These findings suggest that the hygiene of the All-on-4 prostheses could be improved by maximizing the distances between the inserted implants in the jaw, minimizing the prostheses' palatal extension and guiding patients to optimize their oral hygiene practices targeting the palatal area of their prostheses.
Nonreduced bilateral anterior dislocation of the temporomandibular joint (TMJ) is an extremely rare condition, and its prosthodontic rehabilitation is a clinical challenge, especially in patients who refuse to or cannot undergo surgery. There are no previous clinical reports of successful or standardized prosthetic rehabilitation approaches for patients with this condition. This clinical report describes the successful prosthodontic management of an edentulous patient with nonreduced bilateral anterior dislocation of the TMJ.
Objective: To find an optimal force that can be loaded onto an orthodontic microimplant to fulfill the biomechanical demands of orthodontic treatment without diminishing the stability of the microimplant. Materials and Methods: Using the finite element analysis method, 3-D computer-aided design models of a microimplant and four cylindrical bone pieces (incorporating cortical bone thicknesses of 0.5, 1.2, 2.0, and 3.0 mm) into which the microimplant was inserted were used. Various force magnitudes of 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, and 4.0 N were then horizontally and separately applied to the microimplant head as inserted into the different bone assemblies. For each bone/ force assembly tested, peak stresses developed at areas of intimate contact with the microimplant along the force direction were then calculated using regression analysis and compared with a threshold value at which pathologic bone resorption might develop. Results: The resulting peak stresses showed that bone pieces with thicker cortical bone tolerated higher force magnitudes better than did thinner ones. For cortical bone thicknesses of 0.5, 1.2, 2.0, and 3.0 mm, the maximum force magnitudes that could be applied safely were 3.75, 4.1, 4.3, and 4.45 N, respectively. Conclusions: For the purpose of diminishing orthodontic microimplant failure, an optimal force that can be safely loaded onto a microimplant should not exceed a value of around 3. 75-4.5 N. (Angle Orthod. 2016;86:221-226.)
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