The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses
Identifieur interne : 000041 ( Pmc/Checkpoint ); précédent : 000040; suivant : 000042The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses
Auteurs : Danilo Bacchiocchi [Italie] ; Andrea Guida [Brésil]Source :
- International Journal of Dentistry [ 1687-8728 ] ; 2017.
Abstract
To present a new intraoral welding technique, which can be used to manufacture screw-retained, mandibular fixed full-arch prostheses.
Over a 4-year period, all patients with complete mandibular edentulism or irreparably compromised mandibular dentition, who will restore the masticatory function with a fixed mandibular prosthesis, were considered for inclusion in this study. The “Ball Welding Bar” (BWB) technique is characterised by smooth prosthetic cylinders, interconnected by means of titanium bars which are adjustable in terms of distance from ball terminals and are inserted in the rotating rings of the cylinders. All the components are welded and self-posing.
Forty-two patients (18 males; 24 females; mean age 64.2 ± 6.7 years) were enrolled and 210 fixtures were inserted to support 42 mandibular screw-retained, fixed full-arch prostheses. After two years of loading, 2 fixtures were lost, for an implant survival rate of 97.7%. Five implants suffered from peri-implant mucositis and 3 implants for peri-implantitis. Three of the prostheses (3/42) required repair for fracture (7.1%): the prosthetic success was 92.9%.
The BWB technique seems to represent a reliable technique for the fabrication of screw-retained mandibular fixed full-arch prostheses. This study was registered in the ISRCTN register with number
Url:
DOI: 10.1155/2017/2679085
PubMed: 28835752
PubMed Central: 5557257
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses</title><author><name sortKey="Bacchiocchi, Danilo" sort="Bacchiocchi, Danilo" uniqKey="Bacchiocchi D" first="Danilo" last="Bacchiocchi">Danilo Bacchiocchi</name><affiliation wicri:level="1"><nlm:aff id="I1">Private Practice, Castelfidardo, 60022 Ancona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Private Practice, Castelfidardo, 60022 Ancona</wicri:regionArea><wicri:noRegion>60022 Ancona</wicri:noRegion></affiliation></author><author><name sortKey="Guida, Andrea" sort="Guida, Andrea" uniqKey="Guida A" first="Andrea" last="Guida">Andrea Guida</name><affiliation wicri:level="2"><nlm:aff id="I2">Fundacao Universitaria Vida Crista (FUNVIC), 12400-010 Pindamonhangaba, SP, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Fundacao Universitaria Vida Crista (FUNVIC), 12400-010 Pindamonhangaba, SP</wicri:regionArea><placeName><region type="state">État de São Paulo</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28835752</idno><idno type="pmc">5557257</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557257</idno><idno type="RBID">PMC:5557257</idno><idno type="doi">10.1155/2017/2679085</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">002E20</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002E20</idno><idno type="wicri:Area/Pmc/Curation">002E20</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002E20</idno><idno type="wicri:Area/Pmc/Checkpoint">000041</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000041</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses</title><author><name sortKey="Bacchiocchi, Danilo" sort="Bacchiocchi, Danilo" uniqKey="Bacchiocchi D" first="Danilo" last="Bacchiocchi">Danilo Bacchiocchi</name><affiliation wicri:level="1"><nlm:aff id="I1">Private Practice, Castelfidardo, 60022 Ancona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Private Practice, Castelfidardo, 60022 Ancona</wicri:regionArea><wicri:noRegion>60022 Ancona</wicri:noRegion></affiliation></author><author><name sortKey="Guida, Andrea" sort="Guida, Andrea" uniqKey="Guida A" first="Andrea" last="Guida">Andrea Guida</name><affiliation wicri:level="2"><nlm:aff id="I2">Fundacao Universitaria Vida Crista (FUNVIC), 12400-010 Pindamonhangaba, SP, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Fundacao Universitaria Vida Crista (FUNVIC), 12400-010 Pindamonhangaba, SP</wicri:regionArea><placeName><region type="state">État de São Paulo</region></placeName></affiliation></author></analytic><series><title level="j">International Journal of Dentistry</title><idno type="ISSN">1687-8728</idno><idno type="eISSN">1687-8736</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p> To present a new intraoral welding technique, which can be used to manufacture screw-retained, mandibular fixed full-arch prostheses.</p></sec><sec><title> Methods</title><p> Over a 4-year period, all patients with complete mandibular edentulism or irreparably compromised mandibular dentition, who will restore the masticatory function with a fixed mandibular prosthesis, were considered for inclusion in this study. The “Ball Welding Bar” (BWB) technique is characterised by smooth prosthetic cylinders, interconnected by means of titanium bars which are adjustable in terms of distance from ball terminals and are inserted in the rotating rings of the cylinders. All the components are welded and self-posing.</p></sec><sec><title> Results</title><p> Forty-two patients (18 males; 24 females; mean age 64.2 ± 6.7 years) were enrolled and 210 fixtures were inserted to support 42 mandibular screw-retained, fixed full-arch prostheses. After two years of loading, 2 fixtures were lost, for an implant survival rate of 97.7%. Five implants suffered from peri-implant mucositis and 3 implants for peri-implantitis. Three of the prostheses (3/42) required repair for fracture (7.1%): the prosthetic success was 92.9%.</p></sec><sec><title> Conclusions</title><p> The BWB technique seems to represent a reliable technique for the fabrication of screw-retained mandibular fixed full-arch prostheses. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Dent</journal-id><journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id><journal-id journal-id-type="publisher-id">IJD</journal-id><journal-title-group><journal-title>International Journal of Dentistry</journal-title></journal-title-group><issn pub-type="ppub">1687-8728</issn><issn pub-type="epub">1687-8736</issn><publisher><publisher-name>Hindawi</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28835752</article-id><article-id pub-id-type="pmc">5557257</article-id><article-id pub-id-type="doi">10.1155/2017/2679085</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>The Ball Welding Bar: A New Solution for the Immediate Loading of Screw-Retained, Mandibular Fixed Full Arch Prostheses</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bacchiocchi</surname><given-names>Danilo</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-1462-7205</contrib-id><name><surname>Guida</surname><given-names>Andrea</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Private Practice, Castelfidardo, 60022 Ancona, Italy</aff><aff id="I2"><sup>2</sup>Fundacao Universitaria Vida Crista (FUNVIC), 12400-010 Pindamonhangaba, SP, Brazil</aff><author-notes><corresp id="cor1">*Andrea Guida: <email>prof.andreaguida@funvic.edu.br</email></corresp><fn fn-type="other"><p>Academic Editor: Eitan Mijiritsky</p></fn></author-notes><pub-date pub-type="ppub"><year>2017</year></pub-date><pub-date pub-type="epub"><day>1</day><month>8</month><year>2017</year></pub-date><volume>2017</volume><elocation-id>2679085</elocation-id><history><date date-type="received"><day>15</day><month>3</month><year>2017</year></date><date date-type="accepted"><day>24</day><month>5</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017 Danilo Bacchiocchi and Andrea Guida.</copyright-statement><copyright-year>2017</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Purpose</title><p> To present a new intraoral welding technique, which can be used to manufacture screw-retained, mandibular fixed full-arch prostheses.</p></sec><sec><title> Methods</title><p> Over a 4-year period, all patients with complete mandibular edentulism or irreparably compromised mandibular dentition, who will restore the masticatory function with a fixed mandibular prosthesis, were considered for inclusion in this study. The “Ball Welding Bar” (BWB) technique is characterised by smooth prosthetic cylinders, interconnected by means of titanium bars which are adjustable in terms of distance from ball terminals and are inserted in the rotating rings of the cylinders. All the components are welded and self-posing.</p></sec><sec><title> Results</title><p> Forty-two patients (18 males; 24 females; mean age 64.2 ± 6.7 years) were enrolled and 210 fixtures were inserted to support 42 mandibular screw-retained, fixed full-arch prostheses. After two years of loading, 2 fixtures were lost, for an implant survival rate of 97.7%. Five implants suffered from peri-implant mucositis and 3 implants for peri-implantitis. Three of the prostheses (3/42) required repair for fracture (7.1%): the prosthetic success was 92.9%.</p></sec><sec><title> Conclusions</title><p> The BWB technique seems to represent a reliable technique for the fabrication of screw-retained mandibular fixed full-arch prostheses. This study was registered in the ISRCTN register with number <ext-link ext-link-type="uri" xlink:href="https://www.isrctn.com/ISRCTN71229338?q=71229338&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search">ISRCTN71229338</ext-link>. </p></sec></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>The BWB (Ball Welding Bar) consists of smooth prosthetic cylinders, interconnected by means of titanium bars (grade 4) adjustable in distance with ball terminals, which are inserted in the rotating rings of the cylinders. All the components are welded and self-posing, without arcing nor tensions. This BWB has been patented by the authors (patent number AN2014A000111 and variants).</p></caption><graphic xlink:href="IJD2017-2679085.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Drawing of the tapered, double lead threads implant used in this study. (a) Apical threads, deeper and cutting, favour insertion, and initial stability, whereas squared coronal thread enhances bone condensation. (b) Back-tapered collar provides excellent cortical bone management, improving soft tissue support. (c) Octagonal conical connection (2 mm in depth with 8° cone) that guarantees an excellent seal, reducing the risk of micromovements between the implant and the abutment.</p></caption><graphic xlink:href="IJD2017-2679085.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Scanning electron microscopy (SEM) evaluation of the dual acid etched (DAE) implant surface. The surface (a) presented micron-sized shallow cavities uniformly covered by submicroscopic pitting (b) limited by razor-sharp cusps and edges (c).</p></caption><graphic xlink:href="IJD2017-2679085.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Preoperative situation. A 52-year female patient in good general health had a complete removable denture in the maxilla and a severe acute periodontitis in the mandible, with several teeth with reduced bone support and therefore high mobility. The patient asked for a full arch implant supported rehabilitation of the mandible, possibly involving an immediate loading protocol.</p></caption><graphic xlink:href="IJD2017-2679085.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Prior to surgery, a complete lower denture was fabricated in the dental laboratory, made in composite resin with a transparent vacuum-formed template.</p></caption><graphic xlink:href="IJD2017-2679085.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>The lower denture was emptied internally, in order to subsequentially accommodate inside the future intraorally welded titanium framework. The flanges and the supports in the retromolar areas were preserved, in order to facilitate the positioning in the postwelding phase.</p></caption><graphic xlink:href="IJD2017-2679085.006"></graphic></fig><fig id="fig7" orientation="portrait" position="float"><label>Figure 7</label><caption><p>The prosthetic cylinders in titanium were screwed: over these cylinders, the adjustable rings and the rotating spheres were adapted both horizontally and vertically, paying attention to remain well above the bone crest.</p></caption><graphic xlink:href="IJD2017-2679085.007"></graphic></fig><fig id="fig8" orientation="portrait" position="float"><label>Figure 8</label><caption><p>After the intraoral welding, the self-locating bar was removed from the mouth and finished, blasted, and then covered with a white opaque composite resin. The bar was subsequently repositioned onto the MUA abutments.</p></caption><graphic xlink:href="IJD2017-2679085.008"></graphic></fig><fig id="fig9" orientation="portrait" position="float"><label>Figure 9</label><caption><p>The vacuum-formed template was placed over the bar to control the occlusal fairness and to verify the previously measured vertical dimension (a). Holes were made on the prosthesis, using the vacuum-formed template already perforated in the direction of the cylinders, in order to access to the cylinders themselves (b). The prosthesis was relined with composite resin flow (c).</p></caption><graphic xlink:href="IJD2017-2679085.009"></graphic></fig><fig id="fig10" orientation="portrait" position="float"><label>Figure 10</label><caption><p>The fabrication of the prosthesis is completed in the laboratory (a), which after a few hours return the Toronto Bridge to the dentist for clinical application. The clinician delivers the prosthesis to the patient (b), after a careful check of the occlusion that must be perfectly balanced; then, the clinician closes the holes of the cylinders with Teflon soaked in chlorhexidine 5% and light curing flowable composite resin (c). The panoramic radiograph shows the titanium framework and the perfect adaptation of this structure on implant abutments (d).</p></caption><graphic xlink:href="IJD2017-2679085.010"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Inclusion and exclusion criteria for enrollment of patients in the study.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Inclusion criteria</th><th align="left" rowspan="1" colspan="1">Exclusion criteria</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">(1) Complete mandibular edentulism, with functional and aesthetic problems related to the presence of a complete, removable conventional denture.</td><td align="left" rowspan="1" colspan="1">(1) Severely immunocompromised status, severely uncompensated diabetes, radiotherapy of head and neck area, chemotherapy, and treatment with intravenous and/or intraoral amino-bisphosphonates.</td></tr><tr><td colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">(2) Irreparably compromised mandibular dentition, due to advanced periodontal disease or destructive/massive tooth decay that made the residual dental elements unrestorable.</td><td align="left" rowspan="1" colspan="1">(2) Psychiatric disorders.</td></tr><tr><td colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">(3) Sufficient bone volume to allow for the placement of implants of at least 8 mm in length and 3.0 mm in diameter.</td><td align="left" rowspan="1" colspan="1">(3) Alcohol and/or drugs addition.</td></tr><tr><td colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">(4) Will to restore the masticatory function with a fixed mandibular prosthesis supported by dental implants.</td><td align="left" rowspan="1" colspan="1">(4) Need for bone augmentation procedures with autogenous bone or other bone substitutes, to allow for proper implant insertion.</td></tr><tr><td colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">(5) Ability to understand and sign an informed consent form for implant treatment.</td><td align="left" rowspan="1" colspan="1">(5) Previous interventions of regenerative bone surgery.</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list><country><li>Brésil</li><li>Italie</li></country><region><li>État de São Paulo</li></region></list><tree><country name="Italie"><noRegion><name sortKey="Bacchiocchi, Danilo" sort="Bacchiocchi, Danilo" uniqKey="Bacchiocchi D" first="Danilo" last="Bacchiocchi">Danilo Bacchiocchi</name></noRegion></country><country name="Brésil"><region name="État de São Paulo"><name sortKey="Guida, Andrea" sort="Guida, Andrea" uniqKey="Guida A" first="Andrea" last="Guida">Andrea Guida</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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