[Emergencies in restoration by joint prosthesis].
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Denture Design↗
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Results for “Prosthesis Retention”
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Comparison of load transfer by maxillary distal extension removable partial dentures with a spring-loaded plunger attachment and I-bar retainer.
This study photoelastically compared the stress distribution characteristics of two maxillary bilateral distal-extension removable partial denture designs, one using I-bar retention and the other using a semiprecision spring-loaded plunger attachment. Each prosthesis was subjected to vertical and horizontal extension-base loads. Comparisons were made from photographic recordings of isochromatic fringe distributions. The two retention designs produced comparable stresses with splinting of abutments for the plunger attachment. The attachment-retained prosthesis proved less stable with some loadings. Stress patterns followed three trajectories in the maxilla. A basis for stress distribution comparisons to other maxillary removable partial denture attachments is established.
Analysis of Variance↗
Effects of rehabilitation with conventional removable partial dentures on oral health--a cross-sectional study.
The study aims to elucidate the effects on the oral tissues of occlusal rehabilitation through removable partial denture. Sixty eight individuals treated with conventional partial dentures participated in a clinical study of the hygienic conditions around supporting teeth and the partial dentures, the occurrence of increased mobility of supporting teeth and deepened gingival pockets, the incidence of caries, impaired retention and the frequency of use of the prosthesis. A questionnaire was sent out and 84 per cent of the subjects responded anonymously. The results show that the removable partial denture represents a satisfactory method of oral rehabilitation for the individual with a reduced dentition.
Adult↗
Use of radicular attachments with endodontically treated teeth.
An extension of conventional overdenture philosophy with the use of radicular attachments in endodontically treated teeth can be used to improve stability, reduce bony resorption and proprioception and augment retention. However, radicular attachments are not appropriate in all cases. Indications, requirements, advantages and disadvantages of this type of prosthesis are provided.
Dental Prosthesis Design↗
Open-face custom tray for edentulous obturator impression.
1. A new, easy, and predictable method of border molding an edentulous obturator impression is presented. 2. The use of an open-face impression tray facilitates proper extension in the site of the defect. 3. The manipulation of the modeling compound through the open-face tray assures proper seal, compression, and extension of the prosthesis above the mucodermal scar band. 4. The retention of the obturator bulb is mainly mechanical and is dependent upon engaging under-cuts superior to both scar band and the palatal shelf. 5. There should be a continuous peripheral seal between the defect and nondefect side of the obturator.
Dental Impression Technique↗
RPA clasp design for distal-extension removable partial dentures.
The RPA design has been discussed as an alternative to the RPI design. With its mesial rest and special retentive arm design, it gives essentially the same kind of tooth release that the RPI clasp provides. In addition, there are some advantages over the RPI design. The circumferential-type retentive arm is easier to grasp for removal of the prosthesis. The clasp is simple in design with few variations among patients and thus can be easily and consistently fabricated by dental laboratories. But most important, the circumferential retentive arm avoids the tissue problems around abutment teeth and allows the RPA clasp to be used in many situations where the RPI clasp is contraindicated.
Denture Design↗
Altered prosthodontic treatment approach for bilateral complete maxillectomy: a clinical report.
Bilateral maxillary resection offers a significant challenge for prosthodontic rehabilitation with a removable tissue-borne prosthesis, owing in large part to a lack of adequate retention, support, and stability. The clinical management of a patient with a bilateral maxillectomy using an altered prosthodontic treatment sequence is described.
Denture Design↗
Implant superstructures: a comparison of ultimate failure force.
Because of reported prosthodontic failures, alternative implant abutments and screws with suggested strength superiority have been manufactured. However, little quantitative data are available to support these claims. This study compared the force necessary to cause failure in many of the more commonly used implant and abutment combinations. An 18-mm cantilever test prosthesis was constructed for each system and loaded on an MTS machine until failure occurred (n = 5 for each sample). The mean failure forces ranged from 1.22 to 17.23 kg. The failure force and location of failure for each individual system are reported.
Analysis of Variance↗
Effects of implant anchorage on midface prostheses.
STATEMENT OF PROBLEM: Acquired midface defects may produce functional and psychologic impairments that adversely effects a patient's quality of life. Conventional prostheses may lack adequate retention and stability, diminishing the patient's confidence that the prosthesis will remain in place during routine activities. PURPOSE: The experience with and patient response to endosseous implants in prosthetic restoration of midface defects is presented in this study. MATERIAL AND METHODS: Five patients in age from 36 to 88 years were treated with 19 titanium endosseous root-form implants to provide retention and stability for prostheses. Patients responded to a questionnaire rating overall use, effectiveness, and satisfaction of their prosthesis, before and after the use of implants. RESULTS: All 19 implants were judged to be osseointegrated at abutment connection. Of the 17 implants used prosthetically, 14 (82%) remained osseointegrated and 3 (18%) failed. Analysis of the questionnaire tends to indicate an improvement of the quality of life for the patients with an implant-retained prosthesis.
Activities of Daily Living↗
Facial prosthesis following radical maxillofacial surgery.
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Denture Design↗
[ON THE STABILIZATION OF LOWER COMPLETE PROSTHESIS IN ATROPHIED ALVEOLAR RIDGE].
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Alveolar Process↗
[Case of prosthodontic treatment by overdenture with magnetic and bar attachments].
PATIENT: An implant prosthesis with O-ring attachments had been fabricated for edentulous mandible. The patient complained of decreasing retention of the denture and frequent loosening of implant abutments. In order to resolve these problems, an implant overdenture prosthesis with magnetic and bar attachments was planned. DISCUSSION: The patient has been satisfied for 4 years and 9 months after treatment, and poor retention of the denture and loosening of implant abutments have not occurred. The reasons might be consistently good retention of the denture with magnetic attachments, proper load distribution by connecting implants and improved oral care of the patient. CONCLUSION: Periodical recall and adequate oral care are necessary.
Dental Abutments↗
Remote implant anchorage for the rehabilitation of maxillary defects.
The rehabilitation of maxillary defects is a significant challenge in terms of creating retention and preserving existing dentition in an environment of expanded functional stress. The advent of osseointegration has enhanced the dental practitioner's capabilities in this regard with a remarkably improved potential for increasing prosthesis stability and preserving tissue. For patients with extensive prosthetic cantilevers, however, the opportunity for implant placement in defect areas is compromised unless remote bone sites are considered. Implants in the defect buttress zone through the maxillary sinus in non-defect sites (zygoma implants) can be valuable in providing a level of functional rehabilitation previously unattainable.
Dental Implantation, Endosseous↗
Problems with prostheses on implants: a retrospective study.
Prosthetic parameters for implant success have not been well defined but should include patient satisfaction and prosthesis maintenance, including adjustments and repairs. In addition, differences between fixed and removable implant-supported prostheses (ISPs) should be quantified. This study retrospectively evaluated both patient satisfaction and maintenance for 156 patients. Removable ISPs averaged almost three times as many adjustments per prosthesis (2.1 versus 0.8 per fixed ISP) and more than twice as many repairs (1.9 per removable ISP versus 0.9 per fixed ISP). The most common adjustments were to the contour of both types of prosthesis, and the most frequent repairs involved the retentive clips with removable ISPs and the gold screws with fixed ISPs. The incidence of repeat repairs was more than twice as high with removable prostheses compared with fixed prostheses. However, the repairs to opposing dentures most often needed were for conventional dentures opposing fixed ISPs. The vast majority of repairs were needed within the first year of service. Despite the high maintenance needed, patients were satisfied with both types of ISP, with the exception of limited satisfaction with cleansability, particularly with fixed restorations. The high incidence of early repairs, and the greater potential for a removable ISP requiring adjustment and repair, should be considered both when discussing options with the patient and when estimating treatment and maintenance costs before the commencement of implant therapy.
Adult↗
Orientation of retentive matrices on spherical attachments independent of implant parallelism.
Traditionally, it has been advocated that implants planned for use as overdenture abutments be placed parallel to each other to obtain predictable attachment retention and complete seating of the restoration and to prevent premature wear of components. However, it is often difficult or impossible to place implants parallel to each other, and patients with implants that have already been placed in a variety of positions frequently are referred to restorative dentists. This article describes a technique for the fabrication of a matrix-paralleling device as well as 2 of its uses. The device allows proper orientation of the retentive matrices to establish a common path of withdrawal for the prosthesis and all attachments. Provided that the matrices are parallel to each other, spherical overdenture attachments can be used even when the implants are not parallel.
Acrylic Resins↗
Transcatheter closure of membranous ventricular septal defects with a new nitinol prosthesis in a natural swine model.
Transcatheter closure of a membranous ventricular septal defect (MVSD) is much more difficult than closure of other intracardiac defects because of the proximity to the aortic and tricuspid valves and their relatively large size in small children. In this report, transcatheter closure of naturally occurring membranous VSDs was attempted in 12 Yucatan minipigs. The prosthesis is constructed from fine Nitinol wires in the shape of two buttons and a connecting waist filled with polyester fiber. Two kinds of prosthesis were used in this study: concentric and eccentric left-sided retention disks. A 6 or 7 Fr delivery sheath was advanced across the membranous VSD over a wire from femoral vein. The prosthesis was inserted through the sheath by pushing the delivery cable to deploy a button into left ventricle and the second button was then deployed into right ventricle by withdrawing the sheath. Successful implantation of the device was achieved in all animals except one. Complete closure rate was 58.3% immediately after placement, 100% at 1 week, 90.9% at 1 month and 3 months, and 100% at 6 months. An associated aneurysm of the membranous septum increased significantly in size in two of three animals using the concentric device, and in none of the animals using the eccentric device. A trace to mild aortic regurgitation was present in two of the three animals using the concentric device, and only in one of the eight animals using the eccentric device. Five animals developed a trace to mild tricuspid regurgitation. Pathologic examination showed all devices to be covered by smooth neoendothelium at 3 months. This report presents the first experimental study where closure of membranous ventricular septal defects in a swine model was attempted by specially constructed devices. Procedural success and occlusion rates are very encouraging but overall results cannot equal surgery. Further experimentation is needed with devices that are redesigned according to the experience gained from this study.
Alloys↗
Enhanced retention for the distal extension-base removable partial denture using a heat-cured resilient soft liner.
Replacement of the conventional heat-cured acrylic resin with a soft durable liner in the retromylohyoid eminence areas allows the patient to manipulate the distal extension-base mandibular RPD into place without traumatizing the soft tissue. With maximum coverage of the edentulous ridges, the semiflexible flange minimizes food entrapment and improves the retention and stability of the RPD. The procedure can be accomplished during the initial processing of the RPD or when relining the prosthesis. We have also used the technique for overdentures and for improving retention in the maxillary anterior extension-base RPD where anterior clasping was not esthetic or was insufficient.
Denture Design↗
Transpositioned flap vestibuloplasty combined with implant surgery in the severely resorbed atrophic edentulous ridge.
The use of transpositioned flap (lipswitch) vestibuloplasty combined with implant surgery in patients with severely resorbed atrophic edentulous ridges is reviewed. The cases of 17 patients with severely resorbed atrophic edentulous ridges at the mandible undergoing implant rehabilitation were reviewed. Lipswitch vestibuloplasty was followed immediately by the implant surgery. Postoperative follow-up consisted of clinical and radiographic examinations. Seventeen patients with atrophic ridges (12 class II and 5 class III) each had 2 implant fixtures placed in the mandible as abutments for a clip and bar overdenture. The average time of follow-up was 6 years. Before surgery, all patients had severely atrophic ridges with a compromised shallow vestibule of varying degrees. Satisfactory results were observed in regard to the immediate and long-term morphology of the vestibule, the health of the peri-implant tissue, the stability of implant fixtures, and the functionality of the prostheses. The lipswitch vestibuloplasty offers a safe and convenient method of surgical access for implant fixture installation, with the advantage of rebuilding the vestibule of a compromised atrophic ridge in the anterior mandible.
Atrophy↗