The aim of this study was to evaluate the biomechanical impact, in terms of stress and displacement, at the level of a mandibular overdenture, on four mini dental implants (MDIs) after the loss of an implant. A three-dimensional virtual model was obtained by scanning the overdenture, and a biomechanical analysis was carried out, using the finite element method (FEM). The displacements of the overdenture and the equivalent von Mises stresses were evaluated using logarithmic scales. In the case of a mandibular overdenture on four MDIs inserted in the interforaminal area, the frontal loading generated the lowest values for the von Mises stresses, and the bilateral loading generated the least displacement when two implants were inserted in the canine area and two in the molar area. The highest von Mises stress was observed during frontal loading in the situation of the mandibular overdenture on four MDIs, two of which were inserted in the canine area and two in the molar area, following the loss of an implant in the canine area. The largest displacement was noted in the mandibular overdenture on four interforaminal MDIs during unilateral loading, following the loss of a distally inserted implant. The FEM analysis showed aspects that correlated with clinical observations, with predictive value. The concentration of von Mises stresses, and the occurrence of some displacements of the prosthodontic restoration, can explain the emergence of some complications in the overdenture’s biodynamics, and the increased risk of fracture. Complications can be prevented by choosing a certain number of implants and a topographical distribution correlated with biomechanical aspects, and by proposing a correct occlusal scheme with optimal functional loading.
This study aimed to assess the perception of dentists on the complications associated with prosthodontic treatments with acrylic dentures and overdentures in partially or complete edentulous patients. The study analyzed the complications of acrylic dentures and overdentures using a questionnaire with 24 open or closed questions, with single or multiple answers. The participants were 63 dentists, mostly women (77.8%), aged between 30 and 39 years old (52.4%), more than half of them with a clinical experience of less than 15 years. The main complications encountered were: lesions of the oral mucosa (52.4%), lack of maintenance (44.4%) or stability of dentures (39.7%), fracture of acrylic bases (14.3%), and detachment of attachment systems (44.4%). The complete maxillary acrylic dentures fractured most often (38.1%), frequently on the midline (58.7%), the main causes being accidental fall, masticatory stress, or lack of stability of the dentures. The most common intervention to correct the complications of dentures was the repair of fractured acrylic bases (33.3%). The study exposed that dentists are aware of the possible complications of acrylic dentures, which they correlate with the peculiarities of oral structures, but also with some deficiencies of prosthodontic restorations, materials and technologies. Maxillary acrylic dentures, overdentures, and partial acrylic dentures have a high risk and fracture rate, but the use of new technologies and materials can reduce the complications rate of acrylic dentures and overdentures.
This study aimed to highlight the perceived associations between general and oral pathology, among clinicians of different specialties. Data was collected through a questionnaire with 22 questions, with single or multiple answers, to 88 dentists, general practitioners, or pediatricians. The majority of participants were women (89.8%), aged between 30 and 39 years (52.3%), with a professional experience mostly under 10 years (61.3%). Many doctors considered that there was an association between oral and general pathologies (39.8%). The most common general pathologies associated with oral pathology were digestive disorders (n=21, 23.9%), followed by cardiovascular, genetic, endocrine and metabolic, neuropsychiatric, respiratory, hematological, immunological, and oncological pathologies. Tooth decay was mainly found in patients with digestive, respiratory, or neuropsychiatric disorders, and periodontal disease was more common in patients with obstetric disorders. Diseases of the oral mucosa, such as canker sores and gingivostomatitis, were more common in patients with digestive pathology, endocrine and metabolic, or reproductive disorders. The study pointed out that physicians, regardless of their medical training, often observed a relatively rich general pathology associated with oral conditions. It is important to differentiate between primary and secondary oral pathology, associated with general pathology and medication, establishing a correct diagnosis of the disease and treatment according to general or oral diseases and their manifestations.
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