Purpose: This study was conducted to evaluate patient satisfaction & percentage of occlusal force distribution patterns in CAD/CAM and conventional dentures. Materials & Methods: Twenty completely edentulous patients were selected from the outpatient clinic, Faculty of dentistry, Cairo University. Patients were selected with moderately developed residual ridges, sufficient inter-arch space, no muscular disorders & with previous denture experience. Patients were randomly divided into two groups (I) & (II). Group (I): Patients had received CAD/ CAM complete dentures. Group (II): Patient had received conventionally constructed complete dentures. Patient satisfaction was evaluated in the two studied groups following certain items with the aid of a questionnaire after one week, one month & three months. T-scan device was utilized to evaluate occlusal force distribution in the two studied groups one week after denture insertion. Occlusal adjustment was made after occlusal forces analysis to re equilibrate occlusal force distribution. Mean values were recorded, tabulated & statistically analyzed. Results: The results of this study revealed that patients were more satisfied with CAD/ CAM complete dentures than conventional dentures. Occlusal force % was significantly decreased in anterior area of the dentures in both studied groups after occlusal equilibration made after occlusal adjustment. The % of occlusal force was better distributed on the posterior right & left areas in Group (I) & (II). However, CAD/CAM dentures had shown significantly less % force in the anterior area & better force distribution in the posterior areas than conventional ones especially after T scan analysis & occlusal re-equilibration. Conclusions: Within the limitations of the present study it may be concluded that: • Patients may be more satisfied with CAD/ CAM than conventional dentures. • CAD/CAM denture may provide better occlusal force distribution patterns than conventional ones. • T-Scan computerized occlusal analysis helps to obtain bilateral balanced occlusion in complete dentures.
Purpose: This study was an in in-vitro study conducted to compare the stress distribution pattern in implant retained maxillary obturators with three different attachment systems with the aid of three dimensional finite element analysis.Methods: CT scan was made for a patient with hemi-maxillectomy defect. The CT scan file was exported to a personal computer with Materialize Mimics 10.01 program (Materialize, interactive medical image (Materialize Leuven, Belgium). Mimics were utilized to modify the CT scan of the maxilla to construct 3-D model with Solid Works, Concord, Massachusetts, USA) for finite element stress analysis. All components of the models were constructed thereafter, superimposed till construction of maxillary obturator models. Three implants were inserted in the alveolar bone on the intact side. Ball & Nova-lock locator/ bar attachment systems were simulated according to their structural configurations. A static load of 100 N load was applied vertically & obliquely on the defect side. ANSYS program (Canonsburg, PA, USA) was utilized to solve the problems, The resultant Von Misses stresses in bone surrounding implants were evaluated and compared in the 3 studied models.Results: The highest Von Misses stresses were found in cortical bony layers around the implant adjacent to defect & the least stresses at the area of 3 rd implant. Nova-lock retained implant obturtors had recorded the least Von Misses stresses (20. 479 &21.675 Mpa) in comparison to Ball (40.762 & 41.488 Mpa) & locator bar attachment systems (43.526 & 47.203 Mpa) under vertical & oblique load application respectively. All models had shown the highest stresses on oblique load application on the defect side.Conclusions: Within the limitations of this study various conclusions could be drawn: • The load direction has more important role than the attachment type in stress distribution pattern in implant retained maxillary obturators. • Nova-lock attachment system may induce the least stresses onto implant/ bone interface followed by Ball & locator bar attachment systems. • The Locator/ bar attachment may allow better stress distribution in implant retained maxillary obturators than other Bar systems.
Objective: The purpose of this RCL was to evaluate bone height changes around hybrid implants in three implant-retained mandibular overdenture with locator attachment. Materials & Methods: Ten completely edentulous male patients were enrolled in this study. Preoperative Cone beam computed tomography (CBCT) had been made to evaluate bone height & density in areas for implant installation. Patients had received three hybrid implants installed in midline & mandibular canine areas following flapless technique. Implants were early loaded; two weeks after implant installation. Overdentures were functionally fitted onto the locator attachment of the hybrid implants by direct pickup technique. Evaluation: Bone height changes were evaluated with the aid of CBCT at the time of implants' loading, six months and twelve months later. Mesial & distal crestal bone heights were calculated from reconstructed corrected sagittal views. Results: The results had revealed that there was no significant difference in peri-implant bone level throughout the follow-up periods on comparing the three implant sites. However, there was slightly higher bone resorption around the distal implants than the midline ones. Conclusions Three implant retained overdentures with locator attachments may preserve periimplant bone in the anterior mandibular area. Midline implant in three implant overdentures may not be subjected to more stresses than the two distal implants (356)
Background: With the advance of the dental implants, the retention and stability of mandibular complete denture have been improved to a large extent. The implants could be placed interforaminally or in anterior and posterior ridge areas. The placements of the implant in the molar area increase denture support that reflects on improvement in patient mastication and muscles activity. Aim: This study was conducted to evaluate the effect of the distribution of the miniimplants (MIs) on electromyographic (EMG) activity of masticatory muscles and overall patient satisfaction. Materials and Methods: Ten completely edentulous male patients with severely resorbed mandibular ridge were enrolled in this study. Patients were randomly divided into two equal groups. Group (I and II) according to the MIs and distribution pattern. Group (I): Five patients had received four mini-dental implants in interforaminal area. Group (II): Five patients had received four mini-dental implants (two implants in the interforaminal area and two implants in the molar areas). All patients had received implant overdentures. Overdentures were connected to the MIs with O-ring attachments. For each patient, the EMG activity of masticatory muscles and a survey of therapeutic satisfaction before and after connection to the MIs was evaluated. Results: The MI-retained overdentures of the Group II in which the implants placed in the interforaminal area and molar areas showed significant lower EMG values than Group I with soft and hard foods as well as clenching. Conclusions: The distribution of MIs plays a role in the muscle activity, and the placement of implants in the molar area improves the muscle activity and patient satisfaction. Clinical Significance: The placement of MIs to retain mandibular complete denture improves muscles activity and patient satisfaction, particularly, if placed in both anterior and molars areas.
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