Soft Tissue Dehiscence Associated with a Titanium Patient-Specific Implant: A Prosthetic Solution as an Alternative to Soft Tissue Grafting

Patients. This clinical report describes the detailed prosthodontic management of a 23-year-old male patient suffering from soft tissue complication following the placement of a 3d-printed titanium patient-specific implant. This implant was implemented simultaneously with the resection of a calcifying cystic odontogenic tumor related to the maxillary arch. Later, soft tissue dehiscence and implant exposure were encountered with subsequent food impaction, infection, and pus discharge. The treatment plan was to fabricate removable partial denture. The prosthesis was planned to be retained by bar and clip attachment on the patient-specific implant side, while on the other side, the removable prosthesis was allowed to engage two abutments with an embrasure clasp assembly in addition to covering the palatal tissues to offer protection for the soft tissue dehiscence against food impaction. Discussion. Soft tissue dehiscence and implant exposure are among the frequently reported complications associated with the patient-specific implant. The resulting infection complicates the prognosis of the implemented implant and necessitates, in some occasions, its removal. The selection of the removable prosthesis to cover soft tissue dehiscence was a conservative alternative to the implant removal as it protects the exposed titanium surface from food impaction while maintaining the implant functionality. Conclusion. Three-year follow-up showed complete resolution of the patient’s complaints while fulfilling the patient’s aesthetic and functional demands and indicates that the use of detachable overlay prosthesis could be one of the proposed treatment options.

The Influence of Age and Oral Health on Taste Perception in Older Adults: A Case-Control Study

Declining gustatory function, nutrition, and oral health are important elements of health in older adults that can affect the aging process. The aim of the present work was to investigate the effect of age and oral status on taste discrimination in two different groups of elderly subjects living either in an Italian residential institution (TG) or in the community (CG). A total of 90 subjects were enrolled in the study (58 CG vs. 32 TG). Masticatory performance (MP) was assessed using the two-color mixing ability test. Taste function was evaluated using cotton pads soaked with six taste stimuli (salty, acid, sweet, bitter, fat and water). A positive correlation between age and missing teeth (r = 0.51, C.I. [0.33; 0.65], p < 0.0001), and a negative correlation between age and MP (r = −0.39, C.I. [−0.56; −0.20], p < 0.001) were found. Moreover, significant differences for salty taste, between TG and CG were detected (p < 0.05). Significant differences in bitter taste sensitivity between subjects wearing removable and non-removable prosthesis were also determined (p < 0.05). In addition, significant gender differences and between males in TG and CG were identified (p < 0.05). The best understanding of the relationship between MP, taste sensitivity, and nutritional factors is a necessary criterion for the development of new therapeutic strategies to address more effectively the problems associated with malnutrition in elderly subjects.

Rehabilitation of an Extremely Atrophied Mandibule with Cortical Plates

A 74-year-old woman presented in our dental practice with severe loss of alveolar bone and soft tissue without any apparent systemic pathology contributing to her dental conditions. She had a complete removable prosthesis supported with a four locaters system. Unfortunately, two of the four supporting implants were failed. The patient wanted a fixed prosthesis. The treatment plan was to use the remaining implant with an additional axial implant and two cortical plates (Victory ®) followed by implant placement. The implants and plates were immediately loaded with a screw-retained prosthesis made with Znatex frame (Victory Implants ®) and resine.

Traditional Removable Partial Dentures versus Implant-Supported Removable Partial Dentures: A Retrospective, Observational Oral Health-Related Quality-of-Life Study

Removable partial dentures (RPD) are still a valid alternative for the restoration of missing teeth. Additionally, implant-supported removable partial dentures (ISRPD) represent a valid alternative as it allows to avoid the use of clasps and increase stability. The objective of this study was to evaluate through an OHIP-14 questionnaire the level of satisfaction and quality of life (QoL) of patients treated before RPD and then with ISRPD. Twenty patients were rehabilitated with traditional RPDs, and after one year the prosthesis was modified into ISRPD, by inserting an implant and a ball or locator attachment. At the end of both phases, patients completed the Oral Health Impact Profile (OHIP-14) questionnaire. The collected data were statistically analyzed through the Wilcoxon U test, as overall OHIP score and difference between treatments. The mean of the OHIP summary (range from 0 to 56) in the RPD Group was 20.95 (±5.27). In the ISRPD Group it was 13.95 (±3.91), with a statistically significant difference (p < 0.05) between the two Groups. The same findings were highlighted for the differences between groups in every domain question. Patients showed significant improvements after rehabilitation in all areas of investigation, stating how the transformation of a removable prosthesis into an implant-supported one can improve patients’ QoL with benefits in chewing ability, aesthetics and self-satisfaction.

Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports

Aim: Traumatic dental injuries at the anterior region of the maxilla occur frequently in children and adults. In this case report, we aimed to describe the temporary aesthetic restoration of the upper lateral incisor with a fiber-reinforced bridge by using the original tooth crown, which had avulsed after dental trauma. Methodology: Case 1: A 14-year-old girl with an avulsion in tooth #11 due to trauma visited our clinic. During the examination, it was seen that the wound had healed, and there was no luxation in teeth #21 and #12. Since the patient could not undergo prosthetic procedures, for reasons including implants, and did not want a removable prosthesis, a single crown supported by acrylic tooth fibers was constructed. Case 2: A 17-year-old male patient was referred to our clinic because of an avulsed left lateral incisor tooth, which was traumatized 15 days before visiting the clinic. His medical history revealed that his parents had found the tooth two hours after the trauma. However, the emergency clinic that he had previously visited did reimplant that tooth and repaired it with fiber-reinforced composite. Case 3: In the examination of a 12-year-old male patient who applied to our clinic due to trauma, it was observed that tooth #11 had an avulsion and tooth #12 had a crown fracture. Root canal treatment was performed. A crown was made for the patient by supporting the fiber inside the canals of tooth #11 and tooth #21. It was revised aesthetically with the support of the crown of the other tooth. Conclusion: Avulsion after anterior trauma affects patients’ appearance aesthetically; thus, patients want to be treated as soon as possible. Function, phonation, and aesthetics must be quickly provided for a loose anterior tooth. Fiber-reinforced adhesive bridge techniques may be considered as a temporary treatment for providing an aesthetically appealing appearance until the completion of permanent prosthetic treatment. How to cite this article: Şahin M, Toptancı İR. Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports. Int Dent Res 2021;11(Suppl.1):285-91. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.42 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Prevalence and factors associated with the need for removable prostheses in brazilian elderly

Objective: This study aimed to identify the prevalence and factors associated with the need for removable prostheses in the elderly Brazilian population. In addition, its impact on eating difficulties and self-perceived oral health was determined. Methodology: This cross-sectional, population-based study used data from the last National Health Survey (NHS) carried out in Brazil. Chi-square test was used to initially analyze the data, followed by multiple Poisson regression to obtain adjusted prevalence ratios. Results: A total of 11,697 elderly people were included, of whom 90.8% needed removable prostheses. Complete dentures were needed in 40.9% of participants, while partial dentures were needed by 49.9%. The elderly who were older (p=0.001), had grayish-brown complexion (p=0.004), a low level of education (p<0.001), and multiple chronic diseases (p<0.001) had a greater need for removable prostheses. Successively, this need had an impact on poor self-perceived oral health (p<0.001) and greater difficulties in eating (p<0.001). Conclusion: The need for a removable prosthesis is associated with worse socioeconomic and health conditions. In addition, it has a negative impact on self-perceived oral health and feeding.

Feasibility and outcomes of the removable prosthesis in medically compromised patients

Increasing awareness about providing the necessary care of oral health is essential for patients with a removable prosthesis. The awareness is less interested in dental disorders, being busier with the systemic ones. Planning prosthetic management should only be done after a thorough evaluation of the underlying systemic conditions because the treatment plan might vary accordingly. Previous studies have demonstrated that many systemic diseases are associated with removable prosthesis (RP) procedures. We aim to discuss the feasibility and outcomes of the removable prosthesis for medically compromised patients, including many conditions as diabetes mellitus, cardiovascular, renal, hematological, pulmonary, gastrointestinal disorders and immunocompromised patients. Taking adequate care of oral hygiene practices is recommended for these patients. In addition, it is necessary to have frequent care, but short follow-up visits to make sure that the modalities are still valid for additional use, and to investigate for potential complications and adverse events. Adequate prophylaxis against some diseases might also be the only convenient solution. Therefore, proper management of the medical condition might be associated with the enhanced success of the modality with favorable outcomes and better quality of life. Making unified protocols to deal with these patients is also suggested to enhance the practice among the different clinical settings.

Prosthetic Management of a Posterior Ridge Defect Case with Fixed Removable Type of Hybrid Prosthesis - A Case Report

The main aim of prosthetic dentistry is restoring the form, function, comfort and appearance of the patient by the placement of a prosthesis replacing the missing teeth and contiguous tissues.1 Various prosthetic options for partially edentulous patients include an interim removable partial denture (RPD) to a cast partial denture, a fixed dental prosthesis (FDP), and a more implant-retained prosthesis. However, FDP and implant-retained prosthesis are not always feasible, particularly in patients with excessive residual ridge resorption and jaw defects due to trauma and / or surgical ablation. In such a situation, a dentist may resort to another option of fixed-RPD prosthesis, to restore the defective hard and soft tissues to achieve natural aesthetics, phonetics, comfort, and better hygiene. This hybrid prosthesis fulfils the objectives of the rehabilitation such as support, stability, and retention characteristics similar to a fixed prosthesis and aesthetics and hygiene maintenance of a removable prosthesis.2,3,4,5 Any prosthesis designed or fabricated should be based on the prosthetic principles of support, stability, retention, and preservation of remaining structures.1 From the patient's perspective, retention is one of the important factors for its acceptability. These retentive options range from simple bar and clip attachments to more sophisticated spark erosion overdentures.6,7 Spark erosion prosthesis is technique sensitive, bulky, and requires expensive equipment.6,7 On the other hand, precision attachments provide better vertical support and stimulation to the underlying tissue through intermittent vertical massage.8 Treatment with a hybrid denture is an affordable choice to fulfil the patient's aesthetic demands along with providing a good prognosis for the prosthesis and preservation of the remaining dentition. This article presents two case reports of prosthodontic rehabilitation of a patient with mandibular defects using an attachment-retained fixed-removable hybrid prosthesis.

Stress Analysis of Implant-Supported Removable Partial Denture with Anterior Fixed Prostheses and Conventional Implant-Supported Overdentures in the Edentulous Mandible

Aim: To compare new design implant-supported removable partial dentures retained with anterior fixed prosthesis with a conventional locater and bar attached implant overdenture prostheses retained by two or four implants via photoelastic stress analysis. Materials and Methods: Seven edentulous mandibuler acryclic models prepared and divided into two main groups; two to four implant models, subgroup separation as stated; for two implant models overdenture with locator attachment, crown design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with precision attachment retention; and for four implant models prosthesis with bar attachment overdenture, fixed bridge design retained removable prosthesis with clasp retention, fixed retained removable prosthesis with precision attachment retention. A 300 N load was applied to the first premolars. Photoelastic stress analysis method that is a specific method concerning stress visualization, and does not require statistical analysis, was used. The stress distributions were seen in optically using a poloriscope. Results: In the models with two implant-retained removable partial dentures, the stress distribution was found to be lower than that with the four implant-retained removable partial dentures. Nonsplinted implants caused high stress around the distal implant on the loading side. Conclusion: The stress loads were transmitted to other implants by splinting. Implant-supported removable partial dentures with an anterior fixed prosthetic design show lower stress distributions compared with bar retained prosthesis. These dentures appear to be advantageous in terms of stress transmission.

Oral health-related quality of life (OHRQoL) in cardiovascular patients referring to Fatima Zahra Hospital in Sari, Iran

Background Cardiovascular Disease (CVD) is one of the leading causes of mortality and morbidity and significantly impacts the health-related quality of life. Oral infections have been linked to cardiovascular diseases such as thrombosis, cardiac infarction, stroke, and peripheral vascular disease. This study aims to evaluate the effects of oral health on the quality of life in cardiovascular patients. Methods The oral health-related quality of life was measured using the OHIP-14 questionnaire. Demographic information, questions regarding smoke consumption, wearing removable prostheses, nine questions regarding xerostomia, and the existence of other systemic diseases were asked from 240 participants with cardiovascular diseases. The DMFT index was clinically examined in each patient. Also, the Plaque, Gingival, and Sulcular Bleeding Indices were measured on the Ramfjord teeth. Data analysis was conducted using SPSS version 16. The independent t test, Mann–Whitney test, the variance analysis, and the Kruskal–Wallis test were used to compare variables in the present study. Also, regression models were used to eliminate the effect of confounding variables. Results Gender variables, removable prosthesis, xerostomia, DMFT, and SBI were the main determinants of quality of life in CVD patients. The mean ADD-OHIP14 of participants in the study was calculated at 21.34 ± 17.40, and the SC-OHIP14 was 6.11 ± 5.07. The mean OHRQoL was higher in females than in males, and this difference was statistically significant. OHRQoL was significantly lower in patients wearing a removable prosthesis than in those without one. The relationship between age and xerostomia was significant in this study, and patients with xerostomia had a lower quality of life than those without xerostomia. Also, the mean DMFT index in subjects with xerostomia was 23.69 ± 7.76, which was statistically significant compared to those without xerostomia. Conclusion Cardiovascular patients experienced a decreased OHRQoL. Prevention or treatment of these problems seems to justify improving the quality of life in these patients.