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PubMed2002

Early intraoral splinting and loading of one-stage dental implants in the edentulous mandible: literature review and case report.

Recent studies of immediately loaded screw-retained dentures, bar overdentures, and single-tooth replacements have demonstrated success rates comparable to similar restorations using a two-stage procedure. An international study of immediately loaded bar overdentures on a novel single-stage implant is currently being conducted in the United States and Europe. This article presents a case report that illustrates the intraoral construction of an overdenture bar pattern at the time of implant placement, followed by soldering and immediate loading. The elimination of transfer procedures may significantly reduce treatment time and enhance the passive fit of the bar.

Aged↗
PubMed2003

Morphological study of reparative processes in the gingiva during therapy of chronic periodontitis with energostim and application of orthopedic splinting constructions.

We studied morphological characteristics of the regenerative process in gingival tissues during therapy of chronic periodontitis. Energostim stimulated macrophageal reaction and promoted neoangiogenesis in the inflammatory infiltrate. It was not observed after traditional drug therapy. Energostim promoted vascularization in regenerating tissues, normalized the structure at a greater area of the lamina propria of the gingiva, and prevented fibrous and sclerotic changes. The volume of histiolymphocytic infiltrates in regenerating gingival tissues decreased after application of intradental splints.

Capillaries↗
PubMed1995

Clinical management of the avulsed tooth.

Treatment outside the dental office: Replant immediately after gentle washing if practical. If replantation is not practical, store the tooth in the best medium available. Storage media in order of preference are Hank's Balanced Salt Solution (HBSS), milk, saline, and saliva (buccal vestibule). Water is the least desirable storage medium. Treatment in the office: Emergency visit; Place tooth in HBSS while exam is conducted and history is taken. Prepare socket for gentle repositioning of the tooth. Prepare the root. Extraoral dry time < 20 minutes: Closed apex--replant immediately after gentle washing. Open apex--soak in 1 mg doxycycline in 20 mg saline for 5 minutes. Extraoral dry time 20 to 60 minutes: Soak in HBSS for 30 minutes and replant. Extraoral dry time > 60 minutes: soak in citric acid, 2% stannous fluoride, and doxycycline and replant. Endodontics can be done extraorally. Semirigid splint for 7 to 10 days. (If alveolar fracture is present, rigid splint for 4 to 8 weeks). Suture soft-tissue lacerations, particularly in the cervical area. Administer systemic antibiotics (penicillin V potassium if possible) Chlorhexidine rinses and stringent oral hygiene while the splint is in place (7 to 10 days). Analgesics as required. Second visit after 7 to 10 days: Endodontic treatment: Tooth with open apex and extraoral dry time of < 60 minutes: No endodontic treatment initially. Recall every 3 to 4 weeks to examine for evidence of pathosis. If pathosis is noted, disinfect the pulp space and start apexification procedure. Tooth with open apex and extraoral dry time > 60 minutes: If endodontics was not completed in the emergency visit, start endodontics and follow apexification procedure. Tooth with closed apex: Endodontics should be initiated after 7 to 10 days. Careful chemomechanical instrumentation under strict asepsis. Splint removed at end of visit. Obturation visit: If endodontics was initiated 7 to 10 days after the avulsion, obturation can take place after short-term calcium hydroxide treatment. If endodontics was initiated more than 14 days after the avulsion or inflammatory resorption, long-term calcium hydroxide for 6 to 24 months, obturated when an intact lamina dura is traced. Restorations: Temporary restorations: Should be 4 mm deep. Reinforced zinc-oxide-eugenol, acid-etch composite resin, glass-ionomer cement. Permanent restoration: Placed immediately after obturation. Acid-etch resin and dentin bonding agents. Follow-up care: Twice per year for 3 years and yearly for as long as possible. Late complications are common.

Dental Restoration, Permanent↗
PubMed1999

The use of a stent-resin-bonded splint combination to stabilize a free gingival autograft.

This article describes the use of a resin-bonded retainer in combination with an acrylic resin stent to stabilize a free gingival graft. This retainer also prevents migration of muscle attachment after surgery to deepen a section of the vestibule where the oral mucosa closely approached the gingival margin. The acrylic resin stent is attached to the resin-bonded retainer by means of an integrally cast metal framework. After surgery, the retainer is attached to the occlusal two thirds of the buccal surfaces of maxillary molar teeth by using the acid-etched resin bonding technique. The stent effectively retains the graft, is simple to fit, and does not cause any permanent damage to the enamel. It has none of the disadvantages of conventional removable acrylic resin stents.

Acid Etching, Dental↗
PubMed2004

Direct skeletal traction for Le Fort I halo distraction replacing an intraoral dental splint and connecting traction hook.

To obviate dental inconveniences after Le Fort I halo distraction using an intraoral dental splint and connecting traction hook, the authors initiated direct skeletal traction using an traction wire at the parapyriformis buttress area. Halo distraction using this procedure was conducted for 11 cleft lip and palate patients (age range, 13-21 years; 6 females and 5 males). Distraction amount ranged from 11 to 15 mm. A satisfactory occlusion was obtained in all patients. All 11 patients complained of pain during the distraction period, but it was controlled by regular oral intake of the usual amount of analgesics. No other particular complications were encountered during the postoperative follow-up of 8 to 18 months. This form of direct skeletal traction proves effective for Le Fort I halo distraction.

Adolescent↗
PubMed2000

Plasma-treated lenowoven polyethylene ribbon for bone fixation at dentoalveolar osteotomy.

Plasma-treated lenowoven polyethylene ribbon was used for splinting between teeth around osteotomy lines in anterior segmental dentoalveolar osteotomy. This fixation was continued for 2 to 3 months, during which there was no damage or fall of the ribbon. In addition, the patients were able to eat their usual food, had much less pain in the teeth and oral mucosa, did not feel uncomfortable in the mouth, had no tooth damage or carious teeth, and had a good aesthetic appearance. In all eight jaws (five patients), accurate and strong bone fixation was achieved based on the planned occlusion. Patient complaints and pain were obviously less with this method than other methods. Polyethylene ribbon is quite useful for bone fixation in anterior segmental dentoalveolar osteotomy.

Adolescent↗
PubMed1992

[Effects of difference of occlusal splint contacts on masticatory system].

The short-term effects of the difference of occlusal splint contacts on the jaw function were investigated on five healthy subjects. The maxillary stabilization splint (S-type) was fabricated and sectioned into three parts: an anterior section (A-type) and two posterior sections (P-type). These 3 types of splints were used for 10 days for each subject. The EMG activity of the masseter and the anterior and the posterior temporal muscles were measured during the maximum clenching in the intercuspal position and on the wearing splint. Subsequently on the bite force-measuring device with two transducers the bite and the EMG activity were measured during the maximum clenching, and the intercuspal occlusal contacts were recorded. The results were as follows: 1. After wearing the P-type, the total EMG activity during clenching in the intercuspal position was decreased, then increased after removal. 2. After wearing the S-type and the A-type the anteroposterior distribution of the bite force during clenching was changed, then returned after removal. 3. After wearing the A-type, the occlusal contact area of the anterior teeth in the intercuspal position was decreased, then increased after removal, while after wearing the S-type and the P-type that of the posterior teeth was decreased, then increased after removal.

Adult↗
PubMed2003

An involvement of trigeminal mesencephalic neurons in regulation of occlusal vertical dimension in the guinea pig.

Although the occlusal vertical dimension (OVD) is strictly controlled, the neuronal mechanism of its regulation is still unclear. We hypothesize that neurons in the trigeminal mesencephalic nucleus (MesV) play an important role in the regulation of the OVD, because the MesV receives the projection from jaw-closing muscle spindles and periodontal mechanoreceptors. We measured the temporal OVD change in the guinea pig to study the effects of MesV lesions on the OVD. OVD-raised animals without MesV lesions showed a rapid OVD decrease to the same level as that in naïve controls, followed by an OVD increase after the OVD-raising appliance was removed. In contrast, OVD-raised animals with MesV lesions showed only a slight decrease in the OVD for 15 days after removal of the appliance, and then the OVD increased. The time-course of OVD development in normal-bite animals with MesV lesions was similar to that of naïve controls. These results suggest that MesV neurons are involved in OVD regulation.

Animals↗
PubMed1998

Rigidly splinted implants in the resorbed maxilla to retain a hinging overdenture: a series of clinical reports for up to 4 years.

STATEMENT OF PROBLEM: The results of the implant overdenture treatment in the maxilla remains inferior to those in the mandible. Different reasons have been alluded to, such as bone quality and quantity, number of implants, as well as the prosthesis design. PURPOSE: To investigate the latter, a new design for the rehabilitation of the resorbed maxillae was set up. MATERIAL AND METHODS: Thirteen patients were selected and provided with four endosseous maxillary implants, splinted with a rigid-cast bar. RESULTS: After a mean loading time of 3 years, six implants were lost; three at abutment and another three shortly after abutment connection, resulting in a cumulative success rate of 88.6% at year 4. A mean marginal bone loss of 0.3 mm was observed within the first year. After the first year, the marginal bone level, the attachment level, and the Periotest scores hardly changed. The main prosthetic complication was the frequent need to renew or to activate the attachments. A strong improvement in patient satisfaction was observed when compared with the old conventional denture. CONCLUSIONS: Within the limits of this study, the outcome confirmed that, on a medium-term base, implant-retained hinging overdentures on four implants were promising.

Adult↗
PubMed1997

A randomised clinical trial on the influence of splinted and unsplinted oral implants in mandibular overdenture therapy. A 3-year report.

A randomised clinical trial was performed to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. Furthermore, patient satisfaction was evaluated for different attachment systems retaining the overdenture. Thirty-six edentulous patients were randomised into three groups of equal size and treated with either magnets, ball attachments or straight bars (reference group). After 3 years of observation no implants were lost in any of the groups. Besides, no statistically significant differences were noted for the peri-implant outcome. Although the bar group presented the highest retention force, the general satisfaction of the patients in the three groups did not differ. The patients with bar retentions showed less prosthetic complications of the retention elements but more at the level of the denture-supporting mucosa. Finally, the clinical outcome of all groups confirms that overdenture treatment demands regular controls with limited time intervals.

Adult↗
PubMed1998

A 5-year randomized clinical trial on the influence of splinted and unsplinted oral implants in the mandibular overdenture therapy. Part I: Peri-implant outcome.

Thirty-six completely edentulous patients were enrolled for a 5-year prospective study testing the treatment outcome between splinted and unsplinted implants retaining a mandibular hinging overdenture. The patients were randomized into 3 groups of equal size depending on the attachment system used such as: magnets, ball attachments or bars (reference group). Only 1 implant out of the 72 had failed at the abutment stage. Not a single implant failed during the 5-year loading period. The accumulation of plaque was significantly higher for the Magnet than for the Ball group. Bleeding on probing, as well as marginal bone level, attachment level and Periotest values did not statistically differ among the groups, neither at year 1 nor at year 5. However, the Periotest values were significantly lower at year 5 compared to year 1 for all groups, which indicates a higher rigidity at the bone-implant interface. No correlation was found between bleeding on probing and marginal bone loss. We conclude that the connection state of 2 implants retaining a hinging overdenture did not influence the peri-implant outcome.

Adult↗
PubMed2005

Effect of two antimicrobial agents on early in situ biofilm formation.

OBJECTIVES: The aim of this observer-blind, controlled, three-cell cross-over study was to evaluate the influence of an amine fluoride/stannous fluoride (Meridol, 250 ppm; ASF) and a chlorhexidine mouthrinse (CHX; Chlorhexamed forte, 0.2%) compared with water on in situ biofilm growth. MATERIAL AND METHODS: After a professional toothcleaning seven volunteers had to wear a special acrylic appliance, in which six specimens each were inserted to allow the build-up of intra-oral biofilms. The volunteers had to rinse twice daily for 1 min. with 10 ml of the allocated mouthrinse. After 48 h of wearing, the specimens with the adhering biofilms were removed from the splints and stained with two fluorescent dyes, which selectively stain vital bacteria green and dead bacteria red. Under the confocal laser scanning microscope biofilm thickness (BT) was evaluated. To examine bacterial vitality (BV%) the biofilms were scanned (1 microm sections) and digital images were made. An image analysis program was used to calculate the mean BV as well as the BV of the single sections. After a wash-out period of 14 days a new test cycle was started. RESULTS: The use of CHX and ASF resulted in a BT of 8.4+/-4.4 mum and 15.7+/-9.9 compared with 76.7+/-29.4 mum using water. The mean vitality (in %) was reduced from 66.1+/-20.4 to 23.3+/-11.6 and 23.9+/-12.4 using CHX and ASF, respectively. Both active solutions reduced BT and BV significantly compared with water (p<0.001). Differences between the two active solutions were not significant (p>0.05). CONCLUSION: Both mouthrinses showed antibacterial and plaque-reducing properties against the in situ biofilm. The study design enables the examination of an undisturbed oral biofilm and for the first time shows the influence of antibacterial components applied under clinical conditions regarding biofilm formation.

Adult↗
PubMedDate not supplied

Maxillary overdentures retained by splinted and unsplinted implants: a retrospective study.

The purpose of this retrospective study was to evaluate the clinical performance of and patients' satisfaction with maxillary overdentures retained by splinted and unsplinted implants. Patients who had been treated with maxillary implant-retained overdentures because of functional problems with conventional complete dentures were identified and invited to participate in the study. A total of 16 patients fulfilled the enrollment criteria and agreed to participate. Eleven patients were treated with bar-retained overdentures with 3 to 6 clips (mean follow-up 32 months), and 5 patients wore overdentures retained by 2 to 6 ball attachments (mean follow-up 54 months). All subjects were satisfied with their prostheses, and most subjects experienced improvement in their oral function after treatment with implant-retained overdentures. At the time of clinical examination, 92% (n = 77) of the 84 implants placed were functioning satisfactorily. The cumulative survival rate for the implants after 72 months was 90%. Loss of bone support correlated with peri-implant probing depth (r = 0.29; P < .02). No differences in mean bone loss between the subjects with ball-retained or bar-retained overdentures were found. The presence of plaque or peri-implant bleeding was not associated with the type of attachment.

Aged↗
PubMed2002

The efficacy of a mandibular advancement splint in relation to cephalometric variables.

The efficacy of a titratable mandibular advancement splint (MAS) for the management of obstructive sleep apnea (OSA) was investigated in relation to supine cephalometric variables. Fourteen adults with diagnosed OSA were recruited following an initial polysomnogram. Supine cephalographic radiographs were taken at baseline and subjects wore the MAS nightly for 6 to 8 weeks. The polysomnogram and cephalogram were repeated with the MAS at maximal titration. The MAS resulted in complete or partial treatment response in all subjects as measured by the improvement in mean apnea/hypopnea index (AHI) (baseline AHI 34 +/- 22/hr, with MAS 10 +/- 5/hr; p = 0.001). The perpendicular distance between the hyoid bone and the mandibular plane (HYML) measured in awake subjects decreased with the MAS (baseline HYML 25.3 +/- 7.8 mm, with MAS 16.5 +/- 9.6 mm; p = 0.002). Baseline HYML was the only cephalometric variable associated with a successful clinical outcome. It was strongly linked to improvements in AHI (adjusted R(2) = 0.37, p = 0.012) and arousals (adjusted R(2) = 0.455, p = 0.005). We conclude that the MAS is an effective therapy for OSA and baseline HYML is an important predictor of improvement. Improvements in AHI may be explained by the MAS maintaining the new or existing relationship of the hyoid and its surrounding structures, thus preventing obstruction in the upper airway during sleep.

Adult↗
PubMed2005

Dental side-effects of mandibular advancement splint wear in patients who snore.

OBJECTIVES: (a) To evaluate the longer term orthodontic side-effects of a Herbst mandibular advancement splint (MAS) in subjects with sleep disordered breathing. (b) To determine whether these are related to dental occlusion, degree of mandibular advancement or duration of appliance wear. DESIGN: Retrospective, cohort study. SETTING: Teaching hospital dental school. PARTICIPANTS: Subjects with sleep disordered breathing who had been wearing an MAS regularly (a minimum of 5 h per night, six nights a week) for at least 2 years. Of 192 subjects who were identified, 30 fulfilled the inclusion criteria and were prepared to attend for review. INTERVENTIONS: Dental casts were obtained and BMI and Epworth Sleepiness Scale scores recorded. These data were compared with those collected when the subject was first referred. A questionnaire was completed concerning MAS use, side-effects and any problems associated with the device. MAIN OUTCOME MEASURES: Changes in incisor tooth position. RESULTS: Median duration of MAS wear was 3.64 years. Small, statistically significant reductions in both vertical (-0.4 mm) and horizontal (-0.5 mm) overlap of the incisor teeth were found. This correlated with the degree of vertical opening of the MAS but was not related to the amount of mandibular protrusion or the duration of appliance wear. CONCLUSIONS: Patients who are considered suitable for MAS should be warned that dental changes may occur. Thus referring surgeons should also be aware of this possibility.

Adult↗
PubMed1994

Influence of acid-etched splinting methods on discoloration of dental enamel in four media: an in vitro study.

The aim of this in vitro study was to assess the staining of enamel in relation to fixation of luxated teeth. Color changes induced by chlorhexidine, red wine, tea, and coffee were detected with a Minolta Chroma Meter (CR-121) after extracted teeth were treated to simulate construction of dental splinting. L*a*b* color readings were made before and after 7 days of incubation in the above-mentioned media in teeth treated 1) by acid-etching, 2) by acid-etching followed by resin, 3) by resin and composite, 4) by Triad Gel, and 5) by Protemp. L* is an indicator of black (0) and white (100). The a* values relate to the red (+100)-green (-100) color axes, and the b* values to the yellow (+100) and blue (-100) axes. Untreated teeth served as controls. One-way analysis of variance of mean L* values revealed no statistically significant differences in treatment. Discoloration was observed in all teeth, including the control ones. However, Protemp yielded the largest changes in mean L* values. Analysis of variance of mean L* values revealed statistically significant differences between incubation liquids because no increase in staining of enamel was noted after 7 days' incubation in chlorhexidine. Red wine increased the mean L* values more than coffee or tea. Changes in a*b* readings were toward red (+a*) after incubation in red wine, except in the case of teeth treated with resin. The color of all such teeth changed more toward yellow (+b*), because the resin used was yellow.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Etching, Dental↗
PubMedDate not supplied

Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: a 10-year randomized clinical study.

PURPOSE: This study aimed to compare the prosthetic aspects and patient satisfaction with prosthetic care in two-implant-retained mandibular overdentures, whether implants were splinted with a bar or left with magnets or ball attachments. MATERIALS AND METHODS: Thirty-six completely edentulous patients had two Brånemark implants placed in the mandibular canine area. A randomized procedure allocated patients into three groups of equal size, each with a different attachment system: bars, magnets, or balls. Prosthesis retention and mechanical as well as soft tissue complications were recorded in addition to patient satisfaction. A linear mixed model was fitted with attachment type and time as classification variables and adjusted by Turkey's multiple range test. RESULTS: Ball-retained overdentures showed at year 10 the greatest vertical retention force (1,327 g), followed by bars (1,067 g) and magnets (219 g). In the ball group, need for tightening of abutment screws was the most common mechanical complication; in the magnet and bar groups, respectively, the most common complications were wear and corrosion, and the need for clip activation. Prosthesis stability and chewing comfort for the overdenture were rated significantly lower for the magnet group compared to the ball and bar groups. Prosthesis stability of the maxillary denture was rated significantly lower in the bar group compared to ball and magnet groups. CONCLUSION: The ball group scored best in relation to retention of the overdenture, soft tissue complications, and patient satisfaction at year 10. The bar group scored lower for comfort and stability of the maxillary denture. Magnets offered patients the least comfort.

Adult↗
PubMed1986

Resorption of the mouse incisor after the application of cold to the periodontal attachment apparatus.

In order to study in detail the processes leading to the resorption and ankylosis of teeth after trauma, the effects of cold application on the periodontal tissues were studied in the mouse. Liquid nitrogen was applied locally to the outer surface of the lower jaw which resulted in a freezing of the incisor and its surrounding tissues. The healing processes in the damaged periodontal ligament and the accompanying phenomena of ankylosis and dental root resorption were investigated histologically at both the light and electron microscopic levels. As a result of cold application, the cells in the periodontal ligament were killed. After a few days, the ligament started to be repopulated with cells like fibroblasts and macrophages. From 3 days on, mineral crystallites were deposited along the cementum covering the lingual, mesial, and lateral surfaces of the incisor, finally resulting in a 4-6 micron thick layer. During the period of 7-12 days following cold application, this layer of mineralized material started to be phagocytosed and degraded, presumably by mononuclear cells. Finally, extensive root resorption and some ankylosis between the tooth and the alveolar bone were observed. In the resorbed areas, cells were seen which could not be distinguished from osteoclasts. In some instances, their ruffled border was in close apposition with each of the three mineralized tissues--dentin, cementum, and alveolar bone. It is hypothesized that the deposition and subsequent phagocytosis of mineralized material along the root surface may be an important factor in the initiation of dental root resorption.

Animals↗