Search Results (106)

Background/Objectives: When solving the problems of installing zygomatic implants after partial or full maxillectomy with subsequent attachment of a removable overdenture (ROD), computer simulation based on the finite element method (FEM) is an effective tool for treatment planning. In this study, stress-strain states of the ‘zygomatic bones–implants–splinting bar–ROD’ dental structure were evaluated under various loading conditions. Methods: A 3D FEM computer simulation was carried out to estimate stress-strain states of the elements of the dental structure and to study the effect of redistribution of the loads transferred from the ROD to the zygomatic bones through four implants. Results: That successive insertion and removal of the ROD caused identical stresses in the elements of the dental structure. Given the accepted level of critical stress of about 13 MPa, their values may be exceeded in the zygomatic bones during both processes. In the ROD, the equivalent stresses did not exceed the critical levels upon alternate loading of 50 N on the posterior teeth (both molars and premolars) under all biting and mastication. Taking into account the linear dependence of the applied load and the stresses in the ROD, it can be stated that its integrity is maintained until 118 N (or the generally accepted typical value of 100 N). Under the 90° biting angle, the equivalent stresses are below the critical level in all the studied cases; thus, the acceptable value increases to 213 N, but it is only 63 N at a biting angle of 45°. Conclusions: It has been established that the equivalent stresses in the zygomatic bones can exceed the critical stress level of 13 MPa. In addition, some practical recommendations and prospects of the study have been formulated. Full article

Background: Partial edentulism presents an ongoing clinical challenge, and the optimal choice of prosthetic rehabilitation remains a topic of debate. Purpose: This review compares three abutment configurations for removable dentures—natural teeth, implants, and mixed support. The goal was to determine which treatment offers the best longevity, lowest complication rates, and highest survival. Materials and Methods: A systematic search following PRISMA 2020 guidelines and the PICO framework was conducted using PubMed and Scopus, focusing on clinical studies of IARPDs published between 2022 and 2024. Studies were selected based on predefined eligibility criteria. Descriptive analysis of survival and complication outcomes was performed and represented graphically. Results: Nineteen studies were included: four on IARPDs, six on conventional RPDs, and five on IODs. Main parameters included prosthesis survival, abutment (tooth/implant) survival, and complication rates. IARPDs showed favorable implant survival and lower rates of abutment tooth loss than conventional RPDs. Conventional dentures demonstrated lower performance. IODs had the highest survival over mid-term follow-up periods. Discussion: IARPDs demonstrate clinical viability, especially in cases requiring strategic abutment preservation. Although the data are limited by sample size and short follow-up, IARPDs show potential advantages in preserving natural dentition and improving load distribution. Conclusions: IARPDs are a reliable treatment option for partial edentulism, combining implant support with removable versatility. More long-term studies are needed to strengthen current findings, but the existing evidence supports their use in contemporary prosthodontics, in selected cases. Full article

Background: The long-term success of implant-supported mandibular overdentures depends largely on the type of attachment system used. This review compares the clinical performance, complication rates, maintenance requirements, and patient satisfaction between ball and Locator attachments. Methods: A literature search was conducted across PubMed, Scopus, and Web of Science. Studies evaluating clinical outcomes, prosthetic complications, patient-reported satisfaction, and frequency of maintenance in ball and Locator attachments were included. Results: Locator attachments showed higher patient satisfaction scores (mean VAS 8.1–9.0) compared to ball attachments (VAS 6.7–7.9). Complication rates, including matrix wear and attachment loosening, were lower in Locator systems (14–20%) than in ball systems (24–35%). Maintenance needs were more frequent in ball attachments, particularly for the replacement of retentive components (1.8 interventions/year vs. 0.9 in Locator). Peri-implant bone loss was comparable in both systems (<1.5 mm/year), with no statistically significant difference in survival rates over 3–5 years. Conclusions: Locator attachments demonstrate superior clinical performance in terms of patient satisfaction and lower complication rates, with reduced maintenance interventions compared to ball attachments. However, both systems remain viable options depending on anatomical and financial considerations. Full article

Objectives: Ameloblastoma is a locally aggressive odontogenic tumor of the jaws characterized by a high recurrence rate. This work aims to present our clinical experience in managing patient oral rehabilitation following an extensive mandibular ameloblastoma, with a specific focus on mandibular reconstruction using a fibula free flap, followed by dental implant placement and prosthetic rehabilitation in a female patient. Additionally, we provide a comprehensive review of the current evidence on surgical management, reconstruction techniques, and long-term outcomes in ameloblastoma treatment. Methods: A 44-year-old female patient presented with a painless swelling in the left mandible. Orthopantomography (OPG) and computed tomography (CT) demonstrated a well-defined radiolucent lesion extending from the canine to the second premolar. An incisional biopsy was performed, and histopathological examination confirmed the diagnosis of mandibular ameloblastoma. The patient underwent segmental resection of the left mandibular body, followed by immediate reconstruction using a vascularized fibular free flap. Eighteen months postoperatively, four dental implants were placed. One implant failed during the osseointegration phase and was removed. Due to residual hard and soft tissue deficiency, prosthetic rehabilitation was achieved with a metal-reinforced resin overdenture, restoring both function and aesthetics. Results: At the three-year follow-up, clinical and radiographic examinations revealed no evidence of tumor recurrence. The patient remained asymptomatic, reporting neither pain nor functional discomfort. Prosthetic rehabilitation with the metal-reinforced resin overdenture was successfully completed, achieving satisfactory masticatory function and aesthetics. Conclusions: The use of the fibula free flap for mandibular reconstruction after ameloblastoma resection provides excellent flexibility, enabling effective bone integration of dental implants. Full article

Dental implant components are typically fabricated using subtractive manufacturing, often involving metal materials that can be costly, inefficient, and time-consuming. This study explores the use of additive manufacturing (AM) with zirconia for dental implant overdenture bars, focusing on mechanical performance, stress distribution, and fit. Solid and lattice-structured bars were designed in Fusion 360 and produced using LithaCon 210 3Y-TZP zirconia (Lithoz GmbH, Vienna, Austria) on a CeraFab 8500 printer. Post-processing included cleaning, debinding, and sintering. A 3D-printed denture was also fabricated to evaluate fit. Thermography and optical imaging were used to assess adaptation. Custom fixtures were developed for flexural testing, and fracture loads were recorded to calculate stress distribution using finite element analysis (ANSYS R2025). The FEA model assumed isotropic, homogeneous, linear-elastic material behavior. Bars were torqued to 15 Ncm on implant analogs. The average fracture loads were 1.2240 kN (solid, n = 12) and 1.1132 kN (lattice, n = 5), with corresponding stress values of 147 MPa and 143 MPa, respectively. No statistically significant difference was observed (p = 0.578; α = 0.05). The fracture occurred near high-stress regions at fixture support points. All bars demonstrated a clinically acceptable fit on the model; however, further validation and clinical evaluation are still needed. Additively manufactured zirconia bars, including lattice structures, show promise as alternatives to conventional superstructures, potentially offering reduced material use and faster production without compromising mechanical performance. Full article

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

Purpose: The aim of this study was to evaluate the long-term clinical results of two different implant–abutment connection types (screw-retained/Morse locking taper), marginal bone loss, and complications in prosthetic restorations. Materials and Methods: In 2017–2018, 579 implants and 242 implant-supported restorations applied to 137 patients were included in the study. Patients were recalled every six months, clinical evaluations were accomplished, and complications were recorded. When examining the distribution of prosthetic restorations by type, it was determined that 38 (15.70%) were single crowns, 136 (56.19%) were fixed partial cement-retained bridge restorations, 53 (21.90%) were fixed partial screw-retained bridge restorations, and 15 (6.19%) were overdenture prostheses. Findings: Overall, complications included eighteen (21.68%) retention losses, nineteen (22.89%) instances of screw loosening, twenty-one (25.30%) veneer ceramic fractures, three (3.61%) acrylic base fractures, fourteen (16.87%) cases of peri-implantitis, and eight (9.64%) implant losses. Conclusions: Differences in complication rates were observed between implants with different implant–abutment connection designs. While no significant differences were found regarding annual mesial and distal marginal bone loss for implants with conical locking connections, a significant difference was detected in those with screw-retained connections. In both implant groups, mesial and distal marginal bone loss progressed gradually over the follow-up period. Full article

Background: A considerable percentage of people in the population have lost their teeth. According to the Word Health Organization (WHO), 40% have lost teeth for multiple reasons. The lack of restorative treatments and the lack of fixed options could impact the quality of life of patients. Objective: To determine the quality of life of patients treated with dental implants at the School of Dentistry, University of the Americas, Quito, Ecuador, by the Medical Specialty in Oral Rehabilitation from 2017–2022. Materials: The inclusion criterion was patients treated with dental implants age 20 to 70 years old, who agreed to participate in this study, in Quito/Ecuador. The Oral Health Impact Profile (OHIP-14) survey was used. The patients’ clinical history, psychological status, and social status were also recorded. Complementary tests (clinic analysis) were conducted to evaluate the general health status of each patient. Results: After the corresponding analysis, the total number of patients who wished to participate in this study in compliance with the inclusion criteria was n = 1303. The seven questions included patient sex, age, and type of prosthesis used in their rehabilitation (single implant, fixed prosthesis on an implant, overdentures, or hybrid prostheses). The obtained results indicated that single implants and overdentures (two jaw implants) improved quality of life, and no statistically significant difference was noted between the sexes. Conclusions: The quality of life of patients with total dentures who received dental implants improved substantially, and more fixed dentures helped them to recover their masticatory function appropriately. Single implants were not excluded. In the investigated population, the results were unanimous in how implants improved their comfort and even helped in the recovery of their self-esteem. Full article

Introduction: Generally, after an oral oncological therapeutic process in which, unfortunately, surgery plays a fundamental role, a reconstructive and rehabilitative procedure should be initiated, seeking as far as possible to recover the patient’s vital functions (mastication, aesthetics, and phonetics). Case report: We present the case of a patient who successfully underwent treatment for mandibular sarcoma. After a disease-free period of one year, following oncological treatment, an intervention was performed for the insertion of dental implants into the fibula to subsequently rehabilitate the patient prosthetically. There were several challenges, including free-end edentulous space in the lower jaw with a depth of 18 mm on peri-implant tissues consisting of osteoseptocutaneous skin graft, hypotonic perioral musculature, and high aesthetic expectations of the patient. An overdenture with a titanium milled bar substructure with retentive prosthetic components was chosen for treatment. This implant-supported removable prosthesis was selected to facilitate cleaning, since the patient did not maintain oral hygiene habits. The patient was educated on using and handling the prosthesis, and the treatment objectives were achieved (to restore aesthetics and masticatory function). Conclusions: Removable prostheses are a valid alternative for oncologic patients and patients with unfavorable conditions for more complex implant-supported rehabilitation. Full article

Sandblasting and acid etching are common procedures used to treat implant surfaces, enhancing osseointegration and improving clinical success rates. This clinical study aimed to evaluate the long-term outcomes of sandblasted and acid-etched implants. A total of 303 implants were placed in 114 partially and totally edentulous patients using a two-stage surgical technique and an early loading protocol (6–8 weeks). Clinical findings for implants and prosthetics were evaluated over a 12-year follow-up period. A total of 12 implants (3.9%) failed, with 3 failures occurring during the healing period before loading and 9 due to peri-implantitis. The cumulative survival rate for all implants was 96.1%. A total of 156 prostheses were placed on 300 implants, 87 single crowns, 45 partial fixed bridges, 9 full-arch fixed restorations, and 15 overdentures. The mean marginal bone loss was 1.18 mm. (SD. 0.64 mm.). Thirty-nine implants (13%) in twenty-four patients exhibited peri-implantitis. Technical complications, including prosthetic screw loosening or fracture, ceramic chipping, and acrylic fractures, were observed in 24 subjects (21.1%). Sandblasted and acid-etched surface implants placed in the maxilla and mandible reported favorable outcomes and stable tissue conditions with an early loading protocol. Full article

Background: Mini dental implants (MDIs) are alternatives to support an overdenture when a standard diameter implant cannot be placed due to lack of bone volume. They reduce the need for invasive bone grafting and lower the barrier for treatment. Aim: This prospective study reports on implant and patient-centered outcomes of flaplessly placed, early loaded MDIs supporting horseshoe-shaped maxillary overdentures after 7 years of function. Materials and Methods: Patients with a CBCT-confirmed thin alveolar crest received 5–6 one-piece MDIs using mentally guided flapless surgery. The conventional denture was relined and MDIs were provisionally loaded within one week. After 6 months the non-splinted MDIs were actively loaded with a horseshoe overdenture. Implant and prosthetic survival, peri-implant health (PPD and BoP) and patient-related outcomes using OHIP-14 and Subjective Masticatory Evaluation were assessed after 7 years. Results: 185 MDIs were placed in 14 females and 17 males. During provisional loading, 32 MDIs were lost, and 17 replacements were required in 16 patients. In total, 170 out of 202 totally placed MDIs were supporting 29 overdentures after 6 months. Cumulative implant failure increased from 15.8% at the moment of active loading to 34.7% at 7 years. After 7 years, 76% of the initially placed overdentures remained functional, mean PPD was 3.48 (SD 0.86), BoP was 0.20 (SD 0.40) and peri-implantitis incidence was 0.9%. The total OHIP-14 was reduced from 21.3/56 (SD: 13.1) preoperatively to 15.6/56 (SD 12.8) at provisional loading (p > 0.1) and 7.3/56 (SD 6.7) at final loading (p = 0.006), and it remained unchanged up to 7 years at 6.57/56 (SD: 8.92) (p > 0.5). Conclusions: Maxillary MDIs provide an acceptable treatment option in patients with deficient bone volume that cannot or refuse to be treated with bone grafting. Despite one third of the MDIs being lost, remaining MDIs had good peri-implant health, prosthetic success was 71% and Oral Health Related Quality of Life was beyond expectations. Full article

Background and Clinical Significance: Denture stomatitis is a clinical manifestation of oral candidiasis, often seen in individuals wearing removable dentures that lead to the formation of sub-prosthetic stomatitis. This is particularly common in maladjusted appliances that have been in use for many years. Studies have shown that patients with systemic diseases such as diabetes, or other medical complexities, have a higher likelihood of developing denture stomatitis. To address this problem, the use of implant-retained dentures with different types of attachments has been introduced, providing increased comfort and hygiene for edentulous patients. However, this solution is not without its own set of challenges, being that the prolonged contact with mucosal surfaces can lead to challenges in cleaning and managing plaque depending on the attachment. Case Presentation: In this clinical case report, we present a female patient who developed bar-retained prosthetic stomatitis induced by oral candidiasis a few months after receiving her provisional prosthesis. Conclusions: In conclusion, this case report emphasizes the need to consider both systemic and local factors when preventing and treating denture stomatitis. By understanding the risk factors involved, healthcare professionals can provide their patients with the best possible care, helping to reduce the prevalence of oral candidiasis in individuals who use implant-retained dentures. Full article

Background and Objectives: This research describes the management of mandibular fractures in edentulous patients with atrophic mandibles and implant-retained overdentures, exploring etiologies and treatment options. Materials and Methods: A retrospective study (January 2010–December 2023) was conducted on six patients from two hospitals (Hospital Gregorio Marañón y Hospital La Paz, Madrid). The data collected included fracture etiology, treatment type, and complications. Results: All six patients were women, with a mean age of 76.33 years. The most common cause of fracture was peri-implantitis (50%). Surgical treatment (open reduction and internal fixation) was performed in five patients, with different surgical approaches and fixation methods. One patient, due to multiple comorbidities, received conservative treatment. Complications occurred in 50% of cases, including delayed healing and hypoesthesia. The average hospital stay was four days, with a mean follow-up of 34 months. Conclusions: Mandibular fractures in these patients are rare. Surgical treatment using rigid fixation plates is recommended. The rational use of bone grafting should be taken into account. Treatment depends on fracture type, patient condition, and surgeon experience. Full article

This clinical report details the prosthetic rehabilitation of a patient following maxillary ablation to remove a peripheral giant cell granuloma. After a hemimaxillectomy, the defect was reconstructed with a fasciocutaneous radial free flap. Implant placement was digitally planned using the dual scanning technique, and implants were inserted with the aid of an acrylic surgical guide. After implant osseointegration, a removable implant-supported overdenture with an electroplated secondary structure retained on a titanium bar was fabricated. At the 3-year follow-up, peri-implant tissues remained healthy, showing only mild gingival hyperplasia around the bar, while no prosthesis retention loss or significant technical complications were observed. In conclusion, the reconstruction of the moderate maxillary defect using a soft-tissue flap provided satisfactory functional and esthetic outcomes, significantly enhancing patient satisfaction. However, the limited bone availability necessitated precise implant planning to ensure adequate biomechanical support for the overdenture. Full article

Clinical indications for the Ti-Zr alloy (Roxolid^®) mini-implants (MDIs) in subjects with narrow ridges are still under review. The aim was to analyze peri-implant and posterior edentulous area strains dependent on the MDI number, splinting status, loading force, and loading position. Six models were digitally designed and printed. Two, three, or four Ti-Zr MDIs, splinted with a bar or unsplinted (single units), supported mandibular overdentures (ODs), loaded with 50–300 N forces unilaterally, bilaterally, and anteriorly. The artificial mucosa thickness was 2 mm. Strain gauges were bonded on the vestibular and oral peri-implant sides of each MDI, and on the posterior edentulous area under the ODs. Loadings were performed through the metal plate placed on ODs’ artificial teeth (15 times repeated). Arithmetic means with standard deviations and the significance of the differences (MANOVA, Sheffe post hoc) were calculated. Different MDI numbers, loading positions, forces, and splinting elicited different peri-implant microstrains. In the two-MDI models, 300 N force during unilateral loading elicited the highest microstrains (almost 3000 εμ on the loaded side), which can jeopardize bone reparation. On the opposite side, >2500 εμ was registered, which represents high strains. During bilateral loadings, microstrains hardly exceeded 2000 εμ, indicating that bilateral chewers or subjects having lower forces can benefit from the two Ti-Zr MDIs, irrespective of splinting. However, in subjects chewing unilaterally, and inducing higher forces (natural teeth antagonists), or bruxers, only two MDIs may not be sufficient to support the OD. By increasing implant numbers, peri-implant strains decrease in both splinted and single-unit MDI models, far beyond values that can interfere with bone reparation, indicating that splinting is not necessary. When the positions of the loading forces are closer to the implant, higher peri-implant strains are induced. Regarding the distal edentulous area, microstrains reached 2000 εμ only during unilateral loadings in the two-MDI models, and all other strains were lower, below 1500 εμ, confirming that implant-supported overdentures do not lead to edentulous ridge atrophy. Full article