Oral rehabilitation with implants is an alternative to the provision of removable dentures in all patients for whom missing teeth require replacement. However, individuals with cognitive, mental health issues, and/or physical disabilities are often excluded from implant-supported prostheses because of the high perceived risk of failure linked to poor oral health, presence of parafunction, or systemic conditions.
The purpose of this cohort study was to describe the protocols, outcomes, and survival rates of oral rehabilitation with implant-supported prostheses in patients with cognitive and physical disabilities treated under general anesthesia (GA) in a French unit of Special Care Dentistry.
A retrospective cohort study was conducted on patient files. Data collected included demographics and information about the surgical and prosthetic phases of rehabilitation. Clinical and radiological reports were retrieved to establish the survival, success, and failure rates of implant placement according to the Health Scale for Dental Implants (HDSI) classification.
A total of 298 dental implants had been placed under GA in 57 patients between January 2007 and August 2021. The prevalence of technical and biological postoperative complications was found to be 14% and 13% respectively. Thirty implants were determined to be failures. The estimated survival time in the population studied for loaded implants was 144.7 months [138.0; 151.3]. The cumulative survival rate was estimated to be 86% at 157 months.
Implant-supported prostheses were found to be effective, and oral rehabilitation carried out under the conditions described was determined to be stable.
Visual shade selection in dentistry may be influenced by factors that include the background color and the illuminant.
The purpose of this clinical study was to evaluate the influence of using a gray background and a light-correcting device on visual shade selection.
Two experienced clinicians assessed the incisor color of 30 volunteers using the VITA 3D-MASTER shade guide. Visual analyses were carried out using or not (control) a gray background, with and without (control) a light-correcting device (Smile Lite). Furthermore, the use of a polarizing filter was evaluated. Data from a clinical spectrophotometer were defined as the standard instrumental analysis. The agreement and the similarity (based on the whitening indexes of tabs) were evaluated between instrumental and visual analyses. Statistical testing was conducted through ordinal logistic regression and repeated-measures ANOVA. The Shapiro-Wilk test was used to confirm the data distribution, and homogeneity of variance was assessed with the Levene test (α=.05)
The use of Smile Lite resulted in lighter tabs than indicated by the instrumental analysis, and the opposite was observed in its absence. The polarizing filter did not affect the results (P>.05). For similarity, the illuminant improved the results (P<.001). The gray background reduced the differences between visual and instrumental analysis only in the absence of the Smile Lite (P<.001).
The color similarity between visual and instrumental analysis improved with the use of a light-correcting device with or without a polarization filter. A gray background was useful only without the light-correcting device.
Computer-aided design and computer-aided manufacturing technology has been applied to the fabrication of maxillary obturator frameworks, both directly and indirectly. However, with earlier techniques, it was not possible to accurately determine the position of the framework conforming to the palate, an issue that has been resolved in current fabrication methods. Using the patient’s existing denture, prosthodontists can determine where the framework should be positioned in the defect area. This allows the obturator bulb to be hollowed, thereby reducing weight and making adjustment easier. The most appropriate position for the finish line can be determined by accurately establishing the arrangement of the artificial teeth as well as the most appropriate polishing surface morphology. In maxillofacial prosthetics, restoring proper articulation and the swallowing function through rehabilitation is important, and determining the proper palatal morphology enables good tongue movement and facilitates the restoration of adequate function. The lighter weight contributes to protecting the remaining teeth and improves patient comfort.
The process of removing ceramic veneers is difficult, time consuming, and invasive. However, although lasers should provide a straightforward method for the debonding of ceramic veneers, a systematic review is lacking.
The purpose of this systematic review and meta-analysis was to investigate the efficacy of the laser-assisted debonding of ceramic veneers.
A systematic search was conducted in Medline/PubMed, Cochrane, Scopus, and Web of Science databases. Then, an analysis was performed using the meta-analysis approach to investigate the efficacy of the laser-assisted debonding of ceramic veneers. Quality assessment of the included articles was carried out using the Cochrane Collaboration tool. For the meta-analysis, the RevMan 5.4 software program was used to perform a random-effects model of standardized mean differences with 95% confidence intervals.
A total of 1108 studies were identified, of which 627 studies were selected for title and abstract analysis. The qualitative analysis included 16 studies, of which 3 studies were used in the quantitative synthesis. In the meta-analysis, the shear bond strength of the laser groups was compared with that of the control group. A substantial level of heterogeneity was noted in the included studies (I2=67%, P<.001).
The findings suggest that erbium lasers have a significant immediate effect in decreasing the shear bond strength of ceramic veneers. Furthermore, with proper laser settings, veneers can be safely removed without damaging the underlying tooth structure.
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