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At least 1,225 records · Page 68Linked to original sources
PubMed1977

Posterior unilateral condylar displacement: its diagnosis and treatment.

The treatment procedure for posterior unilateral condylar displacement has been described. An acrylic resin repositioning prosthesis may be used to decrease trismus. Occlusal adjustment permits lateral freedom for mandibular movement to the opposite side which provides a dual, or a therapeutic, centric occlusion as well as the existing dysfunctional centric relation. This permits the patient's physiologic adaptive mechanism to choose between the existing dysfunctional centric relation, which resulted in unilateral condylar retrusion and pain, or a therapeutic centric occlusion which is aimed at anterior unilateral condylar repositioning. Over long period of time, muscle reprogramming produces maximum intercuspation of teeth in the planned therapeutic centric occlusion rather than in the original dysfunctional position. No explanation has been established for this phenomenon. It is important, however, to provide a technique that permits physiologic adaptability over a period of time. It should be emphasized that this is not TMJ "remodeling" but a functional change in the position of the jaw. The treatment objectives of bilateral and unilateral posterior condylar displacement are similar, but the clinical techniques are completely different. In either instance, TMJ radiographs are necessary to establish the diagnosis and treatment, as well as to document the postoperative results.

Acrylic Resins↗
PubMed1989

Electromyographic biofeedback and rest position training of masticatory muscles in myofascial pain-dysfunction patients.

Twenty-four women outpatients with myofascial pain-dysfunction were divided into three groups of eight. All received bilateral masseter electromyographic biofeedback training. One group received biofeedback only; one group received additional instructions and modeling to place their jaw in the "rest" position; and one group was given a prosthetic guide that spaced the incisors 6.8 mm apart. Two 15-minute training sessions were conducted at a 1-week interval, with posttreatment assessment 2 weeks later. The instruction and prosthesis groups obtained significantly greater electromyographic reductions in masseter activity and increases in mandibular range of motion compared with the biofeedback-only group. Subjects with pain obtained a significant reduction in therapist and self-report pain ratings. The results suggest that short-term biofeedback treatment may be meaningfully augmented by procedures that place the mandible in the rest position.

Adult↗
PubMed1996

Rehabilitation of mandibular edentulism by single crystal sapphire implants and overdentures: 3-12 year results in 86 patients. A dual center international study.

86 patients, in 2 Scandinavian centers, participated in a prospective study of mandibular edentulism, treated with overdentures supported by Bioceram sapphire implants. Implant success and prosthesis stability as well as parameters for peri-implant health were evaluated. Masticatory function and complications were also documented. The study began in 1991 and clinical treatment of the last patients was completed in 1991. The patients have been followed for at least 3 years, and up to 12 years. 4 patients were lost to follow-up. Of the initial 324 implants, 7 implants failed before prosthetic treatment. 3 patients lost 1 implant each within the 1st year, and 4 patients lost all 4 implants. 16 implants were lost between 36 and 42 months in function, due to lack of osseointegration and pain. The loss of implants could be attributable to an association, not statistically verified, between bone quality and anatomy, with heavy smoking as a risk factor. Based on the remaining implants, the cumulative implant success rates were 95.2%, 91.3%, 91.3%, 91.3% at 3, 5, 10 and 12 year follow-up respectively. The cumulative success rates for overdentures were 96.4%, 92.8% and 92.8% respectively, for the same follow-up periods. Indices for the health of the peri-implant mucosa disclosed no serious inflammatory reactions in the surrounding soft tissues. Patient satisfaction with this form of oral rehabilitation was high in all but 2 patients who experienced discomfort.

Aluminum Oxide↗
PubMed1989

[15 years of treatment of temporomandibular joint algo-dysfunctional syndromes].

For more than 15 years, the maxillo-facial and stomatological center in Lyon has received approximately 100 cases of T.M.A.D.S. per year. The etiological basis of the symptomatology is muscular dysfunction due to malocclusion variable degree and duration. Simple radiological investigations complete the examination. Treatment aims at correcting the malocclusion, either by simple methods: dental occlusion and prosthesis, or by orthognathic orthodontic and surgical techniques. Surgery involving the temporo-mandibular joint is reserved for rare cases of condylar deformation which is often post-traumatic. Favorable results can be obtained in 85% of cases.

Adult↗
PubMedDate not supplied

Implant rehabilitation of irradiated jaws: a preliminary report.

Ten patients (3 maxilla, 7 mandible), who had been treated for a head and neck malignancy by undergoing radiotherapy, had 42 implants (10 maxillary, 32 mandibular) placed into the irradiated sites and either an overdenture or a fixed prosthesis fabricated. Of the 10 implants placed in the maxilla, 6 were lost; however, there was a 100% survival rate of the implants placed in the mandible (mean duration = 33 months). The use of longer implants and pre- or postimplant hyperbaric oxygen may be necessary in maxillary situations.

Adult↗
PubMedDate not supplied

Effect of prefabricated bar design with implant-stabilized prostheses on ridge resorption: a clinical report.

This investigation was concerned with the resorption of the posterior mandibular residual ridge in patients wearing mandibular overdentures supported by either parallel-sided bars (rigid joint) or oval straight bars (resilient joint) on two activated implants. Rotational tomographs were taken shortly after implant placement and up to 8 years later. Using proportional measurement, the area of residual ridge was measured in bilateral posterior areas. Patients rehabilitated with implant-stabilized mandibular overdentures demonstrated posterior mandibular residual ridge resorption at low rates, which were not significantly influenced by the design of the prefabricated bar.

Adult↗
PubMed2006

[Double-barrel fibular free flap for mandibular reconstruction: beneficial alternative for dental implanted rehabilitation (5 cases)].

INTRODUCTION: As major loss of mandibular bone stock requires a vascularized transfer, fibula free flap reconstruction is considered to be the best free flap for its length and reliability. Its main advantage is to accept dental implants. Single or double-barrel reconstruction can be performed. Double-barrel reconstruction is generally preferred because the bone superposition offers enough height to allow dental implants. MATERIAL AND METHODS: We reviewed five selected cases of double-barrel fibula free flap adaptive mandibular reconstruction performed among a series of 11 oral rehabilitations with planned dental implants, focusing on the technical aspects. RESULTS: Today, dental rehabilitation has been achieved in three double-barrel fibula flaps. Details are reported concerning the implant step. DISCUSSION: In this perspective, we discuss the choice of the reconstructive technique in order to obtain adequate bone height. Early in our experience and for different reasons discussed in the text, we used a single barrel fibula flap. This technique provided sufficient height in some cases, but had to be completed by bone grafts in few patients. Our experience illustrates the usefulness of the double barrel technique which provide definitive bone height sufficient for dental implants. The double-barreled technique should be considered as the best solution.

Adult↗
PubMed2003

A survey of treatment outcomes with removable partial dentures.

The patient's satisfaction with removable partial denture (RPD) therapy has become an increasingly important factor in prosthetic treatment. This study examined patients' satisfaction with RPDs in relation to some socio-economic variables, patients' habits of wearing and cleaning RPDs, comfort of wearing RPDs and different RPDs characteristics. A questionnaire was devised for the purpose. Two hundred and five patients were required to assess satisfaction with RPDs. They graded RPDs, depending on the level of satisfaction, on scale ranging from 1 to 5. A dentist determined Kennedy classification, material and denture support, denture base shape, number of missing teeth and evaluated denture construction. Majority of the patients were satisfied with the prosthesis. The patients of a higher education level gave lower grades (P < 0.05) to aesthetics of maxillary RPDs. Almost half of the patients were wearing RPDs during the day. Most of the patients cleaned RPDs three times a day. A significant difference was found between the patients' grades for comfort of wearing mandibular RPDs and number of missing teeth and between hygiene of mandibular RPDs and habits of cleaning them. Majority of the patients treated with RPDs were satisfied with the prosthesis. Dissatisfaction was related to mastication, esthetics, number of missing teeth and maintenance of oral hygiene.

Adult↗
PubMed1995

Heat-cured silicone bimaxillary mouthguard.

A laboratory procedure for the construction of a heat-cured, silicone, custom-made bimaxillary mouthguard for contact sports is described. Contours and vertical dimension are easier to control than with the conventional thermoformed product, and there is no danger of injury from contact between the maxillary and mandibular components.

Dental Prosthesis Design↗
PubMedDate not supplied

The effects of preoperative resorption and jaw anatomy on implant success. A report of 303 cases.

The purpose of this paper is to report the outcome of 1097 consecutively implanted endosteal implants (Brånemark) into 303 jaws, between September 1983 and May 1990. All implants were placed using the prescribed technique suggested by manufacturer, and were restored either with fixed or removable prosthesis. Alveolar bone resorption (quantity) was scored from lesser to greater degree by assigning a value of 1-5 to each jaw, and jaw anatomy was scored from 1-4, based on decreasing cortical and cancellous bone quality. The data were separated into fixed and removable prosthesis and analyzed to determine the correlation between success and the scored resorption and jaw anatomy, as well as implant position. Assessment demonstrated a maxillary success rate of 93.4% and a mandibular success rate of 97.2% over a 36-month period (mean). Results of correlations of success with jaw anatomy for both fixed and removable prosthesis revealed that bone quality 4 exhibited the greatest failure rate. Preoperative resorption values (1-5) had little effect on failure, and quality appears to influence failure more than quantity.

Adult↗
PubMed2000

Design and wear testing of a temporomandibular joint prosthesis articulation.

As part of the development of a total temporomandibular joint prosthesis, a prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial side, which slides along the opposing skull part. The aim of this study was to determine the in vitro wear rate of the articulation, and to predict the in vivo wear rate from the results. Based on a disc thickness of 5 mm and a ball diameter of 8 mm, the stresses within the disc were calculated by means of a finite element computer model. The wear rate of the ball-disc articulation was determined by in vitro wear tests, with a stainless-steel ball rotating against a UHMWPE disc in a serum-based lubricant. Eight discs were tested for seven million cycles each. The in vitro wear rate of the disc-skull part articulation was calculated from the test results of the ball-disc articulation. The maximum Von Mises' stress was less than the yield strength of UHMWPE and, therefore, was sufficiently low. The in vitro wear rate of the ball-disc articulation was 0.47 mm3 per million cycles. The in vivo expected total wear rate is 0.65 mm3 per year, corresponding with a yearly decrease of disc thickness of 0.0094 mm. Although it is difficult to judge whether this wear rate is sufficiently low, because the influence of UHMWPE wear particles in the TMJ region is unknown, both the expected wear rate and the decrease of thickness appear to be acceptable.

Alloys↗
PubMedDate not supplied

Long-term treatment costs associated with implant-supported mandibular prostheses in edentulous patients.

PURPOSE: The study's aim was to report long-term costs in edentulous patients treated with mandibular implant-supported prostheses. MATERIALS AND METHODS: Ninety patients were divided into four groups based on the type of implant prosthesis (fixed or overdenture) and treatment year. Records were obtained from dental charts, and an economic analysis from the patient's perspective was conducted. Clinical time associated with various procedures was measured and applied to the four groups. Salary rates by age, occupation, and gender were used to value patients' time. Direct clinical and time costs over 10 years were converted to 2002 Canadian dollars using the Consumer Price Index and discounted at a 3% rate. A sensitivity analysis at an equal salary rate was carried out to test the robustness of the time costs. RESULTS: Initial treatment and maintenance costs over the observation period were significantly higher for fixed compared to overdenture prostheses. A significant improvement in maintenance costs for the first patient group treated with fixed prostheses was observed over the follow-up period. Longer term (15 years) treatment costs for the initial two groups were significantly higher for the fixed group. The sensitivity analysis at an equal salary rate demonstrated the same trend: Time costs were significantly higher for the fixed groups. CONCLUSION: Long-term treatment costs indicated that the mandibular overdenture was a less expensive treatment compared to the fixed implant prosthesis.

Age Factors↗
PubMed1994

Clinical evaluation of resin-bonded prostheses: Rochette technique.

Ninety patients, with a total of 90 resin-bonded prostheses placed in a private dental office from 1981 to 1991, were recalled for clinical evaluation of their restorations. Tissue condition, patient satisfaction, prosthesis failures by location and by sex of patient were assessed. Debondings occurred in both the mandibular and maxillary arches. In the present study, there were no gender-based differences in the rate of debonding and prostheses with more than two retainers were more likely to have problems.

Adult↗
PubMed1995

Implant rehabilitation of a patient after partial mandibulectomy: a case report.

Radical surgery was performed to remove the left side of the mandible in a patient diagnosed with mandibular carcinoma. For 36 years, the patient functioned with a hinged, removable partial denture anchored to the remaining natural dentition on the mandibular right side. Because of deterioration of the remaining natural dentition, the patient could no longer function with the partial denture. In lieu of reconstruction with a bone graft, the patient chose to undergo treatment with osseointegrated implants to permit insertion of a stable prosthesis with a cantilevered extension into the area of the surgical resection. The rigid attachment of the prosthesis to the remaining mandible provided function as well as soft tissue support in the area of the surgical defect.

Aged↗
PubMed2005

An overview of complete artificial fixed dentition supported by endosseous implants.

The construction of a complete restoration of the dentition by the surgical placement of endosseous titanium implants that support a fixed prosthesis in each jaw is possible. The positionings of the implants and teeth in the prostheses are important factors for a successful long-term result. Distribution of the occlusal biting forces over as many implants as possible is important. Off-axial occlusal biting forces should be diverted to the anterior jaws where the forces are not as great. The posterior teeth should be designed with flat occlusal surfaces that separate during excursionary mandibular chewing movements. Medial mandibular flexure caused by the contraction of the medial pterygoid muscle can be addressed by constructing the prosthesis in segments, so as not to have a rigid entity encased in flexing bone that may induce stress in the bone, potentially leading to loss of implant integration and failure. Segmenting also ensures an appropriate fit of the prosthesis with respect to casting and porcelain firing distortion. Lip support by means of a flange in the prosthesis may be necessary when there has been a large amount of bone loss from edentulous resorption. Cleaning and routine maintenance of the prostheses every 3-6 months is essential.

Bite Force↗