The three attachment systems functioned well after 5 years. The magnets had a low maintenance requirement and high success rate, despite the relatively increased initial costs. Retentive anchor with titanium matrix and locator may be a better choice from a financial point of view, taking into consideration the initial low cost of the components and also the reduced number of complications.
The present study aimed to assess the eighteen month follow-up patient-centered outcomes of a simple and predictable protocol for 3D-printed functional complete dentures manufactured using an improved poly(methyl methacrylate) (PMMA)–nanoTiO2. A detailed morphological and structural characterization of the PMMA–TiO2 nanocomposite, using SEM, EDX, XRD, and AFM, after 3D-printing procedure and post-wearing micro-CT, was also performed. Methods: A total of 35 fully edentulous patients were enrolled in this prospective study. A 0.4% TiO2-nanoparticle-reinforced PMMA composite with improved mechanical strength, morphologically and structurally characterized, was used according to an additive computer-aided design and computer-aided manufacturing (CAD/CAM) protocol for complete denture fabrication. The protocol proposed involved a three-step appointment process. Before denture insertion, 1 week, 12 month, and 18-month follow up patients were evaluated via the Visual Analogue Scale (VAS, 0–10) and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT), with a higher score meaning poor quality of life. Results: A total of 45 complete denture sets were inserted. OHIP-EDENT scored significantly better after 18 months of denture wearing, 20.43 (±4.42) compared to 52.57 (±8.16) before treatment; mean VAS was improved for all parameters assessed. Conclusions: Within the limitations of this study, we can state that the proposed workflow with the improved material used is a viable treatment option for patients diagnosed with complete edentulism.
Color stability through wear and time, one of the most important esthetic factor, influencing patient�s acceptance of an acrylic removable prosthesis, was investigated in vivo in a limited number of studies and solely on prefabricated denture teeth.The aims of the present paper were to assess the color changes occurred with the commercially available PMMA for 3D printing technique, improved by doping with titania nanoparticles, and to evaluate the color stability and stainability of the PMMA with 0.4%TiO2 denture teeth, on denture wearers, over a period of one year. Ten patients rehabilitated with removable complete dentures or implant retained overdentures manufactured using a new nanopolymer, PMMA doped with 0.4% by weight of TiO2 as denture base and artificial teeth material and Digital Light Projection (3D printing) technology, were evaluated in the present study. The color of each denture was assessed with a spectrophotometer, before and after use, in CIE L*a*b* system. The before measurement was made on the positive control - PMMA with nanoTiO2 (PC), while the after was measured the color of the tooth after one year complete denture use. Negative control - PMMA without nanoTiO2 (NC) was also compared to PC and the following parameters were registered: Value (L), Chroma (C), Hue (H), redness/greenness (a) and yellowness/blueness (b). A color difference (DE) between 1.63 and 5.24 was measured for all patients, while for the NC DE was triple (17.65). The highest DE value for all denture wearers with TiO2 nanofiler inclusions was below the maximum acceptability threshold, in accordance to the patient�s subjective evaluation, who were unable to identify the color change.
The aim of the present study was to characterize and preliminary assess the cytotoxicity and genotoxicity of different PMMA-TiO2 nanocomposites suitable to be used for two-parts stereolithographic complete denture manufacturing. In order to improve mechanical and antibacterial characteristics of the materials for 3D printing dentures, two matrix materials consisting in commercially available solutions of poly(methyl methacrylate) (PMMA), referred as dent-PMMA respectively base-PMMA, have been doped with different amount of TiO2 nanoparticles: 0.4, 0.6, 1.0, and 4.0% by weight. The obtained nanocomposites were structural characterized and assessed for antibacterial activity, cytotoxicity and genotoxicity. The newly obtained nanocomposites presented a good inhibitory action against the considered bacterial species-Staphylococcus aureus, good biocompatibility under 4.0% by weight. The results of the preliminary studies on cytotoxicity and genotoxicity assessment recommends the use of 0.4% TiO2 dent-PMMA and base-PMMA for CAD/CAM additive manufacturing of two-parts complete dentures/overdentures.
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories.
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