Objectives: To assess the rate of biologic complications and implant survival in edentulous patie... more Objectives: To assess the rate of biologic complications and implant survival in edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.2 years (range: 1-12 years). Materials and Methods: A single-visit clinical and radiographic examination was performed to assess types and rates of biologic complications with ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Results: Of 457 rough surface dental implants supporting 71 IFCDPs (52 patients), six had failed, yielding an implant survival rate of 98.7% after a mean observation period of 5.2 years after definitive prosthesis insertion. The most frequent minor biologic complication was soft tissue recession (7.7% annual rate), inflammation under the IFCDP (7.4% annual rate), and peri-implant mucositis (6.3% annual rate). The most frequent major biologic complication was peri-implantitis (2.0% annual rate), in 46/457 implants (10.1%) supporting 19 IFCDPs and late implant failure (0.3% annual rate). The frequency of biologic complications was not statistically different between Group 1 and Group 2. The presence of high plaque index had significant effect on bone loss. Conclusions: After a mean exposure time of 5.2 years postdefinitive prosthesis insertion (range: 1-12 years), implant survival rate of 98.7% was achieved. The six implant failures in three patients occurred after 5 years and affected the prosthesis survival. Soft tissue recession was the most frequent minor biologic complication, whereas peri-implantitis was the most frequent major biologic complication. A 10year implant-based mucosal recession rate of 77% (95% CI: 68.2-87.9) and a 10-year implant-based peri-implantitis rate of 20% (95% CI: 16.9-24.9) were found. K E Y W O R D S biologic implant complications, dental implants, full arch implant prostheses, implant failure, implant fixed complete dental prostheses, implant survival
Panos Papaspyridakos, o qual elaborou a ideia do estudo e permitiu que eu a utilizasse para a ela... more Panos Papaspyridakos, o qual elaborou a ideia do estudo e permitiu que eu a utilizasse para a elaboração dessa tese. Além da ajuda com a análise clínica, esteve ao meu lado no desenvolvimento de cada etapa desse projeto e na elaboração dos artigos científicos. Sou muito grata por ter participado em seu grupo de pesquisa, pelo seu constante apoio e suporte, assim como pela sua amizade e companheirismo. Ao meu querido amigo italiano, Dr. Fúlvio Fratipietro, por toda a sua dedicação, tempo e auxílio com a avaliação dos pacientes, mas também por fazer dessa jornada muito mais divertida. Muito obrigada por sua amizade e apoio ("poor Thaisa"). Aos estatísticos, Dr. Sarah Pagni e Dr. Zuhair Natto, por toda a dedicação e paciência nesse extenso e intenso trabalho realizado. Essa pesquisa não poderia ser concluída sem vocês. Aos pacientes que abdicaram de seu tempo para fazerem parte dessa pesquisa, muito obrigada. Ao Programa de Pós-Graduação em Odontologia da PUCRS, na pessoa de sua coordenadora, Prof. Dra. Maria Martha Campos. Sou muito grata a todos os professores do Programa, principalmente Profa. Dra. Rosemary Sadami Arai Shinkai e Prof. Dr. Márcio Lima Grossi, professores da área de Prótese Dentária, assim como a todos os funcionários da pós-graduação. Ao diretor do Programa de Pós-Graduação em Prótese Dentária da TUSDM, Dr. Kiho Kang, por quem tenho uma grande admiração, por permitir meu envolvimento nas atividades diárias do programa, me receber com carinho e principalmente pelo profundo aprendizado. Ao técnico do laboratório de prótese dentária do Programa de Pós-Graduação da TUSDM, Mr. Yukio Kudara, por toda a paciência, gentileza, dedicação e atenção aos ensinamentos da utilização da tecnologia CAD/CAM e por sanar todas as minhas dúvidas quanto à confecção das próteses analisadas nesse estudo. À todos os alunos do Programa de Pós-Graduação em Prótese Dentária e Estética da TUSDM por me receberem com tanto carinho e respeito. Dentre eles Ezdehar, Hiam,
Prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients wearing bimaxillary complete dentures, removable partial dentures and in students with natural dentition
PubMed, 2013
Temporomandibular Disorder (TMD) has attained a prominent role within the context of dental care ... more Temporomandibular Disorder (TMD) has attained a prominent role within the context of dental care due to its high prevalence. The aim of this study was to evaluate the prevalence of signs and symptoms of TMD in students at the State University of West of Paraná (UNIOESTE) with natural dentition, and in patients with removable partial dentures and double complete dentures. A total of 210 randomly selected individuals of both genders were evaluated, being divided into three groups: seventy students at the UNIOESTE with natural dentition (Group 1), seventy patients with removable partial dentures (Group 2) and seventy patients with bimaxillary complete dentures (Group 3). The data were collected by a single examiner using the American Academy of Orofacial Pain questionnaire for triage, where a single affirmative response to any of the situations mentioned was enough to carry out clinical evaluation. Kolmogorov Smirnov, Mann Whitney, Chi-Square, ANOVA and Tukey's statistical tests were performed. The most prevalent signs and symptoms of TMD in Group 1 were pain or difficulty in chewing or talking, perception of recent change in bite and deviations during the course of mandibular movements. In Group 2 they were perceptions of recent changes in the bite, deflections in the mandibular movements, presence of joint sounds, pain during excursive movements and muscle tenderness. The most prevalent signs and symptoms in Group 3 were limited to mouth opening and poor stability and retention of at least one of the prostheses. Group 3 also reported having received treatment for headaches or facial pain with a high prevalence. Group 2 had the highest prevalence of signs and symptoms. Prevalence was similar in Groups 1 and 3.
Proceedings of the 34th SBPqO Annual Meeting Painel Aspirante e Efetivo PN0212 Influencia do mate... more Proceedings of the 34th SBPqO Annual Meeting Painel Aspirante e Efetivo PN0212 Influencia do material de confecção de laminados cerâmicos na distribuição de tensões utilizando o método de elementos finitos
A Deus, por ter me dado forças e iluminado meu caminho para que pudesse concluir mais uma etapa d... more A Deus, por ter me dado forças e iluminado meu caminho para que pudesse concluir mais uma etapa da minha vida. A minha família, a qual me apoia em todos os momentos, por todo amor e incentivo. Agradeço aquele que me acolheu de braços abertos, me conduzindo pelos caminhos da pesquisa com paciência e maestria: meu orientador, Prof. Dr. Eduardo Rolim Teixeira. Obrigada por sugerir um assunto pouco pesquisado na área de prótese dentária e abrir meus horizontes, assim como por sua atenção e dedicação na orientação de cada passo deste trabalho. Quero expressar o meu reconhecimento e minha admiração. Ao meu colega, Dr. Carlos Augusto Accorsi Ribeiro, pela amizade, companheirismo e total dedicação para a realização deste trabalho. Muito obrigada! Ao meu colega, Dr. Daniel Gonçalves Boeckel, por todo apoio e suporte dado para a realização desta pesquisa. Ao CNPq por disponibilizar a oportunidade de realizar esta pesquisa e curso.
Correlates of burnout in predoctoral dental students in the United States
Journal of Dental Education, Apr 19, 2023
ObjectiveThe purpose of this research was to investigate correlates of burnout among predoctoral ... more ObjectiveThe purpose of this research was to investigate correlates of burnout among predoctoral dental students in the United States.MethodsAll 66 dental schools in the US were invited to distribute a survey on topics such as demographics, year of dental school, and burnout to their predoctoral students. Burnout was assessed via the Maslach Burnout Inventory‐Human Services Survey, which has three subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Multivariable modeling was conducted via generalized linear models using the lognormal distribution to adjust for confounding.ResultsThe survey was completed by 631 students from 21 dental schools. When adjusting for confounding, students identifying as African American/Black (Non‐Hispanic) (regression coefficient [95% CI]: −0.13 (−0.23, −0.02]) or Asian/Pacific Islander (−0.08 [−0.13, −0.02]) reported feeling significantly lower PA than students identifying as white. Students identifying as female reported feeling significantly greater EE (0.18 [0.10, 0.26]), but significantly less DP (−0.26 [−0.44, −0.09]), than students identifying as male. Third‐ (0.28 [0.07, 0.50]) and fourth‐year (0.40 [0.17, 0.63]) students reported significantly higher EE than first‐year students, while second‐ (0.40 [0.18, 0.62]), third‐ (1.06 [0.59, 1.53]), and fourth‐year (1.31 [0.82, 1.81]) students reported significantly higher DP than first‐year students.ConclusionsRisk indicators for burnout among US predoctoral dental students may depend on the dimension of burnout. Identifying those at higher risk of burnout can facilitate the implementation of counseling and other effective intervention strategies. Such identification can also provide insight into how the dental school environment might be contributing to the marginalization of those at higher risk.
Avaliação clínica de próteses dentárias totais fixas implantossuportadas - Dados Preliminares
Correlates of burnout in predoctoral dental students in the United States
Temporomandibular Disorder (TMD) has attained a prominent role within the context of dental care ... more Temporomandibular Disorder (TMD) has attained a prominent role within the context of dental care due to its high prevalence. The aim of this study was to evaluate the prevalence of signs and symptoms of TMD in students at the State University of West of Paraná (UNIOESTE) with natural dentition, and in patients with removable partial dentures and double complete dentures. A total of 210 randomly selected individuals of both genders were evaluated, being divided into three groups: seventy students at the UNIOESTE with natural dentition (Group 1), seventy patients with removable partial dentures (Group 2) and seventy patients with bimaxillary complete dentures (Group 3). The data were collected by a single examiner using the American Academy of Orofacial Pain questionnaire for triage, where a single affirmative response to any of the situations mentioned was enough to carry out clinical evaluation. Kolmogorov Smirnov, Mann Whitney, Chi-Square, ANOVA and Tukey's statistical tests we...
Avaliação do desempenho clínico de próteses dentárias totais fixas implantossuportadas (PDTFIs) : estudo retrospectivo
A alta prevalencia de pacientes edentulos associada a pobre retencao das proteses totais convenci... more A alta prevalencia de pacientes edentulos associada a pobre retencao das proteses totais convencionais, combinada com as altas taxas de sobrevivencia de implantes dentarios e uma maior da demanda por odontologia estetica, resultou em um aumento no numero de restauracoes fixas fornecidas aos pacientes. Entretanto, como toda tecnica, esta tambem nao e ausente de falhas e essas podem ocorrer devido a problemas relacionados com a biomecânica do conjunto protese/implante. Essas complicacoes podem ser de origem biologica ou tecnica, sendo a primeira relacionada a processos que afetam os tecidos de suporte peri-implantar e a segunda a danos mecânicos do implante, componentes de implantes e proteses. Devido a escassez de estudos clinicos relatando complicacoes em proteses dentarias totais fixas implantossuportadas (PDTFIs), essa tese teve como objetivo avaliar taxas de sobrevivencia de implantes e proteses, assim como as principais complicacoes observadas em pacientes reabilitados com PDTFI...
Análise comparativa in vitro da citotoxicidade dos ácidos hialurônicos de alto e baixo peso molecular em enxertia óssea
Nas ultimas decadas, tecnicas envolvendo engenharia tecidual tem sido reportadas na literatura co... more Nas ultimas decadas, tecnicas envolvendo engenharia tecidual tem sido reportadas na literatura como opcao alternativa aos enxertos autogenos convencionais para correcao de defeitos osseos e posterior instalacao de implantes dentarios. Estas buscam basicamente um material que apresente as mesmas propriedades biologicas do osso autogeno sem seus fatores limitantes. Tal tecnologia necessita, entre outros componentes, de um scaffold para as celulas, onde o acido hialuronico, um glicosaminoglicano natural, parece ter caracteristicas adequadas para exercer este papel. Ele exerce funcoes biologicas diferentes dependendo do seu peso molecular, que pode ser classificado em alto (> 1000 kDa), baixo (de 50 a 1000 kDa) ou baixissimo (< 50 kDa). Alem disso, no organismo humano ha a presenca da hialuronidase, enzima que degrada o acido hialuronico em fragmentos menores, elementos estes que possivelmente podem influenciar a resposta celular. Desta forma, este estudo buscou avaliar, in vitro,...
Technical Complications and Prosthesis Survival Rates with Implant‐Supported Fixed Complete Dental Prostheses: A Retrospective Study with 1‐ to 12‐Year Follow‐Up
Journal of Prosthodontics, 2019
PURPOSE To report the rate of technical complications and prosthesis survival in a cohort of eden... more PURPOSE To report the rate of technical complications and prosthesis survival in a cohort of edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of at least 1 year. MATERIALS AND METHODS The single-visit examination included clinical and radiographic assessment, occlusal analysis, photographs and questionnaire assessing patient satisfaction in a cohort of 52 patients rehabilitated with 71 IFCDPs (supported by 457 implants). The IFCDPs were assessed for technical complications, number of implants and cantilever extension, retention type and prosthetic material type. Comparison was made between ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Kaplan-Meier survival curve analysis was carried out for assessment of prosthesis survival and was done for both Groups 1 and 2 separately. The Cox proportional hazard model was used for survival analysis, adjusting for a number of potential confounders, to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. Responses to patient satisfaction questions were compared with Fisher's exact test. RESULTS Out of 71 edentulous arches (52 patients) restored with IFCDPs, 6 IFCDPs had failed, yielding a cumulative prosthesis survival rate of 91.6 % after a mean observation period of 5.2 years (range: 1-12 years) after definitive prosthesis insertion. Three IFCDPs were lost due to implant failures after 5.8 to 11 years of functional loading. Additionally, 3 metal-resin IFCDPs failed due to technical complications. Minor complications were the most frequent complications observed, namely wear of the prosthetic material (9.8% annual rate) being the most common, followed by decementation of cement-retained IFCDPs (2.9%), and loss of the screw access filing material of the screw-retained IFCDPs (2.7%). The most frequently observed major complication was fracture of the prosthetic material (1.9% annual rate), followed by fracture of occlusal screw (0.3%), and fracture of framework (0.3%). The annual rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (n = 19/55) and 19.4% for metal-resin IFCDPs (n = 13/16), yielding a statistically significant difference between the 2 groups (p = 0.01). CONCLUSIONS After a mean exposure time of 5.2 years, 91.6% prosthesis survival rates were achieved (65 out of 71 IFCDPs). The most frequent minor technical complication was wear of the prosthetic material with estimated 5-year rate of 49.0%, while the most frequent major complication was fracture of the prosthetic material with estimated 5-year dental unit-based rate of 9.5%. The cumulative rates for "prosthesis free of minor complications" at 5- and 10-years were 60.5% (95% CI: 47.2 - 71.3%) and 8.9% (95% CI: 2.9 - 18.0%), respectively. The cumulative rates for "prosthesis free of major technical complications" at 5- and 10-years were 85.5% (95% CI: 73.0 - 92.5%) and 30.1% (95% CI: 12.0 - 50.6%), respectively. Presence of bruxism, and absence of a nightguard were associated with increased risk for chipping of the prosthetic material of the IFCDPs. This article is protected by copyright. All rights reserved.
INTRODUCTION: Several factors can lead to mechanical complications in implant-supported fixed com... more INTRODUCTION: Several factors can lead to mechanical complications in implant-supported fixed complete dentures (IFCD).CASE DESCRIPTION: This clinical report presents a clinical case of a maxillary IFCDP with recurrent mechanical complications and a possible causal interaction between patient’s intrinsic characteristics (bruxism and high occlusal force) and technical procedures (framework design, occlusal adjustment, interocclusal splint, and posterior occlusal support).CONCLUSION: The 3-year follow-up findings highlight the need for a comprehensive and systemic approach to manage a challenging case of an IFCD patient with moderate bruxism and high occlusal force.
Complications and survival rates of 55 metal-ceramic implant-supported fixed complete-arch prostheses: A cohort study with mean 5-year follow-up
The Journal of Prosthetic Dentistry, 2019
STATEMENT OF PROBLEM Long-term outcomes with metal-ceramic (MC) implant-supported fixed complete ... more STATEMENT OF PROBLEM Long-term outcomes with metal-ceramic (MC) implant-supported fixed complete dental prostheses (IFCDPs) are scarce. PURPOSE The purpose of this retrospective study was to assess the rate of biologic and technical complications in a cohort of edentulous patients treated with MC IFCDPs by residents after a mean clinical follow-up of 5 years (range: 1 to 12 years). MATERIAL AND METHODS Forty-one participants with 55 MC IFCDPs underwent a single-visit comprehensive examination that included a medical and dental history review and clinical and radiographic examinations. All supporting implants and prostheses were examined for biologic and technical complications. Life table analysis and Kaplan-Meier survival curves were calculated. RESULTS Of 359 moderately rough surface dental implants, 2 had failed in 1 patient after 11 years of functional loading, yielding a cumulative implant survival rate of 99.4%. Owing to the implant failure, 1 of 55 edentulous arches restored with IFCDPs failed, yielding a cumulative prosthesis survival rate of 98.2% after mean observation period of 5.0 years. Soft tissue recession was the most frequent minor biologic complication (annual rate 7.8% at the prosthesis level) for both cement and screw-retained IFCDPs (group C and S), and peri-implantitis (annual rate 1.6% at the implant level) the most frequent major biologic complication. Wear of porcelain (annual rate 8.0% at the prosthesis level) was the most frequent minor technical complication for both groups, and fracture of porcelain (annual rate 0.8% at the dental-unit level) was the most frequent major technical complication. Minor complications were the most frequent in both the groups (cement and screw retained). CONCLUSIONS High implant and prosthesis survival rates (above 98%) were achieved, yet substantial complication rates were encountered. The most frequent major biologic complication was peri-implantitis, with a 5-year implant-based rate of 8% (95% confidence interval [CI]: 5.8-11.1), whereas the most frequent major complication was fracture of porcelain with a 5-year dental unit-based rate of 4%. The estimated cumulative rates for "prosthesis free of biologic complications" were 50.4% (95% CI: 36.4% to 63.0%) at 5 years and 10.1% (95% CI: 3.5% to 20.8%) at 10 years, whereas for "prosthesis free of technical complications," they were 56.4% (95% CI: 41.7% to 68.8%) at 5 years and 9.8% (95% CI: 3.2% to 21.0%) at 10 years.
Double Full-Arch Fixed Implant-Supported Prostheses: Outcomes and Complications after a Mean Follow-Up of 5 Years
Journal of Prosthodontics, 2019
PURPOSE To retrospectively assess complications and clinical and radiographic outcomes of edentul... more PURPOSE To retrospectively assess complications and clinical and radiographic outcomes of edentulous patients treated with double full-arch implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.1 years. MATERIALS AND METHODS The single-visit clinical and radiographic examination included medical and dental history review and clinical assessment of biologic and technical complications encountered with all implants and IFCDPs. Life table analysis and Kaplan-Meier survival curves were calculated. Analysis was conducted to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. RESULTS Nineteen edentulous patients restored with 38 IFCDPs were included. A total of 249 implants were placed and 2 implants failed after a mean observation period of 5.1 years (range: 1-12 years), yielding an overall implant survival rate of 99.2% and prosthesis survival rate of 92.1%. Three out of 38 IFCDPs were lost, 1 after implant losses and 2 due to technical complications. The most frequent minor biologic complication was soft tissue recession with an estimated 5-year rate of 45.5% (95% CI: 39.4-57.5), while the most frequent major complication was peri-implantitis with an estimated 5-year implant-based rate of 9.5% (95% CI: 6.7-11.3). The most frequent minor technical complication was wear of the prosthetic material with an estimated 5-year rate of 49.0% (95% CI: 37.4-76.4), while the most frequent major technical complication was fracture of the prosthetic material with an estimated 5-year dental unit-based rate of 8.0% (95% CI: 6.6-10.1). CONCLUSIONS After a mean use time of 5.1 years, high implant and prosthesis survival rates were observed. The most frequent major biologic complication was peri-implantitis, and the most frequent major technical complication was fracture of the prosthetic material. The 5-year estimated cumulative rates for "prosthesis free of biologic complications" was 50.7% (95% CI: 33.7-65.4) and for "prosthesis free of technical complications" was 57.1% (95% CI: 39.3-71.5).
Implant survival rates and biologic complications with implant-supported fixed complete dental prostheses: A retrospective study with up to 12-year follow-up
Clinical oral implants research, 2018
To assess the rate of biologic complications and implant survival in edentulous patients treated ... more To assess the rate of biologic complications and implant survival in edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.2 years (range: 1-12 years). A single-visit clinical and radiographic examination was performed to assess types and rates of biologic complications with ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Of 457 rough surface dental implants supporting 71 IFCDPs (52 patients), six had failed, yielding an implant survival rate of 98.7% after a mean observation period of 5.2 years after definitive prosthesis insertion. The most frequent minor biologic complication was soft tissue recession (7.7% annual rate), inflammation under the IFCDP (7.4% annual rate), and peri-implant mucositis (6.3% annual rate). The most frequent major biologic complication was peri-implantitis (2.0% annual rate), in 46/457 implants (10.1%) supporting 19 IFCDPs and late implant failure (0.3% annual rate). Th...
First-year students' preparedness for an online dental curriculum
Journal of dental education, 2021
The COVID-19 pandemic has forced dental schools to rapidly adapt complex curricula for distance l... more The COVID-19 pandemic has forced dental schools to rapidly adapt complex curricula for distance learning. In order to design high-quality and effective online educational interventions and adapt dental curricula to the postpandemic "new normal," it is crucial to understand students' preparedness for and attitudes toward this rapid and unanticipated pedagogical shift. This survey study (58% response rate) explored entering first-year dental students' attitudes and beliefs regarding online learning and their prior experiences with various online activities. Students' experiences varied widely, but concern about the impact of personal or life stressors on their academic performance and fear of cheating on online exams were common. Students in academic programs immediately preceding dental school were significantly more confident in their computer-based learning skills. Additional interventions may be needed that prepare students for success in future online course...
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