Distraction Osteogenesis of Severely Resorbed Mandible

Edentulous patients require an adequate rehabilitation so that the alveolar ridge in the interforaminal region be restored for subsequent implant-supported overdentures. The ultimate goal of distraction is to reconstruct the alveolar ridge to a suitable height and width compatible with Atwood class 2 in an appropriate direction allowing the sagittal interalveolar relation to be normally restored. Methods. A 65-year-old man presented with a grade 4 Mandibular atrophy as per Atwood classification which resulted in unsatisfactory treatment with full dentures. Endo-Distractor Krenkel® device was used for anterior mandibular vertical distraction osteogenesis. Four mandibular implants (ITI Straumann, Basel, Switzerland) measuring diameter Ø = 4.1 mm and length L = 16 mm were inserted after the required retention period. Standardized prosthetic treatment was completed with titanium bar retained over dentures. Results. A distraction of 11 mm was achieved within 18 days followed by a retention period of 4 months. No signs of infection nor distractor anchorage loosening were detected, and minimal lingual tilting has occurred. Conclusion. Distraction is possible on severely atrophic mandibles. The quality of bone reconstruction is satisfactory for both functional and esthetic results.

Intra Oral Mucosal Conditions in Older Patients With and Without Complete Dentures: A Cross-sectional Study.

Objectives: To obtain baseline information on Oral Mucosal Conditions (OMCs) and its relation to age, sex, medical history and the use of complete denture in a sample of edentulous patients. Materials and methods: Edentulous patients attending a university hospital were examined for the presence of OMCs, and demographic data were recorded. Statistical analysis was carried out on SPSS software; the following statistical tests were utilized: descriptive statistics, The Mann Whitney U test, Spearman’s Rho rank correlations, and The hierarchical logistic regression analysis. Results: A total of one hundred and sixty-one participants were examined (34 females and 127 males with a mean age of 59.08 years). More than half of the participants (59.6 %) were non-denture wearers and (40.6%) were denture wearers. Longer edentulism, using dentures for longer duration, and the use of more previous dentures were associated with higher Atwood’s ridge classification. Smoking was associated with higher prevalence of OMCs, particularly hairy tongue, frictional keratosis, smokers’ palate, and leukoedema. Denture wearers had more denture stomatitis and denture induced hyperplasia, and less frictional keratosis than non-denture wearers. Participants with cardiac disease had more incidences of geographic tongue and tie tongue. Conclusion: Mucosal changes with increased age, smoking, medical conditions, and medications may be superimposed by wearing complete dentures.

Vascular and neurosensory evaluation in relation to lingual canal anatomy after mandibular midline implant installation in edentulous patients

Objectives The aim of this study is to investigate vascular and neurosensory complications in edentulous patients following the installation of mandibular midline single implants in relation to lingual canals. Materials and methods After performing a cone beam computed tomography scan for the 50 recruited patients, the relationship between the potential implant site and the lingual canals was assessed, and all vascular and neurosensory complications were recorded. Results Six patients (12%) reported profuse bleeding during implant placement, and 13 (26%) reported transient neurosensory changes, which were resolved after 3 months. According to the virtual implant planning, 44 patients (88%) would have their implants touching the lingual canals, six of them reported vascular changes (14%), and 12 out of 44 patients reported neurosensory changes (27%). For the six patients who would have their implants not touching the lingual canals, one patient reported transient neurosensory changes. Conclusions The mandibular lingual canals are constant anatomic landmarks. Injury to the supra-spinosum lingual canals may occur during midline implant placement, depending on the implant length and the bone height. Clinical relevance Despite that injury to the supra-spinosum lingual canals during implant insertion does not result in permanent vascular or neurosensory complications, caution is required to avoid the perforation of the lingual cortices.

Patients’ Satisfaction and Oral Health-Related Quality of Life of Edentulous Patients Using Conventional Complete Dentures and Implant-Retained Overdentures in Saudi Arabia

The aim of this study was to compare patients’ satisfaction and quality of life (QoL) when using implant overdentures vs. conventional dentures. The QoL of Saudi patients who were provided mandibular implant-supported overdentures was assessed using a structured questionnaire. Overall satisfaction; ability to speak, eat, and chew food; comfort; esthetics; stability; and satisfaction of general oral health were measured. A total of 48.3% vs. 6.9% were, overall, very satisfied with their implant overdentures and conventional dentures, respectively. A total of 37.9% of the patients were very satisfied regarding speaking with their implant overdentures vs. 17.2% with conventional dentures. Furthermore, 41.4% were very comfortable with their implant overdentures vs. 5.2% were very comfortable using conventional dentures. However, only 15.5% were very satisfied with the esthetics of the conventional dentures compared to 43.1% being satisfied with implant overdentures. Only 1.7% were very satisfied with the stability of conventional dentures vs. 44.8% being satisfied using implant overdentures. About 8.6% of the candidates were very satisfied regarding chewing food with conventional dentures vs. 36.2% being very satisfied using implant overdentures. Approximately 10.3% were very satisfied with their general oral health using conventional dentures compared to 29.3% being very satisfied using implant overdentures. Mandibular implant overdentures had a strong impact on patients’ quality of life over conventional complete dentures and should be considered the minimum standard of care provided to completely edentulous patients.

DIGITAL OCCLUSAL ANALYSIS AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PATIENTS WITH 3D PRINTED COMPLETE DENTURES VERSUS CONVENTIONAL DENTURES

Background: 3D printed complete dentures fabrication with computer-aided designing and computer-aided manufacturing (CAD/CAM) techniques is becoming popular nowadays. However, studies that analyzed the occlusal forces distribution using recent digital methods as T-scan III and further evaluated the dentures effect on patient`s life quality were lacking. Objectives: Evaluation of the occlusal forces distribution using T-scan III, and evaluation of the oral health-related quality of life (OHRQoL) using Oral Health Impact Profile for Edentulous Patients (OHIP-EDEN) questionnaire for 3D printed complete dentures and comparing it with conventional denture fabrication techniques. Methods: Twenty completely edentulous patients were selected and divided randomly into two equal groups according to manufacturing technique group I (patients who received conventional complete dentures), and group II (patients who received 3D printed complete dentures). For all patients, occlusal force analysis (percentage of applied occlusal force on both sides) was performed using the T-Scan III (digital occlusal analysis system). Also, OHRQoL was assessed using (OHIP-EDENT) questionnaire. Results: In the digital occlusal analysis, comparison between right and left sides regarding occlusal forces distribution revealed a significant difference in group I (conventional denture), while in group II (3D printed denture), it revealed an insignificant difference. Regarding, OHIP-EDENT patients in group I (conventional denture) revealed higher scores than group II (3D printed dentures). Also, the correlation between occlusal forces & (OHIP-EDENT) scores revealed a strong negative significant correlation. Conclusions: The 3D printed complete dentures fabricated using CAD/CAM technology proved to be more superior over conventional methods in terms of digital occlusal force analysis and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT). However, further studies are required on more patients to decide the exact superiority of one technique over the other after long-term follow-up periods.

Association Between Depression and Dissatisfaction with Complete Dentures

Objective: The aim of this study was to find out the role of depression in complete denture dissatisfaction and to determine frequencies of depression among the satisfied and dissatisfied patients. Study design: A cross sectional survey was carried out at Department of Prosthodontics, De’Montmorency College of Dentistry. Punjab Dental Hospital. The sample size was 80 edentulous patients having adequate maxillary and mandibular ridges. Methodology: The patients selected would be wearing complete dentures for the first time. All dentures were carefully designed. A socio-demographic form and depression rating questionnaire was filled by every participant involved in the study. After six months, satisfaction or dissatisfaction with the provided complete denture set was assessed through a separate questionnaire. The patients’ opinion concerning satisfaction with their dentures and depression was recorded and statistical analysis done. The results showed that 36.25% depressed versus 63.75% non-depressed. 28.75% were dissatisfied versus 71.25% satisfied. Conclusion: It was concluded that depression played a significant role in decreasing the satisfaction rating in first time denture wearers. Keywords: Depression, dissatisfaction, complete dentures,

Autologous Tooth Dentin Graft: A Retrospective Study in Humans

Background and Objectives: The aim of this study is to evaluate the efficacy of an autologous dentin graft, via extracted teeth that are processed into bacteria-free particulate dentin in a Smart dentin grinder and then grafted immediately into alveolus post extraction or into bone deficiencies. Materials and Methods: Ten healthy, partially edentulous patients with some teeth in the mandible were recruited in the study. After their own teeth were grinded, particulate teeth were placed in empty sockets and bone defects after teeth extractions. Furthermore, after three, six, 12 and 24 months, core samples using a 3 mm trephine were obtained. Results: At three months, the particles of grinded tooth were immersed inside a new connective tissue with a small new bone formation (16.3 ± 1.98). At six months, we observed small particles of dentin integrated in new immature bone, without inflammation in the soft tissue (41.1 ± 0.76). At twelve months, we observed a high amount of bone formation surrounding tooth particles (54.5 ± 0.24), and at twenty-four months, new bone, a big structure of bone, was observed with dentin particles (59.4 ± 1.23), statistically different when compared it with at three months. Conclusions: A particulate dentin graft should be considered as an alternative material for sockets’ preservation, split technique, and also for sinus lifting. One of the special characteristics after 24 months of evaluation was the high resorption rate and bone replacement without inflammation. This material could be considered as an acceptable biomaterial for different bone defects due to its osteoinductive and osteoconductive properties