Thaís Marques Simek Vega Gonçalves

Mastication Improvement After Partial Implant-supported Prosthesis Use

Partially edentulous patients may be rehabilitated by the placement of removable dental prostheses, implant-supported removable dental prostheses, or partial implant fixed dental prostheses. However, it is unclear the impact of each prosthesis type over the masticatory aspects, which represents the objective of this paired clinical trial. Twelve patients sequentially received and used each of these 3 prosthesis types for 2 months, after which maximum bite force was assessed by a strain sensor and food comminution index was determined with the sieving method. Masseter and temporal muscle thicknesses during rest and maximal clenching were also evaluated by ultrasonography. Each maxillary arch received a new complete denture that was used throughout the study. Data were analyzed by analysis of variance for repeated measures, followed by the Tukey test (p < .05). Maximum bite force and food comminution index increased (p < .0001) after implant-supported dental prosthesis and implant fixed dental prosthesis use, with the higher improvement found after the latter’s use. Regardless of implant-retained prosthesis type, masseter muscle thickness during maximal clenching also increased (p < .05) after implant insertion. Partial implant-supported prostheses significantly improved masseter muscle thickness and mastication, and the magnitude of this effect was related to prosthesis type (International Clinical Trial Registration RBR-9J26XD).

Implant retainers for free-end removable partial dentures affect mastication and nutrient intake.

OBJECTIVES This study measured swallowing threshold parameters and nutrient intake in partially dentate subjects rehabilitated by conventional free-end removable partial dentures (RPD) and by RPD over posterior implant retainers and ball attachments (BA). MATERIALS AND METHODS Eight subjects (two men and six women; mean age 60.1 ± 6.6 years old) received conventional total maxillary dentures and free-end RPD in the mandible. Two months after denture insertion, swallowing threshold and nutrient intake assessments occurred, which included an evaluation of the number of masticatory cycles and medium particle size (X₅₀) of a silicone test material (Optocal). A 3-day food diary verified nutrient intake based on a standard Brazilian Food Composition Table. Then, osseointegrated implants were placed bilaterally in the mandibular first molar region, followed by BA, which was fitted in the RPD bases after healing. After 2 months of the RPD over implants and BA use, variables were again assessed. Wilcoxon signed rank tests evaluated the data (P < 0.05). RESULTS Masticatory cycles did not differ (P > 0.05); however, subjects showed decreased X₅₀ values at the swallowing moment (P = 0.008) and increased daily energy (P = 0.008), carbohydrate (P = 0.016), protein (P = 0.023), calcium (P = 0.008), fiber (P = 0.016), and iron (P = 0.016) intake with RPD implants and BA inserts. No differences were found in fat consumption (P > 0.05). CONCLUSION Implants and BA retainers over a free-end RPD resulted in smaller swallowed median particle size and improved nutrient intake.

IMPLANT RETENTION AND SUPPORT FOR DISTAL EXTENSION PARTIAL REMOVABLE DENTAL PROSTHESES: SATISFACTION OUTCOMES

STATEMENT OF PROBLEM The rotational movements of the distal extension denture base of partial removable dental prostheses frequently harm the prosthesis stability, leading to discomfort during function. PURPOSE This study evaluated the use of distal implants to retain and support partial removable dental prostheses and assessed the outcomes with respect to specific aspects of patient satisfaction. MATERIAL AND METHODS Twelve participants (mean age, 62.6 ± 7.8 years) received new conventional mandibular partial removable dental prostheses and complete maxillary dentures. After 2 months of conventional prosthesis use, the participants completed a questionnaire assessing their satisfaction. Implants were then inserted bilaterally in the mandibular posterior region and, after 4 months, ball attachments were placed on the implants and on the partial removable dental prosthesis acrylic resin base. The implants and remaining teeth were followed up with clinical and image examinations. After 2 months, satisfaction was reevaluated, and the data were analyzed by the paired Student t test and the Bonferroni correction (α=.05). RESULTS Clinical evaluation found stable periodontal conditions around the implants, no intrusions or mobility of teeth, and no radiographic changes in bone level. Participants reported significant improvements (P<.05) in retention, comfort, masticatory capacity, and speaking ability after implant placement. CONCLUSIONS Implant-retained and -supported removable prostheses improve retention and stability, minimize rotational movements, and significantly increase participant satisfaction.

Nutritional effects of implant therapy in edentulous patients--a systematic review.

Purpose:The aim of this study was to present all the relevant studies that have evaluated, with valid scientific methodology, the possible physical and nutrient intake improvement of edentulous subjects rehabilitated with removable and supported or retained implant denture, without restriction of suprastructure modalities, compared with those wearing conventional removable dentures. Methods and Materials:Several electronic databases (Pubmed, Medline—Medline In-Process, Cochrane Library Database, Embase, and Lilacs) were searched, without language limitation. References from the selected articles were also hand searched. Abstracts which appeared to fulfill the initial selection criteria (comparison of nutritional state between conventional removable and supported or retained implant denture wearers) were selected by consensus and their original articles were then retrieved. Clinical trials that included anthropometric measurements or nutrient intake in removable and supported or retained implant denture wearers without syndrome and systemic influences, nor presenting surgical or other simultaneous treatment, which could affect the integrity during the evaluation period were finally selected. Results:Only 5 articles met the selection criteria. Two studies (randomized clinical trials and prospective) found inadequate nutrient intake after treatment. One randomized clinical trial presented an improvement in nutritional state after treatment. One cross-sectional study showed an adequate nutritional state before and after treatment. These 4 studies found no significant difference between implant and conventional treatments. Finally, 1 cross-sectional study presented a difference between treatments, showing that the risk of malnutrition was higher for removable complete denture wearers. Conclusion:Considering the available evidence, the effect on the nutritional state in edentulous subjects treated with implant therapy is similar to the 1 obtained with conventional removable dentures. This effect does not necessarily mean an optimum nutritional state, which also depends on other factors not related to prosthodontic treatment.

Mastication and jaw motion of partially edentulous patients are affected by different implant-based prostheses

The main goal of prosthetic treatment is to restore masticatory function. However, insufficient evidence supports the recommendation of one specific prosthetic intervention for partially edentulous patients. Function after the use of three different prostheses by the same partially edentulous subject. Mastication was assessed in 12 subjects (mean age 62.6 ± 7.8 years) after they had used removable partial dentures (RPDs), implant-supported partial dentures (IRPDs) and implant-fixed partial dentures (IFPDs). Masticatory ability (MA) was estimated by visual analogue scale questionnaire, while the mandibular chewing motion was evaluated by kinesiographic device, representing an objective measurement of masticatory function. Data were analysed by repeated-measures anova followed by Tukey-Kramer (P < 0.05). MA improved after IRPD and IFPD use (P < 0.05). Opening, closing and total cycle time duration were reduced after both IRPD and IFPD use (P < 0.05), irrespectively the implant prosthesis type. IFPDs and IRPDs restore the masticatory function of partially edentulous patients better than RPDs.

Effect of vitamin E levels on the cell-mediated immunity of broilers vaccinated against coccidiosis

Studies on the relationships between animal nutrition and immunity have sought reliable methodologies to measure responses. Cellmediated immune response is similarly studied in humans. The cutaneous basophil hypersensitivity test (CBH) is one of the methods to measure that response and consists in the infiltration of inflammatory cells, particularly of lymphocytes and basophils, as result of the application of substances capable of inducing cell proliferation in determined sites, such as wings, wattle, and interdigital space in birds. CBH is considered a simple and fast method and can be applied in birds of different ages. In immunocompetence studies with poultry, phytohemagglutinin-P (PHA-P) is a commonly used substance, despite the variability of the response related to the method of application (intradermal injection) and the antigens used. In the present experiment, PHA-P was used to observe the cell-mediated immune response of 216 chicks fed three dietary levels of vitamin E from 1 to 36 days of age. All birds were immunologically challenged by vaccination against coccidiosis at three days of age and against Newcastle Disease (NCD) at 14 and 30 days of age. At 36 days of age, birds were submitted to the CBH test according to the methodology of Corrier & DeLoach (1990). Birds fed 65mg/kg of vitamin E presented lasting cell reaction (p £0.08), which indicates that this vitamin E level improved cell immune response of birds due to its antioxidant and immunomodulating properties. The use of this vitamin E level can be considered by nutritionists under practical conditions, aiming to improve broiler immunity.

Relationship between non-ulcerative functional dyspepsia, occlusal pairs and masticatory performance in partially edentulous elderly persons

OBJECTIVE To relate occlusal state, masticatory performance and non-ulcerative functional dyspepsia. BACKGROUND In spite of the relationship between gastric disturbances and number of present teeth being recognised, the influence of the number of occlusal pairs and masticatory performance, expressed as median particle size, has not been considered. MATERIALS AND METHODS Thirty-eight subjects (mean age = 71.8 ± 7.7 years) diagnosed with non-ulcerative functional dyspepsia were selected. A further 38 healthy subjects (mean age = 71.9 ± 7.0 years) acted as controls. Subjects were subdivided according to their number of occlusal pairs: (1) 0-4, (2) 5-9 and (3) 10-14. Masticatory performance was evaluated by using the sieving method. Data were analysed using 2-way anova and Bonferroni post-hoc, Chi-square and Odd ratio tests. RESULTS Subjects presenting with non-ulcerative functional dyspepsia and 0-4 occlusal pairs showed the lowest masticatory performance (p < 0.01). No association between the dyspepsia and the number of occlusal pairs (χ(2) = 0.48, p = 0.785) was observed, however results showed association between functional dyspepsia and masticatory performance (χ(2) = 4.07, p = 0.0437) presenting an odds ratio = 3.46 (Confidence Interval = 0.99-12.10). CONCLUSION Changes in masticatory performance were associated with the presence of non-ulcerative functional dyspepsia.

Implant-Supported Removable Partial Denture Improves the Quality of Life of Patients with Extreme Tooth Loss

This study aimed to evaluate oral health-related quality of life (OHRQoL) in partially dentate subjects, presenting extreme tooth loss in posterior region with missing post-canines, comparing the use of conventional removable partial dentures (RPDs) and implant-supported RPDs. OHRQoL was measured using the Brazilian version of the Oral Health Impact Profile. Twelve subjects presenting maxillary total and mandibular Kennedy Class I edentulism (mean age 62.6±7.8 years) first received complete maxillary dentures and conventional mandibular free-end RPDs. After two months, the subjects had their OHRQoL assessed. Osseointegrated implants were inserted bilaterally in the mandibular first molar regions, and after four months ball abutments were placed to support the free-end RPD. Two months later, the patients had their OHRQoL reassessed. Wilcoxon signed-rank test was used to evaluate differences in OHRQoL (α=0.05). Results showed improvement in all OHIP-49 domains (p<0.05) after associating implants to the RPD. The mandibular implant-supported free-end RPD significantly improved OHRQoL.

Multidisciplinary Therapy of Extensive Oligodontia: A Case Report

Oligodontia is a rare congenital disorder consisting in the absence of six or more teeth. This case report describes a multidisciplinary treatment approach for a 12-year-old male with absence of 11 permanent teeth. Prior to any procedure, all primary teeth were scheduled for extraction due to poor crown-to-root ratio. The treatment plan comprised two phases: 1. orthodontic and speech therapy aimed at overbite and anterior open bite adjustment, as well as tongue position improvement; and 2. prosthetic treatment by insertion of removable temporary partial dentures. The multidisciplinary treatment involving orthodontics, speech and prosthetic therapies have reestablished the masticatory function and aesthetics, allowing the patient to achieve greater self-esteem and better social acceptance.

Intra- and Extraoral Prostheses Retained by Zygoma Implants Following Resection of the Upper Lip and Nose

Upper lip cancers are infrequent lesions, being aggressive unless diagnosed and treated early. After the surgical resection, maxillofacial defects require special care in rehabilitation. This article describes the maxillofacial rehabilitation of an edentulous patient diagnosed with upper lip squamous cell carcinoma. The treatment consisted of a large amount of upper lip and nose tissue resection, followed by chemoradiotherapy. After the first surgical healing, zygoma implants were inserted in a two-step procedure. The maxillary and nasal prostheses were installed and fixed by a titanium framework. After 6 years follow-up, no recurrences were observed, and the patient did not develop metastases. Tissues around implants were in good health, and the prostheses remained well-fitted. The use of implant-retained prostheses improved the quality of life, and the patient was extremely satisfied with the final result. The implant-retained prostheses are well accepted by the patient, improving comfort and safety during function while recovering her esthetic apperance.