 3-mm thickness alveolar bone reaming at the first molar area and 2) 1 to 2 fixture premolars, with the additional implant at the maxillary tuberosity region. For the control group, patients who had nontuberosity areas were selected. After 1 to 7 years, marginal bone level, fixture mobility, and radiolucency of tuberosity fixtures of the fixed prostheses were evaluated by digital panorama (Starpacs, Infinitt, Seoul, Korea). None of the fixtures of the tuberosity-installed implants for 1 to 7 years failed. The marginal bone level around the implants of the maxillary tuberosity 1 to 6 years (average 3.4 years) after the final prostheses was approximately 0.6 to 1.3 mm, with an average of 0.94 mm. The fixture installation at the maxillary tuberosity using the unilateral partially edentulous implant-fixed prosthesis would be a clinically acceptable treatment module. 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Dual jaw treatment of edentulism using implant-supported monolithic zirconia fixed prostheses.

PubMed

Altarawneh, Sandra; Limmer, Bryan; Reside, Glenn J; Cooper, Lyndon

2015-01-01

This case report describes restoration of the edentulous maxilla and mandible with implant supported fixed prostheses using monolithic zirconia, where the incisal edges and occluding surfaces were made of monolithic zirconia. Edentulism is a debilitating condition that can be treated with either a removable or fixed dental prosthesis. The most common type of implant-supported fixed prosthesis is the metal acrylic (hybrid), with ceramo-metal prostheses being used less commonly in complete edentulism. However, both of these prostheses designs are associated with reported complications of screw loosening or fracture and chipping of acrylic resin and porcelain. Monolithic zirconia implant-supported fixed prostheses have the potential for reduction of such complications. In this case, the CAD/CAM concept was utilized in fabrication of maxillary and mandibular screw-retained implant-supported fixed prostheses using monolithic zirconia. Proper treatment planning and execution coupled with utilizing advanced technologies contributes to highly esthetic results. However, long-term studies are required to guarantee a satisfactory long-term outcome of this modality of treatment. This case report describes the clinical and technical procedures involved in fabrication of maxillary and mandibular implant-supported fixed prostheses using monolithic zirconia as a treatment of edentulism, and proposes the possible advantages associated with using monolithic zirconia in eliminating dissimilar interfaces in such prostheses that are accountable for the most commonly occurring technical complication for these prostheses being chipping and fracture of the veneering material. © 2015 Wiley Periodicals, Inc.

A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

PubMed

Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

2000-01-01

The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

Sprue Design and Its Effect on the Castability and Porosity of Titanium Removable Partial Denture Frameworks

DTIC Science & Technology

1997-06-10

been in the area of implantology . Recent advances in dental titanium casting machines allow for the use of titanium for crowns, fixed partial dentures...medical implant prostheses (McKinney and Lemons, 1985; Williams, 1981). By the end of the 1960s, titanium found a niche in dental implantology ...as an implant or restorative material. In the field of dental implantology , evidence suggests that metal corrosion and allergenicity may be important

Fiber-reinforced composite fixed dental prostheses: two clinical reports.

PubMed

Zarow, Maciej; Paisley, Carl Stuart; Krupinski, Jerzy; Brunton, Paul Anthony

2010-06-01

Various options are available in clinical practice for the replacement of a single missing tooth, ranging from conventional fixed and removable dental prostheses to a single implant-supported crown. There are situations in which a semipermanent fixed dental prosthesis may be desirable, particularly for patients who have completed orthodontic treatment but are too young to embark on implant therapy. Following advances in fiber-reinforcement technology, fiber-reinforced composite resin (FRC) now represents a lower-cost alternative to traditional metal-ceramic for the construction of resin-bonded prostheses. Two case reports illustrate the use of FRC prostheses as fixed semipermanent_restorations.

Fit Analysis of Different Framework Fabrication Techniques for Implant-Supported Partial Prostheses.

PubMed

Spazzin, Aloísio Oro; Bacchi, Atais; Trevisani, Alexandre; Farina, Ana Paula; Dos Santos, Mateus Bertolini

2016-01-01

This study evaluated the vertical misfit of implant-supported frameworks made using different techniques to obtain passive fit. Thirty three-unit fixed partial dentures were fabricated in cobalt-chromium alloy (n = 10) using three fabrication methods: one-piece casting, framework cemented on prepared abutments, and laser welding. The vertical misfit between the frameworks and the abutments was evaluated with an optical microscope using the single-screw test. Data were analyzed using one-way analysis of variance and Tukey test (α = .05). The one-piece casted frameworks presented significantly higher vertical misfit values than those found for framework cemented on prepared abutments and laser welding techniques (P < .001 and P < .003, respectively). Laser welding and framework cemented on prepared abutments are effective techniques to improve the adaptation of three-unit implant-supported prostheses. These techniques presented similar fit.

Implant dentistry curriculum in undergraduate education: part 2-program at the Albert-Ludwigs University, Freiburg, Germany.

PubMed

Kroeplin, Birgit S; Strub, Joerg R

2011-01-01

The aim of this study was to describe the didactic and clinical undergraduate implant dentistry program of the Albert-Ludwigs University, Freiburg, Germany, with emphasis on the clinical implant experience. A detailed description of the implant curriculum at Albert-Ludwigs University is given with documented exemplary cases and additional flow charts. All students participate in 28 hours of lectures and approximately 64 hours of seminars with hands-on courses and gain clinical experience. All undergraduate students are eligible to place and restore oral implants. Emphasis is placed on prosthetic-driven planning of implant positions, three-dimensional imaging, and computer-guided implant placement. Implant restorations performed by undergraduate students comprise single crowns and small multiunit fixed dental prostheses in partially edentulous posterior maxillae and anterior or posterior mandibles, implant-retained overdentures (snap attachment) in edentulous patients, and telescopic fixed-removable dental prostheses on remaining teeth and strategically placed additional implants. Over the past 2.5 years, 51 patients were treated with 97 dental implants placed by students in the undergraduate program. Seventy-one restorations were inserted: 60.6% single crowns, 7% fixed dental protheses, 21.1% overdentures, and 11.3% telescopic fixed-removable dental prostheses. The implant survival rate was 98.9%. Because survival rates for dental implants placed and restored by students are comparable to those of experienced dentists, oral implant dentistry should be implemented as part of the undergraduate dental curriculum.

International comparative evaluation of knee replacement with fixed or mobile-bearing posterior-stabilized prostheses.

PubMed

Graves, Stephen; Sedrakyan, Art; Baste, Valborg; Gioe, Terence J; Namba, Robert; Martínez Cruz, Olga; Stea, Susanna; Paxton, Elizabeth; Banerjee, Samprit; Isaacs, Abby J; Robertsson, Otto

2014-12-17

Posterior-stabilized total knee prostheses were introduced to address instability secondary to loss of posterior cruciate ligament function, and they have either fixed or mobile bearings. Mobile bearings were developed to improve the function and longevity of total knee prostheses. In this study, the International Consortium of Orthopaedic Registries used a distributed health data network to study a large cohort of posterior-stabilized prostheses to determine if the outcome of a posterior-stabilized total knee prosthesis differs depending on whether it has a fixed or mobile-bearing design. Aggregated registry data were collected with a distributed health data network that was developed by the International Consortium of Orthopaedic Registries to reduce barriers to participation (e.g., security, proprietary, legal, and privacy issues) that have the potential to occur with the alternate centralized data warehouse approach. A distributed health data network is a decentralized model that allows secure storage and analysis of data from different registries. Each registry provided data on mobile and fixed-bearing posterior-stabilized prostheses implanted between 2001 and 2010. Only prostheses associated with primary total knee arthroplasties performed for the treatment of osteoarthritis were included. Prostheses with all types of fixation were included except for those with the rarely used reverse hybrid (cementless tibial and cemented femoral components) fixation. The use of patellar resurfacing was reported. The outcome of interest was time to first revision (for any reason). Multivariate meta-analysis was performed with linear mixed models with survival probability as the unit of analysis. This study includes 137,616 posterior-stabilized knee prostheses; 62% were in female patients, and 17.6% had a mobile bearing. The results of the fixed-effects model indicate that in the first year the mobile-bearing posterior-stabilized prostheses had a significantly higher hazard ratio (1.86) than did the fixed-bearing posterior-stabilized prostheses (95% confidence interval, 1.28 to 2.7; p = 0.001). For all other time intervals, the mobile-bearing posterior-stabilized prostheses had higher hazard ratios; however, these differences were not significant. Mobile-bearing posterior-stabilized prostheses had an increased rate of revision compared with fixed-bearing posterior-stabilized prostheses. This difference was evident in the first year. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Within-subject comparisons of implant-supported mandibular prostheses: psychometric evaluation.

PubMed

de Grandmont, P; Feine, J S; Taché, R; Boudrias, P; Donohue, W B; Tanguay, R; Lund, J P

1994-05-01

In a within-subject cross-over clinical trial, psychometric and functional measurements were taken while 15 completely edentulous subjects wore mandibular fixed prostheses and long-bar removable implant-supported prostheses. In this paper, the results of a psychometric assessment are presented. Eight subjects first received the fixed bridge and seven the removable type. After having worn a prosthesis for a minimum of two months, subjects responded to psychometric scales that measured their perceptions of various factors associated with prostheses. They also chewed test foods while masticatory activity was recorded. The prostheses were then changed and the procedures repeated. At the end of the study, patients were asked to choose the prosthesis that they wished to keep. Patients assigned significantly higher scores, on visual analogue scales, to both types of implant-supported prostheses than to their original conventional prostheses for all factors tested, including general satisfaction. However, no statistically significant differences between the two implant-supported prostheses were detected except for the difficulty of chewing carrot, apple, and sausage. For these foods, the fixed prostheses were rated higher. Subjects' responses to category scales were consistent with their responses to the visual analogue scales. These results suggest that, although patients find the fixed bridge to be significantly better for chewing harder foods, there is no difference in their general satisfaction with the two types of prostheses.

Radiographic, microcomputer tomography, and optical coherence tomography investigations of ceramic interfaces

NASA Astrophysics Data System (ADS)

Sinescu, Cosmin; Negrutiu, Meda Lavinia; Ionita, Ciprian; Topala, Florin; Petrescu, Emanuela; Rominu, Roxana; Pop, Daniela Maria; Marsavina, Liviu; Negru, Radu; Bradu, Adrian; Rominu, Mihai; Podoleanu, Adrian Gh.

2010-12-01

Imagistic investigation of the metal-ceramic crowns and fixed partial prostheses represent a very important issue in nowadays dentistry. At this time, in dental office, it is difficult or even impossible to evaluate a metal ceramic crown or bridge before setting it in the oral cavity. The possibilities of ceramic fractures are due to small fracture lines or material defects inside the esthetic layers. Material and methods: In this study 25 metal ceramic crowns and fixed partial prostheses were investigated by radiographic method (Rx), micro computer tomography (MicroCT) and optical coherence tomography (OCT) working in Time Domain, at 1300 nm. The OCT system contains two interferometers and one scanner. For each incident analysis a stuck made of 100 slices was obtain. These slices were used in order to obtain a 3D model of the ceramic interface. Results: RX and MicroCT are very powerful instruments that provide a good characterization of the dental construct. It is important to observe the reflections due to the metal infrastructure that could affect the evaluation of the metal ceramic crowns and bridges. The OCT investigations could complete the imagistic evaluation of the dental construct by offering important information when it is need it.

Knowledge, attitude, and practice of dental professionals regarding the effect and management of food impaction associated with fixed partial denture prostheses: A survey.

PubMed

Nagarsekar, Aradhana; Gaunkar, Ridhima; Aras, Meena

2016-01-01

This survey was undertaken to assess dentist's opinion regarding the occurrence and pattern of food impaction in relation to fixed partial denture (FPD) prostheses, its commonly observed consequences, factors contributing to it, and its management. A descriptive survey was conducted on a sample size of 150 dental practitioners. The pro forma consisted of informed consent, demographic information, and questionnaire. The results were tallied and quantitative analysis was performed to obtain the descriptive statistics for the data using SPSS version 20. All the study respondents had come across patients who complained of food impaction in relation to FPD. The most common consequences of food impaction were proximal caries of the adjacent teeth and interdental bone loss. Majority of the dentists considered faulty FPD design with improper contact relation, improper crown contour, poor margin adaptation, and faulty pontic design as the most likely reason for food impaction. Repeating the FPD with emphasis on prescribing and reinforcing the use of proper interdental aids was considered as the ideal treatment option. It was also observed that about half of the dentists always communicated inadequate information of the FPD prostheses that needed replacement to the dental laboratory technician for the successive bridge. Most of the times, prosthodontists were consulted to rectify the problem of food impaction resulting from faulty FPD prostheses. However, it is obvious that it is easier and more prudent to prevent rather than treat food impaction. This study gives an overview of some of the common errors in designing the FPD prostheses which often lead to food impaction and measures to be taken to overcome them. It may be concluded as all the dentists participating in the survey agreed that food impaction is one of the common complaint among FPD Patients. Proximal caries and interdental bone loss were the prevalent outcomes of food impaction. Faulty FPD design was allegedly attributed as the reason for food impaction. Prosthodontists were routinely consulted to resolve the dilemma of food impaction. However, it is rational to prevent food impaction rather than to tackle the sequel later.

Awareness, attitudes, need and demand on replacement of missing teeth among a group of partially dentate patients attending a University Dental Hospital.

PubMed

Jayasinghe, Rasika Manori; Perera, Janana; Jayasinghe, Vajira; Thilakumara, Indika P; Rasnayaka, Sumudu; Shiraz, Muhammad Hanafi Muhammad; Ranabahu, Indra; Kularatna, Sanjeewa

2017-07-27

Our objective was to assess awareness, attitudes, need and demand on replacement of missing teeth according to edentulous space, age, gender, ethnicity, educational level and socio-economical status of the patient. 76.2% of the study group was opined that the missing teeth should be replaced by prosthetic means. Majority were keen in getting them replaced mainly for the comfort in mastication. Although 77.9 and 32.9% were aware of the removable prostheses and implants respectively, only 25.2% knew about tooth supported bridges as an option of replacement of missing teeth. Participants' awareness on tooth and implant supported prostheses is at a higher level. Participants' opinion on need of regular dental visit was statistically significant when gender, ethnicity and education level were considered. The highest demand for replacement of missing teeth was observed in Kennedy class I and II situations in both upper and lower arches. Demand for fixed prostheses was significantly highest in Kennedy class II in upper and lower arches. In conclusion, although removable prosthodontic options are known to most of the patients, their awareness on tooth and implant supported prostheses is also at a higher level. The highest demand for replacement of missing teeth is by patients with Kennedy class I and II situations whereas Kennedy class II being the category with highest demand for fixed prostheses. We recommend that the location of missing teeth to be considered as a priority when educating patients on the most appropriate prosthetic treatment options. Dentists' involvement in educating patients on prosthetic options needs to be improved.

Survival of various implant-supported prosthesis designs following 36 months of clinical function.

PubMed

Rodriguez, A M; Orenstein, I H; Morris, H F; Ochi, S

2000-12-01

The use of endosseous dental implants to replace natural teeth lost to trauma, dental caries, or periodontal disease has become a predictable form of prosthetic treatment since gaining popularity in the early 1980s. While numerous clinical studies have focused on the survival of implants, few address the survival of different prosthesis designs. Beginning in 1991, 882 prostheses supported by more than 2,900 implants (687 patients) were placed by the Department of Veterans Affairs Dental Implant Clinical Research Group (DICRG). These prostheses were divided into five research strata based on arch location. The recommended design for each stratum was: bar-supported overdenture (maxillary completely edentulous); screw-retained hybrid denture (mandibular completely edentulous); screw-retained fixed partial denture (mandibular and maxillary posterior partially edentulous); and cemented single crown (maxillary anterior single tooth). Alternative overdenture designs were utilized in the edentulous arches when the recommended prosthesis could not be fabricated. Prosthesis success rates for the research strata were calculated for an observation time of up to 36 months following prosthesis placement. Success rates for the maxillary edentulous stratum ranged from 94.6% for the bar-retained overdenture supported by five to six fixtures to 81.8% for the cap-retained overdenture. The mandibular edentulous strata produced success rates of 98.1% for the fixed hybrid prosthesis to 91.7% for the cap-retained prosthesis. Success rates for maxillary and mandibular posterior fixed partial dentures were 94.3% and 92.6%, respectively, while the maxillary anterior single-tooth prosthesis yielded a success rate of 98.1% for the 36-month observation period. The recommended prosthesis designs investigated in this study proved to be reliable, with encouraging success rates for an observation period of 36 months following placement.

Present status of titanium removable dentures--a review of the literature.

PubMed

Ohkubo, C; Hanatani, S; Hosoi, T

2008-09-01

Although porcelain and zirconium oxide might be used for fixed partial dental prostheses instead of conventional dental metals in the near future, removable partial denture (RPD) frameworks will probably continue to be cast with biocompatible metals. Commercially pure (CP) titanium has appropriate mechanical properties, it is lightweight (low density) compared with conventional dental alloys, and has outstanding biocompatibility that prevents metal allergic reactions. This literature review describes the laboratory conditions needed for fabricating titanium frameworks and the present status of titanium removable prostheses. The use of titanium for the production of cast RPD frameworks has gradually increased. There are no reports about metallic allergy apparently caused by CP titanium dentures. The laboratory drawbacks still remain, such as the lengthy burn-out, inferior castability and machinability, reaction layer formed on the cast surface, difficulty of polishing, and high initial costs. However, the clinical problems, such as discoloration of the titanium surfaces, unpleasant metal taste, decrease of clasp retention, tendency for plaque to adhere to the surface, detachment of the denture base resin, and severe wear of titanium teeth, have gradually been resolved. Titanium RPD frameworks have never been reported to fail catastrophically. Thus, titanium is recommended as protection against metal allergy, particularly for large-sized prostheses such as RPDs or complete dentures.

Frequency of technical complications in fixed implant prosthesis: the effect of prosthesis screw emergence correction by CAD-CAM.

PubMed

Anitua, Eduardo; Flores, Carlos; Piñas, Laura; Alkhraisat, Mohammad

2018-06-05

CAD-CAM technology permits the angular correction of screw emergence into the prosthesis, however there is lack of controlled clinical studies that assess the frequency of technical complications in angled screw channel restorations. This controlled clinical study was designed to assess technical incidences in angled screw channel restorations. Patients having implant prosthesis placed between November, 2014 and December, 2015 were screened. The patients were selected if they received prosthesis with up to 30º correction of the prosthesis screw emergence and had at least one non-angulated prosthesis (screw-retained). All the prostheses were located completely/partially in the posterior region. The frequency of technical complications was the principal variable. A total of 52 patients with a mean age of 62 ± 10 years participated with a total 110 prostheses (55 in the test group and 55 in the control group). A total of 11 technical complications occurred (7 in the test group and 4 in the control group). These differences were not statistically significant. All the prostheses in both groups survived the follow-up. The correction of the screw emergence into the prosthesis has not increased the risk of technical complications in CAD-CAM implant prostheses.

The Overall Survival, Complication-Free Survival, and Related Complications of Combined Tooth-Implant Fixed Partial Dentures: A Literature Review

PubMed Central

Borg, Peter; Puryer, James; McNally, Lisa; O’Sullivan, Dominic

2016-01-01

This paper reviews the literature regarding possible complications, complication-free survival, and overall survival of fixed dental prostheses that use both implants and natural teeth as abutments. The paper also provides clinical guidelines for treatment based on this literature review. An electronic search utilizing the MEDLINE, BIOSIS Citation Index, and Web of Science™ Core Collection databases was undertaken, and a review of the 25 selected texts studying 22 different patient cohorts was carried out. From a total of 1610 implants reviewed, 40 were lost (33 due to loss of integration and 7 due to fracture), whereas, out of a total of 1301 teeth, 38 were lost, of which 16 were due to fracture. Seventy-three cases of tooth intrusion were detected. From a total of 676 frameworks reviewed (metal n = 645, Zirconia n = 31), 7 fractured, while veneer material fracture occurred in 70 out of 672 bridges. Overall, 502 out of 531 tooth-implant fixed prostheses (TIPFs) remained functional, and 336 out of 439 prostheses showed no technical or biological complications and remained functional. Rigid TIFPs permanently cemented to teeth with sufficient coronal structure and with limited use of prosthetic attachments offer a good long-term treatment option to patients with good oral hygiene following sound implant placement. This mode of treatment should be used when free-standing implant-supported options may not be possible. Larger randomized control studies and other clinical studies comparing tooth-to-implant-connected treatment with other forms of treatment are needed to better understand the place of TIFP treatment in oral rehabilitation. PMID:29563458

Performance sustaining intracortical neural prostheses

NASA Astrophysics Data System (ADS)

Nuyujukian, Paul; Kao, Jonathan C.; Fan, Joline M.; Stavisky, Sergey D.; Ryu, Stephen I.; Shenoy, Krishna V.

2014-12-01

Objective. Neural prostheses, or brain-machine interfaces, aim to restore efficient communication and movement ability to those suffering from paralysis. A major challenge these systems face is robust performance, particularly with aging signal sources. The aim in this study was to develop a neural prosthesis that could sustain high performance in spite of signal instability while still minimizing retraining time. Approach. We trained two rhesus macaques implanted with intracortical microelectrode arrays 1-4 years prior to this study to acquire targets with a neurally-controlled cursor. We measured their performance via achieved bitrate (bits per second, bps). This task was repeated over contiguous days to evaluate the sustained performance across time. Main results. We found that in the monkey with a younger (i.e., two year old) implant and better signal quality, a fixed decoder could sustain performance for a month at a rate of 4 bps, the highest achieved communication rate reported to date. This fixed decoder was evaluated across 22 months and experienced a performance decline at a rate of 0.24 bps yr-1. In the monkey with the older (i.e., 3.5 year old) implant and poorer signal quality, a fixed decoder could not sustain performance for more than a few days. Nevertheless, performance in this monkey was maintained for two weeks without requiring additional online retraining time by utilizing prior days’ experimental data. Upon analysis of the changes in channel tuning, we found that this stability appeared partially attributable to the cancelling-out of neural tuning fluctuations when projected to two-dimensional cursor movements. Significance. The findings in this study (1) document the highest-performing communication neural prosthesis in monkeys, (2) confirm and extend prior reports of the stability of fixed decoders, and (3) demonstrate a protocol for system stability under conditions where fixed decoders would otherwise fail. These improvements to decoder stability are important for minimizing training time and should make neural prostheses more practical to use.

The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses

PubMed Central

Bacchiocchi, Danilo

2017-01-01

Purpose To present a new intraoral welding technique, which can be used to manufacture screw-retained, mandibular fixed full-arch prostheses. Methods Over a 4-year period, all patients with complete mandibular edentulism or irreparably compromised mandibular dentition, who will restore the masticatory function with a fixed mandibular prosthesis, were considered for inclusion in this study. The “Ball Welding Bar” (BWB) technique is characterised by smooth prosthetic cylinders, interconnected by means of titanium bars which are adjustable in terms of distance from ball terminals and are inserted in the rotating rings of the cylinders. All the components are welded and self-posing. Results Forty-two patients (18 males; 24 females; mean age 64.2 ± 6.7 years) were enrolled and 210 fixtures were inserted to support 42 mandibular screw-retained, fixed full-arch prostheses. After two years of loading, 2 fixtures were lost, for an implant survival rate of 97.7%. Five implants suffered from peri-implant mucositis and 3 implants for peri-implantitis. Three of the prostheses (3/42) required repair for fracture (7.1%): the prosthetic success was 92.9%. Conclusions The BWB technique seems to represent a reliable technique for the fabrication of screw-retained mandibular fixed full-arch prostheses. This study was registered in the ISRCTN register with number ISRCTN71229338. PMID:28835752

Comparison of in vivo polyethylene wear particles between mobile- and fixed-bearing TKA in the same patients.

PubMed

Minoda, Yukihide; Hata, Kanako; Ikebuchi, Mitsuhiko; Mizokawa, Shigekazu; Ohta, Yoichi; Nakamura, Hiroaki

2017-09-01

Polyethylene wear particle generation is one of the most important factors that affects the mid- to long-term results of total knee arthroplasties (TKA). Mobile-bearing total knee prostheses were developed to reduce polyethylene wear generation. However, whether mobile-bearing prostheses actually generate fewer polyethylene wear particles than fixed-bearing prostheses remains controversial. The aim of this study was to compare, within individual patients, the in vivo polyethylene wear particles created by a newly introduced mobile-bearing prosthesis in one knee and a conventional fixed-bearing prosthesis in other knee. Eighteen patients receiving bilateral TKAs to treat osteoarthritis were included. The synovial fluid was obtained from 36 knees at an average of 3.5 years after the operation. The in vivo polyethylene wear particles were isolated from the synovial fluid using a previously validated method and examined using a scanning electron microscope and an image analyser. The size and shape of the polyethylene wear particles from the mobile-bearing prostheses were similar to those from the conventional fixed-bearing prostheses. Although the number of wear particles from the mobile-bearing prosthesis (1.63 × 10 7  counts/knee) appeared smaller than that from the fixed-bearing prosthesis (2.16 × 10 7  counts/knee), the difference was not statistically significant. The current in vivo study shows that no statistically significant differences were found between the polyethylene wear particles generated by a newly introduced mobile-bearing PS prosthesis and a conventional fixed-bearing PS prosthesis during the early clinical stage after implantation. Therapeutic study, Level III.

Pre-load on oral implants after screw tightening fixed full prostheses: an in vivo study.

PubMed

Duyck, J; Van Oosterwyck, H; Vander Sloten, J; De Cooman, M; Puers, R; Naert, I

2001-03-01

The fit of implant supported fixed prostheses is said to be of clinical concern because of the rigid fixation of an oral implant in its surrounding bone. The influence of the torque sequence of the set screws during fixation of implant supported fixed full prostheses on the final pre-load was investigated in vitro. No significant effect of the torque sequence of the set screws on the final pre-load was observed. The main objective of this study was to quantify and qualify the pre-load in vivo on implants supporting a fixed full prosthesis. This was performed when the prostheses were supported by all five or six implants and was repeated when the prostheses were supported by only four and three implants. A total of 13 patients with a fixed full implant supported prosthesis were selected. The existing abutments were changed for strain gauged abutments. After tightening the set screws with a torque of 10 N cm, the pre-load conditions were registered. The average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 323 N (43 N), 346 N (59 N), 307 N (60 N) 21 N cm (3 N cm) and 21 N cm (2 N cm), 23 N cm (5 N cm), respectively. In addition, the pre-load was registered after fixation of a machined gold cylinder, as delivered by the manufacturer, on each of the supporting implants, representing the 'optimal fit' situation. The corresponding average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 426 N (36 N), 405 N (40 N), 413 N (46 N) and 8 N cm (1 N cm), 8 N cm (1 N cm), 8 N cm (1 N cm), respectively. The induced axial forces after tightening the prostheses were significantly lower then after tightening the gold cylinder in case of five or six supporting implants (P < 0.02). The induced bending moments after tightening the prostheses were statistically significantly higher (P < 0.0001) then after tightening the gold cylinder in all test conditions (five or six, four or three supporting implants). This study underlines the static load present after screw tightening implant supported fixed full prostheses.

Implant prostheses for convertibility, stress control, esthetics, and hygiene.

PubMed

Garfield, R E

1988-07-01

A method of connecting "fixed partial denture" prostheses to osseointegrated implant fixtures has been described. The advantages of this system of restoration for partially and fully edentulous mouths are that it is more effective in addressing the problems of (1) stress-control on abutments, (2) a back-up system for abutment failures, (3) esthetics, and (4) control of bacterial plaques around abutments. To accomplish this procedure, the application of convertible periodontal prosthesis techniques with modifications to some existing implant systems is undertaken. The disadvantages of this method seem insignificant when one considers the complexities and risks involved with the present array of implant prosthesis alternatives. Some patients and dentists might consider the necessity of the prosthesis being detachable as one disadvantage. In reality, the prosthesis can be used as a fixed restoration until the patient has fully adapted to the new proprioception and appearance. A large percentage of patients feel uncomfortable with the word "removable" because it immediately creates a perception of unsightly metallic clasp display, palatal coverage, tongue interference, and negative body image. The use of the term "detachable" coupled with the doctor's offer to perform this task for the patient "whenever necessary" will usually relieve the patient's anxiety and allow the treatment to proceed. Once neuromuscular and esthetic adaptation have occurred and the patient has accepted the prosthesis, daily detaching and home-care hygiene by the patient will follow without incident. Esthetic improvement is obvious (Fig. 3).

In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design.

PubMed

Kim, Seok-Gyu; Park, Jae-Uk; Jeong, Jae-Heon; Bae, Chang; Bae, Tae-Soo; Chee, Winston

2009-01-01

The purpose of this study was to evaluate the clinical efficacy of implant prostheses retained by screws and cement (SCPs) by examining the reverse torque values (RTVs) of the abutment screws and the marginal openings of the implant prostheses. Two implants (3.8 x 13 mm; Camlog Biotechnologies) were embedded in an acrylic resin block 5 mm apart. Eighteen copies of this resin specimen were fabricated and randomly divided into two groups. Two-unit implant prostheses with two different designs-purely cement-retained implant prostheses (group 1) and SCPs (group 2)-were made out of type IV gold alloy and placed on the implants. After tightening to about 30 Ncm, the preloading RTVs of the abutment screws were measured. After retightening the abutment screws or cementing the prostheses, followed by cyclic loading, the postloading RTVs of the abutment screws were examined. Also, the marginal openings of the prostheses in the two groups were measured under a stereomicroscope. These measurements were compared statistically. The postloading RTVs and their differences from the preloading RTVs of the abutment screws demonstrated no significant differences between groups (P > .05). Group 2 prostheses showed significantly smaller marginal openings than group 1 prostheses (P < .05). The forces generated when torquing the abutment screw of the SCP did not cause more loosening of the abutment screws than the purely cement-retained implant prosthesis. The SCP showed better marginal adaptation of the cement-retained part than the purely cement-retained implant prosthesis, possibly as a result of the screw-retained abutment seating the restoration. Within the limitations of this in vitro test, the SCP showed no significant difference in RTV of the abutment screw and a smaller marginal gap compared to a purely cement-retained implant prosthesis.

Occlusal contact of fixed implant prostheses using functional bite impression technique.

PubMed

Suzuki, Yasunori; Shimpo, Hidemasa; Ohkubo, Chikahiro

2015-02-01

Functional bite impression (FBI) has been described as a definitive impression made under occlusal force after functional generated path (FGP) recording. This study compared the accuracy of occlusal contact of implant-fixed prostheses using the FBI technique and the conventional impression technique. Twelve subjects, each missing a single premolar or molar, were selected for this study. The conditions of the occlusal contacts were identified by the modified transillumination method. The occlusal contact condition was determined by comparing the rate of change in the occlusal contact area of the implant-fixed prostheses and both adjacent teeth before and after occlusal adjustment. The rate of change in the occlusal contact area using the FBI technique was 96%, and the rate using the conventional technique was 54%. The occlusal contact of implant prostheses using the FBI technique revealed better accuracy than that of the conventional technique. Regarding the FBI technique, a precise and functional prosthesis could be produced by completing the maxillomandibular registration, impression, and FGP at the same time.

OCT and shear-force evaluations of zirconia Fixed Partial Prosthesis processed with a conventional CAD/CAM technology

NASA Astrophysics Data System (ADS)

Zaharia, C.; Gabor, A.; Sinescu, C.; Topala, F. I.; Negrutiu, M. L.; Levai, C. M.; Duma, V. F.; Bradu, A.; Podoleanu, A. Gh.

2016-03-01

Introduction. Dental ceramics show better biocompatibility and aesthetic properties in dental constructs with regard to metals. However, they also have an insufficient mechanical stability, as well as low resistance limits due to their fragility. Taking into account these aspects, glass infiltrated with ceramic materials such as alumina (i.e., zirconiareinforced ceramics) is being nowadays considered a better material for full fixed partial prostheses (FPPs) than ceramics: the former has a higher mechanical resistance, which makes it more appropriate for restoration areas, where there is an increased mechanical stress. The interest for zirconia is growing due both to its resistance and to the possibility to develop such prostheses using the CAD/CAM technology. Materials and methods. 24 all ceramic FPPs created with CAD/CAM technology were used. The models were scanned with Zeno Wieland Scanner, a one touch scanning machine which requires between 45-60 s for a full model scan. The scanner provides 3 axis-architecture and automatic data processing. The zirconia infrastructures resulted from milling zirconia green disks in Wieland units, followed by the deposition of ceramic masses and then by burning procedures. All the samples were assessed with a Time Domain Optical Coherence Tomography (TD-OCT) system working at a wavelenght of 1300 nm. Using OCT investigations, material defects were detected in the areas of maximal tension, i.e. the connectors, the oclusal, and the cervical areas. These samples with defects in the above areas have not been considered for the study further on. Finally, the samples were loaded in a MultiTest 5 i Mecmesin system and tested until fracture occurred. The MultiTest 5-i creates tensile and compression forces of up to 5 kN. Results and discussions. All the test samples survived a dynamic load of 1.2 x 107 cycles and a thermal cycle mixer simulator version; signs of failure in terms of fracture lines were observed in all samples. The average value of the force necessary to break the FPPs obtained from the tests is 1750 N. Conclusions. Conventional metal-ceramic fixed partial dentures are still considered the standard for edentulous spaces in the posterior region. Therefore, the resistance of metal-ceramic fixed partial dentures has served in this study as a guide for new ceramics tests. All the values from this study conducted in FPP with zirconia frames were much lower than the values reported for metal ceramic fixed partial dentures (i.e., 2500-3000 N), but higher that 1000 N, which is considered the lowest resistance point to be utilized in the rear region of the oral cavity.

Evaluation of the efficacy of mandibular conventional and implant prostheses in a group of Turkish patients: a quality of life study.

PubMed

Cakir, Onur; Kazancioglu, Hakki Oguz; Celik, Gozde; Deger, Sabire; Ak, Gulsum

2014-07-01

The aim of this study was to compare the satisfaction and quality of life (QoL) in a group of patients using mandibular complete dentures, implant-retained overdentures, removable partial dentures (RPDs), or implant-supported fixed partial dentures (FPDs). A total of 116 patients (aged 36 to 81, mean age 58 ± 10.03 years) were assigned to four groups (n = 29) and treated with mandibular implant-retained overdentures, implant-supported FPDs (two implants/three unit FPDs), conventional complete dentures, or RPDs. The groups were well matched in terms of gender, age, and the edentulous period. All patients had edentulous maxillary arches and completely or partially edentulous mandibles. All prostheses were mandibular prostheses. The OHIP-14, OHQoL-UK, and SF-36 surveys were used to determine QoL before implant surgery and 1 year after prosthetic treatment. The baseline and 1-year data from 116 patients were analyzed. A significant improvement was found among the QoL scales for all groups (p < 0.05). The most significant improvement was found in the implant-retained overdenture group (15.67 ± 2.47), while the least improvement was found among the implant-supported FPD group (5.14 ± 2.08). The SF-36 test revealed no differences between the before and after treatment scores for general health, pain, vitality, social function, and physical function difficulties (p > 0.05). The only significant difference was found for mental health (p = 0.011). A positive influence on oral health-related QoL was observed in all groups. The QoL values were the most improved in the implant-retained overdenture group. © 2014 by the American College of Prosthodontists.

Success and complications of implant-retained prostheses provided by the Post-Doctoral Prosthodontics Program, University of Puerto Rico: a cross-sectional study.

PubMed

Loza-Herrero, María A; Rivas-Tumanyan, Sona; Morou-Bermudez, Evangelia

2015-11-01

The success rate of implant-retained prostheses in a postdoctoral prosthodontics program was unknown and could not be related to any set of potential clinical issues or patient characteristics. The purpose of this study was to determine the success rate of implant-retained prostheses placed by prosthodontic residents between 1997 and 2012 and to evaluate the associations between patient classifications and specific restoration characteristics as related to prosthesis success or failure. A total of 272 prostheses in 119 patients were clinically evaluated. Success was defined as the absence of prosthetic complications or any implant-related complication that affected prosthesis survival. Logistic regression was used to evaluate associations between prosthesis success/failure and a wide array of study variables, adjusting for patient age, sex, and prosthesis longevity. The overall success rate was 71%, with a mean prosthesis age of 4.5 years (range: 4 months to 16.8 years). Implant single crowns were the most successful prosthesis type (81% success). The most common complications observed were porcelain fractures in fixed dental prostheses (15%) and lack of stability (31%) and retention (29%) in removable dental prostheses. Having a removable prosthesis (versus natural dentition) in the opposing occlusion significantly decreased the odds of success (OR=0.26, 95% CI: 0.11-0.64). Definitively cemented fixed prostheses were more successful than those cemented with an interim cement (OR=4.56, 95% CI: 1.37-15.22). The overall success rate of the implant-retained prostheses placed in the program was low compared with previously published studies. This study revealed the need for an efficient, comprehensive recall system for patients receiving implant-retained prostheses, either fixed or removable. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of type of prosthesis on oral environment and the number of missing teeth in elderly persons.

PubMed

Tanaka, Junko; Tanaka, Masahiro

2010-01-01

The purpose of this study was to investigate the relationship between the number of missing teeth (MT) and the statuses of oral environmental factors (the stimulated salivary flow rate, buffering capacity, and the counts of mutans streptococci, lactobacilli, and Candida) in the elderly. The subjects were 64 elderly subjects with fixed prostheses and 49 who wore removable partial dentures aged over 65 years. We used one-way ANOVA to test for overall differences of the number of MT among 5 oral environmental factors. The significant differences were observed in the lactobacilli counts for different number of MT. The number of MT increased with an increase in the lactobacilli counts with removable denture. In conclusion, for the patients wearing removable dentures, increasing number of MT was associated with an increase in the lactobacilli counts in saliva. For the patients with crowns and fixed partial dentures, the number of MT was not significantly affected by salivary mutans streptococci, lactobacilli, and Candida counts.

Maxillary rehabilitation using a removable partial denture with attachments in a cleft lip and palate patient: a clinical report.

PubMed

Palmeiro, Marina Rechden Lobato; Piffer, Caroline Scheeren; Brunetto, Vivian Martins; Maccari, Paulo César; Shinkai, Rosemary Sadami Arai

2015-04-01

Clefts of the lip and/or palate (CLP) are oral-facial defects that affect health and overall quality of life. CLP patients often need multidisciplinary treatment to restore oral function and esthetics. This paper describes the oral rehabilitation of a CLP adult patient who had maxillary bone and tooth loss, resulting in decreased occlusal vertical dimension. Functional and cosmetic rehabilitation was achieved using a maxillary removable partial denture (RPD) attached to telescopic crowns. Attachment-retained RPDs may be a cost-effective alternative for oral rehabilitation in challenging cases with substantial loss of oral tissues, especially when treatment with fixed dental prostheses and/or dental implants is not possible. © 2014 by the American College of Prosthodontists.

Fixed and mobile-bearing total ankle prostheses: Effect on tibial bone strain.

PubMed

Terrier, Alexandre; Fernandes, Caroline Sieger; Guillemin, Maïka; Crevoisier, Xavier

2017-10-01

Total ankle replacement is associated to a high revision rate. To improve implant survival, the potential advantage of prostheses with fixed bearing compared to mobile bearing is unclear. The objective of this study was to test the hypothesis that fixed and mobile bearing prostheses are associated with different biomechanical quantities typically associated to implant failure. With a validated finite element model, we compared three cases: a prosthesis with a fixed bearing, a prosthesis with a mobile bearing in a centered position, and a prosthesis with mobile bearing in an eccentric position. Both prostheses were obtained from the same manufacturer. They were tested on seven tibias with maximum axial compression force during walking. We tested the hypothesis that there was a difference of bone strain, bone-implant interfacial stress, and bone support between the three cases. We also evaluated, for the three cases, the correlations between bone support, bone strain and bone-implant interfacial stress. There were no statistically significant differences between the three cases. Overall, bone support was mainly trabecular, and less effective in the posterior side. Bone strain and bone-implant interfacial stress were strongly correlated to bone support. Even if slight differences are observed between fixed and mobile bearing, it is not enough to put forward the superiority of one of these implants regarding their reaction to axial compression. When associated to the published clinical results, our study provides no argument to warn surgeons against the use of two-components fixed bearing implants. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Application of negative molds technology based on three-dimensional printing in digital maxillofacial prostheses].

PubMed

Gu, X Y; Chen, X B; Jiao, T; Zhang, F Q; Jiang, X Q

2017-06-09

Objective: To explore a digital negative molds technique based on three-dimensional (3D) printing to assist in the manufacture of maxillofacial prostheses, and to improve the deficiency of the current clinical treatment. Methods: Seventeen patients with maxillofacial defects (including nasal defects, orbital defects, cheek defects, auricle defect) were scanned by means of facial optical scanning and computer tomography (CT). The 3D models were then reconstructed and global registration was made to merge the reconstructed models into a new digital model for 3D design. The 3D design of the prostheses was implemented in software. The mechanical connection structure was designed by forward engineering technology for 3 patients with intra-oral defects in maxilla who needed to make removable partial dentures, so that the silicone prostheses and removable partial denture could be combined. The removable partial dentures were made by conventional method and connected with the prostheses. According to the 3D data of the prostheses, the digital negative molds were designed, and the 3D printing technology was used to finish the processing of the resin molds. Silicone for prostheses were filled and cured in the resin molds to fabricate the clinical restorations for the patients. The margin adaptation and retention of the prostheses was detected. Results: Twenty patients with varying degrees of maxillofacial defects were rehabilitated using the courses developed in the study. All patients reported no pain or discomfort during the treatment; and they were satisfied with the final prostheses of the shape, color, retention, stability, etc. Eighteen of the prostheses showed good marginal adaptation, and sixteen of the prostheses showed good retention effect. Conclusions: The digital negative molds technique used in this study could greatly reduce the intensity of manual operation and provided a good therapeutic effect for patients with maxillofacial defects.

Marginal and internal fits of fixed dental prostheses zirconia retainers.

PubMed

Beuer, Florian; Aggstaller, Hans; Edelhoff, Daniel; Gernet, Wolfgang; Sorensen, John

2009-01-01

CAM (computer-aided manufacturing) and CAD (computer-aided design)/CAM systems facilitate the use of zirconia substructure materials for all-ceramic fixed partial dentures. This in vitro study compared the precision of fit of frameworks milled from semi-sintered zirconia blocks that were designed and machined with two CAD/CAM and one CAM system. Three-unit posterior fixed dental prostheses (FDP) (n=10) were fabricated for standardized dies by: a milling center CAD/CAM system (Etkon), a laboratory CAD/CAM system (Cerec InLab), and a laboratory CAM system (Cercon). After adaptation by a dental technician, the FDP were cemented on definitive dies, embedded and sectioned. The marginal and internal fits were measured under an optical microscope at 50x magnification. A one-way analysis of variance (ANOVA) was used to compare data (alpha=0.05). The mean (S.D.) for the marginal fit and internal fit adaptation were: 29.1 microm (14.0) and 62.7 microm (18.9) for the milling center system, 56.6 microm (19.6) and 73.5 microm (20.6) for the laboratory CAD/CAM system, and 81.4 microm (20.3) and 119.2 microm (37.5) for the laboratory CAM system. One-way ANOVA showed significant differences between systems for marginal fit (P<0.001) and internal fit (P<0.001). All systems showed marginal gaps below 120 microm and were therefore considered clinically acceptable. The CAD/CAM systems were more precise than the CAM system.

Impact of implant-supported prostheses on nutritional status and oral health perception in edentulous patients.

PubMed

El Osta, Nada; El Osta, Lana; Moukaddem, Farah; Papazian, Tatiana; Saad, Robert; Hennequin, Martine; Rabbaa Khabbaz, Lydia

2017-04-01

Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses. This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index (GOHAI) respectively at Baseline (first visit before treatment), 2-3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment. Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2-3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value <0.05). Our study has shown an enhancement in the quality of life and the nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Biomedical implications of dental-ceramic defects investigated by numerical simulation, radiographic, microcomputer tomography, and time-domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Sinescu, Cosmin; Negrutiu, Meda Lavinia; Ionita, Ciprian; Marsavina, Liviu; Negru, Radu; Topala, Florin; Petrescu, Emanuela; Rominu, Roxana; Fabriky, Mihai; Bradu, Adrian; Rominu, Mihai; Podoleanu, Adrian Gh.

2011-10-01

Imagistic investigation of the metal-ceramic crowns and fixed partial prostheses represent a very important issue in nowadays dentistry. At this time, in dental office, it is difficult or even impossible to evaluate a metal ceramic crown or bridge before setting it in the oral cavity. The possibilities of ceramic fractures are due to small fracture lines or material defects inside the esthetic layers. Material and methods: In this study 25 metal ceramic crowns and fixed partial prostheses were investigated by radiographic method (Rx), micro computer tomography (MicroCT) and optical coherence tomography (OCT) working in Time Domain, at 1300 nm. The OCT system contains two interferometers and one scanner. For each incident analysis a stuck made of 100 slices was obtain. These slices were used in order to obtain a 3D model of the ceramic interface. After detecting the presence and the positions of the ceramic defects the numerical simulation method was used to estimate the biomechanical effect of the masticatory forces on fractures propagations in ceramic materials. Results: For all the dental ceramic defects numerical simulation analysis was performed. The simulation of crack propagation shows that the crack could initiate from the upper, lower or both parts of the defect and propagates through the ceramic material where tensile stress field is present. RX and MicroCT are very powerful instruments that provide a good characterization of the dental construct. It is important to observe the reflections due to the metal infrastructure that could affect the evaluation of the metal ceramic crowns and bridges. The OCT investigations could complete the imagistic evaluation of the dental construct by offering important information when it is need it.

In vitro comparative analysis of the fit of gold alloy or commercially pure titanium implant-supported prostheses before and after electroerosion.

PubMed

Sartori, Ivete Aparecida de Mattias; Ribeiro, Ricardo Faria; Francischone, Carlos Eduardo; de Mattos, Maria da Gloria Chiarello

2004-08-01

For implant-supported prostheses, passive fit is critical for the success of rehabilitation, especially when alternative materials are used. The purpose of this study was to compare interfacial fit of implant-supported prostheses cast in titanium to those cast in gold alloy. Five 3-unit fixed partial dentures were fabricated in gold alloy (Degudent U) as 1-piece castings, and 5 others were similarly cast in commercially pure titanium (Grade 1). The interfacial gaps between the prostheses and the abutments were evaluated with an optical microscope, before and after electroerosion. Readings were made with both screws tightened (10 N.cm torque), and with only 1 side tightened, so as to also evaluate the passive fit of the prostheses. Data were compared statistically by 2-way analysis of variance and the post hoc Tukey multiple range test (alpha=.05). Before electroerosion, the interfacial gaps for the 1-piece prostheses were significantly smaller (P<.001) in the gold alloy group when the screws were tightened (Au=12.6 +/- 3.0 microm, compared to Ti=30.1 +/- 6.4 microm). When the side opposite the tightened side was analyzed, there was no significant difference between the gold alloy and titanium groups (Au=69.2 +/- 24.9 microm and Ti=94.2 +/- 39.6 microm). The electroerosion procedure significantly (P<.001) reduced the gaps at the interfaces for both groups under all conditions. Comparison between groups after electroerosion did not present significant differences when the side opposite the tightened side was analyzed, but the gold alloy group showed better fit when the tightened side was analyzed (12.8 +/- 1.4 microm for gold alloy; 29.6 +/- 4.4 microm for titanium) and when both screws were tightened (5.4 +/- 2.3 microm for gold alloy; 16.1 +/- 5.5 microm for titanium). Cast titanium prostheses, despite showing larger interfacial gaps between the prosthesis and abutment than those obtained with gold alloy, had improved fit after being subjected to electroerosion.

Fabrication of fixed implant prostheses using function bite impression technique (FBI technique).

PubMed

Suzuki, Yasunori; Shimpo, Hidemasa; Ohkubo, Chikahiro; Kurtz, Kenneth S

2012-10-01

The patient was partially edentulous, lacking both the first mandibular molars. The FBI and the conventional impression technique were used for the fabrication of implant-fixed prosthesis replacing the right and left molars, respectively. In the FBI technique, the definitive impression was made under occlusal force and functionally generated path (FGP) recording at the same time. The right and left occlusal contact areas were compared after completing the implant-fixed prosthesis rehabilitation. It has been suggested that accuracy of the impression and maxillomandibular registration is necessary to ensure a satisfactory long-term clinical outcome. The transfer of the exact position of the implants to the working cast is even more important because implants lack the mobility of natural teeth. There are displacement differences between implants and natural teeth under occlusal force. The FBI technique may compensate for this difference in accuracy. Using the FBI technique, a precise prosthesis could be produced by completing simultaneously the maxillomandibular registration, impression and FGP. Copyright © 2012 Japan Prosthodontic Society. All rights reserved.

Spectral components in electromyograms from four regions of the human masseter, in natural dentate and edentulous subjects with removable prostheses and implants.

PubMed

Guzmán-Venegas, Rodrigo A; Palma, Felipe H; Biotti P, Jorge L; de la Rosa, Francisco J Berral

2018-06-01

To compare the frequency or spectral components between different regions of the superficial masseter in young natural dentate and total edentulous older adults rehabilitated with removable prostheses and fixed-implant support. A secondary objective was to compare these components between the three groups. 21 young natural dentate and 28 edentulous (14 with removable prostheses and 14 with fixed-implant support) were assessed. High-density surface electromyography (sEMG) was recorded in four portions of the superficial masseter during submaximal isometric bites. Spectral components were obtained through a spectral analysis of the sEMG signals. An analysis of mixed models was used to compare the spectral components. In all groups, the spectral components of the anterior portion were lower than in the posterior region (p < 0.05). Both edentulous groups showed lower spectral components and median frequency slope than the natural dentate group (p < 0.05). The removable prostheses group showed the greatest differences with natural dentate group. There were significant differences in the spectral components recorded in the different regions of the superficial masseter. The lower spectral components and fatigability of older adults rehabilitated with prostheses could be a cause of a greater loss of type II fibers, especially in the removable prostheses group. Copyright © 2018 Elsevier Ltd. All rights reserved.

The stereognostic ability of natural dentitions versus implant-supported fixed prostheses or overdentures.

PubMed

Jacobs, R; Bou Serhal, C; van Steenberghe, D

1997-06-01

A stereognostic ability test was performed in 60 patients. Forty patients were rehabilitated by means of osseointegrated implants. One group consisted of 20 patients with fixed prostheses on implants in both the upper and lower jaws. The other 20 patients had a maxillary denture while in the mandible an overdenture was retained by means of two implants connected by a bar. They were compared to a group of 20 subjects (controls) with a non-restored natural dentition. For the stereognostic ability test, subjects had to recognise ten different test pieces by manipulating them with two antagonistic incisor teeth, avoiding any contact with other oral structures. Both response time and percentage accuracy of recognition were evaluated. The present findings indicated that subjects with an overdenture on implants did not score significantly different from those with an implant-supported fixed prosthesis. In contrast, subjects with teeth had a significantly better stereognostic ability. The percentage of correct responses was 52% for overdentures, 56% for fixed prostheses on implants and 75% for natural dentitions. From these results, it could be concluded that the stereognostic ability is impaired in subjects rehabilitated with osseointegrated implants by about one-third to one-quarter compared to subjects with natural teeth.

Use of prostheses and footwear in 110 inner-city partial-foot amputees.

PubMed

Sobel, E; Japour, C J; Giorgini, R J; Levitz, S J; Richardson, H L

2001-01-01

The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of all levels. The results showed that about one-half of all patients wore a shoe-insert orthosis. Although 54% wore some form of special footwear to accommodate and protect the residual foot, no patient in this study wore a shoe with a rocker-bottom sole. Only one patient with a transmetatarsal amputation used a brace and only one patient in the entire study wore a modern cosmetic foot prosthesis.

Fracture analysis of randomized implant-supported fixed dental prostheses

PubMed Central

Esquivel-Upshaw, Josephine F.; Mehler, Alex; Clark, Arthur E.; Neal, Dan; Anusavice, Kenneth J.

2014-01-01

Objective Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture. Methods 89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts. Conclusion No significant relationship exists between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only. Clinical Significance This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and lighter contacts than ones supported by natural dentition. PMID:25016139

Three-Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques.

PubMed

Maló, Paulo; de Araújo Nobre, Miguel; Lopes, Armando

2016-07-01

The aim of this prospective clinical study was to evaluate the 3-year outcome of fixed partial prostheses supported by implants with immediate provisionalization without occlusal contacts inserted in predominantly soft bone with flap and flapless protocols. Forty-one patients partially rehabilitated with 72 NobelSpeedy implants (51 maxillary; 21 mandibular) were consecutively included and treated with a flapless surgical protocol (n = 20 patients; 32 implants) and flapped surgical protocol (n = 21 patients; 40 implants). Primary outcome measure was implant survival; secondary outcome measures were marginal bone resorption (comparing the bone levels at 1 and 3 years with baseline) and the incidence of biological, mechanical, and esthetic complications. Survival was computed through life tables; descriptive statistics were applied to the remaining variables of interest. Eight patients with eight implants dropped out of the study. One implant failed in one patient (flapless group) giving an overall cumulative survival rate (CSR) of 98.6%. No failures were noted with the flapped protocol (CSR 100%), while for the implants placed with the flapless surgical technique, a 96.9% CSR was registered. The overall average marginal bone resorption at 3 years was 1.37 mm (SD = 0.94 mm), with 1.14 mm (SD = 0.49 mm) and 1.60 mm (SD = 1.22 mm) for the flap and flapless groups, respectively. Mechanical complications occurred in nine patients (n = 5 patients in the flapless group; n = 4 patients in the flap group). Implant infection was registered in three implants and three patients (flapless group), who exhibited inadequate oral hygiene levels. Partial edentulism rehabilitation through immediate provisionalization fixed prosthesis supported by dental implants inserted through flap or flapless surgical techniques in areas of predominantly soft bone was viable at 3 years of follow-up. The limitations and risks of the "free-hand" method in flapless surgery should be considered when planning implant-supported fixed prosthetic reconstructions. © 2015 by the American College of Prosthodontists.

Dental claims in the Swedish Patient Insurance Scheme.

PubMed

René, N; Owall, B; Cronström, R

1991-06-01

The Swedish Patient Insurance Scheme covers treatment injuries and guarantees the replacement of failed removable prostheses for 1 year and fixed prostheses for 2 years after fitting. In this paper, 573 dental cases are analysed for a 3-month period in 1986, during which crowns and bridges formed the vast majority of failed treatments that were reported.

The edentulous mandible opposed by natural maxillary teeth: a report of six cases treated with implant-retained prostheses.

PubMed

Clark, R K; Comfort, M B

1994-01-01

Dental restoration of the edentulous mandible opposing natural maxillary teeth is often associated with a number of problems, particularly in the occlusion, and an accelerated rate of alveolar bone resorption in the edentulous mandible resulting from occlusal loading. The advent of osseointegrated implants would seem to provide a new means of treating these cases. Accordingly, the cases of six patients for whom either fixed partial dentures or over-dentures supported by Brånemark implants were provided, are reviewed. Three of the mandibles were normal and three had bone grafts. Results so far indicate that this is a viable alternative for treating such cases.

Motor behavior during the first chewing cycle in subjects with fixed tooth- or implant-supported prostheses.

PubMed

Grigoriadis, Joannis; Trulsson, Mats; Svensson, Krister G

2016-04-01

Appropriate sensory information from periodontal mechanoreceptors (PMRs) is important for optimizing the positioning of food and adjustment of force vectors during precision biting. This study was designed to describe motor behavior during the first cycle of a natural chewing task and to evaluate the role of such sensory input in this behavior. While 10 subjects with natural dentition, 11 with bimaxillary fixed tooth-supported prostheses (TSP) and 10 with bimaxillary fixed implant-supported prostheses (ISP) (mean age 69 [range 61-83]) chewed a total of five hazelnuts, their vertical and lateral jaw movements were recorded. Data obtained during the first chewing cycle of each hazelnut were analyzed. The amplitude of vertical and lateral mandibular movement and duration of jaw opening did not differ between the groups, indicating similar behavior during this part of the chewing cycle. However, only 30% of the subjects in the natural dentate group, but 82% of those in the TSP and 70% in the ISP group exhibited slippage of the hazelnut during jaw closure in at least one of five trials. The TSP and ISP groups also exhibited more irregular and narrower patterns of motion (total lateral/vertical movement = 0.15 and 0.19, respectively, compared to 0.27 for the natural group). Subjects with fixed tooth- or implant-supported prostheses in both jaws show altered behavior, including inadequate control of the hazelnut, during the first chewing cycle. We propose that these differences are due to impairment or absence of sensory signaling from PMRs in these individuals. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Framework design and pontics of fiber-reinforced composite fixed dental prostheses - An overview.

PubMed

Perea-Lowery, Leila; Vallittu, Pekka K

2018-05-11

Fiber-reinforced composite (FRC) fixed dental prostheses (FDPs) have shown good performance in clinical applications due to their good mechanical properties and minimally invasive approach. However, typical failure patterns of FRC FDPs are often localized at the pontic site. That reflects the structural considerations at the framework and pontic location that need to be examined when creating these kinds of prostheses. Peer-reviewed articles and other scientific literature were reviewed for providing up-to-date information on how pontics of FRC FDPs can be made. A thorough literature search was done using PubMed and Google Scholar. Two individuals did an assessment of the articles in order to include those related to pontics and framework design of FRC FDPs. The search terms used were "fiber-reinforced dental prosthesis" and "Pontics of fiber-reinforced dental prosthesis". These findings indicate that a cross-sectional fiber design, substructure and thicker pontics made of a variety of materials might reduce failures at the pontic site. The thickness of pontics of FRC FDPs interrelated with the vertical positioning of the FRC framework influences the load-bearing capacities of prostheses of these kinds. The understanding of the factors involved in the fabrication of pontics of FRC FDPs may overcome the drawbacks identified in these prostheses, thus extending their longevity. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Prevalence of peri-implantitis in patients with implant-supported fixed prostheses.

PubMed

Schuldt Filho, Guenther; Dalago, Haline Renata; Oliveira de Souza, João Gustavo; Stanley, Kyle; Jovanovic, Sascha; Bianchini, Marco Aurélio

2014-01-01

The purpose of this study was to evaluate periimplantitis prevalence in patients using implant-supported fixed prostheses that did not have any routine maintenance care. A total of 161 implants (27 patients) were evaluated in patients using implant-supported fixed prostheses. Collected data included information related to patient general health and local factors such as characteristics of implants, time in function, type of loading, positioning, Modified Bleeding Index, bacterial plaque, bleeding on probing (BOP), marginal recession, probing depth (PD), keratinized mucosa, and radiographic bone loss (BL). Factors related to the prostheses were also evaluated. The exclusion criteria were patients that have had any follow-up visit for plaque control of the prosthesis and/or the implants. From a total of 161 implants, 116 (72%) presented without peri-implantitis (PD > 4 mm + BOP + BL > 2 mm) while 45 (28%) had some sign of the disease. Implants placed in the maxilla were 2.98 times more likely to develop the disease (P < .05). Moreover, patients aged ≤ 60 years old were 3.24 times more likely to develop peri-implantitis (P < .05). Another analysis with statistical relevance (P < .05) was that implants with less than 3 mm interimplant distance were three times more likely to have peri-implantitis. There was no statistical relevance considering other analyses. It can be concluded that patients aged ≤ 60 years have a greater chance of presenting periimplantitis, as well as for implants positioned in the maxilla and those placed with an interimplant distance < 3 mm.

Implants for elderly patients.

PubMed

Schimmel, Martin; Müller, Frauke; Suter, Valérie; Buser, Daniel

2017-02-01

In the developed world, the large birth cohorts of the so-called baby boomer generation have arrived in medical and dental practices. Often, elderly patients are 'young-old' baby boomers in whom partial edentulism is the predominant indication for implant therapy. However, the generation 85+ years of age represents a new challenge for the dental profession, as their lives are frequently dominated by dependency, multimorbidity and frailty. In geriatric implant dentistry, treatment planning is highly individualized, as interindividual differences become more pronounced with age. Nevertheless, there are four typical indications for implant therapy: (i) avoidance of removable partial prostheses; (ii) preservation of existing removable partial prostheses; (iii) stabilization of Kennedy Class I removable partial prostheses; and (iv) stabilization of complete prostheses. From a surgical point of view, two very important aspects must be considered when planning implant surgery in elderly patients: first, the consistent strive to minimize morbidity; and, second, the fact that coexisting medical risk factors are significantly more common in elderly patients. Modern three-dimensional cone beam computed tomography imaging is often indicated in order to plan minimally invasive implant surgery. Computer-assisted implant surgery might allow flapless implant surgery, which offers a low level of postoperative morbidity and a minimal risk of postsurgical bleeding. Short and reduced-diameter implants are now utilized much more often than a decade ago. Two-stage surgical procedures should be avoided in elderly patients. Implant restorations for elderly patients should be designed so that they can be modified to become low-maintenance prostheses, or even be removed, as a strategy to facilitate oral hygiene and comfort in the final stage of life. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Wear Distribution Detection of Knee Joint Prostheses by Means of 3D Optical Scanners

PubMed Central

Affatato, Saverio; Valigi, Maria Cristina; Logozzo, Silvia

2017-01-01

The objective of this study was to examine total knee polyethylene inserts from in vitro simulation to evaluate and display—using a 3D optical scanner—wear patterns and wear rates of inserts exposed to wear by means of simulators. Various sets of tibial inserts have been reconstructed by using optical scanners. With this in mind, the wear behavior of fixed and mobile bearing polyethylene knee configurations was investigated using a knee wear joint simulator. After the completion of the wear test, the polyethylene menisci were analyzed by an innovative 3D optical scanners in order to evaluate the 3D wear distribution on the prosthesis surface. This study implemented a new procedure for evaluating polyethylene bearings of joint prostheses obtained after in vitro wear tests and the proposed new approach allowed quantification of the contact zone on the geometry of total knee prostheses. The results of the present study showed that mobile TKPs (total knee prosthesis) have lower wear resistance with respect to fixed TKPs. PMID:28772725

Three-Dimensional (3-D) Printing: A Cost-Effective Solution for Improving Global Accessibility to Prostheses.

PubMed

Silva, Kyle; Rand, Stephanie; Cancel, David; Chen, Yuxi; Kathirithamby, Rani; Stern, Michelle

2015-12-01

The lack of access to prostheses is a global problem, partially caused by the high cost associated with the current manufacturing process. Three-dimensional printing is gaining use in the medical field, and one such area is prosthetics. In addition to using cost-effective materials, this technology allows for rapid prototyping, making it an efficient solution for the development of affordable prostheses. If the rehabilitation medicine community embraces this novel technology, we can help alleviate the global disparity of access to prostheses. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure.

PubMed

Kinsel, Richard P; Lin, Dongming

2009-06-01

Porcelain fracture associated with an implant-supported, metal ceramic crown or fixed partial denture occurs at a higher rate than in tooth-supported restorations, according to the literature. Implant-specific and patient-specific causes of ceramic failure have not been fully evaluated. The purpose of this retrospective study was to evaluate the potential statistical predictors for porcelain fracture of implant-supported, metal ceramic restorations. Over a 6-month period, a consecutive series of patients having previously received implant-supported, metal ceramic fixed restorations were examined during periodic recall appointments. The number of supporting implants, number of dental units, type of restoration, date of prosthesis insertion, location in the dental arch, opposing dentition, type of occlusion, presence of parafunctional habits, use of an occlusal protective device, presence or absence of ceramic fractures, gender, and age were recorded for each patient. The generalized estimating equation (GEE) approach was used for the intrasubject correlated measurements analysis of categorical outcomes (presence or absence of ceramic fractures) to determine which patient- and implant-specific factors would predict porcelain fracture (alpha=.05). Data were collected from 152 patients representing 998 dental units (390 single crowns and 94 fixed partial dentures) supported by 729 implants. Porcelain fractures of 94 dental units occurred in 35 patients. The fractures were significantly (P<.05) associated with opposing implant-supported metal ceramic restorations, bruxism, and not wearing a protective occlusal device. Metal ceramic prostheses (single crown or fixed partial dentures) had approximately 7 times higher odds of porcelain fracture (odds ratio (OR)=7.06; 95% confidence interval (CI): 2.57 to 19.37) and 13 times greater odds of a fracture requiring either repair or replacement (OR=13.95; 95% CI: 2.25 to 86.41) when in occlusion with another implant-supported restoration, as compared to opposing a natural tooth. In addition, patients exhibiting bruxism or not wearing an occlusal device had approximately 7 times higher odds (OR=7.23; 95% CI: 3.86 to 13.54), and 2 times higher odds (OR=1.92; 95% CI: 1.01 to 3.67) of porcelain fracture when compared to patients without bruxism and patients not wearing an occlusal device. Implant-supported metal ceramic single crowns and fixed partial dentures were found to have a significantly higher risk of porcelain fracture in patients with bruxism habits, when a protective occlusal device was not used, and when the restoration opposed another implant-supported metal ceramic restoration.

Survival of anterior cantilevered all-ceramic resin-bonded fixed dental prostheses made from zirconia ceramic.

PubMed

Sasse, Martin; Kern, Matthias

2014-06-01

This study evaluated the clinical outcome of all-ceramic resin-bonded fixed dental prostheses (RBFDPs) with a cantilevered single-retainer design made from zirconia ceramic. Forty-two anterior RBFDPs with a cantilevered single-retainer design were made from yttrium oxide-stabilized zirconium oxide ceramic. RBFDPs were inserted using Panavia 21 TC as luting agent after air-abrasion of the ceramic bonding surface. During a mean observation time of 61.8 months two debondings occurred. Both RBFDPs were rebonded using Panavia 21 TC and are still in function. A caries lesion was detected at one abutment tooth during recall and was treated with a composite filling. Therefore, the overall six-year failure-free rate according to Kaplan-Meier was 91.1%. If only debonding was defined as failure the survival rate increased to 95.2%. Since all RBFDPs are still in function the overall survival rate was 100% after six years. Cantilevered zirconia ceramic RBFDPs showed promising results within the observation period. Single-retainer resin-bonded fixed dental prostheses made from zirconia ceramic show very good mid-term clinical survival rates. They should therefore be considered as a viable treatment alternative for the replacement of single missing anterior teeth especially as compared to an implant therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Immediate loading with fixed full-arch prostheses in the maxilla: Review of the literature

PubMed Central

Peñarrocha-Oltra, David; Covani, Ugo; Peñarrocha-Diago, Miguel

2014-01-01

Objectives: To critically review the evidence-based literature on immediate loading of implants with fixed full-arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure. Study Desing: Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, use of post-extraction implants, minimum implant length and diameter, type of prosthesis, time until loading, implant survival rate, prosthesis survival rate, marginal bone loss, complications andmean follow-up time. Criteria for patient selection, implant primary stability and bone regeneration were also studied. Results: Thirteen studies were included, reporting a total of 2484 immediately loaded implants in 365 patients. Currently accepted performance criteria regarding patient and implant selection, and surgical and prosthetic procedures were deduced from the reviewed articles. Implant survival rates went from 87.5% to 100%, prosthesis survival rates from 93.8% to 100% and radiographic marginal bone loss from 0.8 mm to 1.6 mm.No intraoperative complications and only minor prosthetic complications were reported. Conclusions: The literature on immediate loading with fixed full-arch prostheses in the maxilla shows that a successful outcome can be expected if adequate criteria are used to evaluate the patient, choose the implant and perform the surgical and prosthetic treatment. Lack of homogeneity within studies limits the relevance of the conclusions that can be drawn, and more controlled randomized studies are necessary to enable comparison between the immediate and the conventional loading procedures. Key words:Immediate loading, full-arch, dental implants, loading protocols. PMID:24880445

Success rate in implant-supported overdenture and implant-supported fixed denture in cleft lip and palate patients

PubMed Central

Zanolla, Jaine; Amado, Flávio Monteiro; da Silva, Willian Saranholi; Ayub, Bruno; de Almeida, Ana Lúcia Pompéia Fraga; Soares, Simone

2016-01-01

Background: The prosthetic treatment in cleft patients is challenging. Based on this, the aim of this study was to evaluate the longevity of prosthetic rehabilitation treatment with implant-supported overdenture (IOD) and implant-supported fixed denture (IFD) in cleft lip and palate patients in a period of 22 years. Materials and Methods: The medical records of 72 patients were analyzed (29 males and 43 females), and the survival rate of the implants was evaluated. Moreover, the prostheses’ time of use and the reason for the changing of these were also evaluated. Results: Four-hundred-seventeen implants were installed, and 370 implants survive today. The mean survival time of the implants was 7.6 years. Regarding the 97 prostheses made, the time of average use was 3.28 for the IFDs and 3.92 for IODs. The reasons for the replacements of the prostheses were mainly: fracture of the acrylic base (29.6%) and loss of vertical dimension of occlusion (VDO) (18.5%) in the IFDs. Moreover, in IODs, these were accounted for the loss of VDO due to teeth damage (17.2%) and implant loss (14.6%). Conclusions: The maintenance of the prostheses was challenging because the patients had difficulties returning for periodic control, but this fact did not result in the decrease of the success rate of the implants. The longevity of implants and prostheses was satisfactory; however, the prostheses showed repetitions mainly due to the wear of the teeth, with decreased vertical dimension and fracture of acrylic base. PMID:28299262

[An experimental study of the coagulating properties of a laser beam applied to fix titanium prostheses of auditory ossicles with the use of platelet-rich plasma].

PubMed

Semenov, V F; Semenov, F V

2013-01-01

The displacement of prostheses of auditory ossicles at the concluding stage of surgery and in the early postoperative period is one of the factors influencing the functional outcome of stapedoplasty. The objective of the present experimental study was to estimate the effectiveness of the use of platelet-rich plasma as an alloy for the laser welding in order to improve fixation of titanium prostheses employed in ossiculoplastic surgery. The results of a series of experiments undertaken to assess the possibility of stabilization of titanium prostheses in the desired position with the help of laser welding indicate that this technique with the use of platelet-rich plasma as an alloy may be a reliable method for the fixation of the reconstructed chain of ossicles in the desired position.

Femoro-tibial kinematics after TKA in fixed- and mobile-bearing knees in the sagittal plane.

PubMed

Daniilidis, Kiriakos; Höll, Steffen; Gosheger, Georg; Dieckmann, Ralf; Martinelli, Nicolo; Ostermeier, Sven; Tibesku, Carsten O

2013-10-01

Lack of the anterior cruciate ligament in total knee arthroplasty results in paradoxical movement of the femur as opposed to the tibia under deep flexion. Total knee arthroplasty with mobile-bearing inlays has been developed to provide increased physiological movement of the knee joint and to reduce polyethylene abrasion. The aim of this study was to perform an in vitro analysis of the kinematic movement in the sagittal plane in order to show differences between fixed- and mobile-bearing TKA in comparison with the natural knee joint. Seven knee joints of human cadaver material were used in a laboratory experiment. Fixed- and mobile-bearing inlays were tested in sequences under isokinetic extension in so-called kinemator for knee joints, which can simulate muscular traction power by the use of hydraulic cylinders, which crossover the knee joint. As a target parameter, the a.p. translation of the tibio-femoral relative movement was measured in the sagittal plane under ultrasound (Zebris) control. The results show a reduced tibial a.p. translation in relation to the femur in the bearing group compared to the natural joint. In the Z-axis, between 110° and 50° of flexion, linear movement decreases towards caudal movement under extension. Admittedly, the study did not show differences in the movement pattern between "mobile-bearing" and "fixed-bearing" prostheses. Results of this study cannot prove functional advantages of mobile-bearing prostheses for the knee joint kinematic after TKA. Both types of prostheses show typical kinematics of an anterior instability, hence they were incapable of performing physiological movement.

New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations

PubMed Central

Romero, Luis; Jiménez, Mariano; Espinosa, María del Mar; Domínguez, Manuel

2015-01-01

Aim This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. Method From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Results Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants. PMID:26696528

New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations.

PubMed

Romero, Luis; Jiménez, Mariano; Espinosa, María Del Mar; Domínguez, Manuel

2015-01-01

This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants.

Oral health-related quality of life and masticatory function after conventional prosthetic treatment: A cohort follow-up study.

PubMed

Palomares, Teresa; Montero, Javier; Rosel, Eva M; Del-Castillo, Ramón; Rosales, Juan I

2018-05-01

The impact of conventional prosthetic treatment on both the objective and subjective assessments of mastication as well as on well-being is unclear. The purpose of this clinical study was to compare the impact on oral health-related quality of life and masticatory function in participants treated with conventional dental prostheses. A total of 72 patients requiring prosthetic rehabilitation were enrolled by referral from the Faculty of Dentistry at the University of Granada, Spain. At baseline, demographic, behavioral, and clinical (prosthetic status, occlusal units) data were collected. In addition, the scores for quality of life, oral satisfaction, masticatory ability (Leake index), and masticatory performance (after 5, 10, and 15 cycles of bicolored chewing gum) were obtained. These records were obtained again at 6 to 8 weeks after insertion of the prostheses. The findings revealed that patients treated with fixed prostheses had better quality of life and better masticatory function than patients treated with removable prostheses. This result was even more pronounced for those treated with complete dentures. For all items, most of the treated patients improved the quality of life (average, 8.6 of the 4 items), although only between 5% and 15% of patients, especially those with a removable prosthesis, commented on functional impact after receiving treatment. Generally, masticatory performance was improved between 7% and 18% and was highly correlated not only with the number of natural teeth (r=0.61) and occlusal units (r=0.51) but also with subjective variables such as mastication satisfaction (r=0.31), impact on quality of life (r=0.30), or masticatory ability (r=0.30). Treatment with fixed prostheses achieved better results regarding quality of life, oral satisfaction, and masticatory function than treatment with removable prostheses. A moderate but significant correlation exists between the objective and subjective assessments of the masticatory functions. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The effects of loading on the preload and dimensions of the abutment screw for a 3-unit cantilever-fixed prosthesis design.

PubMed

Setia, Gaurav; Yousef, Hoda; Ehrenberg, David; Luke, Allyn; Weiner, Saul

2013-08-01

The purpose of this study was to use an in vitro model system to compare the effects on the screw torque and screw dimensions within 2 commercially available implant systems from occlusal loading on a cantilevered-fixed partial denture. Cantilevered implant-supported 3-unit prostheses with 2 premolar abutments and 1 premolar pontic (7.3 mm in length) were made on resin casts containing 2 implant analogs for 2 implant systems: BioLok Silhouette Tapered Implant System (Birmingham, AL) and Zimmer Tapered Screw-Vent Implant System (Carlsbad, CA) with 10 samples in each group. Each sample was loaded with either of 2 protocols: (1) a load of 50 N on the cantilevered pontic unit and (2) a loading of 150 N on all 3 units. The outcome measures were (1) changes in residual torque of the abutment screws and (2) changes in screw dimension. The BioLok Silhouette Tapered Implant group demonstrated slight but statistically significant torque loss 18.8% to 28.5% in both abutment screws for both protocols, P ≤ 0.05, without any changes in screw dimension. In the Zimmer Tapered Screw-Vent Implant group, there was a significant elongation of the abutment screws and a markedly significant 44.4%, (P ≤ 0.01) loss in torque in the mesial screw and a 28.5%, (P ≤ 0.05) loss in torque in the distal screw when the cantilever alone was loaded. Differences in screw design influence the maintenance of preload and distortion of the shank. The influence of the interface design, namely an internal hex of 1 mm versus an external hex did not influence the preload. Cantilevered prostheses can cause loss of torque and dimensional changes in abutment screws.

Inlay-retained cantilever fixed dental prostheses to substitute a single premolar: impact of zirconia framework design after dynamic loading.

PubMed

Shahin, Ramez; Tannous, Fahed; Kern, Matthias

2014-08-01

The purpose of this in-vitro study was to evaluate the influence of the framework design on the durability of inlay-retained cantilever fixed dental prostheses (IR-FDPs), made from zirconia ceramic, after artificial ageing. Forty-eight caries-free human premolars were prepared as abutments for all-ceramic cantilevered IR-FDPs using six framework designs: occlusal-distal (OD) inlay, OD inlay with an oral retainer wing, OD inlay with two retainer wings, mesial-occlusal-distal (MOD) inlay, MOD inlay with an oral retainer ring, and veneer partial coping with a distal box (VB). Zirconia IR-FDPs were fabricated via computer-aided design/computer-aided manufacturing (CAD/CAM) technology. The bonding surfaces were air-abraded (50 μm alumina/0.1 MPa), and the frameworks were bonded with adhesive resin cement. Specimens were stored for 150 d in a 37°C water bath during which they were thermocycled between 5 and 55°C for 37,500 cycles; thereafter, they were exposed to 600,000 cycles of dynamic loading with a 5-kg load in a chewing simulator. All surviving specimens were loaded onto the pontic and tested until failure using a universal testing machine. The mean failure load of the groups ranged from 260.8 to 746.7 N. Statistical analysis showed that both MOD groups exhibited significantly higher failure loads compared with the other groups (i.e. the three OD groups and the VB group) and that there was no significant difference in the failure load among the OD groups and the VB group. In conclusion, zirconia IR-FDPs with a modified design exhibited promising failure modes. © 2014 Eur J Oral Sci.

Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 5-year follow-up study.

PubMed

Ortorp, A; Linden, B; Jemt, T

1999-01-01

The purpose of this study was to report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks and to compare their performance with that of prostheses provided with conventional cast frameworks. On a routine basis, a consecutive group of 824 edentulous patients were provided with fixed prostheses supported by implants in the edentulous mandible. In addition to conventional gold-alloy castings, patients were at random provided with 2 kinds of laser-welded titanium frameworks. In all, 155 patients were included in the 2 titanium framework groups. A control group of 53 randomly selected patients with conventional gold-alloy castings was used for comparison. Clinical and radiographic 5-year data was collected for the 3 groups. All followed patients still had fixed prostheses in the mandible after 5 years. The overall cumulative success rates were 95.9% and 99.7% for titanium-framework prostheses and implants, respectively. The corresponding success rates for the control group were 100% and 99.6%, respectively. Bone loss was 0.5 mm on average during the 5-year follow-up period. The most common complications for titanium frameworks were resin or tooth fractures, gingival inflammation, and fractures of the metal frames (10%). One of the cast frameworks fractured and was resoldered. Loose and fractured implant screw components were few (< 1%). Even though the cast frameworks had a higher success rate, the overall titanium framework treatment result was well in accordance with the result of the control group. The test groups performed better after clinicians had gained some experience with the technique, and laser-welded titanium frameworks seem to be a viable alternative to conventional castings in the edentulous mandible.

[Aftercare for durability and profitability of single-unit and multi-unit fixed dental prostheses].

PubMed

de Baat, C; van Loveren, C; van der Maarel-Wierink, C D; Witter, D J; Creugers, N H J

2013-01-01

An important aim ofa treatment with single-unit and multi-unit fixed dental prostheses is a durable and profitable treatment outcome. That requires aftercare, too. First, the frequency of routine oral examinations should be assessed, using an individual risk profile. The objectives of the routine oral examinations are the prevention and, when necessary, the treatment of pathological conditions and complications. With regard to prevention, attention should be paid to information and instruction, oral biofilm and calculus, non-functional activities, hard tooth tissues, periodontal and peri-implant tissues, and saliva. Subsequently, it can be determined whether the intended durability and profitability have been achieved or can still be achieved, whether or not through indicated adjustments. Special attention should be paid to endodontically treated teeth. Restorative, repair or replacement treatments may be indicated in case ofcomplications, such as loose single- or multi-unitfixed dental prosthesis, fracture of a fixed dental prosthesis unit, lost tooth pulp vitality, tooth root fracture, and implant or implant abutment problems.

Implant-Supported Fixed Partial Prostheses With Different Prosthetic Materials: A Three-Dimensional Finite Element Stress Analysis.

PubMed

Arinc, Hakan

2018-06-01

To evaluate the effects of prosthetic material on the degree of stress to the cortical bone, trabecular bone, framework, and implants using finite element analysis (FEA). A mandibular implant-supported fixed prosthesis was designed. Different prosthetic materials [cobalt-chromium-supported ceramic, zirconia-supported ceramic, and zirconia-reinforced polymethyl methacrylate (ZRPMMA)-supported resin] were used. FEA was used to evaluate stress under different loading conditions. Maximum principal (σmax), minimum principal (σmin), and von Mises (σvM) stress values were obtained. Similar σmax, σmin, and σvM values were observed in the cortical and trabecular bones and in implants under both loading conditions, with the exception of the ZRPMMA model, which showed the highest σmax, σmin, and σvM values in oblique loading. The ZRPMMA model had the lowest σvM value in the framework under both loading conditions. ZRPMMA had the lowest stress values in the framework, with increased stress values in the implants and bone tissue. Framework and veneering materials may influence stress values under different loading conditions.

Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications.

PubMed

Gautam, Chandkiram; Joyner, Jarin; Gautam, Amarendra; Rao, Jitendra; Vajtai, Robert

2016-12-06

Zirconia (ZrO 2 ) based dental ceramics have been considered to be advantageous materials with adequate mechanical properties for the manufacturing of medical devices. Due to its very high compression strength of 2000 MPa, ZrO 2 can resist differing mechanical environments. During the crack propagation on the application of stress on the surface of ZrO 2 , a crystalline modification diminishes the propagation of cracks. In addition, zirconia's biocompatibility has been studied in vivo, leading to the observation of no adverse response upon the insertion of ZrO 2 samples into the bone or muscle. In vitro experimentation has exhibited the absence of mutations and good viability of cells cultured on this material leading to the use of ZrO 2 in the manufacturing of hip head prostheses. The mechanical properties of zirconia fixed partial dentures (FPDs) have proven to be superior to other ceramic/composite restorations and hence leading to their significant applications in implant supported rehabilitations. Recent developments were focused on the synthesis of zirconia based dental materials. More recently, zirconia has been introduced in prosthetic dentistry for the fabrication of crowns and fixed partial dentures in combination with computer aided design/computer aided manufacturing (CAD/CAM) techniques. This systematic review covers the results of past as well as recent scientific studies on the properties of zirconia based ceramics such as their specific compositions, microstructures, mechanical strength, biocompatibility and other applications in dentistry.

Rapid prototyping--when virtual meets reality.

PubMed

Beguma, Zubeda; Chhedat, Pratik

2014-01-01

Rapid prototyping (RP) describes the customized production of solid models using 3D computer data. Over the past decade, advances in RP have continued to evolve, resulting in the development of new techniques that have been applied to the fabrication of various prostheses. RP fabrication technologies include stereolithography (SLA), fused deposition modeling (FDM), computer numerical controlled (CNC) milling, and, more recently, selective laser sintering (SLS). The applications of RP techniques for dentistry include wax pattern fabrication for dental prostheses, dental (facial) prostheses mold (shell) fabrication, and removable dental prostheses framework fabrication. In the past, a physical plastic shape of the removable partial denture (RPD) framework was produced using an RP machine, and then used as a sacrificial pattern. Yet with the advent of the selective laser melting (SLM) technique, RPD metal frameworks can be directly fabricated, thereby omitting the casting stage. This new approach can also generate the wax pattern for facial prostheses directly, thereby reducing labor-intensive laboratory procedures. Many people stand to benefit from these new RP techniques for producing various forms of dental prostheses, which in the near future could transform traditional prosthodontic practices.

In vitro biomechanical comparison after fixed- and mobile-core artificial cervical disc replacement versus fusion

PubMed Central

Lou, Jigang; Li, Yuanchao; Wang, Beiyu; Meng, Yang; Wu, Tingkui; Liu, Hao

2017-01-01

Abstract In vitro biomechanical analysis after cervical disc replacement (CDR) with a novel artificial disc prosthesis (mobile core) was conducted and compared with the intact model, simulated fusion, and CDR with a fixed-core prosthesis. The purpose of this experimental study was to analyze the biomechanical changes after CDR with a novel prosthesis and the differences between fixed- and mobile-core prostheses. Six human cadaveric C2–C7 specimens were biomechanically tested sequentially in 4 different spinal models: intact specimens, simulated fusion, CDR with a fixed-core prosthesis (Discover, DePuy), and CDR with a mobile-core prosthesis (Pretic-I, Trauson). Moments up to 2 Nm with a 75 N follower load were applied in flexion–extension, left and right lateral bending, and left and right axial rotation. The total range of motion (ROM), segmental ROM, and adjacent intradiscal pressure (IDP) were calculated and analyzed in 4 different spinal models, as well as the differences between 2 disc prostheses. Compared with the intact specimens, the total ROM, segmental ROM, and IDP at the adjacent segments showed no significant difference after arthroplasty. Moreover, CDR with a mobile-core prosthesis presented a little higher values of target segment (C5/6) and total ROM than CDR with a fixed-core prosthesis (P > .05). Besides, the difference in IDP at C4/5 after CDR with 2 prostheses was without statistical significance in all the directions of motion. However, the IDP at C6/7 after CDR with a mobile-core prosthesis was lower than CDR with a fixed-core prosthesis in flexion, extension, and lateral bending, with significant difference (P < .05), but not under axial rotation. CDR with a novel prosthesis was effective to maintain the ROM at the target segment and did not affect the ROM and IDP at the adjacent segments. Moreover, CDR with a mobile-core prosthesis presented a little higher values of target segment and total ROM, but lower IDP at the inferior adjacent segment than CDR with a fixed-core prosthesis. PMID:29019902

Implant-level prostheses in the edentulous maxilla: a comparison with conventional abutment-level prostheses after 5 years of use.

PubMed

Hjalmarsson, Lars; Smedberg, Jan-Ivan; Pettersson, Mattias; Jemt, Torsten

2011-01-01

Long-term comparisons of frameworks at the implant or abutment level are not available, and knowledge of the clinical function of cobalt-chromium (Co-Cr) alloy frameworks is limited. Primarily, the aim of this study was to compare the 5-year clinical performance of frameworks with or without abutment connections to implants. Secondly, the outcomes of prostheses made from Co-Cr alloy with porcelain veneers to those made of commercially pure titanium (CP Ti) with acrylic veneers were compared. The test groups comprised patients treated with screw-retained fixed prostheses made at the implant level according to the Cresco method in either dental porcelain-veneered Co-Cr alloy (n = 15) or acrylic-veneered CP Ti (n = 25). A control group of 40 randomly selected patients were provided with prostheses made at the standard abutment level in CP Ti with acrylic veneers. For all patients, clinical and radiologic 5-year data were retrospectively collected and evaluated. Five-year implant cumulative survival rates (CSRs) were 98.6% and 97.6% for test and control groups, respectively (P > .05). No major differences in bone level were demonstrated between the groups after 5 years (P > .05). Significantly more complications occurred in the test groups compared to the control group (P < .01), with the most common complications being mucositis and fracture of veneers. After 5 years, the clinical outcomes of implant-level prostheses made of porcelain-veneered Co-Cr or acrylic-veneered CP Ti seem comparable to acrylic-veneered titanium prostheses made at the standard abutment level regarding implant CSR and bone levels. However, more complications were registered in implant-level prostheses compared to the standard abutment-level prostheses.

Results with nine years mean follow up on one hundred and three KAPS® uni knee arthroplasties: eighty six medial and seventeen lateral.

PubMed

Saragaglia, Dominique; Bevand, Adrien; Refaie, Ramsay; Rubens-Duval, Brice; Pailhé, Régis

2018-05-01

The purpose of this study was to present the results of the KAPS® uni knee arthroplasty system, both mobile and fixed bearing with reference to function, alignment and complications in 103 implants with a mean follow-up of nine years. This was a retrospective study of 103 unicompartimental knee arthroplasties in 89 patients operated on between March 2005 and March 2010. The population was composed of 50 males and 39 females, with a mean age of 70.5 ± 7.5 years (41 - 90). Eighty-seven patients had a genu varum deformity (84.5%), one of whom had an osteoid osteoma of the lateral tibial plateau and 16 patients had a genu valgum (15.5%). Eighty-six medial prostheses were implanted (82 mobile bearings and 4 fixed bearings) and 17 lateral prostheses (all fixed bearings) including the osteoid osteoma. At a mean follow-up of 107.5 months (73-138), 72 knees (58 patients) were reviewed (70%). The mean IKS score was of 173 ± 31 points (58 - 200). The mean Oxford knee score was 21 ± 8 points (12 - 50). The cumulated survival rate at a follow up of 132 months was 98.2%. The KAPS® unicompartmental knee arthroplasty gives efficacious and safe outcomes in the majority of cases at a mean follow-up of nine years. The availability of both fixed and mobile bearings with the same instrumentation, allowing to choose the right implant intra-operatively, is a great advantage in order to avoid the occurrence of some complications, specific to mobile bearing prostheses (dislocation and over-correction).

The effect of rigid and non-rigid connections between implants and teeth on biological and technical complications: a systematic review and a meta-analysis.

PubMed

Tsaousoglou, Phoebus; Michalakis, Konstantinos; Kang, Kiho; Weber, Hans-Peter; Sculean, Anton

2017-07-01

To assess survival, as well as technical and biological complication rates of partial fixed dental prostheses (FDPs) supported by implants and teeth. An electronic Medline search was conducted to identify articles, published in dental journals from January 1980 to August 2015, reporting on partial FDPs supported by implants and teeth. The search terms were categorized into four groups comprising the PICO question. Manual searches of published full-text articles and related reviews were also performed. The initial database search produced 3587 relevant titles. Three hundred and eighty-six articles were retrieved for abstract review, while 39 articles were selected for full-text review. A total of 10 studies were selected for inclusion. Overall survival rate for implants ranged between 90% and 100%, after follow-up periods with a mean range of 18-120 months. The survival of the abutment teeth was 94.1-100%, while the prostheses survival was 85-100% for the same time period. The most frequent complications were "periapical lesions" (11.53%). The most frequent technical complication was "porcelain occlusal fracture" (16.6%), followed by "screw loosening" (15%). According to the meta-analysis, no intrusion was noted on the rigid connection group, while five teeth (8.19%) were intruded in the non-rigid connection group [95% CI (0.013-0.151)]. The tooth-implant FDP seems to be a possible alternative to an implant-supported FDP. There is limited evidence that rigid connection between teeth and implants presents better results when compared with the non-rigid one. The major drawback of non-rigidly connected FDPs is tooth intrusion. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Fifteen-year survival of anterior all-ceramic cantilever resin-bonded fixed dental prostheses.

PubMed

Kern, Matthias

2017-01-01

The aim of this follow-up study was to report the long-term outcome of all-ceramic cantilever resin-bonded fixed dental prostheses (RBFDPs). In 16 patients (mean age of 33.3±17.5years) 22 RBFDPs made from a glass-infiltrated alumina ceramic (In-Ceram) were inserted with a phosphate monomer containing luting agent after air-abrasion of the retainer wings. The abutment preparation included a shallow groove on the cingulum and a small proximal box. The restorations replacing 16 maxillary and 6 mandibular incisors were followed over a mean observation time of 188.7 months. No restoration debonded. Two RBFDPs fractured and were lost 48 and 214 months after insertion, respectively. The 10-year and 15-year survival rates were both 95.4% and dropped to 81.8% after 18 years. Anterior all-ceramic cantilever RBFDPs exhibited an excellent clinical longevity. Copyright © 2016 Elsevier Ltd. All rights reserved.

The current use of patient-centered/reported outcomes in implant dentistry: a systematic review.

PubMed

De Bruyn, Hugo; Raes, Stefanie; Matthys, Carine; Cosyn, Jan

2015-09-01

To provide an update on the use of Patient-Reported Outcome Measures (PROMs) in the field of implant dentistry (1); to compare PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition (2). The dental literature was searched on PubMed until December 31, 2014, using a general search algorithm. An overall quantitative analysis was performed, and a qualitative appraisal was made on the output of the last 6 years. Per type of edentulism and prosthetic treatment, the general search algorithm was refined in order to select controlled studies comparing PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition. With nearly half of the output (300 of 635) published in the last 6 years, there is a growing interest in PROMs by the scientific community. When scrutinizing the 300 most recent publications, only 84 controlled studies could be identified among which 38 RCTs and 31 cohort studies. An "ad hoc" approach is commonly employed using non-standardized questions and different scoring methods, which may compromise validity and reliability. Overall, 39 eligible papers related to fully edentulous patients treated with an implant overdenture (IOD) and 9 to fully edentulous patients treated with a fixed implant prosthesis (FIP). There is plenty of evidence from well-controlled studies showing that fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a conventional denture (CD). This may not hold true for fully edentulous patients in the maxilla. In general, fully edentulous patients seem to opt for a fixed or removable rehabilitation on implants for specific reasons. Data pertaining to partially edentulous patients were limited (FIP: n = 6; single implants: n = 16). In these patients, the timing of implant placement does not seem to affect patient satisfaction. Patients seem to prefer straightforward implant surgery over complex surgery that includes bone grafting. There is an urgent need for standardized reporting of PROMs in the field of implant dentistry. Fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a CD. All other types of prostheses have been underexposed to research. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Implant/tooth-connected restorations utilizing screw-fixed attachments: a survey of 3,096 sites in function for 3 to 14 years.

PubMed

Fugazzotto, P A; Kirsch, A; Ackermann, K L; Neuendorff, G

1999-01-01

Numerous problems have been reported following various therapies used to attach natural teeth to implants beneath a fixed prosthesis. This study documents the results of 843 consecutive patients treated with 1,206 natural tooth/implant-supported prostheses utilizing 3,096 screw-fixed attachments. After 3 to 14 years in function, only 9 intrusion problems were noted. All problems were associated with fractured or lost screws. This report demonstrates the efficacy of such a treatment approach when a natural tooth/implant-supported fixed prosthesis is contemplated.

Oral health and oral implant status in edentulous patients with implant-supported dental prostheses who are receiving long-term nursing care.

PubMed

Isaksson, Rita; Becktor, Jonas P; Brown, Andrew; Laurizohn, Christer; Isaksson, Sten

2009-12-01

The aim of this study was to investigate oral health and oral implant status in a group of edentulous patients receiving long-term residential or nursing care (LTC), all of whom had implant-supported fixed or removable dental prostheses. A dental examination was performed on a total of 3310 patients receiving LTC and from this population 35 edentulous patients in whom dental implants had been placed formed the cohort for this study. All examinations were performed by a specialist in hospital dentistry and took place in the patients' own home environment. Oral health was assessed by means of a protocol which evaluated oral hygiene status, possible oral mucosal inflammation and oral mucosal friction levels. Any problems with the implant-supported prosthesis, implant mobility or other complications were also assessed. In addition, patients were asked about any oral symptoms and their usual oral hygiene procedures. About half of the subjects (17/35) were registered as having no/mild inflammation with 18 of 35 having moderate/severe inflammation. Twelve of the 35 patients had good/acceptable oral hygiene and 23 of 35 had poor/bad oral hygiene. Twenty-one of the 35 patients depended on help from the nursing personnel for their daily oral hygiene procedures. Obvious problems with food impaction were noted in 11 patients. A total of 229 implants had been placed in 43 jaws supporting 40 full arch-fixed prostheses and three implant-borne overdentures. There was no evidence of mobility or fractures of either the implants or the prostheses. Fifteen implants showed some exposed screw threads. Pus was exuding from one implant site and general peri-implant gingival hyperplasia was noted in two patients. Twenty-four patients were completely satisfied with the function and appearance of their implant-supported prostheses. Two patients were totally dissatisfied. This study indicates that oral implant therapy can be considered as a treatment of choice in elderly patients, even if oral hygiene is sub-optimal.

Understanding dental CAD/CAM for restorations--the digital workflow from a mechanical engineering viewpoint.

PubMed

Tapie, L; Lebon, N; Mawussi, B; Fron Chabouis, H; Duret, F; Attal, J-P

2015-01-01

As digital technology infiltrates every area of daily life, including the field of medicine, so it is increasingly being introduced into dental practice. Apart from chairside practice, computer-aided design/computer-aided manufacturing (CAD/CAM) solutions are available for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental solutions can be considered a chain of digital devices and software for the almost automatic design and creation of dental restorations. However, dentists who want to use the technology often do not have the time or knowledge to understand it. A basic knowledge of the CAD/CAM digital workflow for dental restorations can help dentists to grasp the technology and purchase a CAM/CAM system that meets the needs of their office. This article provides a computer-science and mechanical-engineering approach to the CAD/CAM digital workflow to help dentists understand the technology.

ELECTROMYOGRAPHIC EVALUATION OF MASTICATION AND SWALLOWING IN ELDERLY INDIVIDUALS WITH MANDIBULAR FIXED IMPLANTSUPPORTED PROSTHESES

PubMed Central

Berretin-Felix, Giédre; Nary, Hugo; Padovani, Carlos Roberto; Trindade, Alceu Sergio; Machado, Wellington Monteiro

2008-01-01

This study evaluated the effect of implant-supported oral rehabilitation in the mandible on the electromyographic activity during mastication and swallowing in edentulous elderly individuals. Fifteen patients aged more than 60 years were evaluated, being 10 females and 5 males. All patients were edentulous, wore removable complete dentures on both dental arches, and had the mandibular dentures replaced by implant-supported prostheses. All patients were submitted to electromyographic evaluation of the masseter, superior orbicularis oris muscles, and the submental muscles, before surgery and 3, 6 and 18 months postoperatively, using foods of different textures. The results obtained at the different periods were analyzed statistically by Kruskal-Wallis non-parametric test. Statistical analysis showed that only the masseter muscle had a significant loss in electromyographic activity (p<0.001), with a tendency of similar response for the submental muscles. Moreover, there was an increase in the activity of the orbicularis oris muscle during rubber chewing after treatment, yet without statistically significant difference. Mandibular fixed implant-supported prostheses in elderly individuals revealed a decrease in electromyographic amplitude for the masseter muscles during swallowing, which may indicate adaptation to new conditions of stability provided by fixation of the complete denture in the mandibular arch. PMID:19089202

Kinematic and biomimetic assessment of a hydraulic ankle/foot in level ground and camber walking

PubMed Central

Bai, Xuefei; Ewins, David; Crocombe, Andrew D.

2017-01-01

Improved walking comfort has been linked with better bio-mimicking of the prosthetic ankle. This study investigated if a hydraulic ankle/foot can provide enough motion in both the sagittal and frontal planes during level and camber walking and if the hydraulic ankle/foot better mimics the biological ankle moment pattern compared with a fixed ankle/foot device. Five active male unilateral trans-femoral amputees performed level ground walking at normal and fast speeds and 2.5° camber walking in both directions using their own prostheses fitted with an “Echelon” hydraulic ankle/foot and an “Esprit” fixed ankle/foot. Ankle angles and the Trend Symmetry Index of the ankle moments were compared between prostheses and walking conditions. Significant differences between prostheses were found in the stance plantarflexion and dorsiflexion peaks with a greater range of motion being reached with the Echelon foot. The Echelon foot also showed significantly improved bio-mimicry of the ankle resistance moment in all walking conditions, either compared with the intact side of the same subject or with the “normal” mean curve from non-amputees. During camber walking, both types of ankle/foot devices showed similar changes in the frontal plane ankle angles. Results from a questionnaire showed the subjects were more satisfied with Echelon foot. PMID:28704428

Kinematic and biomimetic assessment of a hydraulic ankle/foot in level ground and camber walking.

PubMed

Bai, Xuefei; Ewins, David; Crocombe, Andrew D; Xu, Wei

2017-01-01

Improved walking comfort has been linked with better bio-mimicking of the prosthetic ankle. This study investigated if a hydraulic ankle/foot can provide enough motion in both the sagittal and frontal planes during level and camber walking and if the hydraulic ankle/foot better mimics the biological ankle moment pattern compared with a fixed ankle/foot device. Five active male unilateral trans-femoral amputees performed level ground walking at normal and fast speeds and 2.5° camber walking in both directions using their own prostheses fitted with an "Echelon" hydraulic ankle/foot and an "Esprit" fixed ankle/foot. Ankle angles and the Trend Symmetry Index of the ankle moments were compared between prostheses and walking conditions. Significant differences between prostheses were found in the stance plantarflexion and dorsiflexion peaks with a greater range of motion being reached with the Echelon foot. The Echelon foot also showed significantly improved bio-mimicry of the ankle resistance moment in all walking conditions, either compared with the intact side of the same subject or with the "normal" mean curve from non-amputees. During camber walking, both types of ankle/foot devices showed similar changes in the frontal plane ankle angles. Results from a questionnaire showed the subjects were more satisfied with Echelon foot.

Comparison of Metal-Ceramic and All-Ceramic Three-Unit Posterior Fixed Dental Prostheses: A 3-Year Randomized Clinical Trial.

PubMed

Nicolaisen, Maj H; Bahrami, Golnosh; Schropp, Lars; Isidor, Flemming

2016-01-01

The aim of this randomized clinical study was to compare the 3-year clinical outcome of metal-ceramic fixed dental prostheses (MC-FDPs) and zirconia all-ceramic fixed dental prostheses (AC-FDPs) replacing a posterior tooth. A sample of 34 patients with a missing posterior tooth were randomly chosen to receive either a MC-FDP (n = 17) or an AC-FDP (n = 17). The FDPs were evaluated at baseline and yearly until 3 years after cementation. They were assessed using the California Dental Association assessment system. Periodontal parameters were measured at the abutment teeth, and the contralateral teeth served as control. The statistical unit was the FDP/patient. The survival rates for MC-FDPs and AC-FDPs were 100%. The success rate was 76% and 71% for MC-FDPs and AC-FDPs, respectively. Three technical complications were observed in the MC-FDP group and five in the AC-FDP group, all chipping fractures of the ceramic veneer. Furthermore, one biologic complication in the MC-FDP group (an apical lesion) was observed. No framework fractures occurred. All patients had optimal oral hygiene and showed no bleeding on periodontal probing at any of the recalls. Only minor changes in the periodontal parameters were observed during the 3 years of observation. Three-unit posterior MC-FDPs and AC-FDPs showed similar high survival rates and acceptable success rates after 3 years of function, and ceramic veneer chipping fracture was the most frequent complication for both types of restorations.

Load-bearing capacity of all-ceramic posterior inlay-retained fixed dental prostheses.

PubMed

Puschmann, Djamila; Wolfart, Stefan; Ludwig, Klaus; Kern, Matthias

2009-06-01

The purpose of this in vitro study was to compare the quasi-static load-bearing capacity of all-ceramic resin-bonded three-unit inlay-retained fixed dental prostheses (IRFDPs) made from computer-aided design/computer-aided manufacturing (CAD/CAM)-manufactured yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) frameworks with two different connector dimensions, with and without fatigue loading. Twelve IRFDPs each were made with connector dimensions 3 x 3 mm(2) (width x height) (control group) and 3 x 2 mm(2) (test group). Inlay-retained fixed dental prostheses were adhesively cemented on identical metal-models using composite resin cement. Subgroups of six specimens each were fatigued with maximal 1,200,000 loading cycles in a chewing simulator with a weight load of 25 kg and a load frequency of 1.5 Hz. The load-bearing capacity was tested in a universal testing machine for IRFDPs without fatigue loading and for IRFDPs that had not already fractured during fatigue loading. During fatigue testing one IRFDP (17%) of the test group failed. Under both loading conditions, IRFDPs of the control group exhibited statistically significantly higher load-bearing capacities than the test group. Fatigue loading reduced the load-bearing capacity in both groups. Considering the maximum chewing forces in the molar region, it seems possible to use zirconia ceramic as a core material for IRFDPs with a minimum connector dimension of 9 mm(2). A further reduction of the connector dimensions to 6 mm(2) results in a significant reduction of the load-bearing capacity.

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... across-the-joint. This generic type of device is designed to achieve biological fixation to bone without the use of bone cement. This identification includes fixed-bearing knee prostheses where the ultra...

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... across-the-joint. This generic type of device is designed to achieve biological fixation to bone without the use of bone cement. This identification includes fixed-bearing knee prostheses where the ultra...

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... across-the-joint. This generic type of device is designed to achieve biological fixation to bone without the use of bone cement. This identification includes fixed-bearing knee prostheses where the ultra...

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... across-the-joint. This generic type of device is designed to achieve biological fixation to bone without the use of bone cement. This identification includes fixed-bearing knee prostheses where the ultra...

21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... across-the-joint. This generic type of device is designed to achieve biological fixation to bone without the use of bone cement. This identification includes fixed-bearing knee prostheses where the ultra...

A review of clinical and technical considerations for fixed and removable implant prostheses in the edentulous mandible.

PubMed

Zitzmann, Nicola Ursula; Marinello, Carlo Paolo

2002-01-01

The aim of the present article is to review some of the technical treatment options for implant prostheses restoring the edentulous mandible, mainly based on the Brånemark system. Clinical and technical aspects are discussed for the three established concepts: (1) implant-supported fixed prosthesis, (2) removable implant-supported overdenture, and (3) combined implant-retained and soft tissue-supported overdenture prosthesis. The framework of an implant-supported fixed screw-retained prosthesis can be processed in gold, Co-Cr alloy, or titanium with casting, laser-welding, or milling techniques. To improve the stability and retention of a conventional complete denture, one to four implants are indicated, and unsplinted (single attachments) or splinted designs (bar systems) can be applied. The design of the overdenture prosthesis must be carefully planned according to the requirements to ensure adequate stability and optimal form, contour, and esthetics, and the patient's best comfort. A large variety of different treatment modalities exist for both the fixed and removable mandibular implant prosthesis. Clinical and technical aspects should be considered at the beginning of the treatment to: (1) select the optimal implant position, (2) establish an adequate number of functional units, (3) select the appropriate retainers, and (4) apply the best technique for framework processing and veneering.

A retrospective study of sintered porous-surfaced dental implants in restoring the edentulous posterior mandible: up to 9 years of functioning.

PubMed

Sohn, Dong-Seok; Kim, Woo-Sung; Lee, Won-Hyuk; Jung, Heui-Seung; Shin, Im-Hee

2010-10-01

The aim of this retrospective study was to evaluate the survival rate of sintered porous-surfaced implants placed in the edentulous posterior mandibles, in relation to implant length and diameter, crown-to-implant ratio, and types of prostheses, for a maximum of 9 years of functioning (mean: 55.8 months; range: 5-108 months). The study group consisted of 43 partially edentulous patients who visited Catholic University Hospital of Daegu and 1 private dental clinic. A total of 122 sintered porous-surfaced implants--Endopore (Innova Life Sciences, Toronto, Ontario, Canada)--were placed in the edentulous posterior mandibles. Two diameter sizes (4.1 and 5.0 mm) and 4 lengths (5.0, 7.0, 9.0, and 12.0 mm) were used. All implants were restored with fixed prostheses. One hundred three implants were splinted and 21 implants were nonsplinted. Panoramic views and periapical radiographs were taken at the time of the first, postoperative, crown placement, and following checkup visits. The survival rates of the implants in relation to length, diameter, crown-to-implant ratio, and types of prostheses were investigated. Statistical data were analyzed using SPSS Win.Ver 14.0 software with the χ² test. The survival rate of the 4.1-mm-diameter implants was 100% and 91.2% for the 5.0-mm-diameter implants. The survival rates of the implants of differing diameters were found to be statistically different (P = 0.005). The survival rates of both the 5.0-mm and 7.0-mm-length implants were 100%. The survival rate of the 9.0-mm-length implants was 97.9% and for the 12.0-mm-length implants was 95.1%. There was no statistical difference in survival rates for the differing lengths of implants. Of the 103 prostheses that were splinted, the survival rate was 98.0%. The survival rate of splinted prostheses was higher than that of the nonsplinted prostheses but was found to be not statistically different. There were no failed cases when the crown-to-implant ratio was <1.0. When the crown-to-implant ratio was between 1.0 and 1.4, the failure rate of the implants was 6.7%. No failure was recorded with the ratio range of 1.5 to 2.0. Relative to the crown-to-implant ratio of 1.0, the failure rates were statistically different (P = 0.048). The cumulative survival rate of the porous-surfaced implants placed in the edentulous posterior mandibles was 97.5%. Short porous-surfaced implants showed satisfactory results after a maximum of 9 years of functioning in the edentulous posterior mandibles.

A finite element evaluation of mechanical function for 3 distal extension partial dental prosthesis designs with a 3-dimensional nonlinear method for modeling soft tissue.

PubMed

Nakamura, Yoshinori; Kanbara, Ryo; Ochiai, Kent T; Tanaka, Yoshinobu

2014-10-01

The mechanical evaluation of the function of partial removable dental prostheses with 3-dimensional finite element modeling requires the accurate assessment and incorporation of soft tissue behavior. The differential behaviors of the residual ridge mucosa and periodontal ligament tissues have been shown to exhibit nonlinear displacement. The mathematic incorporation of known values simulating nonlinear soft tissue behavior has not been investigated previously via 3-dimensional finite element modeling evaluation to demonstrate the effect of prosthesis design on the supporting tissues. The purpose of this comparative study was to evaluate the functional differences of 3 different partial removable dental prosthesis designs with 3-dimensional finite element analysis modeling and a simulated patient model incorporating known viscoelastic, nonlinear soft tissue properties. Three different designs of distal extension removable partial dental prostheses were analyzed. The stress distributions to the supporting abutments and soft tissue displacements of the designs tested were calculated and mechanically compared. Among the 3 dental designs evaluated, the RPI prosthesis demonstrated the lowest stress concentrations on the tissue supporting the tooth abutment and also provided wide mucosa-borne areas of support, thereby demonstrating a mechanical advantage and efficacy over the other designs evaluated. The data and results obtained from this study confirmed that the functional behavior of partial dental prostheses with supporting abutments and soft tissues are consistent with the conventional theories of design and clinical experience. The validity and usefulness of this testing method for future applications and testing protocols are shown. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Students' perceptions of materials and techniques used at European dental schools in the education of fixed prosthodontics.

PubMed

Brand, Henk S; Kamell, Hassib; Kharbanda, Aron K; Dozic, Alma

2013-09-01

The aim of this study was to explore the materials and procedures used by students in dental schools across Europe for teaching fixed prosthodontics. An online questionnaire, containing twenty-eight dichotomous, multiple-choice, and Likert scale rating questions, was sent to students in forty dental schools. After excluding dental schools in which less than 10 percent of the students responded, 775 questionnaires from ten schools remained for statistical analysis. Among these respondents, acrylic resin teeth were said to be the most commonly used material during preclinical practice (46-96 percent), and use of extracted teeth varied from 8 to 65 percent. At nine of the ten institutions, metal-ceramic was reported to be most commonly used for fixed dental prostheses. There was large variation in the type of finish line for a metal-ceramic fixed dental prosthesis: students at five institutions reported using a shoulder finish line, three a chamfer finish line, and two a shoulder-bevel finish line. A similar variation was observed with regard to the final cementation of metal-ceramic fixed dental prostheses: students at four institutions reporting most frequently using glass ionomer cement, with three using zinc phosphate cement and three using carboxylate cement. The responding European dental students varied considerably in their opinions about whether they were preclinically properly trained for the first preparation on a patient and in their overall rating of their education in fixed prosthodontics. Responding students in the United Kingdom, Sweden, and Nijmegen, The Netherlands, rated their fixed prosthodontics training overall the highest. Overall, this study found a wide variation amongst dental schools with regard to their education in fixed prosthodontics and their rating of this teaching.

Interventions for replacing missing teeth: partially absent dentition.

PubMed

Abt, Elliot; Carr, Alan B; Worthington, Helen V

2012-02-15

Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients. To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction. We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials. Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review. Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data. Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs. Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.

Clinical efficacy of veneered zirconium dioxide-based posterior partial fixed dental prostheses: five-year results.

PubMed

Raigrodski, Ariel J; Yu, Alika; Chiche, Gerard J; Hochstedler, J L; Mancl, Lloyd A; Mohamed, Shawky E

2012-10-01

In recent years, zirconium dioxide-based partial fixed dental prostheses (FDP) have been suggested as an alternative treatment to traditional metal ceramic FDPs. However, clinical studies evaluating their longevity and related complications are limited. The purpose of this cohort clinical study was to assess the efficacy of zirconium dioxide-based posterior 3-unit FDPs. Twenty 3-unit posterior FDPs (Lava) were placed in 16 participants missing a second premolar or a first molar. All participants met specific inclusion and exclusion criteria and provided informed consent. All teeth were prepared in a standardized manner: occlusal reduction of 1.5 to 2 mm; axial reduction of 1 to 1.5 mm; a 1.0 mm 360-degree rounded shoulder placed 0.5 mm subgingivally on the facial aspect and supragingivally on the lingual aspect on sound tooth structure; and rounded internal line angles. Definitive impressions were made with vinyl polysiloxane impression material. Frameworks were fabricated by using computer-aided design and computer-aided manufacturing (CAD/CAM) technology with a uniform retainer thickness of 0.6 mm and a minimal connector surface area of 9 mm(2). Restorations were luted with resin-modified glass ionomer cement (Rely-X Luting). Participants were recalled at 2 weeks, 6 months, and 12 months, and thereafter, annually for up to 60 months. Clinical fracture measurements, marginal discoloration, marginal adaptation, radiographic proximal recurrent caries, and periapical pathoses were assessed over time by using modified Ryge criteria. The probability distributions of these variables were calculated for the baseline data and for the recall data. An analysis of survival was made by using the Kaplan-Meier method. Eighteen FDPs were clinically evaluated at 5 years and 1 at 48 months. Fifteen were rated Alpha for fracture measurements, and 2 were rated Bravo (minor chipping of veneering porcelain and not requiring restoration replacement). Two were rated Charlie (major chipping of veneering porcelain and requiring restoration replacement). Eighteen FDPs were rated Alpha for marginal integrity, and 1 rated Bravo. All restorations were rated Alpha for marginal discoloration. One participant experienced root fracture after 60 months, while another was treated surgically for a periapical pathosis on an endodontically treated abutment. Zirconium dioxide-based posterior 3-unit FDPs performed well after 5 years of service. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Long-term clinical outcomes and survivorship of press-fit condylar sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients.

PubMed

Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Kulkarni, Sourabh S; Kim, Yoon-Hong

2014-10-01

We are aware of no study that has compared press-fit condylar Sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients after more than ten years of follow-up. The purpose of the current study was to compare these two implants with respect to the functional and radiographic results, prevalence of osteolysis, and overall revision rates at a mean of 12.1 years of follow-up. The study consisted of a consecutive series of 444 patients (mean age [and standard deviation], 66.5 ± 7.4 years) who underwent simultaneous bilateral total knee arthroplasty, with one side treated immediately after the other. All of the patients received a press-fit condylar Sigma mobile-bearing prosthesis on one side and a press-fit condylar Sigma fixed-bearing prosthesis on the contralateral side. The minimum duration of follow-up was ten years (mean, 12.1 years; range, ten to thirteen years). At the time of each follow-up visit, the patients were assessed clinically and radiographically. Postoperative total knee scores (95 and 94 points), Western Ontario and McMaster Universities Osteoarthritis Index (19 and 18 points), University of California, Los Angeles activity score (both prostheses, 5 points), range of motion (129° ± 6.3° and 127° ± 6.8°), and radiographic findings did not differ significantly between the press-fit condylar Sigma mobile and fixed-bearing designs at the final follow-up. The prevalence of aseptic loosening (1.4% and 1.8%) did not differ significantly between the mobile and fixed-bearing implant designs. No knee in either group had osteolysis. The estimated survival rate with revision as the end point was 98.2% (95% confidence interval, 91% to 99%) and 97.5% (95% confidence interval, 91% to 99%) at 12.1 years for the mobile and fixed-bearing implant groups, respectively. The results of the present long-term clinical study suggest that excellent clinical and radiographic results were achieved with both the press-fit condylar Sigma mobile and fixed-bearing cruciate-retaining total knee designs. We found no significant clinical advantage for a mobile-bearing over a fixed-bearing total knee prosthesis. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Biomechanical evaluation of the natural abutment teeth in combined tooth-implant-supported telescopic prostheses: a three-dimensional finite element analysis.

PubMed

Chen, Yu; Wang, Chao; Huang, Yuanding; Feng, Tianming; Zou, Huawei; Fan, Yubo

2017-07-01

Telescopic overdentures supported by the combination of natural teeth and implants have been thought a valuable treatment for the severely compromised partially edentulous patients. But the combination of teeth and implants involves highly complex biomechanical problems. This study is to evaluate biomechanical behaviors of the natural abutment teeth with the treatment of combined tooth-implant supported telescopic crown prostheses in mandible through 3D FEA. According to this study, the prosthetic option supported by a combination of teeth and implants and retained by double crowns could protect teeth and their periodontal support tissues acting as a rigid splint, and may be a valuable treatment option for partially edentulous patients with severely reduced remaining teeth in mandible.

Macro-retentive replaceable veneers on crowns and fixed dental prostheses: a new approach in implant-prosthodontics.

PubMed

Schweiger, Josef; Neumeier, Peter; Stimmelmayr, Michael; Beuer, Florian; Edelhoff, Daniel

2013-04-01

Implant-supported prosthetic restorations with veneered crowns and fixed dental prostheses are a proven, scientifically accepted treatment concept in fixed prosthodontics. However, in this area of indication there is a comparatively high technical complication rate, which occurs mainly in the area of the superstructure in the form of minor or major chipping of the veneering material. Various studies have shown that purely implant-supported restorations are subjected to higher loading than those on natural abutment teeth due to the special biomechanical conditions. A possible approach to prevent technical complications is to create higher stability for the implant superstructure through the use of high-strength materials. This would, however, result in undiminished overloading being transmitted to the implant components and could cause increased technical and biological complications. This article describes a new procedure for the use of replaceable veneers made from high-performance polymer material on modified implant abutments. By storing digital datasets for the veneer section, it can be replaced easily and quickly if it becomes worn or is fractured. A reduction in the stresses for the implant components and biological structures under the polymer is also to be expected due the material properties of polymers.

Veneered zirconia inlay-retained fixed dental prostheses: 10-Year results from a prospective clinical study.

PubMed

Rathmann, Friederike; Bömicke, Wolfgang; Rammelsberg, Peter; Ohlmann, Brigitte

2017-09-01

The purpose of this study was to evaluate the 10-year clinical performance of zirconia-based inlay-retained fixed dental prostheses (IRFDP). For replacement of a molar in 27 patients, 30 IRFDP were luted by use of different cements, Panavia F (Kuraray Europe GmbH) or Multilink Automix (Ivoclar Vivadent GmbH), with use of inlay/inlay, inlay/full-crown, or inlay/partial-crown retainers for anchorage. Frameworks were milled from yttria-stabilized zirconia (IPS e.maxZirCAD; Ivoclar Vivadent GmbH) and fully veneered with pressable ceramic (IPS e.max ZirPress; Ivoclar Vivadent GmbH). Before luting, the IRFDP were silica-coated (Rocatec; 3M Espe) and silanized (Monobond S; Ivoclar Vivadent GmbH). Complications (for example, chipping or delamination of the veneering ceramic, debonding, secondary caries, endodontic treatment, and abutment tooth fracture) and failure were reported, by use of standardized report forms, 2 weeks, 6 months, and 1, 2, and 10 years after cementation. Statistical analysis included Kaplan-Meier survival and success (complication-free survival) and Cox regression analysis (α=0.05 for all). During the 10-year observation period, the complications most often observed were chipping of the veneer and debonding. Twenty-five restorations failed and one participant dropped out. Cumulative 10-year survival and success were 12.1% and 0%, respectively. The design of the retainer, use of a dental dam, choice of cement, and location in the dental arch had no statistically significant effect on the occurrence of complications. Use of fully veneered zirconia-based IRFDP with this technique cannot be recommended. A large incidence of complications and poor survival were observed for fully veneered zirconia-based IRFDP, revealing an urgent need for further design improvements for this type of restoration. This, again, emphasizes the need for testing of new restoration designs in clinical trials before implementation in general dental practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Strain of implants depending on occlusion types in mandibular implant-supported fixed prostheses

PubMed Central

Sohn, Byoung-Sup; Heo, Seong-Joo; Koak, Jai-Young; Kim, Seong-Kyun

2011-01-01

PURPOSE This study investigated the strain of implants using a chewing simulator with strain gauges in mandibular implant-supported fixed prostheses under various dynamic loads. MATERIALS AND METHODS Three implant-supported 5-unit fixed prostheses were fabricated with three different occlusion types (Group I: Canine protected occlusion, Group II: Unilaterally balanced occlusion, Group III: Bilaterally balanced occlusion). Two strain gauges were attached to each implant abutment. The programmed dynamic loads (0 - 300 N) were applied using a chewing simulator (MTS 858 Mini Bionix II systems, MTS systems corp., Minn, USA) and the strains were monitored. The statistical analyses were performed using the paired t-test and the ANOVA. RESULTS The mean strain values (MSV) for the working sides were 151.83 µε, 176.23 µε, and 131.07 µε for Group I, Group II, and Group III, respectively. There was a significant difference between Group II and Group III (P < .05). Also, the MSV for non-working side were 58.29 µε, 72.64 µε, and 98.93 µε for Group I, Group II, and Group III, respectively. One was significantly different from the others with a 95% confidence interval (P < .05). CONCLUSION The MSV for the working side of Groups I and II were significantly different from that for the non-working side (Group I: t = 7.58, Group II: t = 6.25). The MSV for the working side of Group II showed significantly larger than that of Group III (P < .01). Lastly, the MSV for the non-working side of Group III showed significantly larger than those of Group I or Group II (P < .01). PMID:21503186

Does location of rotation center in artificial disc affect cervical biomechanics?

PubMed

Mo, Zhongjun; Zhao, Yanbin; Du, Chengfei; Sun, Yu; Zhang, Ming; Fan, Yubo

2015-04-15

A 3-dimensional finite element investigation. To compare the biomechanical performances of different rotation centers (RCs) in the prevalent artificial cervical discs. Various configurations are applied in artificial discs. Design parameters may influence the biomechanics of implanted spine. The RC is a primary variation in the popular artificial discs. Implantation of 5 prostheses was simulated at C5-C6 on the basis of a validated finite element cervical model (C3-C7). The prostheses included ball-in-socket design with a fixed RC located on the inferior endplate (BS-FI) and on the superior endplate (BS-FS), with a mobile RC at the inferior endplate (BS-MI), dual articulation with a mobile RC between the endplates (DA-M), and sliding articulation with various RCs (SA-V). The spinal motions in flexion and extension served as a displacement loading at the C3 vertebrae. Total disc replacements reduced extension moment. The ball-in-socket designs required less flexion moment, whereas the flexion stiffness of the spines with DA-M and SA-V was similar to that of the healthy model. The contributions of the implanted level to the global motions increased in the total disc replacements, except in the SA-V and DA-M models (in flexion). Ball-in-socket designs produced severe stress distributions in facet cartilage, whereas DA-M and SA-V produced more severe stress distribution on the bone-implant interface. Cervical stability was extremely affected in extension and partially affected in flexion by total disc replacement. With the prostheses with mobile RC, cervical curvature was readjusted under a low follower load. The SA-V and BS-FS designs exhibited better performances in the entire segmental stiffness and in the stability of the operative level than the BS-MI and BS-FI designs in flexion. The 5 designs demonstrated varying advantages relative to the stress distribution in the facet cartilages and on the bone-implant interface. 5.

[Clinical evaluation of "All-on-Four" provisional prostheses reinforced with carbon fibers].

PubMed

Li, Bei-bei; Lin, Ye; Cui, Hong-yan; Hao, Qiang; Xu, Jia-bin; Di, Ping

2016-02-18

To assess the clinical effects of carbon fiber reinforcement on the "All-on-Four" provisional prostheses. Provisional prostheses were divided into control group and carbon fiber reinforcing group according to whether carbon fiber reinforcement was used in the provisional prostheses base resin. In our study, a total of 60 patients (32 males and 28 females) with 71 provisional prostheses(28 maxilla and 43 mandible)were enrolled between April 2008 and December 2012 for control group; a total of 23 patients (13 males and 10 females) with 28 provisional prostheses (9 maxillas and 19 mandibles) were enrolled between January 2013 and March 2014 for carbon fiber reinforcing group. The information of provisional prostheses in the patients was recorded according to preoperative examination. We used the date of definitive prosthesis restoration as the cut-off point, observing whether fracture occurred on the provisional prostheses in the two groups. Additionally we observed whether fiber exposure occurred on the tissue surface of the provisional prostheses and caused mucosal irritation. The interface between the denture base resin and the fibers was examined using scanning electron microscopy (SEM). The age [(57.3 ± 10.1) years vs.(55.1 ± 11.4) years], gender (32 males and 28 females vs. 13 males and 10 females), maxilla and mandible distributions (28 maxillas and 43 mandibles vs. 9 maxillas and 19 mandibles), the number of extraction jaws (46 vs. 23), the average using time [(7.8 ± 1.3) months vs. (7.5 ± 1.1) months], and the opposing dentition distributions of provisional prostheses of the patients showed no significant differences between the control and reinforcing groups. There were 21(29.6%) fractures that occurred on the 71 provisional prostheses in the control group; there was no fracture that occurred on the 28 provisional prosthesesin the carbon fiber reinforcing group. The fracture rate of the carbon fiber reinforcing group was significantly lower than that of the control group (P=0.001). No carbon fiber exposure and mucosal irritation were observed from clinical examination.SEM revealed relatively continuous contact between the fiber and acrylic resin, and the resin particles adhered on the surface of the carbon fibers. The addition of carbon fibers between abutments placed on "All-on-Four" provisional fixed denture base resin may be clinically effective in preventing "All-on-Four" denture fracture and can provide several advantages for clinical use.

The effects of two torque values on the screw preload of implant-supported prostheses with passive fit or misfit.

PubMed

Al-Otaibi, Hanan Nejer; Akeel, Riyadh Fadul

2014-01-01

To determine the effect of increased torque of the abutment screw and retorquing after 10 minutes on implant-supported fixed prostheses. Two strain gauges (SGs) were attached to four implants stabilized on an acrylic resin mandible. Four implant-supported frameworks were constructed to represent passive fit (PF) and different amounts of misfit (MF1, MF2, and MF3). Vertical misfit was measured using a traveling microscope. Each framework was torqued to 35 Ncm (the manufacturer's recommendation) and 40 Ncm, and the preload was recorded immediately and again after retorquing 10 minutes later (torque stage). The smallest gap was observed under the PF framework. Three-way analysis of variance revealed significant effects of the framework, torque value, and torque stage on preload. The PF showed the highest mean preload under both torque values. An independent-sample t test between the torque values revealed a statistically significant difference only for MF1 and MF2. A dependent-sample t test of the torque stage revealed a statistically significant difference at a torque value of 35 Ncm under the PF and MF3 frameworks. Increasing the torque value beyond the manufacturer's recommended amount and retorquing of the screws at 10 minutes after the initial torque did not necessarily lead to a significant increase in preload in full-arch implant-supported fixed prostheses, particularly under non-passively fitting frameworks.

Outcomes Assessment of Treating Completely Edentulous Patients with a Fixed Implant-Supported Profile Prosthesis Utilizing a Graftless Approach. Part 1: Clinically Related Outcomes.

PubMed

Alzoubi, Fawaz; Bedrossian, Edmond; Wong, Allen; Farrell, Douglas; Park, Chan; Indresano, Thomas

To assess outcomes of treating completely edentulous patients with a fixed implant-supported profile prosthesis utilizing a graftless approach for the maxilla and for the mandible, with emphasis on clinically related outcomes, specifically implant and prosthesis survival. This was a retrospective study with the following inclusion criteria: completely edentulous patients rehabilitated with a fixed implant-supported profile denture utilizing a graftless approach. Patients fulfilling the inclusion criteria were asked to participate in the study during their follow-up visits, and hence a consecutive sampling strategy was used. Data regarding implant and prosthesis cumulative survival rates (CSRs) were gathered and calculated. Thirty-four patients were identified with a total of 220 implants placed. An overall CSR of 98.2% was recorded with an observation of up to 10 years. For tilted, axial, and zygomatic implants, CSRs of 96.9%, 98.0%, and 100%, respectively, were observed for up to 10 years. For provisional prostheses, CSRs of 92.3% at 1 year, and 84.6% at 2 years were observed. For final prostheses, a CSR of 93.8% was observed at 10 years. The results suggest that treating completely edentulous patients with a fixed profile prosthesis utilizing a graftless approach in the maxilla and the mandible can be a reliable treatment option.

A first experience with digital complete overdentures.

PubMed

Bajunaid, Salwa Omar

2016-07-01

The development of computer-aided design/computer-aided manufacturing systems for dentistry in the 1980s resulted in the successful fabrication of crowns, fixed dental prostheses, and superstructures for both natural teeth and dental implants. Today, this technology is available for constructing digitally designed and milled, completely removable dental prostheses. The procedure uses clinical and laboratory protocols that allow fabrication of completely removable prostheses within two clinical appointments. The aim of this clinical report is to present the author's first experience with digital complete overdentures, the practicality of this technology, and patient feedback. Compared with conventional overdentures, the fit of the digital prostheses was improved because the cameo and flanges of the prostheses were nicely shaped and rolled, and this enhanced their stability and retention. Occlusion was also excellent. However, aesthetics in terms of the alignment, shape, and size of the maxillary overdenture teeth were inacceptable. Despite some of the drawbacks identified in our study, the use of removable digital dentures does provide excellent adaptation of the denture base and requires fewer clinic visits. We anticipate that the unsatisfactory aesthetic outcomes presented in this report can be corrected with more experience. We also believe that acquiring an in-house scanning machine would be beneficial. We highly recommend including this technique in dental school curriculums at both the undergraduate and graduate levels in order to keep students and residents up to date on the latest technology available.

Retention System and Splinting on Morse Taper Implants in the Posterior Maxilla by 3D Finite Element Analysis.

PubMed

Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos; Santiago, Joel Ferreira; Almeida, Daniel Augusto de Faria; Batista, Victor Eduardo de Souza; Noritomi, Pedro Yoshito; Pellizzer, Duardo Piza

2018-01-01

The purpose of this study was to evaluate different retention systems (cement- or screw-retained) and crown designs (non-splinted or splinted) of fixed implant-supported restorations, in terms of stress distributions in implants/components and bone tissue, by 3-dimensional (3D) finite element analysis. Four 3D models were simulated with the InVesalius, Rhinoceros 3D, and SolidWorks programs. Models were made of type III bone from the posterior maxillary area. Models included three 4.0-mm-diameter Morse taper (MT) implants with different lengths, which supported metal-ceramic crowns. Models were processed by the Femap and NeiNastran programs, using an axial force of 400 N and oblique force of 200 N. Results were visualized as the von Mises stress and maximum principal stress (σmax). Under axial loading, there was no difference in the distribution of stress in implants/components between retention systems and splinted crowns; however, in oblique loading, cemented prostheses showed better stress distribution than screwed prostheses, whereas splinted crowns tended to reduce stress in the implant of the first molar. In the bone tissue cemented prostheses showed better stress distribution in bone tissue than screwed prostheses under axial and oblique loading. The splinted design only had an effect in the screwed prosthesis, with no influence in the cemented prosthesis. Cemented prostheses on MT implants showed more favorable stress distributions in implants/components and bone tissue. Splinting was favorable for stress distribution only for screwed prostheses under oblique loading.

Fracture Strength of Three-Unit Implant Supported Fixed Partial Dentures with Excessive Crown Height Fabricated from Different Materials.

PubMed

Nazari, Vahideh; Ghodsi, Safoura; Alikhasi, Marzieh; Sahebi, Majid; Shamshiri, Ahmad Reza

2016-11-01

Fracture strength is an important factor influencing the clinical long-term success of implant-supported prostheses especially in high stress situations like excessive crown height space (CHS). The purpose of this study was to compare the fracture strength of implant-supported fixed partial dentures (FPDs) with excessive crown height, fabricated from three different materials. Two implants with corresponding abutments were mounted in a metal model that simulated mandibular second premolar and second molar. Thirty 3-unit frameworks with supportive anatomical design were fabricated using zirconia, nickel-chromium alloy (Ni-Cr), and polyetheretherketone (PEEK) (n=10). After veneering, the CHS was equal to 15mm. Then; samples were axially loaded on the center of pontics until fracture in a universal testing machine at a crosshead speed of 0.5 mm/minute. The failure load data were analyzed by one-way ANOVA and Games-Howell tests at significance level of 0.05. The mean failure loads for zirconia, Ni-Cr and PEEK restorations were 2086±362N, 5591±1200N and 1430±262N, respectively. There were significant differences in the mean failure loads of the three groups (P<0.001). The fracture modes in zirconia, metal ceramic and PEEK restorations were cohesive, mixed and adhesive type, respectively. According to the findings of this study, all implant supported three-unit FPDs fabricated of zirconia, metal ceramic and PEEK materials are capable to withstand bite force (even para-functions) in the molar region with excessive CHS.

Robotic cadaver testing of a new total ankle prosthesis model (German Ankle System).

PubMed

Richter, Martinus; Zech, Stefan; Westphal, Ralf; Klimesch, Yvone; Gosling, Thomas

2007-12-01

An investigation was carried out into possible increased forces, torques, and altered motions during load-bearing ankle motion after implantation of two different total ankle prostheses. We hypothesized that the parameters investigated would not differ in relation to the two implants compared. We included two different ankle prostheses (Hintegra, Newdeal, Vienne, France; German Ankle System, R-Innovation, Coburg, Germany). The prostheses were implanted in seven paired cadaver specimens. The specimens were mounted on an industrial robot that enables complex motion under predefined conditions (RX 90, Stäubli, Bayreuth, Germany). The robot detected the load-bearing (30 kg) motion of the 100(th) cycle of the specimens without prostheses as the baseline for the later testing, and mimicked that exact motion during 100 cycles after the prostheses were implanted. The resulting forces, torques, and bone motions were recorded and the differences between the prostheses compared. The Hintegra and German Ankle System, significantly increased the forces and torques in relation to the specimen without a prosthesis with one exception (one-sample-t-test, each p < or = 0.01; exception, parameter lateral force measured with the German Ankle System, p = 0.34). The force, torque, and motion differences between the specimens before and after implantation of the prostheses were lower with the German Ankle System than with the Hintegra (unpaired t-test, each p < or = 0.05). The German Ankle System prosthesis had less of an effect on resulting forces and torques during partial weightbearing passive ankle motion than the Hintegra prosthesis. This might improve function and minimize loosening during the clinical use.

Computer-assisted design/computer-assisted manufacturing zirconia implant fixed complete prostheses: clinical results and technical complications up to 4 years of function.

PubMed

Papaspyridakos, Panos; Lal, Kunal

2013-06-01

To report the clinical results and technical complications with computer-assisted design/computer-assisted manufacturing (CAD/CAM) zirconia, implant fixed complete dental prostheses (IFCDPs) after 2-4 years in function. Fourteen consecutive edentulous patients (16 edentulous arches) were included in this study. Ten of the patients were women and four were men, with an average age of 58 years (range: 35-71). Ten mandibular and six maxillary arches were restored with porcelain fused to zirconia (PFZ) IFCDPs. Of the 16 arches, 14 received one-piece and 2 received segmented two-piece IFCDPs, respectively. The mean clinical follow-up period was 3 years (range: 2-4). At the last recall appointment, biological and technical parameters of dental implant treatment were evaluated. The implant and prosthesis survival rate following prosthesis insertion was 100% up to 4-year follow-up. The prostheses in 11 of the 16 restored arches were structurally sound, exhibited favorable soft tissue response, esthetics, and patient satisfaction. Five IFCDPs (31.25%) in four patients exhibited porcelain veneer chipping. Chipping was minor in three prostheses (three patients) and was addressed intraorally with polishing (one prosthesis) or composite resin (two prostheses). One patient with maxillary and mandibular zirconia IFCDP exhibited major porcelain chipping fractures which had to be repaired in the laboratory. Function, esthetics, and patient satisfaction were not affected in three of the four fracture incidents. Median crestal bone loss was 0.1 mm (0.01-0.2 mm). The presence of parafunctional activity, the IFCDP as opposing dentition, and the absence of occlusal night guard were associated with all the incidents of ceramic chipping. CAD/CAM zirconia IFCDPs are viable prosthetic treatment after 2-4 years in function, but not without complications. The porcelain chipping/fracture was the most frequent technical complication, with a 31.25% chipping rate at the prosthesis level. Despite the technical complications, increased patient satisfaction was noted. © 2012 John Wiley & Sons A/S.

Modification of the explant system for the removal of well fixed hip resurfacing sockets.

PubMed

Rawal, Jaikirty S; Soler, J Agustin; Rhee, Jae S; Dobson, Michael H; Konan, Sujith; Haddad, Fares S

2010-10-01

A major concern during revision hip arthroplasty is acetabular bone loss during the extraction of well-fixed acetabular components. Despite the good early survivorship of resurfacing prostheses, revision surgery may be necessary. We recommend the use of the Explant acetabular extraction system (Zimmer, Warsaw, Ind) with a trial liner to preserve acetabular bone stock. We present 2 cases of revised resurfacings using this technique, demonstrating minimal interference to the remaining acetabular bone. Copyright © 2010 Elsevier Inc. All rights reserved.

Three-Dimensional Printed Prosthesis for Repair of Superior Canal Dehiscence.

PubMed

Kozin, Elliott D; Remenschneider, Aaron K; Cheng, Song; Nakajima, Hideko Heidi; Lee, Daniel J

2015-10-01

Outcomes following repair of superior canal dehiscence (SCD) are variable, and surgery carries a risk of persistent or recurrent SCD symptoms, as well as a risk of hearing loss and vestibulopathy. Poor outcomes may occur from inadequate repair of the SCD or mechanical insult to the membranous labyrinth. Repair of SCD using a customized, fixed-length prosthesis may address current operative limitations and improve surgical outcomes. We aim to 3-dimensionally print customized prostheses to resurface or occlude bony SCD defects. Dehiscences were created along the arcuate eminence of superior semicircular canals in cadaveric temporal bones. Prostheses were designed and created using computed tomography and a 3-dimensional printer. The prostheses occupied the superior semicircular canal defect, reflected in postrepair computed tomography scans. This novel approach to SCD repair could have advantages over current techniques. Refinement of prosthesis design and materials will be important if this approach is translated into clinical use. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

Mobile-bearing knees reduce rotational asymmetric wear.

PubMed

Ho, Fang-Yuan; Ma, Hon-Ming; Liau, Jiann-Jong; Yeh, Chuan-Ren; Huang, Chun-Hsiung

2007-09-01

Polyethylene wear of bearing components is the most common long-term complication in total knee arthroplasty. One would anticipate differing kinematics would generate different wear patterns (including wear type, degree, and symmetry) on the articulating surface of mobile-bearing and fixed-bearing inserts. Because mobile-bearing designs facilitate movement of the insert relative to the tray when the knee rotates, we hypothesized mobile-bearing designs would reduce the incidence of rotational asymmetric wear. We examined 51 worn tibial inserts, including 15 from mobile-bearing rotating-platform posterior-cruciate-sacrificing dished prostheses and 36 from fixed-bearing posterior-cruciate-retaining flat prostheses, which were retrieved at revision surgery with an average implantation time of 115 months. We divided wear types into low-grade wear (burnishing, abrasion, and cold flow) and high-grade wear (scratching, pitting, metal embedding, and delamination) to assess wear degree of polyethylene. To assess symmetry of wear, the insert surface was divided into medial and lateral sides and each side was further divided into three equal zones along the anteroposterior direction. Low-grade wear was more common in mobile-bearing knees, whereas high-grade wear was more common in fixed-bearing knees. We identified no internal/external rotational asymmetric wear or anteroposterior asymmetric wear in mobile-bearing knees.

Computational biomechanics of bone's responses to dental prostheses - osseointegration, remodeling and resorption

NASA Astrophysics Data System (ADS)

Li, Wei; Rungsiyakull, Chaiy; Field, Clarice; Lin, Daniel; Zhang, Leo; Li, Qing; Swain, Michael

2010-06-01

Clinical and experimental studies showed that human bone has the ability to remodel itself to better adapt to its biomechanical environment by changing both its material properties and geometry. As a consequence of the rapid development and extensive applications of major dental restorations such as implantation and fixed partial denture (FPD), the effect of bone remodeling on the success of a dental restorative surgery is becoming critical for prosthetic design and pre-surgical assessment. This paper aims to provide a computational biomechanics framework to address dental bone's responses as a result of dental restoration. It explored three important issues of resorption, apposition and osseointegration in terms of remodeling simulation. The published remodeling data in long bones were regulated to drive the computational remodeling prediction for the dental bones by correlating the results to clinical data. It is anticipated that the study will provide a more predictive model of dental bone response and help develop a new design methodology for patient-specific dental prosthetic restoration.

Survival and failure modes: platform-switching for internal and external hexagon cemented fixed dental prostheses.

PubMed

Anchieta, Rodolfo B; Machado, Lucas S; Hirata, Ronaldo; Coelho, Paulo G; Bonfante, Estevam A

2016-10-01

This study evaluated the probability of survival (reliability) of platform-switched fixed dental prostheses (FDPs) cemented on different implant-abutment connection designs. Eighty-four-three-unit FDPs (molar pontic) were cemented on abutments connected to two implants of external or internal hexagon connection. Four groups (n = 21 each) were established: external hexagon connection and regular platform (ERC); external hexagon connection and switched platform (ESC); internal hexagon and regular platform (IRC); and internal hexagon and switched platform (ISC). Prostheses were subjected to step-stress accelerated life testing in water. Weibull curves and probability of survival for a mission of 100,000 cycles at 400 N (two-sided 90% CI) were calculated. The beta values of 0.22, 0.48, 0.50, and 1.25 for groups ERC, ESC, IRC, and ISC, respectively, indicated a limited role of fatigue in damage accumulation, except for group ISC. Survival decreased for both platform-switched groups (ESC: 74%, and ISC: 59%) compared with the regular matching platform counterparts (ERC: 95%, and IRC: 98%). Characteristic strength was higher only for ERC compared with ESC, but not different between internal connections. Failures chiefly involved the abutment screw. Platform switching decreased the probability of survival of FDPs on both external and internal connections. The absence in loss of characteristic strength observed in internal hexagon connections favor their use compared with platform-switched external hexagon connections. © 2016 Eur J Oral Sci.

Impact of Bruxism on Ceramic Defects in Implant-Borne Fixed Dental Prostheses: A Retrospective Study.

PubMed

Mikeli, Aikaterini; Walter, Michael H

2016-01-01

Ceramic veneer fracture is a frequent complication in implant-borne fixed restorations. The retrospective clinical study assesses the effect of bruxism on this complication. A sample of 507 implant-borne fixed units inserted between 1995 and 2011 in 144 patients were examined. Any detected veneer fractures were assigned to one of four groups according to extent and position. A hypothetical correlation between bruxism and ceramic veneer fractures was examined. Of 34 patients (23.6%) with at least one ceramic veneer fracture, 24 were bruxers (70%) and 10 were nonbruxers (30%) (P = .002). Bruxism may pose a risk for ceramic fractures.

Analysis of bone healing in flail chest injury: do we need to fix both fractures per rib?

PubMed

Marasco, Silvana; Liew, Susan; Edwards, Elton; Varma, Dinesh; Summerhayes, Robyn

2014-09-01

Surgical rib fixation (SRF) for severe rib fracture injuries is generating increasing interest in the medical literature. It is well documented that poorly healed fractured ribs can lead to chronic pain, disability, and deformity. An unanswered question in SRF for flail chest injury is whether it is sufficient to fix one fracture per rib, on successive ribs, thus converting a flail chest injury into simple fractured ribs, or whether both ends of the floating segment of the chest wall should be fixed. This study aimed to analyze SRF in flail chest injury, assessing 3-month outcomes for nonfixed fractured rib ends in the flail segment. This is a retrospective review (2005-2013) of 60 consecutive patients who underwent SRF for flail chest injury admitted to the Alfred Hospital, Melbourne, Australia. Imaging by three-dimensional computed tomography (3D CT) of the chest at admission was compared with follow-up 3D CT at 3 months after injury. The 3-month CT scans were assessed for degree of healing and presence of residual deformity at the fracture fixation site. Follow-up CT was performed in 52 of the 60 patients. At 3 months after surgery, 86.5% of the patients had at least partial healing with good alignment and adequate fracture stabilization. Hardware failure was noted in five patients (9.6%) and occurred with the absorbable prostheses only. Six patients who had preoperative overlapping or displacement showed no improvement in deformity despite fixing the lateral fractures. Callus formation and bony bridging between adjacent ribs was often noted in the rib fractures not fixed (28 of 52 patients, 54%) This retrospective review of 3D CT chest at 3 months after rib fixation indicates that a philosophy of fixing only one fracture per rib in a flail segment does not avoid deformity and displacement, particularly in posterior rib fractures. Therapeutic study, level V; epidemiologic study, level V.

Laser micro-etching of metal prostheses for personal identification

PubMed Central

Ganapathy, Dhanraj; Sivaswamy, Vinay; Sekhar, Prathap

2017-01-01

Denture marking techniques play a vital role in establishing personal identification in suitable clinical and forensic situations. The denture marking techniques are categorized broadly into additive and ablative methods. Additive methods involve embedding or impregnation of markers for establishing personal identity. Ablative methods involve partial removal of the denture surface thereby providing a marking for identification. Engraving and etching methods are the commonly used ablative methods. Ablative methods can be of contact and noncontact subtypes. Laser micro-etching is a precise noncontact ablative denture marking technique that could be used for prostheses-guided personal identification. PMID:28584473

Laser micro-etching of metal prostheses for personal identification.

PubMed

Ganapathy, Dhanraj; Sivaswamy, Vinay; Sekhar, Prathap

2017-01-01

Denture marking techniques play a vital role in establishing personal identification in suitable clinical and forensic situations. The denture marking techniques are categorized broadly into additive and ablative methods. Additive methods involve embedding or impregnation of markers for establishing personal identity. Ablative methods involve partial removal of the denture surface thereby providing a marking for identification. Engraving and etching methods are the commonly used ablative methods. Ablative methods can be of contact and noncontact subtypes. Laser micro-etching is a precise noncontact ablative denture marking technique that could be used for prostheses-guided personal identification.

Laser-welded titanium frameworks supported by implants in the partially edentulous mandible: a 10-year comparative follow-up study.

PubMed

Ortorp, Anders; Jemt, Torsten

2008-09-01

Comparative long-term knowledge of different framework materials in the partially edentulous implant patient is not available. To report and compare 10-year data on free-standing implant-supported partial prostheses with laser-welded titanium (test) and conventional gold alloy (control) frameworks. Altogether, 52 partially edentulous patients were consecutively provided with laser-welded prostheses (n = 60) in the partially edentulous lower jaw (test group). A control group of 52 randomly selected patients with gold alloy castings (n = 60) was used for comparison. Clinical and radiographic 10-year data were retrospectively collected and evaluated for both groups. The overall 10-year implant cumulative survival rate (CSR) was 93.0% (loaded implants, 96.4%), with a 10-year implant CSR of 91.5 and 94.7% for test and control implants, respectively (p > .05). Out of a total of 22 lost implants, 17 implants (77.3%) were shorter than 10 mm. The overall 10-year prosthesis CSR was 93.7%, with a corresponding 10-year CSR of 88.4 and 100% for test and control groups, respectively (p < .05). Average 10-year bone loss was 0.46 mm (SD 0.47) and 0.69 mm (SD 0.53) for the test and control groups (p < .001), respectively. Only 1% of the implants had >3 mm accumulated bone loss after 10 years. Altogether, 10 of the prostheses in both groups had implant component mechanical problems (8.3%). None of the frameworks or implants fractured, but more fractures of porcelain veneers were observed in the test group (p < .05). The protocol of implant treatment in the partially edentulous jaw functioned well during 10 years, although prosthodontic maintenance was required. However, laser-welded titanium frameworks presented more problems as compared with gold alloy frameworks. More loaded implants were lost (p < .05), and higher incidence of porcelain chipping was noted in the test group (p < .05). However, bone loss was on an average lower for the test group during the 10 years of follow-up (p < .001).

Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 10-year follow-up study.

PubMed

Ortorp, Anders; Jemt, Torsten

2006-01-01

Long-term follow-up studies for more than 5 years are not available on laser-welded titanium frameworks. To report and compare 10-year data on implant-supported prostheses in the edentulous mandible provided with laser-welded titanium frameworks and conventional gold alloy frameworks. Altogether, 155 patients were consecutively treated with prostheses at abutment level with two generations of fixed laser-welded titanium frameworks (test groups). A control group of 53 randomly selected patients with conventional gold alloy castings was used for comparison. Clinical and radiographic 10-year data were collected for the three groups. All patients followed-up for 10 years (n=112) still had fixed prostheses in the mandible (cumulative success rate [CSR] 100%). The overall 10-year cumulative success rate (CSR) was 92.8 and 100.0% for titanium and gold alloy frameworks, respectively. Ten-year implant cumulative survival rate (CSR) was 99.4 and 99.6% for the test and control groups, respectively. Average 10-year bone loss was 0.56 (SD 0.45) mm for the titanium group and 0.77 (SD 0.36) mm for the control group (p < 0.05). The most common complications for titanium frameworks were resin or veneer fractures, soft tissue inflammation, and fractures (12.9%) of the metal frame. Loose and fractured implant screw components were below 3%. Excellent overall long-term results with 100% CSR could be achieved with the present treatment modality. Fractures of the metal frames and remade prostheses were more common for the laser-welded titanium frameworks, and the first generation of titanium frameworks worked poorly when compared with gold alloy frameworks during 10 years (p < 0.05). However, on average more bone loss was observed for implants supporting gold alloy frameworks during 10 years. The reasons for this difference are not clear.

Comparison of Fixed Dental Prostheses with Zirconia and Metal Frameworks: Five-Year Results of a Randomized Controlled Clinical Trial.

PubMed

Sailer, Irena; Balmer, Marc; Hüsler, Jürg; Hämmerle, Christoph Hans Franz; Känel, Sarah; Thoma, Daniel Stefan

The aim of this study was to test whether posterior zirconia-ceramic (ZC) and metal-ceramic (MC) fixed dental prostheses (FDPs) exhibit similar survival and technical/biologic complication rates. A total of 58 patients in need of 76 posterior FDPs were randomly assigned to receive 40 ZC and 36 MC FDPs. The restorations were examined at baseline (cementation) and yearly for 5 years. Technical and biologic outcomes were compared. The independent treatment groups were compared with nonparametric Mann-Whitney test for metric variables and with Fisher exact test for categoric data. A total of 52 patients with 40 ZC and 29 MC FDPs were examined at 5 years. No FDP failed during the 5 years; 2 ZC FDPs failed at 65.4 and 73.3 months. Debonding occurred at 3 ZC FDPs. Technical outcomes (modified US Public Health Service criteria) and general periodontal parameters did not show significant differences between ZC and MC FDPs. ZC FDPs exhibited similar outcomes to MC FDPs based on 5-year survival estimates. The majority of technical and biologic outcome measures were not significantly different.

Digitally Milled Metal Framework for Fixed Complete Denture with Metal Occlusal Surfaces: A Design Concept.

PubMed

AlBader, Bader; AlHelal, Abdulaziz; Proussaefs, Periklis; Garbacea, Antonela; Kattadiyil, Mathew T; Lozada, Jaime

Implant-supported fixed complete dentures, often referred to as hybrid prostheses, have been associated with high implant survival rates but also with a high incidence of mechanical prosthetic complications. The most frequent of these complications have been fracture and wear of the veneering material. The proposed design concept incorporates the occlusal surfaces of the posterior teeth as part of a digital milled metal framework by designing the posterior first molars in full contour as part of the framework. The framework can be designed, scanned, and milled from a titanium blank using a milling machine. Acrylic resin teeth can then be placed on the framework by conventional protocol. The metal occlusal surfaces of the titanium-countered molars will be at centric occlusion. It is hypothesized that metal occlusal surfaces in the posterior region may reduce occlusal wear in these types of prostheses. When the proposed design protocol is followed, the connection between the metal frame and the cantilever part of the prosthesis is reinforced, which may lead to fewer fractures of the metal framework.

Marginal Vertical Discrepancies of Monolithic and Veneered Zirconia and Metal-Ceramic Three-Unit Posterior Fixed Dental Prostheses.

PubMed

Lopez-Suarez, Carlos; Gonzalo, Esther; Pelaez, Jesus; Serrano, Benjamin; Suarez, Maria J

2016-01-01

The aim of this study was to investigate and compare the marginal fit of posterior fixed dental prostheses (FDPs) made of monolithic and veneered computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia ceramic with metal-ceramic posterior FDPs. Thirty standardized steel dies were prepared to receive posterior three-unit FDPs. Specimens were randomly divided into three groups (n = 10): (1) metal-ceramic (control group), (2) veneered zirconia, and (3) monolithic zirconia. All FDPs were cemented using a glass-ionomer cement. The specimens were subjected to thermal cycling (5°C to 55°C). A scanning electron microscope (SEM) with a magnification of ×500 was used for measurements. The data were statistically analyzed using one-way analysis of variance and paired t test. Both zirconia groups showed similar vertical marginal discrepancies, and no significant differences (P = .661) in marginal adaptation were observed among the groups. No differences were observed in either group in marginal discrepancies between surfaces or abutments. Monolithic zirconia posterior FDPs exhibit similar vertical marginal discrepancies to veneered zirconia posterior FDPs. No influence of localization measurements was observed.

A comparative finite elemental analysis of glass abutment supported and unsupported cantilever fixed partial denture.

PubMed

Ramakrishaniah, Ravikumar; Al Kheraif, Abdulaziz A; Elsharawy, Mohamed A; Alsaleh, Ayman K; Ismail Mohamed, Karem M; Rehman, Ihtesham Ur

2015-05-01

The purpose of this study was to investigate and compare the load distribution and displacement of cantilever prostheses with and without glass abutment by three dimensional finite element analysis. Micro-computed tomography was used to study the relationship between the glass abutment and the ridge. The external surface of the maxilla was scanned, and a simplified finite element model was constructed. The ZX-27 glass abutment and the maxillary first and second premolars were created and modified. The solid model of the three-unit cantilever fixed partial denture was scanned, and the fitting surface was modified with reference to the created abutments using the 3D CAD system. The finite element analysis was completed in ANSYS. The fit and total gap volume between the glass abutment and dental model were determined by Skyscan 1173 high-energy spiral micro-CT scan. The results of the finite element analysis in this study showed that the cantilever prosthesis supported by the glass abutment demonstrated significantly less stress on the terminal abutment and overall deformation of the prosthesis under vertical and oblique load. Micro-computed tomography determined a gap volume of 6.74162 mm(3). By contacting the mucosa, glass abutments transfer some amount of masticatory load to the residual alveolar ridge, thereby preventing damage to the periodontal microstructures of the terminal abutment. The passive contact of the glass abutment with the mucosa not only preserves the health of the mucosa covering the ridge but also permits easy cleaning. It is possible to increase the success rate of cantilever FPDs by supporting the cantilevered pontic with glass abutments. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Performance of zirconia ceramic cantilever fixed dental prostheses: 3-year results from a prospective, randomized, controlled pilot study.

PubMed

Zenthöfer, Andreas; Ohlmann, Brigitte; Rammelsberg, Peter; Bömicke, Wolfgang

2015-07-01

Little is known about the clinical performance of ceramic cantilever fixed dental prostheses on natural teeth. The purpose of this randomized controlled pilot study was to evaluate the clinical performance of ceramic and metal ceramic cantilever fixed dental prostheses (CFDPs) after 3 years of service. Twenty-one participants were randomly allocated to 2 treatment groups. Participants in the ceramic (ZC) group (n=11) each received 1 CFDP made of yttria-stabilized, tetragonal zirconia polycrystal; the others (n=10) were fitted with a metal ceramic (MC) CFDP. All CFDPs were retained by 2 complete crown abutments and replaced 1 tooth. The clinical target variables were survival, incidence of complications, probing pocket depth (PPD), probing attachment level (PAL), plaque index (PI), gingival index (GI), and esthetic performance as rated by the participants. The United States Public Health Service (USPHS) criteria were used to evaluate chipping, retention, color, marginal integrity, and secondary caries. Descriptive statistics and nonparametric analyses were applied to the target variables in the 2 groups. The esthetic performance of the CFDPs was also visualized by using a pyramid comparison. The overall survival of the CFDPs was 100% in both groups. During the 3-year study, 6 clinically relevant complications requiring aftercare were observed among 5 participants (4 in the ZC group and 2 in the MC group). Changes in the PI, GI, PPD, and PAL of the abutment teeth were similar for both groups (P>.05). The participants regarded the esthetic performance of ZC-CFDPs and MC-CFDPs as satisfactory. Within the 3-year observation period, the clinical performance of MC-FDPs and ZC-FDPs was acceptable. More extensive research with larger sample sizes is encouraged, however, to confirm the evaluation of the survival of Y-TZP hand-veneered cantilever FPDs. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A systematic review of the survival and complication rates of inlay-retained fixed dental prostheses.

PubMed

Chen, Junyu; Cai, He; Suo, Lai; Xue, Yiyuan; Wang, Jian; Wan, Qianbing

2017-04-01

The aim of this systematic review was to investigate the survival and complication rates of inlay-retainer fixed dental prostheses (IRFDPs). A systematic search was conducted in the PubMed, EMBASE, and Cochrane Library databases in English and time filters (articles published from 1960) were used. Randomized controlled trails (RCTs), controlled clinical trials (CCTs) and prospective cohort studies on IRFDPs with a mean follow-up period of at least 2 years were included. Among 501 screened articles, one RCT and ten prospective cohort studies were included in this study. Of the included studies, information on failure and complications was independently extracted by two reviewers in duplicate. The failure and complication rates of IRFDPs were pooled with a random effect model and Poisson regression was applied to further investigate the influence of framework materials. The estimated 3- and 5-year survival rates of IRFDPs were 92.6% (95% CI: 85.8-97.6%) and 87.9% (95% CI: 77.4-96.1%), respectively. Debonding, fracture, dentine hypersensitivity and secondary caries were primary complications. The estimated 5-year rates of debonding, veneer fracture and secondary caries were 5.3%, 15.2% and 2.7%, respectively. Additionally, fiber-reinforced composite IRFDPs exhibited a lower incidence of debonding and caries with a higher rate of veneer fracture compared with metal-based and all-ceramic IRFDPs (p<0.05). Compared with conventional fixed dental prostheses (FDPs) and implant-supported single crowns (ISCs), IRFDPs exhibited an acceptable 3-year survival rate but higher complication rates of debonding and veneer fracture. IRFDPs can be recommended as viable short- or middle-term minimally invasive alternatives to short-span conventional FDPs and ISCs, while the clinical outcome of IRFDPs as long-term definitive restorations still calls for further research. The indications of IRFDPs should be strictly controlled and monitored. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prosthetic rehabilitation with an implant-supported fixed prosthesis using computer-aided design and computer-aided manufacturing dental technology for a patient with a mandibulectomy: A clinical report.

PubMed

Yoon, Hyung-In; Han, Jung-Suk

2016-02-01

The fabrication of dental prostheses with computer-aided design and computer-aided manufacturing shows acceptable marginal fits and favorable treatment outcomes. This clinical report describes the management of a patient who had undergone a mandibulectomy and received an implant-supported fixed prosthesis by using additive manufacturing for the framework and subtractive manufacturing for the monolithic zirconia restorations. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Proposing national identification number on dental prostheses as universal personal identification code - A revolution in forensic odontology

PubMed Central

Baad, Rajendra K.; Belgaumi, Uzma; Vibhute, Nupura; Kadashetti, Vidya; Chandrappa, Pramod Redder; Gugwad, Sushma

2015-01-01

The proper identification of a decedent is not only important for humanitarian and emotional reasons, but also for legal and administrative purposes. During the reconstructive identification process, all necessary information is gathered from the unknown body of the victim and hence that an objective reconstructed profile can be established. Denture marking systems are being used in various situations, and a number of direct and indirect methods are reported. We propose that national identification numbers be incorporated in all removable and fixed prostheses, so as to adopt a single and definitive universal personal identification code with the aim of achieving a uniform, standardized, easy, and fast identification method worldwide for forensic identification. PMID:26005294

Accelerated treatment protocols: full arch treatment with interim and definitive prostheses.

PubMed

Drago, Carl

2012-01-01

With the advent of titanium, root form implants and osseointegration, dental treatment has undergone a metamorphosis in recent years. These new techniques enable dentists to provide anchorage for various kinds of prostheses that improve masticatory function, esthetics, and comfort for patients. Implant treatment protocols have been improved relative to implant macro- and micro-geometries, surgical and prosthetic components, and treatment times. Over the past 20 years, immediate occlusal function (also known as loading) has been established as a predictable treatment modality, provided certain specific criteria are met. In many cases, edentulous patients, crippled by the loss of their teeth, can undergo outpatient surgical and prosthetic procedures and return to a masticatory function that is near normal--sometimes after only one day of surgical and prosthetic treatment. This treatment option is also available for patients with advanced, generalized periodontal disease. Computer-assisted design/Computer-assisted manufacturing (CAD/CAM) has transformed how dental prostheses are made, offering improved accuracy, longevity, and biocompatibility; along with reduced labor costs and fewer complications than casting technologies. This article reviews the principles associated with immediate occlusal loading and illustrates one specific accelerated prosthodontic treatment protocol used to treat edentulous and partially edentulous patients with interim and definitive prostheses.

Five-year prospective clinical study of posterior three-unit zirconia-based fixed dental prostheses.

PubMed

Sorrentino, Roberto; De Simone, Giorgio; Tetè, Stefano; Russo, Simona; Zarone, Fernando

2012-06-01

This prospective clinical trial aimed at evaluating the clinical performance of three-unit posterior zirconia fixed dental prostheses (FDPs) after 5 years of clinical function. Thirty-seven patients received 48 three-unit zirconia-based FDPs. The restorations replaced either a premolar or a molar. Specific inclusion criteria were needed. Tooth preparation was standardized. Computer-aided design/computer-assisted manufacturing frameworks with a 9-mm(2) cross section of the connector and a 0.6-mm minimum thickness of the retainer were made. The restorations were luted with resin cement. The patients were recalled after 1, 6, 12, 24, 36, 48, and 60 months. The survival and success of the ceramics and zirconia were evaluated. The technical and aesthetic outcomes were examined using the United States Public Health Service criteria. The biologic outcomes were analyzed at abutment and contralateral teeth. Descriptive statistics were performed. All FDPs completed the study, resulting in 100% cumulative survival rate and 91.9% and 95.4% cumulative success rates for patients wearing one and two FDPs, respectively. No losses of retention were recorded. Forty-two restorations were rated alpha in all measured parameters. A minor chipping of the ceramics was detected in three restorations. No significant differences between the periodontal parameters of the test and control teeth were observed. Five-year clinical results proved that three-unit posterior zirconia-based FDPs were successful in the medium term for both function and aesthetic. Zirconia can be considered a promising substitute of metal frameworks for the fabrication of short-span posterior prostheses.

Cobalt-chromium alloys in fixed prosthodontics in Sweden

PubMed Central

Kassapidou, Maria; Franke Stenport, Victoria; Hjalmarsson, Lars; Johansson, Carina B.

2017-01-01

Abstract Aim: The aim of this study was to compile the usage of Co-Cr alloys in fixed prosthodontics (FP) among dental laboratories in Sweden. Methods: From March to October 2015, questionnaires were sent to 542 registered dental laboratories in Sweden. The questionnaires were divided in two parts, one for fixed dental-supported prosthodontics (FDP) and one for fixed implant-supported prosthodontics (FIP). Reminders were sent three times. Results: In total of 542 dental laboratories, 55% answered the questionnaires. Most dental laboratories use Co-Cr in FP, 134 (74%) in FDP and 89(66%) in FIP. The laboratories used Co-Cr alloys of various compositions in the prostheses, 35 for FDP and 30 for FIP. The most commonly used Co-Cr alloys for tooth-supported FDPs were (a) Wirobond® 280, (b) Cara SLM and (c) Wirobond® C. For implant-supported frameworks the frequently used alloys were: (a) Cara SLM, (b) Cara Milled and (c) Wirobond® 280. Except for the difference in composition of these alloys, they were also manufactured with various techniques. In tooth-supported prostheses the dominating technique was the cast technique while newer techniques as laser-sintering and milling were more commonly reported for implant-supported constructions. A fourth technique; the ‘pre-state’ milling was reported in FDP. Conclusion: More than 30 different Co-Cr alloys were reported as being used in FP. Thus, there is a need for studies exploring the mechanical and physical behavior and the biological response to the most commonly used Co-Cr alloys. PMID:29242813

Standardizing Failure, Success, and Survival Decisions in Clinical Studies of Ceramic and Metal-Ceramic Fixed Dental Prostheses

PubMed Central

Anusavice, Kenneth J.

2011-01-01

“Nothing worthwhile is ever without complications.”– Nora Roberts The recent increase in reports from clinical studies of ceramic chipping has raised the question of which criteria should constitute success or failure of total-ceramic prostheses. Terminology such as minor chipping[1], partial chipping, technical complications[2, 3], and biological complications have crept into the dental terminology and they have complicated our classification of success and failure of these crown and bridge restorations. Some journals have permitted the reporting of fractures as “complications” and they are not necessarily classified as failures in the study. One study has attempted to classify chipping fractures according to their severity and subsequent treatment.[4] This is a promising approach to resolve the challenges to the classification of chipping fracture. The term ‘chipping fracture’ is more descriptive than ‘chipping’ since the latter term tends to imply an event of minor consequence. Two types of statistics are reported routinely in these studies, i.e., percent success, which is a measure of restorations that survive without any adverse effects, and percent survival, which is a measure of all restorations that survive even though they may have exhibited chipping fracture or they may have been repaired. Why has this scenario occurred? One possible explanation is that many of these types of fractures are very small and do not affect function or esthetics. Another reason is that corporate sponsors prefer to use the term chipping since it does not connote failure in the sense that the term fracture does. In any event, we need to be more precise in our scientific observations of fracture and classifications of the various types of fracture including details on the location of fracture and the prosthesis design configuration. Because of the lack of standardized methods for describing chipping fractures, materials scientists are unable to properly analyze the effect of material properties and design factors on the time-dependent survival probability of ceramic fixed dental prostheses (FDPs). Based on the review of clinical trials and systematic reviews of these trials, the present study was designed to develop guidelines for classifying the functional performance, success, survival, and susceptibility to chipping fracture, and subsequent treatment of ceramic and metal-ceramic restorations. Objective To develop comprehensive descriptive guidelines and a clinical reporting form to assist dental scientists in their analyses of chipping fracture behavior of metal-ceramic and all-ceramic prostheses with particular emphasis on veneered-zirconia restorations. These guidelines are required to optimize the recording of fracture features that can be used to differentiate ceramic chipping fracture from bulk fracture and to assist dentists in identifying subsequent treatment that may minimize the need to replace affected restorations. A recording form for clinical fracture observations must be sufficiently clear and complete so that dental health professionals can translate the most relevant information in a context that allows their patients to fully understand the potential risks and benefits of treatment with ceramic restorations. It should clearly allow a clinician to determine whether or not a ceramic fracture constitutes a failure, which requires replacement of the prosthesis, or whether the fracture surface is relatively small or located in a nonfunctional area, i.e., one that is not contribute to occlusion, aesthetics, proximal contacts, or .food impaction. To accomplish this task, a review of the relevant publications of clinical trials was necessary to identify the variability in reporting of fracture events. The reviews were focused on clinical research studies of zirconia-based FDPs and PFM FDPs, which had been monitored through recall exams for three years or more. These reports and systematic reviews of all relevant publications were published in English dental journals between 2004 and 2010. The primary focus in this review was on the susceptibility to chipping fracture or bulk fracture of veneered zirconia-based fixed dental prostheses (FDPs) and metal-ceramic FDPs, which are also referred to in this paper as porcelain-fused-to-metal (PFM) FDPs. PMID:22192254

Orofacial rehabilitation with zygomatic implants: CAD-CAM bar and magnets for patients with nasal cancer after rhinectomy and partial maxillectomy.

PubMed

King, Elizabeth; Abbott, Carl; Dovgalski, Lawrence; Owens, James

2017-06-01

Nasal carcinoma extending into the premaxilla requires radical surgical excision including rhinectomy and partial maxillectomy. Rehabilitation is complex and involves the use of removable prostheses. Three patients treated with zygomatic implants and custom-milled bars to retain an obturator and nasal prosthesis are presented. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Retention Strength of Conical Welding Caps for Fixed Implant-Supported Prostheses.

PubMed

Nardi, Diego; Degidi, Marco; Sighinolfi, Gianluca; Tebbel, Florian; Marchetti, Claudio

This study evaluated the retention strength of welding caps for Ankylos standard abutments using a pull-out test. Each sample consisted of an implant abutment and its welding cap. The tests were performed with a Zwick Roell testing machine with a 1-kN load cell. The retention strength of the welding caps increased with higher abutment diameters and higher head heights and was comparable or superior to the values reported in the literature for the temporary cements used in implant dentistry. Welding caps provide a reliable connection between an abutment and a fixed prosthesis without the use of cement.

Laser vibrometer measurements and middle ear prostheses

NASA Astrophysics Data System (ADS)

Flock, Stephen T.; Dornhoffer, John; Ferguson, Scott

1997-05-01

One of us has developed an improved partial ossicular replacement prosthesis that is easier to implant and, based on pilot clinical measurements, results in better high-frequency hearing as compared to patients receiving one of the alternative prostheses. It is hypothesized that the primary reason for this is because of the relatively light weight (about 25 mg) and low compliance of the prosthesis, which could conceivably result in better high frequency vibrational characteristics. The purpose of our initial work was to develop an instrument suitable for objectively testing the vibrational characteristics of prostheses. We have developed a laser based device suitable for measuring the vibrational characteristics of the oval window or other structures of the middle ear. We have tested this device using a piezoelectric transducer excited at audio frequencies, as well as on the oval window in human temporal bones harvested from cadavers. The results illustrate that it is possible to non-invasively monitor the vibrational characteristics of anatomic structures with a very inexpensive photonic device.

A comparison of the marginal vertical discrepancies of zirconium and metal ceramic posterior fixed dental prostheses before and after cementation.

PubMed

Gonzalo, Esther; Suárez, Maria J; Serrano, Benjamin; Lozano, Jose F L

2009-12-01

Marginal discrepancies of zirconia posterior fixed dental prostheses (FDPs) fabricated using various systems have been assessed to determine the quality of the restorations and facilitate clinical use; however, studies are limited and results are ambiguous because of the sample sizes and measurement methods. The purpose of this in vitro study was to compare changes in marginal fit of posterior fixed dental prostheses of 3 zirconia systems manufactured using CAD/CAM technology and metal ceramic posterior fixed dental protheses fabricated with the conventional lost-wax technique, before and after cementation. Forty standardized master steel dies with 2 abutments simulating first mandibular premolars were fabricated to receive a posterior 3-unit FDP (from first molar to first premolar) and divided into 4 groups (n=10): Lava All-Ceramic System, Procera Bridge Zirconia, VITA In-Ceram 2000 YZ, and metal ceramic (control group). All FDPs were prepared for an internal space of 50 microm. The external marginal gap of the restorations was investigated by measuring 30 points in the middle of the buccal and lingual surfaces; therefore, 60 measurements per abutment were recorded. Measurements were made with an image analysis program on the master steel model before and after conventional cementation with a glass ionomer agent (Ketac Cem Easymix). The data obtained were statistically analyzed using 1-way ANOVA, Duncan's multiple range post hoc test, and Student's paired t test (alpha=.05). No significant differences in the vertical marginal fit before and after cementation were recorded for the analyzed groups. The marginal discrepancy of Procera abutments before and after cementation (9 +/-10 microm and 12 +/-9 microm, respectively) was less than that of the other groups. Significant differences (P=.001) were observed in marginal adaptation between Procera Bridge Zirconia and the other groups. The results of this study showed that cementation did not cause a significant increase in the vertical marginal discrepancies of the FDPs and that an internal space of 50 mum provided a high precision of fit of the restorations. The accuracy of fit achieved for the 3 zirconium oxide groups analyzed was within the range of clinical acceptance, and the discrepancies were lower than in the metal ceramic group. Procera Bridge Zirconia showed the lowest vertical discrepancies.

Cost satisfaction analysis: a novel patient-based approach for economic analysis of the utility of fixed prosthodontics.

PubMed

Walton, T R; Layton, D M

2012-09-01

The aim of this study was to apply a novel economic tool (cost satisfaction analysis) to assess the utility of fixed prosthodontics, to review its applicability, and to explore the perceived value of treatment. The cost satisfaction analysis employed the validated Patient Satisfaction Questionnaire (PSQ). Patients with a known prostheses outcome over 1-20 years were mailed the PSQ. Five hundred patients (50·7%) responded. Remembered satisfaction at insertion (initial costs) and current satisfaction (costs in hindsight) were reported on VAS, and the difference calculated (costs with time). Percentage and grouped responses (low, <40%; medium, 40-70%; high, > 70%) were analysed in relation to patient gender, age and willingness to have undergone the same treatment again, and in relation to prostheses age, type, complexity and outcome. Significance was set at P = 0·05. Averages were reported as means ± standard error. Satisfaction with initial costs and costs in hindsight were unrelated to patient gender and age, and prostheses age, type and complexity. Patients with a failure and those who would elect to not undergo the same treatment again were significantly less satisfied with initial costs (P = 0·021, P < 0·001) and costs in hindsight (P = 0·021, P < 0·001) than their counterparts. Patient's cost satisfaction (entire cohort) had significantly improved from 53 ± 1% at insertion to 81 ± 0·9% in hindsight (28 ± 1% improvement, P < 0·001). Patient cost satisfaction had also significantly improved, and the magnitude of improvement was the same within every individual cohort (P = 0·004 to P < 0·001), including patients with failures, and those who in hindsight would not undergo the same treatment again. Low satisfaction was reported by 166 patients initially, but 94% of these reported improvements in hindsight. Fourteen patients (3%) remained dissatisfied in hindsight, although 71% of these would still choose to undergo the same treatment again. Cost satisfaction analysis provided an evaluation of the patient's perspective of the value of fixed prosthodontic treatment. Although fixed prosthodontic treatment was perceived by patients to be expensive, it was also perceived to impart value with time. Cost satisfaction analysis provides a clinically useful insight into patient behaviour. © 2012 Blackwell Publishing Ltd.

Location of prosthodontic treatment and oral health-related quality of life--an exploratory study.

PubMed

Sukumar, Smitha; John, Mike T; Schierz, Oliver; Aarabi, Ghazal; Reissmann, Daniel R

2015-01-01

Prosthodontic treatment has a positive effect on oral health-related quality of life (OHRQoL); however, there is a paucity of studies assessing the impact of OHRQoL based on where in the mouth ("location") the treatment is performed. This exploratory study investigated the association of the location (anterior, posterior region) of prosthodontic treatment with magnitude and nature of OHRQoL changes. In this non-randomized prospective clinical study, 190 adult patients (17-83 years) were recruited at baseline and 104 were available for the follow-up analyses. Of those, 50 patients received treatment only in the posterior segment and 54 patients in both anterior and posterior regions. Treatment included conventional fixed partial prostheses, removable prostheses or a combination of both. OHRQoL was assessed with the German language version of the 49-item Oral Health Impact Profile (OHIP) at baseline and the questionnaire was repeated 4-6 weeks post-treatment. Magnitude and effect size of changes in summary and sub-scale scores were calculated and data analyzed. Patients experienced a substantially impaired OHRQoL (mean OHIP score: 32.3 points) at baseline and an improvement in OHRQoL of 6.8 OHIP points following treatment. This study showed a greater improvement in OHRQoL in patients treated in both regions compared to those treated in the posterior region alone, especially in the function and aesthetic domains. This explorative study suggests that OHRQoL improvement is affected by where prosthodontic treatment is performed in the mouth. Greater understanding of qualitative aspects of reconstructive therapies is needed for improved treatment planning and patient consent. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Food selection and perceptions of chewing ability following provision of implant and conventional prostheses in complete denture wearers.

PubMed

Allen, Finbarr; McMillan, Anne

2002-06-01

The loss of natural teeth compromises chewing efficiency, and edentulous patients often have a diet that is deficient in fibre and vitamins. Prostheses that are retained on implants offer the possibility of overcoming some of the limitations of conventional dentures in terms of chewing efficiency. The aim of this study was to test the hypothesis that improvement in satisfaction with oral prostheses would result in improved food selection in edentulous patients. This prospective study involved three groups, namely (i) subjects who requested and received implants to stabilise a complete fixed or removable prosthesis (IG, n = 26), (ii) edentulous subjects who requested implant prostheses, but received conventional dentures (CDG1, n = 22), and (iii) edentulous subjects who requested and received conventional dentures (CDG2, n = 35). Data were collected using validated questionnaires pre- and postoperatively. Prior to treatment, all subjects were asked whether they ate a variety of hard and soft foods, to indicate the degree of difficulty they experienced when chewing these foods, and to rate their satisfaction with various aspects of their maxillary and mandibular complete dentures. Following the completion of treatment, subjects completed the questionnaires again. Pre- and postoperative data were compared. Subjects who received implant prostheses reported significant improvement in chewing hard and soft foods. CDG2 subjects also reported improvement, but CDG1 subjects reported no change or even deterioration following treatment. Despite reported improvement in satisfaction with comfort and ability to chew food, 30-50% of IG and CDG2 subjects still avoided eating foods such as carrot and apple. This suggests that, in the absence of tailored dietary advice, apparently successful prosthetic rehabilitation does not necessarily result in a satisfactory diet.

Understanding dental CAD/CAM for restorations--accuracy from a mechanical engineering viewpoint.

PubMed

Tapie, Laurent; Lebon, Nicolas; Mawussi, Bernardin; Fron-Chabouis, Hélène; Duret, Francois; Attal, Jean-Pierre

2015-01-01

As is the case in the field of medicine, as well as in most areas of daily life, digital technology is increasingly being introduced into dental practice. Computer-aided design/ computer-aided manufacturing (CAD/CAM) solutions are available not only for chairside practice but also for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental practice can be considered as the handling of devices and software processing for the almost automatic design and creation of dental restorations. However, dentists who want to use dental CAD/CAM systems often do not have enough information to understand the variations offered by such technology practice. Knowledge of the random and systematic errors in accuracy with CAD/CAM systems can help to achieve successful restorations with this technology, and help with the purchasing of a CAD/CAM system that meets the clinical needs of restoration. This article provides a mechanical engineering viewpoint of the accuracy of CAD/ CAM systems, to help dentists understand the impact of this technology on restoration accuracy.

Post and core build-ups in crown and bridge abutments: Bio-mechanical advantages and disadvantages.

PubMed

Mamoun, John

2017-06-01

Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.

Advances in upper extremity prosthetics.

PubMed

Zlotolow, Dan A; Kozin, Scott H

2012-11-01

Until recently, upper extremity prostheses had changed little since World War II. In 2006, the Defense Advanced Research Projects Agency responded to an increasing number of military amputees with the Revolutionizing Prosthetics program. The program has yielded several breakthroughs both in the engineering of new prosthetic arms and in the control of those arms. Direct brain-wave control of a limb with 22° of freedom may be within reach. In the meantime, advances such as individually powered digits have opened the door to multifunctional full and partial hand prostheses. Restoring sensation to the prosthetic limb remains a major challenge to full integration of the limb into a patient's self-image. Copyright © 2012 Elsevier Inc. All rights reserved.

All-ceramic inlay-retained fixed dental prostheses for replacing posterior missing teeth: A systematic review.

PubMed

Castillo-Oyagüe, Raquel; Sancho-Esper, Rocío; Lynch, Christopher D; Suárez-García, María-Jesús

2018-01-01

To evaluate the current status of all-ceramic inlay-retained fixed dental prostheses (CIR-FDPs) for the replacement of posterior teeth. Screening of titles and abstracts, full-text analysis for inclusion eligibility, quality assessment, data extraction and evaluation of the scientific evidence were performed independently by two reviewers. The electronic databases MEDLINE/PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Compludoc were searched with no restriction to publication date or language. The quality of the studies was evaluated through: the original 'QDP' ('Questionnaire for selecting articles on Dental Prostheses') (for research papers); the 'Guidelines for managing overviews' of the Evidence-Based Medicine Working Group (for reviews); the Cochrane risk of bias tool; and the GRADE scale for grading scientific evidence. This review started with 4942 articles, which were narrowed down to 23 according to the selection criteria. The data was not statistically treated because of the heterogeneity of the studies. Zirconia-based CIR-FDPs may be recommended for restoring posterior single missing teeth, although the prosthesis/tooth bonded interface has yet to be improved. The addition of lateral wings to the classical inlay preparation seems promising. The weakest parts of CIR-FDPs are the connectors and retainers, while caries and endodontic problems are the most common biological complications. The fabrication of CIR-FDPs with monolithic zirconia may eliminate chipping problems. A three-unit CIR-FDP is a viable treatment option for replacing a posterior missing tooth. Appropriate case selection, abutment preparation and luting procedures may be decisive for clinical success. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Reinforcement of a PMMA resin for interim fixed prostheses with silica nanoparticles.

PubMed

Topouzi, Marianthi; Kontonasaki, Eleana; Bikiaris, Dimitrios; Papadopoulou, Lambrini; Paraskevopoulos, Konstantinos M; Koidis, Petros

2017-05-01

Fractures in long span provisional/interim restorations are a common complication. Adequate fracture toughness is necessary to resist occlusal forces and crack propagation, so these restorations should be constructed with materials of improved mechanical properties. The aim of this study was to investigate the possible reinforcement of neat silica nanoparticles and trietoxyvinylsilane-modified silica nanoparticles in a PMMA resin for fixed interim restorations. Composite PMMA-Silica nanoparticles powders were mixed with PMMA liquid and compact bar shaped specimens were fabricated according to the British standard BS EN ISO 127337:2005. The single-edge notched method was used to evaluate fracture toughness (three-point bending test), while the dynamic thermomechanical properties (Storage Modulus, Loss Modulus, tanδ) of a series of nanocomposites with different amounts of nanoparticles (0.25%, 0.50%, 0.75%, 1% w.t.) were evaluated. Statistical analysis was performed and the statistically significant level was set to p<0.05. The fracture toughness of all experimental composites was remarkably higher compared to control. There was a tendency to decrease of fracture toughness, by increasing the concentration of the filler. No statistically significant differences were detected among the modified/unmodified silica nanoparticles. Dynamic mechanical properties were also affected. By increasing the silica nanoparticles content an increase in Storage Modulus was recorded, while Glass Transition Temperature was shifted at higher temperatures. Under the limitations of this in-vitro study, it can be suggested that both neat silica nanoparticles and trietoxyvinylsilane-modified silica nanoparticles, especially at low concentrations, may enhance the overall performance of fixed interim prostheses, as can effectively increase the fracture toughness, the elastic modulus and the Glass Transition Temperature of PMMA resins used in fixed provisional restorations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of Cement, Abutment Surface Pretreatment, and Artificial Aging on the Force Required to Detach Cantilever Fixed Dental Prostheses from Dental Implants.

PubMed

Kappel, Stefanie; Chepura, Taras; Schmitter, Marc; Rammelsberg, Peter; Rues, Stefan

To examine the in vitro effects of different cements, abutment surface preconditioning, and artificial aging on the maximum tensile force needed to detach cantilever fixed dental prostheses (FDPs) from dental implants with titanium abutments. A total of 32 tissue-level implants were combined with standardized titanium abutments. For each test group, eight cantilever FDPs were fabricated using selective laser melting (cobalt-chromium [CoCr] alloy). The inner surfaces of the cantilever FDPs and half of the abutments were sandblasted and then joined by use of four different cements (two permanent and two semi-permanent) in two different amounts per cement. Subgroups were tested after either artificial aging (thermocycling and chewing simulation) or 3 days of water storage. Finally, axial pull off-tests were performed for each abutment separately. Cement type and surface pretreatment significantly affected decementation behavior. The highest retention forces (approximately 1,200 N) were associated with sandblasted abutments and permanent cements. With unconditioned abutments, temporary cements (Fu < 100 N), as well as glass-ionomer cement (Fu ≈ 100 N), resulted in rather low retention forces. Zinc phosphate cement guaranteed high retention forces. After aging, retention was sufficient only for cementation with zinc phosphate cement and for the combination of sandblasted abutments and glass-ionomer cement. When glass-ionomer cement is used to fix cantilever FDPs on implants, sandblasting of standard titanium abutments may help prevent loss of retention. Retention forces were still high for FDPs fixed with zinc phosphate cement, even when the abutments were not pretreated. Use of permanent cements only, however, is recommended to prevent unwanted loosening of cantilever FDPs.

Introduction of a new mobile-bearing total knee prosthesis: minimum three year follow-up of an RCT comparing it with a fixed-bearing device.

PubMed

Beard, D J; Pandit, H; Price, A J; Butler-Manuel, P A; Dodd, C A F; Murray, D W; Goodfellow, J W

2007-12-01

As part of the step-wise validation of a new prosthesis (TMK), we previously published the 1 year results of a randomised controlled trial in patients undergoing bilateral knee replacement [Price A., Rees J., Beard D., Juszczak E. et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. JBJS B 2003;85-B-1:62-7.]. Forty patients had the new mobile-bearing prosthesis implanted in one knee and an established fixed-bearing device in the other (AGC). We now report the 3 year status of these patients and, in addition, review a separate multi-centre cohort of 172 patients who had undergone unilateral arthroplasty with the TMK. No significant differences were found in outcome (American Knee Society Score and Oxford Knee Score) between the two prostheses. The greater incidence of "clicking" in the mobile-bearing knee, reported in the previous review, persisted (TMK=48%, AGC=30%). The presence of this mechanical noise was found to have no relationship with outcome in either of the prostheses. The unilateral cohort study showed an acceptable complication rate for the new prosthesis, although some patients reported subjective instability. The method of controlled introduction of the TMK, of which this constitutes a further step, has allowed us to assess the significance of a reported problem (clicking) and to provide scientific data from which other surgeons can decide about use of the implant.

Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review.

PubMed

Zhang, Qi; Jin, Xin; Yu, Mengliu; Ou, Guoming; Matsui, Hiroyuki; Liang, Xing; Sasaki, Keiichi

Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients. The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature. Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective. Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures.

The accuracy of the CAD system using intraoral and extraoral scanners for designing of fixed dental prostheses.

PubMed

Shimizu, Sakura; Shinya, Akikazu; Kuroda, Soichi; Gomi, Harunori

2017-07-26

The accuracy of prostheses affects clinical success and is, in turn, affected by the accuracy of the scanner and CAD programs. Thus, their accuracy is important. The first aim of this study was to evaluate the accuracy of an intraoral scanner with active triangulation (Cerec Omnicam), an intraoral scanner with a confocal laser (3Shape Trios), and an extraoral scanner with active triangulation (D810). The second aim of this study was to compare the accuracy of the digital crowns designed with two different scanner/CAD combinations. The accuracy of the intraoral scanners and extraoral scanner was clinically acceptable. Marginal and internal fit of the digital crowns fabricated using the intraoral scanner and CAD programs were inferior to those fabricated using the extraoral scanner and CAD programs.

Dissolution of cement, root caries, fracture, and retrofit of post and cores.

PubMed

Rosen, H

1998-10-01

Fixed partial denture abutments severely damaged by dental caries or fracture present a challenge to the dentist. The fixed partial denture may need to be removed for endodontic treatment with post and core fabrication. Frequently, the existing fixed partial denture can be recycled as a provisional restoration. Retrofitting the post and core greatly improves the stabilization of the interim as well as the remake of the definitive fixed partial denture. This article describes a chair side procedure for retrofitting posts and cores and, at the same appointment, converting the original fixed partial denture to an effective provisional restoration.

Simultaneous mobile- and fixed-bearing total knee replacement in the same patients. A prospective comparison of mid-term outcomes using a similar design of prosthesis.

PubMed

Kim, Y-H; Kim, D-Y; Kim, J-S

2007-07-01

We conducted a randomised prospective study to evaluate the clinical and radiological results of a mobile- and fixed-bearing total knee replacement of similar design in 174 patients who had bilateral simultaneous knee replacement. The mean follow-up was for 5.6 years (5.2 to 6.1). The total knee score, pain score, functional score and range of movement were not statistically different (p > 0.05) between the two groups. Osteolysis was not seen in any knee in either group. Two knees (1%) in the mobile-bearing group required revision because of infection; none in the fixed-bearing group needed revision. Excellent results can be achieved with both mobile- and fixed-bearing prostheses of similar design at mid-term follow-up. We could demonstrate no significant clinical advantage for a mobile bearing.

Immediate loading of implants placed in patients with untreated periodontal disease: a 5-year prospective cohort study.

PubMed

Maló, Paulo; Nobre, Miguel de Araújo; Lopes, Armando; Ferro, Ana; Gravito, Inês

2014-01-01

To report the 5-year outcome of immediately loaded dental implants in patients with untreated periodontal disease. This prospective cohort study included 103 consecutive patients (51 females and 52 males) with an average age of 52 years (range: 22 to 80 years) who were rehabilitated with 380 implants supporting 145 prostheses in both jaws (40 single; 33 partial and 72 complete rehabilitations). The implants were inserted in patients with active and untreated periodontitis. The patients did not receive any previous periodontal treatment before implant surgery, except for an oral hygiene session immediately before the implant surgery. In maintenance (every 6 months) patients received periodontal treatment as needed. Outcome measures were: prostheses failures; implant failures; complications; and marginal bone level changes. Fifteen patients dropped out of the study (14.6%). Two patients lost two implants (FDI positions nos.12 and 42), rendering a cumulative survival rate of 97.9% and 99.4% at 5 years of followup using the patient and implant as unit of analysis, respectively. The average (standard deviation) marginal bone resorption was 0.71 mm (0.42 mm) at 5 years. Mechanical complications occurred in 14 patients, consisting of prostheses fractures (10 provisional prostheses and 4 definitive prostheses). Thirteen implants (3.9%) in 13 patients (14.8%) presented peri-implant pathology. Within the limitations of this study, it is possible to conclude that the rehabilitation of patients with untreated periodontitis using immediately loaded dental implants is feasible in the medium-term, when periodontal therapy is provided after rehabilitation and the patients are regularly maintained.

Prosthetic implant treatment of the edentulous maxilla with overdenture.

PubMed

Inversini, M

2006-10-01

The literature concerning the success of prosthetic implant treatment with maxillary overdenture is reviewed, and variables affecting treatment from the implant and prosthetic standpoint are analysed. Guidelines for the fabrication of maxillary overimplants comparable to those for mandibular overimplants are still lacking, as are evidence-based prosthetic design concepts. Individual methods and techniques have been described, but evaluation standards for the outcome of maxillary prosthetic-implant treatment are lacking or individually interpreted. The biomechanics involved in the proposed system are described, together with the advantages of telescopic crowns for the retention of removable partial prosthesis supported by maxillary implants. The positive influence, in terms of long-term prognosis, of the perio-protective design of removable partial prostheses supported by maxillary overimplants is also discussed. The proposed system not only provides stability, support and retention for removable partial prostheses supported by maxillary implants, but also enables implant survival rates to be improved, both for biomechanical reasons and due to improved oral hygiene. The simplification of fabrication procedures, repair, rebasing and re-operating also reduce the cost of follow-up and improve the cost/benefit ratio. However, additional studies are needed to clarify the number and most appropriate distribution of implants, as well as the most favourable prosthetic designs for maxillary overimplants.

Neural prostheses in clinical applications--trends from precision mechanics towards biomedical microsystems in neurological rehabilitation.

PubMed

Stieglitz, T; Schuettler, M; Koch, K P

2004-04-01

Neural prostheses partially restore body functions by technical nerve excitation after trauma or neurological diseases. External devices and implants have been developed since the early 1960s for many applications. Several systems have reached nowadays clinical practice: Cochlea implants help the deaf to hear, micturition is induced by bladder stimulators in paralyzed persons and deep brain stimulation helps patients with Parkinson's disease to participate in daily life again. So far, clinical neural prostheses are fabricated with means of precision mechanics. Since microsystem technology opens the opportunity to design and develop complex systems with a high number of electrodes to interface with the nervous systems, the opportunity for selective stimulation and complex implant scenarios seems to be feasible in the near future. The potentials and limitations with regard to biomedical microdevices are introduced and discussed in this paper. Target specifications are derived from existing implants and are discussed on selected applications that has been investigated in experimental research: a micromachined implant to interface a nerve stump with a sieve electrode, cuff electrodes with integrated electronics, and an epiretinal vision prosthesis.

Experience with the use of a partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft.

PubMed

Birk, Stephanie; Brase, Christoph; Hornung, Joachim

2014-08-01

In the further development of alloplastic prostheses for use in middle ear surgery, the Dresden and Cologne University Hospitals, working together with a company, introduced a new partial ossicular replacement prosthesis in 2011. The ball-and-socket joint between the prosthesis and the shaft mimics the natural articulations between the malleus and incus and between the incus and stapes, allowing reaction to movements of the tympanic membrane graft, particularly during the healing process. Retrospective evaluation To reconstruct sound conduction as part of a type III tympanoplasty, partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft was implanted in 60 patients, with other standard partial ossicular replacement prosthesis implanted in 40 patients and 64 patients. Pure-tone audiometry was carried out, on average, 19 and 213 days after surgery. Results of the partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft were compared with those of the standard prostheses. Early measurements showed a mean improvement of 3.3 dB in the air-bone gap (ABG) with the partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft, giving similar results than the standard implants (6.6 and 6.0 dB, respectively), but the differences were not statistically significant. Later measurements showed a statistically significant improvement in the mean ABG, 11.5 dB, compared with 4.4 dB for one of the standard partial ossicular replacement prosthesis and a tendency of better results to 6.9 dB of the other standard prosthesis. In our patients, we achieved similarly good audiometric results to those already published for the partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft. Intraoperative fixation posed no problems, and the postoperative complication rate was low.

Accuracy of six elastic impression materials used for complete-arch fixed partial dentures.

PubMed

Stauffer, J P; Meyer, J M; Nally, J N

1976-04-01

1. The accuracy of four types of impression materials used to make a complete-arch fixed partial denture was evaluated by visual comparison and indirect measurement methods. 2. None of the tested materials allows safe finishing of a complete-arch fixed partial denture on a cast poured from one single master impression. 3. All of the tested materials can be used for impressions for a complete-arch fixed partial denture provided it is not finished on one single cast. Errors can be avoided by making a new impression with the fitted castings in place. Assembly and soldering should be done on the second cast. 4. In making the master fixed partial denture for this study, inaccurate soldering was a problem that was overcome with the use of epoxy glue. Hence, soldering seems to be a major source of inaccuracy for every fixed partial denture.

Use of mini dental implants in ectodermal dysplasia children: follow-up of three cases.

PubMed

Sfeir, E; Nassif, N; Moukarzel, C

2014-07-01

Ectodermal dysplasia is a hereditary genodermatosis characterised by a congenital defect of ectodermal structures, causing tooth malformations and anomalies. Implantology has become accepted in these subjects. However cases are often complicated by a reduction in the size of the alveolar process, making the insertion of conventional implants difficult without bone grafting. The reduced diameter of mini-implants and their ease of insertion provide an interesting solution in supporting removable or fixed prosthesis. The purpose of this paper is to report the follow-up of three cases of children (11-12 year- old) with ectodermal dysplasia in which mini-implants were used to support the prostheses. In the first case, two mini-implants were inserted into the anterior part of the mandible for stabilising a removable denture (2 years follow-up). In the other two cases, mini- implants were inserted in the maxilla and mandible to replace missing front teeth with fixed prostheses. Patients were called for follow- up every 6 months: in the sencod case follow-up lasted 4 years in the mandible and 2 years in the maxilla; in the third case, 2 years in the maxilla and 1 year in the mandible. The use of mini-implants in children with ectodermal dysplasia can enhance aesthetics, and functional and psychosocial development.

Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study.

PubMed

Pompa, Giorgio; Di Carlo, Stefano; De Angelis, Francesca; Cristalli, Maria Paola; Annibali, Susanna

2015-01-01

This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems.

[Technical complications rates and plaque control of fixed dental prostheses in patients treated for periodontal disease].

PubMed

Xie, Yesi; Meng, Huanxin; Han, Jie; Pan, Shaoxia; Zhang, Li; Shi, Dong

2016-02-01

To compare the incidence of technical complications of implant-supported fixed dental prostheses in Chinese patients with a history of moderate or severe periodontitis and periodontally healthy patients(PHP) and analyze the effects of interproximal papillae patterns on food impaction and efficacy of plaque control. A total of 103 partially edentulous patients treated with implant-supported fixed dental prostheses between December 2009 and December 2012 for a minimum 1-year follow-up period were recruited from Department of Periodontology, Peking University, School and Hospital of Stomatology. Based on the initial periodontal examination, the participants were divided into three groups: 30 PHP, 36 moderate periodontally compromised patients(mPCP) and 37 severe periodontally compromised patients(sPCP). Implant survival/loss, technical complications, plaque index, papilla index, food impaction and degree of proximal contact tightness of each patient were assessed around the implants at follow-up. According to the implant papilla index, the implants were divided into two groups: the "filling" group with the mesial and distal aspects with papilla index=3 and the "no filling" group with at least one aspect with papilla index<3. Data on implant survival, technical complications were analyzed. Comparisons of the incidence of technical complications were performed between the patients with different periodontal conditions with chi-square or Fisher's exact test. The influences of the interproximal papillae loss on food impaction and efficacy of plaque control were estimated with chi-square and Mann-Whitney U tests. The total implant survival rate was 100%(162/162) for all three groups. Technical complications were as following: veneer fractures(1.9%, 3/162), abutment screw loosening(1.9%, 3/162), prosthetic screw loosening(3.1%, 5/162) and decementation(3.1%, 5/162) in all subjects. No implant/screw fracture was noted. The incidence of technical complications in sPCP, mPCP and PHP did not yield statistically significant differences(P>0.05). The proportion of the implant with the mesial and distal papilla index=3 in the sPCP was less than that in the PHP and mPCP. The interproximal papillae loss did not appear to affect the food impaction and the plaque index in all three groups(P>0.05). However, for the PHP, the accumulation of plaque at buccal aspect was more in the "no filling" group compared with the "filling" group (implant plaque index[M(Q)]: 1[1] vs 0[0]), and for the sPCP, the accumulation of plaque at lingual aspect was more in the "filling" group compared with the "no filling" group(implant plaque index[M(Q)]: 1[1] vs 0[1], (P<0.05). The patients with a history of severe periodontitis did not exhibit more technical problems compared with the periodontally healthy patients. The interproximal papillae loss did not show a negative impact on the plaque control and food impaction. However, for the sPCP, changing the morphology and the position of the interproximal contact point to reduce the interdental black triangle may lead to accumulation of plaque at lingual aspect. More attention should be placed on the morphology design of prosthesis, but not the papillae filling up the interproximal space.

Multidisciplinary approach to restoring anterior maxillary partial edentulous area using an IPS Empress 2 fixed partial denture: a clinical report.

PubMed

Dundar, Mine; Gungor, M Ali; Cal, Ebru

2003-04-01

Esthetics is a major concern during restoration of anterior partial edentulous areas. All-ceramic fixed partial dentures may provide better esthetics and biocompatibility in the restoration of anterior teeth. This clinic report describes a multidisciplinary approach and treatment procedures with an IPS Empress 2 fixed partial denture to restore missing anterior teeth.

Effect of implant number and distribution on load transfer in implant-supported partial fixed dental prostheses for the anterior maxilla: A photoelastic stress analysis study.

PubMed

Lee, Jae-In; Lee, Yoon; Kim, Yu-Lee; Cho, Hye-Won

2016-02-01

The 4-, 3- or even 2-implant-supported partial fixed dental prosthesis (PFDP) designs have been used to rehabilitate the anterior edentulous maxilla. The purpose of this in vitro study was to compare the stress distribution in the supporting tissues surrounding implants placed in the anterior maxilla with 5 PFDP designs. A photoelastic model of the human maxilla with an anterior edentulous region was made with photoelastic resin (PL-2; Vishay Micro-Measurements), and 6 straight implants (OsseoSpeed; Astra Tech AB) were placed in the 6 anterior tooth positions. The 5 design concepts based on implant location were as follows: model 6I: 6 implants; model 2C2CI: 4 implants (2 canines and 2 central incisors); model 2C2LI: 4 implants (2 canines and 2 lateral incisors); model 2C1CI: 3 implants (2 canines and 1 central incisor); and model 2C: 2 canines. A load of 127.4 N was applied on the cingulum of 3 teeth at a 30-degree angle to the long axis of the implant. Stresses that developed in the supporting structure were recorded photographically. The 6-implant-supported PFDP exhibited the most even and lowest distribution of stresses in all loading conditions. When the canine was loaded, the 2- or 3-implant-supported PFDP showed higher stresses around the implant at the canine position than did the 4- or 6-implant-supported PFDP. When the central incisor or lateral incisor was loaded, the two 4-implant-supported PFDPs exhibited similar levels of stresses around the implants and showed lower stresses than did the 2- or 3-implant-supported PFDP. Implant number and distribution influenced stress distribution around the implants in the anterior maxilla. With a decrease in implant number, the stresses around the implants increased. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Improving the fit of implant prosthetics: an in vitro study.

PubMed

Yannikakis, Stavros; Prombonas, Anthony

2013-01-01

Accurate and passive fit between a prosthesis and its supporting implants has been considered a prerequisite for successful long-term osseointegration. The objective of this in vitro study was to evaluate the strain development during tightening of a five-unit screw-retained superstructure constructed using five different methods. Five-unit screw-retained fixed partial prostheses (n = 25) were fabricated on three implants embedded in an epoxy resin block using five different methods: (1) cobalt-chromium (Co-Cr), plastic cylinders, one-piece cast; (2) Co-Cr, plastic cylinders, framework sectioned, preceramic laser-welding soldering; (3) gold-platinum (Au-Pt), gold cylinders, one-piece cast; (4) Au-Pt, gold cylinders, framework sectioned, preceramic laser-welding soldering; (5) Co-Cr, one-piece cast, and cementation to "passive abutments" (Southern Implants) after final finishing and polishing. Strain gauges (SG) were attached to the fixed partial prosthesis (FPP) and to the resin block to measure the stress created during screw tightening. The combination of Co-Cr alloy and plastic cylinders in a one-piece cast showed such an inadequate fit among the fabricated methods that this group was excluded from the remainder of the experiment. Specimens of Au-Pt cast on gold cylinders in one piece showed higher strain development than the other groups used in this study, with strains ranging from 223.1 to 2,198.1 Μm/m. Sectioning and soldering significantly improved the overall fit. FPPs of Co-Cr in a one-piece cast cemented to "passive abutments" produced the best level of fit, with the least strain development in the prosthesis and the resin block (59 to 204.6 Μm/m). Absolute fit of superstructures on implants is not possible using conventional laboratory procedures. Cementing FPPs onto prefabricated cylinders directly onto the implants significantly reduces strain development compared to the other fabrication methods.

Enhancing Fracture and Wear Resistance of Dentures/Overdentures Utilizing Digital Technology: A Case Series Report.

PubMed

Afify, Ahmed; Haney, Stephan

2016-08-01

Since it was first introduced into the dental world, computer-aided design/computer-aided manufacturing (CAD/CAM) technology has improved dramatically in regards to both data acquisition and fabrication abilities. CAD/CAM is capable of providing well-fitting intra- and extraoral prostheses when sound guidelines are followed. As CAD/CAM technology encompasses both surgical and prosthetic dental applications as well as fixed and removable aspects, it could improve the average quality of dental prostheses compared with the results obtained by conventional manufacturing methods. The purpose of this article is to provide an introduction into the methods in which this technology may be used to enhance the wear and fracture resistance of dentures and overdentures. This article will also showcase two clinical reports in which CAD/CAM technology has been implemented. © 2016 by the American College of Prosthodontists.

Functional changes through the usage of 3D-printed transitional prostheses in children.

PubMed

Zuniga, Jorge M; Peck, Jean L; Srivastava, Rakesh; Pierce, James E; Dudley, Drew R; Than, Nicholas A; Stergiou, Nicholas

2017-11-08

There is limited knowledge on the use of 3 D-printed transitional prostheses, as they relate to changes in function and strength. Therefore, the purpose of this study was to identify functional and strength changes after usage of 3 D-printed transitional prostheses for multiple weeks for children with upper-limb differences. Gross manual dexterity was assessed using the Box and Block Test and wrist strength was measured using a dynamometer. This testing was conducted before and after a period of 24 ± 2.61 weeks of using a 3 D-printed transitional prosthesis. The 11 children (five girls and six boys; 3-15 years of age) who participated in the study, were fitted with a 3 D-printed transitional partial hand (n = 9) or an arm (n = 2) prosthesis. Separate two-way repeated measures ANOVAs were performed to analyze function and strength data. There was a significant hand by time interaction for function, but not for strength. Conclusion and relevance to the study of disability and rehabilitation: The increase in manual gross dexterity suggests that the Cyborg Beast 2 3 D-printed prosthesis can be used as a transitional device to improve function in children with traumatic or congenital upper-limb differences. Implications for Rehabilitation Children's prosthetic needs are complex due to their small size, rapid growth, and psychosocial development. Advancements in computer-aided design and additive manufacturing offer the possibility of designing and printing transitional prostheses at a very low cost, but there is limited knowledge on the function of this type of devices. The use of 3D printed transitional prostheses may improve manual gross dexterity in children after several weeks of using it.

Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke.

PubMed

Mituuti, Cláudia T; Bianco, Vinicius C; Bentim, Cláudia G; de Andrade, Eduardo C; Rubo, José H; Berretin-Felix, Giédre

2015-01-01

According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses. To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase. Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS) and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30) and two groups designated by the affected body part, right (RHG, n=8) and left (LHG, n=11), excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke. There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02) and RHG (P=0.01). Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01) and lower dental arch in the RHG (P=0.04). A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05). There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04) for the HG. The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with the level of oral intake and the degree of oropharyngeal dysphagia.

Dental Students' Perceived Clinical Competence in Prosthodontics: Comparison of Traditional and Problem-Based Learning Methodologies.

PubMed

Montero, Javier; Dib, Abraham; Guadilla, Yasmina; Flores, Javier; Santos, Juan Antonio; Aguilar, Rosa Anaya; Gómez-Polo, Cristina

2018-02-01

The aim of this study was to compare the perceived competence for treating prosthodontic patients of two samples of fourth-year dental students: those educated using traditional methodologies and those educated using problem-based learning (PBL). Two cohorts of fourth-year dental students at a dental school in Spain were surveyed: the traditional methods cohort (n=46) was comprised of all students in academic years 2012 and 2013, and the PBL cohort (n=57) was comprised of all students in academic years 2014 and 2015. Students in both cohorts reported the number of prosthodontic treatments they carried out per year and their perceived level of competence in performing such treatments. The results showed that the average number of treatments performed was similar for the two cohorts, except the number of metal-based removable partial dentures was significantly higher for students in the traditional (0.8±1.0) than the PBL (0.4±0.6) cohort. The level of perceived competence to treat complete denture patients for the combined cohorts was significantly higher (7.3±1.1) than that for partial acrylic dentures (6.7±1.5) and combined dentures (5.7±1.3). Students' clinical competence in prosthodontics mainly depended on number of treatments performed as the operator as well as the assistant. Students in the traditional methods cohort considered themselves to be significantly more competent at treating patients for removable partial and fixed prostheses (7.8±1.1 and 7.6±1.1, respectively) than did students in the PBL cohort (6.4±1.5 and 6.6±1.5, respectively). Overall, however, the study found that practical experiences were more important than the teaching method used to achieve students' perceived competence.

Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses.

PubMed

Batista, Mauro; Bonachela, Wellington; Soares, Janir

2008-06-01

The extraction of teeth involves the elimination of extremely sensitive periodontal mechanoreceptors, which play an important role in oral sensory perception. The aim of this study was to evaluate the recovery of interocclusal sensory perception for micro-thickness in individuals with different types of implant-supported prostheses. Wearers of complete dentures (CDs) comprised the negative control group (group A, n=17). The experimental group consisted of wearers of prostheses supported by osseointegrated implants (Group B, n=29), which was subsequently divided into 4 subgroups: B(1) (n=5)--implant supported overdentures (ISO) occluding with CD; B(2) (n=6)--implant-supported fixed prostheses (ISFP) occluding with CD; B(3) (n=8)--wearers of maxillary and mandibular ISFP, and B(4) (n=10)--ISFP occluding with natural dentition (ND). Individuals with ND represented the positive control group (Group C, n=24). Aluminum foils measuring 10 microm, 24 microm, 30 microm, 50 microm, 80 microm, and 104 microm thickness were placed within the premolar area, adding up to 120 tests for each individual. The mean tactile thresholds of groups A, B1, B2, B3, B4, and C were 92 microm, 27 microm, 27 microm, 14 microm, 10 microm, and 10 microm, respectively. [Correction added after publication online 18 April 2008: in the preceding sentence 92 microm, 27 microm, 14 microm, 10 microm and 10 microm, was corrected to 92 microm, 27 microm, 27 microm, 14 microm, 10 microm and 10 microm]. The Kruskal-Wallis test revealed significant difference among groups (P<0.05). The Dunn test revealed that group A was statistically different from groups C, B(3), and B(4), and that B(1) and B(2) were statistically different from group C. Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses could be observed. Moreover, ISO and/or ISFP combinations may similarly maximize the recovery of osseoperception.

Design Studies of Cardiac Valve Prostheses

PubMed Central

Liotta, Domingo

1985-01-01

This paper indicates the vital importance of considering prosthesis articulation in the design of cardiac valves. The prosthesis articulation interrelates with the fixed and the movable prosthetic components. Two basic physiological hemodynamic principles are reviewed: [List: see text] A bileaflet, free-tilting, swivelling prosthesis with a central articular mechanism is undergoing investigation. The four articulations have their own perennial preserving mechanisms to prevent potential failure mode by collecting blood elements in the valve tilting design. PMID:15227041

No Clear Evidence of the Effect of Cantilevered Implant Supported Fixed Restorations on the Marginal Bone or the Prosthetic Complications.

PubMed

Radi, Iman Abd-Elwahab

2016-03-01

Effect of cantilevers for implant-supported prostheses on marginal bone loss and prosthetic complications: systematic review and meta-analysis. Torrecillas-Martinez L, Monje A, Lin G, Suarez F, Ortega-Oller I, Galindo-Moreno P, Wang H. Int J Oral Maxillofac Implants 2014;29(6):1315-21. Not reported Systematic review and meta-analysis. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of tightening torque on the marginal adaptation of cement-retained implant-supported fixed dental prostheses

PubMed Central

Ghanbarzadeh, Jalil; Dashti, Hossin; Karamad, Reza; Alikhasi, Marzieh; Nakhaei, Mohammadreza

2015-01-01

Background: The final position of the abutment changes with the amount of tightening torque. This could eventually lead to loss of passivity and marginal misfit of prostheses. The aim of this study was to evaluate the effect of three different tightening torques on the marginal adaptation of 3-unit cement-retained implant-supported fixed dental prostheses (FDPs). Materials and Methods: Two implants (Straumann) were inserted in an acrylic block so that one of the implants was placed vertically and the other at a 15° vertical angle. A straight abutment and a 15° angulated abutment were connected to the vertically and obliquely installed implants, respectively, so that the two abutments were parallel. Then, 10 cement-retained FDPs were waxed and cast. Abutments were tightened with 10, 20, and 35 Ncm torques, respectively. Following each tightening torque, FDPs were luted on respective abutments with temporary cement. The marginal adaptation of the retainers was evaluated using stereomicroscope. FDPs were then removed from the abutments and were sectioned at the connector sites. The retainers were luted again on their respective abutments. Luting procedures and marginal adaptation measurement were repeated. Data were analyzed by ANOVA and least significant difference tests (α = 0.05). After cutting the FDP connectors, the independent samples t-test was used to compare misfit values (α = 0.05). Results: Following 10, 20, and 35 Ncm tightening torques, the marginal discrepancy of the retainers of FDPs significantly increased (P < 0.05). There was no significant difference between the marginal discrepancies of these two retainers (P > 0.05). The marginal gap values of angulated abutment retainers (ANRs) were significantly higher than those of the straight abutment after cutting the connectors (P = 0.026). Conclusion: Within the limitations of this study, the marginal misfit of cement-retained FDPs increased continuously when the tightening torque increased. After cutting the connectors, the marginal misfit of the ANRs was higher than those of the straight abutment retainers. PMID:26288627

Effect of tightening torque on the marginal adaptation of cement-retained implant-supported fixed dental prostheses.

PubMed

Ghanbarzadeh, Jalil; Dashti, Hossin; Karamad, Reza; Alikhasi, Marzieh; Nakhaei, Mohammadreza

2015-01-01

The final position of the abutment changes with the amount of tightening torque. This could eventually lead to loss of passivity and marginal misfit of prostheses. The aim of this study was to evaluate the effect of three different tightening torques on the marginal adaptation of 3-unit cement-retained implant-supported fixed dental prostheses (FDPs). Two implants (Straumann) were inserted in an acrylic block so that one of the implants was placed vertically and the other at a 15° vertical angle. A straight abutment and a 15° angulated abutment were connected to the vertically and obliquely installed implants, respectively, so that the two abutments were parallel. Then, 10 cement-retained FDPs were waxed and cast. Abutments were tightened with 10, 20, and 35 Ncm torques, respectively. Following each tightening torque, FDPs were luted on respective abutments with temporary cement. The marginal adaptation of the retainers was evaluated using stereomicroscope. FDPs were then removed from the abutments and were sectioned at the connector sites. The retainers were luted again on their respective abutments. Luting procedures and marginal adaptation measurement were repeated. Data were analyzed by ANOVA and least significant difference tests (α = 0.05). After cutting the FDP connectors, the independent samples t-test was used to compare misfit values (α = 0.05). Following 10, 20, and 35 Ncm tightening torques, the marginal discrepancy of the retainers of FDPs significantly increased (P < 0.05). There was no significant difference between the marginal discrepancies of these two retainers (P > 0.05). The marginal gap values of angulated abutment retainers (ANRs) were significantly higher than those of the straight abutment after cutting the connectors (P = 0.026). Within the limitations of this study, the marginal misfit of cement-retained FDPs increased continuously when the tightening torque increased. After cutting the connectors, the marginal misfit of the ANRs was higher than those of the straight abutment retainers.

Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses

PubMed Central

Pellicer-Chover, Hilario; Peñarrocha-Oltra, David; Bagán, Leticia; Fichy-Fernandez, Antonio J.; Canullo, Luigi

2014-01-01

Purpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. Results: At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in immediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants (p=0.201). No implants failed in either group. Conclusions: The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up. Key words:Immediate implants, delayed implants, peri-implant health, success rate. PMID:24316712

[All-ceramic resin bonded fixed partial denture made of IPS hot-pressed casting porcelain restore anterior missing teeth: a three years clinical observation].

PubMed

Zhou, Tuan feng; Wang, Xin zhi; Zhang, Gui rong

2011-02-18

To clinic observation of IPS Empress2 and IPS e.max all ceramic resin bonded fixed partial dentures used in one anterior teeth lost in upper jaw or less than two anterior tooth lost in lower jaw. 22 patients, 26 restorations had been made, which included 16 single-retainer all ceramic resin bonded fixed partial dentures and 10 two-retainers all ceramic resin bonded fixed partial dentures. Secondary caries of the abutments, shade in the margin of the retainers and the integrity of the restorations had been observed at 3 months, 6 months, 1 year, 2 years and 3 years after all ceramic resin bonded fixed partial dentures having been bonded. In the 3 years of clinic observation of the anterior all ceramic resin bonded fixed partial dentures, 1 two-retainers restoration lost bond after it had been made for 3 months, a retainer of one two-retainers restoration was broken after 6 months, but they are still used after modified as one-retainer all ceramic resin bonded fixed partial dentures, 1 two-retainers restoration lost bond two year later, It was integrity and re-bonded again that was still stable. No secondary carries and no shade in margin of the retainers had been found. Their color matches with the nature teeth excellently. The success rate was 88.5%. IPS Empress 2 and IPS e.max all ceramic resin bonded fixed partial dentures should be a good selection in one or two teeth lose in anterior jaws.

Implant support for removable partial overdentures: a case report.

PubMed

Halterman, S M; Rivers, J A; Keith, J D; Nelson, D R

1999-01-01

Functional stability and the preservation of remaining alveolar bone are primary, and often elusive, goals when restoring the partially edentulous arch. The incorporation of dental implants for the partial support of removable prostheses offers a practical adjunct in the fulfillment of these objectives. Planning for complex courses of treatment that include dental implants requires close coordination between the surgeon and the restorative dentist. Decisions that deal with type, location, size, number of implant fixtures, and design of the prosthesis are critical. All of these areas must be discussed and established as acceptable to the patient and each clinician before the initiation of treatment. In this report, we present a course of patient treatment in which a removable partial denture is supported by natural remaining teeth in conjunction with osseointegrated implants.

Elements of implant-supported rehabilitation planning in patients with bruxism.

PubMed

Sarmento, Hugo Ramalho; Dantas, Raquel Venâncio Fernandes; Pereira-Cenci, Tatiana; Faot, Fernanda

2012-11-01

The rehabilitation of partial or completely edentulous patients with implant-supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to revise the literature and identify risk factors in implant-supported rehabilitation planning in subjects with bruxism. Available literature was searched through Medline, with no time limit, including only studies in English. Topics discussed were etiology of bruxism and its implications on dental implants, biomechanical considerations regarding the overload on dental implants, and methods to prevent the occurrence of overloads in implant-supported prostheses. The rehabilitation of bruxers using implant-supported prostheses, using implants with adequate length and diameter, as well as proper positioning seems to be a reliable treatment, with reduced risks of failure. Bruxism control through the use of a nightguard by rigid occlusal stabilization appliance relieved in the region of implants is highly indicated. Although it is clear that implant-supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

Bone preserving level of osteotomy in short-stem total hip arthroplasty does not influence stress shielding dimensions - a comparing finite elements analysis.

PubMed

Burchard, Rene; Braas, Sabrina; Soost, Christian; Graw, Jan Adriaan; Schmitt, Jan

2017-08-07

The main objective of every new development in total hip arthroplasty (THA) is the longest possible survival of the implant. Periprosthetic stress shielding is a scientifically proven phenomenon which leads to inadvertent bone loss. So far, many studies have analysed whether implanting different hip stem prostheses result in significant preservation of bone stock. The aim of this preclinical study was to investigate design-depended differences of the stress shielding effect after implantation of a selection of short-stem THA-prostheses that are currently available. Based on computerised tomography (CT), a finite elements (FE) model was generated and a virtual THA was performed with different stem designs of the implant. Stems were chosen by osteotomy level at the femoral neck (collum, partial collum, trochanter sparing, trochanter harming). Analyses were performed with previously validated FE models to identify changes in the strain energy density (SED). In the trochanteric region, only the collum-type stem demonstrated a biomechanical behaviour similar to the native femur. In contrast, no difference in biomechanical behaviour was found between partial collum, trochanter harming and trochanter sparing models. All of the short stem-prostheses showed lower stress-shielding than a standard stem. Based on the results of this study, we cannot confirm that the design of current short stem THA-implants leads to a different stress shielding effect with regard to the level of osteotomy. Somehow unexpected, we found a bone stock protection in metadiaphyseal bone by simulating a more distal approach for osteotomy. Further clinical and biomechanical research including long-term results is needed to understand the influence of short-stem THA on bone remodelling and to find the optimal stem-design for a reduction of the stress shielding effect.

A Three-Year Retrospective Study on Survival of Ceramic-Veneered Zirconia (Y-TZP) Fixed Dental Prostheses Performed in Private Practices

PubMed Central

Norström Saarva, Veronika; Bjerkstig, Göran; Örtorp, Anders

2017-01-01

Objectives The aim of this retrospective study was to evaluate the three-year clinical outcome for ceramic-veneered zirconia fixed dental prostheses (FDPs). Methods All patients who were treated with ceramic-veneered zirconia FDPs, in three private practices in Sweden, during the period June 2003 to April 2007 were included. Case records from 151 patients, treated with a total of 184 zirconia FDPs (692 units), were analysed for clinical data. All complications noted in the charts were registered and compared to definitions for success and survival and statistical analysis was performed using the Kaplan-Meier method and a Cox regression model. Results In total, 32 FDPs in 31 patients experienced some type of complication (17.4% of FDPs, 20.5% of patients). Core fractures occurred in two (1.1%) FDPs. Two (1.1%) FDPs or 0.6% of units showed adhesive veneer fractures. Cohesive veneer fractures occurred in 10 (5.4%) FDPs (1.6% of units). The three-year cumulative success and survival rates (CSR) were 82.3% and 95.2%, respectively. Conclusions Ceramic-veneered zirconia is a promising alternative to metal-ceramic FDPs, even in the posterior area. However, the higher survival rate of metal-ceramic FDPs should be noted and both dentists and patients must be aware of the risks of complications. PMID:28713427

An Evaluation of the Gap Sizes of 3-Unit Fixed Dental Prostheses Milled from Sintering Metal Blocks.

PubMed

Jung, Jae-Kwan

2017-01-01

This study assessed the clinical acceptability of sintering metal-fabricated 3-unit fixed dental prostheses (FDPs) based on gap sizes. Ten specimens were prepared on research models by milling sintering metal blocks or by the lost-wax technique (LWC group). Gap sizes were assessed at 12 points per abutment (premolar and molar), 24 points per specimen (480 points in a total in 20 specimens). The measured points were categorized as marginal, axial wall, and occlusal for assessment in a silicone replica. The silicone replica was cut through the mesiodistal and buccolingual center. The four sections were magnified at 160x, and the thickness of the light body silicone was measured to determine the gap size, and gap size means were compared. For the premolar part, the mean (standard deviation) gap size was nonsignificantly ( p = 0.139) smaller in the SMB group (68.6 ± 35.6  μ m) than in the LWC group (69.6 ± 16.9  μ m). The mean molar gap was nonsignificantly smaller ( p = 0.852) in the LWC (73.9 ± 25.6  μ m) than in the SMB (78.1 ± 37.4  μ m) group. The gap sizes were similar between the two groups. Because the gap sizes were within the previously proposed clinically accepted limit, FDPs prepared by sintered metal block milling are clinically acceptable.

An Evaluation of the Gap Sizes of 3-Unit Fixed Dental Prostheses Milled from Sintering Metal Blocks

PubMed Central

2017-01-01

This study assessed the clinical acceptability of sintering metal-fabricated 3-unit fixed dental prostheses (FDPs) based on gap sizes. Ten specimens were prepared on research models by milling sintering metal blocks or by the lost-wax technique (LWC group). Gap sizes were assessed at 12 points per abutment (premolar and molar), 24 points per specimen (480 points in a total in 20 specimens). The measured points were categorized as marginal, axial wall, and occlusal for assessment in a silicone replica. The silicone replica was cut through the mesiodistal and buccolingual center. The four sections were magnified at 160x, and the thickness of the light body silicone was measured to determine the gap size, and gap size means were compared. For the premolar part, the mean (standard deviation) gap size was nonsignificantly (p = 0.139) smaller in the SMB group (68.6 ± 35.6 μm) than in the LWC group (69.6 ± 16.9 μm). The mean molar gap was nonsignificantly smaller (p = 0.852) in the LWC (73.9 ± 25.6 μm) than in the SMB (78.1 ± 37.4 μm) group. The gap sizes were similar between the two groups. Because the gap sizes were within the previously proposed clinically accepted limit, FDPs prepared by sintered metal block milling are clinically acceptable. PMID:28246605

Implant-supported fixed dental prostheses with CAD/CAM-fabricated porcelain crown and zirconia-based framework.

PubMed

Takaba, Masayuki; Tanaka, Shinpei; Ishiura, Yuichi; Baba, Kazuyoshi

2013-07-01

Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porcelain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed. The aim of this report was to describe the clinical application of a newly developed implant-supported FDP fabrication system, which uses PAZ, and to evaluate the outcome after a maximum application period of 36 months. Implants were placed in three patients with edentulous areas in either the maxilla or mandible. After the implant fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom abutments were first fabricated. Zirconia framework wax-up was performed on the custom abutments, and the CAD/CAM zirconia framework was prepared using the CAD/CAM system. Next, wax-up was performed on working models for porcelain crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive resin cement, and the PAZ was cemented. Cementation of the implant superstructure improved the esthetics and masticatory efficiency in all patients. No undesirable outcomes, such as superstructure chipping, stomatognathic dysfunction, or periimplant bone resorption, were observed in any of the patients. PAZ may be a potential solution for ceramic-related clinical problems such as chipping and fracture and associated complicated repair procedures in implant-supported FDPs. © 2012 by the American College of Prosthodontists.

Marginal and internal fit of posterior three-unit fixed zirconia dental prostheses fabricated with two different CAD/CAM systems and materials.

PubMed

Schönberger, Joana; Erdelt, Kurt-Jürgen; Bäumer, Daniel; Beuer, Florian

2017-11-01

The purpose of this in vitro study was to compare the precision of fit of frameworks milled from semi-sintered regular zirconia and high-translucent (HT) zirconia blanks, fabricated with two different CAD/CAM systems. Three-unit, posterior fixed dental prostheses (FDP) frameworks were fabricated for standardized dies (n = 11) with two different laboratory computer-aided design (CAD)/computer-aided manufacturing (CAM) systems (Cercon/Ceramill). The replica technique was used to evaluate the marginal and internal fit under an optical microscope. Evaluation of the data was performed according to prior studies at a level of significance of 5%. The systems showed a statistically significant influence on the internal fit of the frameworks (p ≤ 0.001) and on the marginal fit (p < 0.001). The type of material showed no influence on the marginal fit for the Cercon system (p = 0.636) and on the marginal fit (p = 0.064) and the internal fit (p = 0.316) for the Ceramill system, while regular zirconia from Cercon showed higher internal values than HT zirconia (p = 0.016). Both investigated systems showed clinically acceptable values within the limitations of this in vitro study. However, one showed less internal accuracy when regular zirconia was used.

Evaluation of Two Protocols to Measure the Accuracy of Fixed Dental Prostheses: An In Vitro Study.

PubMed

Schönberger, Joana; Erdelt, Kurt-Jürgen; Bäumer, Daniel; Beuer, Florian

2017-02-02

The aim of this in vitro study was to compare two measurement protocols of the internal and marginal fit of three-unit zirconia fixed dental prostheses (FDPs). Forty-four FDPs were fabricated for standardized dies by two laboratory CAD/CAM systems: Cercon (n = 22) and Ceramill (n = 22). The fitting was tested using a replica technique (RT = technique 1) with a light-body silicone stabilized with heavy-body material. After producing the replicas, cross-sections were made in the buccolingual and mesiodistal directions. FDPs were cemented on definitive dies, embedded, and sectioned (CST = technique 2). The marginal and internal fits were measured under an optical microscope at 50x magnification with a special software program. Data evaluation was performed according to prior studies at a level of significance of 5%. The mean internal gap width was 51 ± 36 μm for the RT and 52 ± 35 μm for the cross-section technique (CST) (p = 0.74). The mean marginal gap width was 27 ± 18 μm for RT and 30 ± 19 μm for CST (p = 0.19). Statistical tests showed no significant differences (p > 0.05). Both techniques can be used for fit evaluation; however, the noninvasive RT is suitable for clinical use. © 2017 by the American College of Prosthodontists.

Comparison of Conventional Methods and Laser-Assisted Rapid Prototyping for Manufacturing Fixed Dental Prostheses: An In Vitro Study

PubMed Central

Pompa, Giorgio; Di Carlo, Stefano; De Angelis, Francesca; Cristalli, Maria Paola; Annibali, Susanna

2015-01-01

This study assessed whether there are differences in marginal fit between laser-fusion and conventional techniques to produce fixed dental prostheses (FDPs). A master steel die with 2 abutments was produced to receive a posterior 4-unit FDPs and single copings. These experimental models were divided into three groups (n = 20/group) manufactured: group 1, Ni-Cr alloy, with a lost-wax casting technique; group 2, Co-Cr alloy, with selective laser melting (SLM); and group 3, yttria-tetragonal zirconia polycrystal (Y-TZP), with a milling system. All specimens were cut along the longitudinal axis and their adaptation was measured at the marginal and shoulder areas on the right and left sides of each abutment. Measurements were made using a stereomicroscope (×60 magnification) and a scanning electron microscope (×800 magnification). The data were analyzed using one-way analysis of variance and the Bonferroni post hoc test, with a significance cutoff of 5%. Significant differences (P < 0.05) were observed between group 3 and the other groups. The marginal opening was smallest with Co-Cr alloy substructures, while the shoulder opening was smallest with Ni-Cr alloy substructures. Within the limitations of this study, the marginal fit of an FDP is better with rapid prototyping (RP) via SLM than conventional manufacturing systems. PMID:26576419

Use of Oral Chroma™ in the assessment of volatile sulfur compounds in patients with fixed protheses.

PubMed

Sinjari, B; Murmura, G; Caputi, S; Ricci, L; Varvara, G; Scarano, A

2013-01-01

Prosthetic rehabilitation improves the patient's quality of life and oral health. The purpose of the present study was to assess the production of volatile sulfur compounds (VSCs) using Oral Chroma™ in patients wearing provisional and permanent fixed prosthesis, who were treated or not, with supportive non-surgical periodontal therapy. A total of 10 healthy patients not affected by periodontal disease and who needed the restoration of at least two edentulous single sites were included in the present study. Registrations of VSCs were carried out with a Gas Chromatograph OralChroma™ (Oral Chroma™, Abimedical, Abilit Corp., Osaka, Japan) one month after placement of the provisional restoration (group 1) and one month after placement of the final restoration (group 3). After each measurement, professional oral hygiene was carried out both on patients with provisional (group 2) and permanent prostheses (group 4) and VSC values were registered. The results showed that there were no statistical significant differences in the VSC quantity between groups with temporary or permanent prostheses. Meanwhile, statistically significant differences were found in VCS values between groups before and after the professional health care session (p less than 0.05). Also it was observed that dimethyl sulphide (CH3)2S was present in all the study groups. The present preliminary study suggests that OralChroma™ produce a comprehensive assessment of VSC in the clinical diagnosis of halitosis and that professional oral hygiene seems to influence VSC production. However, further clinical long-term studies with a larger sample size are necessary for a better understanding of halitosis manifestation in patients wearing provisional and permanent fixed prosthesis.

A System Approach to Navy Medical Education and Training. Appendix 45. Competency Curricula for Dental Prosthetic Assistant and Dental Prosthetic Technician.

DTIC Science & Technology

1974-08-31

Removable Partial Dentures ..................... 34 XI. Fixed Partial Denture Construction .. ........ 35 l. Construct Master Cast with Removable...Dies . . . 36 2. Construct Patterns for Fixed Partial Dentures .. . ..... 37 3. Spruing and Investing oeu . . . 38 4. Wax Elimination and Casting...42 S. Re3in Jacket Crowns . . ............ 43 9. Temporary Crowns and Fixed Partial Dentures . . 44 10. Post and Core Techniques . . o

[Which colours can we hear?: light stimulation of the hearing system].

PubMed

Wenzel, G I; Lenarz, T; Schick, B

2014-02-01

The success of conventional hearing aids and electrical auditory prostheses for hearing impaired patients is still limited in noisy environments and for sounds more complex than speech (e. g. music). This is partially due to the difficulty of frequency-specific activation of the auditory system using these devices. Stimulation of the auditory system using light pulses represents an alternative to mechanical and electrical stimulation. Light is a source of energy that can be very exactly focused and applied with little scattering, thus offering perspectives for optimal activation of the auditory system. Studies investigating light stimulation of sectors along the auditory pathway have shown stimulation of the auditory system is possible using light pulses. However, further studies and developments are needed before a new generation of light stimulation-based auditory prostheses can be made available for clinical application.

Patients' perceptions of implant placement surgery, the post-surgical healing and the transitional implant prostheses: a qualitative study.

PubMed

Kashbour, Wafa A; Rousseau, Nikki; Thomason, J Mark; Ellis, Janice S

2017-07-01

This study aimed to explore patients' thoughts, feelings about, and experiences of, implant placement surgery (IPS), the post-surgical healing stage and the immediate post-surgical transitional implant prosthesis (TIP) (fixed and removable). A qualitative study design was chosen and 38 semi-structured telephone and face-to-face interviews were conducted with 34 patients at different stages of implant treatment. The interviews were transcribed verbatim; the data collection and coding process followed the principles of thematic analysis, which was facilitated through the use of NVivo10. Patients anticipated that surgery would be painful and unpleasant but were prepared to accept this temporary discomfort for the expected benefits of implant treatment. However, a key finding was that patients felt they had overestimated the trauma of surgery but underestimated the discomfort and difficulties of the healing phase. A number of difficulties were also identified with the TIP phase following implant surgery. Existing research has tended to focus on the longer term benefits of dental implant treatment. This qualitative study has investigated in-depth patients' perceptions of dental implant surgery, including their experiences related to sedation, and of transitional implant restoration. While patients felt their concerns were overestimated in relation to the implant surgery, they experienced greater morbidity than they expected in the healing phase. Recommendations are made for relatively small changes in care provision which might improve the overall patient experience. Partial dentate patients treated with a fixed transitional prosthesis experienced advantages more quickly than patients with an overdenture. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Changes of tooth color in middle and old age: A longitudinal study over a decade.

PubMed

Hassel, Alexander J; Johanning, Marvin; Grill, Sabine; Schröder, Johannes; Wahl, Hans-Werner; Corcodel, Nicoleta; Klotz, Anna-Luisa; Rammelsberg, Peter; Zenthöfer, Andreas

2017-11-12

To evaluate changes in tooth color for 2 age cohorts (younger cohort, YC: 1950-1952; older cohort, OC: 1930-1932) over a mean observation period of 8 years. Sixty-one participants with 106 upper central incisors were subjected to baseline and follow-up examinations (YC: n = 46/OC: n = 15). International Commission on Illumination color coordinates of 1 or 2 unrestored test teeth for each participant were recorded by use of a spectrophotometer (VITA Easyshade 1) during both measurement times. Changes of color coordinates during the study period were evaluated by use of generalized linear mixed models with the variable "participant" as random effect. ΔE ab and E 2000 color differences were calculated between baseline and follow-up. Significant changes in color coordinates were observed, with the exception of lightness in OC. The direction of the changes depended on the cohort. A decrease of lightness (value) was observed in YC (ΔL = 4.0; P < .001) whereas in OC chroma increased (ΔC = -3.3; P < .001). For both groups, a significant shift to more reddish tooth colors was observed. In almost all cases, color differences between baseline and follow-up exceeded the 50:50 acceptability thresholds for color differences (ΔE = 2.7) in both YC (≈90%) and OC (≈80%). For both quinquagenarians and septuagenarians, clinically relevant changes in tooth color were observed after a decade; these could affect the long-term success of prosthetic restorations in terms of a satisfactory color match between natural teeth and dental prostheses. In contrast with the findings of cross-sectional studies, the changes were partially age-group-specific. Tooth color can change over a decade. When fixed dental prostheses are planned, one should consider that changes of tooth color could lead to mismatch between a restoration and adjacent teeth during the period in clinical service. © 2017 Wiley Periodicals, Inc.

Electronic laboratory quality assurance program: A method of enhancing the prosthodontic curriculum and addressing accreditation standards.

PubMed

Moghadam, Marjan; Jahangiri, Leila

2015-08-01

An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Effect of feldspathic porcelain layering on the marginal fit of zirconia and titanium complete-arch fixed implant-supported frameworks.

PubMed

Yilmaz, Burak; Alshahrani, Faris A; Kale, Ediz; Johnston, William M

2018-02-06

Veneering with porcelain may adversely affect the marginal fit of long-span computer-aided design and computer-aided manufacturing (CAD-CAM) implant-supported fixed prostheses. Moreover, data regarding the precision of fit of CAD-CAM-fabricated implant-supported complete zirconia fixed dental prostheses (FDPs) before and after porcelain layering are limited. The purpose of this in vitro study was to evaluate the effect of porcelain layering on the marginal fit of CAD-CAM-fabricated complete-arch implant-supported, screw-retained FDPs with presintered zirconia frameworks compared with titanium. An autopolymerizing acrylic resin-fixed complete denture framework prototype was fabricated on an edentulous typodont master model (all-on-4 concept; Nobel Biocare) with 2 straight in the anterior and 2 distally tilted internal-hexagon dental implants in the posterior with multiunit abutments bilaterally in canine and first molar locations. A 3-dimensional (3D) laser scanner (S600 ARTI; Zirkonzahn) was used to digitize the prototype and the master model by using scan bodies to generate a virtual 3D CAD framework. Five presintered zirconia (ICE Zirkon Translucent - 95H16; Zirkonzahn) and 5 titanium (Titan 5 - 95H14; Zirkonzahn) frameworks were fabricated using the CAM milling unit (M1 Wet Heavy Metal Milling Unit; Zirkonzahn).The 1-screw test was applied by fixing the frameworks at the location of the maxillary left first molar abutment, and an industrial computed tomography (CT) scanner (XT H 225 - Basic Configuration; Nikon) was used to scan the framework-model complex to evaluate the passive fit of the frameworks on the master model. The scanned data were transported in standard tessellation language (STL) from Volume Graphics analysis software to PolyWorks analysis software by using the maximum-fit algorithm to fit scanned planes in order to mimic the mating surfaces in the best way. 3D virtual assessment of the marginal fit was performed at the abutment-framework interface at the maxillary right canine (gap 3) and right first molar (gap 4) abutments without prosthetic screws. The facial or buccal aspects of the teeth on frameworks were layered with corresponding porcelain (Initial Dental Ceramic System; GC) and CT-scanned again using the same protocol. Marginal fit measurements were made for 4 groups: titanium (Ti) (control), porcelain-layered titanium (Ti-P) (control), zirconia (Zr), and porcelain-layered zirconia (Zr-P). 3D discrepancy mean values were computed and calculated, and the results were analyzed with a repeated measures 3-way ANOVA using the maximum likelihood estimation method and Bonferroni adjustments for selected pairwise comparison t-tests (α=.05). The 3D fit was measured at gap 3 and gap 4. Statistically significant differences in mean 3D discrepancies were observed between Zr-P (175 μm) and Zr (89 μm) and between Zr-P and Ti-P (71 μm) (P<.001). Porcelain layering had a significant effect on the marginal fit of CAD-CAM-fabricated complete-arch implant-supported, screw-retained FDPs with partially sintered zirconia frameworks. 3D marginal discrepancy mean values for all groups were within clinically acceptable limits (<120 μm), except for the layered zirconia framework. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Relevance of Variations in the Opposing Dentition for the Functionality of Fixed and Removable Partial Dentures: A Systematic Review

PubMed Central

Pommer, Bernhard; Krainhöfner, Martin; Watzek, Georg; Tepper, Gabor; Dintsios, Charalabos-Markos

2012-01-01

The aim of this systematic review was to evaluate the functionality of fixed and removable partial dentures as test interventions in relation to variations in the opposing dentition and their prosthetic restoration. The abstracts identified in the respective databases were screened independently by two investigators. RCTs and uncontrolled studies were considered, provided the patients were included consecutively and the confounding variables were adequately monitored. Seventeen papers were included. The study and publication quality was assessed using a “biometric quality” tool showing an overall poor quality. The reported outcomes, such as survival rates, were in each case obtained from a single study. Two possible trends could be deduced for the endpoint longevity: (a) the first trend in favor of removable partial dentures, compared to fixed partial dentures, with a fully edentulous opposing arch fitted with a removable prosthesis; (b) the second trend in favor of implant-supported partial dentures, compared to conventionally fixed partial dentures, with natural opposing dentition or with a removable partial denture in the opposing arch. No evidence could be generated as to whether, and if so how, variations in the opposing dentition have a bearing on the decision to fit a partially edentulous arch with a fixed or removable partial denture. PMID:23193407

Creation of a 3-dimensional virtual dental patient for computer-guided surgery and CAD-CAM interim complete removable and fixed dental prostheses: A clinical report.

PubMed

Harris, Bryan T; Montero, Daniel; Grant, Gerald T; Morton, Dean; Llop, Daniel R; Lin, Wei-Shao

2017-02-01

This clinical report proposes a digital workflow using 2-dimensional (2D) digital photographs, a 3D extraoral facial scan, and cone beam computed tomography (CBCT) volumetric data to create a 3D virtual patient with craniofacial hard tissue, remaining dentition (including surrounding intraoral soft tissue), and the realistic appearance of facial soft tissue at an exaggerated smile under static conditions. The 3D virtual patient was used to assist the virtual diagnostic tooth arrangement process, providing patient with a pleasing preoperative virtual smile design that harmonized with facial features. The 3D virtual patient was also used to gain patient's pretreatment approval (as a communication tool), design a prosthetically driven surgical plan for computer-guided implant surgery, and fabricate the computer-aided design and computer-aided manufacturing (CAD-CAM) interim prostheses. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Clinical Evaluation of Dental Restorative Materials

DTIC Science & Technology

1988-08-01

approximately one- third of both sexes possessed fixed prostheses made with identified nickel-chromium dental base-metal alloys, VERABOND, ALPHA MS, and...incidence of nickel sensitivity increased to one- third of this age group. In view of the very significant correlation of pierced ears with the incidence...UNREI.ATED (U) 0 4 0 3 ENDODONTIC TREATMENT (V) 0 4 0 1 CROWN & PRIDGE (W) 0 0 0 0 TOOTH MISSING (X) 0 0 0 0 OumE.R UNRELATED (Y) 0 2 0 0 (PATIENT

[Evaluation of cermet fillings in abutment teeth in removable partial prostheses].

PubMed

Saulic, S; Tihacek-Sojic, Lj

2001-01-01

The aim of the study was to describe the clinical process of setting the purpose filling on abutment teeth, after finishing the removable partial dentures. The aim was also to investigate the use of cermet glass-ionomer cement for the purpose filling in the abutment teeth for removable partial dentures, as well as to investigate the surface of the purpose filling. For the clinical evaluation of purpose filling slightly modified criteria according to Ryg's were used in 20 patients with different type of edentulousness. Changes occurring on the surface of purpose filling have been experimentally established by the method of scanning electron microscopy on the half-grown third molars in seven patients. It could be concluded that cement glass-ionomer was not the appropriate material for the purpose fillings in abutment teeth for removable partial dentures.

Immediate occlusal loading of NanoTite PREVAIL implants: a prospective 1-year clinical and radiographic study.

PubMed

Ostman, Pär-Olov; Wennerberg, Ann; Albrektsson, Tomas

2010-03-01

Recently, a new implant surface texture, featuring application of nanometer-scale calcium phosphate has been shown to enhance early bone fixation and formation in preclinical studies and in human histomorphometric studies, which may be beneficial in immediate loading situations. The purpose of the present prospective clinical study was to, during 1 year, clinically and radiographically evaluate a nanometer scale surface modified implant placed for immediate loading of fixed prostheses in both maxillary and mandibular regions. Thirty-five out of 38 patients who needed implant treatment and met inclusion criteria agreed to participate in the study and were consecutively enrolled. Surgical implant placement requirements consisted of a final torque of a least 25 Ncm prior to final seating and an implant stability quotient above 55. A total of 102 NanoTite PREVAIL (NTP) implants (BIOMET 3i, Palm Beach Gardens, FL, USA) (66 maxillary and 36 mandibular) were placed by one investigator, and the majority of these were placed in posterior regions (65%) and in soft bone (69%). A total of 44 prosthetic constructions were evaluated consisting of 14 single-tooth restorations, 26 fixed partial dentures, and four complete fixed restorations. All provisional constructions were delivered within 1 hour, and the final constructions placed after 4 months. Implants were monitored for clinical and radiographic outcomes at follow-up examinations scheduled for 3, 6, and 12 months. Of the 102 study implants, one implant failed. The simple cumulative survival rate value at 1 year was 99.2%. The average marginal bone resorption was 0.37 mm (SD 0.39) during the first year in function. According to the success criteria of Albrektsson and Zarb, success grade 1 was found with 93% of the implants. Although limited to the short follow-up, immediate loading of NanoTite Prevail implants seems to be a viable option in implant rehabilitation, at least when a good initial fixation is achieved.

A Systematic Review of Outcome Measurements and Quality of Studies Evaluating Fixed Tooth-Supported Restorations

PubMed Central

Patel, Devangkumar Rajnikant; O'Brien, Tim; Petrie, Aviva; Petridis, Haralampos

2014-01-01

Purpose The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005. Materials and Methods An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed. Results The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years. Conclusions Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years. PMID:24947268

Improvements in implant dentistry over the last decade: comparison of survival and complication rates in older and newer publications.

PubMed

Pjetursson, Bjarni E; Asgeirsson, Asgeir G; Zwahlen, Marcel; Sailer, Irena

2014-01-01

The objective of this systematic review was to assess and compare the survival and complication rates of implant-supported prostheses reported in studies published in the year 2000 and before, to those reported in studies published after the year 2000. Three electronic searches complemented by manual searching were conducted to identify 139 prospective and retrospective studies on implant-supported prostheses. The included studies were divided in two groups: a group of 31 older studies published in the year 2000 or before, and a group of 108 newer studies published after the year 2000. Survival and complication rates were calculated using Poisson regression models, and multivariable robust Poisson regression was used to formally compare the outcomes of older and newer studies. The 5-year survival rate of implant-supported prostheses was significantly increased in newer studies compared with older studies. The overall survival rate increased from 93.5% to 97.1%. The survival rate for cemented prostheses increased from 95.2% to 97.9%; for screw-retained reconstruction, from 77.6% to 96.8%; for implant-supported single crowns, from 92.6% to 97.2%; and for implant-supported fixed dental prostheses (FDPs), from 93.5% to 96.4%. The incidence of esthetic complications decreased in more recent studies compared with older ones, but the incidence of biologic complications was similar. The results for technical complications were inconsistent. There was a significant reduction in abutment or screw loosening by implant-supported FDPs. On the other hand, the total number of technical complications and the incidence of fracture of the veneering material was significantly increased in the newer studies. To explain the increased rate of complications, minor complications are probably reported in more detail in the newer publications. The results of the present systematic review demonstrated a positive learning curve in implant dentistry, represented in higher survival rates and lower complication rates reported in more recent clinical studies. The incidence of esthetic, biologic, and technical complications, however, is still high. Hence, it is important to identify these complications and their etiology to make implant treatment even more predictable in the future.

Fracture Surface Analysis of Clinically Failed Fixed Partial Dentures

PubMed Central

Taskonak, B.; Mecholsky, J.J.; Anusavice, K.J.

2008-01-01

Ceramic systems have limited long-term fracture resistance, especially when they are used in posterior areas or for fixed partial dentures. The objective of this study was to determine the site of crack initiation and the causes of fracture of clinically failed ceramic fixed partial dentures. Six Empress 2® lithia-disilicate (Li2O·2SiO2)-based veneered bridges and 7 experimental lithia-disilicate-based non-veneered ceramic bridges were retrieved and analyzed. Fractography and fracture mechanics methods were used to estimate the stresses at failure in 6 bridges (50%) whose fracture initiated from the occlusal surface of the connectors. Fracture of 1 non-veneered bridge (8%) initiated within the gingival surface of the connector. Three veneered bridges fractured within the veneer layers. Failure stresses of the all-core fixed partial dentures ranged from 107 to 161 MPa. Failure stresses of the veneered fixed partial dentures ranged from 19 to 68 MPa. We conclude that fracture initiation sites are controlled primarily by contact damage. PMID:16498078

Decoding brain responses to pixelized images in the primary visual cortex: implications for visual cortical prostheses

PubMed Central

Guo, Bing-bing; Zheng, Xiao-lin; Lu, Zhen-gang; Wang, Xing; Yin, Zheng-qin; Hou, Wen-sheng; Meng, Ming

2015-01-01

Visual cortical prostheses have the potential to restore partial vision. Still limited by the low-resolution visual percepts provided by visual cortical prostheses, implant wearers can currently only “see” pixelized images, and how to obtain the specific brain responses to different pixelized images in the primary visual cortex (the implant area) is still unknown. We conducted a functional magnetic resonance imaging experiment on normal human participants to investigate the brain activation patterns in response to 18 different pixelized images. There were 100 voxels in the brain activation pattern that were selected from the primary visual cortex, and voxel size was 4 mm × 4 mm × 4 mm. Multi-voxel pattern analysis was used to test if these 18 different brain activation patterns were specific. We chose a Linear Support Vector Machine (LSVM) as the classifier in this study. The results showed that the classification accuracies of different brain activation patterns were significantly above chance level, which suggests that the classifier can successfully distinguish the brain activation patterns. Our results suggest that the specific brain activation patterns to different pixelized images can be obtained in the primary visual cortex using a 4 mm × 4 mm × 4 mm voxel size and a 100-voxel pattern. PMID:26692860

[The Bridgelok system for additional retention of bonded prostheses].

PubMed

Maroto García, J; Gutiérrez Molero, F; López Montero, M V

1989-04-01

The partial protesis with metal carving and cemented with composite resin is used frequently as a reversible method in order to substitute teeth, due to the light preparation necessary for the original teeth. Recently, a new system (Bridgelok) with pins has been proposed as safer for this kind of protesis. This paper studies if this new system originates a higher resistance compared to other system without pins.

Clinical performance of long-span zirconia frameworks for fixed dental prostheses: 5-year results.

PubMed

Schmitter, M; Mussotter, K; Rammelsberg, P; Gabbert, O; Ohlmann, B

2012-07-01

The purpose of this prospective cohort study was to assess the performance of tooth-supported, long-span, zirconia fixed dental prostheses (FDPs). Thirty FDPs with span lengths from 36 to 46 mm (mean 40·33 mm), with 4-7 units and with connector dimensions ∼9 mm(2) were inserted (19 in the posterior region, 11 including anterior teeth) using glass-ionomer cement. The performance of the FDPs was assessed (aesthetic evaluation, failures, hypersensitivity/tooth vitality, secondary caries, pocket depth, decementation, and chipping) at baseline and after 5 years. Cox regression analysis was performed to identify risk factors. There were 16 failures after 5 years. Framework fracture occurred for two FDPs, four FDPs had to be re-cemented, one abutment tooth had to be treated endodontically, one abutment tooth fractured and cohesive failure of the veneer occurred for eight. Four FDPs had to be replaced, so survival was 82%. The aesthetics were rated as excellent by the patients at baseline and good at the 5-year recall. Cox regression analysis showed that both length [P = 0·05, exp(B) = 1·22] and location [P = 0·019, exp(B) = 4·09] of the FDP were risk factors for failure. Compared with the previously published 2-year results, the incidence of complications increased dramatically. Additionally, it was shown that long-span FDPs in the molar region are at greater risk of failure than FDPs in the anterior region. © 2012 Blackwell Publishing Ltd.

Effects of two grading techniques of zirconia material on the fatigue limit of full-contour 3-unit fixed dental prostheses

PubMed Central

Villefort, Regina Furbino; Amaral, Marina; Pereira, Gabriel Kalil Rocha; Campos, Tiago Moreira Bastos; Zhang, Yu; Bottino, Marco Antonio; Valandro, Luiz Felipe; de Melo, Renata Marques

2017-01-01

Objective This study evaluated the effects of two grading zirconia techniques on the fatigue limit of 3-unit fixed dental prostheses (FDPs). Methods Presintered blocks of 3Y-TZP were milled to obtain sixty-nine 3-unit FDPs, which were divided into three groups (n = 23). The control group (CTL) was sintered and glazed following manufacturer’s instructuctions. The two experimental groups presintered FDPs received a surface silica/glass infiltration treatment before the sintering process. Silica sol-gel group (SSG) was graded by the sol-gel processing route, while the glass-zirconia-glass group (GZG) was graded by an enameling technique. Graded groups did not receive a glaze layer after sintering. All FDPs were then luted with a dual-curing resin cement on composite abutments, embedded in polyurethane and stored in water for five days. The initial load of the fatigue test was calculated based on the results of the monotonic testing applied on three specimens of each group. To determine the fatigue limit, 20 samples of each group were subjected to staircase testing (100,000 cycles/5 Hz). Results The fatigue limits (in Newtons) were CTL = 1607.27, SSG = 1824.31, and GZG = 2006.57, and the Dixon and Mood test indicated statistically significant differences among groups (95% confidence interval). Significance The infiltration of silica and glass on bulk zirconia, by two different grading methods, increased the fatigue limits of monolithic zirconia FDPs. PMID:28118929

Implant-Supported Prosthetic Rehabilitation of a Patient with Localized Severe Attrition: A Clinical Report.

PubMed

Cekic-Nagas, Isil; Ergun, Gulfem

2015-06-01

Patients usually adapt to their existing occlusal vertical dimension (OVD). It is essential to resolve each of the problems associated with decreased vertical dimension as a result of attrition. This report describes the multidisciplinary dental treatment of a 40-year-old male patient who had severe tooth wear, resulting in reduced vertical dimension. After clinical evaluations, extraoral examination showed a reduction of the lower facial height, drooping, and overclosed commissures. Ten dental implants were placed into the maxillary and mandibular alveolar processes. During the osseointegration period, an interim removable partial denture was made at increased OVD to use in the first stage of rehabilitation. It was used for 3 months as a guide for preparing the definitive restorations. The patient's adaptation to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, the provisional fixed restoration was used for 3 months. Then, full-mouth definitive prostheses supported by a combination of implants and teeth were fabricated to upper and lower jaws. Osseointegration of the implants, peri-implant mucosa health, prosthesis function, and esthetics were assessed after 1 week and 1, 3, and 6 months. After 3 years of follow-up, no functional or esthetic difficulties with the implants and restorations were noted. © 2014 by the American College of Prosthodontists.

Clinical and Radiographic Evaluation of Brånemark Implants with an Anodized Surface following Seven-to-Eight Years of Functional Loading

PubMed Central

Gelb, David; McAllister, Bradley; Nummikoski, Pirkka; Del Fabbro, Massimo

2013-01-01

The aim of this study was to evaluate the clinical and radiographic long-term outcomes of dental implants with an anodized TiUnite surface, placed in routine clinical practice. Two clinical centers participated in the study. One hundred and seven implants (80 in the maxilla and 27 in the mandible) in 52 patients were followed in the long term. Both one- and two-stage techniques were used for 38 and 69 implants, respectively. Thirty-eight single tooth restorations and 22 fixed partial prostheses were delivered, according to a delayed loading protocol, within 4 to 12 months since implant placement. All implants were stable at insertion and at the long-term follow-up visit, which occurred between 7 and 8 years of functional loading. The mean followup was 7.33 ± 0.47 years. The mean marginal bone level change at the long-term followup as compared to baseline was 1.49 ± 1.03 mm. No implant failure occurred. Healthy peri-implant mucosa was found around 95% of implants, whereas 91% of implants showed no visible plaque at the implant surfaces at the long-term followup. The study showed that dental implants with the TiUnite anodized surface demonstrate excellent long-term clinical and radiographic outcomes. PMID:23533412

Rehabilitation with implant-supported overdentures in total edentulous patients: A review.

PubMed

Martínez-Lage-Azorín, Juan F; Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

2013-12-01

The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. We performed a Medline search and review of pertinent articles on the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patients' satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems. Key words:Overdentures, implant occlusion, implant rehabilitation, total edentulous rehabilitation, fixed prosthesis.

Marginal discrepancy of noble metal-ceramic fixed dental prosthesis frameworks fabricated by conventional and digital technologies.

PubMed

Afify, Ahmed; Haney, Stephan; Verrett, Ronald; Mansueto, Michael; Cray, James; Johnson, Russell

2018-02-01

Studies evaluating the marginal adaptation of available computer-aided design and computer-aided manufacturing (CAD-CAM) noble alloys for metal-ceramic prostheses are lacking. The purpose of this in vitro study was to evaluate the vertical marginal adaptation of cast, milled, and direct metal laser sintered (DMLS) noble metal-ceramic 3-unit fixed partial denture (FDP) frameworks before and after fit adjustments. Two typodont teeth were prepared for metal-ceramic FDP abutments. An acrylic resin pattern of the prepared teeth was fabricated and cast in nickel-chromium (Ni-Cr) alloy. Each specimen group (cast, milled, DMLS) was composed of 12 casts made from 12 impressions (n=12). A single design for the FDP substructure was created on a laboratory scanner and used for designing the specimens in the 3 groups. Each specimen was fitted to its corresponding cast by using up to 5 adjustment cycles, and marginal discrepancies were measured on the master Ni-Cr model before and after laboratory fit adjustments. The milled and DMLS groups had smaller marginal discrepancy measurements than those of the cast group (P<.001). Significant differences were found in the number of adjustments among the groups, with the milled group requiring the minimum number of adjustments, followed by the DMLS and cast groups (F=30.643, P<.001). Metal-ceramic noble alloy frameworks fabricated by using a CAD-CAM workflow had significantly smaller marginal discrepancies compared with those with a traditional cast workflow, with the milled group demonstrating the best marginal fit among the 3 test groups. Manual refining significantly enhanced the marginal fit of all groups. All 3 groups demonstrated marginal discrepancies within the range of clinical acceptability. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Mechanical properties of cobalt-chromium 3-unit fixed dental prostheses fabricated by casting, milling, and additive manufacturing.

PubMed

Øilo, Marit; Nesse, Harald; Lundberg, Odd Johan; Gjerdet, Nils Roar

2018-04-25

New additive manufacturing techniques for nonprecious alloys have made the fabrication of metal-ceramic fixed partial dentures (FPDs) less expensive and less time-consuming. However, whether the mechanical properties produced by these techniques are comparable is unclear. The purpose of this in vitro study was to evaluate the mechanical properties of cobalt-chromium frameworks for FPDs fabricated by 3 different techniques. Thirty frameworks for 3-unit FPDs were fabricated by traditional casting, computer-aided design and computer-aided manufacturing (CAD-CAM) milling, and selective laser melting (SLM), with n=10 in each group. The frameworks were weighed, and distal and mesial connector areas measured. The frameworks were cemented and loaded centrally (0.5 mm/s) until deformation above 1 mm occurred. Stiffness was measured as the slope of the axis between 500 and 2000 N. Microhardness was measured on sectioned specimens by Vickers indentation. The microstructure was also analyzed by scanning electron microscopy. One-way ANOVA with Tukey post hoc analysis was used to compare the groups (α=.05). The framework design differed among the groups, making a comparison of strength impossible. The milled frameworks appeared bulky, while the cast and SLM frameworks were more slender. Statistically significant differences were found in microhardness, stiffness, wall thickness, weight, and connector size (P<.05), and a significant correlation was found between hardness and stiffness (-0.4, P<.005). Fabrication method affects the design, stiffness, microhardness, and microstructure of cobalt-chromium FPD frameworks. The SLM frameworks were stiffer and harder than the cast and milled specimens. Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of a commercial multiplex PCR (Unyvero i60®) designed for the diagnosis of bone and joint infections using prosthetic-joint sonication.

PubMed

Prieto-Borja, Laura; Rodriguez-Sevilla, Graciela; Auñon, Alvaro; Pérez-Jorge, Concepción; Sandoval, Enrique; Garcia-Cañete, Joaquín; Gadea, Ignacio; Fernandez-Roblas, Ricardo; Blanco, Antonio; Esteban, Jaime

2017-04-01

The development of sonication protocols over the last few years has improved the sensitivity of conventional cultures for the diagnosis of prosthetic-joint infection (PJI). However, the development of a new, specifically designed kit for the molecular diagnosis of PJI could provide a major improvement in this field. Prostheses retrieved from patients who underwent implant removal from May 2014 to May 2015 were sent for culture, and processed according to a previously defined protocol that included sonication. Furthermore, 180 microlitres of sonication fluid were used to carry out the multiplex PCR test (Unyvero i60 system ® ). A comparison of the sensitivity, specificity, positive (PPV) and negative (NPV) predictive value, was performed. The study was approved by the Clinical Research Ethics Committee. The analysis included 88 prostheses from 68 patients (1.29 prostheses/patient). The type of prostheses studied were knee (n=55), total hip (n=26), partial hip (n=5), and shoulder (n=2). Twenty-nine patients were diagnosed with a PJI (15 delayed, 12 acute, and 2 haematogenous infections). In 24 cases, the result of the PCR was positive, all but 1 corresponding to patients with clinical criteria of PJI. Nine resistance mechanisms were detected from 5 samples. The Unyvero i60 system ® showed slightly better results than traditional culture in terms of specificity and PPV. The Unyvero i60 system ® may play a role in rapid diagnosis of PJI, due to its high specificity and PPV. However, despite these results, cultures have to be performed to detect organisms not detected by the system. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Alternative causes of bioreaction to prosthetic heart valves: three cases with pannus formation.

PubMed

Karakoyun, Süleyman; Gürsoy, Ozan Mustafa; Kalçık, Macit; Coban Kökten, Sermin; Ozkan, Mehmet

2014-01-01

Pannus formation is an infrequent but serious complication of prosthetic heart valve surgery. The cause of pannus is recognized as a bioreaction to the prostheses; histological investigations have shown that pannus comprises collagen and elastic tissues containing endothelial cells, chronic inflammatory cells, and myofibroblasts. However, the detailed mechanism of its formation has not been fully demonstrated. We aimed to evaluate the potential role of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in the pathogenesis of pannus formation in three patients with mechanical prosthetic heart valves. Pannus specimens removed from the prostheses were fixed in 10% neutral-buffered formalin for 24 hours after surgical removal and paraffin-embedded using standard procedures. Serial sections were cut at 4 µm for immunohistochemistry analysis. Hematoxylin and eosin (HE) was used in the histological analysis. VEGF and MMP-2 were studied in the immunohistochemistry analysis. Three patients with mechanical prosthetic obstruction due to pannus overgrowth underwent redo valve surgery. In the first and second patients, the mitral prosthesis was explanted along with the pannus overgrowth. The third patient had both aortic and mitral prostheses; the aortic prosthesis was explanted with obstructive pannus formation, whereas the mitral valve was spared with excision of the nonobstructive pannus. The immunohistochemical study demonstrated the expressions of MMP-2 and VEGF in all of the pannus specimens acquired from these cases. VEGF and MMP-2 may play a role in the mechanism of pannus formation as the elements of the chronic active inflammatory process.

Photoelastic analysis of stress distribution in oral rehabilitation.

PubMed

Turcio, Karina Helga Leal; Goiato, Marcelo Coelho; Gennari Filho, Humberto; dos Santos, Daniela Micheline

2009-03-01

The purpose of this study was to present a literature review about photoelasticity, a laboratory method for evaluation of implants prosthesis behavior. Fixed or removable prostheses function as levers on supporting teeth, allowing forces to cause tooth movement if not carefully planned. Hence, during treatment planning, the dentist must be aware of the biomechanics involved and prevent movement of supporting teeth, decreasing lever-type forces generated by these prosthesis. Photoelastic analysis has great applicability in restorative dentistry as it allows prediction and minimization of biomechanical critical points through modifications in treatment planning.

Quantity and quality analysis of dental prosthodontics among retirement age residents from nursing homes in different regions of Latvia and retirement age patients from dental clinic in Riga.

PubMed

Vidzis, Aldis; Cema, Ingrida; Brinkmane, Anda; Krasta, Ingrida; Broka, Kristine

2012-01-01

The quality of life is closely related with condition of oral health, influence of subjective factors on the whole human body and patients perception of their oral health. In spite of the fact that the most part of Latvian retirement age residents use low-quality dentures and assess them satisfactory, these patients often have problems associated with quality of dentures. The aim of the present study was to evaluate oral health status, prosthodontics indicators and patients satisfaction with oral health among Latvian retirement age residents. There were examined 465 retirement age volunteers (170 men and 295 women), 116 of them in dental clinic Sandent (Riga, 24.9% - control group), 137 (29.5%) in nursing homes in Zemgale and 212 (45.6%) in nursing homes in Kurzeme (Zemgale and Kurzeme are districts of Latvia). There were assessed quantity of prosthodontics among patients with partial defects of dental arches, there were estimated quality of dentures and patients satisfaction with existing prosthodontics. Oral health indicators among Latvian retirement age population are better than the same indicators among elderly residents of nursing homes. Among nursing homes residents with partial edentulousness in most of cases in oral cavities remained only few residual teeth which needed treatment. Removable and fixed dental prostheses used by nursing homes residents do not meet denture's quality criteria. Self-evaluation of dentures quality among retirement age residents of nursing homes is better and not correspond with existing dentures quality. In Latvia the quantity of prosthodontics in respect of partial removable dentures among the retired who regularly visit a dentist does not significantly differ from European retirement age population's dental prosthodontics quantity. Dental prosthodontics indicators of residents of nursing homes in Latvia are unsatisfactory (p<0.001). In retirement age population self-evaluation with quality of dentures is higher than actually existing.

Microscopical analysis of synovial fluid wear debris from failing CoCr hip prostheses

NASA Astrophysics Data System (ADS)

Ward, M. B.; Brown, A. P.; Cox, A.; Curry, A.; Denton, J.

2010-07-01

Metal on metal hip joint prostheses are now commonly implanted in patients with hip problems. Although hip replacements largely go ahead problem free, some complications can arise such as infection immediately after surgery and aseptic necrosis caused by vascular complications due to surgery. A recent observation that has been made at Manchester is that some Cobalt Chromium (CoCr) implants are causing chronic pain, with the source being as yet unidentified. This form of replacement failure is independent of surgeon or hospital and so some underlying body/implant interface process is thought to be the problem. When the synovial fluid from a failed joint is examined particles of metal (wear debris) can be found. Transmission Electron Microscopy (TEM) has been used to look at fixed and sectioned samples of the synovial fluid and this has identified fine (< 100 nm) metal and metal oxide particles within the fluid. TEM EDX and Electron Energy Loss Spectroscopy (EELS) have been employed to examine the composition of the particles, showing them to be chromium rich. This gives rise to concern that the failure mechanism may be associated with the debris.

The role of complete overdentures in esthetic rehabilitation of the adolescent oligodontia patient. A case report.

PubMed

Thalji, Ghadeer N; Cooper, Lyndon F

2010-08-01

Dental agenesis is a common developmental anomaly among human populations. It presents with varying degrees of severity. Oligodontia present in the permanent dentition may have significant esthetic, psychosocial, as well as functional implications. A case of oligodontia in an adolescent patient treated with conventional overdentures is presented in this article. A thorough medical and dental history were taken. Comprehensive clinical and radiographic examinations were made. Diagnostic casts were mounted. The prosthetic denture teeth were set and followed by esthetic and phonetic evaluation. Following approval by the patient, the overdentures were processed in heat cure resin using the conventional techniques. Good esthetic results were achieved. Patient was satisfied with the final prostheses. Simple prosthodontic solutions can be utilized to aid patients with dental agenesis. These have great implications for the patient's self image. Oligodontias are common. The literature frequently addresses esthetic rehabilitation using fixed prostheses and dental implants. This case report illustrates the value of removable prosthodontic procedures as one approach to fulfilling the requirements of esthetic rehabilitation of a young oligodontia patient.

[A light-cured acrylic adhesive for fixing resin retention devices to the wax pattern].

PubMed

Matsumura, H; Tanaka, T; Atsuta, M

1990-04-01

A light-cured acrylic adhesive for fixing resin retention devices to the wax pattern was prepared. The adhesive consisted of trimethylolpropane triacrylate, 2-ethylhexyl acrylate, benzoin methyl ether, p dimethylaminobenzaldehyde and p-methoxyphenol. The adhesive could be cured within 20 sec not only by an UV photo curing unit but by a visible-light source with a xenon lamp. The adhesive and retention beads burned out after about an hour in the electric furnace at 400 c. The metal specimens with retention devices were cast in Ag-Pd-Cu-Au alloy with the use of two types of retention beads adhesive. The light-cured adhesive was superior to the conventional one in handling and some other properties. This adhesive may be used to fabricate composite veneered prostheses with minimum errors in laboratory procedure.

The Incidence and Short Term Functional Effect of Partial PCL Release in Fixed and Mobile Bearing PCL Retaining TKA.

PubMed

Schwarzkopf, Ran; Woolwine, Spencer; Josephs, Lee; Scott, Richard D

2015-12-01

Posterior cruciate ligament (PCL) release may be required to balance the flexion gap in PCL retaining TKA. This study examines the incidence and functional consequences of PCL release in both fixed and mobile bearing TKA. A consecutive series of 1388 TKAs with 1014 fixed bearing, and 374 mobile bearing implants were reviewed for prevalence of partial PCL release, restoration of potential flexion and objective knee stability at minimum one-year follow-up. Patients receiving mobile bearing inserts were more likely to need partial PCL release (42% versus 17.5%). The occurrence of partial PCL release did not have a significant impact on knee range of motion and subjective knee stability. The need for a partial PCL release appears to be greater in mobile than in fixed bearing. Knees that required a release in both groups demonstrated no difference in restoration of flexion compared with unreleased knees and no adverse effects on flexion stability. Copyright © 2015 Elsevier Inc. All rights reserved.

Screwless fixed detachable partial overdenture treatment for atrophic partial edentulism of the anterior maxilla.

PubMed

Flanagan, Dennis

2008-01-01

This is a case report of the restoration of a partially edentulous atrophic anterior maxilla and atrophic mandibular posterior ridges. This case report demonstrates one method for successful treatment of partial edentulism at No. 7 to 10, where interlock attachments on natural cuspids and mini dental implants support an acrylic-based screwless fixed detachable partial denture to provide lip support and masticatory function in the anterior maxilla. The presenting qualities of this case were similar to combination syndrome.

No difference between fixed- and mobile-bearing total knee arthroplasty in activities of daily living and pain: a randomized clinical trial.

PubMed

Amaro, Joicemar Tarouco; Arliani, Gustavo Gonçalves; Astur, Diego Costa; Debieux, Pedro; Kaleka, Camila Cohen; Cohen, Moises

2017-06-01

Until now, there are no definitive conclusions regarding functional differences related to middle- and long-term everyday activities and patient pain following implantation of mobile- and fixed-platform tibial prostheses. The aim of this study was to determine whether there are middle-term differences in knee function and pain in patients undergoing fixed- and mobile-bearing total knee arthroplasty (TKA). Eligible patients were randomized into two groups: the first group received TKA implantation with a fixed tibial platform (group A); the second group received TKA with a mobile tibial platform (group B). Patients were followed up (2 years), and their symptoms and limitations in daily living activities were evaluated using the Knee Outcome Survey-Activities of Daily Living Scale (ADLS), in addition to pain evaluation assessed using the pain visual analogue scale (VAS). There were no significant differences in function and symptoms in the ADLS and VAS between the study groups. The type of platform used in TKA (fixed vs. mobile) does not change the symptoms, function or pain of patients 2 years post-surgery. Although mobile TKAs may have better short-term results, at medium- and long-term follow-up they do not present important clinical differences compared with fixed-platform TKAs. This information is important so that surgeons can choose the most suitable implant for each patient. Randomized clinical trial, Level I.

[Experimental basis of a new material for the manufacture of bases dentures].

PubMed

Shturminskiĭ, V G

2013-10-01

The author studied the problem of improving the quality of prosthetic removable prostheses through the development of new basic material based on polypropylene copolymer. To this end, we examined the physical and chemical structure and hygienic properties of the produced material. The studies found that the developed material of polypropylene optimal solution for the partial plate denture bases, without flaws acrylic prosthesis and improves the properties of the previously used polypropylene plastics.

Zirconia in fixed prosthesis. A literature review

PubMed Central

Román-Rodríguez, Juan L.; Ferreiroa, Alberto; Solá-Ruíz, María F.; Fons-Font, Antonio

2014-01-01

Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that varies between 6% and 15% over a 3- to 5-year period, while for ceramo-metallic restorations the fracture rate ranges between 4 and 10% over ten years. These results provoke uncertainty as to the long-term prognosis for this material in the oral medium. The cause of veneering porcelain fractures is unknown but hypothetically they could be associated with bond failure between the veneer material and the zirconia sub-structure. Key words:Veneering ceramic, zirconia-based ceramic restoration, crown, zirconia, tooth-supported fixed prosthesis. PMID:24596638

Clinical Fit of Partial Removable Dental Prostheses Based on Alginate or Polyvinyl Siloxane Impressions.

PubMed

Fokkinga, Wietske A; Witter, Dick J; Bronkhorst, Ewald M; Creugers, Nico H

The aim of this study was to analyze the clinical fit of metal-frame partial removable dental prostheses (PRDPs) based on custom trays used with alginate or polyvinyl siloxane impression material. Fifth-year students of the Nijmegen Dental School made 25 correct impressions for 23 PRDPs for 21 patients using alginate, and 31 correct impressions for 30 PRDPs for 28 patients using polyvinyl siloxane. Clinical fit of the framework as a whole and of each retainer separately were evaluated by calibrated supervisors during framework try-in before (first evaluation) and after (second evaluation) possible adjustments (score 0 = poor fit, up to score 3 = good fit). Framework fit and fit of the denture base were evaluated at delivery (third evaluation). Finally, postinsertion sessions were evaluated and total number of sessions needed, sore spots, adjustments to the denture base, and reported food-impaction were recorded. No significant differences in clinical fit (of the framework as a whole, for the retainers, or for the denture base) were found between the groups in the three evaluation sessions. Differences were not found for postinsertion sessions with one exception: in the alginate group, four subjects reported food impaction, versus none in the polyvinyl siloxane group. Clinical fit of metal-frame PRDPs based on impressions with custom trays combined with alginate or polyvinyl siloxane was similar.

An evaluation of marginal fit of three-unit fixed dental prostheses fabricated by direct metal laser sintering system.

PubMed

Kim, Ki-Baek; Kim, Woong-Chul; Kim, Hae-Young; Kim, Ji-Hwan

2013-07-01

This in vitro study aimed to evaluate and compare marginal fit of three-unit fixed dental prostheses (FDPs) fabricated using a newly developed direct metal laser sintering (DMLS) system with that of three-unit FDPs by a conventional lost wax technique (LW) method. Ten cobalt-chromium alloy three-unit FDPs using DMLS system and another ten nickel-chromium alloy FDPs using LW method were fabricated. Marginal fit was examined using a light-body silicone. After setting, the silicon film was cut into four parts and the thickness of silicon layer was measured at 160× magnification using a digital microscope to measure absolute marginal discrepancy (AMD), marginal gap (MG) and internal gap (IG). A repeated measure ANOVA for statistical analysis was performed using the SPSS statistical package version 12.0 (α=0.05). The mean values of AMD, MG, and IG were significantly larger in the DMLS group than in the LW group (p<0.001). Means of AMD, MG and IG in the first molars were 83.3, 80.0, and 82.0μm in the LW group; and 128.0, 112.0, and 159.5μm in the DMLS group, respectively. No significant difference between measurements for premolars and molars was found (p>0.05). The marginal fit of the DMLS system appeared significantly inferior compared to that of the conventional LW method and slightly larger than the acceptable range. For clinical application further improvement of DMLS system may be required. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Food Impaction and Periodontal/Peri-Implant Tissue Conditions in Relation to the Embrasure Dimensions Between Implant-Supported Fixed Dental Prostheses and Adjacent Teeth: A Cross-Sectional Study.

PubMed

Jeong, Jin-Seok; Chang, Moontaek

2015-12-01

Food impaction and periodontal/peri-implant tissue conditions were evaluated in relation to the embrasure dimensions between implant-supported fixed dental prostheses (FDPs) and adjacent teeth. A total of 215 embrasures of 150 FDPs in 100 patients (55 males and 45 females, aged 27 to 83 years; mean age: 56 years) were included in the study. Clinical assessments of the periodontal/peri-implant mucosal conditions, radiographic assessments of embrasure dimensions, and overall patient satisfaction were used as explanatory variables for the food impaction and periodontal/peri-implant tissue conditions adjacent to implant-supported FDPs in the generalized estimating equation (GEE) analysis. Food impaction was reported in 96 (44.7%) of 215 embrasures between implant-supported FDPs and adjacent teeth. Food impaction was reported more frequently in the embrasures with proximal contact loss than in those with tight contact (P = 0.009). Overall patient satisfaction was influenced negatively by food impaction in the proximal embrasures (P = 0.01). Among embrasure dimensions, only the embrasure surface area (ESA) significantly influenced food impaction (P = 0.03). Significant influences of various embrasure dimensions on the periodontal/peri-implant mucosal conditions and bone level at the implant were found in the univariate and multivariate GEE analyses. Food impaction between implant-supported FDPs and adjacent teeth occurred more frequently when proximal contact was lost and ESA increased. Food impaction negatively affected overall patient satisfaction. Embrasure dimensions influenced the periodontal/peri-implant mucosal conditions and bone level at the implant.

Analysis of proximal contact loss between implant-supported fixed dental prostheses and adjacent teeth in relation to influential factors and effects. A cross-sectional study.

PubMed

Byun, Soo-Jung; Heo, Seok-Mo; Ahn, Seung-Geun; Chang, Moontaek

2015-06-01

The aim was to analyze influential factors and effects of proximal contact loss between implant-supported fixed dental prostheses (FDP) and adjacent teeth. Ninety-four subjects treated with 135 FDPs supported by 188 implants were included. Degree of proximal contact tightness, food impaction, and periodontal/peri-implant tissue conditions were assessed in 191 proximal embrasures between implant-supported FDPs and adjacent teeth. Potential factors influencing proximal contact loss were estimated with the generalized estimation equation (GEE) procedure. Thirty-four percent of the proximal embrasures between implant-supported FDPs and teeth lost a proximal contact. The proximal contact loss rate continuously increased over the follow-up periods. A longer follow-up period, splinted implants, and mesial aspect of proximal contact were significant factors influencing the proximal contact loss in the univariate GEE analysis, whereas a longer follow-up period was the only significant factor in the multivariate GEE analysis. Food impaction was more frequently reported in the proximal contact loss group than the proximal contact group (odds ratio: 2.2). However, the proximal contact loss did not appear to affect the periodontal/peri-implant tissue conditions. Proximal contact loss between implant-supported FDPs and teeth occurred frequently and increased continuously over the follow-up period. The proximal contact loss significantly affected food impaction, but not the periodontal/peri-implant tissue conditions. Proximal contact loss should be carefully monitored during follow-up examinations in relation to food impaction. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Fracture behavior of metal-ceramic fixed dental prostheses with frameworks from cast or a newly developed sintered cobalt-chromium alloy.

PubMed

Krug, Klaus-Peter; Knauber, Andreas W; Nothdurft, Frank P

2015-03-01

The aim of this study was to investigate the fracture behavior of metal-ceramic bridges with frameworks from cobalt-chromium-molybdenum (CoCrMo), which are manufactured using conventional casting or a new computer-aided design/computer-aided manufacturing (CAD/CAM) milling and sintering technique. A total of 32 metal-ceramic fixed dental prostheses (FDPs), which are based on a nonprecious metal framework, was produced using a conventional casting process (n = 16) or a new CAD/CAM milling and sintering process (n = 16). Eight unveneered frameworks were manufactured using each of the techniques. After thermal and mechanical aging of half of the restorations, all samples were subjected to a static loading test in a universal testing machine, in which acoustic emission monitoring was performed. Three different critical forces were revealed: the fracture force (F max), the force at the first reduction in force (F decr1), and the force at the critical acoustic event (F acoust1). With the exception of the veneered restorations with cast or sintered metal frameworks without artificial aging, which presented a statistically significant but slightly different F max, no statistically significant differences between cast and CAD/CAM sintered and milled FDPs were detected. Thermal and mechanical loading did not significantly affect the resulting forces. Cast and CAD/CAM milled and sintered metal-ceramic bridges were determined to be comparable with respect to the fracture behavior. FDPs based on CAD/CAM milled and sintered frameworks may be an applicable and less technique-sensitive alternative to frameworks that are based on conventionally cast frameworks.

Designing and assessing fixed dental prostheses 2 multimedia-based education in dentistry students.

PubMed

Jahandideh, Yousef; Roohi Balasi, Leila; Vadiati Saberi, Bardia; Dadgaran, Ideh

2016-01-01

Background: Above all methods effective learning results from decent training, acquired in the proper environment and encouraging creative methods. Computer-assisted training by educational software is considered a fundamental measure to improve medical and dentistry education systems. This study aims to design and assess fixed dental prostheses via 2 multimedia instructional contents at the Guilan dentistry school. Methods: This is a descriptive and cross-sectional study. First off, the instructional content was analyzed. The software used to produce multimedia was the iSpring suite Ver.7.0. After designing the instructional multimedia, this software was loaded by LMS. Sixty-nine dentistry students in the 5th semester at Guilan Dentistry School were selected via convenience sampling. At the end of the course, a structured questionnaire containing 26 items were handed to the students to evaluate the instructional multimedia quality. Results: Mean ±SD age was 24.68±3.24 years, 43 were women (62.4%) and 26 were men (37.6%) -the majority of 76.8% used the internet at home. A portion of 33.3% were inclined to use multimedia and the internet with in-person training. About 60% declared that multimedia quality as being good. Conclusion: the instructional multimedia designs which are compatible with lesson objectives and audiovisual facilities can have a great effect on the student's satisfaction. Preparing instructional multimedia makes the instructional content easily accessible for students to be able to review it several times at the proper opportunity and if presented through LMS they would be able to study the lesson subject wherever and whenever accessing the internet.

Reliability and failure modes of implant-supported zirconium-oxide fixed dental prostheses related to veneering techniques

PubMed Central

Baldassarri, Marta; Zhang, Yu; Thompson, Van P.; Rekow, Elizabeth D.; Stappert, Christian F. J.

2011-01-01

Summary Objectives To compare fatigue failure modes and reliability of hand-veneered and over-pressed implant-supported three-unit zirconium-oxide fixed-dental-prostheses(FDPs). Methods Sixty-four custom-made zirconium-oxide abutments (n=32/group) and thirty-two zirconium-oxide FDP-frameworks were CAD/CAM manufactured. Frameworks were veneered with hand-built up or over-pressed porcelain (n=16/group). Step-stress-accelerated-life-testing (SSALT) was performed in water applying a distributed contact load at the buccal cusp-pontic-area. Post failure examinations were carried out using optical (polarized-reflected-light) and scanning electron microscopy (SEM) to visualize crack propagation and failure modes. Reliability was compared using cumulative-damage step-stress analysis (Alta-7-Pro, Reliasoft). Results Crack propagation was observed in the veneering porcelain during fatigue. The majority of zirconium-oxide FDPs demonstrated porcelain chipping as the dominant failure mode. Nevertheless, fracture of the zirconium-oxide frameworks was also observed. Over-pressed FDPs failed earlier at a mean failure load of 696 ± 149 N relative to hand-veneered at 882 ± 61 N (profile I). Weibull-stress-number of cycles-unreliability-curves were generated. The reliability (2-sided at 90% confidence bounds) for a 400N load at 100K cycles indicated values of 0.84 (0.98-0.24) for the hand-veneered FDPs and 0.50 (0.82-0.09) for their over-pressed counterparts. Conclusions Both zirconium-oxide FDP systems were resistant under accelerated-life-time-testing. Over-pressed specimens were more susceptible to fatigue loading with earlier veneer chipping. PMID:21557985

Internal fit of three-unit fixed dental prostheses produced by computer-aided design/computer-aided manufacturing and the lost-wax metal casting technique assessed using the triple-scan protocol.

PubMed

Dahl, Bjørn E; Dahl, Jon E; Rønold, Hans J

2018-02-01

Suboptimal adaptation of fixed dental prostheses (FDPs) can lead to technical and biological complications. It is unclear if the computer-aided design/computer-aided manufacturing (CAD/CAM) technique improves adaptation of FDPs compared with FDPs made using the lost-wax and metal casting technique. Three-unit FDPs were manufactured by CAD/CAM based on digital impression of a typodont model. The FDPs were made from one of five materials: pre-sintered zirconium dioxide; hot isostatic pressed zirconium dioxide; lithium disilicate glass-ceramic; milled cobalt-chromium; and laser-sintered cobalt-chromium. The FDPs made using the lost-wax and metal casting technique were used as reference. The fit of the FDPs was analysed using the triple-scan method. The fit was evaluated for both single abutments and three-unit FDPs. The average cement space varied between 50 μm and 300 μm. Insignificant differences in internal fit were observed between the CAD/CAM-manufactured FDPs, and none of the FPDs had cement spaces that were statistically significantly different from those of the reference FDP. For all FDPs, the cement space at a marginal band 0.5-1.0 mm from the preparation margin was less than 100 μm. The milled cobalt-chromium FDP had the closest fit. The cement space of FDPs produced using the CAD/CAM technique was similar to that of FDPs produced using the conventional lost-wax and metal casting technique. © 2017 Eur J Oral Sci.

[Fixed partial denture on implants. Prosthodontic and biomechanical considerations].

PubMed

del Rio Highsmith, J; Garcia-Lomas, S; Mandinazagoitia, C

1990-01-01

In this issue are analyzed the factors that support the selection of the partial edentulous patients, for the construction of partial fixed prosthesis implantosupported, and the biomechanical considerations that we have to consider in relation to: relation implant-bone, the use of natural teeth, part of the jaw, length of the space, opponent jaw and materials.

Survival of teeth treated with cast post and cores: A retrospective analysis over an observation period of up to 19.5 years.

PubMed

Raedel, Michael; Fiedler, Cliff; Jacoby, Stephan; Boening, Klaus W

2015-07-01

Scientific data about the long-term survival of teeth treated with cast post and cores are scarce. Retrospective studies often use different target events for their analyses. A comparison is therefore complicated. For associated tooth-, jaw-, and patient-related factors little evidence exists as to their effect on survival. The purpose of this study was to extend the knowledge on the survival of teeth treated with cast post and cores for observation periods of more than 10 years. A decrease or increase in survival times according to the presence or absence of associated parameters needs to be evaluated. A retrospective evaluation was conducted of all cast post and cores inserted in 1 university clinic between January 1992 and June 2011. A Kaplan-Meier survival analysis was carried out by using extraction as the target event. The survival curves for different tooth types, the presence or absence of adjacent teeth, and the prosthetic restoration of the respective jaws were compared by using the log-rank test (α=.05). A Cox regression model was calculated for multivariate analyses. A total of 717 cast post and cores for 343 patients were recorded. The mean survival time was 13.5 years. A statistically significant decrease in survival times was found for canines (11.9 years) and premolars (13.4 years) versus molars (14.1 years), no adjacent teeth (10.6 years) versus at least 1 adjacent tooth (13.8 years), and the restoration with removable dental prostheses (12.5 years) versus fixed dental prostheses and single crowns (13.9 years). The largest reduction in survival time was found for teeth being used as an abutment for a double crown-retained removable partial dental prosthesis (telescopic denture) (9.8 years). Tooth type and adjacent tooth status remained as significant variables within the multivariate Cox regression model. Cast post and cores have an acceptable long-term survival time. Because different factors may influence survival, considering these factors in treatment planning may increase the long-term success of these restorations. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Development of a Magnetic Attachment Method for Bionic Eye Applications.

PubMed

Fox, Kate; Meffin, Hamish; Burns, Owen; Abbott, Carla J; Allen, Penelope J; Opie, Nicholas L; McGowan, Ceara; Yeoh, Jonathan; Ahnood, Arman; Luu, Chi D; Cicione, Rosemary; Saunders, Alexia L; McPhedran, Michelle; Cardamone, Lisa; Villalobos, Joel; Garrett, David J; Nayagam, David A X; Apollo, Nicholas V; Ganesan, Kumaravelu; Shivdasani, Mohit N; Stacey, Alastair; Escudie, Mathilde; Lichter, Samantha; Shepherd, Robert K; Prawer, Steven

2016-03-01

Successful visual prostheses require stable, long-term attachment. Epiretinal prostheses, in particular, require attachment methods to fix the prosthesis onto the retina. The most common method is fixation with a retinal tack; however, tacks cause retinal trauma, and surgical proficiency is important to ensure optimal placement of the prosthesis near the macula. Accordingly, alternate attachment methods are required. In this study, we detail a novel method of magnetic attachment for an epiretinal prosthesis using two prostheses components positioned on opposing sides of the retina. The magnetic attachment technique was piloted in a feline animal model (chronic, nonrecovery implantation). We also detail a new method to reliably control the magnet coupling force using heat. It was found that the force exerted upon the tissue that separates the two components could be minimized as the measured force is proportionately smaller at the working distance. We thus detail, for the first time, a surgical method using customized magnets to position and affix an epiretinal prosthesis on the retina. The position of the epiretinal prosthesis is reliable, and its location on the retina is accurately controlled by the placement of a secondary magnet in the suprachoroidal location. The electrode position above the retina is less than 50 microns at the center of the device, although there were pressure points seen at the two edges due to curvature misalignment. The degree of retinal compression found in this study was unacceptably high; nevertheless, the normal structure of the retina remained intact under the electrodes. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint?

PubMed

Wegmann, Kilian; Hain, Moritz K; Ries, Christian; Neiss, Wolfram F; Müller, Lars P; Burkhart, Klaus J

2015-09-01

The fitting accuracy of radial head components has been investigated in the capitulo-radial joint, and reduced contact after prosthetic replacement of the radial head has been observed. The kinematics of the proximal radioulnar joint (PRUJ) are affected by radial head arthroplasty as well, but have not yet been investigated in this regard. The elbow joints of 60 upper extremities of formalin-fixed body donors were disarticulated to obtain a good view of the PRUJ. Each specimen was mounted on the examining table and radial head position in the native PRUJ was assessed in neutral position, full pronation, and full supination. Measurements were repeated after implantation of mono- and bi-polar prostheses. Analysis of the distribution of the joint contacts in the compartments showed significant differences after radial head replacement. In comparison to the native joint, after bipolar and monopolar radial head replacement, the physiological shift of the proximal radius was altered. The physiological shift of the joint contact of the radial head from anterior to posterior during forearm rotation that was found in the native joint in our cadaver model was not observed after prosthetic replacement. With higher conformity and physiological kinematic of radial head prostheses, possibly lower shear forces and lower contact pressures would be generated. The tested radial head prostheses do not replicate the physiological kinematics of the radial head. Further development in the prosthesis design has to be made. The meticulous reconstruction of the annular ligament seems to be of importance to increase joint contact.

Influence of transmucosal height in abutments of single and multiple implant-supported prostheses: a non-linear three-dimensional finite element analysis.

PubMed

Borie, Eduardo; Leal, Eduardo; Orsi, Iara Augusta; Salamanca, Carlos; Dias, Fernando José; Weber, Benjamin

2018-01-01

The aim of this study was to analyze the influence of three different transmucosal heights of the abutments in single and multiple implant-supported prostheses through the finite element method. External hexagon implants, MicroUnit, and EsthetiCone abutments were scanned and placed in an edentulous maxillary model obtained from a tomography database. The simulations were divided into two groups: (1) one implant with 3.75 × 10 mm placed in the upper central incisor, simulating a single implant-supported fixed prosthesis with an EsthetiCone abutment; and (2) two implants with 3.75 × 10 mm placed in the upper lateral incisors with MicroUnit abutments, simulating a multiple implant-supported prosthesis. Subsequently, each group was subdivided into three models according to the transmucosal height (1, 2, and 3 mm). A static oblique load at an angle of 45 degrees to the long axis of the implant in palatal-buccal direction of 150 and 75 N was applied for multiple and single implant-supported prosthesis, respectively. The implants and abutments were assessed according to the equivalent Von Mises stress analyses while the bone and ceramics were analyzed through maximum and minimum principal stresses. The total deformation values increased in all models, while the transmucosal height was augmented. The transmucosal height of the abutments influences the stress values at the bone, ceramics, implants, and abutments of both the single and multiple implant-supported prostheses, with the transmucosal height of 1 mm showing the lowest stress values.

Removable partial denture supported by implants with prefabricated telescopic abutments - a case report.

PubMed

Kumar, Lalit; Sehgal, Komal

2014-06-01

Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy-biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs.

Mobile bearing vs fixed bearing prostheses for posterior cruciate retaining total knee arthroplasty for postoperative functional status in patients with osteoarthritis and rheumatoid arthritis.

PubMed

Hofstede, Stefanie N; Nouta, Klaas Auke; Jacobs, Wilco; van Hooff, Miranda L; Wymenga, Ate B; Pijls, Bart G; Nelissen, Rob G H H; Marang-van de Mheen, Perla J

2015-02-04

It is unclear whether there are differences in benefits and harms between mobile and fixed prostheses for total knee arthroplasty (TKA). The previous Cochrane review published in 2004 included two articles. Many more trials have been performed since then; therefore an update is needed. To assess the benefits and harms of mobile bearing compared with fixed bearing cruciate retaining total knee arthroplasty for functional and clinical outcomes in patients with osteoarthritis (OA) or rheumatoid arthritis (RA). We searched The Cochrane Library, PubMed, EMBASE, CINAHL and Web of Science up to 27 February 2014, and the trial registers ClinicalTrials.gov, Multiregister, Current Controlled Trials and the World Health Organization (WHO) International Clinical Trials Registry Platform for data from unpublished trials, up to 11 February 2014. We also screened the reference lists of selected articles. We selected randomised controlled trials comparing mobile bearing with fixed bearing prostheses in cruciate retaining TKA among patients with osteoarthritis or rheumatoid arthritis, using functional or clinical outcome measures and follow-up of at least six months. We used standard methodological procedures as expected by The Cochrane Collaboration. We found 19 studies with 1641 participants (1616 with OA (98.5%) and 25 with RA (1.5%)) and 2247 knees. Seventeen new studies were included in this update.Quality of the evidence ranged from moderate (knee pain) to low (other outcomes). Most studies had unclear risk of bias for allocation concealment, blinding of participants and personnel, blinding of outcome assessment and selective reporting, and high risk of bias for incomplete outcome data and other bias. Knee painWe calculated the standardised mean difference (SMD) for pain, using the Knee Society Score (KSS) and visual analogue scale (VAS) in 11 studies (58%) and 1531 knees (68%). No statistically significant differences between groups were reported (SMD 0.09, 95% confidence interval (CI) -0.03 to 0.22, P value 0.15). This represents an absolute risk difference of 2.4% points higher (95% CI 0.8% lower to 5.9% higher) on the KSS pain scale and a relative percent change of 0.22% (95% CI 0.07% lower to 0.53% higher). The results were homogeneous. Clinical and functional scores The KSS clinical score did not differ statistically significantly between groups (14 studies (74%) and 1845 knees (82%)) with a mean difference (MD) of -1.06 points (95% CI -2.87 to 0.74, P value 0.25) and heterogeneous results. KSS function was reported in 14 studies (74%) with 1845 knees (82%) as an MD of -0.10 point (95% CI -1.93 to 1.73, P value 0.91) and homogeneous results. In two studies (11%), the KSS total score was favourable for mobile bearing (159 vs 132 for fixed bearing), with MD of -26.52 points (95% CI -45.03 to -8.01, P value 0.005), but with a wide 95% confidence interval indicating uncertainty about the estimate.Other reported scoring systems did not show statistically significant differences: Hospital for Special Surgery (HSS) score (seven studies (37%) in 1021 knees (45%)) with an MD of -1.36 (95% CI -4.18 to 1.46, P value 0.35); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (two studies (11%), 167 knees (7%)) with an MD of -4.46 (95% CI -16.26 to 7.34, P value 0.46); and Oxford total (five studies (26%), 647 knees (29%) with an MD of -0.25 (95% CI -1.41 to 0.91, P value 0.67). Health-related quality of lifeThree studies (16%) with 498 knees (22%) reported on health-related quality of life, and no statistically significant differences were noted between the mobile bearing and fixed bearing groups. The Short Form (SF)-12 Physical Component Summary had an MD of -1.96 (95% CI -4.55 to 0.63, P value 0.14) and heterogeneous results. Revision surgeryTwenty seven revisions (1.3%) were performed in 17 studies (89%) with 2065 knees (92%). In all, 13 knees were revised in the fixed bearing group and 14 knees in the mobile bearing group. No statistically significant differences were found (risk difference 0.00, 95% CI -0.01 to 0.01, P value 0.58), and homogeneous results were reported. MortalityIn seven out of 19 studies, 13 participants (37%) died. Two of these participants had undergone bilateral surgery, and for seven participants, it was unclear which prosthesis they had received; therefore they were excluded from the analyses. Thus our analysis included four out of 191 participants (2.1%) who had died: one in the fixed bearing group and three in the mobile bearing group. No statistically significant differences were found. The risk difference was -0.02 (95% CI -0.06 to 0.03, P value 0.49) and results were homogeneous. Reoperation ratesThirty reoperations were performed in 17 studies (89%) with 2065 knees (92%): 18 knees in the fixed bearing group (of the 1031 knees) and 12 knees in the mobile group (of the 1034 knees). No statistically significant differences were found. The risk difference was -0.01 (95% CI -0.01 to 0.01, P value 0.99) with homogeneous results. Other serious adverse eventsSixteen studies (84%) reported nine other serious adverse events in 1735 knees (77%): four in the fixed bearing group (of the 862 knees) and five in the mobile bearing group (of the 873 knees). No statistically significant differences were found (risk difference 0.00, 95% CI -0.01 to 0.01, P value 0.88), and results were homogeneous. Moderate- to low-quality evidence suggests that mobile bearing prostheses may have similar effects on knee pain, clinical and functional scores, health-related quality of life, revision surgery, mortality, reoperation rate and other serious adverse events compared with fixed bearing prostheses in posterior cruciate retaining TKA. Therefore we cannot draw firm conclusions. Most (98.5%) participants had OA, so the findings primarily reflect results reported in participants with OA. Future studies should report in greater detail outcomes such as those presented in this systematic review, with sufficient follow-up time to allow gathering of high-quality evidence and to inform clinical practice. Large registry-based studies may have added value, but they are subject to treatment-by-indication bias. Therefore, this systematic review of RCTs can be viewed as the best available evidence.

Revision of a Fractured Uncemented Revision Stem Using a Custom Designed Punch and Retrograde Through-Knee Approach

PubMed Central

Nasr, P. J.; Keene, G. S.

2015-01-01

We report a unique case of a fractured modular cobalt chromium connection taper Revitan (Zimmer, Warsaw, IN) revision prosthesis. Macroscopic examination revealed a fracture at the diaphyseal-metaphyseal junction of this modular component. This report highlights that fractures can still occur with modern modular prostheses. We are not aware of any published failures of the Revitan revision prosthesis. We also describe a unique method of retrieval for a broken well fixed uncemented femoral stem, using a custom designed extraction instrument via a through-knee approach. PMID:25793134

Componentry for lower extremity prostheses.

PubMed

Friel, Karen

2005-09-01

Prosthetic components for both transtibial and transfemoral amputations are available for patients of every level of ambulation. Most current suspension systems, knees, foot/ankle assemblies, and shock absorbers use endoskeletal construction that emphasizes total contact and weight distribution between bony structures and soft tissues. Different components offer varying benefits to energy expenditure, activity level, balance, and proprioception. Less dynamic ambulators may use fixed-cadence knees and non-dynamic response feet; higher functioning walkers benefit from dynamic response feet and variable-cadence knees. In addition, specific considerations must be kept in mind when fitting a patient with peripheral vascular disease or diabetes.

Control factors in removable complete dentures: from the articulation quintet to kinetic contact

PubMed Central

Pompa, Giorgio; Giovannetti, Agostino; Gentile, Tina; Di Carlo, Stefano

2010-01-01

Summary Hanau’s laws and the so-called articulation quintet have contributed greatly to the evolution of the prosthetic dentistry and have been further elaborated by various authors. The main aim of this study was to establish the stability of prosthetic plates by attaining balanced occlusion. Several authors have addressed the problem of removable and fixed prostheses by classifying mandibular movements into functional and parafunctional movements which extends the classical occlusal mechanics for the modern occlusal feedback model. Moreover, they suggest the use of the angle of convergence as a reference plane when manufacturing prosthetic. PMID:22238706

Periprosthetic fractures around the femoral stem: overcoming challenges and avoiding pitfalls

PubMed Central

Chen, Antonia F.

2015-01-01

Management of periprosthetic fractures around the femoral stem after total hip arthroplasty (THA) represents a significant challenge and optimal treatment remains controversial. The most common treatment paradigm involves treating fractures around a well-fixed stem with osteosynthesis, whereas fractures around a loose stem require revision arthroplasty and those with poor bone require augmentation with bone graft. Paradoxically, the literature reports a higher rate of failure for osteosynthesis around prostheses considered to be well-fixed. Such a high rate of poor outcomes may result not only from difficult fracture fixation and compromised biologic healing, but also from unrecognized peri-implant pathology. Therefore, proper preoperative and intraoperative evaluation is key, and a subset of patients may benefit from alternative management. We review the appropriate methods for evaluation and treatment of Vancouver type B fractures with particular emphasis on avoiding missteps that can lead to failure. PMID:26539451

Democratic superstring field theory: gauge fixing

NASA Astrophysics Data System (ADS)

Kroyter, Michael

2011-03-01

We show that a partial gauge fixing of the NS sector of the democratic-picture superstring field theory leads to the non-polynomial theory. Moreover, by partially gauge fixing the Ramond sector we obtain a non-polynomial fully RNS theory at pictures 0 and 1/2 . Within the democratic theory and in the partially gauge fixed theory the equations of motion of both sectors are derived from an action. We also discuss a representation of the non-polynomial theory analogous to a manifestly two-dimensional representation of WZW theory and the action of bosonic pure-gauge solutions. We further demonstrate that one can consistently gauge fix the NS sector of the democratic theory at picture number -1. The resulting theory is new. It is a {mathbb{Z}_2} dual of the modified cubic theory. We construct analytical solutions of this theory and show that they possess the desired properties.

Verification of finite element analysis of fixed partial denture with in vitro electronic strain measurement.

PubMed

Wang, Gaoqi; Zhang, Song; Bian, Cuirong; Kong, Hui

2016-01-01

The purpose of the study was to verify the finite element analysis model of three-unite fixed partial denture with in vitro electronic strain analysis and analyze clinical situation with the verified model. First, strain gauges were attached to the critical areas of a three-unit fixed partial denture. Strain values were measured under 300 N load perpendicular to the occlusal plane. Secondly, a three-dimensional finite element model in accordance with the electronic strain analysis experiment was constructed from the scanning data. And the strain values obtained by finite element analysis and in vitro measurements were compared. Finally, the clinical destruction of the fixed partial denture was evaluated with the verified finite element analysis model. There was a mutual agreement and consistency between the finite element analysis results and experimental data. The finite element analysis revealed that failure will occur in the veneer layer on buccal surface of the connector under occlusal force of 570 N. The results indicate that the electronic strain analysis is an appropriate and cost saving method to verify the finite element model. The veneer layer on buccal surface of the connector is the weakest area in the fixed partial denture. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Effect of Framework in an Implant-Supported Full-Arch Fixed Prosthesis: 3D Finite Element Analysis.

PubMed

Menini, Maria; Pesce, Paolo; Bevilacqua, Marco; Pera, Francesco; Tealdo, Tiziano; Barberis, Fabrizio; Pera, Paolo

2015-01-01

The aim of this study was to analyze through a three-dimensional finite element analysis (3D-FEA) stress distribution on four implants supporting a full-arch implant-supported fixed prosthesis (FFP) using different prosthesis designs. A 3D edentulous maxillary model was created and four implants were virtually placed into the maxilla and splinted, simulating an FFP without framework, with a cast metal framework, and with a carbon fiber framework. An occlusal load of 150 N was applied, stresses were transmitted into peri-implant bone, and prosthodontic components were recorded. 3D-FEA revealed higher stresses on the implants (up to +55.16%), on peri-implant bone (up to +56.93%), and in the prosthesis (up to +70.71%) when the full-acrylic prosthesis was simulated. The prosthesis with a carbon fiber framework showed an intermediate behavior between that of the other two configurations. This study suggests that the presence of a rigid framework in full-arch fixed prostheses provides a better load distribution that decreases the maximum values of stress at the levels of implants, prosthesis, and maxillary bone.

Rehabilitation with implant-supported overdentures in total edentulous patients: A review

PubMed Central

Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

2013-01-01

Objectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. Results and conclusions: Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patients’ satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems. Key words:Overdentures, implant occlusion, implant rehabilitation, total edentulous rehabilitation, fixed prosthesis. PMID:24455093

'Limbitless Solutions': the Prosthetic Arm, Iron Man and the Science Fiction of Technoscience.

PubMed

Smith, Susan

2016-12-01

Early last year, a non-profit organisation called 'Limbitless Solutions' modelled a 3D printed prosthetic arm on a fighting suit that features in the popular superhero film series, Iron Man (2008-2013). In addition, 'Limbitless Solutions' resourcefully deployed the fictional character and inventor of the Iron Man suit, weapons specialist and philanthropist, Tony Stark, played by Robert Downey Jr, in a celebrity/superhero endorsed promotional short film, showing 'Tony', the 'real Iron Man', gifting the futuristic military styled 'gauntlet' to Alex, a 7-year-old boy with a partially developed right arm. Engaging with scholarly work on the science fiction of technoscience, prostheses and the posthuman, and disability and DIY assistive technology, I analyse 'Limbitless Solutions' use of science fiction in a high-profile media event that problematically portrays an impaired child 'in need' of 'repair' and subsequently 'fixed' by technology. Overall, the aim is to integrate science fiction tropes, such as the wounded hero, the fighting suit and prosthetic arm, with disability studies, to highlight the sustained challenges that emerging theories of disability and technology face as contemporary economic, political and ideological forces endorse and promote militarised images of cyborg assimilation over human variation and physical difference. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Topological design of all-ceramic dental bridges for enhancing fracture resistance.

PubMed

Zhang, Zhongpu; Chen, Junning; Li, Eric; Li, Wei; Swain, Michael; Li, Qing

2016-06-01

Layered all-ceramic systems have been increasingly adopted in major dental prostheses. However, ceramics are inherently brittle, and they often subject to premature failure under high occlusion forces especially in the posterior region. This study aimed to develop mechanically sound novel topological designs for all-ceramic dental bridges by minimizing the fracture incidence under given loading conditions. A bi-directional evolutionary structural optimization (BESO) technique is implemented within the extended finite element method (XFEM) framework. Extended finite element method allows modeling crack initiation and propagation inside all-ceramic restoration systems. Following this, BESO searches the optimum distribution of two different ceramic materials, namely porcelain and zirconia, for minimizing fracture incidence. A performance index, as per a ratio of peak tensile stress to material strength, is used as a design objective. In this study, the novel XFEM based BESO topology optimization significantly improved structural strength by minimizing performance index for suppressing fracture incidence in the structures. As expected, the fracture resistance and factor of safety of fixed partial dentures structure increased upon redistributing zirconia and porcelain in the optimal topological configuration. Dental CAD/CAM systems and the emerging 3D printing technology were commercially available to facilitate implementation of such a computational design, exhibiting considerable potential for clinical application in the future. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Misfit of implant prostheses and its impact on clinical outcomes. Definition, assessment and a systematic review of the literature.

PubMed

Katsoulis, Joannis; Takeichi, Takuro; Sol Gaviria, Ana; Peter, Lukas; Katsoulis, Konstantinos

Compromised fit between the contact surfaces of screw-retained implant-supported fixed dentures (IFDs) is thought to create uncontrolled strains in the prosthetic components and peri-implant tissues, thus evoking biological and technical complications such as bone loss, screw loosening, component fractures and, at worst, loss of implants or prostheses. The aim of this systematic review was to evaluate the impact of marginal misfit on the clinical outcomes of IFDs, and to elucidate definition and assessment methods for passive fit. A systematic review of the literature was conducted with a PICO question: "For partially or complete edentulous subjects with screw-retained IFDs, does the marginal misfit at the implant-prosthesis interfaces have an impact on the clinical outcomes?". A literature search was performed electronically in PubMed (MEDLINE) with the help of Boolean operators to combine key words, and by hand search in relevant journals. English written in vivo studies published before August 31, 2016 that reported on both clinical outcome and related implant prosthesis misfit (gap, strains, torque) were selected using predetermined inclusion criteria. The initial search yielded 2626 records. After screening and a subsequent filtering process, five human and five animal studies were included in the descriptive analysis. The selected studies used different methods to assess misfit (linear distortion, vertical gap, strains, screw torque). While two human studies evaluated the biological response and technical complications prospectively over 6 and 12 months, the animal studies had an observation period < 12 weeks. Four human studies analysed retrospectively the 3 to 32 years' outcomes. Screw-related complications were observed, but biological sequelae could not be confirmed. Although the animal studies had different designs, bone adaptation and implant displacement was found in histological analyses. Due to the small number of studies and the heterogenic designs and misfit assessment methods, no meta-analysis of the data could be performed. The current literature provides insufficient evidence as to the effect of misfit at the prosthesis-implant interface on clinical outcomes of screw-retained implant-supported fixed dentures. Marginal gaps and static strains due to screw tightening were not found to have negative effects on initial osseointegration or peri-implant bone stability over time. Based on two clinical studies, the risk for technical screw-related complications was slightly higher. While the degree of tolerable misfit remains a matter of debate, the present data do not imply that clinicians neglect good fit, but aim to achieve the least misfit possible. Conflict of interest statement: The authors declare no conflict of interest. The review was conducted as part of the 2016 Foundation of Oral Rehabilitation Consensus Conference on "Prosthetic Protocols in Implant-based Oral Rehabilitation".

Advanced technologies for cardiac valvular replacement, transcatheter innovations and reconstructive surgery.

PubMed

Jamieson, W R Eric

2006-01-01

Since the 2002 Surgical Technology International monograph on valvular prostheses, there have been significant developmental and investigative advances. Aortic bioprostheses and mechanical prostheses have undergone design changes to optimize hemodynamics and prevent patient-prosthesis mismatch to have a potential satisfactory influence on survival. There has been continual technological improvements striving to bring forward advances that improve the durability of bioprostheses and reduce the thrombogenicity of mechanical prostheses. There also has been a continuance to preserve biological tissue with glutaraldehyde, rather than clinically evaluate other cross-linking technologies, by controlling or retarding calcification with therapies to control phospholipids and residual aldehydes. The techniques of mitral valve reconstruction have now been well established and new annuloplasty rings have been designed for the potential of maintaining the anatomical and physiological characteristics of the mitral annulus. Several objectives exist for annuloplasty, namely remodeling of the length and shape of the dilated annulus, prevention of dilatation of the annulus, and support for the potentially fragile area after partial-leaflet resection. Currently, there exists an emergence of catheter-based therapies for management of aortic stenosis and mitral regurgitation. For management of selected populations with critical aortic stenosis, techniques for aortic valve substitution have been developed for both antegrade and retrograde catheter techniques, as well as apical transventricular implantation. Mitral regurgitation has been addressed by experimental transcoronary sinus, stent-like devices and transventricular, edge-to-edge leaflet devices. The devices, descriptions and pictorial images comprise this monograph.

Influence of head size on the development of metallic wear and on the characteristics of carbon layers in metal-on-metal hip joints

PubMed Central

Sprecher, Christoph M; Wimmer, Markus A; Milz, Stefan; Taeger, Georg

2009-01-01

Background and purpose Particles originating from the articulating surfaces of hip endoprostheses often induce an inflammatory response, which can be related to implant failure. We therefore analyzed the metal content in capsular tissue from 44 McKee-Farrar metal-on-metal hip prostheses (with 3 different head sizes) and we also analyzed the morphological structure of layers located on articulating surfaces. Methods Atomic absorption spectrometry (AAS) was used to analyze the metal content in capsular tissue. Visually detectable carbon layers located on the articulating surfaces were evaluated using scanning electron microscopy (SEM), energy-dispersive Xray spectroscopy (EDX), and X-ray photoelectron spectroscopy (XPS). Results Metallic debris was detected in all capsular tissue samples but no statistically significant differences in metal content were found in relation to implant head size. The morphological characteristics of the different layer zones allowed an exact analysis of contact and non-contact areas. Furthermore, surface layers appear to have a protective function because they can prevent sharp-edged particles from damaging the prostheses surface. Interpretation The implant head size does not appear to influence the amount of metallic debris. The layers obviously act like a lubricating agent because the protection function does not occur in regions without layers where the metal surface often shows numerous scratches. As layers are not generated immediately after the implantation of hip prostheses, these findings may at least partially explain the high amount of wear early after implantation. PMID:19421914

Malleus-to-footplate prosthetic interposition: experience with 265 patients.

PubMed

Colletti, V; Fiorino, F G

1999-03-01

Absence of the long process of the incus with or without absence of the stapes head accounts for more than 80% of ossicular discontinuities. Total or partial replacement prostheses, made of various materials, are interposed to restore the transfer function of the middle ear. To simplify ossicular reconstruction, reduce operative times and costs, improve functional outcomes, and avoid the risk of infections, we have adopted, during the past 10 years, a technique that makes use of a personally designed alloplastic prosthetic device. The prosthesis connects the malleus to the footplate, even in the presence of the stapes superstructure. This malleus-to-footplate prosthesis consists in a plastipore-coated steel piston and hydroxyapatite head, complete with a groove. The groove is placed beneath the malleus neck after dissection of the tensor tympani tendon and the shaft of the piston on the footplate. Two hundred ninety primary ossiculoplasties with the malleus-to-footplate prostheses were performed in 265 patients from 1986 to 1995 in the ENT Department of the University of Verona. The average postoperative air-bone gap at 0.5 to 3 kHz was 11 dB at 1 year and 14 dB at 5 years. These outcomes are significantly better than those personally obtained previously with ossicular or alloplastic prostheses. No extrusions occurred. The structural characteristics of the malleus-to-foot-plate prosthesis endow the prosthesis with a high degree of biocompatibility and stability and optimal sound-transfer function. The rationale for this particular ossiculoplasty procedure is discussed.

Randomized clinical trial of implant-supported ceramic-ceramic and metal-ceramic fixed dental prostheses: preliminary results.

PubMed

Esquivel-Upshaw, Josephine F; Clark, Arthur E; Shuster, Jonathan J; Anusavice, Kenneth J

2014-02-01

The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52-75 years) were recruited for the study to receive a three-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD, and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher's exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure (p = 0.68), and connector height (p = 0.91). Although there were no significant associations between connector height, curvature of gingival embrasure, core/veneer thickness ratio, and material system and the survival probability of implant-supported FDPs with zirconia as a core material, the small number of fractures precludes a definitive conclusion on the dominant controlling factor. © 2013 by the American College of Prosthodontists.

Randomized Clinical Trial of Implant-Supported Ceramic-Ceramic and Metal-Ceramic Fixed Dental Prostheses: Preliminary Results

PubMed Central

Esquivel-Upshaw, Josephine F.; Clark, Arthur E.; Shuster, Jonathan J.; Anusavice, Kenneth J.

2013-01-01

Purpose The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. Materials and Methods An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52–75 years) were recruited for the study to receive a 3-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. Material: ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Results Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher’s exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure (p = 0.68), and connector height (p = 0.91). Conclusions Although there were no significant associations between connector height, curvature of gingival embrasure, core/veneer thickness ratio, and material system and the survival probability of implant-supported FDPs with zirconia as a core material, the small number of fractures precludes a definitive conclusion on the dominant controlling factor. PMID:23758092

Neuroprostheses to treat neurogenic bladder dysfunction: current status and future perspectives.

PubMed

Rijkhoff, Nico J M

2004-02-01

Neural prostheses are a technology that uses electrical activation of the nervous system to restore function to individuals with neurological or sensory impairment. This article provides an introduction to neural prostheses and lists the most successful neural prostheses (in terms of implanted devices). The article then focuses on neurogenic bladder dysfunction and describes two clinically available implantable neural prostheses for treatment of neurogenic bladder dysfunction. Special attention is given to the usage of these neural prostheses in children. Finally, three new developments that may lead to a new generation of implantable neural prostheses for bladder control are described. They may improve the neural prostheses currently available and expand further the population of patients who can benefit from a neural prosthesis.

Spatiotemporal Pixelization to Increase the Recognition Score of Characters for Retinal Prostheses

PubMed Central

Kim, Hyun Seok; Park, Kwang Suk

2017-01-01

Most of the retinal prostheses use a head-fixed camera and a video processing unit. Some studies proposed various image processing methods to improve visual perception for patients. However, previous studies only focused on using spatial information. The present study proposes a spatiotemporal pixelization method mimicking fixational eye movements to generate stimulation images for artificial retina arrays by combining spatial and temporal information. Input images were sampled with a resolution that was four times higher than the number of pixel arrays. We subsampled this image and generated four different phosphene images. We then evaluated the recognition scores of characters by sequentially presenting phosphene images with varying pixel array sizes (6 × 6, 8 × 8 and 10 × 10) and stimulus frame rates (10 Hz, 15 Hz, 20 Hz, 30 Hz, and 60 Hz). The proposed method showed the highest recognition score at a stimulus frame rate of approximately 20 Hz. The method also significantly improved the recognition score for complex characters. This method provides a new way to increase practical resolution over restricted spatial resolution by merging the higher resolution image into high-frame time slots. PMID:29073735

Implementation of a laboratory quality assurance program: the Louisville experience.

PubMed

Metz, Michael J; Abdel-Azim, Tamer; Miller, Cynthia J; Lin, Wei-Shao; ZandiNejad, Amirali; Oliveira, Gustavo M; Morton, Dean

2014-02-01

Remakes, or the refabrication of dental prostheses, can occur as a result of inherent inaccuracies in both clinical and laboratory procedures. Because dental schools manage large numbers of predoctoral dental students with limited familiarity and expertise as related to clinical prosthodontic techniques, it is likely these schools will experience an elevated incidence of laboratory remakes and their ramifications. The University of Louisville School of Dentistry, not unlike other dental schools, has experienced remakes associated with both fixed and removable prosthodontic procedures. Limitations in faculty standardization and variable enforcement of established preclinical protocols have been identified as variables associated with the high percentage of remakes documented. The purpose of this study was to introduce the implementation of a new multidepartmental quality assurance program designed to increase consistency and quality in both information provided to commercial dental laboratories and the prostheses returned. The program has shown to be advantageous in terms of cost-effectiveness and treatment outcomes. A statistically significant decrease in remake percentages has been recorded from inception of this program in December 2010 until December 2012. Furthermore, this program has resulted in more consistent communication between the dental school and commercial dental laboratories, among faculty members, and between faculty and students.

Edge chipping and flexural resistance of monolithic ceramics☆

PubMed Central

Zhang, Yu; Lee, James J.-W.; Srikanth, Ramanathan; Lawn, Brian R.

2014-01-01

Objective Test the hypothesis that monolithic ceramics can be developed with combined esthetics and superior fracture resistance to circumvent processing and performance drawbacks of traditional all-ceramic crowns and fixed-dental-prostheses consisting of a hard and strong core with an esthetic porcelain veneer. Specifically, to demonstrate that monolithic prostheses can be produced with a much reduced susceptibility to fracture. Methods Protocols were applied for quantifying resistance to chipping as well as resistance to flexural failure in two classes of dental ceramic, microstructurally-modified zirconias and lithium disilicate glass–ceramics. A sharp indenter was used to induce chips near the edges of flat-layer specimens, and the results compared with predictions from a critical load equation. The critical loads required to produce cementation surface failure in monolithic specimens bonded to dentin were computed from established flexural strength relations and the predictions validated with experimental data. Results Monolithic zirconias have superior chipping and flexural fracture resistance relative to their veneered counterparts. While they have superior esthetics, glass–ceramics exhibit lower strength but higher chip fracture resistance relative to porcelain-veneered zirconias. Significance The study suggests a promising future for new and improved monolithic ceramic restorations, with combined durability and acceptable esthetics. PMID:24139756

Management of long span partially edentulous maxilla with fixed removable denture prosthesis

PubMed Central

Jeyavalan, Mahilan I.; Narasimman, M.; Venkatakrishnan, C. J.; Philip, Jacob M.

2012-01-01

Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis. PMID:23293488

Management of long span partially edentulous maxilla with fixed removable denture prosthesis.

PubMed

Jeyavalan, Mahilan I; Narasimman, M; Venkatakrishnan, C J; Philip, Jacob M

2012-07-01

Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

Designing and assessing fixed dental prostheses 2 multimedia-based education in dentistry students

PubMed Central

Jahandideh, Yousef; Roohi Balasi, Leila; Vadiati Saberi, Bardia; Dadgaran, Ideh

2016-01-01

Background: Above all methods effective learning results from decent training, acquired in the proper environment and encouraging creative methods. Computer-assisted training by educational software is considered a fundamental measure to improve medical and dentistry education systems. This study aims to design and assess fixed dental prostheses via 2 multimedia instructional contents at the Guilan dentistry school. Methods: This is a descriptive and cross-sectional study. First off, the instructional content was analyzed. The software used to produce multimedia was the iSpring suite Ver.7.0. After designing the instructional multimedia, this software was loaded by LMS. Sixty-nine dentistry students in the 5th semester at Guilan Dentistry School were selected via convenience sampling. At the end of the course, a structured questionnaire containing 26 items were handed to the students to evaluate the instructional multimedia quality. Results: Mean ±SD age was 24.68±3.24 years, 43 were women (62.4%) and 26 were men (37.6%) –the majority of 76.8% used the internet at home. A portion of 33.3% were inclined to use multimedia and the internet with in-person training. About 60% declared that multimedia quality as being good. Conclusion: the instructional multimedia designs which are compatible with lesson objectives and audiovisual facilities can have a great effect on the student's satisfaction. Preparing instructional multimedia makes the instructional content easily accessible for students to be able to review it several times at the proper opportunity and if presented through LMS they would be able to study the lesson subject wherever and whenever accessing the internet. PMID:28491830

Single-Surgeon Experience and Complications of a Fixed-Bearing Total Ankle Arthroplasty.

PubMed

Pangrazzi, Garett J; Baker, Erin A; Shaheen, Phillip J; Okeagu, Chikezie N; Fortin, Paul T

2018-01-01

Total ankle arthroplasty (TAA) has historically resulted in inferior survivorship rates compared with total hip and knee arthroplasty, because of technical issues unique to ankle anatomy. In this study, a single-surgeon series of intra- and postoperative complications as well as resultant reoperations/revisions of the Tornier Salto Talaris, a fixed-bearing TAA prosthesis, were reviewed. Medical records from index procedure to latest follow-up of primary TAA were reviewed. Complications were categorized according to the Glazebrook classification; additional complications were documented. Concurrent procedures were recorded, and radiographs were analyzed for alignment, subsidence, and cyst formation. Time to complication onset and learning curve analyses were performed. One hundred four Salto Talaris TAA prostheses (96 patients), with an average follow-up of 46 months, were included. Thirty-five complications were identified in 32 ankles with a 34% complication rate, resulting in 11 reoperations (5 TAA revisions). Technical error (n = 12), wound healing (n = 9), and aseptic loosening (n = 4) were the most common complications, and there were no statistically significant differences in demographics or follow-up duration between cases with versus without complications. In both the cohorts with and without complications, there were moderate, negative correlations between radiographically observed keel osteopenia and lucency (ρ = -0.548, P = .00125, and ρ = -0.416, P = .000303, respectively); also, in the complication cohort, a weak, positive correlation between subsidence and lucency (ρ = 0.357, P = .0450) was found. Salto Talaris TAA survivorship and reoperation rates in our series were comparable with previous reports, using either the same or similar mobile-bearing prostheses; new information regarding complication, radiographic, and learning curve analyses was presented. Level IV, retrospective case series.

Three-unit posterior zirconia-ceramic fixed dental prostheses (FDPs) veneered with layered and milled (CAD-on) veneering ceramics: 1-year follow-up of a randomized controlled clinical trial.

PubMed

Grohmann, Philipp; Bindl, Andreas; Hämmerle, Christoph; Mehl, Albert; Sailer, Irena

2015-01-01

The aim of this multicenter randomized controlled clinical trial was to test posterior zirconia-ceramic fixed dental prostheses (FDPs) veneered with a computer-aided design/computer- assisted manufacture (CAD/CAM) lithium disilicate veneering ceramic (CAD-on) and manually layered zirconia veneering ceramic with respect to survival of the FDPs, and technical and biologic outcomes. Sixty patients in need of one posterior three-unit FDP were included. The zirconia frameworks were produced with a CAD/CAM system (Cerec inLab 3D/Cerec inEOS inLab). Thirty FDPs were veneered with a CAD/CAM lithium disilicate veneering ceramic (Cad-on) (test) and 30 were veneered with a layered zirconia veneering ceramic (control). For the clinical evaluation at baseline, 6, and 12 months, the United States Public Health Service (USPHS) criteria were used. The biologic outcome was judged by comparing the plaque control record (PCR), bleeding on probing (BOP), and probing pocket depth (PPD). Data were statistically analyzed. Fifty-six patients were examined at a mean follow-up of 13.9 months. At the 1-year follow-up the survival rate was 100% in the test and in the control group. No significant differences of the technical outcomes occurred. Major chipping occurred in the control group (n = 3) and predominantly minor chipping in the test group (minor n = 2, major n = 1). No biologic problems or differences were found. Both types of zirconia-ceramic FDPs exhibited very good clinical outcomes without differences between groups. Chipping occurred in both types of FDPs at small amounts, yet the extension of the chippings differed. The test FDPs predominantly exhibited minor chipping, the control FDPs major chipping.

Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro Study.

PubMed

Anchieta, Rodolfo Brunieira; Machado, Lucas Silveira; Hirata, Ronaldo; Bonfante, Estevam Augusto; Coelho, Paulo G

2016-08-01

The aim of this study was to evaluate the probability of survival of cemented and screwed three-unit implant-supported fixed dental prostheses (ISFDP) using different implant-abutment horizontal matching configurations (regular vs switching platforms). One hundred and sixty-eight implants with internal hexagon connection (4 mm diameter, 10 mm length, Emfils; Colosso Evolution System, Itú, SP, Brazil) were selected for this study according to the horizontal implant-abutment matching configuration (regular or switching) and retention method and divided in four groups (n = 21 per group) as follows: 1) regular platform cemented (IRC); 2) or screw-retained (IRS); 3) switched-platform cemented (ISC); or 4) screw-retained (ISS). Regular and platform-switched abutments (Colosso evolution, 4 mm and 3.3 mm, respectively) were torqued, and 84 three-unit metal bridges were fabricated (first molar pontic). Implants were embedded in polymethyl-methacrylate resin and subjected to step-stress accelerated life testing in water. Weibull distribution was used to determine the probability of survival for a mission of 100,000 cycles at 400 N (90% two-sided confidence intervals). Polarized light and scanning electron microscopes were used for fractographic analysis. The β values of 0.50, 1.19, 1.25, and 1.95 for groups IRC, IRS, ISC, and ISS respectively, indicated that fatigue accelerated the failure for all groups, except IRC. The cement-retained groups presented significantly higher probability of survival (IRC - 98%, ISC - 59%) than screw-retained groups (IRS - 23% and ISS - 0%). Screw-retained FDPs exclusively failed by abutment-screw fractures, whereas cement-retained presented implant/screw/abutment fractures. The probability of survival of cement-retained ISFDP was higher than screw-retained, irrespective of implant-abutment horizontal configuration. © 2015 Wiley Periodicals, Inc.

A fractographic study of clinically retrieved zirconia-ceramic and metal-ceramic fixed dental prostheses.

PubMed

Pang, Zhen; Chughtai, Asima; Sailer, Irena; Zhang, Yu

2015-10-01

A recent 3-year randomized controlled trial (RCT) of tooth supported three- to five-unit zirconia-ceramic and metal-ceramic posterior fixed dental prostheses (FDPs) revealed that veneer chipping and fracture in zirconia-ceramic systems occurred more frequently than those in metal-ceramic systems [1]. This study seeks to elucidate the underlying mechanisms responsible for the fracture phenomena observed in this RCT using a descriptive fractographic analysis. Vinyl-polysiloxane impressions of 12 zirconia-ceramic and 6 metal-ceramic FDPs with veneer fractures were taken from the patients at the end of a mean observation of 40.3±2.8 months. Epoxy replicas were produced from these impressions [1]. All replicas were gold coated, and inspected under the optical microscope and scanning electron microscope (SEM) for descriptive fractography. Among the 12 zirconia-ceramic FDPs, 2 had small chippings, 9 had large chippings, and 1 exhibited delamination. Out of 6 metal-ceramic FDPs, 5 had small chippings and 1 had large chipping. Descriptive fractographic analysis based on SEM observations revealed that fracture initiated from the wear facet at the occlusal surface in all cases, irrespective of the type of restoration. Zirconia-ceramic and metal-ceramic FDPs all fractured from microcracks that emanated from occlusal wear facets. The relatively low fracture toughness and high residual tensile stress in porcelain veneer of zirconia restorations may contribute to the higher chipping rate and larger chip size in zirconia-ceramic FDPs relative to their metal-ceramic counterparts. The low veneer/core interfacial fracture energy of porcelain-veneered zirconia may result in the occurrence of delamination in zirconia-ceramic FDPs. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A fractographic study of clinically retrieved zirconia–ceramic and metal–ceramic fixed dental prostheses

PubMed Central

Pang, Zhen; Chughtai, Asima; Sailer, Irena; Zhang, Yu

2015-01-01

Objectives A recent 3-year randomized controlled trial (RCT) of tooth supported three- to five-unit zirconia–ceramic and metal–ceramic posterior fixed dental prostheses (FDPs) revealed that veneer chipping and fracture in zirconia–ceramic systems occurred more frequently than those in metal–ceramic systems [1]. This study seeks to elucidate the underlying mechanisms responsible for the fracture phenomena observed in this RCT using a descriptive fractographic analysis. Methods Vinyl-polysiloxane impressions of 12 zirconia–ceramic and 6 metal–ceramic FDPs with veneer fractures were taken from the patients at the end of a mean observation of 40.3 ± 2.8 months. Epoxy replicas were produced from these impressions [1]. All replicas were gold coated, and inspected under the optical microscope and scanning electron microscope (SEM) for descriptive fractography. Results Among the 12 zirconia–ceramic FDPs, 2 had small chippings, 9 had large chippings, and 1 exhibited delamination. Out of 6 metal–ceramic FDPs, 5 had small chippings and 1 had large chipping. Descriptive fractographic analysis based on SEM observations revealed that fracture initiated from the wear facet at the occlusal surface in all cases, irrespective of the type of restoration. Significance Zirconia–ceramic and metal–ceramic FDPs all fractured from microcracks that emanated from occlusal wear facets. The relatively low fracture toughness and high residual tensile stress in porcelain veneer of zirconia restorations may contribute to the higher chipping rate and larger chip size in zirconia–ceramic FDPs relative to their metal–ceramic counterparts. The low veneer/core interfacial fracture energy of porcelain-veneered zirconia may result in the occurrence of delamination in zirconia–ceramic FDPs. PMID:26233469

Are sectioning and soldering of short-span implant-supported prostheses necessary procedures?

PubMed

Bianchini, Marco A; Souza, João G O; Souza, Dircilene C; Magini, Ricardo S; Benfatti, Cesar A M; Cardoso, Antonio C

2011-01-01

The aim of this study was to evaluate the fit between dental abutments and the metal framework of a 3-unit fixed prosthesis screwed to two implants to determine whether sectioning and soldering of the framework are in fact necessary procedures. The study was based on a model of a metal framework of a 3-unit prosthesis screwed to two implants. A total of 18 metal frameworks were constructed and divided into 3 groups: (1) NS group - each framework was cast in one piece and not sectioned; (2) CS group - the components of each sectioned framework were joined by conventional soldering; and (3) LW group - the components of each sectioned framework were joined by laser welding. The control group consisted of six silver-palladium alloy copings that were not cast together. Two analyses were mperformed: in the first analysis, the framework was screwed only to the first abutment, and in the second analysis, the framework was screwed to both abutments. The prosthetic fit was assessed at a single point using a measuring microscope (Measurescope, Nikon, Japan) and the marginal gap was measured in micrometers. Statistical analysis was performed using analysis of variance (ANOVA), Scheffe's test, Student's t-test, and Mann-Whitney U test. The NS group had larger marginal gaps than the other groups (p<0.01), while the CS and LW groups had a similar degree of misfit with no significant difference between them. The results revealed that, in the case of short-span 3-unit fixed prostheses, the framework should be sectioned and soldered or welded to prevent or reduce marginal gaps between the metal framework and dental abutments.

Influence of retainer design on two-unit cantilever resin-bonded glass fiber reinforced composite fixed dental prostheses: an in vitro and finite element analysis study.

PubMed

Keulemans, Filip; De Jager, Niek; Kleverlaan, Cornelis J; Feilzer, Albert J

2008-10-01

The aim of this study was to evaluate in vitro the influence of retainer design on the strength of two-unit cantilever resin-bonded glass fiber-reinforced composite (FRC) fixed dental prostheses (FDP). Four retainer designs were tested: a proximal box, a step-box, a dual wing, and a step-box-wing. Of each design on 8 human mandibular molars, FRC-FDPs of a premolar size were produced. The FRC framework was made of resin impregnated unidirectional glass fibers (Estenia C&B EG Fiber, Kuraray) and veneered with hybrid resin composite (Estenia C&B, Kuraray). Panavia F 2.0 (Kuraray) was used as resin luting cement. FRC-FDPs were loaded to failure in a universal testing machine. One-way ANOVA and Tukey's post-hoc test were used to evaluate the data. The four designs were analyzed with finite element analysis (FEA) to reveal the stress distribution within the tooth/restoration complex. Significantly lower fracture strengths were observed with inlay-retained FDPs (proximal box: 300 +/- 65 N; step-box: 309 +/- 37 N) compared to wing-retained FDPs (p < 0.05) (step-box-wing: 662 +/- 99 N; dual wing: 697 +/- 67 N). Proximal-box-, step-box-, and step-box-wing-retained FDPs mainly failed with catastrophic cusp fracture (proximal box 100%, step-box 100%, and step-box-wing 75%), while dual-wing-retained FDPs mainly failed at the adhesive interface and/or due to pontic failure (75%). FEA showed more favorable stress distributions within the tooth/restoration complex for dual wing retainers. A dual-wing retainer is the optimal design for replacement of a single premolar by means of a two-unit cantilever FRC-FDPs.

Monolithic and bi-layer CAD/CAM lithium-disilicate versus metal-ceramic fixed dental prostheses: comparison of fracture loads and failure modes after fatigue.

PubMed

Schultheis, Stefan; Strub, Joerg R; Gerds, Thomas A; Guess, Petra C

2013-06-01

The authors analyzed the effect of fatigue on the survival rate and fracture load of monolithic and bi-layer CAD/CAM lithium-disilicate posterior three-unit fixed dental prostheses (FDPs) in comparison to the metal-ceramic gold standard. The authors divided 96 human premolars and molars into three equal groups. Lithium-disilicate ceramic (IPS-e.max-CAD) was milled with the CEREC-3-system in full-anatomic FDP dimensions (monolithic: M-LiCAD) or as framework (Bi-layer: BL-LiCAD) with subsequent hand-layer veneering. Metal-ceramic FDPs (MC) served as control. Single-load-to-failure tests were performed before and after mouth-motion fatigue. No fracture failures occurred during fatigue. Median fracture loads in [N], before and after fatigue were, respectively, as follows: M-LiCAD, 1,298/1,900; BL-LiCAD, 817/699; MC, 1,966/1,818. M-LiCAD and MC FPDs revealed comparable fracture loads and were both significantly higher than BL-LiCAD. M-LiCAD and BL-LiCAD both failed from core/veneer bulk fracture within the connector area. MC failures were limited to ceramic veneer fractures exposing the metal core. Fatigue had no significant effect on any group. Posterior monolithic CAD/CAM fabricated lithium-disilicate FPDs were shown to be fracture resistant with failure load results comparable to the metal-ceramic gold standard. Clinical investigations are needed to confirm these promising laboratory results. Monolithic CAD/CAM fabricated lithium-disilicate FDPs appeared to be a reliable treatment alternative for the posterior load-bearing area, whereas FDPs in bi-layer configuration were susceptible to low load fracture failure.

First clinical experiences with CAD/CAM-fabricated PMMA-based fixed dental prostheses as long-term temporaries.

PubMed

Huettig, Fabian; Prutscher, Andreas; Goldammer, Christoph; Kreutzer, Curt A; Weber, Heiner

2016-01-01

The clinical performance of polymethylmethacrylate (PMMA)-based fixed dental prostheses (FDP) was evaluated in the indication of long-term temporaries. In the current indication of the applied machinable PMMA-based material (Vita CAD-Temp), i.e. temporary crowns and FDPs, 27 patients with compromised dentitions (uncertain dental prognosis or postponement of a removable treatment option) were recruited and 45 FDPs (3 or 4 units, 37 terminal-retained, 8 cantilevered) were inserted. Frameworks were computer-aided design (CAD)/computer-aided manufacturing (CAM)-manufactured after conventional impression taking and labside scanning of stone master casts. A resin-modified hybrid cement material (RelyX Unicem) was used for luting in a conventional protocol. Clinical follow-up was performed biannually. Over an observation time from 2 to 26 months (median 13 months), 11 complications were found in 9 out of 45 PMMA restorations: 4 losses of retention, 5 complete fractures; two of these subsequent to a trepanation for endodontic treatment. Thereby, 3 out of 8 cantilevered FDPs had to be removed within 8 months. Thus, the statistical evaluation included FDPs with abutment at end, only. These standard design FDPs (n = 37) showed a 90.4 % survival rate with a complication-free rate of 88.3 % estimated for an observation time of 16 months. Cantilevered FDPs and reconstructions on abutment teeth with markedly reduced biological prognosis or endodontic intervention yielded a high-failure rate. Terminal-retained FDPs performed clinically well in cases without compromised abutment teeth. PMMA-based material might be used successfully for long-term temporization with 3- to 4-unit FDPs in a standard design over at least one year.

a Review of Retinal Prosthesis Approaches

NASA Astrophysics Data System (ADS)

Kien, Tran Trung; Maul, Tomas; Bargiela, Andrzej

Age-related macular degeneration and retinitis pigmentosa are two of the most common diseases that cause degeneration in the outer retina, which can lead to several visual impairments up to blindness. Vision restoration is an important goal for which several different research approaches are currently being pursued. We are concerned with restoration via retinal prosthetic devices. Prostheses can be implemented intraocularly and extraocularly, which leads to different categories of devices. Cortical Prostheses and Optic Nerve Prostheses are examples of extraocular solutions while Epiretinal Prostheses and Subretinal Prostheses are examples of intraocular solutions. Some of the prostheses that are successfully implanted and tested in animals as well as humans can restore basic visual functions but still have limitations. This paper will give an overview of the current state of art of Retinal Prostheses and compare the advantages and limitations of each type. The purpose of this review is thus to summarize the current technologies and approaches used in developing Retinal Prostheses and therefore to lay a foundation for future designs and research directions.

An in vivo assessment of the effects of using different implant abutment occluding materials on implant microleakage and the peri-implant microbiome

NASA Astrophysics Data System (ADS)

Rubino, Caroline

Microleakage may be a factor in the progression of peri-implant pathology. Microleakage in implant dentistry refers to the passage of bacteria, fluids, molecules or ions between the abutment-implant interface to and from the surrounding periodontal tissues. This creates a zone of inflammation and reservoir of bacteria at the implant-abutment interface. Bone loss typically occurs within the first year of abutment connection and then stabilizes. It has not yet been definitively proven that the occurrence of microleakage cannot contribute to future bone loss or impede the treatment of peri-implant disease. Therefore, strategies to reduce or eliminate microleakage are sought out. Recent evidence demonstrates that the type of implant abutment channel occluding material can affect the amount of microleakage in an in vitro study environment. Thus, we hypothesize that different abutment screw channel occluding materials will affect the amount of observed microleakage, vis-a-vis the correlation between the microflora found on the abutment screw channel occluding material those found in the peri-implant sulcus. Additional objectives include confirming the presence of microleakage in vivo and assessing any impact that different abutment screw channel occluding materials may have on the peri-implant microbiome. Finally, the present study provides an opportunity to further characterize the peri-implant microbiome. Eight fully edentulous patients restored with at dental implants supporting screw-retained fixed hybrid prostheses were included in the study. At the initial appointment (T1), the prostheses were removed and the implants and prostheses were cleaned. The prostheses were then inserted with polytetrafluoroethylene tape (PTFE, TeflonRTM), cotton, polyvinyl siloxane (PVS), or synthetic foam as the implant abutment channel occluding material and sealed over with composite resin. About six months later (T2), the prostheses were removed and the materials collected. Paper points were used to sample the peri-implant sulcus bacteria. All samples were then submitted to DNA purification, polymerase chain reaction (PCR), and sequencing protocols to assess relative numbers of bacterial species. Periodontal parameters were collected at both time points. Overall, our findings support several conclusions. Different implant abutment channel occluding materials appear to have no effect on the amount of observed microleakage and the peri-implant microbiome. Evidence for microleakage was found in the present study, corroborating existing in vivo evidence. Finally, we gained several insights regarding the peri implant microbiome. Of note, the peri-implant microbiome is well described by the classical periodontal microbial complexes, but a large portion consists of bacteria not previously classified into the microbial complexes.

Retrospective cohort study of the clinical performance of 1-stage dental implants.

PubMed

Carr, Alan B; Choi, Yong-Geun; Eckert, Steven E; Desjardins, Ronald P

2003-01-01

To evaluate long-term clinical performance of 1-stage dental implant prostheses at a single clinic, emphasizing clinical and demographic characteristics that affect implant survival. Dental records of all 308 patients (674 implants) treated with 1-stage implants at Mayo Clinic from October 1993 through May 2000 were reviewed from implant placement to last visit. Exposure and outcome variables affecting performance were collected separately to control bias in the data collection process. Additional confounding factors (age and sex) were adjusted with the stratified Cox proportional hazards model. Implant survival was determined by means of a Kaplan-Meier survival estimate. The log-rank test was used to determine the role of clinical and demographic variables in implant survival. The relative risk associated with the possible effect of clinical and demographic variables on implant survival was estimated with the Cox proportional hazards model. The implant survival rate (n = 654 implants) was 97% (mean +/- SD follow-up, 21.0 +/- 18.8 months; range, 1 to 78 months). Performance bias was limited because nearly all patients were treated by 1 prosthodontist. Two implants failed after loading (6 and 9 months). The incidence of complications was less than 4%. Among the implant failures, use of heterogeneous bone graft was associated with 4.8 times more failures than was use of autogenous bone graft (P = .04). After augmentation, delaying implant placement for 5 to 6 months resulted in 8.6 times more failures than the rate after earlier placement (P < .001). Retrospective review of the clinical performance of a 1-stage dental implant system yielded a 97% survival rate, with no failures noted after 13 months. Prosthetic complications were low, especially for fixed implant prostheses. Clinical performance of 1-stage dental implant prostheses between 1993 and 2000 demonstrated a high level of predictability.

Structural stability of posterior retainer design for resin-bonded prostheses: a 3D finite element study.

PubMed

Lin, Jie; Zheng, Zhiqiang; Shinya, Akikazu; Matinlinna, Jukka Pekka; Botelho, Michael George; Shinya, Akiyoshi

2015-09-01

The purpose of this in vitro study was to compare the stress distribution and natural frequency of different shape and thickness retainer designs for maxillary posterior resin-bonded prostheses using finite element (FE) method. A 3D FE model of a three unit posterior resin-bonded prosthesis analysis model was generated. Three different shaped retainer designs, viz. C-shaped (three axial surface wraparounds), D-shaped (three axial surface wraparounds with central groove) and O-shaped (360° wraparounds), and three different thicknesses, viz., 0.4, 0.8, and 1.2 mm, resin-bonded prostheses were used in this study. The resin-bonded prosthesis analysis model was imported into an FE analysis software (ANSYS 10.0, ANSYS, USA) and attribution of material properties. The nodes at the bottom surface of the roots were assigned fixed zero displacement in the three spatial dimensions. A simulated angle of 45° loading of a 100 N force was applied to the node of the pontic lingual cusp surface. The stress distributions and corresponding natural frequencies were analyzed and resolved. The C-shaped retainer for 0.4 mm thickness recorded the greatest von Mises stresses of 71.4 MPa for all three groups. C-shaped, D-shaped and O-shaped retainer presented natural frequencies 3,988, 7,754, and 10,494 Hz, respectively. D-shaped retainer and O-shaped retainer increased natural frequencies and structural rigidity over the traditional C-shaped retainer. The maximum von Mises stresses values of the remaining tooth and prosthesis decreased with greater retainer thickness. D-shaped retainer and O-shaped retainer increased natural frequencies and structural rigidity over the traditional C-shaped retainer.

Immediate occlusal loading of double acid-etched surface titanium implants in 41 consecutive full-arch cases in the mandible and maxilla: 6- to 74-month results.

PubMed

Ibañez, Juan C; Tahhan, Marcelo J; Zamar, Juan A; Menendez, Alicia B; Juaneda, Agustina M; Zamar, Nicolas J; Monqaut, Jose L

2005-11-01

The high success rate of dental implants has changed the quality of life for many patients. Immediate loading finds its application in some clinical cases and certainly adds another modality of treatment for the implant patient. Starting with a few implants immediately loaded with a bar overdenture in the mandible, the concept of immediate loading evolved to loading multiple implants in both the maxilla and mandible. In this investigation, 41 consecutive patients who needed full-arch restorations were treated with 343 double acid-etched surface implants between May 1998 and March 2004. The sample included smokers and bruxers. Twenty-three mandibular and 26 maxillary cases were treated, loading the implants within 48 hours, by using resin provisional prostheses, metal-reinforced provisional prostheses, or definitive prostheses (metal-acrylic or metal-ceramic). All implants were followed for 12 to 74 months. Follow-up consisted of clinical as well as radiographic examination. Furthermore, resonance frequency analysis was done in most of the implants during the last 2 years. The success rate obtained was 99.42% (only two mandibular implants that are still surviving were considered failures). The bone level was measured every year. The average radiographic bone level change was 0.56 mm at 12, 0.76 mm at 24, 0.84 mm at 36, 0.82 mm at 48, 0.83 mm at 60, and 0.94 mm at 72 months. A high success rate can be achieved when double acid-etched surface implants are immediately loaded with fixed full-arch restorations in the maxilla and mandible.

Clinical and Radiographic Assessment of Three-Implant-Supported Fixed-Prosthesis Rehabilitation of the Edentulous Mandible: Immediate Versus Delayed Loading.

PubMed

Primo, Bruno Tochetto; Mezzari, Leonardo Marcos; da Fontoura Frasca, Luís Carlos; Linderman, Raquel; Rivaldo, Elken Gomes

To evaluate and compare the clinical and radiographic outcomes of mandibular rehabilitation with fixed prostheses on three implants with immediate versus delayed loading. The sample comprised 21 patients who underwent treatment with immediate loading and 23 who received delayed loading. All had worn their prostheses for at least 18 months. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, length of cantilever (effort) and resistance arms, presence of plaque on prosthetic abutments, and hygiene of the prosthesis. One implant failed in each group, resulting in a 95.23% treatment success rate with immediate loading and 95.65% with delayed loading (no statistically significant between-group difference). In the immediate-loading group, the mean bone loss was 1.96 ± 0.73 mm around central implants and 1.64 ± 0.84 mm at distal implants. In the delayed-loading group, the mean bone loss was 1.85 ± 0.67 mm around central implants and 1.70 ± 0.77 mm at distal implants. According to Student t test, there was no significant within-group difference in bone loss and no difference between the immediate-loading and delayed-loading groups. The only prosthesis-related complications that differed significantly between groups were "condition of the acrylic base," "occlusion," and "presence of right cover screw." There was no statistically significant association of lever arm ratio with peri-implant bone loss or bone loss on the mesial surfaces compared to the distal surfaces of the distal implants. The three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular edentulous patients with maxillary complete dentures, regardless of whether loading was immediate or delayed, with no difference in peri-implant bone loss.

Distortion of CAD-CAM-fabricated implant-fixed titanium and zirconia complete dental prosthesis frameworks.

PubMed

Al-Meraikhi, Hadi; Yilmaz, Burak; McGlumphy, Edwin; Brantley, William A; Johnston, William M

2018-01-01

Computer-aided design and computer-aided manufacturing (CAD-CAM)-fabricated titanium and zirconia implant-supported fixed dental prostheses have become increasingly popular for restoring patients with complete edentulism. However, the distortion level of these frameworks is not well known. The purpose of this in vitro study was to compare the 3-dimensional (3D) distortion of CAD-CAM zirconia and titanium implant-fixed screw-retained complete dental prostheses. A master edentulous model with 4 implants at the positions of the maxillary first molars and canines was used. Multiunit abutments (Nobel Biocare) secured to the model were digitally scanned using scan bodies and a laboratory scanner (S600 ARTI; Zirkonzahn). Titanium (n=5) and zirconia (n=5) frameworks were milled using a CAD-CAM system (Zirkonzahn M1; Zirkonzahn). All frameworks were scanned using an industrial computed tomography (CT) scanner (Nikon/X-Tek XT H 225kV MCT Micro-Focus). The direct CT scans were reconstructed to generate standard tessellation language (STL) files. To calculate the 3D distortion of the frameworks, STL files of the CT scans were aligned to the CAD model using a sum of the least squares best-fit algorithm. Surface comparison points were placed on the CAD model on the midfacial aspect of all teeth. The 3D distortion of each direct scan to the CAD model was calculated. In addition, color maps of the scan-to-CAD comparison were constructed using a ±0.500 mm color scale range. Both materials exhibited distortion; however, no significant difference was found in the amount of distortion from the CAD model between the materials (P=.747). Absolute values of deviations from the CAD model were evident in the x and y plane and less so in the z direction. Zirconia and titanium frameworks showed similar 3D distortion compared with the CAD model for the tested CAD-CAM and implant systems. The distortion was more pronounced in the horizontal and sagittal plane than in the vertical plane. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

[Distal stenosis of the choledochus in chronic pancreatitis: endoscopic drainage or operation?].

PubMed

Meyer, W; Bödeker, H; Schönekäs, H; Gebhardt, C

1996-09-01

With the less invasive techniques for complications regarding chronic pancreatitis, such as tubular choledochostenosis, the endoscopic transpapillary bile drainage therapy by means of endoprosthesis has undergone an enlargement of its indications range. Blocked and dislocated prostheses, however, further raise the already existing possibility of septic complications. With 15 out of 43 patients undergoing medium-term endodrainage treatment, we observed different resulting conditions of chronic cholestasis, such as abscess-forming cholangitis, hepatic abscesses, retroperitoneal phlegmon and sepsis up to biliary cirrhosis. Thus, in the case of chronic pancreatitis we still regard choledochostenosis- which, due to scarring, is mostly fixed-as a primary indication for operation.

Interdisciplinary treatment for a compensated Class II partially edentulous malocclusion: Orthodontic creation of a posterior implant site.

PubMed

Chiu, Grace; Chang, Chris; Roberts, W Eugene

2018-03-01

A 36-year-old woman with good periodontal health sought treatment for a compensated Class II partially edentulous malocclusion associated with a steep mandibular plane (SN-MP, 45°), 9 missing teeth, a 3-mm midline discrepancy, and compromised posterior occlusal function. She had multiple carious lesions, a failing fixed prostheses in the mandibular right quadrant replacing the right first molar, and a severely atrophic edentulous ridge in the area around the mandibular left first and second molars. After restoration of the caries, the mandibular left third molar served as anchorage to correct the mandibular arch crowding. The mandibular left second premolar was retracted with a light force of 2 oz (about 28.3 cN) on the buccal and lingual surfaces to create an implant site between the premolars. Modest lateral root resorption was noted on the distal surface of the mandibular left second premolar after about 7 mm of distal translation in 7 months. Six months later, implants were placed in the mandibular left and right quadrants; the spaces were retained with the fixed appliance for 5 months and a removable retainer for 1 month. Poor cooperation resulted in relapse of the mandibular left second premolar back into the implant site, and it was necessary to reopen the space. When the mandibular left fixture was uncovered, a 3-mm deep osseous defect on the distobuccal surface was found; it was an area of relatively immature bundle bone, because the distal aspect of the space was reopened after the relapse. Subsequent bone grafting resulted in good osseous support of the implant-supported prosthesis. The relatively thin band of attached gingiva on the implant at the mandibular right first molar healed with a recessed contour that was susceptible to food impaction. A free gingival graft restored soft tissue form and function. This severe malocclusion with a discrepancy index value of 28 was treated to an excellent outcome in 38 months of interdisciplinary treatment. The Cast-Radiograph Evaluation score was 13. However, the treatment was complicated by routine relapse and implant osseous support problems. Retreatment of space opening and 2 additional surgeries were required to correct an osseous defect and an inadequate soft tissue contour. Orthodontic treatment is a viable option for creating implant sites, but fixed retention is required until the prosthesis is delivered. Bone augmentation is indicated at the time of implant placement to offset expected bone loss. Complex restorative treatment may result in routine complications that are effectively managed with interdisciplinary care. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Biomechanical considerations on tooth-implant supported fixed partial dentures

PubMed Central

Calvani, Pasquale; Hirayama, Hiroshi

2012-01-01

This article discusses the connection of teeth to implants, in order to restore partial edentulism. The main problem arising from this connection is tooth intrusion, which can occur in up to 7.3% of the cases. The justification of this complication is being attempted through the perspective of biomechanics of the involved anatomical structures, that is, the periodontal ligament and the bone, as well as that of the teeth- and implant-supported fixed partial dentures. PMID:23255882

Biomechanical evaluation of two types of short-stemmed hip prostheses compared to the trust plate prosthesis by three-dimensional measurement of micromotions.

PubMed

Fottner, Andreas; Schmid, Markus; Birkenmaier, Christof; Mazoochian, Farhad; Plitz, Wolfgang; Volkmar, Jansson

2009-06-01

Stemless and short-stemmed hip prostheses have been developed to preserve femoral bone stock. While all these prostheses claim a more or less physiological load transfer, clinical long-term results are only available for the stemless thrust plate prosthesis. In this study, the in vitro primary stability of the thrust plate prosthesis was compared to two types of short-stemmed prostheses. In addition to the well-established Mayo prosthesis, the modular Metha prosthesis was tested using cone adapters with 130 degrees and 140 degrees neck-shaft-angles. The prostheses were implanted in composite femurs and loaded dynamically (300-1700 N). Three-dimensional micromotions at the bone-prosthesis interface were measured. In addition, the three-dimensional deformations at the surface of the composite femur were measured to gain data on the strain distribution. For all tested prostheses, the micromotions did not exceed 150 microm, the critical value for osteointegration. The thrust plate prosthesis revealed similar motions as the short-stemmed prostheses. The short-stemmed prosthesis with the 130 degrees cone tended to have the highest micromotions of all tested short-stemmed prostheses. The thrust plate prosthesis revealed the lowest alteration of bone surface deformation after implantation. The comparably low micromotions of the thrust plate prosthesis and the short-stemmed prostheses should be conducive to osseous integration. The higher alteration of load transmission after implantation reveals a higher risk of stress shielding for the short-stemmed prostheses.

The effect of adhesive strength of hydroxyapatite coating on the stability of hydroxyapatite-coated prostheses in vivo at the early stage of implantation

PubMed Central

Duan, Yonghong; Zhu, Shu; Guo, Fei; Zhu, Jinyu; Li, Mao; Ma, Jie

2012-01-01

Introduction With the increase in joint revision surgery after arthroplasty, defects of hydroxyapatite (HA)-coated prostheses have been observed increasingly often. These defects adversely affect the prosthetic stability in vivo. This study has analyzed the potential effect of the adhesive strength of HA coating on the stability of HA-coated prostheses in vivo after its implantation. Material and methods Sixty experimental rabbits were divided into HA- and Ti-coated groups. HA-coated prostheses were implanted into the bilateral epicondyle of rabbits femurs. Ti-coated prostheses were implanted as control. At different time points(4, 9, and 15 weeks) after implantation, bone tissue samples were fetched out respectively for histomorphometric analysis. Push-out testing was used to detect the ultimate shear strength at the bone-prosthesis interface. Scanning electron microscope (SEM) observation and energy-dispersive X-ray spectroscopy (EDX) analysis were used to observe the changes in surface composition of the prostheses after the ultimate shear strength testing. The coating adhesive strength of two kinds of coatings were also examined by scratch testing. Results Hydroxyapatite coating has an obvious advantage in facilitating osteogenesis and its plays a critical role in the stability of prostheses. However, the ultimate shear strength of HA-coated prostheses is much lower than that of Ti-coated implants (p < 0.01). Further study has demonstrated that the stability of HA-coated prostheses in vivo is affected by the relatively low adhesive strength between coating and substrate. Conclusions Obvious advantage in facilitating osteogenesis around HA-coated prostheses is not the only factor that determines the stability of prostheses in vivo. PMID:22661990

Effects of Impression Material, Impression Tray Type, and Type of Partial Edentulism on the Fit of Cobalt-Chromium Partial Denture Frameworks on Initial Clinical Insertion: A Retrospective Clinical Evaluation.

PubMed

Baig, Mirza Rustum; Akbar, Jaber Hussain; Qudeimat, Muawia; Omar, Ridwaan

2018-02-15

To evaluate the effects of impression material, impression tray type, and type of partial edentulism (ie, Kennedy class) on the accuracy of fit of cobalt-chromium (Co-Cr) partial removable dental prostheses (PRDP) in terms of the number of fabricated frameworks required until the attainment of adequate fit. Electronic case documentations of 120 partially edentulous patients provided with Co-Cr PRDP treatment for one or both arches were examined. Statistical analyses of data were performed using analysis of variance and Tukey honest significant difference test to compare the relationships between the different factors and the number of frameworks that needed to be fabricated for each patient (α = .05). Statistical analysis of data derived from 143 records (69 maxillary and 74 mandibular) revealed no significant correlation between impression material, tray type, or Kennedy class and the number of construction attempts for the pooled or individual arch data (P ≥ .05). In PRDP treatment, alginate can be chosen as a first-choice material, and metal stock trays can be a preferred option for making final impressions to fabricate Co-Cr frameworks.

Tooth replacement for partially dentate elders: A willingness-to-pay analysis.

PubMed

McKenna, G; Tada, S; Woods, N; Hayes, M; DaMata, C; Allen, P F

2016-10-01

The primary aim of this study was to investigate partially dentate elders' willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures (RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups' WTP for dental implant treatment. 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n=27) and SDA (n=28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients' social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted. The median age for the patient sample was 72.0 years (IQR: 71-75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500-650) than those patients who had received SDA treatment (€500; IQR: 450-550) (p=0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600-650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500-600) (p<0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500-1000). Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Toward Balance Recovery With Leg Prostheses Using Neuromuscular Model Control

PubMed Central

Geyer, Hartmut

2016-01-01

Objective Lower limb amputees are at high risk of falling as current prosthetic legs provide only limited functionality for recovering balance after unexpected disturbances. For instance, the most established control method used on powered leg prostheses tracks local joint impedance functions without taking the global function of the leg in balance recovery into account. Here we explore an alternative control policy for powered transfemoral prostheses that considers the global leg function and is based on a neuromuscular model of human locomotion. Methods We adapt this model to describe and simulate an amputee walking with a powered prosthesis using the proposed control, and evaluate the gait robustness when confronted with rough ground and swing leg disturbances. We then implement and partially evaluate the resulting controller on a leg prosthesis prototype worn by a non-amputee user. Results In simulation, the proposed prosthesis control leads to gaits that are more robust than those obtained by the impedance control method. The initial hardware experiments with the prosthesis prototype show that the proposed control reproduces normal walking patterns qualitatively and effectively responds to disturbances in early and late swing. However, the response to mid-swing disturbances neither replicates human responses nor averts falls. Conclusions The neuromuscular model control is a promising alternative to existing prosthesis controls, although further research will need to improve on the initial implementation and determine how well these results transfer to amputee gait. Significance This work provides a potential avenue for future development of control policies that help improve amputee balance recovery. PMID:26315935

Image Processing Strategies Based on a Visual Saliency Model for Object Recognition Under Simulated Prosthetic Vision.

PubMed

Wang, Jing; Li, Heng; Fu, Weizhen; Chen, Yao; Li, Liming; Lyu, Qing; Han, Tingting; Chai, Xinyu

2016-01-01

Retinal prostheses have the potential to restore partial vision. Object recognition in scenes of daily life is one of the essential tasks for implant wearers. Still limited by the low-resolution visual percepts provided by retinal prostheses, it is important to investigate and apply image processing methods to convey more useful visual information to the wearers. We proposed two image processing strategies based on Itti's visual saliency map, region of interest (ROI) extraction, and image segmentation. Itti's saliency model generated a saliency map from the original image, in which salient regions were grouped into ROI by the fuzzy c-means clustering. Then Grabcut generated a proto-object from the ROI labeled image which was recombined with background and enhanced in two ways--8-4 separated pixelization (8-4 SP) and background edge extraction (BEE). Results showed that both 8-4 SP and BEE had significantly higher recognition accuracy in comparison with direct pixelization (DP). Each saliency-based image processing strategy was subject to the performance of image segmentation. Under good and perfect segmentation conditions, BEE and 8-4 SP obtained noticeably higher recognition accuracy than DP, and under bad segmentation condition, only BEE boosted the performance. The application of saliency-based image processing strategies was verified to be beneficial to object recognition in daily scenes under simulated prosthetic vision. They are hoped to help the development of the image processing module for future retinal prostheses, and thus provide more benefit for the patients. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Full-mouth rehabilitation with immediate loading of implants inserted with computer-guided flap-less surgery: a 3-year multicenter clinical evaluation with oral health impact profile.

PubMed

Marra, Roberto; Acocella, Alessandro; Rispoli, Alessandra; Sacco, Roberto; Ganz, Scott D; Blasi, Andrea

2013-10-01

The purpose of this report is to present the clinical outcomes and patients' satisfaction of full-mouth rehabilitation using computer-aided flapless implant placement and immediate loading of a prefabricated prosthesis. The study included 30 consecutive fully edentulous patients who received 312 implants. Mandible and maxilla were treated in the same surgical session with computer-guided flapless approach using the NobelGuide protocol. Prefabricated screw-retained fixed prostheses were inserted at the end of surgery. Clinical and radiographic evaluations were assessed at 6, 12, and 36 months. At baseline and 6 months after surgery, patients answered Oral Health Impact Profile in Edentulous Adults questionnaire to assess satisfaction. The implant survival rate was 97.9%, whereas the average marginal bone loss was 1.9 ± 1.3 mm after 3 years. At 6 months, patients showed significantly greater satisfaction with their fixed rehabilitation when compared with conventional dentures. The results of this study confirm that rehabilitation with a prefabricated fixed prosthesis supported by implants placed with NobelGuide protocol is a viable and predictable treatment and increases patients' satisfaction and improves oral health-related quality of life.

Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty.

PubMed

Van Hamersveld, Koen T; Marang-Van De Mheen, Perla J; Van Der Heide, Huub J L; Van Der Linden-Van Der Zwaag, Henrica M J; Valstar, Edward R; Nelissen, Rob G H H

2018-04-01

Background and purpose - Mobile-bearing total knee prostheses (TKPs) were developed in the 1970s in an attempt to increase function and improve implant longevity. However, modern fixed-bearing designs like the single-radius TKP may provide similar advantages. We compared tibial component migration measured with radiostereometric analysis (RSA) and clinical outcome of otherwise similarly designed cemented fixed-bearing and mobile-bearing single-radius TKPs. Patients and methods - RSA measurements and clinical scores were assessed in 46 randomized patients at baseline, 6 months, 1 year, and annually thereafter up to 6 years postoperatively. A linear mixed-effects model was used to analyze the repeated measurements. Results - Both groups showed comparable migration (p = 0.3), with a mean migration at 6-year follow-up of 0.90 mm (95% CI 0.49-1.41) for the fixed-bearing group compared with 1.22 mm (95% CI 0.75-1.80) for the mobile-bearing group. Clinical outcomes were similar between groups. 1 fixed-bearing knee was revised for aseptic loosening after 6 years and 2 knees (1 in each group) were revised for late infection. 2 knees (1 in each group) were suspected for loosening due to excessive migration. Another mobile-bearing knee was revised after an insert dislocation due to failure of the locking mechanism 6 weeks postoperatively, after which study inclusion was preliminary terminated. Interpretation - Fixed-bearing and mobile-bearing single-radius TKPs showed similar migration. The latter may, however, expose patients to more complex surgical techniques and risks such as insert dislocations inherent to this rotating-platform design.

Fixed point theorems for generalized contractions in ordered metric spaces

NASA Astrophysics Data System (ADS)

O'Regan, Donal; Petrusel, Adrian

2008-05-01

The purpose of this paper is to present some fixed point results for self-generalized contractions in ordered metric spaces. Our results generalize and extend some recent results of A.C.M. Ran, M.C. Reurings [A.C.M. Ran, MEC. Reurings, A fixed point theorem in partially ordered sets and some applications to matrix equations, Proc. Amer. Math. Soc. 132 (2004) 1435-1443], J.J. Nieto, R. Rodríguez-López [J.J. Nieto, R. Rodríguez-López, Contractive mapping theorems in partially ordered sets and applications to ordinary differential equations, Order 22 (2005) 223-239; J.J. Nieto, R. Rodríguez-López, Existence and uniqueness of fixed points in partially ordered sets and applications to ordinary differential equations, Acta Math. Sin. (Engl. Ser.) 23 (2007) 2205-2212], J.J. Nieto, R.L. Pouso, R. Rodríguez-López [J.J. Nieto, R.L. Pouso, R. Rodríguez-López, Fixed point theorem theorems in ordered abstract sets, Proc. Amer. Math. Soc. 135 (2007) 2505-2517], A. Petrusel, I.A. Rus [A. Petrusel, I.A. Rus, Fixed point theorems in ordered L-spaces, Proc. Amer. Math. Soc. 134 (2006) 411-418] and R.P. Agarwal, M.A. El-Gebeily, D. O'Regan [R.P. Agarwal, M.A. El-Gebeily, D. O'Regan, Generalized contractions in partially ordered metric spaces, Appl. Anal., in press]. As applications, existence and uniqueness results for Fredholm and Volterra type integral equations are given.

A System Approach to Navy Medical Education and Training. Appendix 44. Competency Curriculum for Dental Assistant.

DTIC Science & Technology

1974-08-31

Prosthodontic Appliances - Partial Dentures .... ....... ....... .... 59 2. Removable Prosthodontic Appliances - Full Dentures ..... ........... . 60 3...PROCEDURES I This unit includes the following Modules: Number Title Page 1 Removable Prosthodontic Appliances - Partial Dentures 59. ......... ...... 2...Removable Prostbodontic Appliances - Full Dentures ..... ...... a .. .. .. . 60 3 Fixed Prosthodontic Appliances - Fixed Bridge. . 61 4 Mouthquard

[Time course of microbial colonization of different voice prostheses].

PubMed

Schuldt, T; Dommerich, S; Pau, H-W; Kramp, B

2010-10-01

For the vocal rehabilitation of laryngectomized patients, voice prostheses are actually one of the best known methods. Caused by the surface colonisation with bacteria and fungi the life time of the prostheses is limited to 3-4 months. In a time period of 127 months we analysed the surface colonisation of 118 voice prostheses. The mean life time of the prostheses was 156 days. In reference to the prosthesis model we also recorded different times of usage (ESKA-Herrmann 141, Provox 2 184 and Provox 1 204 days (p>0.05)). In the microbiological examination the dominating bacteria were S. aureus, Klebsiella sp. and Proteus sp. It was possible to cultivate all these bacteria on every type of prosthesis used in the study. In addition C. albicans, C. glabrata, C. krusei and C. tropicalis were the main fungi on the silicone surface. Thereby a more frequent colonisation with C. krusei on ESKA-Herrmann prostheses was measured, caused by the bigger contact area with saliva on this model (p=0.034). Because of the similar position and way of function, all types of voice prostheses are colonized by almost the same species of bacteria and fungi. But in dependency of the type an affinity of individual species to special prostheses exist. The knowledge of these individual affinities is necessary for the further development of voice prostheses. Furthermore the diversity of bacteria and fungi species showed a level of saturation on the surface. This is caused by the limited space on the silicone prostheses. © Georg Thieme Verlag KG Stuttgart · New York.

Mechanical characterization and comparison of energy storage and return prostheses.

PubMed

Rigney, Stacey M; Simmons, Anne; Kark, Lauren

2017-03-01

The suitability of finite element analysis (FEA) for standardizing the mechanical characterization of energy storage and return (ESAR) prostheses was investigated. A methodology consisting of both experimental and numerical analysis was proposed and trialed for the Vari-flex ® Modular TM , Flex-foot Cheetah and Cheetah Xtreme by Össur ® and a 1E90 Sprinter by Ottobock ® . Gait analysis was conducted to determine suitable orientation angles for non-destructive testing (NDT) of the ESAR prostheses followed by a quasi-static inverse FEA procedure within COMSOL Multiphysics ® , where the NDT conditions were replicated to determine the homogenized material properties of the prostheses. The prostheses' loading response under bodyweight for an 80kg person was then simulated, using both Eigenfrequency and time-dependent analysis. The apparent stiffness under bodyweight was determined to be 94.7, 48.6, 57.4 and 65.0Nmm -1 for the Vari-flex ® Modular TM , Flex-foot Cheetah, Cheetah Xtreme and 1E90 Sprinter, respectively. Both the energy stored and returned by the prostheses varied negatively with stiffness, yet the overall efficiency of the prostheses were similar, at 52.7, 52.0, 51.7 and 52.4% for the abovementioned prostheses. The proposed methodology allows the standardized assessment and comparison of ESAR prostheses without the confounding influences of subject-specific gait characteristics. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Masseter muscle fatigue during sustained clenching in subjects with complete dentures, implant-supported prostheses, and natural teeth.

PubMed

Jacobs, R; van Steenberghe, D

1993-03-01

A sustained submaximal (50%) clenching effort was performed in four patient groups to establish whether implant-supported prosthetic reconstructions influence myoelectrical signal parameters. The first group consisted of patients with natural teeth in both jaws. The other three groups consisted of patients who were edentulous in both jaws: one group had complete dentures; one had an overdenture in the mandible on two implants connected by a bar; and the third had an implant-supported fixed prosthesis in either the maxilla or the mandible. Surface electromyography indicated an increased myoelectrical output level that paralleled a higher bite force level for implant-supported reconstructions compared with complete dentures. Power spectrum analysis revealed a downward shift of the mean power frequency during sustained clenching in all groups except the implant-supported fixed prosthesis. The absence of a spectral shift in the latter group probably reflected a fear of biting too hard and fracturing the prosthesis.

[Long-term observation of 920 porcelain fused to metal prostheses].

PubMed

Jiang, Yong-Lin; Sun, Jian; Weng, Wei-Min; Zhang, Fu-Qiang

2006-10-01

To evaluate the long-term clinical results of porcelain fused to metal prostheses. Since January 1995, 920 porcelain fused to metal prostheses were fabricated. The long-term outcome were evaluated according to the condition of the prosthese, abutment and the periodontal tissue in the respects of successful rate and causes of failure. 74 patients were found to be during the follow up period, including 36 anterior crowns (46 units), 18 posterior crowns (22 units), 12 percentage of anterior bridges and 8 posterior bridges. The overall failure rate was 8.04%, 4.84% for crown, 8.77% for bridge. The failed prostheses was 5.39%. Porcelain fused to metal prostheses is an ideal method for restoration. The standard process both for the clinician and the technician must be obeyed to improve the success rate.

Combined tooth-implant-supported telescopic prostheses in a midterm follow-up of > 2 years.

PubMed

Joda, Tim

2013-01-01

The aim of this trial was to evaluate telescopic-retained prostheses on teeth and implants. Ten patients with a mean of 2.8 teeth received strategic implants to achieve triangular/quadrangular support. Survival and complication rates were estimated for telescopic abutments and prostheses. After a mean observation period of > 2 years, no abutment was lost and all prostheses were in function. Complication rates were low, and maintenance services were limited to minor interventions. Combined tooth-implant-retained telescopic prostheses improve prosthetic support and offer successful function over a midterm period in patients with a severely reduced dentition.

Additive Manufacturing Techniques in Prosthodontics: Where Do We Currently Stand? A Critical Review.

PubMed

Alharbi, Nawal; Wismeijer, Daniel; Osman, Reham B

The aim of this article was to critically review the current application of additive manufacturing (AM)/3D-printing techniques in prosthodontics and to highlight the influence of various technical factors involved in different AM technologies. A standard approach of searching MEDLINE, EMBASE, and Google Scholar databases was followed. The following search terms were used: (Prosth* OR Restoration) AND (Prototype OR Additive Manufacture* OR Compute* OR 3D-print* OR CAD/CAM) AND (Dentistry OR Dental). Hand searching the reference lists of the included articles and personal connections revealed additional relevant articles. Selection criteria were any article written in English and reporting on the application of AM in prosthodontics from 1990 to February 2016. From a total of 4,290 articles identified, 33 were seen as relevant. Of these, 3 were narrative reviews, 18 were in vitro studies, and 12 were clinical in vivo studies. Different AM technologies are applied in prosthodontics, directly and indirectly for the fabrication of fixed metal copings, metal frameworks for removable partial dentures, and plastic mock-ups and resin patterns for further conventional metal castings. Technical factors involved in different AM techniques influence the overall quality, the mechanical properties of the printed parts, and the total cost and manufacturing time. AM is promising and offers new possibilities in the field of prosthodontics, though its application is still limited. An understanding of these limitations and of developments in material science is crucial prior to considering AM as an acceptable method for the fabrication of dental prostheses.

Fixed Point Results of Locally Contractive Mappings in Ordered Quasi-Partial Metric Spaces

PubMed Central

Arshad, Muhammad; Ahmad, Jamshaid

2013-01-01

Fixed point results for a self-map satisfying locally contractive conditions on a closed ball in an ordered 0-complete quasi-partial metric space have been established. Instead of monotone mapping, the notion of dominated mappings is applied. We have used weaker metric, weaker contractive conditions, and weaker restrictions to obtain unique fixed points. An example is given which shows that how this result can be used when the corresponding results cannot. Our results generalize, extend, and improve several well-known conventional results. PMID:24062629

Wireless technologies for closed-loop retinal prostheses.

PubMed

Ng, David C; Bai, Shun; Yang, Jiawei; Tran, Nhan; Skafidas, Efstratios

2009-12-01

In this paper, we discuss various technologies needed to develop retinal prostheses with wireless power and data telemetry operation. In addition to the need to communicate with the implanted device, supply of power to the retinal prosthesis is especially difficult. This is because, in the implanted state, the device is not fixed in position due to constant motion of the eye. Furthermore, a retinal prosthesis incorporating a high density electrode array of more than 1000 electrodes is expected to consume approximately 45 mW of power and require 300 kbps of image and stimulation data. The front end of the wireless power and data transmission, the antenna, needs to be small compared to the size of the eye. Also, the wireless module is expected to operate in the reactive near-field region due to small separation between the transmit and receive antennas compared to their size and corresponding operating wavelength. An inductive link is studied as a means to transfer power and for data telemetry between the implant and external unit. In this work, the use of integrated circuit and microfabrication technologies for implementing inductive links is discussed. A closed-loop approach is taken to improve performance and reach optimum operation condition. Design and simulation data are presented as the basis for development of viable wireless module prototypes.

Wireless technologies for closed-loop retinal prostheses

NASA Astrophysics Data System (ADS)

Ng, David C.; Bai, Shun; Yang, Jiawei; Tran, Nhan; Skafidas, Efstratios

2009-12-01

In this paper, we discuss various technologies needed to develop retinal prostheses with wireless power and data telemetry operation. In addition to the need to communicate with the implanted device, supply of power to the retinal prosthesis is especially difficult. This is because, in the implanted state, the device is not fixed in position due to constant motion of the eye. Furthermore, a retinal prosthesis incorporating a high density electrode array of more than 1000 electrodes is expected to consume approximately 45 mW of power and require 300 kbps of image and stimulation data. The front end of the wireless power and data transmission, the antenna, needs to be small compared to the size of the eye. Also, the wireless module is expected to operate in the reactive near-field region due to small separation between the transmit and receive antennas compared to their size and corresponding operating wavelength. An inductive link is studied as a means to transfer power and for data telemetry between the implant and external unit. In this work, the use of integrated circuit and microfabrication technologies for implementing inductive links is discussed. A closed-loop approach is taken to improve performance and reach optimum operation condition. Design and simulation data are presented as the basis for development of viable wireless module prototypes.

Comparison of bone-anchored prostheses and socket prostheses for patients with a lower extremity amputation: a systematic review.

PubMed

Leijendekkers, Ruud A; van Hinte, Gerben; Frölke, Jan Paul; van de Meent, Hendrik; Nijhuis-van der Sanden, Maria W G; Staal, J Bart

2017-06-01

This study aimed to provide an overview of a) the used measurement instruments in studies evaluating effects on quality of life (QoL), function, activity and participation level in patients with a lower extremity amputation using bone-anchored prostheses compared to socket prostheses and b) the effects themselves. A systematic literature search was conducted in MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science. Included studies compared QoL, function, activity and/or participation level in patients with bone-anchored or socket prostheses. A best-evidence synthesis was performed. Out of 226 studies, five cohort and two cross-sectional studies were eligible for inclusion, all had methodological shortcomings. These studies used 10 different measurement instruments and two separate questions to assess outcome. Bone-anchored prostheses were associated with better condition-specific QoL and better outcomes on several of the physical QoL subscales, outcomes on the physical bodily pain subscale were inconclusive. Outcomes on function and activity level increased, no change was found at participation level. The level of evidence was limited. There is a need for a standard set of instruments. There was limited evidence that bone-anchored prostheses resulted in higher QoL, function and activity levels than socket prostheses, in patients with socket-related problems. Implications for Rehabilitation Use of bone-anchored prostheses in combination with intensive outpatient rehabilitation may improve QoL, function and activity level compared with socket prosthesis use in patients with a transfemoral amputation and socket-related problems. All clinicians and researchers involved with bone-anchored prostheses should use and publish data on QoL, function, activity and participation level. There needs to be an agreement on a standard set of instruments so that interventions for patients with a lower extremity amputation are assessed consistently.

[Evolution of the number and type of penile prostheses implanted in France for erectile dysfunction: Analysis of French national coding database (2006-2013)].

PubMed

Lipsker, A; Saljoghi, R; Lecuelle, D; Caillet, K; Alezra, E; Le Roux, F; Demailly, M; Saint, F

2016-09-01

Patients who are not responding to injectable and/or vacuum oral pharmacological treatments can receive a penile prosthesis. Three types of penile prostheses are used in France: rigid, semi-rigid and inflatable prostheses 3-piece or 2-piece. We have assessed the National surgical insertion practices between 2006 and 2013 (number of prostheses insertions, types, procedure locations, number of surgeons and distribution [public or private sectors]). Data analysis from the French Technical Agency of Information on Hospitals (ATIH) (2006-2013) using the common classification of medical acts (CCAM) and after code extractions related to this surgery (JHLA002, JHLA003, JHLA004). Between 2006 and 2013, the number of penile implants in France doubled (307 to 633), inflatable penile prostheses with an extracavernous component remained the most frequently used (87 %) (228 to 552) (+142 %). The use of semi-rigid prostheses declined by 26.7 %. The distribution between the private and public sector was close to 1 in 2013. More than half of French penile prostheses were implanted in three regions (Île-de-France, Languedoc-Roussillon, Rhône-Alpes). Nearly 62 % of surgeons implanted only one or two three-compartment prostheses in 2013. The number of penile prostheses in France doubled between 2006 and 2013. Three regions were particularly active as far as this surgery is concerned (Île-de-France, Languedoc-Roussillon, Rhône-Alpes). They were boosted by 5 surgeons with more than 20 prostheses surgeries a year. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Surface properties of polyetheretherketone after different laboratory and chairside polishing protocols.

PubMed

Heimer, Sina; Schmidlin, Patrick R; Roos, Malgorzata; Stawarczyk, Bogna

2017-03-01

Polyetheretherketone (PEEK) can be used as a framework material for fixed dental prostheses. However, information about laboratory and chairside polishing methods is still scarce. The purpose of this in vitro study was to determine the effects of laboratory and chairside polishing methods on the surface roughness (SR) and surface free energy (SFE) of PEEK, an autopolymerizing poly(methyl methacrylate), and a veneering composite resin. For each of the 3 materials, 80 specimens were prepared (N=240) and divided into 7 polishing groups and 1 control group (n=10). The 7 groups were split into 4 laboratory protocols: polishing paste (Abraso), a second polishing paste (Opal L), silicone polisher (Ceragum), and diamond grinder (Diagen-Turbo grinder). The other 3 groups were chairside protocols: rainbow technique (Super-Snap kit), polishing paste (Prisma gloss), and a polishing system (Enhance finishing). Machine polishing with SiC P4000 served as the control treatment. The protocols' average SRs and SFEs were measured, and their surface topographies were evaluated with scanning electron microscopy (SEM). The logarithmically transformed data were analyzed using covariance analysis, 2-way and 1-way ANOVA, and partial correlation (α=.05). The polishing protocol exerted the highest influence on SR and SFE values (P<.001; SR: partial eta squared η P 2 =.970; SFE: η P 2 =.450), followed by material group (P<.001, SR: η P 2 =.319; SFE: η P 2 =.429). The interaction effect of the binary combinations of the 2 independent parameters (polishing protocol and material group) was also significant (P<.001, SR: η P 2 =.681; SFE: η P 2 =.365). Chairside methods presented lower SR values than laboratory methods, and specimens polished using the 2-body mode showed higher SR than did specimens polished using the 3-body mode. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Intraoral scanners in dentistry: a review of the current literature.

PubMed

Mangano, Francesco; Gandolfi, Andrea; Luongo, Giuseppe; Logozzo, Silvia

2017-12-12

Intraoral scanners (IOS) are devices for capturing direct optical impressions in dentistry. The purpose of this narrative review on the use of IOS was to: (1) identify the advantages/disadvantages of using optical impressions compared to conventional impressions; (2) investigate if optical impressions are as accurate as conventional impressions; (3) evaluate the differences between the IOS currently available commercially; (4) determine the current clinical applications/limitations in the use of IOS. Electronic database searches were performed using specific keywords and MeSH terms. The searches were confined to full-text articles written in English and published in peer-reviewed journals between January 2007 and June 2017. One hundred thirty-two studies were included in the present review; among them, 20 were previous literature reviews, 78 were in vivo clinical studies (6 randomized controlled/crossover trials, 31 controlled/comparative studies; 24 cohort studies/case series; 17 case reports) and 34 were in vitro comparative studies. Optical impressions reduce patient discomfort; IOS are time-efficient and simplify clinical procedures for the dentist, eliminating plaster models and allowing better communication with the dental technician and with patients; however, with IOS, it can be difficult to detect deep margin lines in prepared teeth and/or in case of bleeding, there is a learning curve, and there are purchasing and managing costs. The current IOS are sufficiently accurate for capturing impressions for fabricating a whole series of prosthetic restorations (inlays/onlays, copings and frameworks, single crowns and fixed partial dentures) on both natural teeth and implants; in addition, they can be used for smile design, and to fabricate posts and cores, removable partial prostheses and obturators. The literature to date does not support the use of IOS in long-span restorations with natural teeth or implants. Finally, IOS can be integrated in implant dentistry for guided surgery and in orthodontics for fabricating aligners and custom-made devices.

Using CAD/CAM technology to create a 10-unit zirconia fixed partial denture--a UTHSCSA dental school case report.

PubMed

Zimmermann, Richard; Seitz, Stefanie; Magness, Brent; Wieck, Blaine

2013-10-01

From diagnosis and treatment planning to the materials being used, technology is changing dentistry. New materials are providing dentists greater options for treatment, while technology is streamlining the workflow in the office and dental laboratory. Traditionally the creation of a long-span fixed partial denture was a labor intense project--from waxing up the prosthesis--to stacking of the porecelain. For larger frameworks, it was recommended for the dentist to bring in the patient in for a framework try-in. However, advances in both CAD/CAM technology and dental materials are revolutionizing the way dentistry is being done. The following describes the fabrication of a 10-unit full contour zirconia fixed partial denture completed in the pre-doctorate program at UTHSCSA Dental School.

Long-term results after artificial iris implantation in patients with aniridia.

PubMed

Rickmann, Annekatrin; Szurman, Peter; Januschowski, Kai; Waizel, Maria; Spitzer, Martin S; Boden, Karl T; Szurman, Gesine B

2016-07-01

The custom-made, flexible artificial iris developed by HumanOptics and Koch can reconstruct the anterior segment of patients with aniridia. The aim of this study was to evaluate the long-term clinical outcome and complication spectrum after artificial iris implantation and the role of the embedded fiber mesh in view of specific complications. In this retrospective interventional case series, patients received an artificial iris between 2004 and 2013. Only eyes with a minimum follow-up period of 2 years were included. Indications were congenital, traumatic, or iatrogenic aniridia. The artificial iris was used either with or without embedded fiber mesh for partial or full prostheses. We included 34 patients (mean age 48.8 years; SD ±17.2) with a mean follow-up of 50.0 months (SD ±18.9 months). No repositioning of prostheses was necessary. In cases of keratopathy (17.6 %) visual function increased from baseline mean 1.6 logMAR (SD ±0.7) to 1.2 logMAR (SD ±0.7) after artificial iris implantation. The remaining iris tissue darkened during the follow-up in 23.5 % (83.3 % with and 10.7 % without mesh), 8.8 % developed glaucoma (50 % with and 0 % without mesh) and 14.7 % needed consecutive surgery after prostheses implantation (50 % with and 7.1 % without mesh). In three out of seven trauma cases (42.9 %) silicone oil was spilled into the anterior chamber after 2.5 years on average. The artificial iris prosthesis revealed a good clinical outcome in terms of long-term stability, cosmetic appearance, visual function, and represents a good functional iris diaphragm for compartmentalisation. Complications such as glaucoma, darkening of iris tissue, and need for consecutive anterior segment surgery are clearly associated with implants with integrated fiber mesh, but not to those without. Hence, the use of full iris prostheses without embedded fiber mesh, even in cases with remnant iris, and the use of slightly smaller implants than officially recommended may be beneficial.

Collagen-conjugated tracheal prosthesis tested in dogs without omental wrapping and silicone stenting.

PubMed

Liu, Yu; Lu, Tao; Zhang, Yongxing; Qiao, Yulei; Xi, Junjie; Wang, Qun

2016-11-01

Artificial tracheas fabricated from collagen-conjugated mesh appear to overcome fatal postoperative complications, namely anastomotic dehiscence and prosthesis dislocation. Such prostheses are incorporated by host tissue, provided they are wrapped in omentum (necessitating an additional abdominal procedure) and a silicone tube is used as a stent (to be extracted several weeks postoperatively). To mitigate related host impact (i.e. injury, pain and distress), we investigated the feasibility of implanting this type of tracheal prosthesis (∼5 cm in length) alone, without omental wrapping and use of a silicone stent. Porous-type tracheal prostheses that were reinforced with a continuous polypropylene spiral and sealed by collagen sponge from porcine skin replaced segments of cervical trachea (∼5 cm long) in 10 dogs through the method of telescopic anastomosis. Omental wrapping and silicone stent placement were omitted. Postoperatively, bronchoscopic examination was performed periodically. When dogs died or were sacrificed, tracheal prostheses were harvested for haematoxylin and eosin staining and electron microscopic scanning of luminal surface conditions. With the exception of one death from an anaesthesia-related incident during fibre-optic bronchoscopy (postsurgical week 1), nine dogs survived uneventfully (until sacrifice), without prosthesis dislocation or anastomotic dehiscence. The longest observation period was 2 years and 8 months. Bronchoscopic examination revealed that no stenosis or local infection was evident in the prostheses of five dogs. Moderate (n = 2) and slight (n = 2) stenoses were observed in the other four animals. All four animals survived for a long time, without dyspnoea or stridor. Histological examination showed that partial inner surface of the artificial trachea was covered with the pseudostratified ciliated epithelium. Regeneration of ciliated epithelium was also confirmed by scanning electron microscopy. This pilot study revealed that implantation of a collagen-conjugated tracheal prosthesis (∼5 cm in length) is feasible without the need for omental wrapping and silicone stenting as ancillary measures. This approach considerably simplified the surgical procedures to minimize host intrusion, which indicated a possible clinical application. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral Rehabilitation

PubMed Central

FREITAS, José Alberto de Souza; de ALMEIDA, Ana Lúcia Pompéia Fraga; SOARES, Simone; NEVES, Lucimara Teixeira das; GARIB, Daniela Gamba; TRINDADE-SUEDAM, Ivy Kiemle; YAEDÚ, Renato Yassutaka Faria; LAURIS, Rita de Cássia Moura Carvalho; OLIVEIRA, Thais Marchini; PINTO, João Henrique Nogueira

2013-01-01

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients. PMID:23857655

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: oral rehabilitation.

PubMed

Freitas, José Alberto de Souza; Almeida, Ana Lúcia Pompéia Fraga de; Soares, Simone; Neves, Lucimara Teixeira das; Garib, Daniela Gamba; Trindade-Suedam, Ivy Kiemle; Yaedú, Renato Yassutaka Faria; Lauris, Rita de Cássia Moura Carvalho; Oliveira, Thais Marchini; Pinto, João Henrique Nogueira

2013-01-01

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

Democratic Superstring Field Theory and Its Gauge Fixing

NASA Astrophysics Data System (ADS)

Kroyter, M.

This work is my contribution to the proceedings of the conference``SFT2010 -- the third international conference on string field theory and related topics'' and it reflects my talk there, which described the democratic string field theory and its gauge fixing. The democratic string field theory is the only fully RNS string field theory to date. It lives in the large Hilbert space and includes all picture numbers. Picture changing amounts in this formalism to a gauge transformation. We describe the theory and its properties and show that when partially gauge fixed it can be reduced to the modified theory and to the non-polynomial theory. In the latter case we can even include the Ramond sector in the picture-fixed action. We also show that another partial gauge-fixing leads to a new consistent string field theory at picture number -1.

Microbial biofilms on facial prostheses.

PubMed

Ariani, Nina; Vissink, Arjan; van Oort, Robert P; Kusdhany, Lindawati; Djais, Ariadna; Rahardjo, Tri Budi W; van der Mei, Henny C; Krom, Bastiaan P

2012-01-01

The composition of microbial biofilms on silicone rubber facial prostheses was investigated and compared with the microbial flora on healthy and prosthesis-covered skin. Scanning electron microscopy showed the presence of mixed bacterial and yeast biofilms on and deterioration of the surface of the prostheses. Microbial culturing confirmed the presence of yeasts and bacteria. Microbial colonization was significantly increased on prosthesis-covered skin compared to healthy skin. Candida spp. were exclusively isolated from prosthesis-covered skin and from prostheses. Biofilms from prostheses showed the least diverse band-profile in denaturing gradient gel electrophoresis (DGGE) whereas prosthesis-covered skin showed the most diverse band-profile. Bacterial diversity exceeded yeast diversity in all samples. It is concluded that occlusion of the skin by prostheses creates a favorable niche for opportunistic pathogens such as Candida spp. and Staphylococcus aureus. Biofilms on healthy skin, skin underneath the prosthesis and on the prosthesis had a comparable composition, but the numbers present differed according to the microorganism.

Reduced prosthetic stiffness lowers the metabolic cost of running for athletes with bilateral transtibial amputations.

PubMed

Beck, Owen N; Taboga, Paolo; Grabowski, Alena M

2017-04-01

Inspired by the springlike action of biological legs, running-specific prostheses are designed to enable athletes with lower-limb amputations to run. However, manufacturer's recommendations for prosthetic stiffness and height may not optimize running performance. Therefore, we investigated the effects of using different prosthetic configurations on the metabolic cost and biomechanics of running. Five athletes with bilateral transtibial amputations each performed 15 trials on a force-measuring treadmill at 2.5 or 3.0 m/s. Athletes ran using each of 3 different prosthetic models (Freedom Innovations Catapult FX6, Össur Flex-Run, and Ottobock 1E90 Sprinter) with 5 combinations of stiffness categories (manufacturer's recommended and ± 1) and heights (International Paralympic Committee's maximum competition height and ± 2 cm) while we measured metabolic rates and ground reaction forces. Overall, prosthetic stiffness [fixed effect (β) = 0.036; P = 0.008] but not height ( P ≥ 0.089) affected the net metabolic cost of transport; less stiff prostheses reduced metabolic cost. While controlling for prosthetic stiffness (in kilonewtons per meter), using the Flex-Run (β = -0.139; P = 0.044) and 1E90 Sprinter prostheses (β = -0.176; P = 0.009) reduced net metabolic costs by 4.3-4.9% compared with using the Catapult prostheses. The metabolic cost of running improved when athletes used prosthetic configurations that decreased peak horizontal braking ground reaction forces (β = 2.786; P = 0.001), stride frequencies (β = 0.911; P < 0.001), and leg stiffness values (β = 0.053; P = 0.009). Remarkably, athletes did not maintain overall leg stiffness across prosthetic stiffness conditions. Rather, the in-series prosthetic stiffness governed overall leg stiffness. The metabolic cost of running in athletes with bilateral transtibial amputations is influenced by prosthetic model and stiffness but not height. NEW & NOTEWORTHY We measured the metabolic rates and biomechanics of five athletes with bilateral transtibial amputations while running with different prosthetic configurations. The metabolic cost of running for these athletes is minimized by using an optimal prosthetic model and reducing prosthetic stiffness. The metabolic cost of running was independent of prosthetic height, suggesting that longer legs are not advantageous for distance running. Moreover, the in-series prosthetic stiffness governs the leg stiffness of athletes with bilateral leg amputations.

Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty

PubMed Central

Van Hamersveld, Koen T; Marang-Van De Mheen, Perla J; Van Der Heide, Huub J L; Van Der Linden-Van Der Zwaag, Henrica M J; Valstar, Edward R; Nelissen, Rob G H H

2018-01-01

Background and purpose Mobile-bearing total knee prostheses (TKPs) were developed in the 1970s in an attempt to increase function and improve implant longevity. However, modern fixed-bearing designs like the single-radius TKP may provide similar advantages. We compared tibial component migration measured with radiostereometric analysis (RSA) and clinical outcome of otherwise similarly designed cemented fixed-bearing and mobile-bearing single-radius TKPs. Patients and methods RSA measurements and clinical scores were assessed in 46 randomized patients at baseline, 6 months, 1 year, and annually thereafter up to 6 years postoperatively. A linear mixed-effects model was used to analyze the repeated measurements. Results Both groups showed comparable migration (p = 0.3), with a mean migration at 6-year follow-up of 0.90 mm (95% CI 0.49–1.41) for the fixed-bearing group compared with 1.22 mm (95% CI 0.75–1.80) for the mobile-bearing group. Clinical outcomes were similar between groups. 1 fixed-bearing knee was revised for aseptic loosening after 6 years and 2 knees (1 in each group) were revised for late infection. 2 knees (1 in each group) were suspected for loosening due to excessive migration. Another mobile-bearing knee was revised after an insert dislocation due to failure of the locking mechanism 6 weeks postoperatively, after which study inclusion was preliminary terminated. Interpretation Fixed-bearing and mobile-bearing single-radius TKPs showed similar migration. The latter may, however, expose patients to more complex surgical techniques and risks such as insert dislocations inherent to this rotating-platform design. PMID:29448880

Computer-aided dental prostheses construction using reverse engineering.

PubMed

Solaberrieta, E; Minguez, R; Barrenetxea, L; Sierra, E; Etxaniz, O

2014-01-01

The implementation of computer-aided design/computer-aided manufacturing (CAD/CAM) systems with virtual articulators, which take into account the kinematics, constitutes a breakthrough in the construction of customised dental prostheses. This paper presents a multidisciplinary protocol involving CAM techniques to produce dental prostheses. This protocol includes a step-by-step procedure using innovative reverse engineering technologies to transform completely virtual design processes into customised prostheses. A special emphasis is placed on a novel method that permits a virtual location of the models. The complete workflow includes the optical scanning of the patient, the use of reverse engineering software and, if necessary, the use of rapid prototyping to produce CAD temporary prostheses.

Cardiac arrest due to left circumflex coronary artery embolism as a complication of subtherapeutic oral anticoagulation in a patient with mitral and aortic mechanical valve prostheses

PubMed Central

Protasiewicz, Marcin; Gajek, Jacek; Mysiak, Andrzej

2013-01-01

We report a case of a 65-year-old female patient after replacement of aortic and mitral valve with mechanical prostheses and implantation of a pacemaker hospitalized in our clinic due to acute coronary syndrome complicated with cardiac arrest due to ventricular fibrillation. The electrocardiogram performed on admission showed signs of myocardial infarction with concomitant ventricular pacing. After successful resuscitation the coronary angiography was performed, which showed occlusion of the left circumflex artery (LCx) by thrombus. On the basis of intravascular ultrasound imaging the presence of vulnerable plaque, parietal thrombus and dissection of LCx were excluded. It suggested that occlusion of the LCx resulted from its embolism by left-sided heart thrombus due to subtherapeutic oral anticoagulation. In this case suboptimal anticoagulation was partially iatrogenic. Two weeks before the patient had been given vitamin K intravenously due to indeterminable international normalized ratio (INR) level, which caused transient resistance to oral anticoagulants. This case report illustrates tragic difficulties in the treatment with vitamin K antagonists, which concern as many as 2/3 of anticoagulated patients. These troubles contributed to the search for new, more efficient and safer anticoagulants. There are two classes of new oral anticoagulant drugs, which do not require monitoring of coagulation: direct thrombin inhibitors (e.g. dabigatran) and factor Xa inhibitors (e.g. rivaroxaban). In spite of their proven efficacy in the prevention of ischaemic stroke related to atrial fibrillation and prevention or treatment of deep vein thrombosis and pulmonary embolism, the use of new oral anticoagulants for the treatment of patients with mechanical valve prostheses needs further research. PMID:24570697

Cardiac arrest due to left circumflex coronary artery embolism as a complication of subtherapeutic oral anticoagulation in a patient with mitral and aortic mechanical valve prostheses.

PubMed

Protasiewicz, Marcin; Rojek, Aleksandra; Gajek, Jacek; Mysiak, Andrzej

2013-01-01

We report a case of a 65-year-old female patient after replacement of aortic and mitral valve with mechanical prostheses and implantation of a pacemaker hospitalized in our clinic due to acute coronary syndrome complicated with cardiac arrest due to ventricular fibrillation. The electrocardiogram performed on admission showed signs of myocardial infarction with concomitant ventricular pacing. After successful resuscitation the coronary angiography was performed, which showed occlusion of the left circumflex artery (LCx) by thrombus. On the basis of intravascular ultrasound imaging the presence of vulnerable plaque, parietal thrombus and dissection of LCx were excluded. It suggested that occlusion of the LCx resulted from its embolism by left-sided heart thrombus due to subtherapeutic oral anticoagulation. In this case suboptimal anticoagulation was partially iatrogenic. Two weeks before the patient had been given vitamin K intravenously due to indeterminable international normalized ratio (INR) level, which caused transient resistance to oral anticoagulants. This case report illustrates tragic difficulties in the treatment with vitamin K antagonists, which concern as many as 2/3 of anticoagulated patients. These troubles contributed to the search for new, more efficient and safer anticoagulants. There are two classes of new oral anticoagulant drugs, which do not require monitoring of coagulation: direct thrombin inhibitors (e.g. dabigatran) and factor Xa inhibitors (e.g. rivaroxaban). In spite of their proven efficacy in the prevention of ischaemic stroke related to atrial fibrillation and prevention or treatment of deep vein thrombosis and pulmonary embolism, the use of new oral anticoagulants for the treatment of patients with mechanical valve prostheses needs further research.

Quantification of dental prostheses on cone‐beam CT images by the Taguchi method

PubMed Central

Kuo, Rong‐Fu; Fang, Kwang‐Ming; TY, Wong

2016-01-01

The gray values accuracy of dental cone‐beam computed tomography (CBCT) is affected by dental metal prostheses. The distortion of dental CBCT gray values could lead to inaccuracies of orthodontic and implant treatment. The aim of this study was to quantify the effect of scanning parameters and dental metal prostheses on the accuracy of dental cone‐beam computed tomography (CBCT) gray values using the Taguchi method. Eight dental model casts of an upper jaw including prostheses, and a ninth prosthesis‐free dental model cast, were scanned by two dental CBCT devices. The mean gray value of the selected circular regions of interest (ROIs) were measured using dental CBCT images of eight dental model casts and were compared with those measured from CBCT images of the prosthesis‐free dental model cast. For each image set, four consecutive slices of gingiva were selected. The seven factors (CBCTs, occlusal plane canting, implant connection, prosthesis position, coping material, coping thickness, and types of dental restoration) were used to evaluate scanning parameter and dental prostheses effects. Statistical methods of signal to noise ratio (S/N) and analysis of variance (ANOVA) with 95% confidence were applied to quantify the effects of scanning parameters and dental prostheses on dental CBCT gray values accuracy. For ROIs surrounding dental prostheses, the accuracy of CBCT gray values were affected primarily by implant connection (42%), followed by type of restoration (29%), prostheses position (19%), coping material (4%), and coping thickness (4%). For a single crown prosthesis (without support of implants) placed in dental model casts, gray value differences for ROIs 1–9 were below 12% and gray value differences for ROIs 13–18 away from prostheses were below 10%. We found the gray value differences set to be between 7% and 8% for regions next to a single implant‐supported titanium prosthesis, and between 46% and 59% for regions between double implant‐supported, nickel‐chromium alloys (Ni‐Cr) prostheses. Quantification of the effect of prostheses and scanning parameters on dental CBCT gray values was assessed. PACS numbers: 87.59.bd, 87.57Q PMID:26894354

Resilient Attachments as an Alternative to Conventional Cast Clasp Removable Partial Denture: 3-Year Follow-up.

PubMed

Schuh, Cristian; Adiel Skupien, Jovito; Mesko, Mauro Elias; Valentini, Fernanda; Pereira-Cenci, Tatiana; Boscato, Noéli

2014-12-01

The present clinical report describes the prosthodontic management for a patient with uncontrolled bleeding and diabetes mellitus treated with a maxillary complete denture and a mandibular partial fixed dental prosthesis designed to interface with a removable cast framework partial denture retained by 2 ERA attachments. This approach was undertaken to improve both retention and stability of the distal extension Kennedy Class I removable partial denture. The rehabilitation provided better anterior esthetics than if treated with a conventional clasp retained removable partial denture, by employing a simple, practical design and offering a significant biomechanical advantages, restoring both oral health and function. Thus, this treatment modality, involving an ERA system and transfixation in fixed crowns, is an effective treatment and can be indicated as a clinical alternative for edentulous and partially edentulous patients with systemic disorders or for patients in economic situations that might preclude implant-based rehabilitation.

A provisional fixed partial denture that simulates gingival tissue at the pontic-site defect.

PubMed

Haj-Ali, Reem; Walker, Mary P

2002-03-01

A technique is presented for the fabrication of an esthetic, provisional fixed partial denture that compensates for a pontic-site ridge defect. This provisional restoration enables both the dentist and the patient to evaluate whether this prosthetic approach will adequately camouflage the pontic-site defect or whether surgical correction of the pontic site should also be considered. Copyright 2002 by The American College of Prosthodontists.

Four-unit fixed dental prostheses replacing the maxillary incisors supported by two narrow-diameter implants - a five-year case series.

PubMed

Moráguez, Osvaldo; Vailati, Francesca; Grütter, Linda; Sailer, Irena; Belser, Urs C

2017-07-01

(1) To determine the survival rate of 10 four-unit fixed dental prostheses (FDPs) replacing the four maxillary incisors, supported by 20 narrow-diameter implants (NDIs), (2) to assess the incidence of mechanical and biological complications, and (3) to evaluate bone level changes longitudinally after final FDP insertion. Ten patients (six women, four men), mean age 49.4 ± 12.6 years, were treated with a four-unit anterior maxillary FDP (six screw-retained; four cemented). Biological parameters, eventual technical complications, radiographic measurements, and study casts were assessed at 1 (baseline), 3, and 5 years after implant placement. A multilevel logistic regression test was performed on clinical parameters and bone level changes (significance level P < 0.05). The 5-year implant and FDP survival rate was 100%. Mean modified plaque index (mPI) values were 0.03 and 0.02 at 3 and 5 years, significantly lower when compared to mPI (0.11 ± 0.31) at 1 year. Mean modified sulcus bleeding index (mSBI) was 0.08, 0.08, and 0.15 over time. Probing depth (PD) values were 1.57, 1.64, and 2.03 mm. Statistically significant differences were found between 1 vs. 5 year (P = 0.0003) and 3 vs. 5 year (P = 0.001). Keratinized mucosa (3.65 mm) remained stable during observation period. DIB mean values were 2.01 ± 0.34, 2.13 ± 0.13, and 2.17 ± 0.38 mm. Patient satisfaction based on visual analog scale revealed favorable fulfillment of overall treatment and esthetic expectations. Two NDIs supporting a four-unit FDP to replace the four missing maxillary incisors may be considered a predictable treatment modality. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A preliminary report on short-term clinical outcomes of three-unit resin-bonded fixed prostheses using two adhesive cements and surface conditioning combinations.

PubMed

Dündar, Mine; Ozcan, Mutlu; Cömlekoğlu, M Erhan; Güngör, Mehmet Ali

2010-01-01

The aim of this study was to evaluate the survival rate of three-unit surface-retained, resin-bonded, metal-ceramic fixed dental prostheses (RBFDP) using two adhesive cements and two surface conditioning methods. Between 2005 and 2009, a total of 58 patients (34 women, 24 men; mean age: 42.1 years) received 58 three-unit RBFDPs made of a nonprecious alloy (Wirocast Co-Cr). Restorations were cemented employing the following combinations: (1) alumina air abrasion-silane + Panavia F 2.0 (group A1), (2) tribochemical silica coating (CoJet)-silane + Panavia F 2.0 (group A2), (3) alumina air abrasion-silane + Super-Bond C and B (group B1), and (4) CoJet-silane + Super-Bond C and B (group B2). Teeth were conditioned using the adhesives of the cements accordingly. Adaptation, debonding, fracture, and crack and caries formation were considered for clinical evaluation. Data were collected at baseline, 6 months, and annually thereafter. Forty-eight RBFDPs were available for follow-up (mean: 20.3 months, minimum: 6 months, maximum: 42 months). The effect of cement type on the survival rate of RBFDPs was not significant (P > .05). The survival rate was also not significantly affected by the location (maxilla: 93.2%, mandible: 92.9%; P = .928). All experienced failures were observed within the first year after cementation. In total, four complete debondings were encountered (two in group A1, one in group A2, and one in group B1 at months 1, 3, 7, and 3, respectively). Group B2 did not result in any failures during the observation period. The failures were adhesive debondings between the metal surface and the cement. Early findings did not show significant differences between the cement and conditioning type combinations, with group B2 presenting no failures.

Intraoral Laser Welding (ILW): ultrastructural and mechanical analysis

NASA Astrophysics Data System (ADS)

Fornaini, Carlo; Passaretti, Francesca; Villa, Elena; Nammour, Samir

2010-05-01

Nd:YAG, currently used since 1970 in dental laboratories to weld metals on dental prostheses has some limits such great dimensions, high costs and fixed delivery system. Recently it was proposed the possibility to use the Nd:YAG laser device commonly utilised in dental office, to repair broken fixed, removable and orthodontic prostheses and to weld metals directly into the mouth. The aim of this work is to value, through SEM (Scanning Electron Microscope), EDS (Energy Dispersive X-Ray Spectroscopy) and DMA (Dynamic Mechanical Analysis), quality and mechanical strength of the welding process comparing a device normally used in dental lab and a device normally used in dental office for oral surgery. Sixteen CoCrMo metal plates and twenty steel orthodontic wires were divided in four groups: one was welded without metal apposition by laboratory laser, one was welded with metal apposition by laboratory laser, one was welded without metal apposition by office laser and one was welded with metal apposition by office laser. The welding process was analysed by SEM, EDS and DMA to compare the differences between the different samples. By SEM analysis it was seen that the plates welded by office laser without apposition metal showed a greater number of fissurations compared with the other samples. By EDS analysis it was seen a homogeneous composition of the metals in all the samples. The mechanical tests showed a similar elastic behaviour of the samples, with minimal differences between the two devices. No wire broke even under the maximum strength by the Analyser. This study seems to demonstrate that the welding process by office Nd:YAG laser device and the welding process by laboratory Nd:YAG laser device, analysed by SEM, EDS and DMA, showed minimal and not significant differences even if these data will be confirmed by a greater number of samples.

Time-dependent fracture probability of bilayer, lithium-disilicate-based, glass-ceramic, molar crowns as a function of core/veneer thickness ratio and load orientation.

PubMed

Anusavice, Kenneth J; Jadaan, Osama M; Esquivel-Upshaw, Josephine F

2013-11-01

Recent reports on bilayer ceramic crown prostheses suggest that fractures of the veneering ceramic represent the most common reason for prosthesis failure. The aims of this study were to test the hypotheses that: (1) an increase in core ceramic/veneer ceramic thickness ratio for a crown thickness of 1.6mm reduces the time-dependent fracture probability (Pf) of bilayer crowns with a lithium-disilicate-based glass-ceramic core, and (2) oblique loading, within the central fossa, increases Pf for 1.6-mm-thick crowns compared with vertical loading. Time-dependent fracture probabilities were calculated for 1.6-mm-thick, veneered lithium-disilicate-based glass-ceramic molar crowns as a function of core/veneer thickness ratio and load orientation in the central fossa area. Time-dependent fracture probability analyses were computed by CARES/Life software and finite element analysis, using dynamic fatigue strength data for monolithic discs of a lithium-disilicate glass-ceramic core (Empress 2), and ceramic veneer (Empress 2 Veneer Ceramic). Predicted fracture probabilities (Pf) for centrally loaded 1.6-mm-thick bilayer crowns over periods of 1, 5, and 10 years are 1.2%, 2.7%, and 3.5%, respectively, for a core/veneer thickness ratio of 1.0 (0.8mm/0.8mm), and 2.5%, 5.1%, and 7.0%, respectively, for a core/veneer thickness ratio of 0.33 (0.4mm/1.2mm). CARES/Life results support the proposed crown design and load orientation hypotheses. The application of dynamic fatigue data, finite element stress analysis, and CARES/Life analysis represent an optimal approach to optimize fixed dental prosthesis designs produced from dental ceramics and to predict time-dependent fracture probabilities of ceramic-based fixed dental prostheses that can minimize the risk for clinical failures. Copyright © 2013 Academy of Dental Materials. All rights reserved.

Three-dimensional finite element analysis of vertical and angular misfit in implant-supported fixed prostheses.

PubMed

Assunção, Wirley Gonçalves; Gomes, Erica Alves; Rocha, Eduardo Passos; Delben, Juliana Aparecida

2011-01-01

Three-dimensional finite element analysis was used to evaluate the effect of vertical and angular misfit in three-piece implant-supported screw-retained fixed prostheses on the biomechanical response in the peri-implant bone, implants, and prosthetic components. Four three-dimensional models were fabricated to represent a right posterior mandibular section with one implant in the region of the second premolar (2PM) and another in the region of the second molar (2M). The implants were splinted by a three-piece implant-supported metal-ceramic prosthesis and differed according to the type of misfit, as represented by four different models: Control = prosthesis with complete fit to the implants; UAM (unilateral angular misfit) = prosthesis presenting unilateral angular misfit of 100 μm in the mesial region of the 2M; UVM (unilateral vertical misfit) = prosthesis presenting unilateral vertical misfit of 100 μm in the mesial region of the 2M; and TVM (total vertical misfit) = prosthesis presenting total vertical misfit of 100 μm in the platform of the framework in the 2M. A vertical load of 400 N was distributed and applied on 12 centric points by the software Ansys, ie, a vertical load of 150 N was applied to each molar in the prosthesis and a vertical load of 100 N was applied at the 2PM. The stress values and distribution in peri-implant bone tissue were similar for all groups. The models with misfit exhibited different distribution patterns and increased stress magnitude in comparison to the control. The highest stress values in group UAM were observed in the implant body and retention screw. The groups UVM and TVM exhibited high stress values in the platform of the framework and the implant hexagon, respectively. The three types of misfit influenced the magnitude and distribution of stresses. The influence of misfit on peri-implant bone tissue was modest. Each type of misfit increased the stress values in different regions of the system.

Precision Fit of Screw-Retained Implant-Supported Fixed Dental Prostheses Fabricated by CAD/CAM, Copy-Milling, and Conventional Methods.

PubMed

de França, Danilo Gonzaga; Morais, Maria Helena; das Neves, Flávio D; Carreiro, Adriana Fonte; Barbosa, Gustavo As

The aim of this study was to evaluate the effectiveness of fabrication methods (computer-aided design/computer-aided manufacture [CAD/CAM], copy-milling, and conventional casting) in the fit accuracy of three-unit, screw-retained fixed dental prostheses. Sixteen three-unit implant-supported screw-retained frameworks were fabricated to fit an in vitro model. Eight frameworks were fabricated using the CAD/CAM system, four in zirconia and four in cobalt-chromium. Four zirconia frameworks were fabricated using the copy-milled system, and four were cast in cobalt-chromium using conventional casting with premachined abutments. The vertical and horizontal misfit at the implant-framework interface was measured using scanning electron microscopy at ×250. The results for vertical misfit were analyzed using Kruskal-Wallis and Mann-Whitney tests. The horizontal misfits were categorized as underextended, equally extended, or overextended. Statistical analysis established differences between groups according to the chi-square test (α = .05). The mean vertical misfit was 5.9 ± 3.6 μm for CAD/CAM-fabricated zirconia, 1.2 ± 2.2 μm for CAD/CAM-fabricated cobalt-chromium frameworks, 7.6 ± 9.2 μm for copy-milling-fabricated zirconia frameworks, and 11.8 (9.8) μm for conventionally fabricated frameworks. The Mann-Whitney test revealed significant differences between all but the zirconia-fabricated frameworks. A significant association was observed between the horizontal misfits and the fabrication method. The percentage of horizontal misfits that were underextended and overextended was higher in milled zirconia (83.3%), CAD/CAM cobaltchromium (66.7%), cast cobalt-chromium (58.3%), and CAD/CAM zirconia (33.3%) frameworks. CAD/CAM-fabricated frameworks exhibit better vertical misfit and low variability compared with copy-milled and conventionally fabricated frameworks. The percentage of interfaces equally extended was higher when CAD/CAM and zirconia were used.

Fracture load of metal-ceramic, monolithic, and bi-layered zirconia-based posterior fixed dental prostheses after thermo-mechanical cycling.

PubMed

López-Suárez, Carlos; Castillo-Oyagüe, Raquel; Rodríguez-Alonso, Verónica; Lynch, Christopher D; Suárez-García, María-Jesús

2018-06-01

This study aims to evaluate the fracture load of differently fabricated 3-unit posterior fixed dental prostheses (FDPs) with an intermediate pontic. Fifty sets of two stainless-steel abutments were randomly assigned to five groups (n = 10 each) depending on the material and technique used for manufacturing the FDPs: (1) Metal-ceramic (MC, control); (2) Lava Zirconia (LZ, bi-layered); (3) Lava Plus (LM, monolithic); (4) VITA In-Ceram YZ (YZ, bi-layered); and (5) IPS e-max ZirCAD (ZZ, bi-layered). After being luted to the dies, all FDPs were submitted to thermo-mechanical cycling (120,000 masticatory cycles, 50 N; plus 774 thermal cycles of 5 °C/55 °C, dwell time: 30 s). Samples were then subjected to a three-point bending test until fracture in a universal testing machine (cross-head speed: 1 mm/min). Fracture load of the veneering ceramic (VF) and total fracture load (TF) were recorded. Microstructure and failure patterns were assessed. Data was analysed using one-way ANOVA and Tukey HSD post-hoc tests (α = 0.05). MC restorations recorded higher VF and TF values than did zirconia FDPs (p = 0.0001), which showed no between-group differences. Within the bi-layered groups, TF was significantly higher than VF. LM pieces registered lower average grain size than did LZ specimens (p = 0.001). Overall, the connector was the weakest part. All of the groups tested could withstand clinical chewing forces in terms of average fracture load. Zirconia-based samples performed similarly to each other, but showed lower mean fracture load values than did metal-ceramic ones. Monolithic zirconia may be recommendable for solving the chipping problem. Copyright © 2018 Elsevier Ltd. All rights reserved.

Time-dependent fracture probability of bilayer, lithium-disilicate-based glass-ceramic molar crowns as a function of core/veneer thickness ratio and load orientation

PubMed Central

Anusavice, Kenneth J.; Jadaan, Osama M.; Esquivel–Upshaw, Josephine

2013-01-01

Recent reports on bilayer ceramic crown prostheses suggest that fractures of the veneering ceramic represent the most common reason for prosthesis failure. Objective The aims of this study were to test the hypotheses that: (1) an increase in core ceramic/veneer ceramic thickness ratio for a crown thickness of 1.6 mm reduces the time-dependent fracture probability (Pf) of bilayer crowns with a lithium-disilicate-based glass-ceramic core, and (2) oblique loading, within the central fossa, increases Pf for 1.6-mm-thick crowns compared with vertical loading. Materials and methods Time-dependent fracture probabilities were calculated for 1.6-mm-thick, veneered lithium-disilicate-based glass-ceramic molar crowns as a function of core/veneer thickness ratio and load orientation in the central fossa area. Time-dependent fracture probability analyses were computed by CARES/Life software and finite element analysis, using dynamic fatigue strength data for monolithic discs of a lithium-disilicate glass-ceramic core (Empress 2), and ceramic veneer (Empress 2 Veneer Ceramic). Results Predicted fracture probabilities (Pf) for centrally-loaded 1,6-mm-thick bilayer crowns over periods of 1, 5, and 10 years are 1.2%, 2.7%, and 3.5%, respectively, for a core/veneer thickness ratio of 1.0 (0.8 mm/0.8 mm), and 2.5%, 5.1%, and 7.0%, respectively, for a core/veneer thickness ratio of 0.33 (0.4 mm/1.2 mm). Conclusion CARES/Life results support the proposed crown design and load orientation hypotheses. Significance The application of dynamic fatigue data, finite element stress analysis, and CARES/Life analysis represent an optimal approach to optimize fixed dental prosthesis designs produced from dental ceramics and to predict time-dependent fracture probabilities of ceramic-based fixed dental prostheses that can minimize the risk for clinical failures. PMID:24060349

Influence of preliminary damage on the load-bearing capacity of zirconia fixed dental prostheses.

PubMed

Kohorst, Philipp; Butzheinen, Lutz Oliver; Dittmer, Marc Philipp; Heuer, Wieland; Borchers, Lothar; Stiesch, Meike

2010-12-01

The objective of this investigation was to evaluate the influence of differently shaped preliminary cuts in combination with artificial aging on the load-bearing capacity of four-unit zirconia fixed dental prostheses (FDPs). Forty frameworks were fabricated from white-stage zirconia blanks (InCeram YZ, Vita) by means of a computer-aided design/computer-aided manufacturing system (Cerec inLab, Sirona). Frameworks were divided into four homogeneous groups with ten specimens each. Prior to veneering, frameworks of two groups were "damaged" by defined saw cuts of different dimensions, to simulate accidental flaws generated during shape cutting. After the veneering process, FDPs, with the exception of a control group without preliminary damage, were subjected to thermal and mechanical cycling (TMC) during 200 days storage in distilled water at 36°C. Following the aging procedure, all specimens were loaded until fracture, and forces at fracture were recorded. The statistical analysis of force at fracture data was performed using two-way ANOVA, with the level of significance chosen at 0.05. Neither type of preliminary mechanical damage significantly affected the load-bearing capacity of FDPs. In contrast, artificial aging by TMC proved to have a significant influence on the load-bearing capacity of both the undamaged and the predamaged zirconia restorations (p < 0.001); however, even though load-bearing capacity decreased by about 20% due to simulated aging, the FDPs still showed mean load-bearing capacities of about 1600 N. The results of this study reveal that zirconia restorations have a high tolerance regarding mechanical damages. Irrespective of these findings, damage to zirconia ceramics during production or finishing should be avoided, as this may nevertheless lead to subcritical crack growth and, eventually, catastrophic failure. Furthermore, to ensure long-term clinical success, the design of zirconia restorations has to accommodate the decrease in load-bearing capacity due to TMC in the oral environment. © 2010 by The American College of Prosthodontists.

Clinical evaluation of immediate loading of electroeroded screw-retained titanium fixed prostheses supported by tilted implant: a multicenter retrospective study.

PubMed

Acocella, Alessandro; Ercoli, Carlo; Geminiani, Alessandro; Feng, Changyong; Billi, Mauro; Acocella, Gabriele; Giannini, Domenico; Sacco, Roberto

2012-05-01

Immediate occlusal loading of dental implants in the edentulous mandible has proven to be an effective, reliable, and predictable treatment protocol. However, there is limited long-term data available in the literature, when an electroeroded definitive cast-titanium fixed prosthesis is used for this treatment protocol. The aim of this study was to evaluate the clinical effectiveness of dental implants (Astra Tech Dental, Mölndal, Sweden) in the edentulous mandible immediately loaded with an electroeroded cast-titanium screw-retained fixed prosthesis. Forty-five patients received five implants each in the interforaminal area. All the implants were inserted with torque up to 40 Ncm and the distal implants were distally tilted approximately 20 to 30 degrees to minimize the length of posterior cantilevers. Implants were loaded within 48 hours of placement with an acrylic resin-titanium screw-retained prosthesis fabricated by electroerosion. Two of the 225 inserted implants failed after 3 and 16 months of healing, respectively, with a cumulative survival rate of 99.1% and a prosthetic survival rate of 97.8%. Immediate loading of tilted dental implants inserted in the edentulous mandible with a screw-retained titanium definitive prosthesis fabricated with electrical discharge machining provide reliable and predictable results. © 2011 Wiley Periodicals, Inc.

An analytical model to design circumferential clasps for laser-sintered removable partial dentures.

PubMed

Alsheghri, Ammar A; Alageel, Omar; Caron, Eric; Ciobanu, Ovidiu; Tamimi, Faleh; Song, Jun

2018-06-21

Clasps of removable partial dentures (RPDs) often suffer from plastic deformation and failure by fatigue; a common complication of RPDs. A new technology for processing metal frameworks for dental prostheses based on laser-sintering, which allows for precise fabrication of clasp geometry, has been recently developed. This study sought to propose a novel method for designing circumferential clasps for laser-sintered RPDs to avoid plastic deformation or fatigue failure. An analytical model for designing clasps with semicircular cross-sections was derived based on mechanics. The Euler-Bernoulli elastic curved beam theory and Castigliano's energy method were used to relate the stress and undercut with the clasp length, cross-sectional radius, alloy properties, tooth type, and retention force. Finite element analysis (FEA) was conducted on a case study and the resultant tensile stress and undercut were compared with the analytical model predictions. Pull-out experiments were conducted on laser-sintered cobalt-chromium (Co-Cr) dental prostheses to validate the analytical model results. The proposed circumferential clasp design model yields results in good agreement with FEA and experiments. The results indicate that Co-Cr circumferential clasps in molars that are 13mm long engaging undercuts of 0.25mm should have a cross-section radius of 1.2mm to provide a retention of 10N and to avoid plastic deformation or fatigue failure. However, shorter circumferential clasps such as those in premolars present high stresses and cannot avoid plastic deformation or fatigue failure. Laser-sintered Co-Cr circumferential clasps in molars are safe, whereas they are susceptible to failure in premolars. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

UNICOMPARTMENTAL KNEE ARTHROPLASTY: CURRENT PERSPECTIVES AND TRENDS IN BRAZIL

PubMed Central

Arliani, Gustavo Gonçalves; Júnior, João Alberto Yazigi; Angelini, Felipe Bertelli; Ferlin, Fernando; Hernandes, Andrea Canizares; Astur, Diego da Costa; Cohen, Moises

2015-01-01

Objective: The aim of this study was to evaluate the approaches and procedures used by Brazilian orthopedic surgeons for treating osteoarthrosis by means of unicompartmental knee arthroplasty and high tibial osteotomy of the knee. Methods: A questionnaire with 14 closed questions was developed and applied to Brazilian knee surgeons during the three days of the 43rd Brazilian Congress of Orthopedics and Traumatology. Results: A total of 113 surgeons filled out the questionnaire completely and became part of the sample analyzed. In this study, the majority of the surgeons performed fewer than five unicompartmental knee arthroplasty procedures/year (61.1%) and between 5 and 15 high tibial osteotomy procedures/year (37.2%). Use of computerized navigation systems during surgery remains uncommon in our environment, since only 0.9% of the specialists were using it. 65.5% of the surgeons reported that they had chosen to use total knee arthroplasty rather than partial arthroplasty due to lack of familiarity with the surgical technique. When asked about the possibility that the number of unicompartmental prostheses used in Brazil would grow as surgeons in this country become increasingly familiar with the technique, 80.5% of the respondents believed in this hypothesis. In this sample, we found that the greater the surgeon's experience was, the greater the numbers of unicompartmental prostheses and tibial osteotomies performed annually were (r = 0.550 and r = 0.465, respectively; p < 0.05). Conclusions: There is a clear evolutional trend towards treatment of unicompartmental osteoarthritis using partial knee arthroplasty in Brazil. However, further prospective controlled studies are needed in order to evaluate the clinical and scientific benefits of these trends. PMID:27047891

Fabrication of low cost soft tissue prostheses with the desktop 3D printer

NASA Astrophysics Data System (ADS)

He, Yong; Xue, Guang-Huai; Fu, Jian-Zhong

2014-11-01

Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

Fabrication of low cost soft tissue prostheses with the desktop 3D printer

PubMed Central

He, Yong; Xue, Guang-huai; Fu, Jian-zhong

2014-01-01

Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods. PMID:25427880

A Powered Prosthetic Intervention for Bilateral Transfemoral Amputees

PubMed Central

Lawson, Brian E.; Ruhe, Brian; Shultz, Amanda; Goldfarb, Michael

2014-01-01

This paper presents the design and validation of a control system for a pair of powered knee and ankle prostheses to be used as a prosthetic intervention for bilateral transfemoral amputees. The control system leverages communication between the prostheses for enhanced awareness and stability, along with power generation at the knee and ankle joints to better restore biomechanical functionality in level ground walking. The control methodology employed is a combination of an impedance-based framework for weight-bearing portions of gait and a trajectory-based approach for the non-weight-bearing portions. The control system was implemented on a pair of self-contained powered knee and ankle prostheses, and the ability of the prostheses and control approach to provide walking functionality was assessed in a set of experimental trials with a bilateral transfemoral amputee subject. Specifically, experimental data from these trials indicate that the powered prostheses and bilateral control architecture provide gait kinematics that reproduce healthy gait kinematics to a greater extent than the subject’s daily-use passive prostheses. PMID:25014950

Assessment of the mechanical performance of titanium cranial prostheses manufactured by super plastic forming and single point incremental forming

NASA Astrophysics Data System (ADS)

Sgambitterra, Emanuele; Piccininni, Antonio; Guglielmi, Pasquale; Ambrogio, Giuseppina; Fragomeni, Gionata; Villa, Tomaso; Palumbo, Gianfranco

2018-05-01

Cranial implants are custom prostheses characterized by quite high geometrical complexity and small thickness; at the same time aesthetic and mechanical requirements have to be met. Titanium alloys are largely adopted for such prostheses, as they can be processed via different manufacturing technologies. In the present work cranial prostheses have been manufactured by Super Plastic Forming (SPF) and Single Point Incremental Forming (SPIF). In order to assess the mechanical performance of the cranial prostheses, drop tests under different load conditions were conducted on flat samples to investigate the effect of the blank thickness. Numerical simulations were also run for comparison purposes. The mechanical performance of the cranial implants manufactured by SPF and SPIF could be predicted using drop test data and information about the thickness evolution of the formed parts: the SPIFed prosthesis revealed to have a lower maximum deflection and a higher maximum force, while the SPFed prostheses showed a lower absorbed energy.

Fabrication of low cost soft tissue prostheses with the desktop 3D printer.

PubMed

He, Yong; Xue, Guang-huai; Fu, Jian-zhong

2014-11-27

Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

Hip prostheses in young adults. Surface prostheses and short-stem prostheses.

PubMed

Gallart, X; Riba, J; Fernández-Valencia, J A; Bori, G; Muñoz-Mahamud, E; Combalia, A

The poor results obtained in young patients when using a conventional prosthesis led to the resurgence of hip resurfacing to find less invasive implants for the bone. Young patients present a demand for additional activity, which makes them a serious challenge for the survival of implants. In addition, new information technologies contribute decisively to the preference for non-cemented prostheses. Maintaining quality of life, preserving the bone and soft tissues, as well as achieving a very stable implant, are the goals of every hip orthopaedic surgeon for these patients. The results in research point to the use of smaller prostheses, which use the metaphyseal zone more and less the diaphyseal zone, and hence the large number of the abovementioned short stem prostheses. Both models are principally indicated in the young adult. Their revision should be a more simple operation, but this is only true for hip resurfacing, not for short stems. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Mechanical behavior and failure analysis of prosthetic retaining screws after long-term use in vivo. Part 4: Failure analysis of 10 fractured retaining screws retrieved from three patients.

PubMed

Al Jabbari, Youssef S; Fournelle, Raymond; Ziebert, Gerald; Toth, Jeffrey; Iacopino, Anthony M

2008-04-01

The aim of this study was to perform a failure analysis on fractured prosthetic retaining screws after long-term use in vivo. Additionally, the study addresses the commonly asked question regarding whether complex repeated functional occlusal forces initiate fatigue-type cracks in prosthetic retaining screws. Ten fractured prosthetic retaining screws retrieved from three patients treated with fixed detachable hybrid prostheses were subjected to a failure analysis. In patients 1 and 2, the middle three retaining screws of the prostheses were found fractured at retrieval time after they had been in service for 20 and 19 months, respectively. In patient 3, the middle three and one of the posterior retaining screws were found to be fractured at retrieval after they had been in service for 18 months. Low power stereomicroscopy and high-power scanning electron microscopy (SEM) were performed to analyze the fractured surfaces of the retaining screws examining fatigue cracks in greater detail. Typical fatigue failure characterized by ratchet mark formation was revealed by light microscopy and SEM for all examined screws. Using low magnification light microscopy, ratchet marks were visible on the fracture surfaces of only two screws. SEM examination revealed all three classical stages of fatigue failure, and it was possible to see the ratchet marks on the fracture surfaces of all specimens, indicating a fatigue zone. The final catastrophic overload fracture appeared fibrous, indicating ductile fracture. The final overload ductile fracture surfaces showed equiaxed dimples, suggesting tensile overload in all examined screws except in two specimens that showed an elongated dimple pattern indicating shear/tearing overload forces. Fracture of prosthetic retaining screws in hybrid prostheses occurs mainly through a typical fatigue mode involving mostly the middle anterior three screws. Fatigue cracks can grow in more than one prosthetic retaining screw, leading to fracture before the patient or clinician determines that any problem exists.

Composite Materials for Maxillofacial Prostheses.

DTIC Science & Technology

1981-08-01

necessary and Identify byv block number) MAXILLOFACIAL PROSTHESES; PROSTHETIC MATERIALS: MICROCAPSULES : SOFT FILLERS; ELASTOMER COMPOSITES 2,. ABSTRACT...used as fillers in the fabrication of maxillofacial prostheses. The projected systems are elastomeric-shelled, liquid-filled microcapsules . Improvements...elastomeric-shelled, liquid-filled microcapsules . Experiments continued on the interfacial polymerization process, with spherical, sealed, capsules

Multiple retentive means for prosthetic restoration of a large facial defect - a case report.

PubMed

Abdulhadi, Laith Mahmoud

2010-01-01

A 70-year-old man who suffered from extensive extra and intraoral defects was rehabilitated with a prosthesis using multiple retaining means. The treatment was performed in two parts: externally involving the construction of an episthesis supported only by the remaining intact boundaries of the defect and retained by mini-dental implants and spectacle frame with a modified ear hook; and intraorally by an acrylic resin obturator to restore the function of the hemi-sectioned hard and soft palate. The episthesis was securely retained with minimal movement and/or dislodgment of the prosthesis during function. Multiple retentive techniques may be used to fix heavy external prostheses as an alternative to conventional implants or biological adhesives.

Content and goals of preclinical prosthodontic programs at german-language dental schools.

PubMed

Hey, Jeremias; Stimmelmayr, Michael; Hirsch, Christian; Beuer, Florian

2014-04-01

The Association for Dental Education in Europe (ADEE) makes recommendations regarding the skills graduates of European dental schools need to achieve and advises dental schools regarding necessary changes to be made to the curriculum. In 2010 to 2011, a survey was conducted in German-language dental schools to validate the curricula and goals of preclinical prosthodontic programs with regard to laboratory work. The survey was mailed to the course instructors of the preclinical programs at 37 dental schools. Of these, 35 schools returned the completed survey, resulting in a response rate of 95%. Bent wire, wax-up exercises, metal-ceramic single crowns, fixed dental prostheses, cast metal single crowns, temporary removable dental prostheses, and full dentures were part of the dental laboratory work at most schools; however, most instructors considered laboratory work as less important, and there were few similarities among the programs in this area. According to the instructors responsible for preclinical education, honing of fine motor skills, realistic self-assessment, and the ability to work independently were the main goals of the programs. The results of this survey show that with regard to laboratory work, there were more differences than similarities among preclinical prosthodontic programs at German-language dental schools, contrary to the recommendations of the ADEE. These findings should be taken into account when program reforms are planned. © 2013 by the American College of Prosthodontists.

Influence of the prosthetic arm length (palatal position) of zygomatic implants upon patient satisfaction

PubMed Central

Pellicer-Chover, Hilario; Cervera-Ballester, Juan; Peñarrocha-Oltra, David; Bagán, Leticia; Peñarrocha-Diago, María

2016-01-01

Background To assess the influence of the prosthetic arm length (palatal position) of zygomatic implants upon patient comfort and stability, speech, functionality and overall satisfaction. Material and Methods A retrospective clinical study was made of patients subjected to rehabilitation of atrophic maxilla with complete maxillary implant-supported fixed prostheses involving a minimum of two zygomatic implants (one on each side) in conjunction with premaxillary implants, and with 12 months of follow-up after implant loading. Subjects used a VAS to score general satisfaction, comfort and stability, speech and functionality, and the results were analyzed in relation to the prosthetic arm length of the zygomatic implants 12 months after prosthetic delivery. Results Twenty-two patients participated in the study, receiving 22 prostheses anchored on 148 implants (44 were zygomatic and 94 were conventional implants). The mean right and left prosthetic arm length was 5.9±2.4 mm and 6.1±2.7 mm, respectively, with no statistically significant differences between them (p=0.576). The mean scores referred to comfort/retention, speech, functionality and overall satisfaction were high - no correlation being found between prosthetic arm length and patient satisfaction (p=0.815). Conclusions No relationship could be identified between prosthetic arm length (palatal position) and patient satisfaction. Key words:Zygomatic implants, patient satisfaction, zygomatic prosthesis, prosthetic arm length. PMID:26946206

In vitro rapid intraoral adjustment of porcelain prostheses using a high-speed dental handpiece.

PubMed

Song, Xiao-Fei; Yin, Ling; Han, Yi-Gang; Wang, Hui

2008-03-01

In vitro rapid intraoral adjustment of porcelain prostheses was conducted using a high-speed dental handpiece and diamond bur. The adjustment process was characterized by measurement of removal forces and energy, with scanning electron microscopic (SEM) observation of porcelain debris, surfaces and subsurface damage produced as a function of operational feed rate. Finite element analysis (FEA) was applied to evaluate subsurface stress distributions and degrees of subsurface damage. The results show that an increase in feed rate resulted in increases in both tangential and normal forces (analysis of variance (ANOVA), P<0.01). When the feed rate approached the highest rate of 60mm min(-1) at a fixed depth of cut of 100microm, the tangential force was nearly seven times that at the lowest feed rate of 15mm min(-1). Consequently, the specific removal energy increased significantly (ANOVA, P<0.01), and the maximum depth of subsurface damage obtained was approximately 110 and 120microm at the highest feed rate of 60mm min(-1) using SEM and FEA, respectively. The topographies of both the adjusted porcelain surfaces and the debris demonstrate microscopically that porcelain was removed via brittle fracture and plastic deformation. Clinicians must be cautious when pursuing rapid dental adjustments, because high operational energy, larger forces and severe surface and subsurface damage can be induced.

Analysis of the causes of dental implant fracture: A retrospective clinical study.

PubMed

Stoichkov, Biser; Kirov, Dimitar

2018-01-01

Fracture of osseointegrated dental implants is the most severe mechanical complication. The aim of the present study was to analyze possible causative factors for implant body fracture. One hundred and one patients with 218 fitted implants and a follow-up period of 3 to 10 years were studied. Factors associated with biomechanical and physiologic overloading such as parafunctional activity (eg, bruxism), occlusion, and cantilevers, and factors related to the planning of the dental prosthesis, available bone volume, implant area, implant diameter, number of implants, and their inclination were tracked. The impact of their effect was analyzed using the Bonferroni-corrected post-hoc Mann-Whitney test for each group. The incidence of dental implant fracture was 2.3% in the investigated cases. Improper treatment planning, bruxism, and time of the complication setting in were the main factors leading to this complication. Typical size effect was established only for available bruxism, occlusal errors, and their activity duration. These complications were observed most often with single crown prostheses, and in combination with parafunctional activities such as bruxism and lack of implant-protected occlusion. Occlusal overload due to bruxism or inappropriate or inadequate occlusion as a single factor or a combination of these factors during the first years after the functional load can cause implant fracture. Fracture of the implant body more frequently occurred with single crowns than with other implant-supported fixed dental prostheses.

A simple, time-saving chairside device for radiographic diagnosis of vertical bone height and soft tissue thickness for implant placement--clinical report.

PubMed

Kharade, Pankaj; Banerjee, Ardhendu; Gupta, Tapas

2012-01-01

A diagnostic radiograph of the posterior regions of the jaws is mandatory if implant placement is considered at these sites. The goal is to avoid damage to important anatomical structures such as the inferior alveolar canal and maxillary sinus. Using radiographs to evaluate the remaining bone height available for implant insertion is a common procedure. Many articles have evaluated the success rates of fixed prostheses supported by osseointegrated implants, indicating high rates of success for prostheses 5-10 years in function. However, if an orthopantomogram machine is not readily available, periapical radiographs can be used for vertical bone height assessment. The familiar procedure of incorporating a metal ball of known diameter into an acrylic template is the method of choice. This is a relatively tedious and expensive procedure involving multiple steps, including impression taking, creation of a study model, and manufacture of a metal ball-bearing acrylic template. A further disadvantage for the patient is that a diagnostic radiograph can be taken only at the next appointment. This paper describes a quick and simple method to obtain a radiographic evaluation of remaining alveolar bone height and soft tissue thickness prior to implant placement with help of a metal ball device to avoid template fabrication and time consumption. Soft tissue thickness is measured nonsurgically.

Surgical Treatment, Oral Rehabilitation, and Orthognathic Surgery After Failure of Pharmacologic Treatment of Central Giant Cell Lesion: A Case Report.

PubMed

Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira

2016-12-01

Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Digital Versus Conventional Impressions in Fixed Prosthodontics: A Review.

PubMed

Ahlholm, Pekka; Sipilä, Kirsi; Vallittu, Pekka; Jakonen, Minna; Kotiranta, Ulla

2018-01-01

To conduct a systematic review to evaluate the evidence of possible benefits and accuracy of digital impression techniques vs. conventional impression techniques. Reports of digital impression techniques versus conventional impression techniques were systematically searched for in the following databases: Cochrane Central Register of Controlled Trials, PubMed, and Web of Science. A combination of controlled vocabulary, free-text words, and well-defined inclusion and exclusion criteria guided the search. Digital impression accuracy is at the same level as conventional impression methods in fabrication of crowns and short fixed dental prostheses (FDPs). For fabrication of implant-supported crowns and FDPs, digital impression accuracy is clinically acceptable. In full-arch impressions, conventional impression methods resulted in better accuracy compared to digital impressions. Digital impression techniques are a clinically acceptable alternative to conventional impression methods in fabrication of crowns and short FDPs. For fabrication of implant-supported crowns and FDPs, digital impression systems also result in clinically acceptable fit. Digital impression techniques are faster and can shorten the operation time. Based on this study, the conventional impression technique is still recommended for full-arch impressions. © 2016 by the American College of Prosthodontists.

Characterizing the Mechanical Properties of Running-Specific Prostheses

PubMed Central

Beck, Owen N.; Taboga, Paolo; Grabowski, Alena M.

2016-01-01

The mechanical stiffness of running-specific prostheses likely affects the functional abilities of athletes with leg amputations. However, each prosthetic manufacturer recommends prostheses based on subjective stiffness categories rather than performance based metrics. The actual mechanical stiffness values of running-specific prostheses (i.e. kN/m) are unknown. Consequently, we sought to characterize and disseminate the stiffness values of running-specific prostheses so that researchers, clinicians, and athletes can objectively evaluate prosthetic function. We characterized the stiffness values of 55 running-specific prostheses across various models, stiffness categories, and heights using forces and angles representative of those measured from athletes with transtibial amputations during running. Characterizing prosthetic force-displacement profiles with a 2nd degree polynomial explained 4.4% more of the variance than a linear function (p<0.001). The prosthetic stiffness values of manufacturer recommended stiffness categories varied between prosthetic models (p<0.001). Also, prosthetic stiffness was 10% to 39% less at angles typical of running 3 m/s and 6 m/s (10°-25°) compared to neutral (0°) (p<0.001). Furthermore, prosthetic stiffness was inversely related to height in J-shaped (p<0.001), but not C-shaped, prostheses. Running-specific prostheses should be tested under the demands of the respective activity in order to derive relevant characterizations of stiffness and function. In all, our results indicate that when athletes with leg amputations alter prosthetic model, height, and/or sagittal plane alignment, their prosthetic stiffness profiles also change; therefore variations in comfort, performance, etc. may be indirectly due to altered stiffness. PMID:27973573

Inflatable hollow obturator prostheses for patients undergoing an extensive maxillectomy: a case report

PubMed Central

Hou, Yue-Zhong; Huang, Zhi; Ye, Hong-Qiang; Zhou, Yong-Sheng

2012-01-01

The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot be considered. This case report described the use of an air valve in a hollow silicone obturator to manufacture an inflatable obturator that could be extended further into undercut area to retain itself. The inflatable obturator exhibited adequate retention, stability and border sealing, thereby improving the masticatory, pronunciation and swallowing functions of patients. It may be a suitable alternative treatment option to an implant-retained obturator. PMID:22653550

Marginal Accuracy and Internal Fit of Dental Copings Fabricated by Modern Additive and Subtractive Digital Technologies.

PubMed

Nelson, Neha; K S, Jyothi; Sunny, Kiran

2017-03-01

The margins of copings for crowns and retainers of fixed partial dentures affect the progress of microleakage and dental caries. Failures occur due to altered fit which is also influenced by the method of fabrication. An in-vitro study was conducted to determine among the cast base metal, copy milled zirconia, computer aided designing computer aided machining/manufacturing zirconia and direct metal laser sintered copings which showed best marginal accuracy and internal fit. Forty extracted maxillary premolars were mounted on an acrylic model and reduced occlusally using a milling machine up to a final tooth height of 4 mm from the cementoenamel junction. Axial reduction was accomplished on a surveyor and a chamfer finish line was given. The impressions and dies were made for fabrication of copings which were luted on the prepared teeth under standardized loading, embedded in self-cure acrylic resin, sectioned and observed using scanning electron microscope for internal gap and marginal accuracy. The copings fabricated using direct metal laser sintering technique exhibited best marginal accuracy and internal fit. Comparison of mean between the four groups by ANOVA and post-hoc Tukey HSD tests showed a statistically significant difference between all the groups (p⟨0.05). It was concluded that the copings fabricated using direct metal laser sintering technique exhibited best marginal accuracy and internal fit. Additive digital technologies such as direct metal laser sintering could be cost-effective for the clinician, minimize failures related to fit and increase longevity of teeth and prostheses. Copyright© 2017 Dennis Barber Ltd.

An overview of zirconia ceramics: basic properties and clinical applications.

PubMed

Manicone, Paolo Francesco; Rossi Iommetti, Pierfrancesco; Raffaelli, Luca

2007-11-01

Zirconia (ZrO2) is a ceramic material with adequate mechanical properties for manufacturing of medical devices. Zirconia stabilized with Y2O3 has the best properties for these applications. When a stress occurs on a ZrO2 surface, a crystalline modification opposes the propagation of cracks. Compression resistance of ZrO2 is about 2000 MPa. Orthopedic research led to this material being proposed for the manufacture of hip head prostheses. Prior to this, zirconia biocompatibility had been studied in vivo; no adverse responses were reported following the insertion of ZrO2 samples into bone or muscle. In vitro experimentation showed absence of mutations and good viability of cells cultured on this material. Zirconia cores for fixed partial dentures (FPD) on anterior and posterior teeth and on implants are now available. Clinical evaluation of abutments and periodontal tissue must be performed prior to their use. Zirconia opacity is very useful in adverse clinical situations, for example, for masking of dischromic abutment teeth. Radiopacity can aid evaluation during radiographic controls. Zirconia frameworks are realized by using computer-aided design/manufacturing (CAD/CAM) technology. Cementation of Zr-ceramic restorations can be performed with adhesive luting. Mechanical properties of zirconium oxide FPDs have proved superior to those of other metal-free restorations. Clinical evaluations, which have been ongoing for 3 years, indicate a good success rate for zirconia FPDs. Zirconia implant abutments can also be used to improve the aesthetic outcome of implant-supported rehabilitations. Newly proposed zirconia implants seem to have good biological and mechanical properties; further studies are needed to validate their application.

A 3-year clinical and radiographic study of implants placed simultaneously with maxillary sinus floor augmentations using a new nanocrystalline hydroxyapatite.

PubMed

Heinemann, F; Mundt, T; Biffar, R; Gedrange, T; Goetz, W

2009-12-01

The aims of this case series was to evaluate the success rate of implants and their restorations, the sinus bone graft resorption, and the marginal bone loss around the implants when nanocristalline HA embedded in a silica matrix was exclusively used as grafting material. In 13 partially edentulous patients of a private practice having missing teeth in the posterior maxilla and a subantral bone height between 3 and 7 mm, 19 sinus augmentations (100% Nanobone, Artoss, Rostock, Germany) by the lateral lift technique were performed. The implants (Tiolox/Tiologic Implants, Dentaurum, Ispringen, Germany) were simultaneously placed. After 6 to 9 months 37 implants were restored with fixed dental prostheses. The clinical evaluation included peri-implant parameters, periotest measurements and the restorations. The radiographic bone heights over time were estimated with linear mixed models. The implant success rate was 100% after three years. The periotest values (between -7 and -6) after implant abutment connection indicated a solid osseointegration. The mean rates of the marginal bone loss over the first year were higher (mesial: -0.55, distal: -0.51 mm) than the annual rates thereafter (mesial: -0.09 mm, distal: -0.08 mm). The mean rates of changes in the total bone height were neglectable (<0.2 mm) and not significant. The prosthodontic and esthetic evaluation revealed a successful outcome. Within the limits of this clinical report it may be concluded that maxillary sinus augmentation using 100% nanocristalline HA embedded in a silica matrix to support implants is a reliable procedure.

[Effect of CO2 laser on prostheses used in middle ear surgery].

PubMed

Szymański, Marcin

2005-01-01

The use of CO2 laser is advocated in primary and revision stapes surgery. The aim of the study was to assess the effect of CO2 laser on stapes prostheses. CO2 laser was applied on several types of stapes prostheses and PORPs, with power settings suggested by the manufacturer (continuous wave, 2 W and 6 W; 0,05 s). Application of the laser on stainless steel or titanium prosthesis did not exert any effect on the structure of the prosthesis. The use of the laser on the Teflon piston caused superficial burning with power 2 W, and melting and holes in the piston with power settings at 6W. Similar plastipore prostheses were melting. Hydroxyapatite PORP shattered after application of the laser energy. Teflon and hydroxyapatite prostheses are easily damaged by the laser energy, therefore applying a laser on them should be avoided. CO2 laser can be used on stainless steel and titanium prostheses without risk of damaging them. However the possibility of transmission of heat to the vestibule has to be taken into consideration.

Is scale-invariance in gauge-Yukawa systems compatible with the graviton?

NASA Astrophysics Data System (ADS)

Christiansen, Nicolai; Eichhorn, Astrid; Held, Aaron

2017-10-01

We explore whether perturbative interacting fixed points in matter systems can persist under the impact of quantum gravity. We first focus on semisimple gauge theories and show that the leading order gravity contribution evaluated within the functional Renormalization Group framework preserves the perturbative fixed-point structure in these models discovered in [J. K. Esbensen, T. A. Ryttov, and F. Sannino, Phys. Rev. D 93, 045009 (2016)., 10.1103/PhysRevD.93.045009]. We highlight that the quantum-gravity contribution alters the scaling dimension of the gauge coupling, such that the system exhibits an effective dimensional reduction. We secondly explore the effect of metric fluctuations on asymptotically safe gauge-Yukawa systems which feature an asymptotically safe fixed point [D. F. Litim and F. Sannino, J. High Energy Phys. 12 (2014) 178., 10.1007/JHEP12(2014)178]. The same effective dimensional reduction that takes effect in pure gauge theories also impacts gauge-Yukawa systems. There, it appears to lead to a split of the degenerate free fixed point into an interacting infrared attractive fixed point and a partially ultraviolet attractive free fixed point. The quantum-gravity induced infrared fixed point moves towards the asymptotically safe fixed point of the matter system, and annihilates it at a critical value of the gravity coupling. Even after that fixed-point annihilation, graviton effects leave behind new partially interacting fixed points for the matter sector.

Precise Point Positioning with Partial Ambiguity Fixing.

PubMed

Li, Pan; Zhang, Xiaohong

2015-06-10

Reliable and rapid ambiguity resolution (AR) is the key to fast precise point positioning (PPP). We propose a modified partial ambiguity resolution (PAR) method, in which an elevation and standard deviation criterion are first used to remove the low-precision ambiguity estimates for AR. Subsequently the success rate and ratio-test are simultaneously used in an iterative process to increase the possibility of finding a subset of decorrelated ambiguities which can be fixed with high confidence. One can apply the proposed PAR method to try to achieve an ambiguity-fixed solution when full ambiguity resolution (FAR) fails. We validate this method using data from 450 stations during DOY 021 to 027, 2012. Results demonstrate the proposed PAR method can significantly shorten the time to first fix (TTFF) and increase the fixing rate. Compared with FAR, the average TTFF for PAR is reduced by 14.9% for static PPP and 15.1% for kinematic PPP. Besides, using the PAR method, the average fixing rate can be increased from 83.5% to 98.2% for static PPP, from 80.1% to 95.2% for kinematic PPP respectively. Kinematic PPP accuracy with PAR can also be significantly improved, compared to that with FAR, due to a higher fixing rate.

Precise Point Positioning with Partial Ambiguity Fixing

PubMed Central

Li, Pan; Zhang, Xiaohong

2015-01-01

Reliable and rapid ambiguity resolution (AR) is the key to fast precise point positioning (PPP). We propose a modified partial ambiguity resolution (PAR) method, in which an elevation and standard deviation criterion are first used to remove the low-precision ambiguity estimates for AR. Subsequently the success rate and ratio-test are simultaneously used in an iterative process to increase the possibility of finding a subset of decorrelated ambiguities which can be fixed with high confidence. One can apply the proposed PAR method to try to achieve an ambiguity-fixed solution when full ambiguity resolution (FAR) fails. We validate this method using data from 450 stations during DOY 021 to 027, 2012. Results demonstrate the proposed PAR method can significantly shorten the time to first fix (TTFF) and increase the fixing rate. Compared with FAR, the average TTFF for PAR is reduced by 14.9% for static PPP and 15.1% for kinematic PPP. Besides, using the PAR method, the average fixing rate can be increased from 83.5% to 98.2% for static PPP, from 80.1% to 95.2% for kinematic PPP respectively. Kinematic PPP accuracy with PAR can also be significantly improved, compared to that with FAR, due to a higher fixing rate. PMID:26067196

Analytical pricing of geometric Asian power options on an underlying driven by a mixed fractional Brownian motion

NASA Astrophysics Data System (ADS)

Zhang, Wei-Guo; Li, Zhe; Liu, Yong-Jun

2018-01-01

In this paper, we study the pricing problem of the continuously monitored fixed and floating strike geometric Asian power options in a mixed fractional Brownian motion environment. First, we derive both closed-form solutions and mixed fractional partial differential equations for fixed and floating strike geometric Asian power options based on delta-hedging strategy and partial differential equation method. Second, we present the lower and upper bounds of the prices of fixed and floating strike geometric Asian power options under the assumption that both risk-free interest rate and volatility are interval numbers. Finally, numerical studies are performed to illustrate the performance of our proposed pricing model.

Radial head reconstruction in elbow fracture-dislocation: monopolar or bipolar prosthesis?

PubMed

Hartzler, Robert U; Morrey, Bernard F; Steinmann, Scott P; Llusa-Perez, Manuel; Sanchez-Sotelo, Joaquin

2014-07-01

Monopolar and bipolar radial head prosthetic arthroplasties have been used successfully to treat elbow fracture-dislocation with unsalvageable radial head fractures. The relative stability of these two designs in different clinical situations is a topic of ongoing investigation. We tested the effects of monopolar and bipolar fixed-neck prosthetic radial head implants on improvement in elbow coronal and axial plane laxity in a terrible triad biomechanical model that accounted for lateral collateral ligament integrity and the presence of a transverse coronoid fracture. Kinematic data were collected on six fresh-frozen cadaveric upper extremities tested with passive motion throughout the flexion arc. Varus and valgus gravity stress were applied with the wrist in neutral position. A lateral collateral ligament reconstruction was simulated. We assessed instability after radial head resection and reconstruction with either a monopolar or bipolar implant in the presence of a transversely fractured (Regan and Morrey Type 2) or fixed coronoid process. With collateral ligament integrity, no difference was detected, with the numbers available, in valgus laxity between implants under valgus stress (p = 1.0). Laxity improvement with each prosthesis was higher when the coronoid was fractured (mean ± SD: monopolar: 7.4° ± 1.6°, p < 0.001; bipolar: 6.4° ± 1.6°, p = 0.003) than when it was fixed (monopolar: 4.0° ± 1.6°, p = 0.02; bipolar: 4.2° ± 1.6°, p = 0.01). With the numbers available, there was no difference in external rotation laxity between implants under valgus stress (p = 1.0). The greatest stabilizing effect of the prostheses occurred when the coronoid was fractured (monopolar: 3.3° ± 1.2°, p = 0.15; bipolar: 3.3° ± 1.2°, p = 0.17). Radial head arthroplasty offered no substantial stability under varus stress for varus or internal rotation laxity. In our terrible triad cadaveric model, coronoid fixation was effective in improving varus laxity with a monopolar or bipolar prosthesis in place. Also, both types of prostheses were effective in improving valgus and external rotation laxity to the elbow, regardless of coronoid status. With collateral ligaments reconstructed, no large kinematic differences were noted between implants regardless of the varus-valgus position or whether the coronoid was fractured or fixed. The data from our cadaveric model support the use of either implant type in terrible triad injuries if the collateral ligaments are intact or reconstructed.

Composite Materials for Maxillofacial Prostheses.

DTIC Science & Technology

1979-08-01

block number) MAXILLOFACIAL PROSTHESES; PROSTHETIC MATERIALS; MICROCAPSULES ; SOFT FILLERS; ELASTuMER COMPOSITES 20,_ ABSTRACT ’Continue on reverse side...approaches were pursued toward making such microcapsules . One approach involves coaxial extrusion of a catalyzed elastomer precursor and core liquid into a...fabrication of maxillofacial prostheses. The projected composite systems are elastomeric-shelled, liquid-filled microcapsules . Two experimental approaches were

Generalized contractive mappings and weakly α-admissible pairs in G-metric spaces.

PubMed

Hussain, N; Parvaneh, V; Hoseini Ghoncheh, S J

2014-01-01

The aim of this paper is to present some coincidence and common fixed point results for generalized (ψ, φ)-contractive mappings using partially weakly G-α-admissibility in the setup of G-metric space. As an application of our results, periodic points of weakly contractive mappings are obtained. We also derive certain new coincidence point and common fixed point theorems in partially ordered G-metric spaces. Moreover, some examples are provided here to illustrate the usability of the obtained results.

Generalized Contractive Mappings and Weakly α-Admissible Pairs in G-Metric Spaces

PubMed Central

Hussain, N.; Parvaneh, V.; Hoseini Ghoncheh, S. J.

2014-01-01

The aim of this paper is to present some coincidence and common fixed point results for generalized (ψ, φ)-contractive mappings using partially weakly G-α-admissibility in the setup of G-metric space. As an application of our results, periodic points of weakly contractive mappings are obtained. We also derive certain new coincidence point and common fixed point theorems in partially ordered G-metric spaces. Moreover, some examples are provided here to illustrate the usability of the obtained results. PMID:25202742

Quantifying metal artefact reduction using virtual monochromatic dual-layer detector spectral CT imaging in unilateral and bilateral total hip prostheses.

PubMed

Wellenberg, R H H; Boomsma, M F; van Osch, J A C; Vlassenbroek, A; Milles, J; Edens, M A; Streekstra, G J; Slump, C H; Maas, M

2017-03-01

To quantify the impact of prosthesis material and design on the reduction of metal artefacts in total hip arthroplasties using virtual monochromatic dual-layer detector Spectral CT imaging. The water-filled total hip arthroplasty phantom was scanned on a novel 128-slice Philips IQon dual-layer detector Spectral CT scanner at 120-kVp and 140-kVp at a standard computed tomography dose index of 20.0mGy. Several unilateral and bilateral hip prostheses consisting of different metal alloys were inserted and combined which were surrounded by 18 hydroxyapatite calcium carbonate pellets representing bone. Images were reconstructed with iterative reconstruction and analysed at monochromatic energies ranging from 40 to 200keV. CT numbers in Hounsfield Units (HU), noise measured as the standard deviation in HU, signal-to-noise-ratios (SNRs) and contrast-to-noise-ratios (CNRs) were analysed within fixed regions-of-interests placed in and around the pellets. In 70 and 74keV virtual monochromatic images the CT numbers of the pellets were similar to 120-kVp and 140-kVp polychromatic results, therefore serving as reference. A separation into three categories of metal artefacts was made (no, mild/moderate and severe) where pellets were categorized based on HU deviations. At high keV values overall image contrast was reduced. For mild/moderate artefacts, the highest average CNRs were attained with virtual monochromatic 130keV images, acquired at 140-kVp. Severe metal artefacts were not reduced. In 130keV images, only mild/moderate metal artefacts were significantly reduced compared to 70 and 74keV images. Deviations in CT numbers, noise, SNRs and CNRs due to metal artefacts were decreased with respectively 64%, 57%, 62% and 63% (p<0.001) compared to unaffected pellets. Optimal keVs, based on CNRs, for different unilateral and bilateral metal hip prostheses consisting of different metal alloys varied from 74 to 150keV. The Titanium alloy resulted in less severe artefacts and were reduced more effectively compared to the Cobalt alloy. Virtual monochromatic dual-layer Spectral CT imaging results in a significant reduction of streak artefacts produced by beam-hardening in mild and moderate artefacts by improving CT number accuracy, SNRs and CNRs, while decreasing noise values in a total hip arthroplasty phantom. An optimal monochromatic energy of 130keV was found ranging from 74keV to 150keV for different unilateral and bilateral hip prostheses consisting of different metal alloys. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

[Significance of various implantate localizations of Sparks prostheses, experimental studies in rats].

PubMed

Brieler, H S; Parwaresch, R; Thiede, A

1976-01-01

Our investigations show that Sparks prostheses after subcutaneous implantation are suitable for vascular grafting. At the end of the organization period the connective tissue becomes strong, and after the third and fourth weeks collagenous and elastic fibers can be seen. Ten weeks after s.c. implantation, collagenous fibers predominate. After this the Sparks prostheses can be used as a vascular graft. Intraperitoneal implantation, however, shows a histologically different picture with characteristic findings: only fat cells can be observed, a strong granulation tissue with elastic and collagenous fibers is not present. After intraperitoneal implantation Sparks prostheses are therefore unsuitable for vascular grafts.

[Posturographic study of total prostheses in the leg. Apropos of 88 patients examined].

PubMed

Lord, G; Gentaz, R; Gagey, P M; Baron, J B

1976-01-01

By suppressing certain articular sensory receptors, the reconstructive surgery of joints using total prostheses modifies tonic postural activity and, by this means, alters the regulation of balance in the subjects of operation. This doubtless explains certain discrepancies between the apparently excellent results in respect of joint movement and muscle strength and poor utilisation of the joint in every day life (instability, use of sticks or failure to use the joint in walking). Drawing on the experience and basic work of specialists in posture, the authors have undertaken a study of tonic postural activity in patients who had received a total prosthesis in the lower limb, both from the clinical aspect and by graphic measurement using an electronic apparatus, the statokinesiometer. Fourteen normal subjects were tested to calibrate the apparatus and 8 patients suffering from established osteoarthritis of the hip were studied as controls. Analysis of tonic postural activity was made in 66 patients who had received total prostheses in the lower limb. The results showed significant disturbance in balance in ankle prostheses, minimal disturbance in knee prostheses and not significant disturbance in hip prostheses. Certain therapeutic implications are derived from this study.

Surgical treatment of tracheal collapse using pliable total ring prostheses: results in one experimental and 4 clinical cases.

PubMed Central

Ayres, S A; Holmberg, D L

1999-01-01

Pliable total ring prostheses were created from the polyvinyl chloride drip chambers of intravenous administration sets. The total ring prostheses were placed in one clinically normal research dog and in 4 client-owned dogs diagnosed with tracheal collapse. The research dog was euthanized one month after placement of the prostheses. Histopathological analysis of the trachea adjacent to the prostheses revealed a mild inflammatory response. The follow-up period for the clinical cases was from 4 months to 11 years. Radiographs taken and fluoroscopy performed 1 day to 5 months after surgery revealed improvement or resolution of the tracheal collapse. One dog was asymptomatic 28 weeks following surgery. Two dogs died 7 and 9 years after surgery, with one requiring intermittent medical management for coughing. They were euthanized for nonrespiratory illness. One dog had a persistent nonproductive cough, due to collapse of the mainstem bronchi, when last evaluated 4 months postoperatively. Pliable total ring prostheses provided adequate stability to the trachea and had the advantage of conforming to the trachea and being easy to create, place, and suture. Images Figure 1. Figure 2. PMID:10563237

Maxillary rehabilitation using fixed and removable partial dentures with attachments: a clinical report.

PubMed

dos Santos Nunes Reis, José Maurício; da Cruz Perez, Luciano Elias; Alfenas, Bruna Fernandes Moreira; de Oliveira Abi-Rached, Filipe; Filho, João Neudenir Arioli

2014-01-01

Despite requiring dental crown preparation and possible root canal treatment, besides the difficulty of clinical and laboratory repairs, and financial burden, the association between fixed (FPD) and removable partial dentures (RPD) by means of attachments is an important alternative for oral rehabilitation, particularly when the use of dental implants and FPDs is limited or not indicated. Among the advantages of attachment-retained RPDs are the improvements in esthetics and biomechanics, as well as correction of the buccal arrangement of anterior teeth in Kennedy Class III partially edentulous arches. This article describes the treatment sequence and technique for the use of attachments in therapy combining FPD/RPD. © 2013 by the American College of Prosthodontists.

Coplanar intensity-modulated radiotherapy class solution for patients with prostate cancer with bilateral hip prostheses with and without nodal involvement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Young K., E-mail: Young.Lee@rmh.nhs.uk; McVey, Gerard P.; South, Chris P.

2013-07-01

Dose distributions for prostate radiotherapy are difficult to predict in patients with bilateral hip prostheses in situ, due to image distortions and difficulty in dose calculation. The feasibility of delivering curative doses to prostate using intensity-modulated radiotherapy (IMRT) in patients with bilateral hip prostheses was evaluated. Planning target volumes for prostate only (PTV1) and pelvic nodes (PTV2) were generated from data on 5 patients. PTV1 and PTV2 dose prescriptions were 70 Gy and 60 Gy, respectively, in 35 fractions, and an additional nodal boost of 65 Gy was added for 1 plan. Rectum, bladder, and bowel were also delineated. Beammore » angles and segments were chosen to best avoid entering through the prostheses. Dose-volume data were assessed with respect to clinical objectives. The plans achieved the required prescription doses to the PTVs. Five-field IMRT plans were adequate for patients with relatively small prostheses (head volumes<60 cm{sup 3}) but 7-field plans were required for patients with larger prostheses. Bowel and bladder doses were clinically acceptable for all patients. Rectal doses were deemed clinically acceptable, although the V{sub 50} {sub Gy} objective was not met for 4/5 patients. We describe an IMRT solution for patients with bilateral hip prostheses of varying size and shape, requiring either localized or whole pelvic radiotherapy for prostate cancer.« less

Clinical outcome and complications of thoracic and pelvic limb stump and socket prostheses.

PubMed

Phillips, Andrew; Kulendra, Elvin; Bishop, Edith; Monk, Michelle; Parsons, Kevin; House, Arthur

2017-07-20

To describe the use, quality of life, compliance, complications, and outcome of animals fitted with stump socket prostheses. Medical records of dogs fitted with a stump socket prosthesis were reviewed. Functional outcome, quality of life and complications were retrospectively assessed from an owner questionnaire. Thirteen stump socket prostheses (12 dogs) were fitted for a variety of reasons including trauma, congenital abnormalities, and neoplasia. Eight dogs had a good outcome overall and four a poor outcome. Quality of life (QOL) remained good or excellent in 10/12 dogs. Nine complications were seen in 7/12 dogs, most were manageable; surgical wound complications (n = 2) and pressures sores (n = 4) were the most frequently encountered. One dog suffered multiple complications. Thoracic and pelvic limb stump socket prostheses had a similar complication rate, however all animals with a poor outcome had a thoracic limb stump socket prosthesis; two were small breed dogs (under 10 kg) and two had bilateral thoracic limb abnormalities. Stump socket prostheses are feasible and versatile in animals. In correctly selected cases, good to excellent outcomes are possible. However, complications are frequent but often manageable. Further investigations are required into the risk factors for poor outcomes and prospective studies are required to assess changes in biomechanics, function, and QOL before and after fitting of a stump socket prosthesis. Until further evidence is available, careful consideration should be given before fitting bilateral thoracic limb stump socket prostheses or thoracic limb stump socket prostheses to small breed dogs.

In vivo testing of porous Ti-25Nb alloy serving as a femoral stem prosthesis in a rabbit model

PubMed Central

Weng, Xiaojun; Yang, Hailin; Xu, Jian; Li, Xiaosheng; Liao, Qiande; Wang, Jing

2016-01-01

The aim of the present study was to observe the performance of Ti-25Nb alloys with various porosities as femoral stem prostheses in a rabbit model, thus providing basic experimental evidence for the development of porous prostheses. The porous Ti-25Nb alloy prostheses were designed according to the morphology of the medullary cavity. These prostheses were placed into the femoral medullary cavities in 36 New Zealand white rabbits. Postoperative X-ray films, scanning electron microscopy (SEM) of the implant interface, energy-dispersive spectroscopy (EDS) analysis of the implant surface, pulling-out test and general observations were conducted. The specimens showed good biocompatibility; there was no obvious bone absorption in porous Ti-25Nb specimens with different porosities at different time points observed using X-ray films. Under SEM examination, calcium deposits were observed inside the pores and in the interface between bone and prostheses. The EDS analysis demonstrated that calcium deposits were present on the surface of the prostheses at the eight-week point postoperatively. The pulling-out test showed good bonding strength between bone and implant; after pulling out, the surface and inside the pores of the prostheses all presented bone mass. Porous Ti-25Nb alloy implants presents good biocompatibility as well as providing a biological fixation between the bone and implant. A porosity of 70% is more advantageous to the newborn bone ingrowth, combined with achieving a more solid bone-implant interface. PMID:27602063

Computerized design of speech prostheses.

PubMed

Leonard, R J

1991-08-01

The use of computerized techniques to assist in the design of palatal and/or glossal prostheses is described. Patients with oropharyngeal resection and associated speech impairment are candidates for such prostheses. Procedures discussed allow for the design of some features of the prosthesis, such as shape, location, and tests of its effect on certain speech parameters, prior to actual fabrication. Advantages and current limitations of the techniques are also discussed.

Access to Breast Prostheses via a Government-Funded Service in Victoria, Australia: Experience of Women and Service Providers

ERIC Educational Resources Information Center

Livingston, Patricia M.; White, Victoria; Roberts, Susan; Pritchard, Emma; Gibbs, Anne; Hill, David J.

2003-01-01

For many women, the only alternative to breast reconstruction following a mastectomy is to use external prostheses, which need replacing regularly at a cost of up to $395 per prosthesis. Commonwealth and state governments across Australia have responded to this need by providing subsidies to assist in the purchase of breast prostheses. However,…

Ceramic Defects in Metal-Ceramic Fixed Dental Prostheses Made from Co-Cr and Au-Pt Alloys: A Retrospective Study.

PubMed

Mikeli, Aikaterini; Boening, Klaus W; Lißke, Benjamin

2015-01-01

Ceramic defects in porcelain-fused-to-metal (PFM) restorations may depend on framework alloy type. This study assessed ceramic defects on cobalt-chromium- (Co-Cr-) and gold-platinum- (Au-Pt-) based PFM restorations. In this study, 147 Co-Cr-based and 168 Au-Pt-based PFM restorations inserted between 1998 and 2010 (139 patients) were examined for ceramic defects. Detected defects were assigned to three groups according to clinical defect relevance. Ceramic defect rates (Co-Cr-based: 12.9%; Au-Pt-based: 7.2%) revealed no significant difference but a strong statistical trend (U test, P = .082). Most defects were of little clinical relevance. Co-Cr PFM restorations may be at higher risk for ceramic defects compared to Au-Pt-based restorations.

Precision attachments for the partially dentate mouth

PubMed Central

Preiskel, H W

1974-01-01

Some uses of precision attachments in restoring the partially dentate mouth are considered. These devices are indicated where neither the clasp-retained denture nor the fixed bridge is entirely suitable. ImagesFig. 2 PMID:4614689

Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact.

PubMed

van Stralen, R A; Heesterbeek, P J C; Wymenga, A B

2015-11-01

In anteroposterior (AP)-gliding mobile-bearing total knee arthroplasty (TKA), the femoral component can theoretically slide forward resulting in a more anterior contact point, causing pain due to impingement. A lower lever arm of the extensor apparatus can also attribute to higher patella pressures and pain. The goal of this study was to determine the contact point in a cohort of mobile- and fixed-bearing TKAs, to determine whether the contact point lies more anteriorly in mobile-bearing TKA and to confirm whether this results in anterior knee pain. We used 38 fixed-bearing TKA and 40 mobile-bearing TKA from a randomized trial with straight lateral knee X-rays and measured the contact point. The functional outcome was measured by Knee Society Score at 12 months postoperatively. Pain scores were analysed using a VAS score (0-100 mm) in all patients at rest and when moving. Difficulty at rising up out of a chair was also assessed using a VAS score. The contact point in mobile-bearing TKA was situated at 59.5 % of the AP distance of the tibia and in the fixed-bearing TKA group at 66.1 % (P< 0.05). Patients with mobile- and fixed-bearing TKAs had similar knee scores, pain scores and difficulty in chair rise. No significant correlation was found between contact point and knee pain. The hypothesis of a more anterior contact point in the mobile-bearing cohort was confirmed but no correlation with functional and pain scores in this cohort could be found. The tibiofemoral contact point could not be correlated with a different clinical outcome and higher incidence of anterior knee pain. This study further adds to the knowledge on possible differences between mobile- and fixed-bearing prostheses. Next to that, bad outcomes could not be explained by CP. Case series, Level IV.

Prostheses for stapes surgery.

PubMed

Slattery, W H; House, J W

1995-04-01

A variety of different implants are available today for use by the otologic surgeon. All prostheses are well tolerated, and the risks of complication as a result of their implantation are comparable. The most commonly used prostheses are the wire-Teflon piston and the stainless steel bucket handle. Although the otologic surgeon has a wide variety of prostheses to choose from, most have a preference for one particular type. Results of hearing improvement following a successful stapedectomy is more a function of the surgeon's experience than of the type of prosthesis used. As James L. Sheehy, MD, so often says, "if a technique is working well for you, don't change for change's sake" (personal communication, 1994).

Frequency of partial edentulism and awareness to restore the same: a cross sectional study in the age group of 18-25 years among kerala student population.

PubMed

Abdurahiman, V T; Abdul Khader, M; Sanju John Jolly

2013-12-01

Treating partial edentulousness forms a major share of prosthodontic clinical practice. The purpose of this study was to find out the frequency of partial edentulism, its arch distribution status, awareness to restore, and the ratio of removable to fixed prosthesis among a student sample aged 18-25 years. The methodology selected was a questionnaire survey followed by clinical examination of the student community from Tirur taluk, Malappuram district, Kerala. The results showed that the frequency of partial edentulism among the surveyed group was significant with predominance in maxillary posterior edentulousness in men and mandibular posterior edentulousness in women. Though there was not any significant gender difference in the partial edentulism, women were more aware than men to restore it. All restored cases were with fixed bridges and no anterior edentulousness was found. The study also revealed a lack of awareness and need to educate the population.

Forensic odontology: A prosthodontic view

PubMed Central

Gosavi, Sulekha; Gosavi, Siddharth

2012-01-01

The most common role of the forensic dentist is the identification of deceased individuals. Dental identifications have always played a key role in natural and manmade disaster situations, and in particular, the mass casualties normally associated with aviation disasters. Because of the lack of a comprehensive fingerprint database, dental identification continues to be crucial in the world. An all-acrylic resin appliance such as a full denture or an all-acrylic partial denture (or orthodontic appliance), prior to delivery, could be inscribed with the patient's full name on a substrate (paper, metal) and sealed inconspicuously into the surface of a denture by various processes. It has been noted by several authors that in many cases of air disaster where the limbs are completely burnt off, some denture materials survive, especially the posterior part of acrylic dentures and metal-based dentures. Thus, marked dental prostheses (full and partial dentures, mouthguards and removal orthodontic appliances) would lead to rapid identification in the event of accidents and disaster. PMID:23087581

A functional speech impression used to fabricate a maxillary speech prosthesis for a partial glossectomy patient.

PubMed

Knowles, J C; Chalian, V A; Shanks, J C

1984-02-01

Surgery for cancer of the floor of the mouth often results in alteration of the muscles of the tongue and floor of the mouth. Both primary and secondary surgical procedures often result in scar formation with reduced mobility of the tongue during speech and deglutition. Speech is often used as a diagnostic tool in the placement of the anterior teeth during fabrication of a prosthesis. Speech can similarly be used to help determine the proper placement of a speech portion of the prosthesis. The prosthetic rehabilitation approach described lowers the palatal vault with a false palate to enable the tongue to function against it during speech (Fig. 15). Group studies have shown that the design and fabrication of speech prostheses for partial glossectomy patients have significantly improved speech and swallowing for these patients. A speech pathologist is helpful during diagnosis, and speech therapy is necessary for significant speech improvement. Prosthetic rehabilitation alone cannot be expected to improve speech.

Speech assessment of patients using three types of indwelling tracheo-oesophageal voice prostheses.

PubMed

Heaton, J M; Sanderson, D; Dunsmore, I R; Parker, A J

1996-04-01

A multidisciplinary prospective study compared speech acceptability between three types of indwelling tracheo-oesophageal voice prostheses. Twenty male laryngectomees took part over five years, using 42 prostheses. Speech was assessed on a discrete scale by trained and untrained personnel. The majority scored in the mid-range for each assessor. The kappa coefficient was used to test similarity between assessors, and for all pairings agreement was significant (p < 0.05). The speech and language therapist tended to give higher scores and the patient lower. A relationship was found between patients' ages categorized by decade and the surgeon's score alone. This relationship held for Groningen high resistance and Provox prostheses individually too (p < 0.05). The untrained assessed similarly to the professionals--humans are all voice listeners. The analysis suggests surgeons find tracheo-oesophageal speech in older patients better than in younger ones; or make more allowances for the elderly. There was a trend for Provox prostheses to produce the best scores.

Optical coherence tomography and confocal microscopy investigations of dental prostheses

NASA Astrophysics Data System (ADS)

Negrutiu, Meda L.; Sinescu, Cosmin; Hughes, Michael; Bradu, Adrian; Rominu, Mihai; Todea, Carmen; Dobre, George; Podoleanu, Adrian

2008-09-01

Dental prostheses are very complex systems, heterogenous in structure, made up from various materials, with different physical properties. An essential question mark is on the physical, chemical and mechanical compatibility between these materials. They have to satisfy high stress requirements as well as esthetic challenges. The masticatory stress may induce fractures of the prostheses, which may be triggered by initial materials defects or by alterations of the technological process. The failures of dental prostheses lead to functional, esthetic and phonetic disturbances which finally render the prosthetic treatment inefficient. The purpose of this study is to evaluate the capability of en-face optical coherence tomography as a possible non-invasive high resolution method in supplying the necessary information on the material defects of dental prostheses and microleakage at prosthetic interfaces. C-scan and B-scan OCT images as well as confocal images are acquired from a large range of samples. Gaps between the dental interfaces and material defects are clearly exposed. We conclude that OCT can successfully be used as a noninvasive analysis method.

Using speech for mode selection in control of multifunctional myoelectric prostheses.

PubMed

Fang, Peng; Wei, Zheng; Geng, Yanjuan; Yao, Fuan; Li, Guanglin

2013-01-01

Electromyogram (EMG) recorded from residual muscles of limbs is considered as suitable control information for motorized prostheses. However, in case of high-level amputations, the residual muscles are usually limited, which may not provide enough EMG for flexible control of myoelectric prostheses with multiple degrees of freedom of movements. Here, we proposed a control strategy, where the speech signals were used as additional information and combined with the EMG signals to realize more flexible control of multifunctional prostheses. By replacing the traditional "sequential mode-switching (joint-switching)", the speech signals were used to select a mode (joint) of the prosthetic arm, and then the EMG signals were applied to determine a motion class involved in the selected joint and to execute the motion. Preliminary results from three able-bodied subjects and one transhumeral amputee demonstrated the proposed strategy could achieve a high mode-selection rate and enhance the operation efficiency, suggesting the strategy may improve the control performance of commercial myoelectric prostheses.

Bioelectronic retinal prosthesis

NASA Astrophysics Data System (ADS)

Weiland, James D.

2016-05-01

Retinal prosthesis have been translated to clinical use over the past two decades. Currently, two devices have regulatory approval for the treatment of retinitis pigmentosa and one device is in clinical trials for treatment of age-related macular degeneration. These devices provide partial sight restoration and patients use this improved vision in their everyday lives to navigate and to detect large objects. However, significant vision restoration will require both better technology and improved understanding of the interaction between electrical stimulation and the retina. In particular, current retinal prostheses do not provide peripheral visions due to technical and surgical limitations, thus limiting the effectiveness of the treatment. This paper reviews recent results from human implant patients and presents technical approaches for peripheral vision.

Sport prostheses and prosthetic adaptations for the upper and lower limb amputees: an overview of peer reviewed literature.

PubMed

Bragaru, Mihai; Dekker, Rienk; Geertzen, Jan H B

2012-09-01

Sport prostheses are used by both upper- and lower-limb amputees while participating in sports and other physical activities. Although the number of these devices has increased over the past decade, no overview of the peer reviewed literature describing them has been published previously. Such an overview will allow specialists to choose appropriate prostheses based on available scientific evidence rather than on personal experience or preference. To provide an overview of the sport prostheses as they are described by the papers published in peer reviewed literature. Literature review. Four electronic databases were searched using free text and Medical Subject Headings (MESH) terms. Papers were included if they concerned a prosthesis or a prosthetic adaptation used in sports. Papers were excluded if they did not originate from peer reviewed sources, if they concerned prostheses for body parts other than the upper or lower limbs, if they concerned amputations distal to the wrist or ankle, or if they were written in a language other than English. Twenty-four papers were included in this study. The vast majority contained descriptive data and consisted of expert opinions and technical notes. Data concerning the energy efficiency, technical characteristics and special mechanical properties of prostheses or prosthetic adaptations for sports, other than running, are scarce.

Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review.

PubMed

Carey, Stephanie L; Lura, Derek J; Highsmith, M Jason

2015-01-01

The choice of a myoelectric or body-powered upper-limb prosthesis can be determined using factors including control, function, feedback, cosmesis, and rejection. Although body-powered and myoelectric control strategies offer unique functions, many prosthesis users must choose one. A systematic review was conducted to determine differences between myoelectric and body-powered prostheses to inform evidence-based clinical practice regarding prescription of these devices and training of users. A search of 9 databases identified 462 unique publications. Ultimately, 31 of them were included and 11 empirical evidence statements were developed. Conflicting evidence has been found in terms of the relative functional performance of body-powered and myoelectric prostheses. Body-powered prostheses have been shown to have advantages in durability, training time, frequency of adjustment, maintenance, and feedback; however, they could still benefit from improvements of control. Myoelectric prostheses have been shown to improve cosmesis and phantom-limb pain and are more accepted for light=intensity work. Currently, evidence is insufficient to conclude that either system provides a significant general advantage. Prosthetic selection should be based on a patient's individual needs and include personal preferences, prosthetic experience, and functional needs. This work demonstrates that there is a lack of empirical evidence regarding functional differences in upper-limb prostheses.

Bounding the Resource Availability of Partially Ordered Events with Constant Resource Impact

NASA Technical Reports Server (NTRS)

Frank, Jeremy

2004-01-01

We compare existing techniques to bound the resource availability of partially ordered events. We first show that, contrary to intuition, two existing techniques, one due to Laborie and one due to Muscettola, are not strictly comparable in terms of the size of the search trees generated under chronological search with a fixed heuristic. We describe a generalization of these techniques called the Flow Balance Constraint to tightly bound the amount of available resource for a set of partially ordered events with piecewise constant resource impact We prove that the new technique generates smaller proof trees under chronological search with a fixed heuristic, at little increase in computational expense. We then show how to construct tighter resource bounds but at increased computational cost.

Ferromagnetic movements of middle ear implants and stapes prostheses in a 3-T magnetic resonance field.

PubMed

Fritsch, Michael H; Gutt, Jason J

2005-03-01

A 3-T magnetic resonance field may cause motion or displacement of middle ear implants not seen in studies with 1.5-T magnets. Previous publications have described the safety limitations of some otologic implants in 1.5-T magnetic resonance fields. Several company-wide recalls of implants were issued. No studies to date have been reported for otologic implants within a 3-T magnetic resonance field, nor have there been comparisons with a 1.5-T field strength. Eighteen commonly used middle ear implants and prostheses were selected. In Part 1, the prostheses were placed in Petri dishes and exposed to a 3-T magnetic resonance field. In Part 2, the particular prostheses that showed movement in Part 1 were placed into their intended use positions within temporal bone laboratory specimens and exposed to a 3-T field. Both parts were repeated in a 1.5-T field. In Part 1, three prostheses moved dramatically from their start positions when exposed to the 3-T magnetic resonance field. In Part 2, the three particular prostheses that showed movement in Part 1 showed no gross displacement or movement from their start positions within the temporal bone laboratory specimens. No implants moved in the 1.5-T field in either Part 1 or Part 2. Certain stapes prostheses move dramatically in Petri dishes in 3-T fields. When placed into temporal bone laboratory specimens, the same prostheses show no signs of movement from the surgical site in a 3-T field, and it appears that the surgical position holds the implants firmly in place. Results of published 1.5-T field studies should not be used directly for safety recommendations in a 3-T magnetic resonance. Heat, voltage induction, and vibration during exposure to the magnetic resonance fields should be considered as additional possible safety issues. Preference should be given to platinum and titanium implants in manufacturing processes and surgical selection.

Machined and plastic copings in three-element prostheses with different types of implantabutment joints: a strain gauge comparative analysis

PubMed Central

NISHIOKA, Renato Sussumu; NISHIOKA, Lea Nogueira Braulino de Melo; ABREU, Celina Wanderley; de VASCONCELLOS, Luis Gustavo Oliveira; BALDUCCI, Ivan

2010-01-01

Objective Using strain gauge (SG) analysis, the aim of this in vitro study was quantify the strain development during the fixation of three-unit screw implant-supported fixed partial dentures, varying the types of implant-abutment joints and the type of prosthetic coping. The hypotheses were that the type of hexagonal connection would generate different microstrains and the type of copings would produce similar microstrains after prosthetic screws had been tightened onto microunit abutments. Materials and methods Three dental implants with external (EH) and internal (IH) hexagonal configurations were inserted into two polyurethane blocks. Microunit abutments were screwed onto their respective implant groups, applying a torque of 20 Ncm. Machined Co-Cr copings (M) and plastic prosthetic copings (P) were screwed onto the abutments, which received standard wax patterns. The wax patterns were cast in Co-Cr alloy (n=5), forming four groups: G1) EH/M; G2) EH/P; G3) IH/M and G4) IH/P. Four SGs were bonded onto the surface of the block tangentially to the implants, SG 1 mesially to implant 1, SG 2 and SG 3 mesially and distally to implant 2, respectively, and SG 4 distally to implant 3. The superstructure’s occlusal screws were tightened onto microunit abutments with 10 Ncm torque using a manual torque driver. The magnitude of microstrain on each SG was recorded in units of microstrain (µε). The data were analyzed statistically by ANOVA and Tukey’s test (p<0.05). Results Microstrain values of each group were: G1= 338.1±223.0 µε; G2= 363.9±190.9 µε; G3= 415.1±53.5 µε; G4= 363.9±190.9 µε. No statistically significant difference was found between EH and IH, regardless of the type of copings (p>0.05). The hypotheses were partially accepted. Conclusions It was concluded that the type of hexagonal connection and coping presented similar mechanical behavior under tightening conditions. PMID:20856998

Two-stage implant systems.

PubMed

Fritz, M E

1999-06-01

Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of osseointegration. New types of reinforcements for dental implants and the use of growth factors to augment bone regeneration so that implants can be placed more easily are now being actively investigated.

Friction in hip prostheses.

PubMed

Hall, R M; Unsworth, A

1997-08-01

Although the reduction of frictional torques was the driving force behind the design of the Charnley prosthesis, later concerns about wear and subsequent loosening of this and other hip replacements have dominated debate within the bioengineering community. To stimulate discussion on the role of friction in loosening, a review of the frictional characteristics of different prostheses was undertaken. The use of simple laboratory screening-type machines in the frictional assessment of different material combinations is discussed together with experiments performed on single axis simulators using both conventional and experimental prostheses. In particular, recent developments in the use of soft layer components are highlighted. Further, the possible link between excessively high frictional torques and loosening is discussed in the light of current results obtained from explanted prostheses.

The use of prostheses in skeletally immature patients.

PubMed

Abudu, Adesegun; Grimer, Robert; Tillman, Roger; Carter, Simon

2006-01-01

Prosthetic reconstruction in the skeletally immature patient is challenging because of the necessity to cope with expected disruption of limb growth after resection of one or more major growth plates and the high demands placed on implants by young patients. Although prosthetic reconstruction in children is fraught with many problems, it is usually possible to obtain a good functional limb at skeletal maturity. Extendable prostheses are readily acceptable to patients and their parents. The availability of noninvasive extendable prostheses is expected to lead to fewer complications, fewer surgical interventions, and even improved function. This article reviews the indication, evolution, and clinical and functional results of extendable endoprostheses, drawing from experience in the last 30 years of using such prostheses in children.

Ten-year survival and complication rates of lithium-disilicate (Empress 2) tooth-supported crowns, implant-supported crowns, and fixed dental prostheses.

PubMed

Teichmann, Maren; Göckler, Fabian; Weber, Volker; Yildirim, Murat; Wolfart, Stefan; Edelhoff, Daniel

2017-01-01

To prospectively evaluate the clinical long-term outcome of tooth-supported crowns (SCs), implant-supported crowns (ISCs), and fixed dental prostheses (FDPs) made of a lithium-disilicate glass-ceramic framework material (IPS Empress 2). Between 1997 and 1999, a total of 184 restorations (106 SCs, 32 ISCs, 33 FDPs, and 13 diverse restorations) were placed in 73 patients. Kaplan-Meier estimation was applied for survival and chipping-free rates. Inter-group comparison of both rates was realized by a log rank test and a 2×2 contingency table. Also, SCs and FDPs were compared regarding adhesive vs. conventional cementation, and anterior vs. posterior positioning, for impact on survival. Due to 14 dropouts (34 restorations) and reasonable exclusion of 19 other restorations, the final dataset included: i) 87 SCs [37 patients, mean observation time 11.4 (±3.8)years]; ii) 17 ISCs [12 patients, mean observation time 13.3 (±2.3)years; and iii) 27 FDPs [19 patients, mean observation time 8.9 (±5.4)years]. The 10-year survival rate/chipping-free rate for SCs were 86.1%/83.4%, for ISCs 93.8%/94.1%, and for FDPs were 51.9%/90.8%. Both ISCs and SCs had a significantly higher survival than FDPs (ISCs vs. FDPs: both tests p=0.001; SCs vs. FDPs: p=0.001 and p=0.005). Differences in the chipping-free rates did not reach significance. Also, neither the cementation mode nor positioning of the restoration had an impact on survival. SCs had a slightly lower outcome than can generally be expected from single crowns. In contrast, ICSs had a favorable outcome and the FDPs predominantly failed. The practitioner's choice of dental materials is based (at best) on long-term experience. The present 10-year results are based on comprehensive data analyses and show the high potential of lithium-disilicate as a reliable material, especially for single-unit restoration. Copyright © 2016 Elsevier Ltd. All rights reserved.

In vitro kinematic measurements of the patellar tendon in two different types of posterior-stabilized total knee arthroplasties.

PubMed

Zhu, Zhonglin; Ding, Hui; Dang, Xiao; Tang, Jing; Zhou, Yixin; Wang, Guangzhi

2010-01-01

Fixed-bearing posterior-stabilized (PS) total knee arthroplasty (TKA) has been used in Asian countries for several years, but few studies have investigated differences in the kinematic properties of the patellar tendon after standard PS TKA as compared to high-flex PS TKA. To quantify the in vitro three-dimensional (3D) kinematics of the patellar tendon during passive high flexion and full extension before and after two different types of PS TKAs. Six fresh-frozen cadaveric knees were tested under the following conditions: the unaltered state, status-post traditional PS prostheses (Simth-nephew GENESIS II) replacement, and status-post high-flexion PS prostheses replacement. The soft tissue around the knee and the quadriceps muscle were preserved, then tested under the load of a specific weight in an Oxford knee rig. We designed a specialized rigid body with four active markers fixed to each bone to track the 3D passive motion of the cadaveric knees. Flexion and extension was controlled by the knee rig and captured by an Optotrak Certus high precision optical tracking system. The attachment sites of the patellar tendon were registered as virtual markers to calculate the 3D kinematics. The patellar tendon of the unaltered knee and both TKA knees showed similar deformation. We found the length of the patellar tendon changed significantly during a motion from full extension to 30°, but there was no significant change in length while undergoing a motion from 30° to full flexion. Both the sagittal plane and coronal plane angles of the patellar tendon decreased after PS TKAs. There was no significant difference in patellar tendon kinematics between the two types of PS TKAs. We believe the changes observed in the sagittal plane and coronal plane angles of the patellar tendon after PS TKAs may influence the extensor mechanism and be an important cause of patella-femoral complications. These data may be used to assess patella-femoral complications after surgery so as to improve the design of high-flexion TKAs for Asians and achieve long-term stability.

Marginal adaptation and CAD-CAM technology: A systematic review of restorative material and fabrication techniques.

PubMed

Papadiochou, Sofia; Pissiotis, Argirios L

2018-04-01

The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation. The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material. An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database. Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials. Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of occlusal loading on peri-implant clinical parameters. A pilot study

PubMed Central

Pellicer-Chover, Hilario; Viña-Almunia, José; Romero-Millán, Javier; Peñarrocha-Oltra, David; Peñarrocha-Diago, María

2014-01-01

Objectives: To investigate the relation between occlusal loading and peri-implant clinical parameters (probing depth, bleeding on probing, gingival retraction, width of keratinized mucosa, and crevicular fluid volume) in patients with implant-supported complete fixed prostheses in both arches. Material and Methods: This clinical study took place at the University of Valencia (Spain) dental clinic. It included patients attending the clinic for regular check-ups during at least 12 months after rehabilitation of both arches with implant-supported complete fixed ceramo-metallic prostheses. One study implant and one control implant were established for each patient using the T-Scan®III computerized system (Tesco, South Boston, USA). The maxillary implant closest to the point of maximum occlusal loading was taken as the study implant and the farthest (with least loading) as the control. Occlusal forces were registered with the T-Scan® III and then occlusal adjustment was performed to distribute occlusal forces correctly. Peri-implant clinical parameters were analyzed in both implants before and two and twelve months after occlusal adjustment. Results: Before occlusal adjustment, study group implants presented a higher mean volume of crevicular fluid (51.3±7.4 UP) than the control group (25.8±5.5 UP), with statistically significant difference. Two months after occlusal adjustment, there were no significant differences between groups (24.6±3.8 UP and 26±4.5 UP respectively) (p=0.977). After twelve months, no significant differences were found between groups (24.4±11.1 UP and 22.5±8.9 UP respectively) (p=0.323). For the other clinical parameters, no significant differences were identified between study and control implants at any of the study times (p>0.05). Conclusions: Study group implants receiving higher occlusal loading presented significantly higher volumes of crevicular fluid than control implants. Crevicular fluid volumes were similar in both groups two and twelve months after occlusal adjustment. Key words:Occlusal loading, crevicular fluid, peri-implant clinical parameters, T-Scan®. PMID:24316708

Impact of removable partial denture prosthesis on chewing efficiency

PubMed Central

BESSADET, Marion; NICOLAS, Emmanuel; SOCHAT, Marine; HENNEQUIN, Martine; VEYRUNE, Jean-Luc

2013-01-01

Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described. Objectives The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters. Material and Methods Nineteen removable partial denture prosthesis (RPDP) wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I). All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Number of chewing cycles (CC), chewing time (CT) and chewing frequency (CF=CC/CT) were video recorded. Results With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP), F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01). With or without RPD, the boluses' granulometry values were above the masticatory normative index (MNI) determined as 4,000 µm. Conclusion RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function. Clinical relevance This study encourages the clinical improvement of oral rehabilitation procedure. PMID:24212983

Posttreatment quantification of patient experiences with full-arch implant treatment using a modification of the OHIP-14 questionnaire.

PubMed

Babbush, Charles A

2012-06-01

Patient well-being is always the goal of rehabilitation of edentulism; however, evaluations of treatment success often overlook the patient's subjective feelings about comfort, function, speech, social image, social inhibitions, psychological discomfort, and/or disabilities. The purpose of this study was to assess these patient responses using an oral health questionnaire. To assess such feelings, a self-administered 20-question multiple-choice patient-reported Edentulous Patient Impact Questionnaire was developed, based upon the previously validated Oral Health Impact Profile patient-assessment tool. Responses were solicited from randomly selected patients treated with an implant-supported, fixed, immediately loaded full arch prosthesis. The questionnaires were completed by 250 patients. Of the respondents, 95% described themselves as being either extremely satisfied (74%) or satisfied (21%) with their new teeth, and 98% said they would definitely recommend similar treatment (88%) or consider recommending it (10%) to a friend or colleague. Based upon an oral health impact survey completed by 250 patients treated with full-arch implant-supported, immediately loaded fixed dental prostheses, it appears that patient satisfaction is high and that treated patients would generally be willing to recommend this treatment to others.

Immediate and early function of Brånemark System implants placed in the esthetic zone: a 1-year prospective clinical multicenter study.

PubMed

Maló, Paulo; Friberg, Bertil; Polizzi, Giovanni; Gualini, Federico; Vighagen, Torbjörn; Rangert, Bo

2003-01-01

Immediate/early implant function means great benefits for patients and therapists because treatment time and cost can be substantially reduced. This concept has become an accepted alternative for complete arch fixed restorations in the mandible, and clinical documentation is emerging for other indications. The purpose of this prospective clinical multicenter study was to evaluate the outcome of implants placed in incisor, canine, and premolar regions in maxillas or mandibles. Implants were loaded with provisional crowns and bridges on the same day or within a few days and were followed up for 1 year during function. Four centers treated 76 patients each in need of an implant-retained prosthesis in the anterior and premolar regions in the maxilla or mandible. A total of 116 titanium implants with machined surfaces (Brånemark System , Nobel Biocare AB, Gothenburg, Sweden) were placed: 74 in maxillas and 42 in mandibles. Eighty-seven prostheses were made, of which 63 were single crowns and 24 were bridges (supported by 53 splinted implants). Twenty-two implants in 14 patients were placed in fresh extraction sites. The goal with the preparation and insertion technique was to achieve good primary implant stability and a minimum implant insertion torque of 30 Ncm before the implant was completely seated. The occlusion was adjusted to eliminate direct contact with the provisional prostheses. After 6 months, the patients received their permanent prostheses. Sixty-seven patients were followed for 1 year. Five implants were lost in five patients, three in the maxilla and two in the mandible. Four of the lost implants were single-tooth replacements and one was splinted. The cumulative survival rate (CSR) was 95.7% for all implants after 1 year and 93.7% and 98.1% for single-tooth and splinted implants, respectively. There were no implant losses in the extraction sites. The CSR of 96% at 1 year indicates that immediate function of Brånemark System implants placed in incisor to premolar regions in both jaws is a viable concept. More failures occurred with single-tooth replacements (6.3%) than with splinted implants (1.9%).

Comparative Evaluation of Marginal Accuracy of a Cast Fixed Partial Denture Compared to Soldered Fixed Partial Denture Made of Two Different Base Metal Alloys and Casting Techniques: An In vitro Study.

PubMed

Jei, J Brintha; Mohan, Jayashree

2014-03-01

The periodontal health of abutment teeth and the durability of fixed partial denture depends on the marginal adaptation of the prosthesis. Any discrepancy in the marginal area leads to dissolution of luting agent and plaque accumulation. This study was done with the aim of evaluating the accuracy of marginal fit of four unit crown and bridge made up of Ni-Cr and Cr-Co alloys under induction and centrifugal casting. They were compared to cast fixed partial denture (FPD) and soldered FPD. For the purpose of this study a metal model was fabricated. A total of 40 samples (4-unit crown and bridge) were prepared in which 20 Cr-Co samples and 20 Ni-Cr samples were fabricated. Within these 20 samples of each group 10 samples were prepared by induction casting technique and other 10 samples with centrifugal casting technique. The cast FPD samples obtained were seated on the model and the samples were then measured with travelling microscope having precision of 0.001 cm. Sectioning of samples was done between the two pontics and measurements were made, then the soldering was made with torch soldering unit. The marginal discrepancy of soldered samples was measured and all findings were statistically analysed. The results revealed minimal marginal discrepancy with Cr-Co samples when compared to Ni-Cr samples done under induction casting technique. When compared to cast FPD samples, the soldered group showed reduced marginal discrepancy.

Frequency and Type of Prosthetic Complications Associated with Interim, Immediately Loaded Full-Arch Prostheses: A 2-Year Retrospective Chart Review.

PubMed

Drago, Carl

2016-08-01

The purpose of this report was to retrospectively evaluate implant and immediate full-arch prosthesis survival rates over a 24-month period; patients were consecutively treated with immediate occlusal loading. Dental arch, gender, and implant orientation (vertical vs. tilted) were also noted. All Brånemark System implants (Nobel Active) and interim, all-acrylic resin prostheses placed in patients following an All-on-Four™ protocol, in a single private practice were assessed by retrospective patient chart review. The amount of space provided surgically for implant restorative components and prostheses was determined from measurements of the vertical heights of the interim prostheses in the right/left anterior and posterior segments. These measurements were made in the laboratory. Interim prosthetic repairs (type, frequency, length of time from insertion) were analyzed by type, arch, gender, and implant orientation. Implant survival and insertion torque values were also measured. Inclusion criteria consisted of all Brånemark System implants placed with the All-on-Four protocol from September 1, 2011, until August 31, 2013. Specific dietary instructions were given for the first 7 days immediately postoperatively and for the weeks prior to insertion of the definitive prostheses. One hundred twenty-nine patients, comprising 191 arches (766 implants) from September 1, 2011, until August 31, 2013, were included in the study. One patient experienced implant failure yielding an overall implant survival rate (SR) of 99.5% (762 of 766). Four hundred twenty-six of 430 maxillary implants and 336 of 336 mandibular implants survived for SRs of 99.1% and 100%, respectively. Regarding implant orientation, 415 of 417 tilted implants (SR 99.5%) and 343 of 345 (CSR 95.6%) vertical implants were noted to be clinically stable. Interim, all-acrylic resin prostheses were in place for a mean of 199.2 days; mandibular prostheses were in place for an average of 195.4 days; maxillary prostheses were in place for an average of 202.0 days. Thirty four of the 191 interim prostheses (17.8%) warranted at least one repair during the treatment period. The average overall implant insertion torque value was 60.74 Ncm; mandibular torque values averaged 63.08 Ncm; maxillary torque values averaged 59.00 Ncm. The results from this study suggest that dental arch, gender, and implant orientation for implants placed and immediately restored with interim, all-acrylic resin, full-arch prostheses per the All-on-Four protocol did not have significant statistical or clinical effects on prosthetic complications of the interim prostheses or implant survival. Only one of the 129 patients experienced implant failures, indicating that the All-on-Four treatment protocol used in this study is a viable alternative to other protocols for rehabilitating edentulous patients. © 2015 by the American College of Prosthodontists.

Rapid Prototyping Technologies and their Applications in Prosthodontics, a Review of Literature

PubMed Central

Torabi, Kianoosh; Farjood, Ehsan; Hamedani, Shahram

2015-01-01

The early computer-aided design/computer-aided manufacturing (CAD/CAM) systems were relied exclusively on subtractive methods. In recent years, additive methods by employing rapid prototyping (RP) have progressed rapidly in various fields of dentistry as they have the potential to overcome known drawbacks of subtractive techniques such as fit problems. RP techniques have been exploited to build complex 3D models in medicine since the 1990s. RP has recently proposed successful applications in various dental fields, such as fabrication of implant surgical guides, frameworks for fixed and removable partial dentures, wax patterns for the dental prosthesis, zirconia prosthesis and molds for metal castings, and maxillofacial prosthesis and finally, complete dentures. This paper aimed to offer a comprehensive literature review of various RP methods, particularly in dentistry, that are expected to bring many improvements to the field. A search was made through MEDLINE database and Google scholar search engine. The keywords; ‘rapid prototyping’ and ‘dentistry’ were searched in title/abstract of publications; limited to 2003 to 2013, concerning past decade. The inclusion criterion was the technical researches that predominately included laboratory procedures. The exclusion criterion was meticulous clinical and excessive technical procedures. A total of 106 articles were retrieved, recited by authors and only 50 met the specified inclusion criteria for this review. Selected articles had used rapid prototyping techniques in various fields in dentistry through different techniques. This review depicted the different laboratory procedures employed in this method and confirmed that RP technique have been substantially feasible in dentistry. With advancement in various RP systems, it is possible to benefit from this technique in different dental practices, particularly in implementing dental prostheses for different applications. PMID:25759851

Rapid Prototyping Technologies and their Applications in Prosthodontics, a Review of Literature.

PubMed

Torabi, Kianoosh; Farjood, Ehsan; Hamedani, Shahram

2015-03-01

The early computer-aided design/computer-aided manufacturing (CAD/CAM) systems were relied exclusively on subtractive methods. In recent years, additive methods by employing rapid prototyping (RP) have progressed rapidly in various fields of dentistry as they have the potential to overcome known drawbacks of subtractive techniques such as fit problems. RP techniques have been exploited to build complex 3D models in medicine since the 1990s. RP has recently proposed successful applications in various dental fields, such as fabrication of implant surgical guides, frameworks for fixed and removable partial dentures, wax patterns for the dental prosthesis, zirconia prosthesis and molds for metal castings, and maxillofacial prosthesis and finally, complete dentures. This paper aimed to offer a comprehensive literature review of various RP methods, particularly in dentistry, that are expected to bring many improvements to the field. A search was made through MEDLINE database and Google scholar search engine. The keywords; 'rapid prototyping' and 'dentistry' were searched in title/abstract of publications; limited to 2003 to 2013, concerning past decade. The inclusion criterion was the technical researches that predominately included laboratory procedures. The exclusion criterion was meticulous clinical and excessive technical procedures. A total of 106 articles were retrieved, recited by authors and only 50 met the specified inclusion criteria for this review. Selected articles had used rapid prototyping techniques in various fields in dentistry through different techniques. This review depicted the different laboratory procedures employed in this method and confirmed that RP technique have been substantially feasible in dentistry. With advancement in various RP systems, it is possible to benefit from this technique in different dental practices, particularly in implementing dental prostheses for different applications.

Effect of different aging methods on the mechanical behavior of multi-layered ceramic structures.

PubMed

Borba, Márcia; de Araújo, Maico D; Fukushima, Karen A; Yoshimura, Humberto N; Griggs, Jason A; Della Bona, Álvaro; Cesar, Paulo F

2016-12-01

To evaluate the effect of two aging methods (mechanical cycling and autoclave) on the mechanical behavior of veneer and framework ceramic specimens with different configurations (monolithic, two and three-layers). Three ceramics used as framework for fixed dental prostheses (YZ-Vita In-Ceram YZ; IZ-Vita In-Ceram Zirconia; AL-Vita In-Ceram AL) and two veneering porcelains (VM7 and VM9) were studied. Bar-shaped specimens were produced in three different designs: monolithic, two layers (porcelain-framework) and three layers (porcelain-framework-porcelain). Specimens were tested for three-point flexural strength at 1MPa/s in 37°C artificial saliva. Three different experimental conditions were evaluated (n=10): control; mechanical cycling (2Hz, 37°C artificial saliva); and autoclave aging (134°C, 2 bars, 5h). Bi-layered specimens were tested in both conditions: with porcelain or framework ceramic under tension. Fracture surfaces were analyzed using stereomicroscope and scanning electron microscopy. Results were statistically analyzed using Kruskal-Wallis and Student-Newman-Keuls tests. Only for AL group, mechanical cycling and autoclave aging significantly decreased the flexural strength values in comparison to the control (p<0.01). YZ, AL, VM7 and VM9 monolithic groups showed no strength degradation. For multi-layered specimens, when the porcelain layer was tested in tension (bi and tri-layers), the aging methods evaluated also had no effect on strength (p≥0.05). Total and partial failure modes were identified. Mechanical cycling and autoclave aging protocols had no effect on the flexural strength values and failure behavior of YZ and IZ ceramic structures. Yet, AL monolithic structures showed a significant decrease in flexural strength with any of the aging methods. Copyright © 2016. Published by Elsevier Ltd.

10-year prospective cohort follow-up of immediately restored XiVE implants.

PubMed

Degidi, Marco; Nardi, Diego; Piattelli, Adriano

2016-06-01

The aim of this prospective cohort study was to assess the ten-year performance of the condensing thread, self-tapping apex and internal hexagonal connection XiVE implant supporting partial fixed prostheses placed with an immediate restoration approach. All patients received a fixed two- to four-unit partial provisional restoration supported by immediately loaded implants. The final gold alloy/ceramic restorations were cemented approximately 28 weeks after implant insertion. Marginal bone level, pocket probing depth and percentage of bleeding on probing, biological or technical complications and any other adverse events were measured annually up to ten years after surgery. The overall success and survival rates at implant level were evaluated following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference criteria. Implant placement in post-extractive or healed sites, smoking and a history of periodontal treatment were evaluated to assess whether they had an influence on bone resorption or on implant survival. Of 114 patients, for a total of 284 implants, fulfilled all the inclusion criteria and were enrolled in the study. 78 (27.5%) implants placed in 30 (26.3%) patients were lost to follow-up. Eight of 284 (2.8%) implants failed in 8 of 114 (7.0%) patients: one (12.5% of losses) due to failure to achieve osseointegration and seven (87.5% of losses) due to peri-implantitis. No cluster implant failures were assessed. The failure of the implant caused the failure of the prosthesis due to the strategic position of the implant in four patients. At the final ten-year follow-up, 121 (61.4%) implants exhibited a "full success" status with an optimal health condition, 21 (10.9%) implants scored a "satisfactory survival" condition, while 49 (25.49%) of the implants were classified as "compromised survival" status (Misch et al. 2008). Smoking was found to be statistically associated with "implant failure" (P = 0.010), while no association was found for patients treated for periodontal disease (P = 0.679) and post-extractive surgical sites (P = 0.664). Statistically significant more marginal bone loss was found in patients treated for periodontal disease (P < 0.0001). An increased bone loss was also observed in smokers, but the difference with the non-smokers was not statistically significant (P = 0.06). The XiVE implants can be successfully used to support immediate prosthesis. Patients with a history of periodontitis show increased bone loss and risk to develop peri-implant disease. Smoking seems to jeopardize the long-term implant survival. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The essential oil of Allium sativum as an alternative agent against Candida isolated from dental prostheses.

PubMed

Mendoza-Juache, Alejandro; Aranda-Romo, Saray; Bermeo-Escalona, Josué R; Gómez-Hernández, Araceli; Pozos-Guillén, Amaury; Sánchez-Vargas, Luis Octavio

The colonization of the surfaces of dental prostheses by Candida albicans is associated with the development of denture stomatitis. In this context, the use of fluconazole has been proposed, but its disadvantage is microbial resistance. Meanwhile, the oil of Allium sativum has shown an effect in controlling biofilm formation by C. albicans. The objective of this study was to determine the antifungal activities of the essential oil of A. sativum and fluconazole against clinical isolates of Candida species obtained from rigid, acrylic-based partial or total dentures and to compare these agents' effects on both biofilm and planktonic cells. A total of 48 clinical isolates obtained from the acrylic surface of partial or complete dentures were examined, and the following species were identified: C. albicans, Candida glabrata, Candida tropicalis, and Candida krusei. For each isolate, the antifungal activities of the essential oil of A. sativum and fluconazole against both biofilm and planktonic cells were evaluated using the Clinical & Laboratory Standards Institute (CLSI) M27-A3 method. The isolates were also evaluated by semiquantitative XTT reduction. All planktonic Candida isolates were susceptible to the essential oil of A. sativum, whereas 4.2% were resistant to fluconazole. Regarding susceptibilities in biofilms, 43.8% of biofilms were resistant to A. sativum oil, and 91.7% were resistant to fluconazole. All planktonic cells of the different Candida species tested are susceptible to <1mg/ml A. sativum oil, and the majority are susceptible to fluconazole. Susceptibility decreases in biofilm cells, with increased resistance to fluconazole compared with A. sativum oil. The essential oil of A. sativum is thus active against clinical isolates of Candida species obtained from dentures, with effects on both biofilm and planktonic cells in vitro. Copyright © 2017 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical Outcome of Double Crown-Retained Mandibular Removable Dentures Supported by a Combination of Residual Teeth and Strategic Implants.

PubMed

Rinke, Sven; Ziebolz, Dirk; Ratka-Krüger, Petra; Frisch, Eberhard

2015-07-01

There is a lack of data regarding the clinical outcome of removable partial dentures (RPDs) supported by a combination of residual natural teeth and implants placed in strategic positions. The aim of the present case series was to conduct a retrospective investigation of the clinical outcome of mandibular tooth-implant-retained partial dentures (TIRPD) rigidly retained via telescopic double crowns. Between 1999 and 2010, 18 patients with reduced residual dentition (1 to 3 natural abutment teeth) and in need of an RPD received 1 to 3 implants in strategic positions for support of the removable prostheses. All TIRPDs were rigidly retained by telescopic crowns according to the Marburg Double Crown (MDC) technique; all prostheses were placed in a private practice. Tooth/implant survival and success rates, prosthetic maintenance requirements, and peri-implant parameters were analyzed retrospectively using patient records and clinical examinations during the final recall appointments. Only patients attending at least annual supportive post-implant hygiene therapy visits (SIT) were included. After a mean functional period of 5.84 ± 3 years (range: 3.01-12.21), 14 patients with 14 dentures supported by 24 implants and 27 teeth (mean number of abutments: 3.6) were available for assessment. Four teeth (survival rate: 85.19%) and no implants (survival rate: 100%) were lost. Peri-implantitis was observed around one implant (4.17%). All 14 dentures were functional (survival rate: 100%) and required only limited maintenance (i.e., screw loosening, acrylic resin fracture repairs, relining) amounting to 0.086 treatments per patient per year (T/P/Y). Within the limitations of this case series, it can be concluded that TIRPDs retained via MDCs might represent a viable treatment option in mandibles with few remaining abutment teeth. Further long-term clinical evaluations with a greater sample size are needed for a more detailed evaluation of this treatment concept. © 2014 by the American College of Prosthodontists.

Challenges of coronary angiography and intervention in patients previously treated by TAVI.

PubMed

Blumenstein, Johannes; Kim, Won-Keun; Liebetrau, Christoph; Gaede, Luise; Kempfert, Joerg; Walther, Thomas; Hamm, Christian; Möllmann, Helge

2015-08-01

Since the beginning of the transcatheter aortic valve implantation (TAVI) era, many prosthetic valves have entered clinical practice. TAVI prostheses differ regarding stent design and some may potentially interfere with diagnostic or interventional catheters. The aim of our analysis was to evaluate the feasibility of coronary angiography (CA) or percutaneous coronary intervention (PCI) in patients with prior TAVI. From 2011 to 2014, 1,000 patients were treated by TAVI at our center using eight different valve prostheses (Symetis ACURATE TA and ACURATE TF; Medtronic CoreValve and Engager; JenaValve, SJM Portico; Edwards Lifesciences SAPIEN and SAPIEN XT). In this analysis, all patients were included who underwent either CA or PCI after TAVI. CA or PCI were rated as fully feasible when coronary ostia could be fully intubated, partially feasible when coronary arteries could be displayed only unselectively or unfeasible when coronary arteries could not be displayed. A total of 35 patients underwent CA/PCI after TAVI at our hospital. In all patients with valves implanted in a subcoronary position (SAPIEN n = 19; JenaValve n = 1), selective intubation was feasible using standard catheters. Out of 15 patients with valve types that are placed over the coronary ostia (CoreValve n = 10, ACURATE n = 4, Portico n = 1), selective intubation of coronary arteries was not possible in 9 cases, even with the use of different diagnostic catheters. Full accessibility was possible only in 3 cases. In 2 cases, display of the right CA was only feasible using unselective aortography. In 1 case, coronary arteries could not be displayed at all immediately after a valve-in-valve procedure. CA or PCI after TAVI is usually feasible. Devices that are placed in a partially supracoronary position, however, can interfere with diagnostic or guiding catheters and impede straightforward intervention, especially when the prosthesis is not implanted in the correct position.

What are estimated reimbursements for lower extremity prostheses capable of surgical and nonsurgical lengthening?

PubMed

Henderson, Eric R; Pepper, Andrew M; Letson, G Douglas

2012-04-01

Growing prostheses accommodate skeletally immature patients with bone tumors undergoing limb-preserving surgery. Early devices required surgical procedures for lengthening; recent devices lengthen without surgery. Expenses for newer expandable devices that lengthen without surgery are more than for their predecessors but overall reimbursement amounts are not known. We sought to determine reimbursement amounts associated with lengthening of growing prostheses requiring surgical and nonsurgical lengthening. We retrospectively reviewed 17 patients with growing prostheses requiring surgical expansion and eight patients with prostheses capable of nonsurgical expansion. Insurance documents were reviewed to determine the reimbursement for implantation, lengthening, and complications. Growth data were obtained from the literature. Mean reimbursement amounts of surgical and nonsurgical lengthenings were $9950 and $272, respectively. Estimated reimbursements associated with implantation of a growing prosthesis varied depending on age, sex, and location. The largest difference was found for 4-year-old boys with distal femoral replacement where reimbursement for expansion to maturity for surgical and nonsurgical lengthening prostheses would be $379,000 and $208,000, respectively. For children requiring more than one surgical expansion, net reimbursements were lower when a noninvasive lengthening device was used. Annual per-prosthesis maintenance reimbursements to address complications for surgical and nonsurgical lengthening prostheses were $3386 and $1856, respectively. This study showed that reimbursements for lengthening of growing endoprostheses capable of nonsurgical expansion may be less expensive in younger patients, particularly male patients undergoing distal femur replacement, than endoprostheses requiring surgical lengthening. Longer outcomes studies are required to see if reimbursements for complications differ between devices. Level III, economic and decision analysis. See the Guidelines for Authors for a complete description of levels of evidence.

Prosthesis use in adult acquired major upper-limb amputees: patterns of wear, prosthetic skills and the actual use of prostheses in activities of daily life.

PubMed

Østlie, Kristin; Lesjø, Ingrid Marie; Franklin, Rosemary Joy; Garfelt, Beate; Skjeldal, Ola Hunsbeth; Magnus, Per

2012-11-01

To describe patterns of prosthesis wear and perceived prosthetic usefulness in adult acquired upper-limb amputees (ULAs). To describe prosthetic skills in activities of daily life (ADL) and the actual use of prostheses in the performance of ADL tasks. To estimate the influence of prosthetic skills on actual prosthesis use and the influence of background factors on prosthetic skills and actual prosthesis use. Cross-sectional study analysing population-based questionnaire data (n = 224) and data from interviews and clinical testing in a referred/convenience sample of prosthesis-wearing ULAs (n = 50). Effects were analysed using linear regression. 80.8% wore prostheses. 90.3% reported their most worn prosthesis as useful. Prosthetic usefulness profiles varied with prosthetic type. Despite demonstrating good prosthetic skills, the amputees reported actual prosthesis use in only about half of the ADL tasks performed in everyday life. In unilateral amputees, increased actual use was associated with sufficient prosthetic training and with the use of myoelectric vs cosmetic prostheses, regardless of amputation level. Prosthetic skills did not affect actual prosthesis use. No background factors showed significant effect on prosthetic skills. Most major ULAs wear prostheses. Individualised prosthetic training and fitting of myoelectric rather than passive prostheses may increase actual prosthesis use in ADL.

Temporary implant-supported prosthesis for immediate loading according to a chair-side concept: technical note and results from 37 consecutive cases.

PubMed

Ostman, Pär-Olov; Hellman, Mats; Sennerby, Lars; Wennerberg, Ann

2008-05-01

During the last years, focus has been paid to implant treatment using immediate function protocols, and different approaches to provide patients with temporary constructions have been presented. Most of these techniques involve dental technicians producing the temporary construction, for example, rebuilding existing dentures, acrylic bridges, etc. The purpose of this prospective clinical study was to evaluate the clinical outcome of a chair-side technique of a cost-effective temporary prosthesis. Fixture survival rate and risk of temporary bridge failure were analyzed. Thirty-seven partially or totally edentate patients (18 female and 19 male; mean age: 66.7 years) treated with chair-side manufactured temporary restorations (QuickBridge, BIOMET 3i, Palm Beach, Fl, USA) for immediate loading have been evaluated. The prostheses extended from two unit bridges supported by two implants to full-arch construction supported by six implants. The temporary prostheses were monitored from the day of surgery and delivery to the time of replacement with a permanent prosthetic construction 3 to 6 months later. No implants were lost during the observation time. One (3%) temporary prosthesis fractured and additional two (6%) loosened during the follow-up time. The study indicated that the tested chair-side concept for manufacturing of temporary prosthesis for immediate loading of dental implants is a viable approach.

Association Between Masticatory Function and Oral Health-Related Quality of Life in Partial Maxillectomy Patients.

PubMed

Said, Mohamed Moustafa; Otomaru, Takafumi; Aimaijiang, Yiliyaer; Li, Na; Taniguchi, Hisashi

The aim of this study was to investigate associations between objectively and subjectively measured masticatory function and oral health-related quality of life (OHRQoL) in partial maxillectomy patients wearing dentomaxillary prostheses. A sample of 32 consecutively treated patients who had undergone a partial maxillectomy were enrolled. Masticatory function was assessed using two objective measures and one subjective measure. The objective measures were masticatory performance (MP), which was estimated by measuring the glucose extracted from gummy jelly, and food mixing ability (a*), which was assessed using color-changeable chewing gum. The subjective measure was perceived chewing ability, rated as masticatory score (MS) based on the patient's responses to a food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Relationships between the masticatory function measures and OHRQoL were analyzed using Spearman rank correlation coefficient. The correlation coefficients (r) obtained were 0.57 (P = .001) for MS and GOHAI, 0.247 (P = .173) for MP and GOHAI, -0.173 (P = .343) for a* and GOHAI, 0.517 (P = .002) for MP and a*, 0.199 (P = .257) for MP and MS, and 0.019 (P = .919) for a* and MS. Subjective MS showed a significant positive correlation with GOHAI score, suggesting that perceived chewing ability could be an important factor in the estimation of OHRQoL in partial maxillectomy patients.

Experimental and Monte Carlo evaluation of Eclipse treatment planning system for effects on dose distribution of the hip prostheses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Çatlı, Serap, E-mail: serapcatli@hotmail.com; Tanır, Güneş

2013-10-01

The present study aimed to investigate the effects of titanium, titanium alloy, and stainless steel hip prostheses on dose distribution based on the Monte Carlo simulation method, as well as the accuracy of the Eclipse treatment planning system (TPS) at 6 and 18 MV photon energies. In the present study the pencil beam convolution (PBC) method implemented in the Eclipse TPS was compared to the Monte Carlo method and ionization chamber measurements. The present findings show that if high-Z material is used in prosthesis, large dose changes can occur due to scattering. The variance in dose observed in the presentmore » study was dependent on material type, density, and atomic number, as well as photon energy; as photon energy increased back scattering decreased. The dose perturbation effect of hip prostheses was significant and could not be predicted accurately by the PBC method for hip prostheses. The findings show that for accurate dose calculation the Monte Carlo-based TPS should be used in patients with hip prostheses.« less

21 CFR 888.6 - Degree of constraint.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ORTHOPEDIC DEVICES General Provisions § 888.6 Degree of constraint. Certain joint prostheses provide more... affecting the safety and effectiveness of orthopedic prostheses. FDA is defining the following standard...

21 CFR 888.6 - Degree of constraint.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ORTHOPEDIC DEVICES General Provisions § 888.6 Degree of constraint. Certain joint prostheses provide more... affecting the safety and effectiveness of orthopedic prostheses. FDA is defining the following standard...

21 CFR 888.6 - Degree of constraint.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ORTHOPEDIC DEVICES General Provisions § 888.6 Degree of constraint. Certain joint prostheses provide more... affecting the safety and effectiveness of orthopedic prostheses. FDA is defining the following standard...

21 CFR 888.6 - Degree of constraint.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ORTHOPEDIC DEVICES General Provisions § 888.6 Degree of constraint. Certain joint prostheses provide more... affecting the safety and effectiveness of orthopedic prostheses. FDA is defining the following standard...

Results after mitral valve replacement with cloth-covered Starr-Edwards prostheses (models 6300, 6310/6320, and 6400).

PubMed Central

Forman, R; Beck, W; Barnard, C N

1978-01-01

The actuarial survival and thromboembolic rates for the three types of cloth-covered Starr-Edwards mitral prostheses, models 6300, 6310/6320, and 6400 followed 6, 5, and 2 years, respectively, were not significantly different throughout the years they were followed. The combined cumulative survival and thromboembolic proportion at 5 years for these prostheses were 71 and 66 per cent, respectively. The thromboembolic rates were not different in the following two groups: (a) 238 patients receiving anticoagulants, and (b) 52 patients who had discontinued or who were not receiving anticoagulants. Four patients thrombosed their mitral prostheses. Another 8 per cent had class 3 symptoms after operation, which were attributed to myopathic or restrictive left ventricular dysfunction or other valvular disease. PMID:656234

[Case of occlusal reconstruction for severe attrition].

PubMed

Ueda, Takayuki

2006-01-01

A 57-year-old female complained of aesthetic disturbance, dysmasesis and phonation disorder by attrition. She had severe attrition of almost teeth. To avoid metal color exposure and attrition of opposing teeth, hybrid ceramics were used for veneered crowns and fixed partial denture. Since the prosthetic treatment, the patient wears a night guard to prevent attrition of her teeth and prosthesis. There has been no specific trouble during the 4-year follow-up. It is considered that using hybrid ceramics for veneering crowns and fixed partial denture and night guard help to prevent the attrition of opposing teeth and abrasion of prosthesis.

Wear rates of artificial denture teeth opposed by natural dentition.

PubMed

Douglas, W H; Delong, R; Pintado, M R; Latta, M A

1993-01-01

The wear rate of polymeric or composite-based artificial denture teeth on fixed, removable and implant prostheses is important in the maintenance of cuspal form, masticatory efficiency and occlusal stability. A servo-hydraulic based artificial mouth in which an occlusion was established between artificial denture teeth, and the palatal cusp of a human maxillary third molar was established and used to assess the wear resistance of 5 artificial denture tooth materials. Volumetric wear was determined for Dentsply Trublend SLM, Dentsply IPN, Vita Vitapan, Ivoclar Orthotyp and Ivoclar Orthosit denture teeth. Scanning electron microscopy was also done to assess the textural character of the wear facets of each denture tooth sample. The lowest volume loss was observed for Trublend SLM followed by IPN, Orthotyp, Vitapan and Orthosit. Textural assessment of the materials was consistent with the objective wear data.

[Design and optimization of wireless power and data transmission for visual prosthesis].

PubMed

Lei, Xuping; Wu, Kaijie; Zhao, Lei; Chai, Xinyu

2013-11-01

Boosting spatial resolution of visual prostheses is an effective method to improve implant subjects' visual perception. However, power consumption of visual implants greatly rises with the increasing number of implanted electrodes. In respond to this trend, visual prostheses need to develop high-efficiency wireless power transmission and high-speed data transmission. This paper presents a review of current research progress on wireless power and data transmission for visual prostheses, analyzes relative principles and requirement, and introduces design methods of power and data transmission.

Progress in the clinical development and utilization of vision prostheses: an update

PubMed Central

Brandli, Alice; Luu, Chi D; Guymer, Robyn H; Ayton, Lauren N

2016-01-01

Vision prostheses, or “bionic eyes”, are implantable medical bionic devices with the potential to restore rudimentary sight to people with profound vision loss or blindness. In the past two decades, this field has rapidly progressed, and there are now two commercially available retinal prostheses in the US and Europe, and a number of next-generation devices in development. This review provides an update on the development of these devices and a discussion on the future directions for the field. PMID:28539798

48 CFR 49.208 - Equitable adjustment after partial termination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Equitable adjustment after partial termination. 49.208 Section 49.208 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS Additional Principles for Fixed-Price Contracts...

A Comparative Analysis on Two Types of Oral Implants, Bone-Level and Tissue-Level, with Different Cantilever Lengths of Fixed Prosthesis.

PubMed

Mosavar, Alireza; Nili, Monireh; Hashemi, Sayed Raouf; Kadkhodaei, Mahmoud

2017-06-01

Depending on esthetic, anatomical, and functional aspects, in implant-prosthetic restoration of a completely edentulous jaw, the selection of implant type is highly important; however, bone- and tissue-level implants and their stress distribution in bone have not yet been comparatively investigated. Hence, finite element analysis was used to study the influence of cantilever length in a fixed prosthesis on stress distribution in peri-implant bone around these two types of oral implants. A 3D edentulous mandible was modeled. In simulations, a framework with four posterior cantilever lengths and two types of implants, bone-level and tissue-level, was considered. A compressive load was applied to the distal regions of the cantilevers, and the von-Mises stress of peri-implant bone was investigated. The independent t-test and the Pearson correlation coefficient analyzed the results (α = 0.05). Stresses in the cortical bone around the bone-level implants were greater than those in the tissue-level implants with the same cantilever length. In addition, by extending the cantilever length, the stress values in peri-implant bone increased. Therefore, when the cantilever was at its maximum length, the maximum stress was in cortical bone and around the bone-level distal implants. The results of the present study indicate that treatment with tissue-level implants is potentially more advantageous than with bone-level implants for implant-supported fixed prostheses. © 2015 by the American College of Prosthodontists.

Comparison of using different bridge prosthetic designs for partial defect restoration through mathematical modeling.

PubMed

Styranivska, Oksana; Kliuchkovska, Nataliia; Mykyyevych, Nataliya

2017-01-01

To analyze the stress-strain states of bone and abutment teeth during the use of different prosthetic designs of fixed partial dentures with the use of relevant mathematical modeling principles. The use of Comsol Multiphysics 3.5 (Comsol AB, Sweden) software during the mathematical modeling of stress-strain states provided numerical data for analytical interpretation in three different clinical scenarios with fixed dentures and different abutment teeth and demountable prosthetic denture with the saddle-shaped intermediate part. Microsoft Excel Software (Microsoft Office 2017) helped to evaluate absolute mistakes of stress and strain parameters of each abutment tooth during three modeled scenarios and normal condition and to summarize data into the forms of tables. In comparison with the fixed prosthetic denture supported by the canine, first premolar, and third molar, stresses at the same abutment teeth with the use of demountable denture with the saddle-shaped intermediate part decreased: at the mesial abutment tooth by 2.8 times, at distal crown by 6.1 times, and at the intermediate part by 11.1 times, respectively, the deformation level decreased by 3.1, 1.9, and 1.4 times at each area. The methods of mathematical modeling proved that complications during the use of fixed partial dentures based on the overload effect of the abutment teeth and caused by the deformation process inside the intermediate section of prosthetic construction.

Usefulness of magnetic resonance imaging in the postsurgical assessment of patients with inflatable penile prostheses.

PubMed

Pacheco Usmayo, A; Torregrosa Andrés, A; Flores Méndez, J; Luján Marco, S; Rogel Bertó, R

To describe the types of penile prostheses and their components, to review the appropriate magnetic resonance imaging (MRI) acquisition protocol, and to describe the normal imaging findings and possible complications in patients with inflatable penile implants. Three-piece inflatable penile prostheses are the last link in the treatment chain for erectile dysfunction. They can develop complications, which are classified as non-infectious related to the surgical technique, infectious, or due to mechanical failure of the device. MRI is the most appropriate imaging technique for the postsurgical evaluation of penile prostheses. Images are acquired in three planes using sequences with high spatial resolution, first with the prosthesis at rest and then with the prosthesis activated. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Appearance of low signal intensity lines in MRI of silicone breast implants.

PubMed

Stroman, P W; Rolland, C; Dufour, M; Grondin, P; Guidoin, R G

1996-05-01

Magnetic resonance (MR) images of five explanted mammary prostheses were obtained with a 1.5 T GE Signa system using a conventional spin-echo pulse sequence, in order to investigate the low-intensity curvilinear lines which may be observed in MR images of silicone gel-filled breast implants under pressure from fibrous capsules. MR images showed ellipsoid prostheses, often containing multiple low-intensity curvilinear lines which in some cases presented an appearance very similar to that of the linguine sign. Upon opening the fibrous capsules, however, all of the prostheses were found to be completely intact demonstrating that the appearance of multiple low signal intensity curvilinear lines in MR images of silicone gel-filled prostheses is not necessarily a sign of prosthesis rupture. The MR image features which are specific to the linguine sign must be more precisely defined.

["Bionic" arm prostheses. State of the art in research and development].

PubMed

Pylatiuk, C; Döderlein, L

2006-11-01

A new generation of arm prostheses is being developed worldwide. These so-called bionic prostheses are intended to offer additional functions, such as sensory feedback, extended range of possible movement, intuitive movement control as far as possible, and a more natural cosmetic appearance. In recent years, prosthetic components with much enhanced performance have been developed for use at various levels of the upper limb. Artificial hands that allow for additional grips are are being tested in clinical settings. Innovative methods of signal acquisition and communication with the patient are being intensively researched. Several patients have been provided with prototypes of new arm prostheses. At the moment, the results are limited by the restricted communication between patient and prosthesis. However, we can expect the options for prosthesis control to be extended in the near future.

Development of friction and wear full-scale testing for TKR prostheses with reliable low cost apparatus

NASA Astrophysics Data System (ADS)

Suwandi, Agri; Soemardi, Tresna P.; Kiswanto, Gandjar; Kusumaningsih, Widjajalaksmi; I. Gusti Agung I. G., W.

2018-02-01

Prostheses products must undergo simulation and physical testing, before clinical testing. Finite element method is a preliminary simulation for in vivo test. The method visualizes the magnitude of the compressive force and the critical location of the Total Knee Replacement (TKR) prostheses design. In vitro testing is classified as physical testing for prostheses product. The test is conducted to evaluate the potential failure of the product and the characteristics of the prostheses TKR material. Friction and wear testing are part of the in vivo test. Motion of knee joints, which results in the phenomena of extension and deflection in the femoral and tibia insert, is represented by friction and wear testing. Friction and wear tests aim to obtain an approximate lifetime in normal and extreme load patterns as characterized by the shape of the friction surface area. The lifetime estimation requires friction and wear full-scale testing equipments for TKR prostheses products. These are necessary in obtaining initial data on potential product failures and characterizing of the material based on the ASTM F2724-08 standards. Based on the testing result and statistical analysis data, the average wear rate value per year is 2.19 × 10-3 mg/MC, with a 10 % safety limit of volume and 14,400 cycles times, for 15 hours moving nonstop then the prediction of wear life of the component tibia insert is ± 10 years.

A Three-Dimensional Finite Element Analysis of the Stress Distribution Generated by Splinted and Nonsplinted Prostheses in the Rehabilitation of Various Bony Ridges with Regular or Short Morse Taper Implants.

PubMed

Toniollo, Marcelo Bighetti; Macedo, Ana Paula; Rodrigues, Renata Cristina; Ribeiro, Ricardo Faria; de Mattos, Maria G

The aim of this study was to compare the biomechanical performance of splinted or nonsplinted prostheses over short- or regular-length Morse taper implants (5 mm and 11 mm, respectively) in the posterior area of the mandible using finite element analysis. Three-dimensional geometric models of regular implants (Ø 4 × 11 mm) and short implants (Ø 4 × 5 mm) were placed into a simulated model of the left posterior mandible that included the first premolar tooth; all teeth posterior to this tooth had been removed. The four experimental groups were as follows: regular group SP (three regular implants were rehabilitated with splinted prostheses), regular group NSP (three regular implants were rehabilitated with nonsplinted prostheses), short group SP (three short implants were rehabilitated with splinted prostheses), and short group NSP (three short implants were rehabilitated with nonsplinted prostheses). Oblique forces were simulated in molars (365 N) and premolars (200 N). Qualitative and quantitative analyses of the minimum principal stress in bone were performed using ANSYS Workbench software, version 10.0. The use of splinting in the short group reduced the stress to the bone surrounding the implants and tooth. The use of NSP or SP in the regular group resulted in similar stresses. The best indication when there are short implants is to use SP. Use of NSP is feasible only when regular implants are present.

Estimation of appropriate lubricating film thickness in ceramic-on-ceramic hip prostheses

NASA Astrophysics Data System (ADS)

Tauviqirrahman, M.; Muchammad, Bayuseno, A. P.; Ismail, R.; Saputra, E.; Jamari, J.

2016-04-01

Artificial hip prostheses, consisting of femoral head and acetabular cup are widely used and have affected the lives of many people.However, the primary issue associated with the long term performance of hip prostheses is loosening induced by excessive wear during daily activity. Therefore, an effective lubrication is necessary to significantly decrease the wear. To help understand the lubricating performance of such typical hip joint prostheses, in the present paper a hydrodynamic lubrication model based on Reynolds equationwas introduced. The material pairs of ceramic acetabular cup against ceramic femoral head was investegated.The main aim of this study is to investigate of the effect of loading on the formation of lubricating film thickness.The model of a ball-in-socket configuration was considered assuming that the cup was stationary while the ball was to rotate at a steady angular velocityvarying loads.Based on simulation result, it was found that to promote fluid film lubrication and prevent the contacting components leading to wear, the film thickness of lubricant should be determined carefully based on the load applied. This finding may have useful implication in predicting the failure of lubricating synovial fluid film and wear generation in hip prostheses.

Incus replacement prostheses of hydroxylapatite in middle ear reconstruction.

PubMed

Wehrs, R E

1989-05-01

Hydroxylapatite is a calcium bioceramic that has the same chemical composition as living bone, Ca10 (PO4) 6 (OH) 2. Since 1970 it has been used as a material in reconstructive prostheses and augmentation of lost tissues in various surgical specialties including maxillofacial surgery, plastic surgery, otolaryngology, and orthopedics. For over 20 years the author has used autograft and homograft ossicles in tympanoplasty. These incudi have been modified into prostheses that were utilized in ossicular reconstruction. During this time two principle prostheses have evolved, the notched incus with short and long processes. The short process prosthesis is used with an intact stapes, whereas the notched incus with long process carries the sound pressure directly to the stapedial footplate. These prostheses have been successful in improving and maintaining hearing following tympanoplasty. Unfortunately, however, the use of human tissue has certain limitations: it is not readily accessible and has a limited shelf life. Furthermore, clinicians are wary of using homograft tissue as concern over the AIDS virus spreads. Therefore it was felt prudent to develop a manmade prosthesis that would as nearly as possible match the advantages of living bone. Hydroxylapetite most nearly met those qualifications.

Prototyping for surgical and prosthetic treatment.

PubMed

Goiato, Marcelo Coelho; Santos, Murillo Rezende; Pesqueira, Aldiéris Alves; Moreno, Amália; dos Santos, Daniela Micheline; Haddad, Marcela Filié

2011-05-01

Techniques of rapid prototyping were introduced in the 1980s in the field of engineering for the fabrication of a solid model based on a computed file. After its introduction in the biomedical field, several applications were raised for the fabrication of models to ease surgical planning and simulation in implantology, neurosurgery, and orthopedics, as well as for the fabrication of maxillofacial prostheses. Hence, the literature has described the evolution of rapid prototyping technique in health care, which allowed easier technique, improved surgical results, and fabrication of maxillofacial prostheses. Accordingly, a literature review on MEDLINE (PubMed) database was conducted using the keywords rapid prototyping, surgical planning, and maxillofacial prostheses and based on articles published from 1981 to 2010. After reading the titles and abstracts of the articles, 50 studies were selected owing to their correlations with the aim of the current study. Several studies show that the prototypes have been used in different dental-medical areas such as maxillofacial and craniofacial surgery; implantology; neurosurgery; orthopedics; scaffolds of ceramic, polymeric, and metallic materials; and fabrication of personalized maxillofacial prostheses. Therefore, prototyping has been an indispensable tool in several studies and helpful for surgical planning and fabrication of prostheses and implants.

Exploiting arm posture synergies in activities of daily living to control the wrist rotation in upper limb prostheses: A feasibility study.

PubMed

Montagnani, Federico; Controzzi, Marco; Cipriani, Christian

2015-01-01

Although significant technological advances have been made in the last forty years, natural and effortless control of upper limb prostheses is still an open issue. Commercially available myoelectric prostheses present limited Degrees of Freedom (DoF) mainly because of the lack of available and reliable independent control signals from the human body. Thus, despite the crucial role that an actuated wrist could play in a transradial prosthesis in terms of avoiding compensatory movements, commercial hand prostheses present only manually adjustable passive wrists or actuated rotators controlled by (unnatural) sequential control strategies. In the present study we investigated the synergies between the humeral orientation with respect to the trunk and the forearm pronation/supination angles during the execution of a wide range of activities of daily living, in healthy subjects. Our results showed consistent postural synergies between the two selected body segments for almost the totality of the activities of daily living under investigation. This is a promising result because these postural synergies could be exploited to automatically control the wrist rotator unit in transradial prostheses improving the fluency and the dexterity of the amputee.

Effect of joining the sectioned implant-supported prosthesis on the peri-implant strain generated in simulated mandibular model.

PubMed

Singh, Ipsha; Nair, K Chandrasekharan; Shetty, Jayakar

2017-01-01

The aim of this study is to evaluate the strain developed in simulated mandibular model before and after the joining of an implant-supported screw-retained prosthesis by different joining techniques, namely, arc welding, laser welding, and soldering. A specimen simulating a mandibular edentulous ridge was fabricated in heat-cured acrylic resin. 4-mm holes were drilled in the following tooth positions; 36, 33, 43, 46. Implant analogs were placed in the holes. University of California, Los Angeles, abutment was attached to the implant fixture. Eight strain gauges were attached to the acrylic resin model. Six similar models were made. Implant-supported screw-retained fixed prosthesis was fabricated in nickel-chromium alloy. A load of 400 N was applied on the prosthesis using universal testing machine. Resultant strain was measured in each strain gauge. All the prostheses were sectioned at the area between 36 and 33, 33 and 43, and 43 and 46 using 35 micrometer carborundum disc, and strain was measured in each strain gauge after applying a load of 400 N on the prosthesis. Specimens were joined by arc welding, soldering, and laser welding. After joining, a load of 400 N was applied on each prosthesis and the resultant strain was measured in each strain gauge. Highest mean strain values were recorded before sectioning of the prostheses (889.9 microstrains). Lowest mean strain values were recorded after sectioning the prosthesis and before reuniting it (225.0 microstrains). Sectioning and reuniting the long-span implant prosthesis was found to be a significant factor in influencing the peri-implant strain.

Comparative study on stress distribution around internal tapered connection implants according to fit of cement- and screw-retained prostheses.

PubMed

Lee, Mi-Young; Heo, Seong-Joo; Park, Eun-Jin; Park, Ji-Man

2013-08-01

The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of α=.05. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 µm/m at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.

Prostheses and orthoses in the collections of the Auschwitz-Birkenau State Museum.

PubMed

Przeździak, Bogumił; Lutomirski, Adam; Kulczyk, Maria

2011-01-01

The authors described 424 orthopaedic appliances left by the prisoners of the Nazi Concentration Camp in Oświęcim. A collection of prostheses and orthoses, which is currently a part of the Auschwitz-Birkenau State Museum's exhibition, is extraordinary as it illustrates the fate of innocent, crippled people, who were incarcerated and murdered. Another point of value of the collection is its technical aspect, as it provides a clear picture of construction of prostheses and orthoses at the beginning of the 20th century.

An economic model to evaluate cost-effectiveness of computer assisted knee replacement surgery in Norway.

PubMed

Gøthesen, Øystein; Slover, James; Havelin, Leif; Askildsen, Jan Erik; Malchau, Henrik; Furnes, Ove

2013-07-06

The use of Computer Assisted Surgery (CAS) for knee replacements is intended to improve the alignment of knee prostheses in order to reduce the number of revision operations. Is the cost effectiveness of computer assisted surgery influenced by patient volume and age? By employing a Markov model, we analysed the cost effectiveness of computer assisted surgery versus conventional arthroplasty with respect to implant survival and operation volume in two theoretical Norwegian age cohorts. We obtained mortality and hospital cost data over a 20-year period from Norwegian registers. We presumed that the cost of an intervention would need to be below NOK 500,000 per QALY (Quality Adjusted Life Year) gained, to be considered cost effective. The added cost of computer assisted surgery, provided this has no impact on implant survival, is NOK 1037 and NOK 1414 respectively for 60 and 75-year-olds per quality-adjusted life year at a volume of 25 prostheses per year, and NOK 128 and NOK 175 respectively at a volume of 250 prostheses per year. Sensitivity analyses showed that the 10-year implant survival in cohort 1 needs to rise from 89.8% to 90.6% at 25 prostheses per year, and from 89.8 to 89.9% at 250 prostheses per year for computer assisted surgery to be considered cost effective. In cohort 2, the required improvement is a rise from 95.1% to 95.4% at 25 prostheses per year, and from 95.10% to 95.14% at 250 prostheses per year. The cost of using computer navigation for total knee replacements may be acceptable for 60-year-old as well as 75-year-old patients if the technique increases the implant survival rate just marginally, and the department has a high operation volume. A low volume department might not achieve cost-effectiveness unless computer navigation has a more significant impact on implant survival, thus may defer the investments until such data are available.

Two-unit cantilevered resin-bonded fixed partial denture as a substitute for a prosthodontic-orthodontic treatment plan: a 5-year case report.

PubMed

Emami, Elham; St-Georges, Annie; de Grandmont, Pierre

2012-01-01

In this case report, we describe the successful long-term treatment of a patient with dental agenesis. The initial treatment plan included an orthodontic phase to provide adequate space for replacing missing lateral incisors with implants. However, because of some complications encountered after 2 years of orthodontic treatment, a revised treatment plan was considered to achieve functional and esthetic goals. The patient was completely satisfied 5 years after being treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost.

Biodeterioration of medical-grade silicone rubber used for voice prostheses: a SEM study.

PubMed

Neu, T R; Van der Mei, H C; Busscher, H J; Dijk, F; Verkerke, G J

1993-05-01

Silicone voice prostheses used for rehabilitation of speech after total laryngectomy are inserted in an non-sterile habitat. Deposits on explanted Groningen Button voice prostheses revealed a biofilm, due to heavy colonization of the silicone surface by bacteria and yeasts. Furthermore, it was demonstrated by scanning electron microscopy on sectioned explants that the silicone material was deteriorated by filamentous and vegetative yeast cells. The different explants showed a variety of sharp-edged, discrete yeast colonies. The yeasts grew just under the silicone surface and up to 700 microns into the silicone material. Finally, nine different types of defects in the silicone material created by the yeasts are described. This deterioration of the silicone by yeasts seems to be the main reason for the failure and the frequent replacement of the prostheses. The mechanisms of silicone deterioration are still hypothetical.

Trends in Computer-Aided Manufacturing in Prosthodontics: A Review of the Available Streams

PubMed Central

Bennamoun, Mohammed

2014-01-01

In prosthodontics, conventional methods of fabrication of oral and facial prostheses have been considered the gold standard for many years. The development of computer-aided manufacturing and the medical application of this industrial technology have provided an alternative way of fabricating oral and facial prostheses. This narrative review aims to evaluate the different streams of computer-aided manufacturing in prosthodontics. To date, there are two streams: the subtractive and the additive approaches. The differences reside in the processing protocols, materials used, and their respective accuracy. In general, there is a tendency for the subtractive method to provide more homogeneous objects with acceptable accuracy that may be more suitable for the production of intraoral prostheses where high occlusal forces are anticipated. Additive manufacturing methods have the ability to produce large workpieces with significant surface variation and competitive accuracy. Such advantages make them ideal for the fabrication of facial prostheses. PMID:24817888

Implant-retained craniofacial prostheses for facial defects

PubMed Central

Federspil, Philipp A.

2012-01-01

Craniofacial prostheses, also known as epistheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant-retained prostheses came with the development of the modern silicones and bone anchorage. Following the discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium in the 1960s. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral implant systems were developed. Grouped implant systems have also been developed which may be placed more reliably in areas with low bone presentation, as in the nasal and orbital region, or the ideally pneumatised mastoid process. Today, even large facial prostheses may be securely retained. The classical atraumatic surgical technique has remained an unchanged prerequisite for successful implantation of any system. This review outlines the basic principles of osseointegration as well as the main features of extraoral implantology. PMID:22073096

[In situ aortofemoral reconstructions in surgical treatment of infected aortofemoral grafts].

PubMed

Badretdinov, I A; Pokrovsky, A V

2015-01-01

The article presents a review of literature sources covering possibilities of peiforming in situ aortofemoral reconstructions in surgical treatment of infected aortofemoral grafts. This methodology makes it possible to improve the outcomes of treatment for paraprosthetic infection at the expense of decreasing lethality and morbidity, increasing parameters of patency of grafts and lower limb salvage in the remote postoperative period. Mention should be made that in situ secondary aortofemoral reconstructions are fraught with danger of relapsing paraprosthetic infection, therefore many publications are dedicated to search for prostheses most resistant to infection. The article also presents the results of works devoted to the use of various types of prostheses for in situ secondary aortofemoral reconstructions: prostheses made of polytetrafluoroethylene (PTFE), synthetic grafts saturated with various antibacterial drugs and gelatine, cadaveric allografts, synthetic prostheses treated with silver ions, autovenous conduits based on the femoral and popliteal veins.

Reflections on the present and future of upper limb prostheses.

PubMed

Farina, Dario; Amsüss, Sebastian

2016-01-01

Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients.

Effect of alignment changes on socket reaction moments during gait in transfemoral and knee-disarticulation prostheses: case series.

PubMed

Kobayashi, Toshiki; Orendurff, Michael S; Boone, David A

2013-09-27

The alignment of a lower-limb prosthesis is critical to the successful prosthetic fitting and utilization by the wearer. Loads generated by the socket applied to the residual limb while walking are thought to be different in transfemoral and knee-disarticulation prostheses. The aim of this case series was to compare the socket reaction moments between transfemoral and knee-disarticulation prostheses and to investigate the effect of alignment changes on them. Two amputees, one with a transfemoral prosthesis and another with a knee-disarticulation prosthesis, participated in this study. A Smart Pyramid™ was used to measure socket reaction moments while walking under 9 selected alignment conditions; including nominally aligned, angle malalignments of 6° (flexion, extension, abduction and adduction) and translation malalignments of 15 mm (anterior, posterior, medial and lateral) of the socket relative to the foot. This study found that the pattern of the socket reaction moments was similar between transfemoral and knee-disarticulation prostheses. An extension moment in the sagittal plane and a varus moment in the coronal plane were dominant during stance under the nominally aligned condition. This study also demonstrated that alignment changes might have consistent effects on the socket reaction moments in transfemoral and knee-disarticulation prostheses. Extension and posterior translation of the socket resulted in increases in an extension moment, while abduction and lateral translation of the socket resulted in increases in a varus moment. The socket reaction moments may potentially serve as useful biomechanical parameters to evaluate alignment in transfemoral and knee-disarticulation prostheses. Copyright © 2013 Elsevier Ltd. All rights reserved.

Temperature variations in sintering ovens for metal ceramic dental prostheses: non-destructive assessment using OCT

NASA Astrophysics Data System (ADS)

Sinescu, C.; Bradu, A.; Duma, V.-F.; Topala, F. I.; Negrutiu, M. L.; Podoleanu, A. G.

2018-02-01

We present a recent investigation regarding the use of optical coherence tomography (OCT) in the monitoring of the calibration loss of sintering ovens for the manufacturing of metal ceramic dental prostheses. Differences in the temperatures of such ovens with regard to their specifications lead to stress and even cracks in the prostheses material, therefore to the failure of the dental treatment. Evaluation methods of the ovens calibration consist nowadays of firing supplemental samples; this is subjective, expensive, and time consuming. Using an in-house developed swept source (SS) OCT system, we have demonstrated that a quantitative assessment of the internal structure of the prostheses, therefore of the temperature settings of the ovens can be made. Using en-face OCT images acquired at similar depths inside the samples, the differences in reflectivity allow for the evaluation of the differences in granulation (i.e., in number and size of ceramic grains) of the prostheses material. Fifty samples, divided in five groups, each sintered at different temperatures (lower, higher, or equal to the prescribed one) have been analyzed. The consequences of the temperature variations with regard to the one prescribed were determined. Rules-of-thumb were extracted to monitor objectively, using only OCT images of currently manufactured samples, the settings of the oven. The method proposed allows for avoiding producing prostheses with defects. While such rules-of-thumb achieve a qualitative assessment, an insight in our on-going work on the quantitative assessment of such losses of calibration on dental ovens using OCT is also made.

3D printing and intraoperative neuronavigation tailoring for skull base reconstruction after extended endoscopic endonasal surgery: proof of concept.

PubMed

Essayed, Walid I; Unadkat, Prashin; Hosny, Ahmed; Frisken, Sarah; Rassi, Marcio S; Mukundan, Srinivasan; Weaver, James C; Al-Mefty, Ossama; Golby, Alexandra J; Dunn, Ian F

2018-03-02

OBJECTIVE Endoscopic endonasal approaches are increasingly performed for the surgical treatment of multiple skull base pathologies. Preventing postoperative CSF leaks remains a major challenge, particularly in extended approaches. In this study, the authors assessed the potential use of modern multimaterial 3D printing and neuronavigation to help model these extended defects and develop specifically tailored prostheses for reconstructive purposes. METHODS Extended endoscopic endonasal skull base approaches were performed on 3 human cadaveric heads. Preprocedure and intraprocedure CT scans were completed and were used to segment and design extended and tailored skull base models. Multimaterial models with different core/edge interfaces were 3D printed for implantation trials. A novel application of the intraoperative landmark acquisition method was used to transfer the navigation, helping to tailor the extended models. RESULTS Prostheses were created based on preoperative and intraoperative CT scans. The navigation transfer offered sufficiently accurate data to tailor the preprinted extended skull base defect prostheses. Successful implantation of the skull base prostheses was achieved in all specimens. The progressive flexibility gradient of the models' edges offered the best compromise for easy intranasal maneuverability, anchoring, and structural stability. Prostheses printed based on intraprocedure CT scans were accurate in shape but slightly undersized. CONCLUSIONS Preoperative 3D printing of patient-specific skull base models is achievable for extended endoscopic endonasal surgery. The careful spatial modeling and the use of a flexibility gradient in the design helped achieve the most stable reconstruction. Neuronavigation can help tailor preprinted prostheses.

Paré and prosthetics: the early history of artificial limbs.

PubMed

Thurston, Alan J

2007-12-01

There is evidence for the use of prostheses from the times of the ancient Egyptians. Prostheses were developed for function, cosmetic appearance and a psycho-spiritual sense of wholeness. Amputation was often feared more than death in some cultures. It was believed that it not only affected the amputee on earth, but also in the afterlife. The ablated limbs were buried and then disinterred and reburied at the time of the amputee's death so the amputee could be whole for eternal life. One of the earliest examples comes from the 18th dynasty of ancient Egypt in the reign of Amenhotep II in the fifteenth century bc. A mummy in the Cairo Museum has clearly had the great toe of the right foot amputated and replaced with a prosthesis manufactured from leather and wood. The first true rehabilitation aids that could be recognized as prostheses were made during the civilizations of Greece and Rome. During the Dark Ages prostheses for battle and hiding deformity were heavy, crude devices made of available materials - wood, metal and leather. Such were the materials available to Ambroise Paré who invented both upper-limb and lower-limb prostheses. His 'Le Petit Lorrain', a mechanical hand operated by catches and springs, was worn by a French Army captain in battle. Subsequent refinements in medicine, surgery and prosthetic science greatly improved amputation surgery and the function of prostheses. What began as a modified crutch with a wooden or leather cup and progressed through many metamorphoses has now developed into a highly sophisticated prosthetic limb made of space-age materials.

[The application of laser beam welding of biological tissues for the purpose of ossiculoplasty].

PubMed

Semenov, V F

2013-01-01

The objective of the present work was to estimate the functional outcome of ossiculoplasty in the patients presenting with chronic suppurative otitis media and treated by means of laser beam welding of biological tissues. In order to obtain a good functional result of tympanoplasty including ossiculoplasty, it is necessary to conserve the elements of the sound-conducting system in the positions to which they were set during surgery. We reached this goal by fixing individual elements of the chain of the auditory ossicles by means of the laser beam welding of biological tissues with the use of platelet-rich plasma as a solder alloy. The audiometric examination of the patients within 1, 3, and 12 months after surgery showed that this technique improves the functional outcome of the treatment of the patients with chronic suppurative otitis media using prostheses for the substitution of the auditory ossicles.

Three-Dimensional Static Articulation Accuracy of Virtual Models-Part II: Effect of Model Scanner-CAD Systems and Articulation Method.

PubMed

Yee, Sophia Hui Xin; Esguerra, Roxanna Jean; Chew, Amelia Anya Qin'An; Wong, Keng Mun; Tan, Keson Beng Choon

2018-02-01

Accurate maxillomandibular relationship transfer is important for CAD/CAM prostheses. This study compared the 3D-accuracy of virtual model static articulation in three laboratory scanner-CAD systems (Ceramill Map400 [AG], inEos X5 [SIR], Scanner S600 Arti [ZKN]) using two virtual articulation methods: mounted models (MO), interocclusal record (IR). The master model simulated a single crown opposing a 3-unit fixed partial denture. Reference values were obtained by measuring interarch and interocclusal reference features with a coordinate measuring machine (CMM). MO group stone casts were articulator-mounted with acrylic resin bite registrations while IR group casts were hand-articulated with poly(vinyl siloxane) bite registrations. Five test model sets were scanned and articulated virtually with each system (6 test groups, 15 data sets). STL files of the virtual models were measured with CMM software. dR R , dR C , and dR L , represented interarch global distortions at right, central, and left sides, respectively, while dR M , dX M , dY M , and dZ M represented interocclusal global and linear distortions between preparations. Mean interarch 3D distortion ranged from -348.7 to 192.2 μm for dR R , -86.3 to 44.1 μm for dR C , and -168.1 to 4.4 μm for dR L . Mean interocclusal distortion ranged from -257.2 to -85.2 μm for dR M , -285.7 to 183.9 μm for dX M , -100.5 to 114.8 μm for dY M , and -269.1 to -50.6 μm for dZ M . ANOVA showed that articulation method had significant effect on dR R and dX M , while system had a significant effect on dR R , dR C , dR L , dR M , and dZ M . There were significant differences between 6 test groups for dR R, dR L dX M , and dZ M . dR R and dX M were significantly greater in AG-IR, and this was significantly different from SIR-IR, ZKN-IR, and all MO groups. Interarch and interocclusal distances increased in MO groups, while they decreased in IR groups. AG-IR had the greatest interarch distortion as well as interocclusal superior-inferior distortion. The other groups performed similarly to each other, and the overall interarch distortion did not exceed 0.7%. In these systems and articulation methods, interocclusal distortions may result in hyper- or infra-occluded prostheses. © 2017 by the American College of Prosthodontists.

Effect of Nd:YAG laser parameters on the penetration depth of a representative Ni-Cr dental casting alloy.

PubMed

Al Jabbari, Youssef S; Koutsoukis, Theodoros; Barmpagadaki, Xanthoula; El-Danaf, Ehab A; Fournelle, Raymond A; Zinelis, Spiros

2015-02-01

The effects of voltage and laser beam (spot) diameter on the penetration depth during laser beam welding in a representative nickel-chromium (Ni-Cr) dental alloy were the subject of this study. The cast alloy specimens were butted against each other and laser welded at their interface using various voltages (160-390 V) and spot diameters (0.2-1.8 mm) and a constant pulse duration of 10 ms. After welding, the laser beam penetration depths in the alloy were measured. The results were plotted and were statistically analyzed with a two-way ANOVA, employing voltage and spot diameter as the discriminating variables and using Holm-Sidak post hoc method (a = 0.05). The maximum penetration depth was 4.7 mm. The penetration depth increased as the spot diameter decreased at a fixed voltage and increased as the voltage increased at a fixed spot diameter. Varying the parameters of voltage and laser spot diameter significantly affected the depth of penetration of the dental cast Ni-Cr alloy. The penetration depth of laser-welded Ni-Cr dental alloys can be accurately adjusted based on the aforementioned results, leading to successfully joined/repaired dental restorations, saving manufacturing time, reducing final cost, and enhancing the longevity of dental prostheses.

Experimental study on heat transfer enhancement of laminar ferrofluid flow in horizontal tube partially filled porous media under fixed parallel magnet bars

NASA Astrophysics Data System (ADS)

Sheikhnejad, Yahya; Hosseini, Reza; Saffar Avval, Majid

2017-02-01

In this study, steady state laminar ferroconvection through circular horizontal tube partially filled with porous media under constant heat flux is experimentally investigated. Transverse magnetic fields were applied on ferrofluid flow by two fixed parallel magnet bar positioned on a certain distance from beginning of the test section. The results show promising notable enhancement in heat transfer as a consequence of partially filled porous media and magnetic field, up to 2.2 and 1.4 fold enhancement were observed in heat transfer coefficient respectively. It was found that presence of both porous media and magnetic field simultaneously can highly improve heat transfer up to 2.4 fold. Porous media of course plays a major role in this configuration. Virtually, application of Magnetic field and porous media also insert higher pressure loss along the pipe which again porous media contribution is higher that magnetic field.

Association between oral health status and central obesity among Brazilian independent-living elderly.

PubMed

Peruchi, Carla Thais Rosada; Poli-Frederico, Regina Célia; Cardelli, Alexandrina Aparecida Maciel; Fracasso, Marina de Lourdes Calvo; Bispo, Carina Gisele Costa; Neves-Souza, Rejane Dias; Cardoso, Jefferson Rosa; Maciel, Sandra Mara

2016-10-24

The aim of this study was to investigate the association between oral health status and central obesity (CO) in Brazilian independent-living elderly. A cross-sectional study was carried out in a sample of 489 elderly, who were participants of the Study on Aging and Longevity, in Londrina, state of Parana. The number of natural teeth and use of prostheses were evaluated according to the World Health Organization criteria. The presence of CO was assessed using measures of waist circumference (WC) and waist-hip ratio (WHR). Information concerning sociodemographic profile and some systemic conditions was also collected. Data were analyzed using stepwise logistic regression, α=5%. According to WC and WHR measures, the prevalence of central obesity was 79.3% and 76.1%, respectively. CO according to WC was not associated with oral status. Considering the WHR measure, the following oral conditions were associated to CO: having fewer natural teeth (OR = 2.61; 95%CI = 1.17-5.80), being edentulous and wearing both upper and lower complete dentures (OR = 2.34; 95%CI = 1.11-4.93), and being edentulous wearing only the upper complete denture (OR = 2.64; 95%CI = 1.01-6.95). Traditional risk factors for CO such as gender, dyslipidemia, hypertension and diabetes were associated with both measures. A poor oral health due to extensive tooth loss, whether partial or complete, even if rehabilitated by removable prostheses, may be considered a good predictor of CO in Brazilian independent-living elderly.

Prognosis of Combining Remaining Teeth and Implants in Double-Crown-Retained Removable Dental Prostheses: A Systematic Review and Meta-Analysis.

PubMed

Lian, Meifei; Zhao, Kai; Feng, Yunzhi; Yao, Qian

The reliability of combining natural teeth and implants in one removable prosthesis is controversial. This systematic review was conducted to evaluate the prognosis of combined tooth/implant-supported double-crown-retained removable dental prostheses (DCR-RDPs) and to compare them with solely implant-supported prostheses with a minimum observation period of 3 years. Electronic database (PubMed, Embase, Central, and SCI) and manual searches up to August 2016 were conducted to identify human clinical studies on tooth/implant-supported DCR-RDPs. Literature selection and data extraction were accomplished by two independent reviewers. Meta-analyses of survival and complication rates were performed separately for combined tooth/implant-supported and solely implant-supported DCRRDPs. Among the initially identified 366 articles, 17 were included in a quantitative analysis. The estimated overall cumulative survival rate (CSR) for implants in combined tooth/implant-supported DCRRDPs was 98.72% (95% confidence interval [95% CI]: 96.98% to 99.82%), and that for implants in solely implant-supported DCR-RDPs was 98.83% (95% CI: 97.45% to 99.75%). The summary CSR for abutment teeth was 92.96% (95% CI: 85.38% to 98.12%). Double-crown-retained dentures with both abutment types showed high CSRs, most of which were approximately 100%. Regarding prosthetic maintenance treatment, the estimated incidence for patients treated with combined tooth/implant-supported RDPs was 0.164 (95% CI: 0.089 to 0.305) per patient per year (T/P/Y) and that for patients restored with solely implant-supported RDPs was 0.260 (95% CI: 0.149 to 0.454) T/P/Y. Based on four studies with combined tooth/implant-supported DCR-RDPs, no intrusion phenomena were encountered. Subject to the limitations of the present review, combining remaining teeth and implants in DCR-RDPs is a reliable and predictable treatment modality for partially edentulous patients. Comparable high survival rates and minor biologic or technical complications are observed for combined tooth/implant-supported and solely implant-supported DCR-RDPs. Due to the heterogeneity of the included studies, the results must be interpreted with caution.

Mouse hepatitis virus immunofluorescence in formalin- or Bouin's-fixed tissues using trypsin digestion.

PubMed

Brownstein, D G; Barthold, S W

1982-02-01

Mouse hepatitis viral antigens were demonstrated by immunofluorescence in formalin- and Bouin's-fixed tissues processed routinely for histopathology followed by partial digestion with trypsin. Staining was superior in tissues fixed in formalin and was not diminished in tissue sections from paraffin blocks stored at room temperature as long as 2 years. The relative ease of this procedure and the commercial availability of reagents makes this a useful technique for the definitive diagnosis of mouse hepatitis virus infection.

Surface evaluation of orthopedic hip implants marketed in Brazil

NASA Astrophysics Data System (ADS)

Souza, M. M.; Trommer, R. M.; Maru, M. M.; Roesler, C. R. M.; Barros, W. S.; Dutra, M. S.

2016-07-01

One of the factors that contribute to the quality of total hip prostheses is the degree of accuracy in the manufacturing of the joint surfaces. The dimensional control of joint components is important because of its direct influence on the durability and, consequently, in the patients’ life quality. This work presents studies on the form and roughness of orthopedic hip prostheses marketed in Brazil. The results provide data for quality control of the surfaces of the femoral heads and acetabular components of hip prostheses and indicate the need of improvement in the procedures used to this control.

Differential effects of speech prostheses in glossectomized patients.

PubMed

Leonard, R J; Gillis, R

1990-12-01

Five patients representing different categories of glossal resection were fitted with prostheses specifically designed to improve speech. Speech recordings made for subjects with and without their prostheses were subjected to a variety of analyses. Prosthetic influence on listeners' judgments of severity level/intelligibility, number of consonants in error, and on the acoustic measure F2 range of vowels was evaluated. Findings indicated that all subjects demonstrated improvement on the speech measures. However, the extent of improvement on each measure varied across speakers and resection categories. Implications of the findings for prosthetic speech rehabilitation in this population are discussed.

Fabrication of a new silicone auricular prosthesis without removing the existing metallic framework.

PubMed

Goveas, Reiyal; Shrestha, Binit; Srithavaj, M L Theerathavaj; Thaworanunta, Sita

2014-12-01

Silicone prostheses require constant repair and refabrication. Auricular prostheses retained with implants have better retention than adhesive-retained prostheses. However, refabrication is complicated if the patient is unwilling to surrender the metallic framework attached to the implants and revert to the use of adhesives. This article describes a technique by which the metal framework of the existing prosthesis need not be removed, thereby improving the patient's quality of life until the new prosthesis is delivered. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Re-operation for aortic and mitral prosthetic dysfunctions.

PubMed

Kaul, T K; Sastry, M R; Mercer, J L; Meade, J B

1985-01-01

The overall incidence of re-operation and prosthetic valve endocarditis was low in the present series as mechanical prostheses were used predominantly. The prosthetic dysfunctions were less frequent following the primary implantation with Bjork Shiley prostheses, but high operative risk was associated with the clotted Bjork Shiley prostheses. We also had unusual experience of strut fracture and sticking of Bjork Shiley discs in the closed position in both aortic and mitral positions. The early deaths were nil since the use of cardioplegic protection. Intra-operative bleeding due to adhesions can be minimised by using synthetic or heterologous pericardium during the primary operation.

Design features of implants for direct skeletal attachment of limb prostheses

PubMed Central

Pitkin, M.

2013-01-01

In direct skeletal attachment (DSA) of limb prostheses, a construct is implanted into an amputee’s residuum bone and protrudes out of the residuum’s skin. This technology represents an alternative to traditional suspension of prostheses via various socket systems, with clear indications when the sockets cannot be properly fitted. Contemporary DSA was invented in the 1990s, and several implant systems have been introduced since then. The current review is intended to compare the design features of implants for DSA whose use in humans or in animal studies has been reported in the literature. PMID:23554122

Complete denture analyzed by optical coherence tomography

NASA Astrophysics Data System (ADS)

Negrutiu, Meda L.; Sinescu, Cosmin; Todea, Carmen; Podoleanu, Adrian G.

2008-02-01

The complete dentures are currently made using different technologies. In order to avoid deficiencies of the prostheses made using the classical technique, several alternative systems and procedures were imagined, directly related to the material used and also to the manufacturing technology. Thus, at the present time, there are several injecting systems and technologies on the market, that use chemoplastic materials, which are heat cured (90-100°C), in dry or wet environment, or cold cured (below 60°C). There are also technologies that plasticize a hard cured material by thermoplastic processing (without any chemical changes) and then inject it into a mold. The purpose of this study was to analyze the existence of possible defects in several dental prostheses using a non invasive method, before their insertion in the mouth. Different dental prostheses, fabricated from various materials were investigated using en-face optical coherence tomography. In order to discover the defects, the scanning was made in three planes, obtaining images at different depths, from 0,01 μm to 2 mm. In several of the investigated prostheses we found defects which may cause their fracture. These defects are totally included in the prostheses material and can not be vizualised with other imagistic methods. In conclusion, en-face OCT is an important investigative tool for the dental practice.

Intensity-Modulated Radiation Therapy with Noncoplanar Beams for Treatment of Prostate Cancer in Patients with Bilateral Hip Prosthesis-A Case Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brooks, Chris; Cheung, Rex Min; Kudchadker, Rajat J.

2010-07-01

Megavoltage photon intensity-modulated radiation therapy (IMRT) is typically used in the treatment of prostate cancer at our institution. Approximately 1% to 2% of patients with prostate cancer have hip prostheses. The presence of the prosthesis usually complicates the planning process because of dose perturbation around the prosthesis, radiation attenuation through the prosthesis, and the introduction of computed tomography artifacts in the planning volume. In addition, hip prostheses are typically made of materials of high atomic number, which add uncertainty to the dosimetry of the prostate and critical organs in the planning volume. When the prosthesis is bilateral, treatment planning ismore » further complicated because only a limited number of beam angles can be used to avoid the prostheses. In this case study, we will report the observed advantages of using noncoplanar beams in the delivery of IMRT to a prostate cancer patient with bilateral hip prostheses. The treatment was planned for 75.6 Gy using a 7-field coplanar approach and a noncoplanar arrangement, with all fields avoiding entrance though the prostheses. Our results indicate that, compared with the coplanar plan, the noncoplanar plan delivers the prescribed dose to the target with a slightly better conformality and sparing of rectal tissue versus the coplanar plan.« less

Movement quality of conventional prostheses and the DEKA Arm during everyday tasks

PubMed Central

Cowley, Jeffrey; Resnik, Linda; Wilken, Jason; Walters, Lisa Smurr; Gates, Deanna

2017-01-01

Background Conventional prosthetic devices fail to restore the function and characteristic movement quality of the upper limb. The DEKA Arm is a new, advanced prosthesis featuring a compound, powered wrist and multiple grip configurations. Objectives The purpose of this study was to determine if the DEKA Arm improved the movement quality of upper limb prosthesis users compared to conventional prostheses. Study design Case series. Methods Three people with transradial amputation completed tasks of daily life with their conventional prosthesis and with the DEKA Arm. A total of 10 healthy controls completed the same tasks. The trajectory of the wrist joint center was analyzed to determine how different prostheses affected movement duration, speed, smoothness, and curvature compared to patients’ own intact limbs and controls. Results Movement quality decreased with the DEKA Arm for two participants, and increased for the third. Prosthesis users made slower, less smooth, more curved movements with the prosthetic limb compared to the intact limb and controls, particularly when grasping and manipulating objects. Conclusion The effects of one month of training with the DEKA Arm on movement quality varied with participants’ skill and experience with conventional prostheses. Future studies should examine changes in movement quality after long-term use of advanced prostheses. PMID:26932980

Evaluation of Osseous Integration of PVD-Silver-Coated Hip Prostheses in a Canine Model

PubMed Central

Hauschild, Gregor; Hardes, Jendrik; Gosheger, Georg; Blaske, Franziska; Wehe, Christoph; Karst, Uwe; Höll, Steffen

2015-01-01

Infection associated with biomaterials used for orthopedic prostheses remains a serious complication in orthopedics, especially tumor surgery. Silver-coating of orthopedic (mega)prostheses proved its efficiency in reducing infections but has been limited to surface areas exposed to soft tissues due to concerns of silver inhibiting osseous integration of cementless stems. To close this gap in the bactericidal capacity of silver-coated orthopedic prostheses extension of the silver-coating on surface areas intended for osseous integration seems to be inevitable. Our study reports about a PVD- (physical-vapor-deposition-) silver-coated cementless stem in a canine model for the first time and showed osseous integration of a silver-coated titanium surface in vivo. Radiological, histological, and biomechanical analysis revealed a stable osseous integration of four of nine stems implanted. Silver trace elemental concentrations in serum did not exceed 1.82 parts per billion (ppb) and can be considered as nontoxic. Changes in liver and kidney functions associated with the silver-coating could be excluded by blood chemistry analysis. This was in accordance with very limited metal displacement from coated surfaces observed by laser ablation inductively coupled plasma-mass spectrometry (LA-ICP-MS) 12 months after implantation. In conclusion our results represent a step towards complete bactericidal silver-coating of orthopedic prostheses. PMID:25695057

Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects.

PubMed

Said, Mohamed M; Otomaru, Takafumi; Yeerken, Yesiboli; Taniguchi, Hisashi

2017-07-01

The healing pattern after surgical resection of tumors of the oral cavity involving the maxilla may vary from one patient to another. The result may be open communication between the oral and nasal cavities (open defect) or complete oronasal separation after healing of the defect area (closed defect). The purpose of this clinical study was to compare masticatory function and oral health-related quality of life (OHRQoL) between patients with closed and open defects who had undergone a partial maxillectomy and were wearing dentomaxillary prostheses. Thirty-eight participants who had undergone a partial maxillectomy and who were wearing dentomaxillary prostheses were enrolled between September 2014 and April 2016. Participants were assigned to 2 groups according to the type of defect after healing: 19 participants had a closed defect, and 19 participants had an open defect. Masticatory function was evaluated objectively and subjectively. The objective measurement was food-mixing ability, which was assessed using color-changeable chewing gum. The subjective measurement was perceived mastication ability, rated as a masticatory score based on the patient's responses to a 35-item food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI questionnaire consists of 12 items reflecting 3 hypothesized domains of the impact of oral disease: physical function, psychosocial function, and pain or discomfort. Differences in the scores obtained by the 3 measurements were compared between the 2 groups, using the Wilcoxon rank-sum test (α=.05). No significant differences were seen between the 2 groups in objective mixing ability, subjective masticatory score, or GOHAI (P>.05). Regarding the GOHAI physical function domain, only the swallowing item was significantly lower (P=.025) in participants with an open defect than in participants with a closed defect. Regarding the GOHAI psychological function domain, the item related to patients' psychological worries or concerns about their teeth, gingival tissue, or dentures was significantly lower (P=.045) in patients with an open defect than in those with a closed defect. Other items related to physical function, psychological function, and pain or discomfort were not significantly different (P>.05) between the 2 groups. The closed or open defect in patients who had undergone a partial maxillectomy may not influence patients' masticatory function and overall OHRQoL if they have adequate prosthetic rehabilitation. However, special consideration should be given to patients with an open defect with regard to swallowing function and psychological concerns in order to improve their OHRQoL. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Removable partial overdentures with natural root structure and osseointegrated fixtures.

PubMed

Jackson, T R

1990-10-01

The development and refinement of osseointegration have had primary impetus in treatment of the totally edentulous patient. The same principles, however, may be applied to the partially edentulous patient. Osseointegrated fixtures used in conjunction with mechanical or magnetic attachments may be used to construct partial or full overdentures. This allows treatment with removable prosthodontics in many cases in which it is not practical to achieve anchorage for a fixed prosthesis.

A FLEXIBLE APPROACH FOR EVALUATING FIXED RATIO MIXTURES OF FULL AND PARTIAL AGONISTS FOR MIXTURES OF MANY CHEMICALS.

EPA Science Inventory

Detecting interaction in chemical mixtures can be complicated by differences in the shapes of the dose-response curves of the individual components (e.g. mixtures of full and partial agonists with differing response maxima). We present an analysis scheme where flexible single che...

[A scanning electron microscopy study of the surface of porous-textured breast implants and their capsules. Description of the "velcro" effect of porous-textured breast prostheses].

PubMed

Danino, A; Rocher, F; Blanchet-Bardon, C; Revol, M; Servant, J M

2001-02-01

The efficacy of breast prosthesis texturing in the prevention of capsular contracture has been established for about 20 years. This successful procedure has led to the development and marketing of a number of different models. In the present study, four porous-textured breast prostheses have been examined: the Arion monoblock implant, the CUI (McGahn), the Biocell (Mcgahn), and the Sebbin LS21. Scanning electron microscopic (SEM) investigation of the implant surfaces of the different prostheses was carried out on new samples received from the manufacturers. During a prospective study on eight patients, capsule samples corresponding to the four above-mentioned prostheses were taken to determine whether a secondary intervention was necessary for correction of asymmetry or malpositioning. These samples were analyzed by SEM to investigate whether there could be a correlation between prosthesis texturing and the aspect of the corresponding capsules. Significant ultrastructural differences were found between the various prostheses examined: the results showed that only the CUI and Biocell prostheses presented a mirror image of the capsule texturing, with a correspondence between the depressions on the prosthesis and the contacts on the capsule. This finding seems to be linked to the existence of a critical size for the pores that constitute the implant surface. This observation led to the hypothesis of an adhesive "velcro" effect between the prosthesis and its capsule. Although the latter may not be directly linked to the prevention of capsular contracture it can, however, have a major effect on implant stabilization in cases of primary breast reconstruction and in possible secondary adjustments of asymmetry and malpositioning.

Mastication and oral health-related quality of life in removable denture wearers with Alzheimer disease.

PubMed

Campos, Camila H; Ribeiro, Giselle R; Rodrigues Garcia, Renata C M

2018-05-01

Alzheimer disease (AD) can affect masticatory function, affecting oral health-related quality of life (OHRQoL). Whether oral rehabilitation with conventional removable prostheses can restore masticatory function and improve OHRQoL in these individuals is unknown. The purpose of this clinical study was to evaluate the influence of oral rehabilitation with removable prostheses on masticatory efficiency and OHRQoL in elders with and without AD. Thirty-two elders with mild AD (n=16, mean age=76.7 ±6.3 years) or without AD (n=16, mean age=75.2 ±4.4 years) were recruited. All participants first underwent masticatory efficiency and OHRQoL evaluations, and 2 months after insertion of new removable prostheses, the variables were reassessed. Masticatory efficiency was determined using the sieving method, and OHRQoL was measured by applying the Geriatric Oral Health Assessment Index (GOHAI). The data from the baseline and after insertion of the new removable prostheses were compared by paired t test. Group differences at each time point were assessed by t test (α=.05). After insertion of the new removable prostheses, masticatory efficiency and OHRQoL improved in both the elders with AD and the control. At baseline, elders with AD had lower masticatory efficiency and higher OHRQoL than controls (P<.05). After removable prosthesis insertion, elders with AD continued to show lower masticatory efficiency values than controls, but their OHRQoL was similar. Oral rehabilitation with new removable prostheses improved the masticatory efficiency and OHRQoL of elders with and without AD, although masticatory efficiency did not reach control levels in elders with AD. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of the Alteration of Occlusal Distribution in Unilateral Free-End and Intermediate Missing Cases.

PubMed

Kon, Kazuhiro; Shiota, Makoto; Sakuyama, Aoi; Ozeki, Maho; Kozuma, Wataru; Kawakami, Sawako; Kasugai, Shohei

2017-02-01

The present study aimed to evaluate the effect of implant prostheses on the occlusal force and area as well as the distribution of occlusal loading in unilateral free-end and intermediate missing cases. Fourteen healthy subjects (7 free-end missing cases in the first and second molars and 7 intermediate missing cases in the first molar region) were included. Six months after the implant prosthesis was placed, an occlusal evaluation was performed with or without the implant superstructure by using Dental Prescale film and an occluder device. In free-end missing cases, the total occlusal force and area, implant-side occlusal force and area, and implant-side occlusal force and area of the residual natural teeth were significantly affected by the implant prostheses. In intermediate missing cases, the implant-side occlusal force of the residual natural teeth was significantly affected by the implant prostheses. In free-end missing cases, the proportions of implant-side occlusal force, non-implant-side occlusal force, and implant-side occlusal force of the residual natural teeth relative to the total occlusal force were significantly affected by the implant prostheses. In the intermediate missing cases, the proportion of the implant-side occlusal force of the residual natural teeth relative to the total occlusal force was significantly affected by the implant prostheses. The proportion of the occlusal area was also significantly affected. In free-end missing cases, implant prostheses significantly increased the occlusal force and area, which resulted in the proper occlusal distribution. In intermediate missing cases, an implant prosthesis may only improve the same-side occlusal loading of the natural teeth.

Characterisation of the responsive properties of two running-specific prosthetic models.

PubMed

Grobler, Lara; Ferreira, Suzanne; Vanwanseele, Benedicte; Terblanche, Elmarie E

2017-04-01

The need for information regarding running-specific prosthetic properties has previously been voiced. Such information is necessary to assist in athletes' prostheses selection. This study aimed to describe the characteristics of two commercially available running-specific prostheses. The running-specific prostheses were tested (in an experimental setup) without the external interference of athlete performance variations. Four stiffness categories of each running-specific prosthetic model (Xtend ™ and Xtreme ™ ) were tested at seven alignment setups and three drop masses (28, 38 and 48 kg). Results for peak ground reaction force (GRF peak ), contact time ( t c ), flight time ( t f ), reactive strength index (RSI) and maximal compression (Δ L) were determined during controlled dropping of running-specific prostheses onto a force platform with different masses attached to the experimental setup. No statistically significant differences were found between the different setups of the running-specific prostheses. Statistically significant differences were found between the two models for all outcome variables (GRF peak , Xtend > Xtreme; t c , Xtreme > Xtend; t f , Xtreme > Xtend; RSI, Xtend > Xtreme; Δ L, Xtreme > Xtend; p < 0.05). These findings suggest that the Xtreme stores more elastic energy than the Xtend, leading to a greater performance response. The specific responsive features of blades could guide sprint athletes in their choice of running-specific prostheses. Clinical relevance Insights into the running-specific prosthesis (RSP) properties and an understanding of its responsive characteristics have implications for athletes' prosthetic choice. Physiologically and metabolically, a short sprint event (i.e. 100 m) places different demands on the athlete than a long sprint event (i.e. 400 m), and the RSP should match these performance demands.

Usefulness of Mitral Valve Prosthetic or Bioprosthetic Time Velocity Index Ratio to Detect Prosthetic or Bioprosthetic Mitral Valve Dysfunction.

PubMed

Luis, Sushil Allen; Blauwet, Lori A; Samardhi, Himabindu; West, Cathy; Mehta, Ramila A; Luis, Chris R; Scalia, Gregory M; Miller, Fletcher A; Burstow, Darryl J

2017-10-15

This study aimed to investigate the utility of transthoracic echocardiographic (TTE) Doppler-derived parameters in detection of mitral prosthetic dysfunction and to define optimal cut-off values for identification of such dysfunction by valve type. In total, 971 TTE studies (647 mechanical prostheses; 324 bioprostheses) were compared with transesophageal echocardiography for evaluation of mitral prosthesis function. Among all prostheses, mitral valve prosthesis (MVP) ratio (ratio of time velocity integral of MVP to that of left ventricular outflow tract; odds ratio [OR] 10.34, 95% confidence interval [95% CI] 6.43 to 16.61, p<0.001), E velocity (OR 3.23, 95% CI 1.61 to 6.47, p<0.001), and mean gradient (OR 1.13, 95% CI 1.02 to 1.25, p=0.02) provided good discrimination of clinically normal and clinically abnormal prostheses. Optimal cut-off values by receiver operating characteristic analysis for differentiating clinically normal and abnormal prostheses varied by prosthesis type. Combining MVP ratio and E velocity improved specificity (92%) and positive predictive value (65%) compared with either parameter alone, with minimal decline in negative predictive value (92%). Pressure halftime (OR 0.99, 95% CI 0.98 to 1.00, p=0.04) did not differentiate between clinically normal and clinically abnormal prostheses but was useful in discriminating obstructed from normal and regurgitant prostheses. In conclusion, cut-off values for TTE-derived Doppler parameters of MVP function were specific to prosthesis type and carried high sensitivity and specificity for identifying prosthetic valve dysfunction. MVP ratio was the best predictor of prosthetic dysfunction and, combined with E velocity, provided a useful parameter for determining likelihood of dysfunction and need for further assessment. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

PubMed

Yoon, Hyung-In

2016-10-01

This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

Failures and complications in patients with birth defects restored with fixed dental prostheses and single crowns on teeth and/or implants.

PubMed

Krieger, Oliver; Matuliene, Giedre; Hüsler, Jürg; Salvi, Giovanni E; Pjetursson, Bjarni; Brägger, Urs

2009-08-01

To assess retrospectively, over at least 5 years, the incidences of technical and biological complications and failures in young adult patients with birth defects affecting the formation of teeth. All insurance cases with a birth defect that had crowns and fixed dental prostheses (FDPs) inserted more than 5 years ago were contacted and asked to participate in a reexamination. The median age of the patients was 19.3 years (range 16.6-24.7 years) when prosthetic treatment was initiated. Over the median observation period of 15.7 years (range 7.4-24.9 years) and considering the treatment needs at the reexamination, 19 out of 33 patients (58%) with reconstructions on teeth remained free from all failures or complications. From the patients with FDPs and single unit crowns (SCs) on implants followed over a median observation period of 8 years (range 4.6-15.3 years), eight out of 17% or 47% needed a retreatment or repair at some point due to a failure or a complication. From the three groups of patients, the cases with amelogenesis/dentinogenesis imperfecta demonstrated the highest failure and complication rates. In the cases with cleft lip, alveolus and palate (CLAP) or hypodontia/oligodontia, 71% of the SCs and 73% of the FDPs on teeth (FDP T) remained complication free over a median observation period of about 16 years. Sixty-two percent of the SCs and 64% of the FDPs on implants remained complication free over 8 years. Complications occurred earlier with implant-supported reconstructions. Because healthy, pristine teeth can be left unprepared, implant-supported SCs and FDPs are the treatment choice in young adults with birth defects resulting in tooth agenesis and in whom the edentulous spaces cannot be closed by means of orthodontic therapy. However, the trend for earlier and more frequent complications with implant-supported reconstructions in young adults, expecting many years of function with the reconstructions, has to be weighed against the benefits of keeping teeth unprepared. In cases with CLAP in which anatomical conditions render implant placement difficult and in which teeth adjacent to the cleft require esthetic corrections, the conventional FDP T still remains the treatment of choice.

Evaluation of zirconium-oxide-based ceramic single-unit posterior fixed dental prostheses (FDPs) generated with two CAD/CAM systems compared to porcelain-fused-to-metal single-unit posterior FDPs: a 5-year clinical prospective study.

PubMed

Vigolo, Paolo; Mutinelli, Sabrina

2012-06-01

The purpose of this prospective clinical study was to determine the success rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM) single-unit posterior FDPs after 5 years of function. From 2005 to 2006, 60 patients who needed a single-unit FDP on a first molar in the mandibular jaw (left or right) in a private office setting were included in this study. The 60 first mandibular molars were randomly divided into three groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the other two groups CAD/CAM technology was used for the fabrication of the zirconium-oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated with the Procera system (group P, Nobel Biocare); 20 single-unit posterior FDPs with zirconia copings were generated with the Lava system (group L, 3M ESPE). For the ANOVA follow-up data, the clinical life table method was applied. The statistical analysis was performed using two nonparametric tests, the log-rank test for k-groups and the Fisher exact test. No statistically significant difference in the clinical outcome of zirconia-ceramic FDPs of both groups (P and L) evaluated together and metal-ceramic posterior single FDPs was found at 5 years of function; however, clinical data showed that technical problems, such as extended fracture of the veneering ceramic, tended to occur more frequently in the zirconia-ceramic FDP groups. The difference in the frequency of failure was statistically significant only in the comparison of groups C and P. Even if no statistically significant difference in the clinical outcome of zirconia-ceramic FDPs of both groups (P and L) considered together and metal-ceramic posterior single FDPs was found at 5 years of function, clinical data showed that the two zirconia-ceramic FDP groups tended to have more frequent clinical problems: for this reason all the clinical and technical variables related to the use of zirconia-ceramic FDPs generated with CAD/CAM systems should be carefully considered prior to all treatment procedures. © 2012 by the American College of Prosthodontists.

Full-arch implant fixed prostheses: a comparative study on the effect of connection type and impression technique on accuracy of fit.

PubMed

Papaspyridakos, Panos; Hirayama, Hiroshi; Chen, Chun-Jung; Ho, Chung-Han; Chronopoulos, Vasilios; Weber, Hans-Peter

2016-09-01

The aim of this study was to assess the effect of connection type and impression technique on the accuracy of fit of implant-supported fixed complete-arch dental prostheses (IFCDPs). An edentulous mandibular cast with five implants was fabricated to serve as master cast (control) for both implant- and abutment-level baselines. A titanium one-piece framework for an IFCDP was milled at abutment level and used for accuracy of fit measurements. Polyether impressions were made using a splinted and non-splinted technique at the implant and abutment level leading to four test groups, n = 10 each. Hence, four groups of test casts were generated. The impression accuracy was evaluated indirectly by assessing the fit of the IFCDP framework on the generated casts of the test groups, clinically and radiographically. Additionally, the control and all test casts were digitized with a high-resolution reference scanner (IScan D103i, Imetric, Courgenay, Switzerland) and standard tessellation language datasets were generated and superimposed. Potential correlations between the clinical accuracy of fit data and the data from the digital scanning were investigated. To compare the accuracy of casts of the test groups versus the control at the implant and abutment level, Fisher's exact test was used. Of the 10 casts of test group I (implant-level splint), all 10 presented with accurate clinical fit when the framework was seated on its respective cast, while only five of 10 casts of test group II (implant-level non-splint) showed adequate fit. All casts of group III (abutment-level splint) presented with accurate fit, whereas nine of 10 of the casts of test group IV (abutment-level non-splint) were accurate. Significant 3D deviations (P < 0.05) were found between group II and the control. No statistically significant differences were found between groups I, III, and IV compared with the control. Implant connection type (implant level vs. abutment level) and impression technique did affect the 3D accuracy of implant impressions only with the non-splint technique (P < 0.05). For one-piece IFCDPs, the implant-level splinted impression technique showed to be more accurate than the non-splinted approach, whereas at the abutment-level, no difference in the accuracy was found. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of core design, production technique, and material selection on fracture behavior of yttria-stabilized tetragonal zirconia polycrystal fixed dental prostheses produced using different multilayer techniques: split-file, over-pressing, and manually built-up veneers.

PubMed

Mahmood, Deyar Jallal Hadi; Linderoth, Ewa H; Wennerberg, Ann; Vult Von Steyern, Per

2016-01-01

To investigate and compare the fracture strength and fracture mode in eleven groups of currently, the most commonly used multilayer three-unit all-ceramic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) fixed dental prostheses (FDPs) with respect to the choice of core material, veneering material area, manufacturing technique, design of connectors, and radii of curvature of FDP cores. A total of 110 three-unit Y-TZP FDP cores with one intermediate pontic were made. The FDP cores in groups 1-7 were made with a split-file design, veneered with manually built-up porcelain, computer-aided design-on veneers, and over-pressed veneers. Groups 8-11 consisted of FDPs with a state-of-the-art design, veneered with manually built-up porcelain. All the FDP cores were subjected to simulated aging and finally loaded to fracture. There was a significant difference (P<0.05) between the core designs, but not between the different types of Y-TZP materials. The split-file designs with VITABLOCS(®) (1,806±165 N) and e.max(®) ZirPress (1,854±115 N) and the state-of-the-art design with VITA VM(®) 9 (1,849±150 N) demonstrated the highest mean fracture values. The shape of a split-file designed all-ceramic reconstruction calls for a different dimension protocol, compared to traditionally shaped ones, as the split-file design leads to sharp approximal indentations acting as fractural impressions, thus decreasing the overall strength. The design of a framework is a crucial factor for the load bearing capacity of an all-ceramic FDP. The state-of-the-art design is preferable since the split-file designed cores call for a cross-sectional connector area at least 42% larger, to have the same load bearing capacity as the state-of-the-art designed cores. All veneering materials and techniques tested in the study, split-file, over-press, built-up porcelains, and glass-ceramics are, with a great safety margin, sufficient for clinical use both anteriorly and posteriorly. Analysis of the fracture pattern shows differences between the milled veneers and over-pressed or built-up veneers, where the milled ones show numerically more veneer cracks and the other groups only show complete connector fractures.

Comparison of marginal and internal fit of 3-unit ceramic fixed dental prostheses made with either a conventional or digital impression.

PubMed

Su, Ting-Shu; Sun, Jian

2016-09-01

For 20 years, the intraoral digital impression technique has been applied to the fabrication of computer aided design and computer aided manufacturing (CAD-CAM) fixed dental prostheses (FDPs). Clinical fit is one of the main determinants of the success of an FDP. Studies of the clinical fit of 3-unit ceramic FDPs made by means of a conventional impression versus a digital impression technology are limited. The purpose of this in vitro study was to evaluate and compare the internal fit and marginal fit of CAD-CAM, 3-unit ceramic FDP frameworks fabricated from an intraoral digital impression and a conventional impression. A standard model was designed for a prepared maxillary left canine and second premolar and missing first premolar. The model was scanned with an intraoral digital scanner, exporting stereolithography (STL) files as the experimental group (digital group). The model was used to fabricate 10 stone casts that were scanned with an extraoral scanner, exporting STL files to a computer connected to the scanner as the control group (conventional group). The STL files were used to produce zirconia FDP frameworks with CAD-CAM. These frameworks were seated on the standard model and evaluated for marginal and internal fit. Each framework was segmented into 4 sections per abutment teeth, resulting in 8 sections per framework, and was observed using optical microscopy with ×50 magnification. Four measurement points were selected on each section as marginal discrepancy (P1), mid-axial wall (P2), axio-occusal edge (P3), and central-occlusal point (P4). Mean marginal fit values of the digital group (64 ±16 μm) were significantly smaller than those of the conventional group (76 ±18 μm) (P<.05). The mean internal fit values of the digital group (111 ±34 μm) were significantly smaller than those of the conventional group (132 ±44 μm) (P<.05). CAD-CAM 3-unit zirconia FDP frameworks fabricated from intraoral digital and conventional impressions showed clinically acceptable marginal and internal fit. The marginal and internal fit of frameworks fabricated from the intraoral digital impression system were better than those fabricated from conventional impressions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A microcomputed tomography evaluation of the marginal fit of cobalt-chromium alloy copings fabricated by new manufacturing techniques and alloy systems.

PubMed

Kim, Eun-Ha; Lee, Du-Hyeong; Kwon, Sung-Min; Kwon, Tae-Yub

2017-03-01

Although new digital manufacturing techniques are attracting interest in dentistry, few studies have comprehensively investigated the marginal fit of fixed dental prostheses fabricated with such techniques. The purpose of this in vitro microcomputed tomography (μCT) study was to evaluate the marginal fit of cobalt-chromium (Co-Cr) alloy copings fabricated by casting and 3 different computer-aided design and computer-aided manufacturing (CAD-CAM)-based processing techniques and alloy systems. Single Co-Cr metal crowns were fabricated using 4 different manufacturing techniques: casting (control), milling, selective laser melting, and milling/sintering. Two different commercial alloy systems were used for each fabrication technique (a total of 8 groups; n=10 for each group). The marginal discrepancy and absolute marginal discrepancy of the crowns were determined with μCT. For each specimen, the values were determined from 4 different regions (sagittal buccal, sagittal lingual, coronal mesial, and coronal distal) by using imaging software and recorded as the average of the 4 readings. For each parameter, the results were statistically compared with 2-way analysis of variance and appropriate post hoc analysis (using Tukey or Student t test) (α=.05). The milling and selective laser melting groups showed significantly larger marginal discrepancies than the control groups (70.4 ±12.0 and 65.3 ±10.1 μm, respectively; P<.001), whereas the milling/sintering groups exhibited significantly smaller values than the controls (P=.004). The milling groups showed significantly larger absolute marginal discrepancy than the control groups (137.4 ±29.0 and 139.2 ±18.9 μm, respectively; P<.05). In the selective laser melting and milling/sintering groups, the absolute marginal discrepancy values were material-specific (P<.05). Nonetheless, the milling/sintering groups yielded statistically comparable (P=.935) or smaller (P<.001) absolute marginal discrepancies to the control groups. The findings of this in vitro μCT study showed that the marginal fit values of the Co-Cr alloy greatly depended on the fabrication methods and, occasionally, the alloy systems. Fixed dental prostheses produced by using the milling/sintering technique can be considered clinically acceptable in terms of marginal fit. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Nonparametric estimation and testing of fixed effects panel data models

PubMed Central

Henderson, Daniel J.; Carroll, Raymond J.; Li, Qi

2009-01-01

In this paper we consider the problem of estimating nonparametric panel data models with fixed effects. We introduce an iterative nonparametric kernel estimator. We also extend the estimation method to the case of a semiparametric partially linear fixed effects model. To determine whether a parametric, semiparametric or nonparametric model is appropriate, we propose test statistics to test between the three alternatives in practice. We further propose a test statistic for testing the null hypothesis of random effects against fixed effects in a nonparametric panel data regression model. Simulations are used to examine the finite sample performance of the proposed estimators and the test statistics. PMID:19444335

Targeted traction of impacted teeth with C-tube miniplates.

PubMed

Chung, Kyu-Rhim; Kim, Yong; Ahn, Hyo-Won; Lee, Dongjoo; Yang, Dong-Min; Kim, Seong-Hun; Nelson, Gerald

2014-09-01

Orthodontic traction of impacted teeth has typically been performed using full fixed appliance as anchorage against the traction force. This conventional approach can be difficult to apply in the mixed dentition if the partial fixed appliance offers an insufficient anchor unit. In addition, full fixed appliance can induce unwanted movement of adjacent teeth. This clinical report presents 3 cases where impacted teeth were recovered in the mixed or transitional dentition with skeletal anchorage on the opposite arch without full fixed appliance. Instead, intermaxillary traction was used to bring the impacted teeth into position. With this approach, side effects on teeth and periodontal tissues adjacent to the impaction were minimized.

Clinical performance of removable dental prostheses in the moderately reduced dentition: a systematic literature review.

PubMed

Moldovan, Ovidiu; Rudolph, Heike; Luthardt, Ralph G

2016-09-01

Evidence-based therapeutic recommendations for removable dental prostheses are still lacking. The aim of the present study was a systematic review and meta-analysis of the survival rates of removable dentures in the moderately reduced dentition. In 2014, a systematic literature search in established medical databases (MEDLINE, EMBASE, BIOSIS, SciSearch, Cochrane, FIZ Technik Web) and a hand search of relevant dental journals were conducted. The search terms were relevant MeSH terms, free search terms, and combinations of the two. The search included RCTs, prospective and retrospective studies on survival rates of removable dental prostheses in the moderately reduced dentition with at least 15 participants, an observation period of at least 2 years, and a dropout rate of less than 25 %. The selection of relevant publications was carried out at the title, abstract, and full-text level by at least two of the authors involved. The publications included were tabulated and analyzed. Of the original 12,994 matches, 1923 were analyzed by title, 650 by abstract, and 111 according to the full text. The final review included 19 publications, of which 6 were multiple publications. Cast-metal framework dentures exhibited failure rates of between 33 and 50 % after 5 years. One study with a 25-year observation period reported failure rates of 50 %. Better results were obtained with proper pretreatment and a good recall scheme. Bilateral attachment prostheses showed failure rates of between 11 and 30 % after 5 years. Unilateral attachment prostheses showed failure rates of 75 % after 5 years. Double-crown prostheses dentures show failure rates of 0 to 21.7 % after 3 to 6 years. Heterogeneous study designs and data analyses rendered a meta-analysis impossible, so that an evaluation at the highest level of evidence could not be performed. Within the limitations of this study, it would be correct to state that removable dental prostheses, given suitable pretreatment and follow-up regimes, can provide satisfactory solutions. Based on only one paper, they revealed acceptable results even over a very long observation period (25 years).

Recent advances in bioelectric prostheses

PubMed Central

Pasquina, Paul F.; Perry, Briana N.; Miller, Matthew E.; Ling, Geoffrey S.F.; Tsao, Jack W.

2015-01-01

Summary Worldwide prevalence of amputation has created an increasing demand for improved upper and lower extremity prostheses. Current prosthetics are often uncomfortable and difficult to control and provide limited functional restoration. Moreover, the inability to normalize anthropomorphic biomechanics with a prosthesis increases one's risk of developing long-term health risks such as arthritis, skin breakdown, and pain. Recent advances in bionic prosthetic development hold great promise for rehabilitation and improving quality of life with limb loss. This brief review discusses the current state of advanced prostheses, the integration of robotics in the care of individuals with major limb amputation, and some innovative surgical techniques that are being explored for clinical feasibility. PMID:29443190

Processing of hydroxylapatite coatings on titanium alloy bone prostheses

DOEpatents

Nastasi, M.A.; Levine, T.E.; Mayer, J.W.; Pizziconi, V.B.

1998-10-06

Processing of hydroxylapatite sol-gel films on titanium alloy bone prostheses. A method utilizing non-line-of-sight ion beam implantation and/or rapid thermal processing to provide improved bonding of layers of hydroxylapatite to titanium alloy substrates while encouraging bone ingrowth into the hydroxylapatite layers located away from the substrate, is described for the fabrication of prostheses. The first layer of hydroxylapatite is mixed into the substrate by the ions or rapidly thermally annealed, while subsequent layers are heat treated or densified using ion implantation to form layers of decreasing density and larger crystallization, with the outermost layers being suitable for bone ingrowth.

Processing of hydroxylapatite coatings on titanium alloy bone prostheses

DOEpatents

Nastasi, Michael A.; Levine, Timothy E.; Mayer, James W.; Pizziconi, Vincent B.

1998-01-01

Processing of hydroxylapatite sol-gel films on titanium alloy bone prostheses. A method utilizing non-line-of-sight ion beam implantation and/or rapid thermal processing to provide improved bonding of layers of hydroxylapatite to titanium alloy substrates while encouraging bone ingrowth into the hydroxylapatite layers located away from the substrate, is described for the fabrication of prostheses. The first layer of hydroxylapatite is mixed into the substrate by the ions or rapidly thermally annealed, while subsequent layers are heat treated or densified using ion implantation to form layers of decreasing density and larger crystallization, with the outermost layers being suitable for bone ingrowth.

Tibial rotation kinematics subsequent to knee arthroplasty

PubMed Central

Collins, Duane J.; Khatib, Yasser H.; Parker, David A.; Jenkin, Deanne E.; Molnar, Robert B.

2015-01-01

Background The use of computer assisted joint replacement has facilitated precise intraoperative measurement of knee kinematics. The changes in “screw home mechanism” (SHM) resulting from Total Knee Arthroplasty (TKA) with different prostheses and constraints has not yet been accurately described. Methods A pilot study was first completed. Intraoperative kinematic data was collected two groups of 15 patients receiving different prostheses. Results On average, patients lost 5.3° of ER (SD = 6.1°). There was no significant difference between the prostheses or different prosthetic constraints. Conclusions There significant loss of SHM after TKA. Further research is required to understand its impact on patient function. PMID:25829754

Identification of dynamic load for prosthetic structures.

PubMed

Zhang, Dequan; Han, Xu; Zhang, Zhongpu; Liu, Jie; Jiang, Chao; Yoda, Nobuhiro; Meng, Xianghua; Li, Qing

2017-12-01

Dynamic load exists in numerous biomechanical systems, and its identification signifies a critical issue for characterizing dynamic behaviors and studying biomechanical consequence of the systems. This study aims to identify dynamic load in the dental prosthetic structures, namely, 3-unit implant-supported fixed partial denture (I-FPD) and teeth-supported fixed partial denture. The 3-dimensional finite element models were constructed through specific patient's computerized tomography images. A forward algorithm and regularization technique were developed for identifying dynamic load. To verify the effectiveness of the identification method proposed, the I-FPD and teeth-supported fixed partial denture structures were investigated to determine the dynamic loads. For validating the results of inverse identification, an experimental force-measuring system was developed by using a 3-dimensional piezoelectric transducer to measure the dynamic load in the I-FPD structure in vivo. The computationally identified loads were presented with different noise levels to determine their influence on the identification accuracy. The errors between the measured load and identified counterpart were calculated for evaluating the practical applicability of the proposed procedure in biomechanical engineering. This study is expected to serve as a demonstrative role in identifying dynamic loading in biomedical systems, where a direct in vivo measurement may be rather demanding in some areas of interest clinically. Copyright © 2017 John Wiley & Sons, Ltd.

28 CFR 43.1 - Administrative determination and assertion of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for the furnishing of hospital, medical, surgical or dental care and treatment (including prostheses... dental care and treatment was or will be furnished for an injury or disease caused under circumstances..., medical, surgical, or dental care and treatment (including prostheses and medical appliances) furnished by...

Thermoelastic stress analysis to validate tibial fixation technique in total ankle prostheses - a pilot study.

PubMed

Ficklscherer, Andreas; Wegener, Bernd; Niethammer, Thomas; Pietschmann, Matthias F; Müller, Peter E; Jansson, Volkmar; Trouillier, Hans-Heinrich

2013-03-01

Recent literature has shown a persistently high rate of aseptic loosening of the tibial component in total ankle prostheses. We analyzed the interface between the tibial bone and tibial component with a thermoelastic stress analysis to demonstrate load transmission onto the distal tibia. In this regard, we used two established ankle prostheses, which were implanted in two human cadaveric and in two third-generation composite tibia bones (Sawbones®, Sweden). Subsequently, the bones were attached to a hydropulser and a sinusoidal load of 700 N was applied. Both prostheses had an inhomogeneous load transmission onto the distal tibia. Instead of distributing load equally to the subarticular bone, forces were focused around the bolting stem, accumulating as stress maxima with forces up to 90 MPa. Furthermore, we were able to demonstrate load transmission into the metaphysis of the bone. As demonstrated in this study, anchoring systems with stems used in all established total ankle prostheses lead to an inhomogeneous load transmission onto the distal tibia, and furthermore, to a distribution of load into the weaker metaphyseal bone. For these reasons, we favor a prosthetic design with minimal bone resection and without any stem or stem-like anchoring system, which facilitates a homogeneous load transmission onto the distal tibia. Thermoelastic stress analysis proved to be a fast and easy-to-perform method to visualize load transmission.

Three-phase bone scan and indium white blood cell scintigraphy following porous coated hip arthroplasty: A prospective study of the prosthetic tip

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oswald, S.G.; Van Nostrand, D.; Savory, C.G.

1989-08-01

Although few reports address the use of three-phase bone scanning (TPBS) and {sup 111}In-labeled white blood cell (In-WBC) scintigraphy in hip arthroplasty utilizing a porous coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen in the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and In-WBC at approximately 7 days, and at 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the prosthetic tip. Only one of 136more » flow studies were abnormal and only two of 136 blood-pool images demonstrated focally increased activity. All 25 prostheses (120 of 143 scans) demonstrated increased uptake on the bone phase images. The area about the tip was divided into three segments; increased uptake at 24 mo was noted in the medial, distal, and lateral segments in 16%, 72%, and 56% of prostheses, respectively. Twenty of 25 prostheses (82 of 142 scans) showed uptake on In-WBC scintigraphy, being noted in 48% of prostheses at 24 mo. We conclude that scintigraphic patterns in the uncomplicated patient with a porous coated prosthesis appear to differ from patterns described in cemented prostheses.« less

Dental implant suprastructures using cobalt-chromium alloy compared with gold alloy framework veneered with ceramic or acrylic resin: a retrospective cohort study up to 18 years.

PubMed

Teigen, Kyrre; Jokstad, Asbjørn

2012-07-01

An association between the long-term success and survival of implant-supported prostheses as a function of biomaterial combinations has not been established. The use of cast cobalt-chromium for the suprastructure framework may be an alternative to the conventional approach of using type 3 gold alloys. A retrospective chart audit of all patients who had received implant-supported fixed dental prostheses (FDP) before 1996 was identified in a private practice clinic. Data were recorded for FDPs made from four combinations of alloy frameworks and veneering material, i.e. type 3 gold and cobalt-chromium with ceramic or prefabricated acrylic teeth. The extracted data from the charts were subjected to explorative statistical tests including Kaplan-Meier survival analyses. Patients (n=198) with 270 short and extensive FDPs supported entirely by 1117 implants were identified. The average follow-up observation periods varied between 4 and 220 months, with an average of 120 months. The success and survival, as well as event rates and types of biological and technical complications, were similar for implant-supported FDPs using cobalt-chromium and type 3 gold alloy frameworks veneered with ceramics or prefabricated acrylic teeth. An influence of the suprastructure biomaterial combination on the clinical performance of the individual supporting implants could not be established. Implant-supported FDPs made from type 3 gold or cobalt-chromium frameworks and veneered with ceramic or prefabricated acrylic teeth demonstrate comparable clinical performance. The biomaterial combinations do not appear to influence the success or survival of the individual implants. © 2011 John Wiley & Sons A/S.