Search Results (114)

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine. Full article

Background. Digital dentistry continues to evolve, offering improved accuracy, efficiency, and patient experience across various prosthodontic procedures. Many previous reviews have focused on digital applications in prosthodontics. But the use of a fully digital workflow for full-arch implant-supported prostheses in edentulous patients remains an emerging and underexplored area in the literature. Objective. This article presents a comprehensive methodological review of the digital workflow in full-arch implant-supported rehabilitation. It follows a structured literature exploration and synthesizes relevant technological processes from patient assessment to prosthetic delivery. Methods. The relevant literature was retrieved from the PubMed database on 20 June 2024, to identify the most recent and relevant studies. A total of 22 articles met the eligibility criteria and were included in the review. The majority included case and technical reports. Results. The review illustrates the integration and application of digital tools in implant dentistry, including cone-beam computed tomography (CBCT) exposure, intraoral scanning, digital smile design, virtual patients, guided surgery, and digital scanning. The key findings demonstrate multiple advantages of a fully digital workflow, such as reduced treatment time and cost, increased patient satisfaction, and improved interdisciplinary communication. Conclusions. Despite these benefits, limitations persist due to the low level of evidence, technological challenges, and the lack of standardized protocols. Further randomized controlled trials and long-term clinical evaluations are essential to validate the effectiveness and feasibility of a fully digital workflow for full-arch implant-supported rehabilitation. Full article

Background/Objectives: Subperiosteal implants (SPIs) were first used in the 1940s, but due to their complications and the rise of dental implants, they were discontinued. Thanks to new technologies and new materials, nowadays they are being used again and studied as a treatment for severe bone defects. This review analyzes the clinical results—survival rates and complications—of SPIs used to support full arch rehabilitations of severely resorbed maxillae and mandibles, comparing the outcomes resulting from implant placement conducted in one or two surgical interventions. Methods: An automated search was conducted in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library), as well as a manual search for relevant clinical articles published before 28 February 2025. The review included human studies with at least four patients, in which SPIs were placed to restore full-arch edentulous maxillae and mandibles. Quality of evidence was evaluated using the Newcastle–Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Results: A total of 14 studies met the inclusion criteria and were included for analysis, including 958 patients and 973 SPIs. The survival rate was 100% when one surgical intervention was performed and 85% when two interventions were performed after 4–38 months and 3–22 years follow-up, respectively. Conclusions: SPIs would appear to offer a good alternative for patients with severe bone atrophies, especially SPIs fabricated using digital techniques in a single step, presenting promising survival rates and a low complication rate, although more randomized clinical trials with long-term follow-up are needed. Full article

Background: This study aimed to investigate the provision of dental care to patients admitted to a public tertiary hospital due to SARS-CoV-2 infection. Methods: A chart review was conducted using medical records of patients admitted with a confirmed diagnosis of SARS-CoV-2 infection at a public tertiary hospital. Patients hospitalized for at least 10 days were included, and data were collected on demographic variables, comorbidities, oral health status, and hospitalization outcomes. Results: A total of 295 patients were included (mean age 60.8 ± 17.4 years). Comorbidities were common, with 29.8% of patients diagnosed with diabetes and 53.3% with hypertension. Only 47.5% of patients received an oral health assessment upon admission, and 58% received oral hygiene care during hospitalization. Oral health evaluations revealed that older adults exhibited significantly higher rates of total edentulism, received more oral hygiene care during hospitalization, and were more likely to undergo oral evaluation at admission. Regarding clinical outcomes, patients with altered mouth opening had significantly lower Glasgow Coma Scale scores (p < 0.001), and those with altered oral mucosa showed reduced oxygen saturation levels (p = 0.006). Conclusions: These study findings highlight the importance of dental care in critically ill COVID-19 patients, particularly in ICU settings. It emphasizes the need for improved dental documentation and integration of dental professionals into hospital-care teams to reduce complications and enhance both oral and systemic health outcomes. Full article

Background/Objectives: Digital workflows for implant-supported full-arch restorations remain challenging. This study evaluated the accuracy and precision of digital impressions using reverse scan body (RSB) prototypes and intraoral scanners (IOSs) for rehabilitating fully edentulous patients following the All-on-4 protocol. Secondary objectives included comparing accuracy between expert clinicians and beginners, as well as desktop scanners and various RSB designs. Methods: An in vitro study was conducted using a fully edentulous mandible model with four Osstem TSIII implants. A final-year dental student and an expert clinician captured digital impressions using IOSs and desktop scanners. Four groups were analyzed: (A) original scan bodies with the IOS, (B) short RSBs with the IOS, (C) RSBs with desktop scanners (short sandblasted, long sandblasted, long coated), and (D) a control group using original scan bodies with a desktop scanner. Root mean square (RMS) values measured dimensional differences, with statistical analysis performed using the Wilcoxon signed-rank test and one-way ANOVA (α = 0.05). Results: A total of 42 scans were analyzed. No significant difference was found between expert and student for original scan bodies using the IOS (p = 0.220), while RSB prototypes showed significant differences (p = 0.008). No significant accuracy differences were noted between original scan bodies and RSBs with the IOS, but IOSs outperformed desktop scanners. Among RSBs scanned with desktop scanners, no significant differences were observed between designs. Conclusions: RSB prototypes are a viable alternative to original scan bodies for fully digital workflows in All-on-4 rehabilitations, with IOSs offering superior accuracy. However, proper training is crucial for optimizing RSB accuracy. Variations in height and coating did not impact overall accuracy. Full article

Background: Autogenous bone grafting has long been the standard for augmenting bone prior to implant placement in atrophic ridges. However, innovative techniques are continually sought to enhance outcomes. This study introduces the honeycomb technique for horizontal bone augmentation in edentulous posterior mandibular ridges, presenting the methodology and long-term follow-up results of this novel approach. Methods: This study includes healthy patients with moderate to severe horizontal atrophy in posterior mandibular regions who underwent bone augmentation using the honeycomb technique and were followed up for a period of 10 to 14 years. The patients had orthoradiographs immediately post-surgery and underwent regular clinical and radiographic evaluations. Computed tomography at four months assessed the bone gain, followed by reentry for implant insertion and evaluation of the bone volume and quality. Fixed prosthesis-supported dental implants were placed four months post-insertion. The survival and success of the dental implants were evaluated based on the acceptable clinical and radiographic criteria. Results: A cohort of 23 patients (17 women, 6 men, mean age 47 years) underwent bone augmentation at 39 sites, with follow-up ranging from 10 to 14 years. The procedure demonstrated a 95–100% success rate with minimal morbidity and horizontal bone gain averaging 3–8 mm. Partial graft exposure occurred in two cases but was successfully managed without compromising augmentation. A total of 103 implants were placed in the augmented sites in 37 sites. The long-term survival of the dental implants was confirmed based on clinical and radiographic evaluation, with minimal marginal bone loss observed during the extended follow-up period. Conclusions: The honeycomb technique proves effective in horizontal bone augmentation of atrophic ridges in posterior mandibular defects. The satisfactory long-term outcomes validate its potential as a valuable addition to bone augmentation strategies preceding implant placement. Full article

Background/Objectives: Excessive occlusal forces manifest in bruxism and have consequences on teeth and jaws. The aim of this study was to determine the association of bruxism with clinical and radiological signs of excessive occlusal forces, such as tooth wear, fatigue dental fissures and fractures, abfraction, masseter muscle hypertrophy, and bone apposition at the mandibular angle. Methods: This cross-sectional clinical study included 181 patients presented for treatment in a general dentistry clinic. For each patient, data were extracted from the dental chart, as follows: demographic data (sex, age, and smoking), clinical data (number of teeth present, Eichner edentulous score, TWI wear score, number of fractured teeth, number of teeth with abfraction, presence of masseter hypertrophy, presence of hypersensitivity), and radiological data (bone apposition at the mandibular angle). The patients were divided into two groups according to the presence or absence of bruxism. A binomial logistic regression model was run to determine the association between bruxism and clinical and radiological signs of excessive occlusal forces. The data were statistically processed in SPSS. Results: In total, 99 women and 82 men with mean age 44.87 ± 12.67 were included in the study. Compared to the group without bruxism, the group of patients with bruxism (39.78%) showed statistically significant higher tooth wear index (TWI) (p < 0.0005), a higher number of fractured teeth (p = 0.037), a higher number of teeth with abfraction lesions (p = 0.001), and a significantly higher bone apposition score (p < 0.0005). The binomial logistic regression model showed a high prediction bruxism score for masseter muscle hypertrophy (15 times, p < 0.0005), for tooth wear index (almost 7 times, p = 0.010), and for bone apposition score (almost 3 times, p = 0.044). Conclusions: Patients with bruxism showed masseter muscle hypertrophy, higher attrition-type tooth wear index, and more teeth with fatigue fractures and abfractions than those without bruxism. Bruxism clinical signs were positively correlated with a higher bone apposition score. Full article

Background: Dental implantology is the greatest popular choice for the treatment of partial or total edentulism. However, despite its apparent simplicity, it represents a technique that necessitates adequate surgical knowledge and significant technical skills. There are several potential complications related to dental implant surgery and some of these can be particularly dangerous. The aim of the present study is to make a comprehensive review of head and neck abscess as a complication of dental implant infections and the consequent medical and therapeutic approach. Case report: A case of submental abscess related to peri-implantitis is presented from the hospital access to the emergence surgical treatment and medical therapy. The patient presented with painful swelling in the right submental and submandibular region. The surgical procedure included both an extraoral and intraoral approach. Extraorally, a right paramedian submental incision was performed. Intraorally, after removal of the fixed prosthesis screwed to a single implant, a muco-periosteal flap was elevated in correspondence of the third and fourth quadrants to allow implant exposure. All implant sites of infection and possible complications were removed. Then, Penrose-type drains were positioned intraorally and extraorally. Results: The patient remained hospitalized for ten days for clinical conditions assessment, the wounds were treated, and the drains replaced. Laboratory tests showed that neutrophils and PCR returned to normal values, indicating an interruption of the inflammatory process. The patient was discharged in good general and local clinical conditions with dedicated therapy. Conclusions: At 5-month follow-up the swelling had vanished and tissues appeared normotrophic and healthy. However, a computed tomography (CT) scan of the lower arch showed significant generalized bone loss at the mandibular level compatible with a state of advanced bone atrophy. The early diagnosis and treatment of these complications is fundamental for the patient prognosis. Full article

Background: Transalveolar sinus floor elevation (TSFE) is a surgical technique for the placement of dental implants in patients with reduced height of the maxillary posterior alveolar bone. This study aims to demonstrate the clinical outcomes of TSFE using the minimal invasive sinus elevation (MISE) technique in partially and totally edentulous maxillary patients. Methods: This prospective clinical study followed STROBE guidelines. TSFE was performed using the MISE technique with the simultaneous placement of implants. Dental implants were loaded at 6 months. Maxillary vertical bone gain was measured by CBCT, and marginal bone loss was assessed by periapical radiographs. Results: Ninety-one patients, with a mean age of 62.1 ± 11.8 years, were treated with TSFE and the placement of 107 implants, with a mean follow-up of 96.2 ± 11.7 months. An increase of 4.3 ± 0.4 mm in bone height was achieved, with a dental implant cumulative survival rate of 97.2%. Peri-implantitis was observed in 9.3% of implants, and membrane perforation occurred in 7.7% of cases. Technical complications were noted in 5.5% of patients. Conclusions: Within the limitations of this clinical study, it can be concluded that the MISE technique is a successful protocol for the placement of implants in the posterior maxilla with reduced height of the alveolar ridge, with a rate of biological and prosthetic complications below 10% over an average follow-up period of 8 years. 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

Given the rising global population of older adults and their association with edentulism and the use of complete removable prostheses [CRP], it is imperative to pursue solutions for issues such as the relationship between poor diets and masticatory deficiency. Objective: To examine the research on the efficacy of dietary counseling in enhancing mastication and nutrition in older adults with CRP. Methods: A systematic literature review was performed in the PubMed, Trip, and Web of Science databases. Results: 812 results were retrieved from the databases, from which 6 clinical studies that fulfilled the qualifying criteria were selected. The selected studies reported reduced nutrition in patients with CRP due to impaired masticatory function. Research suggests that employing basic dietary guidelines or simplified nutritional recommendations enhances the masticatory function of patients with CRP, thereby ensuring sufficient nutritional intake. Conclusion: Dietary counseling improves nutritional intake and masticatory function in patients with CRP. This would allow simple dietary advice to be given to patients with total prostheses in clinical practice. Further randomized clinical trials are recommended to increase the available evidence. Full article

Background and Objectives: Oral rehabilitation seeks to enhance mastication, a vital component of oral function that is compromised by tooth loss. This study aimed to assess the degree of improvement of masticatory performance in partially edentulous patients rehabilitated with removable partial dentures (RPD) or fixed partial dental prosthesis (FPDP). Changes in the occlusal contact area (OCA) and satisfaction with their chewing ability during the adaptation period were also evaluated. Materials and Methods: in total, 34 partially edentulous participants (median age 65.3 years; 56% women) who received an RPD or FPDP were assessed using masticatory performance assay, OCA calculation, and a visual analog scale (VAS). Results: Masticatory performance improved by 20% (range from 17% to 25%, p < 0.05) depending on the edentulism and the rehabilitation types. The OCA improved by 4.7 mm² (p < 0.05) and satisfaction with the masticatory function improved by 9% (p < 0.05) 3 months after prosthesis insertion. Conclusions: Conventional prostheses benefited partially edentulous individuals, improving masticatory performance by 20%. Treatment also increased the OCA in all types of partial edentulism, except in Kennedy class I patients rehabilitated with RPD. Patients’ satisfaction with their chewing ability only increased in Kennedy class III patients rehabilitated with RPD. Full article

The purpose of this clinical epidemiological investigation was to examine the oral health conditions of homeless people in the city of Rome, Italy. A total of 157 homeless subjects were subjected to a first dental visit, during which anamnestic information was recorded in a digital medical record. A diagnosis of dental disorders was performed by assessing oral hygiene conditions, periodontal health, the presence of caries and/or root residues, and the presence of partial and/or total edentulousness. Caries and missing teeth were evaluated by the DMFT index. The first major criticality was represented by poor or absent oral hygiene. The examined sample showed a major percentage of high DMFT (63.0%); the most common clinical condition was the presence of numerous root residues. Regarding periodontal health, 73.2% of patients had gingivitis, 21.6% periodontitis, while 11 patients had periodontal pathologies with tooth mobility (7%). Finally, 8.9% of patients had one or two missing elements, 22.9% had partial edentulousness, and 8.9% of the sample had total edentulism. This analysis provides an important basis for strengthening health promotion and the importance of accessible and effective care for this population. It will therefore be necessary to continue to adopt a patient-centered approach geared towards addressing the demands that this population faces in maintaining their oral health. Full article

Background: For optimal clinical outcomes in full mouth rehabilitations, it is vital to determine the optimal jaw relations and confirm the appropriate vertical dimension of occlusion (VDO). The current study aims to evaluate various facial measurements as an adjunct in determining VDO in dentate individuals. Methods: A total of one hundred and twenty subjects, sixty males and sixty females, of the age group 19-30 were selected for the study. VDO (chin–nose distance) and other facial measurements like the glabella to subnasion (G-S) distance, both right and left pupil to rima oris (P-R) distance, both right and left corner of mouth to outer canthus of eye (M-E) distance, and both right and left ear to eye (E-e) distance were measured using a Vernier caliper. Results: The mean ± standard deviation of the C-N distance, G-S distance, right P-R distance, right M-E distance, left M-E distance, right E-e distance, and left E-e distance were 67.70 mm ± 3.22 mm, 60.29 mm ± 3.67 mm, 65.99 mm ± 3.72 mm, 66.00 mm ± 3.91 mm, 69.51 mm ± 3.71 mm, 69.48 mm ± 3.68 mm, 69.59 mm ± 3.98 mm, and 69.51 mm ± 3.95 mm, respectively. Pearson’s correlation coefficient between the C-N distance and M-E distance was found to be 0.739 (right), 0.730 (left); that between the C-N distance and E-e distance was found to be 0.738 (right), 0.732 (left); that between the C-N distance and P-R distance was found to be 0.660(right), 0.670(left); and that between the C-N distance and G-s distance was found to be 0.417. Conclusions: The present study reported a high positive correlation between the chin to nose distance and the distance between both the right and left lateral corner of the mouth to the outer canthus of the eye, and the distance between both the right and left ear to the eye. Hence, these measurements can be used as an adjunct for establishing VDO in the edentulous patient. Full article

Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra axial forces, abutment tooth fracture is a common cause of failure for TCDs; thus, PC treatment is often needed to refit the existing telescopic crown (TC). However, there are no clinical survival data on whether the PC treatment was used to refit the TC after abutment tooth fracture (PC2) or the PC was already fitted at the time of TCD treatment (PC1). A total of 246 patients with 399 PC treatments were retrospectively evaluated for follow-ups up to 17.33 years. The files were analysed for PC1 and PC2. Furthermore, the influence of the jaw, type of tooth, luting material, PC material, bone attachment, therapist and cause of failure was recorded. For statistical analysis, Kaplan–Meier and Cox regression analyses were conducted. PC2 showed highly significant lower survival probabilities than PC1 (p < 0.001). Moreover, the bone attachment and the age of the patient at the time of fitting the PC crown had an influence on the survival (p < 0.001). Therefore, PC2 should be carefully discussed with the patient and PC1 should be favoured in endodontically treated abutment teeth for TCDs. Full article